scholarly journals An Oropharyngeal Obstructive Lesion in a Neonate

2021 ◽  
pp. 014556132199501
Author(s):  
Swar N. Vimawala ◽  
Hamza A. Shaikh ◽  
William J. Rafferty ◽  
Donald Solomon

Neonatal HNT in the pharynx is a rare cause of respiratory distress and poor feeding in the newborn, but must be differentiated from teratoma, encephalocele, and nasal glioma. While surgical resection is the preferred treatment modality, we posit there is a role for sclerosis of the glial heterotopic cyst if complete surgical excision is not possible or carries risk of high morbidity. Here, we present a case of a 7-day-old neonate presenting with acute respiratory distress found to have a nasopharyngeal/oropharyngeal mass ultimately treated with sclerotherapy at 9 months of age.


2020 ◽  
Vol 24 (03) ◽  
pp. e347-e350
Author(s):  
Luis Pacheco-Ojeda ◽  
Andrés Ayala-Ochoa ◽  
Karla Salvador

Introduction Branchial cleft anomalies are the second most common congenital anomaly in children. However, some lesions may not develop clinically and are not diagnosed until adulthood. The recent literature of branchial cysts (BCs) in the adult population is really scanty. For this reason, we analyzed the clinical and surgical management of the adult population treated for a BC at a tertiary care general hospital. Methods A retrospective review of the clinical records of all the patients with histological diagnosis of BC who were surgically treated at the Social Security Hospital in Quito, Ecuador, was performed. Fifty-one patients (27 women) with congenital anomalies of the 2nd (43 patients with cysts) and 3rd (6 patients with cysts and 2 with fistula) branchial arches were diagnosed and treated. Diagnosis was made on clinical grounds and by computed tomography scan. Results The 43 patients with a 2nd branchial cleft cyst underwent complete surgical excision through a wide mid-neck transverse cervicotomy. The 6 cases of 3rd branchial cleft cyst underwent surgical resection through a lower-neck transverse incision, and the 2 patients with clinical fistula in the lower aspect of the neck were operated on via an elliptical incision around this external fistula opening. Postoperative evolution was uneventful in all patients. Conclusions Branchial cysts can occasionally be diagnosed in adult patients in the setting of a general hospital population. A correct clinical and imaging assessment was diagnostic in most patients. Complete surgical resection was curative in all our patients, and postoperative complications were exceptional.



2020 ◽  
Vol 11 ◽  
pp. 308
Author(s):  
Abhinandan Reddy Mallepally ◽  
Rajat Mahajan ◽  
Sandesh Pacha ◽  
Tarush Rustagi ◽  
Nandan Marathe ◽  
...  

Background: Osteoid osteoma (OO) is a rare benign tumor of the spine that involves the posterior elements with 75% tumors involving the neural arch. The common presenting symptoms include back pain, deformity like scoliosis, and rarely radiculopathy. Methods: From 2011 to 2017, we evaluated cases of OO managed by posterior surgical resection while also reviewing the appropriate literature. Results: We assessed five patients (three males and two females) averaging 36.60 years of age diagnosed with spinal OOs. Two involved the lumbar posterior elements, two were thoracic, and one was in the C3 lateral mass. All patients underwent histopathological confirmation of OO. They were managed by posterior surgical resection with/without stabilization. No lesions recurred over the minimum follow-up period of 24 months. Conclusion: Surgical excision is the optimal treatment modality for treating spinal OOs. The five patients in this study demonstrated good functional outcomes without recurrences. Further, the literature confirms that the optimal approach to these tumors is complete surgical excision with/without radiofrequency ablation.



2020 ◽  
Author(s):  
Danni Cheng ◽  
Yufang Rao ◽  
Ke Qiu ◽  
Jianqing Qiu ◽  
Yijun Dong ◽  
...  

