scholarly journals Management of extra-abdominal fibromatosis in a musculoskeletal tumour centre in Hong Kong

2021 ◽  
pp. 221049172198908
Author(s):  
Lam Wei Sze Yvette ◽  
Fong Sin Tak ◽  
Mak Ka Lok
Keyword(s):  
Watchful Waiting ◽  
Surgical Excision ◽  
Treatment Modalities ◽  
Management Approach ◽  
Conservative Approach ◽  
Management Options ◽  
Musculoskeletal Tumour ◽  
Female Predominance ◽  
Tumour Location ◽  
Marginal Status

Introduction: Fibromatosis is a benign disease yet prone to recurrence. The best treatment option remains controversial. The purpose of this study was to analyse the management approach in our musculoskeletal tumour centre. Materials and Methods: Thirty-four patients with extra-abdominal fibromatosis referred to our centre between 2000 to 2018 were included. Patients’ demographics, tumour location and size, year of diagnosis, treatment modalities, surgical margins, recurrence, and subsequent management were analysed. Results: Patients mostly presented in the second and third decade, with female predominance. Twenty-seven patients underwent excision. Other management options included ‘watchful waiting’, pharmacological treatment and radiotherapy. Recurrence rate was 51.9%. There was no statistically significant relationship between marginal status and recurrence. Conclusion: We report our experiences on management of fibromatosis, with strategy shifted from early excision to a conservative approach over the years. Surgical excision is still indicated in some situations. Tumour recurrence is not rare but second excision is not always necessary.

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.

Pegfilgrastim-Induced Bone Pain: A Review on Incidence, Risk Factors, and Evidence-Based Management

2017 ◽  
Vol 51 (9) ◽  
pp. 797-803 ◽  
Author(s):  
Donald C. Moore ◽  
Annie E. Pellegrino
Keyword(s):  
Risk Factors ◽  
Bone Pain ◽  
English Language ◽  
Data Extraction ◽  
Treatment Modalities ◽  
Management Options ◽  
Data Synthesis ◽  
Pharmacological Management ◽  
Study Selection ◽  
Incidence Risk

Objective: To review the incidence, risk factors, and management of pegfilgrastim-induced bone pain (PIBP). Data Sources: PubMed was searched from 1980 to March 31, 2017, using the terms pegfilgrastim and bone pain. Study Selection and Data Extraction: English-language, human studies and reviews assessing the incidence, risk factors, and management of PIBP were incorporated. Data Synthesis: A total of 3 randomized, prospective studies and 2 retrospective studies evaluated pharmacological management of PIBP. Naproxen compared with placebo demonstrated a reduction in the degree, incidence, and duration of bone pain secondary to pegfilgrastim. Loratadine was not effective in reducing the incidence of bone pain prophylactically, but a retrospective study evaluating dual antihistamine blockade with loratadine and famotidine demonstrated a decreased incidence in bone pain when administered before pegfilgrastim. Conclusion: Naproxen is effective at managing PIBP. Although commonly used, antihistamines have a paucity of data supporting their use. Dose reductions of pegfilgrastim and opioids may also be potential management options; however, data supporting these treatment modalities are scarce.

Zosteriform Nevus Comedonicus

2020 ◽  
Vol 11 (SPL4) ◽  
pp. 2609-2612
Author(s):  
Babbita S ◽  
Thillaikkarasi A ◽  
Sathyanarayanana R ◽  
Narasimhalu CRV ◽  
Sulochana Sonti
Keyword(s):  
Topical Therapy ◽  
Treatment Options ◽  
Neck Region ◽  
Surgical Excision ◽  
Hair Follicles ◽  
Treatment Modalities ◽  
Developmental Defect ◽  
Linear Distribution ◽  
Head And Neck Region ◽  
Typical Morphology

