Palatal Reconstruction after Major Surgical Excision.

Oncological excision surgery in the oral and maxillofacial area amputates important structures or open cavities (sinus, nose, mouth) which are usually "closed". The disappearance of an eye, tongue, soft palate or cheek, raises serious issues regarding the resumption of partial or total functions of that region, in terms of social reintegration of the patient. In the cephalic extremity, the reconstruction material is limited, so specialists resort to resources located away from the defect to achieve closure. The temporal flap isn't used very often, although this procedure has the advantages of a shorter time for surgery and for healing.

Epidemiological Aspects in Lip Tumors in Oltenia Region of Romania During 2012-2016.

PURPOSE: The objective of this study was to review lip tumor diagnosed subjects from Oltenia region, in the past 5 years according to gender, age, home environment, profession, geographic area, smoking habit, associated diseases, tumor location, macroscopic aspect and histological type. MATERIAL AND METHODS: The study was done at the Oral and Maxillo-Facial Clinic of the Emergency Clinical County Hospital of Craiova, and involved the analysis of patient file records, surgical registers, histopathological bulletins, from 2012-2016. RESULTS: Of the 175 subjects included in this study, all of them diagnosed with lip tumor pathology, 109 (62.29%) were men, and 66 (37.71%) were women, all of them with ages between 6 and 92 years, with a mean age of 61 years. Distribution of study participants according to the home residence showed that majority of the subjects lived in rural area. The most frequently localization of lip tumors in study participants was at the lower lip-140 cases (80%), than at the upper lip-35 cases (20%).According to histological characteristics, distribution of the malignant lip tumors was 87.39%-squamous cell carcinoma (SCC), 5.41%-basal cell carcinoma (BCC) and 7.20%-other type of tumors. CONCLUSIONS: The lower lip was the most affected, by lip cancer, and squamous cell carcinoma represents the most frequently histological type of these tumors.

The Correlation between the Complexity of the Reconstruction in the Labial Region and the Extent of the Postoperative Defect - Report of 3 Cases.

Lips are structures that play an essential role in aesthetics, nutrition and speech. Their complex anatomy-with three different layers composed of skin, mucosa, and muscles-makes surgical management of this area a therapeutic challenge. We report here 3 cases of surgical reconstruction of the upper lip after the excision of tumors of varying sizes. The resulted defect from tumor extirpation is always closely linked to the time elapsed from the appearance of the tumor to the presentation in the ambulatory of Oral and Maxillofacial Surgery.

Primary mucinous eccrine adenocarcinoma of the skin in a 69-year-old man.

The authors report a rare case of primary mucinous eccrine adenocarcinoma of the skin initially diagnosed as metastatic adenocarcinoma and treated with local excision and adjuvant radiotherapy in another center. The tumor reoccurred in the left axilla 2.5 years later after the initial treatment. Diagnosis in our center was primary cutaneous eccrine mucinous adenocarcinoma. We present the clinical, histological, and immunohistochemical features of this rare tumor in the light of the searched literature.

99mTc-sestamibi muscle scintigraphy to assess the response to neuromuscular electrical stimulation of normal quadriceps femoris muscle.

OBJECTIVES: Neuromuscular electrical stimulation (NMES) is widely used for improving muscle strength by simultaneous contraction in the prevention of muscle atrophy. Although there exist many clinical methods for evaluating the therapeutic response of muscles, 99mTc-sestamibi which is a skeletal muscle perfusion and metabolism agent has not previously been used for this purpose. The aim of our work was to ascertain whether 99Tc-sestamibi muscle scintigraphy is useful in the monitoring of therapeutic response to NMES in healthy women. METHODS: The study included 16 women aged between 21 and 45, with a mean age of 32.7 +/- 6.4. Both quadriceps femoris muscles (QFM) of each patient were studied. After randomization to remove the effect of the dominant side, one QFM of each patient was subjected to the NMES procedure for a period of 20 days. NMES was performed with an alternating biphasic rectangular current, from a computed electrical stimulator daily for 23 minutes. After measurement of skinfold thickness over the thigh, pre- and post-NMES girth measurements were assessed in centimeters. Sixty minutes after injections of 555 MBq 99mTc-sestamibi, static images of the thigh were obtained for 5 minutes. The thigh-to-knee uptake ratio was calculated by semiquantitative analysis and normalized to body surface area (NUR = normalized uptake ratio). RESULTS: The difference between the pre and post NMES NUR values was significant (1.76 +/- 0.31 versus 2.25 +/- 0.38, p = 0.0000). The percentage (%) increase in NUR values also well correlated with the % increase in thigh girth measurements (r = 0.89, p = 0.0000). CONCLUSION: These results indicated that 99mTc-sestamibi muscle scintigraphy as a new tool may be useful in evaluating therapeutic response to NMES.

