ABSTRACT
PURPOSE: The purpose of the present study was to establish the reliability of fine needle aspiration (FNA) in the diagnosis of malignant salivary gland tumors in our population and to compare our results with those of other authors. MATERIAL AND METHODS: This was a retrospective study of clinical data from 172 patients, 153 parotid tumors and 19 submandibular tumors who underwent preoperative FNA between January 2004 and December 2013. Sensitivity, specificity, positive and negative predictive values of FNA for the preoperative diagnosis of malignancy were analyzed. RESULTS: For the diagnosis of malignancy an S value of 60% was obtained, which means that 40% of malignant tumors were not diagnosed by FNA. Besides an E value of 97.5% was obtained, thus indicating that FNA was negative for malignancy in up to 97.5% of all benign neoplasms. According to predictive values, we observe that FNA hit in 83.3% cases given as malignant and in 92% of cases giving as benign (PPV=83,3%; NPV=92%). CONCLUSION: With a scarce 60% sensitivity value in our series, fine needle aspiration has evident limitations for diagnosis of malignancy in major salivary gland neoplasms. Being highly conditioned by the staff and the conditions in which it is performed, FNA is a complementary test that helps the preoperative diagnosis of the major salivary glands with radiological tests, medical history and physical examination, but that alone it is not defining of malignancy.
Subject(s)
Biopsy, Fine-Needle , Salivary Gland Neoplasms/pathology , Adolescent , Adult , Aged , Aged, 80 and over , Child , Female , Humans , Male , Middle Aged , Sensitivity and SpecificityABSTRACT
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Subject(s)
Humans , Female , Adolescent , Maxillary Sinus Neoplasms/surgery , Osteoma/surgery , Orbital Neoplasms/surgery , Maxillary Sinus/physiopathology , Exophthalmos/etiology , Eye Diseases/diagnosis , Calcinosis/diagnosisABSTRACT
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Subject(s)
Humans , Female , Adolescent , Maxillary Sinus Neoplasms/surgery , Osteoma/surgery , Orbital Neoplasms/surgery , Maxillary Sinus/physiopathology , Exophthalmos/etiology , Eye Diseases/diagnosis , Calcinosis/diagnosisABSTRACT
Primary malignant melanoma of the oral cavity is a rare neoplasm, especially on the tongue. We report a case of mucosal melanoma at the base of the tongue, an extremely rare location (only about 30 cases have been reported in literature). The extension study doesn´t revealed distant metastatic lesions. The patient was treated by subtotal glossectomy and bilateral functional neck dissection. Tongue is one of the most difficult structures to reconstruct, because of their central role in phonation, swallowing and airway protection. The defect was reconstructed with anterolateral thigh free flap. Surgical treatment was supplemented with adjuvant immunotherapy. The post-operative period was uneventful. At present, 24 months after surgery, patient is asymptomatic, there isn´t evidence of recurrence of melanoma and he hasn´t any difficulty in swallowing or phonation. Key words:Malignant mucosal melanoma, anterolateral thigh free flap, phonation, swallowing.
