scholarly journals Multimodality Treatment Options and Outcomes of Laryngeal Carcinosarcoma: A Clinical Analysis of a Rare Tumor from a Single Hospital

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Yang Zhang ◽  
Zhigang Huang ◽  
Neil Gross ◽  
Jugao Fang ◽  
Xiaohong Chen ◽  
...  
Keyword(s):  
Neck Dissection ◽  
Clinical Symptoms ◽  
Early Stage ◽  
Postoperative Radiotherapy ◽  
Treatment Options ◽  
Case Series ◽  
Multimodality Treatment ◽  
Clinical Analysis ◽  
Partial Laryngectomy ◽  
Rare Type

Primary laryngeal carcinosarcoma is a rare type of malignancies, and the standard therapeutic protocol for its treatment has yet to be established. This retrospective study analyzed the clinical and pathological characteristics, risk factors, treatment options, and prognosis of 13 patients with primary laryngeal carcinosarcomas. This case series included 11 males and 2 females with an age range from 32 to 78 years at diagnosis. The initial clinical symptoms included hoarseness, dyspnea, and foreign body sensation in the throat. The primary tumor sites were at the glottis, supraglottis, and larynx. All these patients were active or passive smokers, and more than half of them were alcohol addictive. The surgical treatment for laryngeal carcinosarcomas included CO2 laser surgery in seven cases, partial laryngectomy and neck dissection in three cases, and total laryngectomy and neck dissection in three cases. Among them, seven cases received postoperative radiotherapy. After follow-up with a mean of 31.15-month, four cases died. Primary laryngeal carcinosarcoma is a rare but more aggressive malignancy. Contralateral lymph node metastasis can occur at the early stage of this disease. A treatment combining surgery and postoperative radiotherapy is strongly recommended.

scholarly journals Non-Melanoma Skin Cancer in People Living With HIV: From Epidemiology to Clinical Management

2021 ◽  
Vol 11 ◽  
Author(s):  
Emmanuele Venanzi Rullo ◽  
Maria Grazia Maimone ◽  
Francesco Fiorica ◽  
Manuela Ceccarelli ◽  
Claudio Guarneri ◽  
...  
Keyword(s):  
Skin Cancer ◽  
Early Stage ◽  
Treatment Options ◽  
Case Series ◽  
Surgical Excision ◽  
People Living With Hiv ◽  
Skin Cancers ◽  
Ablative Techniques ◽  
Living With Hiv ◽  
Melanoma Skin

Skin cancers represent the most common human tumors with a worldwide increasing incidence. They can be divided into melanoma and non-melanoma skin cancers (NMSCs). NMSCs include mainly squamous cell (SCC) and basal cell carcinoma (BCC) with the latest representing the 80% of the diagnosed NMSCs. The pathogenesis of NMSCs is clearly multifactorial. A growing body of literature underlies a crucial correlation between skin cancer, chronic inflammation and immunodeficiency. Intensity and duration of immunodeficiency plays an important role. In immunocompromised patients the incidence of more malignant forms or the development of multiple tumors seems to be higher than among immunocompetent patients. With regards to people living with HIV (PLWH), since the advent of combined antiretroviral therapy (cART), the incidence of non-AIDS-defining cancers (NADCs), such as NMSCs, have been increasing and now these neoplasms represent a leading cause of illness in this particular population. PLWH with NMSCs tend to be younger, to have a higher risk of local recurrence and to have an overall poorer outcome. NMSCs show an indolent clinical course if diagnosed and treated in an early stage. BCC rarely metastasizes, while SCC presents a 4% annual incidence of metastasis. Nevertheless, metastatic forms lead to poor patient outcome. NMSCs are often treated with full thickness treatments (surgical excision, Mohs micro-graphic surgery and radiotherapy) or superficial ablative techniques (such as cryotherapy, electrodesiccation and curettage). Advances in genetic landscape understanding of NMSCs have favored the establishment of novel therapeutic strategies. Concerning the therapeutic evaluation of PLWH, it’s mandatory to evaluate the risk of interactions between cART and other treatments, particularly antiblastic chemotherapy, targeted therapy and immunotherapy. Development of further treatment options for NMSCs in PLWH seems needed. We reviewed the literature after searching for clinical trials, case series, clinical cases and available databases in Embase and Pubmed. We review the incidence of NMSCs among PLWH, focusing our attention on any differences in clinicopathological features of BCC and SCC between PLWH and HIV negative persons, as well as on any differences in efficacy and safety of treatments and response to immunomodulators and finally on any differences in rates of metastatic disease and outcomes.

