scholarly journals Parathyromatosis: a very rare cause of recurrent primary hyperparathyroidism – case report and review of the literature

2019 ◽  
Vol 101 (8) ◽  
pp. e178-e183 ◽  
Author(s):  
M Haciyanli ◽  
S Karaisli ◽  
S Gucek Haciyanli ◽  
A Atasever ◽  
D Arikan Etit ◽  
...  
Keyword(s):  
Primary Hyperparathyroidism ◽  
Subcutaneous Tissue ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Pathological Examination ◽  
Rare Entity ◽  
Review Of The Literature ◽  
En Bloc ◽  
First Case ◽  
History Of

Parathyromatosis is a rare entity and usually appears as a consequence of the seeding on previous parathyroid surgery which was applied for the secondary hyperparathyroidism. A 63-year-old woman presented with a history of subtotal thyroidectomy 20 years ago and parathyroidectomy due to primary hyperparathyroidism (PHPT) four years ago. Imaging methods revealed multiple parathyromatosis foci on subcutaneous tissue of the neck. En-bloc resection was performed and pathological examination confirmed the diagnosis of parathyromatosis. After an uneventful 10 months, biochemical and radiological tests revealed recurrence on bilateral thyroid lodges. En-bloc resection was performed. The patient has remained well for 24 months after the second operation and has been followed-up with normal parathormone and serum calcium values. To the best of our knowledge, this report describes the twenty-first case of parathyromatosis in PHPT setting in the literature. It should be kept in mind that parathyromatosis may recur at different sites in the neck even in patients with PHPT.

scholarly journals Parathyroid carcinoma

2006 ◽  
Vol 63 (8) ◽  
pp. 765-769
Author(s):  
Aleksandar Filipovic ◽  
Ivan Paunovic ◽  
Dragutin Savjak ◽  
Tamara Zivkovic
Keyword(s):  
Primary Hyperparathyroidism ◽  
Parathyroid Carcinoma ◽  
Disease Recurrence ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Endocrine Tumors ◽  
En Bloc ◽  
Histologic Diagnosis ◽  
Serum Pth

Background. Parathyroid carcinoma is the least frequent malignancy among endocrine tumors. In the most reported series of patients with primary hyperparathyroidism the incidence of carcinoma is less than 1%. Recognition by a surgeon that the parathyroid tumor is malignant, and the performance of an adequate en bloc removal of primary lesion, with histologic diagnosis offer the best treatment of a patient with this unusual malignancy. Case report. We reported a 30-year-old patient with parathyroid carcinoma, primary hyperparathyroidism, and recurrent nephrocalcinosis. Marked hypercalcemia, low serum phosphorus, and substantial elevation of serum parathyroid hormone indicated a diagnosis of primary hiperparathyroidism. General symptoms were anorexia, muscle weakness, back pain and depression. Ultrasonography done before the surgery revealed a 2 cm upper left parathyroid gland with solid and cystic areas. The neck exploration was done with en block resection of the tumor. A histopathological evaluation confirmed the diagnosis of parathyroid carcinoma. Over more than a three-year-follow-up, the patient had no evidence of the disease recurrence and his serum PTH and calcium levels remained within the normal. Conclusion. Parathyroid carcinoma is a rare cause of primary hyperparathyroidism. Preoperative diagnosis remains a challenge. Radical en bloc resection of the tumor is the treatment of choice for this malignancy.

scholarly journals Successful treatment of multifocal pedal Prototheca wickerhamii infection in a feline immunodeficiency virus-positive cat with multiple Bowenoid in situ carcinomas containing papillomaviral DNA sequences

2017 ◽  
Vol 3 (1) ◽  
pp. 205511691668859 ◽  
Author(s):  
Allan E Kessell ◽  
Derek McNair ◽  
John S Munday ◽  
Richard Savory ◽  
Catriona Halliday ◽  
...  
Keyword(s):  
Dna Sequences ◽  
Feline Immunodeficiency Virus ◽  
Skin Lesions ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
En Bloc ◽  
First Case ◽  
Immunodeficiency Virus ◽  
Prototheca Wickerhamii