ABSTRACT
No disponible
Subject(s)
Humans , Male , Female , Child , Adolescent , Chondrosarcoma, Mesenchymal/complications , Chondrosarcoma, Mesenchymal/diagnosis , Chondrosarcoma, Mesenchymal/surgery , Surgical Flaps , Radiography, Panoramic/instrumentation , Radiography, Panoramic/methods , Radiography, Panoramic , Chondrosarcoma, Mesenchymal/physiopathology , Chondrosarcoma, Mesenchymal , Maxilla/pathology , Maxilla , Maxillary Sinus Neoplasms/diagnosis , Maxillary Sinus Neoplasms/surgery , Maxillary Neoplasms/surgery , Maxillary Neoplasms , Radiotherapy, Adjuvant , Chemoradiotherapy, AdjuvantABSTRACT
Introducción. Los sarcomas son tumores malignos poco frecuentes, siendo raros en cabeza y cuello. En su etiología se involucran factores como agentes químicos, radiación, inmunosupresión y síndromes y anomalías genéticas. Caso clínico. Varón de 64 años, que presenta lesión en piel de mejilla derecha de un año de evolución, localización en la que presentó hace veinte años un carcinoma basocelular tratado con radioterapia. Tras descartar existencia de metástasis, se realizó exéresis de la lesión con márgenes de seguridad y reconstrucción con colgajo de Mustardé. Se complementó el tratamiento con radioterapia. Discusión. El diagnóstico es anatomopatológico, siendo fundamental descartar afectación metastásica. Para mejorar la supervivencia y disminuir su elevada tasa de recidiva, deberían tratarse de forma multidisciplinar (cirugía, radioterapia y/o quimioterapia). Conclusión. A pesar de su baja frecuencia, los sarcomas deben estar presentes en el diagnóstico diferencial de toda lesión que aparezca en zonas radiadas previamente, especialmente en la piel facial(AU)
Introduction. Sarcomas are malignant tumors that are infrequent, being rare in the head and neck. Factors such as chemical agents, radiation, immunosuppression, and genetic syndromes and abnormalities are involved in their etiology. Case report. A 64-year-old man developed a skin lesion on the right cheek one year earlier at the site where he had presented a basal cell carcinoma 20 years earlier that was treated with radiation therapy. After ruling out the existence of metastasis, the lesion was treated by surgical resection with safety margins and reconstruction with the Mustardé flap. Treatment was supplemented with radiation therapy. Discussion. The diagnosis of sarcomas is histopathologic and it is essential to rule out metastasis. To improve survival and reduce the high rate of recurrence, a multidisciplinary approach to treatment should be used (surgery, radiation therapy and chemotherapy). Conclusion. Despite the low frequency of sarcomas, these tumors must be considered in the differential diagnosis of any lesion that appears on previously irradiated areas, especially on facial skin(AU)
Subject(s)
Humans , Male , Middle Aged , Sarcoma/complications , Sarcoma/diagnosis , Radiotherapy/adverse effects , Skin Neoplasms/complications , Skin Neoplasms/diagnosis , Surgical Flaps , Head and Neck Neoplasms/complications , Head and Neck Neoplasms/diagnosis , Head and Neck Neoplasms/surgery , Diagnosis, Differential , Carcinoma, Basal Cell/complications , Head and Neck Neoplasms/drug therapy , Head and Neck Neoplasms/physiopathology , Head and Neck NeoplasmsABSTRACT
Giant cell granuloma is a relatively rare benign entity but can be locally aggressive. Histologically characterized by intense proliferation of multinucleated giant cells and fibroblasts. Affects bone supported tissues. Definitive diagnosis is given by biopsy. Clinically manifest as a mass or nodule of reddish color and fleshy, occasionally ulcerated surface. They can range from asymptomatic to destructive lesions that grow quickly. It is a lesion to be considered in the differential diagnosis of osteolytic lesions affecting the maxilla or jaw. Its management passed from conservative treatment with intralesional infiltration of corticosteroids, calcitonin or interferon, to the surgical resection and reconstruction, for example with microvascular free flaps. Key words:Giant cell granuloma, intralesional injection, microvascular free flap, fibula.
ABSTRACT
El traumatismo por arma de fuego en el territorio maxilofacial constituye uno de los mayores retos a los que se enfrenta el cirujano a la hora de la reconstrucción. La diferencia esencial con otro tipo de traumatismos es la severidad de la lesión y la pérdida de tejidos óseos y blandos. Podemos encontrar en la literatura numerosos artículos sobre reconstrucción facial tras extirpación oncológica; sin embargo, hay pocos documentos que discutan la utilización de colgajos locales y libres microvascularizados para reconstrucción de defectos tras traumatismos de alta energía, y los algoritmos terapéuticos para reconstrucción postraumática. En este trabajo se presenta un caso de reconstrucción del tercio inferior facial tras intento de autolisis y se hace una revisión de los principios de tratamiento de este tipo de pacientes(AU)
Gunshot wounds to the maxillofacial region are a challenging problem for the surgeon responsible for reconstruction. The essential difference with respect to other injuries is the severity of the lesion and soft and hard tissue loss. Extensive literature exists on facial reconstruction following tumor extirpation, but there are few reports on the use of local flaps and free tissue transfer for the post-traumatic reconstruction of high-energy defects and therapeutic algorithms for post-traumatic reconstruction. The authors report the case of a patient with reconstruction of the lower third of the face after a suicide attempt and review the principles of treatment of these patients(AU)