scholarly journals An EBV+ lymphoepithelioma-like cholangiocarcinoma in a young woman with chronic hepatitis B

2019 ◽  
Vol 12 (7) ◽  
pp. e229520 ◽  
Author(s):  
Sofia V Gearty ◽  
Ayman Al Jurdi ◽  
Meredith E Pittman ◽  
Renuka Gupta
Keyword(s):  
Chronic Hepatitis ◽  
Nasopharyngeal Carcinoma ◽  
Epstein Barr Virus ◽  
Systemic Chemotherapy ◽  
Early Stage ◽  
Treatment Options ◽  
Rare Type ◽  
Barr Virus ◽  
Epstein Barr ◽  
Almost All

Epstein-Barr virus (EBV) is implicated in the tumorigenesis of a variety of malignancies, including Burkitt’s lymphoma, Hodgkin’s disease and nasopharyngeal carcinoma (NPC). EBV+ lymphoepithelioma-like cholangiocarcinoma (LELCC) is a rare type of intrahepatic cholangiocarcinoma with a distinct pathology and poorly understood treatment options. Morphologically, this neoplasm resembles undifferentiated NPC, a commonly EBV+ tumour with a prominent lymphoid infiltrate. Almost all of the current literature regarding LELCC describes early stage tumours that are treated surgically and achieve good outcomes. In contrast, this report documents a late stage LELCC treated unsuccessfully with systemic chemotherapy.

scholarly journals Adult primary liver sarcoma: systematic review

2020 ◽  
Vol 47 ◽  
Author(s):  
ANTONIO CAVALCANTI DE ALBUQUERQUE MARTINS ◽  
DUÍLIO CABRAL DA COSTA NETO ◽  
JÚLIO DOURADO DE-MATOS E SILVA ◽  
YGOR MONTEIRO MORAES ◽  
CRISTIANO SOUZA LEÃO ◽  
...  
Keyword(s):  
Systematic Review ◽  
Prognostic Factors ◽  
Case Reports ◽  
Treatment Options ◽  
Case Series ◽  
Epithelioid Hemangioendothelioma ◽  
Treatment Modalities ◽  
R0 Resection ◽  
Rare Type ◽  
Degree Of Differentiation

ABSTRACT Introduction: primary liver sarcoma is a rare type of tumor, more common in children. Among adults, it represents a spectrum of neoplasms with reserved prognosis. There is no consensus on the treatment of choice of these lesions, justifying a systematic review of the literature on treatment options, prognostic factors, and survival. Material/Methods: a systematic review of articles published in Pubmed, Medline, LiLacs e SciElo, from 1966 to March/2019, presenting the keywords: primary-liver-sarcoma and primary-hepatic-sarcoma was undertaken. Studies including patients older than 18 years, and published in English, Portuguese and Spanish were included. Case reports, metastatic tumors and multiple oncologic diagnosis were excluded. The initial search listed 1,318 articles. 1,206 did not meet the inclusion criteria. After reviewing 112 eligible articles, 15 were selected (14 case series and 1 retrospective-cohort). Results: proposed treatment modalities for primary liver sarcoma included surgery and/or chemotherapy and/or radiotherapy or liver transplantation. The most common histological types were angiosarcoma (32%), leiomyosarcoma (29%), epithelioid hemangioendothelioma (15%) and embryonal sarcoma (7%). Histology, degree of differentiation and R0 resection were mentioned positive prognostic factors. Median survival ranged from two to 23 months. Five-year survival rate varied from 0% to 64%, on average 21%. Conclusion: surgical resection (R0 resection) is the main treatment for primary liver sarcomas. Development of effective systemic therapies are required to improve prognosis of patients harboring this type of tumor.

