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1.
Clin Case Rep ; 12(7): e9167, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38979089

RESUMO

Key Clinical Message: In cases adjacent to critical structures, such as the internal carotid artery, surgeons should meticulously explore the feasibility of surgery before declaring the neoplasm unresectable. Abstract: Salvage treatment for locally recurrent carcinoma of the nasopharynx constitutes a unique challenge. Surgery remains the gold standard treatment modality. Endoscopic nasopharyngectomy is considered a safe and feasible procedure overcoming the morbidities of an open surgery. Tumor adjacency to the internal carotid artery (ICA) is not an absolute contradiction for the endoscopic approach. Even in cases adjacent to critical structures, surgeons should meticulously explore the feasibility of surgery before declaring the neoplasm unresectable. We present the case of a 56-year-old male with locally recurrent adenoid cystic carcinoma (AdCC) of the nasopharynx adjacent to the ICA treated with endoscopic nasopharyngectomy.

3.
Am J Otolaryngol ; 44(2): 103823, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37190996

RESUMO

PURPOSE: The superior thyroid artery (STA) point of origin is strongly debated with controversial results among studies. External carotid artery (ECA), carotid bulb, and common carotid artery (CCA) have been presented as points of origin with variable percentages among authors. We conducted a systematic review of all existing studies that included cadaveric, surgical, and angiographic specimens and recorded the origin of STA according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. MATERIALS AND METHODS: Fifty-two studies, with an overall of 5488 specimens were included. RESULTS: Our results indicated ECA as the most common site of origin (55.0 %) followed by carotid bifurcation at 27.5 % and CCA at 15.0 %. Absent STA or branching from the internal carotid artery (ICA) was an extremely rare finding. We proposed a new simple classification system based on our results. CONCLUSIONS: The huge variability in the branching pattern of STA makes head and neck surgery and radiographic interventions challenging and poses the integrity of STA at risk. Therefore, we strongly recommend preoperative angiographic studies for STA identification to prevent an intraoperative iatrogenic injury.


Assuntos
Artéria Carótida Externa , Glândula Tireoide , Humanos , Glândula Tireoide/diagnóstico por imagem , Glândula Tireoide/cirurgia , Glândula Tireoide/irrigação sanguínea , Artéria Carótida Externa/diagnóstico por imagem , Artéria Carótida Interna/diagnóstico por imagem , Pescoço , Angiografia
4.
Cureus ; 15(3): e35943, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37038565

RESUMO

Hepatocellular carcinoma (HCC) is the most dominant malignant neoplasm of the liver and constitutes the majority of all primary malignancies. Most reported cases of HCC occur in the developing world and are mainly associated with chronic hepatitis B and C viruses. Both hematogenous and lymphatic spreading is common in HCC. Patients with HCC might manifest extra-hepatic metastases and the lungs are the most common potential site of metastatic deposits. Rare sites of metastatic disease have also been described. Oropharyngeal metastases of HCC are rare and there are few reports available in the literature. We report a rare case of extra-hepatic metastasis of HCC to the right tonsil in an 84-year-old patient. The clinical appearance of metastatic oral lesions could be easily underestimated, and diagnosis of the primary tumor might delay. A biopsy of the oral lesion is important for an accurate diagnosis. Metastasis in the oral cavity and oropharynx of an HCC is usually evidence of widespread disease and predisposes to an ominous prognosis.

5.
Auris Nasus Larynx ; 50(5): 720-726, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36746693

RESUMO

OBJECTIVE: Canal wall up (CWU) and canal wall down (CWD) mastoidectomies represent the most common cholesteatoma surgical techniques. In this meta-analysis, we compare the postoperative quality of life (QoL) in patients treated with either CWU or CWD mastoidectomy. METHODS: A literature search was conducted in the following three electronic databases: Medline/PubMed, ScienceDirect, and Google Scholar. Articles were assessed for eligibility in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement and data were extracted independently by two authors. Biases assessment was conducted for each study according to the Methodological Items for Non-Randomized Studies (MINORS) tool. Meta-analysis was performed for postoperative QoL following CWU versus CWD mastoidectomy. RESULTS: Our systematic review included four studies that met the inclusion criteria, three prospective cohort studies, and one retrospective cohort study. The meta-analysis did not favor treatment with one of the two surgical techniques. Postoperative QoL did not show a statistically significant difference between CWU and CWD mastoidectomies (p>0.05). CONCLUSION: Our systematic review and meta-analysis results indicate that QoL is not statistically significantly better among patients who underwent CWU mastoidectomies when compared with CWD. The trend of selecting CWU over CWD mastoidectomies in selected cases - for QoL purposes - is not always based on evidence-based data. The statistically insignificant difference between the two surgical techniques suggests that an initial more radical approach might prevent patients from further surgeries, without affecting postoperative QoL.


Assuntos
Colesteatoma da Orelha Média , Processo Mastoide , Humanos , Processo Mastoide/cirurgia , Colesteatoma da Orelha Média/cirurgia , Qualidade de Vida , Meato Acústico Externo/cirurgia , Estudos Retrospectivos , Estudos Prospectivos , Resultado do Tratamento
6.
Folia Med (Plovdiv) ; 65(6): 1015-1019, 2023 Dec 31.
Artigo em Inglês | MEDLINE | ID: mdl-38351794

RESUMO

Transposition of inferior vena cava, or, left-sided inferior vena cava (LS-IVC) is a rare clinical entity, in which the inferior vena cava ascends along the left side of the abdominal aorta. Literature contains mainly clinical case reports. Although it is usually not associated with clinical symptomatology, this anomaly should be detected during preoperative planning to avoid iatrogenic injuries intraoperatively. We present a case of left-sided inferior vena cava encountered during laparoscopic lymphadenectomy in a 45-year-old man with previous laparoscopic hemicolectomy due to colon adenocarcinoma. Preoperative CT abdomen revealed the left-sided location of infrarenal IVC and laparoscopic trans-peritoneal aortic lymphadenectomy was decided. Intraoperatively, transposition of inferior vena cava was confirmed in accordance with the CT findings. Resection of lymph node block was conducted with no complications and with minimal blood loss. The postoperative course was uneventful, and the patient was discharged from the hospital the day following surgery. In conclusion, transposition of the inferior vena cava, although rare, constitutes an anatomical variant that should be identified preoperatively to decrease intraoperative risks. Several anatomical variants have been associated with left-sided inferior vena cava.


Assuntos
Adenocarcinoma , Neoplasias do Colo , Laparoscopia , Neoplasias Retais , Masculino , Humanos , Pessoa de Meia-Idade , Veia Cava Inferior/cirurgia , Veia Cava Inferior/anormalidades , Adenocarcinoma/cirurgia , Neoplasias do Colo/cirurgia , Excisão de Linfonodo , Neoplasias Retais/cirurgia
7.
Cureus ; 14(10): e30901, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36465752

RESUMO

Liposarcomas are rare mesenchymal tissue tumors and are divided into subtypes based on their histopathological characteristics. They are mostly well-differentiated neoplasms with the tendency to recur locally. Lymph node involvement or distant metastases have been reported as extremely rare. Common manifestations are progressive dyspnea, dysphagia, choking, and stridor. Surgical excision of laryngeal liposarcomas is considered the gold standard treatment modality for disease eradication. In persistent or recurrent cases, a total laryngectomy should be performed. There is much controversy regarding the role of radiotherapy which is mostly used as adjuvant treatment in specific cases. We present a case of dedifferentiated laryngeal liposarcoma with multiple recurrences and metachronous transformation to a neoplasm with myxofibrosarcomatous elements.

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