Case summary A 16-year-old, castrated male, feline immunodeficiency virus (FIV)-positive, domestic shorthair cat developed multiple skin lesions. Most of these were Bowenoid carcinoma in situ and contained DNA sequences consistent with Felis catus papillomavirus type 2. Two additional lesions that developed in the skin and subcutaneous tissues between the digital and carpal pads on the left forelimb and right hindlimb were shown by cytology, histology and culture to be caused by Prototheca wickerhamii. These lesions failed to improve in response to systemic therapy treatment with itraconazole, but excision by sharp en bloc resection with follow-up oral itraconazole therapy proved curative for one lesion, although the other lesion recurred, necessitating a second surgery. Relevance and novel information This is only the second reported case of feline protothecosis from Australia and the first case that has been cultured and identified to the species level. Also of great interest was the presence of multiple papillomavirus-associated neoplastic lesions, which may have afforded a portal of entry for the algal pathogen and the cat’s positive FIV status; the latter might have impacted on both viral and algal pathogenesis by effects on immunocompetence.

Leiomyosarcoma metastases to the spine

2007 ◽  
Vol 6 (2) ◽  
pp. 178-183 ◽  
Author(s):  
Mohamed Samy A. Elhammady ◽  
Glen R. Manzano ◽  
Nathan Lebwohl ◽  
Allan D. Levi
Keyword(s):  
Spinal Metastases ◽  
Smooth Muscle Tumor ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Initial Presentation ◽  
En Bloc ◽  
Initial Manifestation ◽  
Term Survival ◽  
Imaging Characteristics ◽  
History Of

✓Leiomyosarcoma is a rare malignant smooth-muscle tumor that rarely metastasizes to bone. It is extremely uncommon for osseous metastasis to be the initial presentation of leiomyosarcoma or to be the initial manifestation of recurrence in patients with a history of leiomyosarcoma. The authors have treated four cases of metastatic leiomyosarcoma with the lesion initially presenting in the spine, and a fifth case of disseminated leiomyosarcoma that involved the spine. In their report, they highlight the cases of two of these patients and provide tabular data for the remaining three. The authors performed a comprehensive review of the literature on spinal leiomyosarcomas and retrospective chart reviews of five surgically treated patients in whom a spinal metastatic leiomyosarcoma was diagnosed. Their series consists of five women who ranged in age from 36 to 47 years (mean age 43.2 years). Four patients had known, or presumed, uterine primary lesions, whereas one harbored a retroperitoneal primary tumor. These lesions generally appear as lytic foci on imaging studies, but variable imaging characteristics were observed. All cases were managed aggressively: four patients underwent posterior/posterolateral decompression and fusion, and one underwent anterior–posterior en bloc resection and fusion. In all cases preoperative symptoms resolved. Two patients died 9 and 13 years after initial presentation. The remaining patients are alive and neurologically intact. Metastatic spinal leiomyosarcomas tend to symptomatically involve only one spinal level at the time of diagnosis and are known to recur locally. These lesions commonly affect women in early middle age, and long-term survival, even in those with systemic metastatic lesions, is better than that seen in individuals with more aggressive spinal metastases. Attempted gross-total resection with fusion, as opposed to minimal palliative decompression, is recommended.

Pediatric Malignant Glomus Tumor of the Cervical Paraspinal Tissue: Case Report and Review of the Literature

2020 ◽  
Author(s):  
Andrea Ziegler ◽  
Eric Thorpe
Keyword(s):  
Glomus Tumor ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
The Body ◽  
Long Term Outcomes ◽  
Mesenchymal Tumors ◽  
En Bloc ◽  
Glomus Tumors ◽  
First Case

AbstractGlomus tumors are mesenchymal tumors that arise from glomus bodies and most frequently occur in the distal extremities. These tumors can occur throughout the body and are typically benign. However, a very small fraction of glomus tumors displays aggressive features and are considered atypical or malignant. We report on our experience and management of the first case in the literature of a malignant glomus tumor in a child originating in the paraspinal region with involvement of the cervical spine. Malignant glomus tumors tend to be locally aggressive, and en bloc resection is difficult, especially when the tumors occur in the head and neck. Additional studies on disease progression and adjuvant treatment outcomes are necessary to determine the best treatment approach and long-term outcomes in patients with malignant glomus tumors.