Development of actual measurement-based RBE calculation model for carbon beam therapy and high-precision clinical analysis

Impact ◽  
2021 ◽  
Vol 2021 (6) ◽  
pp. 12-14
Author(s):  
Ryosuke Kohno
Keyword(s):  
Early Stage ◽  
Medical Physics ◽  
Treatment Options ◽  
Proton Beam Therapy ◽  
Clinical Analysis ◽  
Fine Tuning ◽  
Particle Therapy ◽  
Surrounding Tissue ◽  
Surgical Removal ◽  
Actual Measurement

Cancer can reduce quality of life, place strain on families and even kill. Treatment methods are not always effective nor precise and involve either surgical removal of cancerous tissues or a combination of drugs and radiation. Advances in physics are providing new hope for treatment options in the form of radiation and, specifically, particle therapy, which includes proton beam therapy and carbon ion radiotherapy (CIRT). This improves treatment precision as the beam can be targeted so that it kills cancer and not the surrounding tissue. Ryosuke Kohno, Department of Accelerator and Medical Physics, National Institutes for Quantum and Radiological Science and Technology, Japan, is interested in how applied physics can bridge with medicine, becoming medical physics. He has developed several beam therapies protocols over the years and is particularly interested in CIRT and how the technique can be improved. Kohno is currently working on fine tuning a model that can be optimally calibrated to attack all types of tumours. He and his team are also working on Intensity-Modulated Composite Particle Therapy (IMPACT). Kohno is collaborating with a multidisciplinary radiotherapy team and his interdisciplinary research involves the integration of radiation/medical physics, radiation biology and radiation oncology. He is also assisting early-stage researchers so that the next-generation of researchers can form new bridges between basic science and medicine.

EMDR Treatment of Children and Adolescents With a Choking Phobia

2008 ◽  
Vol 2 (3) ◽  
pp. 201-211 ◽  
Author(s):  
Carlijn de Roos ◽  
Ad de Jongh
Keyword(s):  
Differential Diagnosis ◽  
Children And Adolescents ◽  
Effective Treatment ◽  
Clinical Symptoms ◽  
Treatment Options ◽  
Case Series ◽  
Time Lapse ◽  
Positive Outcomes ◽  
Rapid Elimination

Given the limited number of reported cases in literature, it might be concluded that it is rare to develop a choking phobia in childhood. However, it appears as though confusion in terminology and the time lapse between the onset of the disorder and treatment often results in the diagnosis being missed. In this article, we discuss a review of the clinical symptoms, differential diagnosis, comorbidity, etiology, and treatment options for choking phobia. We present a case series, describing the successful EMDR treatment of choking phobia for 4 children and adolescents, with positive outcomes achieved in 1 or 2 sessions. In addition, a detailed transcript is presented of a 15-year-old girl with a choking phobia related to an incident that occurred 5 years previously. The rapid elimination of symptoms in all 4 cases indicates that EMDR can be an effective treatment for choking phobias resulting from previous disturbing events. Randomized research on this promising intervention is strongly suggested.