Abstract Background and Objectives: Carcinomas derived from myoepithelial cells in head and neck regions (CMCHN) are rare. The aim of this study was to demonstrate the clinical behaviors and treatment outcomes of these tumors.Methods: A retrospective review of fifteen CMCHN cases between 2002 and 2019 in a single institution was performed. Results: All of the fifteen patients (100%) underwent primary surgical resection. Eleven patients (73.3%) received conventional postoperative radiotherapy and four (26.7%) received systemic chemotherapy. Consequently, six patients (40%) had frequently recurrence after surgical resection, and seven patients (46.7%) received second or even third operations. Up to the time of last follow-up, only one patient died and the mean survival time was 15.8 years.Conclusions: Currently, complete surgical excision with or without systemic therapy is preferred, but it has limited efficacy on reducing the risk of recurrence. Thus, more effective systemic therapies are required and the researches on the mechanism of CMCHN recurrence should be encouraged.



1993 ◽  
Vol 78 (3) ◽  
pp. 446-451 ◽  
Author(s):  
John A. Anson ◽  
Robert F. Spetzler

✓ Cavernous malformations are being increasingly well recognized throughout the central nervous system, where they compose approximately 1% of all vascular lesions and 15% of all vascular malformations. These malformations are uncommon in the spinal column and rarely found within the spinal cord. There have been only a few isolated reports of surgical resection of intramedullary spinal cord cavernous malformations. A series of six patients with intramedullary spinal cord cavernous malformations is described; all were treated by complete surgical excision, and all had a good or excellent outcome with partial or complete relief of neurological symptoms. There were no surgical complications, although transient postoperative neurological worsening was common. The clinical, radiological, and surgical features of these patients are discussed. It is concluded that intramedullary spinal cord cavernous malformations are an uncommon cause of progressive myelopathy that can be safely and effectively treated by surgical excision.



2016 ◽  
Vol 10 (1) ◽  
pp. 26-28 ◽  
Author(s):  
Swapan Kumar Paul ◽  
Suprotim Howlader ◽  
Diponker Kumar Saha ◽  
Abdur Rahed Khan

Lymphangiomas are benign hamartomatous lymphatic tumours characterized by multiple communicating lymphatic channels and cystic spaces. Cystic lyphangiomas may be seen anywhere in the body but are common in neck, axilla, mediastinum and groin. Treatment options are surgical resection, radiation, sclerotherapy etc but have got high recurrence rate and complications. In the present study we hypothesized that complete surgical resection along with keeping a drain for 2-3 wks, may reduce recurrence rate. This prospective study was performed from July 2008 to June 2013. Total 21 children treated during this period by the technique of complete surgical excision with keeping drain tube in situ for 2 to 3 weeks. Ultrasound performed in all patients, CT scan and Duplex study performed in some patients, histopathology done in all patients. Patients with intra-abdominal lymphangioma not included in this study. Twenty one patients were operated during the study period and average duration of keeping drain tube was 18.57 days. Among the 21 cases 2 (9.52%) patients developed mild infection, 1 (4.76%) patient developed infection with pus formation and 1 (4.76%) patient developed recurrence. Our success in the treatment warrants further verification of potential benefits of keeping drain tube in situ for 2-3 weeks after surgical excision of lymphangiomas.Faridpur Med. Coll. J. Jan 2015;10(1): 26-28





2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Moaied A. Hassan ◽  
Hasan K. Gatea ◽  
Thura K. Ja’afar

Abstract Background Lymphatic malformations are rare benign cystic tumors that result from localized disordered embryologic development of the lymphatic system and can develop anywhere in the body, predominantly in the head and neck. These lesions are classified according to the diameter of the largest cystic cavity within the lesion into microcystic and macrocystic types. Historically, surgical excision has been considered the mainstay of treatment and still remains the first therapeutic option of choice for many surgeons particularly for giant macrocystic lesions. Several alternative therapeutic modalities emerged including intralesional sclerotherapy and laser therapy with encouraging results. The study is designed to assess the effectiveness and safety of surgical excision as an initial therapeutic option in the management of these malformations. Results Asymptomatic mass with parental cosmetic and functional concerns was the mode of presentation in six (66.7%) patients. Seven (77.8%) patients were presented before the age of 2 years. Six (66.7%) of the patients had their lesions in the neck. Complete surgical excision was achieved in eight (88.9%) patients without any evident significant injury to vital neurovascular structures. None of the patients had any difficulties with breathing, swallowing, or phonation and cosmetic results were satisfactory in the majority (88.9%) of them. Conclusion Radical surgical excision of giant macrocystic lymphatic malformations in children is possible in experienced hands. It is an effective and safe initial therapeutic option and gives satisfactory esthetic and functional results.



