Myoepithelioma of nasal septum: a rare minor salivary gland tumour

Myoepithelioma is rare benign neoplasm, usually involves salivary glands and very less often seen in minor salivary glands of nose. Clinically it resembles like other tumour masses and thus posed challenge to clinician and pathologist. It becomes very difficult to diagnose due to its varied presentation and propensity for malignant transformation. We reported a case of a male patient with pink fleshy mass in the left nose with epistaxis and nasal obstruction. Preliminary biopsy and contrast-enhanced CT were done to delineate tumour size and type and then patient underwent endoscopic en-bloc resection. Histopathology and immunohistochemistry were found to be consistent for myoepithelioma. No recurrence was seen during a 6-month follow-up period. Its rarity should be a part of differential diagnosis among nasal tumours. Many of the tumour recurrences are associated with incomplete surgical resection so wide local excision with regular follow-up is essential for this rare entity.

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Long-term follow-up after colorectal endoscopic submucosal dissection in 182 cases

Endoscopy International Open ◽

10.1055/a-1321-1271 ◽

2021 ◽

Vol 09 (02) ◽

pp. E258-E262

Author(s):

Christian Suchy ◽

Moritz Berger ◽

Ingo Steinbrück ◽

Tsuneo Oyama ◽

Naohisa Yahagi ◽

...

Keyword(s):

Case Series ◽

En Bloc Resection ◽

Bloc Resection ◽

Published Data ◽

Low Grade ◽

Recurrence Rates ◽

En Bloc ◽

Long Term Follow Up

Abstract Background and study aims We previously reported a case series of our first 182 colorectal endoscopic submucosal dissections (ESDs). In the initial series, 155 ESDs had been technically feasible, with 137 en bloc resections and 97 en bloc resections with free margins (R0). Here, we present long-term follow-up data, with particular emphasis on cases where either en bloc resection was not achieved or en bloc resection resulted in positive margins (R1). Patients and methods Between September 2012 and October 2015, we performed 182 consecutive ESD procedures in 178 patients (median size 41.0 ± 17.4 mm; localization rectum vs. proximal rectum 63 vs. 119). Data on follow-up were obtained from our endoscopy database and from referring physicians. Results Of the initial cohort, 11 patients underwent surgery; follow-up data were available for 141 of the remaining 171 cases (82,5 %) with a median follow-up of 2.43 years (range 0.15–6.53). Recurrent adenoma was observed in 8 patients (n = 2 after margin positive en bloc ESD; n = 6 after fragmented resection). Recurrence rates were lower after en bloc resection, irrespective of involved margins (1.8 vs. 18,2 %; P < 0.01). All recurrences were low-grade adenomas and could be managed endoscopically. Conclusions The rate of recurrence is low after en bloc ESD, in particular if a one-piece resection can be achieved. Recurrence after fragmented resection is comparable to published data on piecemeal mucosal resection.

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Parathyroid carcinoma

Vojnosanitetski pregled ◽

10.2298/vsp0608765f ◽

2006 ◽

Vol 63 (8) ◽

pp. 765-769

Author(s):

Aleksandar Filipovic ◽

Ivan Paunovic ◽

Dragutin Savjak ◽

Tamara Zivkovic

Keyword(s):

Primary Hyperparathyroidism ◽

Parathyroid Carcinoma ◽

Disease Recurrence ◽

En Bloc Resection ◽

Bloc Resection ◽

Endocrine Tumors ◽

En Bloc ◽

Histologic Diagnosis ◽

Serum Pth

Background. Parathyroid carcinoma is the least frequent malignancy among endocrine tumors. In the most reported series of patients with primary hyperparathyroidism the incidence of carcinoma is less than 1%. Recognition by a surgeon that the parathyroid tumor is malignant, and the performance of an adequate en bloc removal of primary lesion, with histologic diagnosis offer the best treatment of a patient with this unusual malignancy. Case report. We reported a 30-year-old patient with parathyroid carcinoma, primary hyperparathyroidism, and recurrent nephrocalcinosis. Marked hypercalcemia, low serum phosphorus, and substantial elevation of serum parathyroid hormone indicated a diagnosis of primary hiperparathyroidism. General symptoms were anorexia, muscle weakness, back pain and depression. Ultrasonography done before the surgery revealed a 2 cm upper left parathyroid gland with solid and cystic areas. The neck exploration was done with en block resection of the tumor. A histopathological evaluation confirmed the diagnosis of parathyroid carcinoma. Over more than a three-year-follow-up, the patient had no evidence of the disease recurrence and his serum PTH and calcium levels remained within the normal. Conclusion. Parathyroid carcinoma is a rare cause of primary hyperparathyroidism. Preoperative diagnosis remains a challenge. Radical en bloc resection of the tumor is the treatment of choice for this malignancy.

