Scalp malignant trichilemmal tumour with bony erosion: a new clinical entity

2021 ◽  
Vol 14 (5) ◽  
pp. e239161
Author(s):  
Amrita Virdi ◽  
Khaled Borghol ◽  
Bethan Edwards ◽  
Neal Barnard
Keyword(s):  
Surgical Excision ◽  
Skin Lesions ◽  
Malignant Potential ◽  
Treatment Modalities ◽  
Intracranial Extension ◽  
Radical Radiotherapy ◽  
Root Sheath ◽  
Neck Area ◽  
Bony Erosion

Trichilemmoma is a benign tumour which arises from the hair follicle root sheath, and commonly occurs in the head and neck area. Malignant transformation and locally aggressive growth of these tumours are very rare. Surgical excision remains the mainstay of management, with scarce evidence for other treatment modalities. We describe our experience of a malignant trichilemmal tumour which demonstrated bony erosion with intracranial extension. Our patient was treated with radical radiotherapy, with a good response at 6 months of follow-up. This case highlights the need to consider malignant potential in recurrent skin lesions, along with the potential for trichilemmoma to erode bone, necessitating the consideration of different treatment modalities.

ROLE OF COMPUTED TOMOGRAPHY SCAN IN POST-COVID SINO-NASAL MUCORMYCOSIS WITH CLINICO-EPIDEMIOLOGICAL CORELATION

2021 ◽  
pp. 49-52
Author(s):  
Srijit Saha ◽  
Aarti Anand ◽  
Debraj Saha
Keyword(s):  
Broad Spectrum ◽  
Health Care Professionals ◽  
Epidemiological Data ◽  
Treatment Modalities ◽  
Intracranial Extension ◽  
P Value ◽  
Comorbid Condition ◽  
Invasive Ventilation ◽  
Broad Spectrum Antibiotics

Ÿ OBJECTIVE: Ÿ To evaluate the spectrum of radiological ndings in post-COVID sinonasal mucormycosis cases Ÿ To evaluate the demography, comorbidities and treatment modalities used in these patients which may be attributable to development of sinonasal mucormycosis after recovery from COVID-19 disease. Ÿ MATERIALS AND METHODS: In this retrospective study, 80 out of 793 patients who came for follow-up after recovering from COVID pneumonia, had symptoms related to paranasal sinus and orbit. CECT PNS and orbit was performed in them and 69 patients had positive CT ndings. Clinico-epidemiological data was recorded. The correlation between CT ndings and clinical history was performed by Chi2 test. P value <0.05 was considered as statistically signicant. Ÿ RESULTS: Majority - 48 (69.5%) belonged to age group between 40-60 years. Diabetes mellitus was the most common comorbid condition seen in 58 (84%) patients. The treatment history during COVID-19 disease revealed administration of intravenous or oral steroids in 54 (78.2%) patients, Injection Remdesivir in 48 (69.5%), broad-spectrum antibiotics in 36 (52.2%). 15 (21.7%) were given non-invasive ventilation and 7 (10.1%) needed invasive ventilation. Ethmoidal sinus- 68 cases (98.5%) and maxillary sinus- 65 cases (94.2%) were most frequently affected sinus. Intraorbital extension of the soft tissue was seen in 37 (53.6%) and intracranial extension was seen in 11 (15.9%) cases. On follow-up, fungal hyphae were detected in 39 (56.5%) cases via KOH mount or biopsy. Ÿ CONCLUSION: The widespread use of steroids/monoclonal antibodies/broad-spectrum antibiotics/oxygen therapy for treating COVID-19 may lead to the development/exacerbation of pre-existing fungal diseases. Health care professionals should act promptly when there is a suspicion of mucormycosis

A Rare Case of Nasopharyngeal Glial Heterotopia in a Neonate

2021 ◽  
pp. 097321792110425
Author(s):  
Viveka Singh ◽  
Neha Nabar ◽  
Sanjiv Badhwar ◽  
Preetha Joshi
Keyword(s):  
Gold Standard ◽  
Rare Case ◽  
Neural Tissue ◽  
Surgical Excision ◽  
Intracranial Extension ◽  
Resonance Imaging ◽  
Radiological Studies ◽  
Rule Out ◽  
Glial Heterotopia

Nasopharyngeal glial heterotopias is an extremely rare, nonhereditary, developmental malformation manifesting as a mass composed of mature neural tissue with no intracranial continuity. Glial heterotopia is a rare, non-neoplastic, extracranial midline malformation. Nasal glioma is the most frequently encountered entity among congenital nasal masses. Cases which are associated with intracranial extension are termed as encephalocele. It must be considered in the differential diagnosis of airway obstruction in neonates. Magnetic resonance imaging is mandatory to rule out intracranial extension. We report a rare case of heterotopic brain tissue in nasopharynx with no intracranial extension to attract attention to the diagnostic workup of nasopharyngeal obstruction in a neonate with respiratory distress. Clinical examination and radiological studies are diagnostic while early surgical excision and histopathological confirmation is the gold standard. This baby underwent complete intranasal endoscopic excision of mass on day 20 of life. The postoperative course was uneventful and the baby is growing well on follow-up. This case would be one of the few cases reported from India.

