RESUMEN
This paper presents commentaries on endotherapy for esophageal perforation/leaks; treatment of esophageal perforation; whether esophageal stents should be used for treating benign esophageal strictures; what determines the optimal stenting period in benign esophageal strictures/leaks; how to choose an esophageal stent; how a new fistula secondary to an esophageal stent should be treated; which strategy should be adopted when a fistula of a cervical anastomosis occurs; intralesional steroids for refractory esophageal strictures; balloon and bougie dilators for esophageal strictures and predictors of response to dilation; whether refractory strictures from different etiologies respond differently to endotherapy; surgical therapy of benign esophageal strictures; and whether stenoses following severe esophageal burns should be treated by esophageal resection or esophageal bypass.
Asunto(s)
Estenosis Esofágica/terapia , Esofagoscopía , Stents , Estenosis Esofágica/patología , Esófago/patología , Humanos , Resultado del TratamientoRESUMEN
O estesioneuroblastoma é uma neoplasia maligna incomum, que tem origem no epitélio olfatório e corresponde de 4% a 6% dos tumores malignos dos seios paranasais. A última grande revisão sobre esses tumores mostra que, desde sua descoberta, há oitenta anos, menos de mil casos foram publicados na literatura mundial. As manifestações clínicas usuais constituem-se por anosmia, obstrução nasal e epistaxe. Devido às características microscópicas serem bastante variadas e inespecíficas, é importante que o diagnóstico seja bem estabelecido pela histoquímica e imunoistoquímica, pois disso dependerá o prognóstico do paciente. Por se tratar de uma doença rara, ainda não há consenso quanto ao melhor tipo de tratamento, mas os relatos de casos bem sucedidos incluíram tratamento multidisciplinar com quimioterapia, ressecção cirúrgica e radioterapia. Em um período de seis anos (janeiro/ 2000 a janeiro/2006), ocorreram quatro casos no serviço do Hospital e Maternidade Celso Pierro, que são aqui reportados
Esthesioneuroblastoma is an uncommon malignant neoplasm that arises from the olfactory epithelium and corresponds to 4% - 6% of all malignant tumors in the paranasal sinuses. The last extensive review on these tumors reveals that less than one thousand cases have been published in the literature since its discovery eighty years ago. The common clinical manifestations are anosmia, nasal obstruction and epistaxis. Since its microscopic characteristics vary greatly and are unspecific, a precise diagnosis using histochemical and immunohistochemical techniques cannot be overemphasized as the patient?s prognosis depends on the diagnosis. As it is a rare disease, there is no consensus regarding the best treatment, but reports of cases treated successfully cite a multidisciplinary approach, which includes chemotherapy, surgical resection and radiation therapy. Our service has treated four cases over a period of six years (January 2000 - January 2006) that are reported here