scholarly journals Ductal Adenocarcinoma Ex Pleomorphic Adenoma of the Lacrimal Gland: a Rare and Morbid Malignancy

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Prashanth Ashok Kumar ◽  
Shweta Paulraj ◽  
Kanish Mirchia ◽  
Seung Shin Hahn ◽  
Abirami Sivapiragasam
Keyword(s):  
Pleomorphic Adenoma ◽  
Lacrimal Gland ◽  
En Bloc Resection ◽  
Rapid Onset ◽  
Bloc Resection ◽  
Ductal Adenocarcinoma ◽  
Lytic Lesion ◽  
Carcinoma Ex Pleomorphic Adenoma ◽  
En Bloc ◽  
Orbital Wall

Carcinoma ex pleomorphic adenoma (Ca ex PA) is a rare malignant transformation of a benign primary pleomorphic adenoma (PA). We report the case of a 62-year-old male who presented with a swelling over his left temple. Imaging revealed a lytic lesion over the left orbital wall with soft tissue extension suggestive of malignancy. He underwent an en bloc resection of the mass with orbital exenteration, craniotomy, and reconstruction. Pathology demonstrated a lacrimal gland ductal adenocarcinoma arising from a PA which led to the diagnosis of ductal adenoCa ex PA. Postoperatively, he received chemotherapy with 6 cycles of cisplatin and concurrent radiation therapy (RT), but his course was complicated by recurrent bacterial meningitis and abscesses and he ultimately opted for comfort measures. Patients with PA of the lacrimal gland experience an insidiously enlarging painless swelling of the orbit with transformation to Ca ex PA highlighted by a rapid onset of bulbar enlargement, displacement, and often proptosis. Ductal adenoCa ex PA is aggressive with a poor prognosis and has no established standard of care. This case highlights the rarity of this condition and the need for more literature to help direct treatment.

scholarly journals Advantages of the open approach in sinonasal tract tumors with midfacial and suprastructure invasion

2020 ◽  
Vol 10 (37) ◽  
pp. 30-34 ◽  
Author(s):  
Daniela Vrinceanu ◽  
Bogdan Banica ◽  
Mihai Dumitru ◽  
Gabriela Musat
Keyword(s):  
Frontal Sinus ◽  
Malignant Tumors ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Open Approach ◽  
External Approach ◽  
En Bloc ◽  
Orbital Wall ◽  
Midfacial Degloving ◽  
And Control

AbstractBACKGROUND. In case of rhinosinusal malignant tumors, it is important to have a unified and simple terminology. The suprastructure refers to the ethmoid sinus, the sphenoid sinus, the frontal sinus and the olfactory area of the nose. The mesostructure includes the maxillary sinus, excepting the orbital wall, and the respiratory part of the nose.MATERIAL AND METHODS. We will present two clinical cases admitted and surgically treated in our department. The first one is a left-side suprastructure mass in a 39-year-old male patient, with a particular evolution. The second one is a left-side midfacial and suprastructure tumor with 3 prior negative biopsies in a 57-year-old patient. In both cases, we performed an external surgical approach.DISCUSSIONS. For an external approach in mesostructure malignant tumors, we propose a combined approach using lateral nasal rhinotomies, sub-labial rhinotomies and midfacial degloving. The external approach in malignant tumors of the supra-structure is centred on a classical incision for the frontal sinus or a hemicoronal or coronal approach. There are some clear advantages of the open approach to be considered.CONCLUSION. The advantages of the external approach are represented by a direct visualization and control of the tumor during the ablative time; a better control for negative margins; a better control of haemostasis; a better chance for en-bloc resection versus piece-meal resection.

Experience with the Resection of Parapharyngeal Cancers via the Infratemporal Fossa Approach

1986 ◽  
Vol 94 (3) ◽  
pp. 291-301 ◽  
Author(s):  
Peter G. Smith ◽  
Daniel E. Sharkey
Keyword(s):  
Internal Carotid ◽  
Infratemporal Fossa ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Carcinoma Ex Pleomorphic Adenoma ◽  
Upper Aerodigestive Tract ◽  
En Bloc ◽  
Curative Intent ◽  
Cranial Fossa

Between 1982 and 1984, a modified Infratemporal fossa approach was used to resect cancers with extensive primary or secondary Involvement of the Infratemporal fossa and parapharynx in 10 patients. Nine patients exhibited persistent or recurrent disease of the upper aerodigestive tract and posterior cranial fossa following planned, curative-Intent therapy; the remaining patient had a carcinoma ex-pleomorphic adenoma of the deep lobe of the parotid gland with a significant Infratemporal fossa extension. Considered to have “unresectable” tumors, by traditional methods, 7 of the 10 patients underwent an en-bloc resection of their lesions with tumor-free margins. Tumor was present at the margins of the specimens in the other 3 patients. Two of the 10 patients died early in the postoperative period of medical complications. Another died 5 months postoperatively of a tumor-Induced Internal carotid artery rupture at the level of the foramen lacerum. A fourth patient died of his disease 6 months following his resection. One patient is alive, but has metastatic meningioma 2 years after surgery. The 5 remaining patients are without evidence of disease, with a mean follow up of 2 years. Indications for and refinements of the operative technique, particularly those related to the repair of such extensive ablative defects, are outlined on the basis of this early experience.

scholarly journals Underwater endoscopic mucosal resection for en bloc resection of a neuroendocrine tumor in the duodenal bulb

Endoscopy ◽  
2021 ◽  
Author(s):  
Hugo Uchima ◽  
Alberto Diez-Caballero ◽  
Jaume Capdevila ◽  
Mercé Rosinach ◽  
Alfredo Mata ◽  
...  
Keyword(s):  
Neuroendocrine Tumor ◽  
Endoscopic Mucosal Resection ◽  
Duodenal Bulb ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
En Bloc ◽  
Mucosal Resection

scholarly journals Fibrin glue: Novel submucosal injection agent for endoscopic submucosal dissection

2021 ◽  
Vol 09 (03) ◽  
pp. E319-E323
Author(s):  
Madoka Takao ◽  
Yoshitaka Takegawa ◽  
Toshitatsu Takao ◽  
Hiroya Sakaguchi ◽  
Yoshiko Nakano ◽  
...  
Keyword(s):  
Endoscopic Submucosal Dissection ◽  
Fibrin Glue ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
En Bloc ◽  
Submucosal Injection ◽  
Submucosal Dissection ◽  
Vitro Model ◽  
Histopathologic Findings

Abstract Background and study aims Adequate mucosal elevation by submucosal injection is crucial for patient safety and efficiency during endoscopic submucosal dissection (ESD). This study aimed to evaluate the efficacy of fibrin glue (FG) as a long-lasting submucosal injection agent and to evaluate the technical feasibility of FG injection for ESD. Materials and methods To compare the capabilities of different agents in maintaining submucosal evaluation, we injected FG, hyaluronic acid solution, and normal saline into the porcine gastric specimen that was incised into approximately 5 × 5 cm squares. Then, we measured the height of submucosal elevations over time. Moreover, three hypothetical lesions from the resected porcine stomach underwent ESD with FG injection. Thereafter, we conducted macroscopic and histopathologic analyses. Results FG maintained the greatest submucosal elevation among all the injection agents. Three ESD procedures were performed with en bloc resection. Both macroscopic and histopathologic findings showed a thick FG clot on the ulcers. Conclusions The FG solution can be potentially used as an ESD submucosal injection agent in an in vitro model.

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