Anterior approaches in juvenile nasopharyngeal angiofibromas with intracranial extension

2000 ◽  
Vol 122 (2) ◽  
pp. 277-283 ◽  
Author(s):  
Giovanni Danesi ◽  
Benedict Panizza ◽  
Antonio Mazzoni ◽  
Vincenzo Calabrese
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Cavernous Sinus ◽  
Internal Carotid ◽  
Surgical Excision ◽  
Residual Tumor ◽  
Lateral Approach ◽  
Treatment Modalities ◽  
Intracranial Extension ◽  
Midface Degloving

Although surgery is regarded as the mainstay of treatment for juvenile nasopharyngeal angiofibromas (JNAs), ancillary treatment modalities such as radiotherapy and on rare occasions chemotherapy are still recommended by many for intracranial extension with apparent radiologic involvement of the cavernous sinus and internal carotid artery. Further, most authors undertaking surgical excision of this subgroup of patients would recommend a lateral or combined frontal and lateral approach for its removal. In a series of 49 cases of JNA, 14 were found during surgery to have intracranial extradural extension; the anterior approach was used for their removal. Although in these cases, on radiography the cavernous sinus often looked to be invaded and the internal carotid artery was displaced superolaterally, there was no difficulty in establishing a plane of dissection. Total removal was achieved in 11 of the 14 cases with a single-stage procedure. Of the 3 cases with residual tumor, only 1 occurred intracranially. Removal was achieved by a subtemporal approach in this case. For the extracranial residual tumors 1 required a midface degloving and the other, with a 1-cm residual tumor in the nasopharynx, has been treated conservatively for 6 years with no evidence of growth. No deaths or significant complications have occurred, and radiotherapy has not been required. We conclude that JNAs are tumors with a predilection for spread but that rarely invade dura, acting instead to displace it. We believe that surgery is the method of choice for treating these lesions and that an anterior surgical approach with microsurgical techniques should be used in the first instance. In the last 2 cases we preferred a midface degloving technique to avoid facial scarring and because this approach allows a widening of the surgical field if needed by the performance of bilateral maxillary free bone flaps. On the rare occasion that a lateral approach, with its attendant permanent conductive hearing loss, is found to be necessary for total tumor removal, this can be done as a staged procedure. This may be necessary when the tumor has spread lateral to the horizontal internal carotid artery.

scholarly journals Nasolabial cyst: case report and review of management options

BMC Surgery ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Abdulhakeem Almutairi ◽  
Abeer Alaglan ◽  
Mazyad Alenezi ◽  
Sultan Alanazy ◽  
Osama Al-Wutayd
Keyword(s):  
Soft Tissue ◽  
Nasal Obstruction ◽  
Surgical Excision ◽  
Mass Effect ◽  
Treatment Modalities ◽  
Open Approach ◽  
Management Options ◽  
Case Presentation ◽  
Complete Surgical Excision

Abstract Background Nasolabial cysts are rare, non-odontogenic, soft-tissue cysts that develop between the upper lip and nasal vestibule with an overall incidence of 0.7% out of all maxillofacial cysts. The predominant presentation of a nasolabial cyst is a painless localized swelling with varying degrees of nasal obstruction. Several treatment modalities have described in the management of the nasolabial cyst. In this paper, we present a case of a nasolabial cyst in a 44 years old man with discussions of the treatment modalities in the lights of the literature. Case presentation We present a case of a nasolabial cyst in a 44-year-old man that slowly increased in size through a period of 3 years, with associated mild pain and nasal obstruction. It had caused a mass effect upon the maxilla, resulting in scalloping. The cyst was excised entirely with no evidence of recurrence at the two months follow up. Conclusions The nasolabial cyst is a rare soft-tissue cyst. Complete surgical excision using an open approach performed to our case, which considered with the complete endoscopic removal of the best treatment for the nasolabial cysts with a rare recurrence rate.