Nevus comedonicus is an uncommon cutaneous developmental defect of follicular apparatus characterized by unilateral and linear distribution of bundles of dilated hair follicles filled with keratin plugs. It is usually seen on the head and neck region, trunk and upper arm. This condition may be present at birth or can occur later in life. The term nevus comedonicus is a misnomer as there are no true comedones and is better termed as follicular keratotic nevus. It is also known as nevus zoniforme or nevus acneiformis unilateralis. There are two types of nevus comedonicus, namely inflammatory and non-inflammatory (non-pyogenic). When nevus comedonicus is manifested with other extracutaneous symptoms, it is termed as nevus comedonicus syndrome. Diagnosis is mainly clinical, based on history and typical morphology. As the disease runs a benign course, no aggressive treatment is required. Patients seek treatment, especially for cosmetic purposes and inflammatory type of lesions. Various treatment modalities like topical therapy, surgical excision, lasers are available and treatment options are individualized based on the size and extent of the lesion. We herein present a case of unilateral nevus comedonicus with no systemic associations in a 30-year-old female on her lower limb which is not a common site of occurrence.

Efficacy of Different Treatment Modalities for Eye Cancer in Bovines

2021 ◽  
Author(s):  
M. Prasanna Lakshmi ◽  
P. Veena ◽  
R.V. Suresh Kumar ◽  
D. Rani Prameela ◽  
K. Jagan Mohan Reddy
Keyword(s):  
Squamous Cell Carcinoma ◽  
Growth Factor ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Dietary Habits ◽  
Growth Factor Receptor ◽  
Surgical Excision ◽  
Treatment Modalities ◽  
Treatment Protocols ◽  
Hereditary Factors

Background: Bovine ocular squamous cell carcinoma also called cancer eye, represents the most economically important neoplasm in large animals. Hereditary factors, environmental factors (e.g: latitude, altitude, exposure to sunlight), lack of eyelid pigmentation, age and dietary habits have all been reported to play a role in the etiopathogenesis of bovine ocular squamous cell carcinoma. In addition, in cattle the etiology has been linked to a number of viral agents, especially bovine papilloma virus and bovine herpes virus type 1 and 5. Nevertheless, ultraviolet light, viruses and circumocular pigmentation are the major epidemiologic risk factors for the development of the tumor. The efficacy of different treatment modalities for eye cancer in bovines was studied.Methods: All the animals were divided in to four groups of six animals each. Surgical excision, intra lesion BCG vaccine, surgery with auto vaccine and surgery with mitomycin was the treatment protocols followed. Immunohistochemical studies were conducted to know the rate of proliferation of bovine ye cancer. Immunopositive reaction was observed against Vascular Endothelial Growth Factor and Epidermal Growth Factor Receptor in all the cases.Result: The benefits of different treatment modalities depended on nature, type, location and extensiveness of tumor. Early detection and aggressive treatment were essential in the successful management of these tumors. A multimodal treatment approach was recommended with surgery, immunotherapy and chemotherapy in providing 100% disease free interval.

Cytostatic Agents in the Management of Malignant Gliomas

1998 ◽  
Vol 5 (2) ◽  
pp. 150-162 ◽  
Author(s):  
Tom Mikkelsen
Keyword(s):  
Signal Transduction ◽  
Brain Tumors ◽  
Tumor Invasion ◽  
Proteinase Inhibitors ◽  
Malignant Gliomas ◽  
Cytotoxic Agents ◽  
Management Approach ◽  
Cytostatic Agents ◽  
Management Options ◽  
Malignant Brain Tumors

Background: Cytotoxic therapy for malignant gliomas is limited by poor delivery and drug resistance, and local therapy is ineffective in managing migratory cells. However, recent developments in malignant glioma therapy involve trials of cytostatic rather than conventional cytotoxic agents. Methods: The biology of the brain extracellular matrix, tumor invasion, and angiogenesis are reviewed, and the cytostatic agents that inhibit matrix metalloproteinases, angiogenesis, cell proliferation, and signal transduction are discussed, as well as studies of the angiogenic and migratory capacity of malignant brain tumors. Results: Two specific and interrelated areas, anti-invasion (migration) and anti-angiogenesis, are potential areas to develop new treatment strategies. Tumor invasion and angiogenesis are important components of the spread and biologic effects of malignant gliomas. Several proteinase inhibitors are in clinical trial, as well as anti-angiogenic agents and signal transduction cascade inhibitors. Conclusions: Biologic control of brain tumor cell populations may offer a new management approach to add to currently available management options for malignant brain tumors.

scholarly journals Giant Ocular Surface Squamous Neoplasia Wrapping Almost the Whole Cornea: A Case Report

