scholarly journals The Correction of The Auricle in Neurofibroma with Aggressive Tumor Removal Principle and Two Stages Total Ear Reconstruction

1970 ◽  
Vol 1 (3) ◽  
Author(s):  
Kristaninta Bangun ◽  
Zung Chung Chen
Keyword(s):  
Satisfactory Result ◽  
Costal Cartilage ◽  
Radical Resection ◽  
Benign Tumors ◽  
Anatomical Site ◽  
Ear Reconstruction ◽  
Tumor Removal ◽  
Two Stage ◽  
Large Tumor ◽  
Aggressive Tumor

Background: Neurofibroma is a major facial hamartoma and is one of the most destructive and debilitating disease affecting the skin, muscle, mucosa, and the skeletal systems. Involvement of the ear usually increases the dimensions of the auricular skin and underlying tissues, distorts normal architecture along with auricular malpositioning, producing an ear that is abnormal in size, shape and position. The correction of the auricle in neurofibroma and benign tumors of the head and neck has been reported, but overall favorable results appear difficult to attain. We present a case of neurofibroma of the auricle in which radical resection was performed, and reconstruction was done in a two-stage surgery with satisfactory result. Patient and Methods: A 30 years-old female presented with type-1 neurofibroma to our office, especially concerned of a large tumor growth on the right auricle. With prior experience in treating microtia cases by Nagata’s method, we performed a two-stage operation on the patient. The first operation involved excising the whole auricular mass, and fabricating as well as grafting of a three-dimensional costal cartilage framework. In the second stage, the ear was elevated.Result: Nine months after the second surgery, the result was satisfactory with good auricular definition attained, and proper elevation of the ear at the correct anatomical site. No sign of neurofibroma recurrence was found on the surrounding reconstructed auricle.Summary: In our experience, the correction Neurofibroma of the ear by using the aggressive tumor removal principle combined with Nagata’s two-stage total ear reconstruction delivered a satisfactory result.

scholarly journals Microtia reconstruction: our experiences of first 10 cases in Bangladesh

1970 ◽  
Vol 1 (2) ◽  
pp. 14-19
Author(s):  
MS Khondoker ◽  
R Awwal ◽  
MM Sarker ◽  
SH Khundkar
Keyword(s):  
Plastic Surgery ◽  
Costal Cartilage ◽  
Three Dimensional ◽  
Ear Reconstruction ◽  
Two Stage ◽  
College Hospital ◽  
Auricular Reconstruction ◽  
Medical College ◽  
Second Stage ◽  
One Year

Varying degrees of congenital ear deformity (microtia) occurs 1 in about 8000 to 10,000 live births. One of the greatest challenges in plastic surgery is total auricular reconstruction as it demands precise technique as well as artistic creativity. In Bangladesh, recent advancement in the technique of carving and sculpting rib cartilage  and better training for achieving finer anatomic details has given a break through in the surgical management of  deformed ear. Between January 2009 and January 2010, total ear reconstruction was done with a two-stage method using  autogenous costal cartilage in the Department of Plastic Surgery, Dhaka Medical College Hospital, Dhaka. In the first stage, lobule rotation, fabrication of the cartilage framework and its implantation were performed. In  the second stage, elevation of the auricle and formation of the tragus were done. A total of 10 cases with microtia comprising different age group have been operated. All of them underwent stage I operation; among them 8 patients went through stage II procedure while the other 2 are waiting for the same. Results: 10 patients, ranging in age between 8 and 25 years, were operated on using autogenous costal cartilage between 2009 and 2010. Six patients were males and four were females. Unilateral microtia was present in all of these patients (7 right, 3 left). Eight cases were with Grade III microtia; the remaining 2 cases presented with Grade II microtia. The follow-up period was one month to one year. Seven among 8 cases presented acceptable ear contour after second stage ear reconstruction. The cranioauricular angle of the reconstructed ears was also similar to that of the opposite ears. Unfavourable result was deformation of the constructed helix which occurred in one case. Though it is impossible to reconstruct an ear that appears exactly as the opposite one, the new ears which were  made were of correct size and in normal position with impressive finer three dimensional details that achieved patient’s satisfaction as well as surgeon’s professional gratification.Key words: Microtia; Two stage auricular reconstruction; Autologous costochondral cartilageBDJPS 2010; 1(2): 14-19

scholarly journals Duodenal Gangliocytic Paraganglioma Requiring a Pancreaticoduodenectomy: A Case Report and Review of the Literature