Subglottic haemangioma in children: experience with open surgical excision

2006 ◽  
Vol 120 (12) ◽  
pp. 1033-1037 ◽  
Author(s):  
Y Bajaj ◽  
B E J Hartley ◽  
M E Wyatt ◽  
D M Albert ◽  
C M Bailey
Keyword(s):  
Surgical Excision ◽  
Treatment Modalities ◽  
Direct Result ◽  
Tertiary Referral Centre ◽  
Threatening Condition ◽  
Life Threatening ◽  
One Stop ◽  
Open Excision ◽  
Subglottic Haemangioma

Subglottic haemangioma is a potentially life-threatening condition for which various treatment modalities are available. The objective of this study was to evaluate our results for open excision of subglottic haemangioma. The study assessed 18 patients who had been treated at a paediatric tertiary referral centre. Most of these patients (83.3 per cent) had undergone open surgical excision without post-operative tracheostomy and had been intubated for several days post-operatively (single-stage procedure). In most of these patients (66.7 per cent), an anterior cartilage graft had been used for reconstruction. The average follow up in this study was 25 months. All the patients in this series had achieved an adequate airway after the procedure. One patient had developed a recurrence of haemangioma in the trachea at a later date. The results of open surgical excision in this study were very encouraging. Seventeen out of 18 (94.4 per cent) patients had avoided tracheostomy or had been decannulated as a direct result of surgery. One of these 18 patients (5.6 per cent) had required a temporary post-operative tracheostomy for 13 months as the subglottis cleared; this was classed as a partial success. Our experience is that open excision is a highly successful ‘one stop’ treatment for subglottic haemangioma, which avoids prolonged use of steroids and multiple endoscopic procedures. No patient in this series developed subglottic stenosis, which can be a significant complication of laser application.

scholarly journals Osteoma of mastoid part of temporal bone - a rare clinical entity

1970 ◽  
Vol 16 (2) ◽  
pp. 136-138
Author(s):  
Naseem Yasmeen ◽  
M Alamgir Chowdhury ◽  
SM Golam Rabbani ◽  
Mousumi Malakar
Keyword(s):  
Temporal Bone ◽  
Postoperative Period ◽  
Surgical Excision ◽  
Rare Clinical Entity ◽  
Malignant Cells ◽  
X Ray ◽  
Slow Growing ◽  
Bony Erosion ◽  
Stony Hard

Here a case of osteoma is described situated in right mastoid part of temporal bone (post auricular region) in a 35-year-old female. The swelling was slow-growing, oval in shape, stony hard in consistency, 3cm x 5cm in size with normal & free overlying skin but fixed to the bone & non-tender. FNAC revealed no malignant cells. X-ray Mastoids Towne's view showed right mastoiditis. CT scan findings were in favour of angular dermoid without bony erosion. Surgical excision was done under general anaesthesia. Histopathological report was osteoma. Postoperative period was uneventful and follow up after 10 days was fine. Key words: Osteoma; Temporal bone.DOI: 10.3329/bjo.v16i2.6851Bangladesh J Otorhinolaryngol 2010; 16(2): 136-138

Microsurgical excision of a primary isolated hypothalamic eosinophilic granuloma

1997 ◽  
Vol 87 (5) ◽  
pp. 768-772 ◽  
Author(s):  
Domenico d'Avella ◽  
Maria Giusa ◽  
Alfredo Blandino ◽  
Filippo Flavio Angileri ◽  
Giovanni La Rosa ◽  
...  
Keyword(s):  
Eosinophilic Granuloma ◽  
Brain Lesion ◽  
Surgical Excision ◽  
Residual Tumor ◽  
Treatment Modalities ◽  
Hypothalamic Region ◽  
Peripheral Tissues ◽  
Content Type ◽  
Complete Surgical Excision

✓ Solitary focal eosinophilic granuloma (EG) is one element in the spectrum of diseases associated with Langerhans' cell histiocytosis (LCH). This report documents the occurrence of a primary isolated hypothalamic EG in a man who presented with diabetes insipidus and panhypopituitarism. His treatment consisted of complete microsurgical excision of the lesion. After a 13-month follow-up period, no residual tumor was evident on magnetic resonance imaging and no other lesions were present in peripheral tissues. This case is unique in several respects: 1) it is the third documented case of a primary isolated hypothalamic LCH granuloma diagnosed in a living patient; 2) it is the only known example of complete microsurgical excision of such a lesion in the hypothalamic region; and 3) it demonstrates the efficacy of direct surgery in this scenario, as compared with other treatment modalities such as biopsy and irradiation, suggesting that complete surgical excision may represent the treatment of choice for isolated intracerebral LCH granulomas, being curative in most instances. Also, the literature is reviewed for information about the diagnosis and treatment of this particular type of unifocal brain lesion.

scholarly journals Case Report: A rapidly growing cyst on the scalp

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 779
Author(s):  
Emma Short ◽  
Aisling O'Shea ◽  
Krishna Mukkanna ◽  
Girish Patel ◽  
Stefan Docjinov ◽  
...  
Keyword(s):  
Surgical Excision ◽  
Skin Lesions ◽  
Hair Follicles ◽  
The Body ◽  
Low Grade ◽  
Outer Root Sheath ◽  
Rare Tumour ◽  
Suspected Infection ◽  
Root Sheath ◽  
History Of