Eight Cases of Nasal Tuberculosis

2007 ◽  
Vol 137 (3) ◽  
pp. 500-504 ◽  
Author(s):  
Yong Min Kim ◽  
Ah Young Kim ◽  
Yong Ho Park ◽  
Dong Hyun Kim ◽  
Ki-Sang Rha
Keyword(s):  
Nasal Septum ◽  
Medical Literature ◽  
Clinical Symptoms ◽  
Treatment Options ◽  
Clinical Analysis ◽  
Sinus Surgery ◽  
Experimental Drug ◽  
Diagnostic Difficulties ◽  
High Index Of Suspicion ◽  
Subsequent Improvement

OBJECTIVE: To elucidate the clinical characteristics of nasal tuberculosis and to discuss its diagnostic difficulties. STUDY DESIGN: Retrospective clinical analysis. RESULTS: A total of eight patients presented with nasal tuberculosis during the study period (from January 1989 through December 2006). Six were female and two were male. The patient age varied from 17 to 51 years, with a mean of 31 years. The most commonly involved site was the nasal septum (7 of 8). Perforation of the nasal septum was observed in three cases. Sinus invasion was observed in two cases and required sinus surgery. Six of the cases were a result of primary infections, while two were secondary disease manifestations. All patients were treated with anti-tuberculosis medications, with subsequent improvement with regard to clinical symptoms and physical signs. CONCLUSIONS: We present the largest number of nasal tuberculosis cases reported in the medical literature from a single institute. Diagnosing nasal tuberculosis requires a high index of suspicion and occasionally the use of experimental drug treatment options.

Orthotic Care Based on the Ferrari Concept for Children and Adults with Meningomyelocele

2019 ◽  
Vol 157 (06) ◽  
pp. 695-705
Author(s):  
Tim Schmid ◽  
Elisabeth Strehl ◽  
Regina Trollmann ◽  
Raimund Forst ◽  
Albert Fujak
Keyword(s):  
Clinical Medicine ◽  
Clinical Symptoms ◽  
Early Stage ◽  
Treatment Options ◽  
Positive Influence ◽  
Lower Limbs ◽  
Duration Of Treatment ◽  
Folic Acid Supplements ◽  
Individual Concepts

Abstract Background Even today, myelomeningocele (MMC) is still encountered in clinical medicine and its incidence has not decreased over the last 20 years despite a known reduction in risk due to the use of folic acid supplements. The spectrum of clinical symptoms is extremely broad and, depending on the level of the defect, varies from mild to severe. Subject to the degree of paralysis, patients are reliant on the use of orthopaedic aids and orthoses for the treatment of primary contractures and deformities and the prevention of secondary ones. This forms the basis for attaining or maintaining mobility in many patients. The objective of the study was to determine the practical application of the proposed Ferrari concept for the provision of orthoses for children and adults. Patients and Material The retrospective study comprised medical records of 180 patients (97 m) with an average age of 19.44 years (3 – 52 years, SD 9.3) at the time of investigation. The average duration of treatment was 15.34 years (1 – 38 years, SD 8.96). Data relating to deformities of the vertebral column and lower limbs, provision of hydrocephalus shunts and orthoses, and patient mobility was evaluated. Results Most patients were given systematic treatment with orthoses at an early stage. In 58,9% of cases, it was possible to implement the proposed concept for providing patients with dynamic orthoses, whereby the treatment concept was more difficult to implement with high lumbar lesions than with lower lesions. Moreover, a decrease in the patientsʼ mobility with increasing age was noticeable. Some 42.3% of adult patients were able to walk with marked variations in mobility in relation to the different levels of lesions. Conclusion Taking into consideration the complexity of both the clinical picture and therefore the provision of orthopaedic devices, the result of the implementation of the proposed orthotic concept can be considered positive. Similarly, early commencement of provision of orthoses and hence the possibility of achieving a positive influence on later mobility can be considered a success. The need for individual concepts and further development in order to increase mobility particularly in the case of patients with thoracic or high lumbar lesions is evident. A more comprehensive provision of information to patients regarding orthotic treatment options and their consequences for prophylaxis and quality of life should be an important component of interdisciplinary long-term patient care.

scholarly journals Supracricoid Partial Laryngectomy: The Second Coming

2010 ◽  
Vol 2 (3) ◽  
pp. 201-205 ◽  
Author(s):  
Biswajyoti Hazarika
Keyword(s):  
Total Laryngectomy ◽  
Residual Disease ◽  
Postoperative Radiotherapy ◽  
Multimodality Treatment ◽  
Concurrent Chemotherapy ◽  
Partial Laryngectomy ◽  
Carcinoma Larynx ◽  
Supracricoid Partial Laryngectomy ◽  
Single Modality ◽  
Treatment Surgery