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Laurie Adams ◽  
Theodore M. Friedman ◽  
Timothy R. Shaver ◽  
George Younan
Keyword(s):  
Radical Resection ◽  
Major Surgery ◽  
Benign Tumors ◽  
Neuroendocrine Neoplasms ◽  
Gangliocytic Paraganglioma ◽  
Appropriate Treatment ◽  
Upper Gastrointestinal Bleed ◽  
Submucosal Resection ◽  
Upper Gastrointestinal ◽  
Caucasian Female

Introduction. Duodenal gangliocytic paragangliomas (GPs) are a subclass of duodenal neuroendocrine neoplasms and are exceedingly rare. They have been associated with an indolent behavior; however, they can rarely metastasize. Radical resection like a pancreaticoduodenectomy is sometimes indicated. We hereby present a case requiring major surgery and perform a literature search about this disease. Presentation of Case. A 49-year-old Caucasian female, who presented with an upper gastrointestinal bleed, was found to have a hypodense mass in the second/third portion of the duodenum. A biopsy of the mass during upper endoscopy was inconclusive. A pancreaticoduodenectomy was recommended based on the high suspicion for a duodenal adenocarcinoma and was performed successfully. Her final pathology revealed a duodenal gangliocytic paraganglioma. Discussion. The majority of duodenal GPs present as gastrointestinal bleeds while others less commonly present with anemia, abdominal pain, duodenal obstructive symptoms, pancreatitis, or abnormal incidental findings on axial abdominal imaging. Duodenal GPs were initially viewed as benign tumors of the duodenum; however, there have been increasing incidence reports of hematogenous and lymphatic metastasis. Appropriate treatment of duodenal GPs is still controversial and ranges from local endoscopic submucosal resection to major radical surgery. Conclusion. Duodenal GPs are very rare tumors of the second portion of the duodenum presenting with upper gastrointestinal bleeding and local symptoms of surrounding organs. Local or radical resection is usually recommended to prevent bleeding and the minor risk of metastatic spread.

scholarly journals Ear Reconstruction Simulation: From Handcrafting to 3D Printing

2019 ◽  
Vol 6 (1) ◽  
pp. 14 ◽  
Author(s):  
Elisa Mussi ◽  
Rocco Furferi ◽  
Yary Volpe ◽  
Flavio Facchini ◽  
Kathleen S. McGreevy ◽  
...  
Keyword(s):  
Costal Cartilage ◽  
Surgical Reconstruction ◽  
Ear Reconstruction ◽  
Autologous Tissue ◽  
Aesthetic Appearance ◽  
History Of ◽  
Common Clinical Practice ◽  
The Aesthetic ◽  
Manufacturing Technologies ◽  
High Level

Microtia is a congenital malformation affecting one in 5000 individuals and is characterized by physical deformity or absence of the outer ear. Nowadays, surgical reconstruction with autologous tissue is the most common clinical practice. The procedure requires a high level of manual and artistic techniques of a surgeon in carving and sculpting of harvested costal cartilage of the patient to recreate an auricular framework to insert within a skin pocket obtained at the malformed ear region. The aesthetic outcomes of the surgery are highly dependent on the experience of the surgeon performing the surgery. For this reason, surgeons need simulators to acquire adequate technical skills out of the surgery room without compromising the aesthetic appearance of the patient. The current paper aims to describe and analyze the different materials and methods adopted during the history of autologous ear reconstruction (AER) simulation to train surgeons by practice on geometrically and mechanically accurate physical replicas. Recent advances in 3D modelling software and manufacturing technologies to increase the effectiveness of AER simulators are particularly described to provide more recent outcomes.