Recurrent cervical stitch sinus arising from the deep neck space after thyroidectomy: case study and review

2021 ◽  
Vol 30 (8) ◽  
pp. 612-616
Author(s):  
Hsing-Fu Chen ◽  
Marios Papadakis ◽  
Seng-Feng Jeng
Keyword(s):  
Past History ◽  
Muscle Flap ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
En Bloc ◽  
Single Centre Study ◽  
History Of ◽  
Surgical Cure

Objective: We describe a one-stage surgical technique for the management of recurrent cervical stitch sinus after thyroidectomy. Method: A retrospective, single-centre study of all patients who were operated on because of cervical neck sinus after thyroidectomy. We provide a detailed description of our surgical approach, based on guided sinus removal after prior tract staining with methylene blue and subsequent obliteration using local strap muscle flap. Results: A total of seven patients with a mean age of 46 years were included in the study. All patients had a past history of thyroidectomy because of goitre (n=5) or thyroid cancer (n=2) which had previously been unsuccessfully debrided two or three times. Surgical sinus removal was successful in all cases and no recurrence was observed during the follow-up time. Conclusions: We conclude that a comprehensive en bloc resection down to the suture granuloma is essential in order to provide surgical cure and prevent recurrence.

Recurring Intracranial Malignant Peripheral Nerve Sheath Tumor: Case Report and Systematic Review of the Literature

Neurosurgery ◽  
2011 ◽  
Vol 68 (4) ◽  
pp. E1152-E1159 ◽  
Author(s):  
Pepijn van den Munckhof ◽  
Menno R. Germans ◽  
Antoinette Y. N. Schouten-van Meeteren ◽  
Foppe Oldenburger ◽  
Dirk Troost ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Presentation ◽  
Cranial Nerves ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Nerve Sheath Tumor ◽  
Review Of The Literature ◽  
En Bloc ◽  
Peripheral Nerve Sheath Tumor ◽  
Nerve Sheath

Abstract BACKGROUND AND IMPORTANCE: To report the clinical presentation and management of an intracranial frontoparietal malignant peripheral nerve sheath tumor (MPNST) and its recurrence in a 6-year-old girl, along with a systematic review of the literature. CLINICAL PRESENTATION: A previously healthy 6-year-old girl presented with severe signs of increased intracranial pressure. Magnetic resonance imaging (MRI) revealed a large heterogeneously enhancing mass at the right frontoparietal convexity. The tumor was completely removed, the histological diagnosis was MPNST, and the patient underwent adjuvant radio- and chemotherapy. Fifteen months later, MRI revealed a small local recurrence. After upfront chemotherapy, the recurrence was removed in a radical, ie, true oncological, neuronavigationally guided, en bloc resection, including approximately 1 cm surrounding gray and white matter and overlying dura mater. Neuropathological examination revealed tumor-free margins. The patient again received adjuvant chemotherapy. Four years after diagnosis and 20 months after cessation of adjuvant therapy, there are no signs of tumor recurrence. The literature search resulted in 17 cases of intracranial MPNSTs not associated with cranial nerves. Despite macroscopically complete resection in many cases and adjuvant radio- and chemotherapy, overall survival was poor, with only 5 patients still alive upon publication (including the current patient). CONCLUSION: Intracranial MPNSTs not associated with cranial nerves are extremely rare and highly malignant tumors with poor overall survival, probably because of infiltrating growth into surrounding brain tissue. We therefore advocate consideration of nonconventional true oncological en bloc resection when approaching this rare tumor or its recurrence.

scholarly journals An IDH1-mutated primary gliosarcoma: case report

2017 ◽  
Vol 126 (2) ◽  
pp. 476-480 ◽  
Author(s):  
Jason K. Hsieh ◽  
Christopher S. Hong ◽  
Sunil Manjila ◽  
Mark L. Cohen ◽  
Simon Lo ◽  
...  
Keyword(s):  
Isocitrate Dehydrogenase ◽  
Brain Mri ◽  
High Grade Glioma ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Low Grade ◽  
Isocitrate Dehydrogenase 1 ◽  
En Bloc ◽  
History Of ◽  
Isocitrate Dehydrogenase Mutation