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En Bloc Resection of the Duodenum for Locally Advanced Right Colon Adenocarcinoma

The American Surgeon ◽

10.1177/000313480707301031 ◽

2007 ◽

Vol 73 (10) ◽

pp. 1063-1066 ◽

Cited By ~ 3

Author(s):

Ahmad N. Hakimi ◽

David K. Rosing ◽

Bruce E. Stabile ◽

Beverley A. Petrie

Keyword(s):

Colon Cancer ◽

Locally Advanced ◽

En Bloc Resection ◽

Bloc Resection ◽

Morbidity And Mortality ◽

Right Colon ◽

En Bloc ◽

Adjacent Structures ◽

Duodenal Invasion

Direct invasion of colorectal adenocarcinoma into adjacent structures occurs frequently, but only rarely is the duodenum involved. This study was undertaken to assess the safety and efficacy of en bloc resection of locally advanced right colon carcinoma invading the duodenum. A retrospective review of 49 patients with locally advanced colon cancer, surgically managed between 2000 and 2005, was performed. Forty-six patients underwent en bloc resection of colon and adjacent organs not involving the duodenum. Three patients with duodenal invasion underwent en bloc partial duodenectomy. The mean operative blood loss, length of stay, postoperative morbidity, and mortality compare favorably between these two groups of patients. Of the 46 patients with en bloc resection of other organs, 27 are alive at 12 to 60 months follow up. Two patients with duodenal invasion are alive without recurrence at 15 and 20 months follow up. En bloc resection of colon cancer invading the duodenum can be performed safely because morbidity and mortality rates are comparable to those attending extended resections of other locally advanced colon carcinomas. Overall survival in patients who underwent surgery with curative intent justifies en bloc duodenal resection in selected patients.

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Mandibular periosteal (juxtacortical) chondrosarcoma

Brazilian Dental Journal ◽

10.1590/s0103-64402009000500013 ◽

2009 ◽

Vol 20 (5) ◽

pp. 428-433 ◽

Cited By ~ 3

Author(s):

Elisângela Maria Cunha Costa ◽

Bárbara Lima Lucas ◽

Mariana Reis Silva ◽

Renata Hinhug Vilarinho ◽

Paulo Rogério de Faria ◽

...

Keyword(s):

Final Diagnosis ◽

En Bloc Resection ◽

Bloc Resection ◽

Bone Surface ◽

En Bloc ◽

Grade Ii ◽

Well Differentiated ◽

Slow Growing ◽

Tomography Scan

Periosteal (juxtacortical) chondrosarcoma (PC) is a well-differentiated malignant cartilage-forming tumor arising from the external bone surface, especially in long bones. The therapy of choice is en-bloc resection and, in general, its prognosis is good. This paper reports a rare case of PC affecting the mandible of a 41-year-old man. The lesion presented as a slow-growing-painless swelling that lasted 2 months. Computed tomography scan showed a tumoral mass arising from the external bone surface, extending into the adjacent soft tissue presenting patchy regions of popcorn-like calcifications. A final diagnosis of PC (grade II) was rendered after biopsy. Hemimandibulectomy was undertaken followed by complementary radiotherapy with 70 Gy. Although no episodes of recurrence or metastasis had been noticed after 18 months of follow-up, the patient died and causa mortis could not be established.

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Therapeutic strategy involving endoscopic resection for cN0 superficial carcinoma of the esophagus.