Early results of surgery in patients with nonfunctioning pituitary adenoma and analysis of the risk of tumor recurrence

2008 ◽  
Vol 108 (3) ◽  
pp. 525-532 ◽  
Author(s):  
Marco Losa ◽  
Pietro Mortini ◽  
Raffaella Barzaghi ◽  
Paolo Ribotto ◽  
Maria Rosa Terreni ◽  
...  
Keyword(s):  
Tumor Recurrence ◽  
Postoperative Radiotherapy ◽  
Residual Tumor ◽  
Benign Tumors ◽  
Surgical Removal ◽  
Tumor Diameter ◽  
Tumor Removal ◽  
Early Results ◽  
Results Of Surgery

Object Nonfunctioning pituitary adenomas (NFPAs) are benign tumors of the pituitary gland that typically cause visual and/or hormonal dysfunction. Surgery is the treatment of choice, but patients remain at risk for tumor recurrence for several years afterwards. The authors evaluate the early results of surgery and the long-term risk of tumor recurrence in patients with NFPAs. Methods Between 1990 and 2005, 491 previously untreated patients with NFPA underwent surgery at the Università Vita-Salute. Determinations of recurrence or growth of the residual tumor tissue during the follow-up period were based on neuroradiological criteria. Results Residual tumor after surgery was detected in 173 patients (36.4%). Multivariate analysis showed that invasion of the cavernous sinus, maximum tumor diameter, and absence of tumor apoplexy were associated with an unfavorable surgical outcome. At least 2 sets of follow-up neuroimaging studies were obtained in 436 patients (median follow-up 53 months). Tumors recurred in 83 patients (19.0%). When tumor removal appeared complete, younger age at surgery was associated with a risk of tumor recurrence. In patients with incomplete tumor removal, adjunctive postoperative radiotherapy had a marked protective effect against growth of residual tumor. Conclusions Complete surgical removal of NFPAs can be safely achieved in > 50% of cases. Visual symptoms and, less frequently, pituitary function may improve after surgery. However, tumor can recur in patients after apparently complete surgical removal. In patients with incomplete tumor removal, radiation therapy is the most effective adjuvant therapy for preventing residual tumor growth.

scholarly journals WHEN SHOULD CLEARANCE OF THE HEPATODUODENAL LIGAMENT (STATION 12) DURING RADICAL RESECTION FOR GASTRIC CANCER BE PERFORMED

2016 ◽  
Vol 3 (1) ◽  
pp. 51-55
Author(s):  
I. Negoi ◽  
S. Păun ◽  
S. Hostiuc ◽  
A. Runcanu ◽  
Ruxandra Irina Negoi ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Hepatic Artery ◽  
Radical Resection ◽  
Tumor Location ◽  
Hepatoduodenal Ligament ◽  
Proper Hepatic Artery ◽  
D2 Dissection ◽  
Gastric Tumors ◽  
The Common ◽  
Aggressive Tumor

In Western countries gastric cancer continues to remain a biologically aggressive tumor, with poorlong-term oncological outcomes. In Romania, the estimated gastric cancer was the fifth cause ofoncological death in men and the eighth cause of oncological death in women in 2012.The objectiveof the study is to detail when should the hepatoduodenal ligament (station 12) be cleared surgicallyas a part of D2 dissection during radical gastrectomy.We have performed a review of the Englishlanguage literature using PubMed/Medline library. As keywords we used a combination of thefollowing terms: ‘gastrectomy’, ‘stomach’, ‘cancer’, and ‘lymphadenectomy’. According to theJapanese Gastric Cancer Association, the hepatoduodenal ligament includes the lymph nodesstation 12, which are further divided in 12a – along left side of the proper hepatic artery, 12b –right side of the ligament and posterior to the common bile duct, and 12p – posterior to the portalvein. For middle and lower third gastric tumors, station 12a represents the N2 tier, while for upperthird gastric tumors, it represents the N3 tier. Lymph nodes 12b and 12p represent N3, irrespectiveof the tumor location. For middle and lower third gastric tumors the clearance of the lymph nodessurrounding the proper hepatic artery is a part of the D2 dissection. Dissection of the lymph nodessurrounding the proper hepatic artery is a component of the D2 spleen and pancreas preservinglymphadenectomy, for lesions which extend further than submucosa.