2020 ◽  
Vol 42 (2) ◽  
pp. 94-96
Author(s):  
Poonam Shrestha ◽  
Mukesh Pandey
Keyword(s):  
Ocular Surface ◽  
Histopathological Examination ◽  
Promising Result ◽  
Intraepithelial Neoplasia ◽  
Surgical Excision ◽  
Treatment Modalities ◽  
Ocular Surface Squamous Neoplasia ◽  
History Of ◽  
Grade 3 ◽  
Clinical Pictures

Ocular surface squamous neoplasia (OSSN) includes the dysplastic lesions involving the epithelium of conjunctiva and cornea with various clinical pictures. Histopathological examination of the excised tissue is the benchmark for diagnosis. Surgery, chemotherapy, immunotherapy are the various treatment modalities which in combination shows promising result. We present here a case of 83 years old female patient with history of fleshy mass covering the cornea and the patient was diagnosed clinically as ocular surface squamous neoplasia. Patient underwent surgical excision of the mass followed by cryotherapy. Histopathological examination revealed conjunctival intraepithelial neoplasia of grade 3. Six months after treatment the patient is completely tumor free with no recurrence.

Cranial neuralgias and persistent idiopathic facial pain

2020 ◽  
pp. 237-247
Author(s):  
Aydin Gozalov ◽  
Messoud Ashina ◽  
Joanna M. Zakrzewska
Keyword(s):  
Neuropathic Pain ◽  
Trigeminal Neuralgia ◽  
Facial Pain ◽  
Orofacial Pain ◽  
Treatment Modalities ◽  
Management Approach ◽  
Trigeminal Neuropathy ◽  
Facial Region ◽  
Persistent Idiopathic Facial Pain ◽  
Chronic Orofacial Pain

Orofacial pain is a complex problem and affects up to 7% of the population. Although trigeminal neuralgia has been considered the prime neuralgic condition in the facial region, other forms of neuropathic pain are now being more frequently recognized and require recognition and a different management approach. Many patients with chronic orofacial pain report numerous comorbidities, such as psychiatric or personality disorders, which significantly affect management. Various pain conditions present in the facial region. Some of them rarely present extra-orally (unless as radiating pain) such as atypical odontalgia or persistent dento-alveolar pain disorder and burning mouth syndrome, whereas others will present in both areas such as classical trigeminal neuralgia, post-traumatic trigeminal neuropathy, trigeminal neuropathy attributed to multiple sclerosis, and persistent idiopathic facial pain. Myofascial pain syndrome related to the muscles of mastication is very common and may also be associated with temporomandibular joint problems. Trigeminal neuralgia and the rarer glossopharyngeal neuralgia are similar in quality and characteristics with specific treatment modalities, but differ in pain location. Trigeminal neuropathic pain is caused most frequently by trauma. If no other diagnostic criteria are fulfilled, a diagnosis of persistent idiopathic facial pain is made. It is crucial for these patients to be managed by multidisciplinary teams.

scholarly journals Breaking the Bottleneck: Conflicts Metamorphosis of Chure Landscape Management in Federal Nepal

2018 ◽  
Vol 16 (1) ◽  
pp. 71-86
Author(s):  
Bhola Bhattarai ◽  
Dipak Bishwokarma ◽  
Mathilde Legras
Keyword(s):  
Local Governments ◽  
Community Forestry ◽  
Management Practice ◽  
Landscape Management ◽  
Management Approach ◽  
Resource Exploitation ◽  
Management Options ◽  
Community Conflict ◽  
Environmental Protection Area ◽  
Protection Area

Chure forests, which is one of the youngest and most fragile landscapes of Nepal, continue to be degraded due to resource exploitation and conflict over its management. This region is considered to be the lifeline to down-stream communities - mainly for water - while inhabiting millions of poor and rural people that depend on natural resources - especially forests commons. Government initiatives to manage Chure have escalated contestations in the recent years. Its decision to declare Chure landscape as ‘Environmental Protection Area’ manifests a protection-centric management approach. This research scrutinises the genesis of contestation on Chure management utilising three–elements of conflicts described by Brown et al. (2017). It analyses power–relation to demonstrate potential implications on Chure landscape management as well as conflict resolution options, in the changed political context of federal Nepal. Our research reveals that all stakeholders are well aware of the continuous degradation of Chure landscape and have agreed on discovering the common locus of sustainable management. However, the state-community contestation still persists due to divergent understandings of degradation. Despite multiple strands of management options, contextualised community-based approach still appears to be an appropriate option to solve this persistent contestation, building on the practices of community forestry and historic failures of top-down, protection-centric management practice. The newly elected provincial and local governments could further facilitate a more effective management of Chure landscape through resolving the contentious state-community conflict.