Monitoring the chemotherapeutic response in primary lung cancer using 99mTc-MIBI SPET.

Prediction and evaluation of the response to chemotherapy (CTx) are important for the correct and cost-effective treatment of patients with primary lung cancer. Although fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) is accepted as the most useful and accurate nuclear medicine technique for this purpose, its expense and limited availability restrict its use. Compared with PET agents, technetium-99m methoxyisobutylisonitrile (MIBI), which is used in nuclear oncology, is cheaper and available in any nuclear medicine clinic. With this in mind, in this study we aimed to evaluate the role of 99mTc-MIBI in monitoring the chemotherapeutic response in primary lung cancer. Twenty patients with primary lung cancer underwent 99mTc-MIBI single-photon emission tomography (SPET) at 15 min (early) and 3-4 h (delayed) after injection of the tracer. All patients underwent 99mTc-MIBI SPET study twice: before and after the 3rd cycle of CTx. Patients were divided into two groups, responders [R(+), n=10] and nonresponders [R(-), n=10], according to the change in tumour size on CT scan taken 2 weeks after the last cycle of the CTx. From the SPET images early and delayed tumour/lung ratios (ER and DR) were obtained before and after CTx. In the R(+) group, ER and DR decreased significantly after CTx, from 3.28+/-1.55 to 1.78+/-0.72 (P<0.04) and from 3.23+/-1.55 to 2.0+/-0.88 (P<0.05), respectively. However, in the R(-) group, while ER showed a slight and statistically insignificant increase after CTx (from 2.51+/-1.23 to 2.65+/-1.86), DR increased significantly, from 2.74+/-1.37 to 3.27+/-2.31 (P<0.03). The percentage decreases in ER and DR in the R(+) group after CTx was significantly higher than that in the R(-) group: 34.36%+/-26.7% vs -13.78%+/-27.58% (P<0.0002) and 29.45%+/-25.23% vs -18.58%+/-20.51% (P<0.0005), respectively. Using a decrease of > or =10% as a threshold for monitoring the chemotherapeutic response, 99mTc-MIBI had a sensitivity of 90% and a specificity of 100%. We found a positive correlation in 14 patients between ER and DR and survival: r=0.6754 and P=0.008, and r=0.5755 and P=0.031, respectively. Our results suggest that 99mTc-MIBI might be used in routine practice to monitor the chemotherapeutic response in patients with primary lung cancer, especially when PET is not available.

Monitoring the chemotherapeutic response in primary lung cancer using (99m)Tc-MIBI SPET.

Prediction and evaluation of the response to chemotherapy (CTx) are important for the correct and cost-effective treatment of patients with primary lung cancer. Although fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) is accepted as the most useful and accurate nuclear medicine technique for this purpose, its expense and limited availability restrict its use. Compared with PET agents, technetium-99m methoxyisobutylisonitrile (MIBI), which is used in nuclear oncology, is cheaper and available in any nuclear medicine clinic. With this in mind, in this study we aimed to evaluate the role of (99m)Tc-MIBI in monitoring the chemotherapeutic response in primary lung cancer. Twenty patients with primary lung cancer underwent (99m)Tc-MIBI single-photon emission tomography (SPET) at 15 min (early) and 3-4 h (delayed) after injection of the tracer. All patients underwent (99m)Tc-MIBI SPET study twice: before and after the 3rd cycle of CTx. Patients were divided into two groups, responders [R(+), n=10] and non-responders [R(-), n=10], according to the change in tumour size on CT scan taken 2 weeks after the last cycle of the CTx. From the SPET images early and delayed tumour/lung ratios (ER and DR) were obtained before and after CTx. In the R(+) group, ER and DR decreased significantly after CTx, from 3.28±1.55 to 1.78±0.72 (P<0.04) and from 3.23±1.55 to 2.0±0.88 (P<0.05), respectively. However, in the R(-) group, while ER showed a slight and statistically insignificant increase after CTx (from 2.51±1.23 to 2.65±1.86), DR increased significantly, from 2.74±1.37 to 3.27±2.31 (P<0.03). The percentage decreases in ER and DR in the R(+) group after CTx was significantly higher than that in the R(-) group: 34.36%±26.7% vs -13.78%±27.58% (P<0.0002) and 29.45%±25.23% vs -18.58%±20.51% (P<0.0005), respectively. Using a decrease of ≥10% as a threshold for monitoring the chemotherapeutic response, (99m)Tc-MIBI had a sensitivity of 90% and a specificity of 100%. We found a positive correlation in 14 patients between ER and DR and survival: r=0.6754 and P=0.008, and r=0.5755 and P=0.031, respectively. Our results suggest that (99m)Tc-MIBI might be used in routine practice to monitor the chemotherapeutic response in patients with primary lung cancer, especially when PET is not available.