Journal of Clinical Oncology ◽

10.1200/jco.2011.29.4_suppl.1 ◽

2011 ◽

Vol 29 (4_suppl) ◽

pp. 1-1

Author(s):

T. Iizuka ◽

D. Kikuchi ◽

S. Hoteya

Keyword(s):

Endoscopic Resection ◽

En Bloc Resection ◽

Bloc Resection ◽

Additional Treatment ◽

En Bloc ◽

Carcinoma Of The Esophagus ◽

Secondary Hemorrhage ◽

Long Term Follow Up

1 Background: With the progress in endoscopic submucosal dissection (ESD) which enables en bloc resection irrespective of the size of lesion, a therapeutic strategy has become feasible whereby ESD is undertaken first, followed by considering additional treatment based on the results of histologic exploration. In this study, we attempted to clarify the clinical results in patients who had undergone additional treatment after endoscopic resection (ER) for cN0 superficial carcinoma. Methods: Of 140 patients diagnosed as having T1a-MM-SM2 lesions of squamous cell carcinoma of the esophagus who had undergone ER between January 1998 and March 2010, 83 patients who received additional treatment after ER (surgery, 27 pts; chemoradiotherapy [CRT], 56 pts.) were the subjects of this study. The mean duration of observation was 45.1 months. Results: The en bloc resection rate was 86%. There were 5 patients (6%) who had complications associated with ER, including perforation in 2 patients, secondary hemorrhage in a patient and pneumonia in 2 patients. Complications associated with additional treatment were noted in 13 patients (15.6%), including secondary hemorrhage, recurrent laryngeal nerve paralysis and pulmonary infarction in one patient each, pneumonia in 3, grade ≥ 3 myelosuppression in 5, and syndrome of inappropriate secretion of antidiuretic hormone (SIADH) and radiation pneumonitis in one patient each. Long-term follow-up revealed no local recurrence and no patients who experienced late toxicity due to CRT. The tumor recurred in 4 patients, the site of recurrent lesion being the mediastinum in 3 patients and the cervical lymph node in one patient, of whom 2 patients died of the primary disease. The 5-year survival rate was 88.4%. Conclusions: Endoscopic resection plus additional treatment for superficial carcinoma of the esophagus did not entail the development of any serious complications; thus, such combined treatment was safe and feasible. The long-term follow-up results were fairly gratifying, and ER with subsequent additional treatment is considered to be valid for patients with cN0 superficial carcinoma of the esophagus. No significant financial relationships to disclose.

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Giant Splenic Artery Pseudoaneurysm: A Case Report and Literature Review

International Surgery ◽

10.9738/intsurg-d-15-00043.1 ◽

2015 ◽

Vol 100 (7-8) ◽

pp. 1244-1248 ◽

Cited By ~ 6

Author(s):

Yusuf Yagmur ◽

Sami Akbulut ◽

Serdar Gumus ◽

Firat Demircan

Keyword(s):

Splenic Artery ◽

En Bloc Resection ◽

Bloc Resection ◽

Clinical Findings ◽

Abdominal Aneurysm ◽

En Bloc ◽

Abdominal Ultrasonography ◽

Artery Pseudoaneurysm ◽

Contrast Enhanced Ct ◽

Asymptomatic Patients

Splenic artery aneurysms (SAAs) are the third most frequent intra-abdominal aneurysm, following abdominal aorta and iliac artery aneurysms. SAAs are classified according to their involvement of arterial wall layers: true aneurysms involve all 3 layers (intima, media, and adventitia), and pseudoaneurysms involve only one or two. Herein we present a new case of giant pseudo SAA. A 65-year-old female patient with a pancreatic mass and iron deficiency was referred to our clinic for further investigation. Abdominal ultrasonography, contrast-enhanced CT and magnetic resonance imaging showed a lesion resembling a subcapsular hemangioma in the spleen, and aneurysmatic dilation of the splenic artery with a diameter of >5 cm. The large size of the aneurysm and the clinical findings were indications for surgical treatment. The patient underwent en bloc resection of the spleen, distal pancreas, and aneurysmatic segment of the splenic artery. The patient remains complication-free 2 months after the operation. Spontaneous rupture is the most important life-threatening complications of giant SAAs. Therefore, all symptomatic patients with SAA should be treated, as well as asymptomatic patients with lesions ≥2 cm, who are pregnant or fertile, have portal hypertension, or are candidates for liver transplantation. Despite advances in endovascular techniques, conventional abdominal surgery remains the gold standard for treatment.

