RESUMO
Nevus lipomatosus cutaneous superficialis is a rare disease, and its magnetic resonance imaging features have not been reported. A 1-year-old male infant was admitted to our hospital for examination of a mass on his right shoulder. Magnetic resonance imaging revealed hypertrophic skin and a lipomatous subcutaneous mass, consistent with a hamartoma-like lesion or mesenchymal tumor; after surgery, the tumor was pathologically diagnosed as nevus lipomatosus cutaneous superficialis. To the best of our knowledge, this is the first case report focusing on the magnetic resonance imaging features of this disease. Hypertrophy of all skin structures involved (epidermis, dermis, and subcutaneous fat) may be specific to nevus lipomatosus cutaneous superficialis, enabling its differentiation from other tumors.
Assuntos
Antineoplásicos Fitogênicos/administração & dosagem , Vincristina/administração & dosagem , Coagulação Intravascular Disseminada/sangue , Coagulação Intravascular Disseminada/terapia , Hemangioma Capilar/sangue , Hemangioma Capilar/terapia , Humanos , Recém-Nascido , Síndrome de Kasabach-Merritt , Masculino , Dosagem RadioterapêuticaRESUMO
The authors describe, in the first report of this type of replantation surgery, a high success rate using delayed venous anastomosis in 16 consecutive distal phalangeal replantations under digital block. Among these replantations, seven fingers (43.8 percent) showed postoperative venous congestion and five fingers were reoperated on with delayed venous drainage under digital block. All the reoperated fingers were successfully drained by additional single or double venous drainage with a vein graft. As a result, 13 fingers survived (81.3 percent success rate). All operations were performed under a digital block.
Assuntos
Traumatismos dos Dedos/cirurgia , Dedos/cirurgia , Complicações Pós-Operatórias/cirurgia , Reimplante , Insuficiência Venosa/cirurgia , Adolescente , Adulto , Idoso , Amputação Traumática/cirurgia , Anastomose Cirúrgica , Implante de Prótese Vascular , Feminino , Dedos/irrigação sanguínea , Humanos , Masculino , Microcirurgia/métodos , Pessoa de Meia-Idade , Bloqueio Nervoso , Resultado do Tratamento , Veias/fisiologia , Veias/transplanteRESUMO
New flow-through perforator flaps with a large, short vascular pedicle are proposed because of their clinical significance and a high success rate for reconstruction of the lower legs. Of 13 consecutive cases, the authors describe two cases of successful transfer of a new short-pedicle anterolateral or anteromedial thigh flow-through flap for coverage of soft-tissue defects in the legs. This new flap has a thin fatty layer and a small fascial component, and is vascularized with a perforator originating from a short segment of the descending branch of the lateral circumflex femoral system. The advantages of this flap are as follows: flow-through anastomosis ensures a high success rate for free flaps and preserves the recipient arterial flow; there is no need for dissecting throughout the lateral circumflex femoral system as the pedicle vessel; minimal time is required for flap elevation; there is minimal donor-site morbidity; and the flap is obtained from a thin portion of the thigh. Even in obese patients, thinning of the flap with primary defatting is possible, and the donor scar is concealed. This flap is suitable for coverage of defects in legs where a single arterial flow remains. It is also suitable for chronic lower leg ulcers, osteomyelitis, and plantar coverage.