scholarly journals Nodular fasciitis of the parotid gland engulfing the facial nerve: a conservative approach

2019 ◽  
Vol 12 (10) ◽  
pp. e231203
Author(s):  
Stephen Bennett ◽  
Kristian Hutson ◽  
Olakunle Ajayi ◽  
Andreas Hilger
Keyword(s):  
Parotid Gland ◽  
Facial Nerve ◽  
Benign Lesion ◽  
Surgical Excision ◽  
Needle Aspiration ◽  
Nodular Fasciitis ◽  
Conservative Approach ◽  
Complete Excision ◽  
Diagnostic Uncertainty ◽  
Accepted Practice

Nodular fasciitis (NF) is a rapidly growing benign lesion rarely reported in the parotid gland. It shares cytological features with other benign and malignant parotid neoplasms and may be difficult to diagnose based on fine needle aspiration cytology alone. Given this diagnostic conundrum, surgical excision for histology is recommended to facilitate definitive diagnosis. A case with significant involvement of the facial nerve is described, which has not previously been reported in the literature. Despite features of potential malignancy, the decision was taken to biopsy the lesion and not proceed to complete excision in an attempt to reduce the risk of facial nerve injury. Expert opinion later diagnosed NF. Contrary to accepted practice, where diagnostic uncertainty remains around the malignant potential of a lesion, risks and benefits of complete excision versus a conservative approach should be carefully weighed especially when the facial nerve is involved and NF is a possible diagnosis.

scholarly journals Keloids: Current and emerging therapies

2020 ◽  
Vol 6 ◽  
pp. 205951312094049
Author(s):  
Nkemcho Ojeh ◽  
Ambadasu Bharatha ◽  
Uma Gaur ◽  
Andrew LeRoy Forde
Keyword(s):  
Molecular Biology ◽  
Botulinum Toxin Type A ◽  
Scar Formation ◽  
Treatment Modalities ◽  
Management Options ◽  
Converting Enzyme Inhibitors ◽  
Pressure Therapy ◽  
Impaired Wound Healing ◽  
Recent Advances ◽  
Emerging Therapies

Keloids are pathological scars that grow over time and extend beyond the initial site of injury after impaired wound healing. These scars frequently recur and rarely regress. They are aesthetically disfiguring, can cause pain, itching, discomfort as well as psychological stress, often affecting quality of life. Many treatment modalities, including surgical and non-surgical, have been explored and have been reported to be beneficial; however, none have been absolutely satisfactory or optimal for the treatment of all keloid subtypes to date. This poses a major challenge to clinicians. Often, a combinational therapeutic approach appears to offer the best results with higher patient satisfaction compared to monotherapy. The aetiopathogenesis of keloids is not fully elucidated; however, with recent advances in molecular biology and genetics, insight is being gained on the complex process of scar formation and hence new therapeutic and management options for keloids. In this paper, we explore the literature and summarise the general concepts surrounding keloid development and review both current (corticosteroids, surgical excision, silicone-based products, pressure therapy, radiotherapy, cryotherapy, laser therapy, imiquimod and 5-fluorouracil) and emerging (stem cell therapy, mitomycin C, verapamil, interferons, bleomycin, botulinum toxin type A and angiotensin-converting enzyme inhibitors) treatments. Increased knowledge and understanding in this area may potentially lead to the discovery and development of novel therapeutic options that are more efficacious for all keloid types. Lay Summary [Formula: see text] Keloids are problematic scars that are difficult to treat and manage. The aetiopathogenesis of keloids is not clear; however, recent advances in molecular biology and genetics are beginning to shed light on the underlying mechanisms implicated in keloid scar formation which will hopefully lead to the development of treatment options for all keloid types. This review summarises current and emerging therapies.

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