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Laparoscopic treatment of complete obliteration of the cul-de-sac associated with endometriosis: long-term follow-up of en bloc resection

Fertility and Sterility ◽

10.1016/s0015-0282(01)01913-6 ◽

2001 ◽

Vol 76 (2) ◽

pp. 358-365 ◽

Cited By ~ 206

Author(s):

David B. Redwine ◽

Jeremy T. Wright

Keyword(s):

En Bloc Resection ◽

Bloc Resection ◽

Laparoscopic Treatment ◽

En Bloc ◽

Complete Obliteration ◽

Long Term Follow Up

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En Bloc Resection of Lamina and Ossified Ligamentum Flavum in the Treatment of Thoracic Ossification of the Ligamentum Flavum

Neurosurgery ◽

10.1227/01.neu.0000369516.17394.b0 ◽

2010 ◽

Vol 66 (6) ◽

pp. 1181-1186 ◽

Cited By ~ 24

Author(s):

Lian-shun Jia ◽

Xiong-sheng Chen ◽

Sheng-yuan Zhou ◽

Jiang Shao ◽

Wei Zhu

Keyword(s):

Evaluation System ◽

Ligamentum Flavum ◽

En Bloc Resection ◽

Bloc Resection ◽

Neurological Dysfunction ◽

Thoracic Myelopathy ◽

En Bloc ◽

Improvement Rate ◽

The Mean

Abstract OBJECTIVE We performed a retrospective patient chart review to determine the feasibility and safety of en bloc resection of lamina and ossified ligamentum flavum in the treatment of thoracic ossification of ligamentum flavum (OLF). METHODS From January 2000 to June 2006, 36 patients with thoracic OLF underwent en bloc resection of lamina and ossified ligamentum flavum by a burr-grinding technique. The range of resection included one lamina superior and one lamina inferior to the diseased segments. Ossified dura mater was removed if present, and simultaneous repair was carried out. RESULTS The mean preoperative Japanese Orthopedic Association (JOA) score (an evaluation system for thoracic myelopathy with a total score of 11 points) was 5 points (range, 3–9 points). The mean JOA score at the last follow-up visit (mean follow-up period, 3.9 years) was 8.44 points (range, 6–11 points). The range of improvement was from 2 to 6 points, and the mean improvement rate was 60.5% (range, 33.3%–100%). No postoperative aggravation of neurological dysfunction, leakage of cerebrospinal fluid (CSF), wound infection, kyphosis, or recurrence occurred. A CSF cyst found in one patient 3 weeks postoperatively was absorbed automatically after 10 months. CONCLUSION The en bloc resection technique described here is both safe and effective.

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Tumor rupture of gastric gastrointestinal stromal tumors during endoscopic resection: a risk factor for peritoneal metastasis?

Endoscopy International Open ◽

10.1055/a-0619-4803 ◽

2018 ◽

Vol 06 (08) ◽

pp. E950-E956 ◽

Cited By ~ 1

Author(s):

Shiyi Song ◽

Wei Ren ◽

Yi Wang ◽

Shu Zhang ◽

Song Zhang ◽

...

Keyword(s):

Risk Factor ◽

Endoscopic Resection ◽

Peritoneal Metastasis ◽

Gastrointestinal Stromal Tumors ◽

En Bloc Resection ◽

Bloc Resection ◽

Tumor Rupture ◽

En Bloc ◽

Stromal Tumors

Abstract Background and study aims Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors in the gastrointestinal tract. Up to the present time, complete surgical excision has been the standard treatment for primary GISTs greater than 2 cm. It is well known that tumor rupture during surgery is an independent risk factor for peritoneal metastasis; however, it is not known whether the risk of peritoneal metastasis increases in cases where the tumor is ruptured during endoscopic resection. Patients and methods A total of 195 patients treated for GIST between January 2014 and December 2016 in our hospital were enrolled in this study. They were divided into two groups according to whether the tumor was ruptured during endoscopic resection. The rate of peritoneal metastasis in patients in the two groups who also suffered perforation was investigated from the follow-up results. Results Approximately 55.4 % of all patients were female and the average age of the study group was 59.0 ± 10.3 years. Of the 195 patients, the tumors in 27 were ruptured and the remaining 168 patients underwent en bloc resection. There was no statistically significant difference in gender or age between the two groups. The median tumor size (maximum diameter) in all patients was 1.5 cm (0.3 – 5.0 cm): 2.5 cm (0.8 – 5.0 cm) and 1.4 cm (0.3 – 4.0 cm) in the tumor rupture group and en bloc resection group, respectively (P < 0.001). Most of the tumors were located in the gastric fundus. At a median follow-up of 18.7 ± 10.2 months, neither tumor recurrence (liver metastasis, peritoneal metastasis, local recurrence) nor mortality related to GISTs were detected. Conclusions Tumor rupture during endoscopic resection of gastric GISTs may not be a risk factor for peritoneal metastasis.

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