Trichilemmal carcinoma is a rare tumour derived from the outer root sheath of hair follicles.  It can be difficult to distinguish both clinically and histologically from other skin lesions, particularly squamous cell carcinoma.  We present the case of a 62-year-old female with a 20-year history of three 1-cm cysts on her scalp.  Over a six-month period, a cyst overlying the occiput had become painful and grown in size.  The general practitioner and subsequently local emergency department suspected infection.  The lesion was incised, and the patient was treated with oral antibiotics.  At the time of surgical excision, the lesion measured 3 x 4 cm. Microscopic examination identified rounded dermal lobules of squamous epithelium with trichilemmal keratinization, in keeping with a pre-existing pilar cyst.  There were areas with nuclear pleomorphism, mitoses and an infiltrative architecture.  A diagnosis of trichilemmal carcinoma arising in a pilar cyst was made.  Trichilemmal carcinomas are considered to be a low-grade tumour, but they have the potential to spread to lymph nodes and to metastasise to distant sites in the body, therefore adequate excision and appropriate follow-up are required.

Treatment of primary cutaneous B-cell lymphomas of follicle center cell origin: a clinical follow-up study of 55 patients treated with radiotherapy or polychemotherapy.

1996 ◽  
Vol 14 (2) ◽  
pp. 549-555 ◽  
Author(s):  
J U Rijlaarsdam ◽  
J Toonstra ◽  
O W Meijer ◽  
E M Noordijk ◽  
R Willemze
Keyword(s):  
Complete Remission ◽  
B Cell ◽  
Relapse Rate ◽  
Distinct Group ◽  
Skin Lesions ◽  
Treatment Modalities ◽  
B Cell Lymphomas ◽  
Favorable Prognosis ◽  
Center Cell

PURPOSE Primary cutaneous follicle center cell lymphomas (PCFCCL) are a distinct group of cutaneous B-cell lymphomas with a favorable prognosis after radiotherapy (RT) or polychemotherapy (PCT). In the literature, conflicting data exist regarding the efficacy and the relapse rate of both treatment modalities. In the present study, treatment results and follow-up data of a large group of PCFCCL are evaluated. PATIENTS AND METHODS Fifty-five patients with a PCFCCL who presented with skin lesions on either the head (n = 12), the trunk (n = 35), or lower legs (n = 8), and who were initially treated with RT (40 cases) or PCT (15 cases) were studied. RESULTS RT resulted in a complete remission in all 40 cases. Eight cases relapsed and three of these patients died as a result of their lymphoma. The estimated 5-year survival was 89%. Four of eight relapses and all three lymphoma-related deaths occurred in the group of patients presenting with tumor(s) on the lower legs. Treatment with cyclophosphamide, doxorubicin vincristine, and prednisone (CHOP) or cyclophosphomide, vincristine, and prednisone (COP) resulted in a complete remission in 14 of 15 cases. All four cases treated with COP relapsed, whereas only two of 11 patients treated with CHOP had a relapse. The estimated 5-year survival rate of the PCT group was 93%. CONCLUSION Both RT and CHOP PCT are highly effective modes of treatment for PCFCCL. In localized PCFCCL, RT is the treatment of choice. In patients with multiple tumors involving anatomic nonrelated parts of the skin, CHOP rather than COP PCT is the preferred mode of treatment. PCFCCL on the lower legs, a subgroup that characteristically occur in elderly patients, have a higher relapse rate and a less favorable prognosis than PCFCCL presenting on the head or trunk.

scholarly journals Giant omental inflammatory myofibroblastic tumour causing intestinal obstruction: a rare care report and review of literature

2020 ◽  
Vol 7 (7) ◽  
pp. 2399
Author(s):  
Utkarsh Kumar ◽  
Gaurav Thami ◽  
Hemlata Kamra ◽  
Nivesh Agarwal
Keyword(s):  
Surgical Excision ◽  
Malignant Potential ◽  
World Health ◽  
Inflammatory Myofibroblastic Tumour ◽  
Unknown Aetiology ◽  
Review Of Literature ◽  
Mesenchymal Tumour ◽  
Complete Surgical Excision ◽  
Health Organization

It is a rare mesenchymal tumour of intermediate biologic potential (according to World Health Organization), with unknown aetiology. It is benign tumour with malignant potential. It frequently recurs and rarely metastasizes. Abdominopelvic inflammatory myofibroblastic tumours have the recurrence rate of 85% so meticulous follow up is necessary. Complete surgical excision is the main stay treatment.

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