2020 ◽  
Vol 28 (1) ◽  
pp. 220-225
Author(s):  
Ashley Drohan ◽  
Jennifer Melvin ◽  
Joanne Murphy ◽  
Carman Giacomantonio ◽  
Lucy Helyer

Eccrine porocarcinoma is a rare aggressive cutaneous malignancy. Complete surgical excision is the standard of care, although there are high rates of local and distant recurrence. We present a unique case of locally recurrent and metastatic subungal porocarcinoma successfully treated with intralesional interleukin-2.



Medicina ◽  
2021 ◽  
Vol 57 (7) ◽  
pp. 728
Author(s):  
Jeong-Hyouk Choi ◽  
Koo-Han Yoo ◽  
Dong-Gi Lee ◽  
Gyeong-Eun Min ◽  
Gou-Young Kim ◽  
...  

Background and Objectives: Retroperitoneal schwannoma is a very rare case of schwannoma which commonly occurs in the other part of the body. However, it is difficult to distinguish schwannoma from other tumors before pathological examination because they do not show specific characteristics on imaging study such as ultrasound, computed tomography (CT), and magnetic resonance image (MRI). Case summary: A 60-year-old male showed a retroperitoneal cystic tumor which is found incidentally during evaluation of coexisted bladder tumor. Neurogenic tumor was suspicious for the retroperitoneal tumor through pre-operative imaging study. Finally, a schwannoma was diagnosed by immunohistochemical examination after complete surgical excision laparoscopically. Conclusion: As imaging technology is developed, there may be more chances to differentiate schwannoma from other neoplasm. However, still surgical resection and histopathological examination is feasible for diagnosis of schwannoma.



Neurosurgery ◽  
2011 ◽  
Vol 68 (4) ◽  
pp. 974-984 ◽  
Author(s):  
Matthew M. Kimball ◽  
Kelly D. Foote ◽  
Frank J. Bova ◽  
Yueh-Yun Chi ◽  
William A. Friedman

Abstract BACKGROUND: Nonvestibular schwannomas are uncommon tumors of the brain often treated by surgical resection. Surgery may be associated with high morbidity. OBJECTIVE: We present a series of nonvestibular schwannomas treated with linear accelerator radiosurgery during a 19-year period. METHODS: This is a retrospective analysis of patients who underwent treatment of nonvestibular schwannomas at the University of Florida with linear accelerator radiosurgery between August 1989 and February 2008. Forty-nine patients underwent treatment during the study period, and 6 were lost to follow up. The mean age was 51 years (range, 17-82 years), 39% had previous surgical resection, and 67% presented with preradiosurgery cranial nerve deficits. There were 25 trigeminal, 18 jugular foramen, 2 facial, 2 oculomotor, 1 hypoglossal, and 1 high cervical schwannomas. The median tumor volume was 5.3 mL (range, 0.3-24.5 mL), treated with a median dose of 1250 cGy (range, 1000-1500 cGy). Study endpoints were actuarial local tumor control and neurological outcome. RESULTS: Forty-three patients were available for a median follow-up of 37 months (range, 6-210 months). Actuarial local tumor control was 97% at 1 year, 91% at 4.5 years, and 83% at 5 years. There were 4 new cranial nerve deficits (9%) including facial numbness (2 patients), anesthesia dolorosa (1 patient), and facial weakness (1 patient). Thirty-nine percent had documented clinical and/or symptomatic improvement. There were no other morbidity and no mortality with treatment. CONCLUSION: Radiosurgery for nonvestibular schwannomas offers good actuarial local tumor control and has superior morbidity compared with surgical resection. This is the largest linear accelerator radiosurgical series, and the second largest radiosurgical series reported to date.



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