The authors present the case of a primary gliosarcoma with an isocitrate dehydrogenase-1 (IDH1) mutation. A 75-year-old man presented with a 3-day history of multiple focal seizures and was found on MRI to have a 2.2-cm left parietal enhancing mass lesion. Brain MRI for tremor performed 8 years prior to this presentation was normal. En bloc resection revealed a high-grade glioma with sarcomatous components that was immunoreactive for the R132H variant of IDH1 by antibody. Gliosarcoma is a rare variant of glioblastoma that arises most frequently as a primary tumor, and has equal or worse survival and an increased propensity for extracranial metastases compared with other Grade 4 gliomas. In contrast, isocitrate dehydrogenase-1 and -2 mutations are associated with low-grade gliomas with increased survival and less commonly with glioblastoma. To the authors' knowledge, there has been only 1 other published report of a primary gliosarcoma carrying an isocitrate dehydrogenase mutation. This rare genetic-histological combination highlights potential differences between glioblastoma and gliosarcoma and may warrant additional study.

Upper facet joint en bloc resection for the treatment of thoracic myelopathy caused by ossification of the ligamentum flavum

2013 ◽  
Vol 19 (1) ◽  
pp. 81-89 ◽  
Author(s):  
Zhong Yang ◽  
Yuan Xue ◽  
Qin Dai ◽  
Chao Zhang ◽  
H. Fang Zhou ◽  
...  
Keyword(s):  
Thoracic Spine ◽  
Ligamentum Flavum ◽  
Facet Joint ◽  
Neurological Status ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Pathological Examination ◽  
Thoracic Myelopathy ◽  
En Bloc ◽  
The Mean

Object The authors introduce a novel technique to treat thoracic myelopathy caused by ossification of the ligamentum flavum (OLF): upper facet joint en bloc resection. This surgical procedure avoids surgery to the most heavily compressed cord surface, contact with the cord, and cord injury. The epidural venous plexus bleeding point can be directly seen and easily controlled during the decompression. Methods Between January 2007 and January 2009, thoracic myelopathy caused by OLF was diagnosed in 38 patients using plain radiography, CT, and MRI, and diagnoses were confirmed by postoperative pathological examination. All upper facet joint en bloc resection procedures were performed in 2 steps. First, the bony structures above the upper facet joint surfaces were resected and the upper facet joints were isolated. Second, en bloc resection of the upper facet joint was performed by dissection of the junction between the pedicle and upper facet joint. Intraoperative neurological monitoring was performed in all cases. The modified Japanese Orthopaedic Association (mJOA) scoring system was used to assess neurological status. The degree of postoperative expansion of the spinal cord was calculated on axial MR images. The pre- and postdecompression Cobb angle was applied to assess the magnitude of local kyphosis. Results Of the 38 cases of OLF, 6 were single level, 12 were double level, and 20 were multilevel. Of the 92 ossified segments in this study, 23 (25.0%) were located in the upper thoracic spine (T1–4), 13 (14.1%) were located in the midthoracic spine (T5–8), and 56 (60.9%) were located in the lower thoracic spine (T9–L1). The mean intraoperative blood loss was 340 ± 54 ml. The neurological status improved during follow-up (mean 46.1 months) from a preoperative mean mJOA score of 5.39 ± 1.52 to 8.97 ± 1.22 points (t = 18.39, p < 0.05). The neurological function recovery rate ranged from 28.6% to 100%. The mean increase in pre- and postoperative kyphosis of the involved vertebrae was only 1.3° ± 1.6°. The increase in the cross-sectional area of the dural sac at the level of maximum compression suggested that decompression was complete. Conclusions Upper facet joint en bloc resection is effective and may be a reasonable alternative treatment choice for thoracic myelopathy caused by OLF.

Sign in / Sign up

Export Citation Format

Share Document