RESUMO
Nasal hemangiopericytoma-like (HPCL) tumor is a rare vascular tumor and should be differentiated from typical hemangiopericytomas (HPCs). This study reports the case of an HPCL tumor in a 77-year-old man with histological and immunohistochemical features. After preoperative evaluation of the blood supply, the dark-red right intranasal tumor was resected completely via the right maxillary sinus. The final histopathological diagnosis was HPCL tumor based on several stains: vimentin (+), alpha-SMA (+), etc. Moreover, there were few p53 (+) cells and the Ki-67 and topoisomerase IIalpha labeling indices were both under 5%. These findings indicated that this tumor was a low-grade malignancy. The immunohistochemical investigations used are useful for making the diagnosis of HPCL tumor and determining the treatment, malignancy, and prognosis.
Assuntos
Hemangiopericitoma/patologia , Neoplasias Nasais/patologia , Idoso , Diagnóstico Diferencial , Hemangiopericitoma/diagnóstico , Humanos , Imuno-Histoquímica , Masculino , Septo Nasal/patologia , Neoplasias Nasais/diagnósticoRESUMO
Flecainide toxicity can impair cardiac function and precipitate circulatory collapse, which in turn depresses clearance and redistribution of flecainide. Treatment directed at improving cardiac function is often ineffective in the presence of persistently increased flecainide levels. We report a novel approach to severe flecainide overdose using peripheral cardiopulmonary bypass support (CBS) to maintain perfusion of the liver, thereby allowing clearance of the drug. CBS was initiated to resuscitate a young woman who had ingested flecainide in a suicide attempt. The patient had an agonal rhythm, no effective blood pressure, and a flecainide level of 5.4 micrograms/mL (therapeutic range, .2 to 1.0 microgram/mL). During 10 hours of CBS, the flecainide level decreased to 1.4 micrograms/mL, a half-life of 6 hours. Effective cardiac rhythm and blood pressure returned. CBS successfully supported this patient until the flecainide level decreased as a result of redistribution and normal clearance mechanisms. Unfortunately, because of severe neurologic damage sustained at the time of overdose, the patient died 4 days after admission.
Assuntos
Antiarrítmicos/intoxicação , Bradicardia/terapia , Ponte Cardiopulmonar/métodos , Flecainida/intoxicação , Hipotensão/terapia , Adulto , Bradicardia/induzido quimicamente , Overdose de Drogas , Evolução Fatal , Feminino , Hemodinâmica , Humanos , Hipotensão/induzido quimicamente , Taxa de Depuração Metabólica , Tentativa de Suicídio , Distribuição TecidualAssuntos
Carcinoma/patologia , Neoplasias Mandibulares/patologia , Neoplasias das Glândulas Salivares/patologia , Glândulas Salivares Menores , Carcinoma/química , Carcinoma/ultraestrutura , Diagnóstico Diferencial , Feminino , Glicogênio/análise , Humanos , Imuno-Histoquímica , Queratinas/análise , Neoplasias Mandibulares/química , Neoplasias Mandibulares/ultraestrutura , Pessoa de Meia-Idade , Neoplasias das Glândulas Salivares/química , Neoplasias das Glândulas Salivares/ultraestruturaAssuntos
Mucocele/patologia , Doenças Parotídeas/patologia , Neoplasias Parotídeas/patologia , Adulto , Carcinoma/complicações , Carcinoma/patologia , Carcinoma/cirurgia , Feminino , Humanos , Mucocele/complicações , Mucocele/cirurgia , Doenças Parotídeas/complicações , Doenças Parotídeas/cirurgia , Neoplasias Parotídeas/complicações , Neoplasias Parotídeas/cirurgia , Gravidez , Complicações Neoplásicas na GravidezRESUMO
A case is reported of schwannoma of the right masseteric nerve, invading the pterygopalatine fossa and the parapharyngeal space through the mandibular notch in a 61-year-old woman. The tumor in this case was composed of four various-sized interconnected nodules, simulating a string of beads. The tumor was the cause of the patient's chronic hemicrania, as confirmed by the relief from and disappearance of head pain after surgical removal of the tumor. The most important aspects of this case are the anatomic site of the schwannoma and its uncommon clinicopathologic manifestations; this tumor originated from the masseteric nerve and is the first case reported to straddle the mandibular notch.
Assuntos
Neoplasias dos Nervos Cranianos/complicações , Músculo Masseter/inervação , Transtornos de Enxaqueca/etiologia , Neurilemoma/complicações , Neoplasias dos Nervos Cranianos/cirurgia , Eletromiografia , Feminino , Humanos , Pessoa de Meia-Idade , Neurilemoma/cirurgia , Articulação Temporomandibular/inervaçãoAssuntos
Doenças da Boca/patologia , Mucocele/patologia , Adolescente , Adulto , Criança , Humanos , Pessoa de Meia-IdadeRESUMO
A method is presented of conserving the inferior alveolar nerve where resection of the mandible is necessary. The technique features the delivery of the nerve through the mandibular foramen and the end-to-end anastomosis of the previously sectioned nerve. The technique is particularly indicated in the treatment of carefully chosen cases of benign and locally invasive neoplasms and cysts with complex cavities.