Ensuring the most effective strategy for cancer treatment of patients with brain tumors.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e14000-e14000
Author(s):  
Elena A. Sheiko ◽  
Elena M. Frantsiyants ◽  
Eduard E. Rostorguev ◽  
Irina V. Kaplieva ◽  
Valeria A. Bandovkina ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Brain Tumors ◽  
Blood Plasma ◽  
Histological Analysis ◽  
Malignant Tumors ◽  
Kinetic Method ◽  
Benign Tumors ◽  
Tumor Removal ◽  
Plastic Tube ◽  
Malignant Brain Tumors

e14000 Background: The purpose of the study was to analyze changes in the total activity of trypsin-like proteinases (TLPs) in the blood plasma in patients with brain tumors for the preoperative differential diagnosis of benign, primary and secondary malignant brain tumors. Methods: TLPs were measured in 164 patients with brain tumors. The blood had been collected from the patients in a standard plastic tube with 3.8% sodium citrate (9:1) 3 days prior to the surgery. Citrate blood was centrifuged; citrated plasma was obtained and used to determine the total TLP activity by the unified kinetic method. Results were compared with the data in donors. Results: TLP activity in 37 (22.6%) of 164 patients was within the normal range (258–402 IU/mL, on the average 333.0±27.1 IU/mL). Benign brain tumors (meningioma) were diagnosed in all 37 patients after the tumor removal and histological analysis. In 74 (45.1%) of 164 patients, TLP activity was within 1158–1626 IU/mL (on the average 1331.0±102.4 IU/mL, p < 0.05), i.e. 3.8-5.3 times higher than the norm in donors (malignancy coefficient on average 4.4±0.3 times). Primary malignant brain tumors (glioblastoma) were diagnosed in all 74 patients after the tumor removal and histological analysis. In 53 (32.3%) of 164 patients, TLP activity was within 1794–2868 IU/mL (on the average 2227.0±174.1 IU/mL, p < 0.05), i.e. 5.9-9.4 times higher than the norm in donors (malignancy coefficient on average 7.3±0.5 times). Secondary malignant brain tumors (metastases) were diagnosed in all 53 patients after the tumor removal and histological analysis. Conclusions: The specificity of the proposed method for the differential diagnosis of brain tumors was very high: for benign tumors - 97.2%, for primary malignant tumors - 98.6% and for secondary malignant tumors - 98.1%. So, TLP activity indices in the blood plasma are an informative auxiliary laboratory test that will help in clarifying and/or confirming the differential diagnosis of brain tumors.

Microtia Repair

2019 ◽  
pp. 461-470
Author(s):  
Melissa Kanack ◽  
Catherine Tsai ◽  
Amanda Gosman
Keyword(s):  
Skin Graft ◽  
Costal Cartilage ◽  
Ear Reconstruction ◽  
External Ear ◽  
Cartilage Graft ◽  
Associated Anomalies ◽  
Ear Canal ◽  
Genetic Syndrome ◽  
Definition Of ◽  
Costal Cartilage Graft

Microtia may occur as an isolated finding or in conjunction with other associated anomalies or a genetic syndrome. Ear reconstruction for these patients is typically performed no earlier than 6 years of age. In this chapter, a staged autogenous method of ear reconstruction is described using costal cartilage. In the first stage, a costal cartilage graft is harvested and placed. The next stages involve lobule transposition, detachment of the auricle with placement of a posterior skin graft, and further refinement of the external ear landmarks with tragus creation and definition of the conchal bowl and ear canal.

scholarly journals Study of Bone Tumors in a Tertiary Care Hospital of Dhaka City

2018 ◽  
Vol 5 (1) ◽  
pp. 23-28
Author(s):  
Kazi Nishat Ara Begum ◽  
Syed Salahuddin Ahmed ◽  
Md Ayub Ali ◽  
Md Abdul Gani Mollah ◽  
Md Nurul Amin ◽  
...  
Keyword(s):  
Giant Cell ◽  
Bone Tumors ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Benign Tumors ◽  
Bone Lesions ◽  
Anatomical Location ◽  
Anatomical Site ◽  
Care Hospital ◽  
Orthopedic Rehabilitation