Abstract Early cancer of the larynx can be addressed by single modality treatment (surgery or radiotherapy) while advanced cancer larynx is addressed with multimodality treatment—surgery (total laryngectomy) + postoperative RT or concurrent chemotherapy + radiotherapy. But there is a subset of population with carcinoma larynx in whom single modality treatment with radiotherapy or conventional partial laryngectomy may not be sufficient while total laryngectomy with postoperative radiotherapy may be overkill. In this subset of population supracricoid partial laryngectomy is the perfect answer which bridges the gap between partial laryngectomy and total laryngectomy. In addition to utilizing this procedure in the post-RT residual disease scenario the upfront performance of SCPL can also avoid adjuvant RT in many instances. Supracricoid partial laryngectomy is an organ preservation procedure in the true sense that it can achieve an oncological safe margin and also provide a high quality of life.

scholarly journals Lymph Node Involvement in T1a Glottic Carcinoma: Controversial Case Series

2020 ◽  
Vol 6 (01) ◽  
pp. 41-43
Author(s):  
Eda Tuna Yalcinozan ◽  
Mustafa Asim Safak
Keyword(s):  
Lymph Nodes ◽  
Neck Dissection ◽  
Treatment Modality ◽  
Early Stage ◽  
Case Reports ◽  
Case Series ◽  
Lymph Node Involvement ◽  
Elective Neck Dissection ◽  
Glottic Carcinoma ◽  
Cervical Lymph Nodes

AbstractThe treatment modality of laryngeal cancer is complete resection of the primary lesion and dissection of the cervical lymph nodes that is related to their staging. Following the patient without neck dissection is the usual expectation in T1 glottic carcinomas. However, a combination of elective neck dissection with surgical treatment for clinically N0 neck in early glottic tumors may be an effective treatment modality in the prevention of missed micrometastases. In these two case reports, elective neck dissection and re-examination of the treatment were discussed accordingly. We aimed to point out the importance of evaluation, examination, and, if it is uncertain, moreover the dissection of lymph nodes in early-stage glottic carcinoma since there are rarely any studies available.

In-block lateralization as a new technique for mobilization of the inferior alveolar nerve: a technique case series

2020 ◽  
Author(s):  
Marcos Augusto Tomazi ◽  
Alexandre da Silveira Gerzson ◽  
Angelo Menuci Neto ◽  
André Luciano Pasinato da Costa
Keyword(s):  
Treatment Options ◽  
Inferior Alveolar Nerve ◽  
Case Series ◽  
New Technique ◽  
Autogenous Bone ◽  
Minimal Risk ◽  
Short Implants ◽  
Bone Atrophy ◽  
A New Technique ◽  
Number Of Treatment

The edentulous atrophic posterior mandible is often a great challenge for implant rehabilitation. Although a number of treatment options have been proposed, including the use of short implants and surgical grafting techniques, in cases of severe bone atrophy, techniques for mobilization of the inferior alveolar nerve (IAN) have been shown to be efficient, with good results. Four female patients underwent IAN lateralization for prosthetic rehabilitation of the posterior mandible from 2013 to 2019, with 1 year to 5 years and 4 months of follow-up. This case series describes a new technique for mobilization of the IAN, named in-block lateralization, to facilitate access to the IAN and to reduce nerve manipulation. The implant is immediately installed (allowing nerve lateralization in unitary spaces) and the original mandibular anatomy is restored with autogenous bone from the original bed during the same surgical procedure. When well indicated and well performed, this new approach provides better and easier visualization of the IAN as well as safer manipulation aiming to achieve good results for implant stability and minimal risk of neurosensory disturbances, allowing rehabilitation even in unitary spaces.

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