ABSTRACT
INTRODUCTION: Among vascular malformations, arteriovenous malformations (AVM) are potentially the most invasive and destructive especially when located on the face. Their management is still subject to controversy and yet no consensus exists. Our aim was to report long-term therapeutic outcomes for patients with facial AVM managed either by embolization alone or by resection with/without preoperative embolization. MATERIAL AND METHODS: A bi-centric retrospective study was carried out covering the period from 2001 to 2018 including 30 patients with a facial AVM. Outcomes were categorized as follows: with 1=controlled disease, 2=improved disease (residual, no expansion), 3=persistent or stable disease (neither improved nor worsened), and 4=recurrent or worsened disease. RESULTS: The initial treatment modality was embolization (n=5, 16.7%), surgical resection (n=16, 53.3%), and surgical resection after embolization (n=9, 30%). The follow-up period ranged from 12 to 216 months with a median of 54.9 months. Taking all treatment modalities together, disease control was achieved in 60% of the cases. Disease control was achieved in 77.8% of the cases after embolization followed by surgery, in 68.7% after surgery alone and in none of the cases after embolization alone. CONCLUSIONS: According to our results, optimal treatment is based on a combination of embolization followed by a well-conducted surgical treatment.
Subject(s)
Embolization, Therapeutic , Intracranial Arteriovenous Malformations , Face , Humans , Intracranial Arteriovenous Malformations/therapy , Retrospective Studies , Treatment OutcomeABSTRACT
INTRODUCTION: Salivary-glands tumors come in various presentations and the epidemiological data are variable. The aim of this retrospective study was to establish an epidemiological profile of salivary-glands tumors in a Tunisian teaching hospital and to compare it to published data. PATIENTS AND METHODS: The study was made on 76 men and 80 women with a mean age of 43 years (five months to 85 years). Sixty percent of the tumors were parotid lesions, 16% were submandibular and 24% located on minor salivary glands. Eighty-four percent of parotid tumors were benign. Malignant-parotid tumors often affected men over 60 years of age. Most minor salivary-glands tumors were located on the palate. DISCUSSION: Benign salivary-glands tumors, often have a parotid localization affect, more women in the Tunisian population. Contrary to the literature, in our series, malignant tumors were predominant in women.
Subject(s)
Salivary Gland Neoplasms/epidemiology , Adenoma, Pleomorphic/epidemiology , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Carcinoma, Adenoid Cystic/epidemiology , Carcinoma, Mucoepidermoid/epidemiology , Child , Child, Preschool , Epidemiologic Studies , Female , Hospitals, Teaching/statistics & numerical data , Humans , Infant , Male , Middle Aged , Parotid Neoplasms/epidemiology , Retrospective Studies , Salivary Glands, Minor/pathology , Sex Factors , Submandibular Gland Neoplasms/epidemiology , Tunisia/epidemiologyABSTRACT
INTRODUCTION: Myoepithelial carcinoma accounts for less than 1% of salivary gland malignant tumors. It may develop de novo or, in approximately 50% of the cases, from a pleomorphic adenoma. OBSERVATION: A 57-year-old man with a history of a pleomorphic adenoma of the parotid treated surgically 6 years earlier, presented with a 2 cm tumor mass, palpable in the scar region. The histological examination and immunohistochemical study revealed a low-grade myoepithelial carcinoma. The patient had no complementary treatment. He presented 5 years later with a 2 cm parapharyngeal recurrence which was resected. There was no evidence of recurrent tumor or of distant metastasis at 4 year follow-up. DISCUSSION: Although myoepithelial cells are often predominant in pleomorphic adenomas, carcinomas developing in pleomorphic adenomas show in most cases a glandular differentiation and myoepithelial carcinomas are rare. Currently the diagnostic criteria, the prognosis, and the management of myoepithelial carcinomas are not well documented. Invasive carcinomas developing in pleomorphic adenoma are known to be highly aggressive neoplasms and myoepithelial carcinomas ex-pleomorphic adenoma seem to have a better prognosis. Our reported case was characterized by the weak aggressiveness of the lesion.
Subject(s)
Adenoma, Pleomorphic/pathology , Carcinoma/pathology , Parotid Neoplasms/pathology , Humans , Male , Middle AgedABSTRACT
OBSERVATION: A 30-year-old patient presented with a left painful pre-auricular tumefaction for one year. CT-scan suggested the diagnosis of temporomandibular synovial cyst or first branchial cleft cyst. This was confirmed by surgery. DISCUSSION: Temporomandibular synovial cysts are rare, the etiology is not documented. Revealing symptoms are those mentioned above. The common treatment is surgery.
Subject(s)
Synovial Cyst/diagnosis , Temporomandibular Joint Disorders/diagnosis , Adult , Branchioma/diagnosis , Diagnosis, Differential , Female , Head and Neck Neoplasms/diagnosis , HumansABSTRACT
The Turbellarian Monocelis fusca Oersted is abundant in the lagoon of Ghar-el-Melh. Traumatic regeneration in this animal is realised for the first time. Transversal sections through two levels of the body are made, and pointed out the presence or the absence of regeneration ability with the considered fragment.