Background: The wide spectrum of bone tumors, their rarity, diverse origin and tendency to produce overlapping anatomic patterns pose a definite diagnostic challenge to the orthopedic surgeons and the pathologists.Objective: The present study was intended to find the pattern of bone tumors and their anatomical locations, and histopathological characteristics in a tertiary care hospital of Dhaka.Methodology: A retrospective review of the histopathological records of patients with established diagnosis of bone tumors at National Institute of Traumatology and Orthopedic Rehabilitation (NITOR), Dhaka, Bangladesh was done from January 2015 to December 2016 for a period of two (02) years. The demographic data such as the age and sex, anatomical location and histopathological findings were studied from the existing records of the patients and their slides were reexamined. Bone lesions of inflammatory origin were excluded from this study leaving the lesions of both neoplastic and tumor-like origin for further study.Result: A total 283 cases of bone lesions were primarily included in the study. Bone lesions of inflammatory origin (n = 65) were excluded from this study leaving 218 lesions of both neoplastic and tumor-like origin for further study. The median age of the patients was 22 (range: 3 – 75) years. In terms of anatomical site of the tumors, over one-third (36.6%) was located in femur 21.1% in tibia, 12.2% in humerus, 6.1% in radius and 5.6% in ulna. In terms of types of bone tumor, 105(48.2%) were benign, 66(30.3%) malignant, 47(21.5%) tumor-like lesions. About 65% of the benign tumors were of Giant cell tumor, 28.5% were osteochondroma, 1% osteoma and 5.7% were of other types. Of the malignant tumors, one-third (33.3%) was of metastatic type, 27.3% Ewing’s sarcoma, 22.7% osteosarcoma, 9.1% chondrosarcoma and 4.6% were of other varieties.Conclusion: Primary bone tumors are mainly benign; however, giant cell and metastatic tumors are the most common benign and malignant bone tumors respectively.Journal of Current and Advance Medical Research 2018;5(1):23-28

scholarly journals Paraganglioma of Prostatic Origin

2012 ◽  
Vol 5 ◽  
pp. CCRep.S9742 ◽  
Author(s):  
B. Padilla-Fernández ◽  
P. Antúnez-Plaza ◽  
M.F. Lorenzo-Gómez ◽  
M. Rodríguez-González ◽  
A. Martín-Rodríguez ◽  
...  
Keyword(s):  
Digital Rectal Examination ◽  
Pelvic Mass ◽  
Radical Resection ◽  
Perineal Pain ◽  
Benign Tumors ◽  
Histopathological Study ◽  
Moderate Increase ◽  
Adrenergic Blockade ◽  
Clinical Criteria ◽  
Young Males

Introduction Paragangliomas are usually benign tumors arising from chromaffin cells located outside the adrenal gland. Prostatic paraganglioma is an unusual entity in adult patients, with only 10 cases reported in the medical literature. Case Report A 34-year-old male with a history of chronic prostatitis consulted for perineal pain. On digital rectal examination the prostate was enlarged and firm, without nodules. The PSA level was 0.8 ng/mL and the catecholamines in the urine were elevated. On ultrasound a retrovesical 9 cm mass of undetermined origin measuring was present. A PET-CT scan showed a pelvic lesion measuring 9 cm with moderate increase in glucidic metabolism localized in the area of the prostate. A biopsy of the prostate revealed a neuroendocrine tumor, possibly a prostatic paraganglioma. A body scintigraphy with MIBG I-123 ruled out the presence of metastases or multifocal tumor. A radical prostatectomy with excision of the pelvic mass was performed under adrenergic blockade. One year after surgery the patient is asymptomatic and disease free. Discussion/Conclusions Prostatic paraganglioma is a rare, usually benign tumor, which should be considered in the differential diagnosis of prostate tumors in young males. Its diagnosis is based on the determination of catecholamine in blood and 24-hour urine and in imaging studies principally scintigraphy with MIBG I-123. Diagnostic confirmation is by histopathological study. The treatment consists of radical resection under adrenergic blockade and volume expansion. Given the limited number of cases reported, it is difficult to establish prognostic factors. Malignancy is defined by clinical criteria, and requires life long follow-up.

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