scholarly journals Giant Epignathus Teratoma Discovered at Birth: A Case Report and 7-Year Follow-Up

2017 ◽  
Vol 28 (2) ◽  
pp. 256-261 ◽  
Author(s):  
Cyntia Helena Pereira de Carvalho ◽  
Cassiano Francisco Weege Nonaka ◽  
Cassandra Teixeira Valle Elias ◽  
Rita de Cassia Simões Matheus ◽  
Roberto Menezes Bezerra Dias ◽  
...  
Keyword(s):  
Surgical Repair ◽  
Mature Teratoma ◽  
Clinical Signs ◽  
Microscopic Analysis ◽  
Rare Condition ◽  
Residual Tumor ◽  
Complete Regression ◽  
Surface Areas ◽  
Cell Layers

Abstract Teratomas are tumors composed by tissues derived from the three germ cell layers, and they are relatively uncommon in head and neck. The term epignathus has been applied to teratomas from the oropharynx. This paper reports the case of a giant epignathus teratoma discovered at birth, which was successfully managed and followed up for 7 years. A newborn boy presented a polypoid tumor mass exteriorizing through the mouth over a length of 9 cm, with some surface areas resembling skin and others exhibiting hair. Computed tomography showed that the mass arose deep from the left hemiface. Alpha-fetoprotein (AFP) levels were high (316,000 ng/mL). Surgery was performed and microscopic analysis confirmed the diagnosis of mature teratoma. Because of residual tumor and high AFP levels, the patient was submitted to chemotherapy, resulting in complete regression of the lesion and normalization of AFP levels. Surgical repair of a cleft palate was performed at 5 years of age. At 7 years of age, the patient was in good general health and showed no clinical signs of recurrence. Although epignathus is a rare condition, it should be diagnosed in the fetus as early as possible. Prenatal care provides unquestionable benefits, providing the early diagnosis of anomalies that can jeopardize the life of the fetus and contributing to the indication of cases that require treatment before birth.

scholarly journals Oral Epignathus with Maxilla Duplication: Report of a Rare Case

2019 ◽  
Vol 12 (1) ◽  
pp. 62-66
Author(s):  
Roberto S. Tunes ◽  
Gabriel Z. Cavalcanti ◽  
José Mauro O. Squarisi ◽  
Lucas G. Patrocinio
Keyword(s):  
Mature Teratoma ◽  
Clinical Signs ◽  
Microscopic Analysis ◽  
Rare Condition ◽  
Benign Tumors ◽  
Unique Case ◽  
Contrast Enhanced ◽  
Female Predominance ◽  
Uncommon Case ◽  
Tomography Scan

Epignathus is a rare congenital oropharyngeal teratoma that arises from the oropharynx, especially the sphenoid, palatine, and ethmoid bones. Teratomas are benign tumors containing cells from ectodermal, mesodermal, and endodermal layers. The incidence of epignathus is between 1:35,000 and 1:200,000 live births with a female predominance. We reported an uncommon case of epignathus in a female newborn baby with an ill-defined oral mass protruding through a cleft in the hard palate. Computed tomography scan showed a contrast-enhanced solid mass with areas of calcification simulating a unique case of maxilla duplication. Surgery was performed, the mass was excised successfully, and microscopic analysis confirmed the diagnosis of mature teratoma. The patient evolved with good general health and showed no clinical signs of recurrence. Although epignathus is a rare condition, it should be diagnosed in the fetus as early as possible, especially to avoid fatal airway obstruction. In such cases, the treatment option is exclusively surgical, and complete resection is curative in most cases during the early neonatal period.

scholarly journals Acute otitis media in an infant complicated with osteoarthritis of temporomandibular joint and sub-periosteal abscess of the clavicle

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Kaoutar Cherrabi ◽  
Hind Cherrabi
Keyword(s):  
Septic Arthritis ◽  
Temporomandibular Joint ◽  
Nutritional Assessment ◽  
Acute Otitis Media ◽  
Clinical Signs ◽  
Rare Condition ◽  
Pediatric Emergency ◽  
Ear Infections ◽  
The Right

Abstract Background Otomastoiditis is a very frequent affection and a current complication of mal-treated benign ear infections in children. However, this a very rare case of the association of two rare complications of otomastoiditis in a newborn. On the one hand, septic arthritis of the temporomandibular joint which is a very rare condition that is difficult to diagnose, and when unrecognized or not treated accordingly, it can resolve in serious infectious complication and or definitive injury to the temporomandibular joint. On the other hand, osteomyelitis of the clavicle is also very rare, and only a few cases have been cited in the literature concerning infants. Case presentation This 46-day-old infant was brought to pediatric emergency consultation for 2 swelling inflammatory bulges, one in the right mastoid and pre-auricular regions, and another in the right basi-cervical area. The infant was hypertrophic febrile, hypotonic, and pale. He had preserved archaic reflexes. Besides, blood test showed an inflammatory syndrome, inflammatory anemia, and no other abnormalities. Upon supplementary computed tomodensitometry exam, the diagnosis of a combination of septic arthritis of the right temporomandibular joint and sub-periosteal abscess of the ipsilateral clavicle in a context of hypotrophy and malnutrition was suspected. A pus sample was obtained for bacteriological evaluation, after which the infant had a course of intravenous associated antibiotics, along with nutritional assessment and management. Surgical drainage of both collections was performed. The 6-month follow-up was satisfactory, without clinical signs of functional impact on temporomandibular joint, or acromioclavicular joint. Conclusion This work stresses the necessity of thorough clinical examination of infants even in cases of benign ear infections, as well as the importance of adapted treatment and follow-up, which could allow early diagnosis, appropriate treatment, or even prevention of severe complications that can be associated with such benign conditions.

Slide Tracheoplasty in the Management of Congenital Tracheal Stenosis

1997 ◽  
Vol 106 (11) ◽  
pp. 914-919 ◽  
Author(s):  
Steven H. Dayan ◽  
Michael E. Dunham ◽  
Constantine Mavroudis ◽  
Carl L. Backer ◽  
Lauren D. Holinger
Keyword(s):  
Early Diagnosis ◽  
Tracheal Stenosis ◽  
Surgical Repair ◽  
Surgical Intervention ◽  
Rare Condition ◽  
Pericardial Patch ◽  
Congenital Tracheal Stenosis ◽  
Slide Tracheoplasty ◽  
Lost To Follow Up

Long-segment congenital tracheal stenosis (LSCTS) is a rare condition. Originally, it was felt to be uniformly fatal; however, advances in technique have made surgical repair and survival possible. Our objective is to report results and technique of slide tracheoplasty for the treatment of LSCTS in the context of the overall experience at the Children's Memorial Hospital in Chicago. We reviewed 37 cases of infants and children with LSCTS. Thirty of the 37 infants underwent surgical intervention. Slide tracheoplasty resulted in survival in 1 of 2 infants, and pericardial patch tracheoplasty resulted in survival in 21 of 28 (75%). Of the 30 patients who had surgical repair, 7 (23%) have died, and 1 has been lost to follow-up (3%). Follow-up has ranged from 6 months to 13 years. Slide tracheoplasty is a satisfactory adjunct to existing techniques. With early diagnosis and appropriate management of LSCTS, survival is possible in a majority of patients.

Preliminary evaluation of chemotherapy plus residual tumor excision for testis conservation to provide justification for a randomized trial versus orchidectomy to reduce metabolic syndrome in patients with germ cell cancer

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 5087-5087
Author(s):  
R. Oliver ◽  
J. Shamash ◽  
V. Nargund
Keyword(s):  
Metabolic Syndrome ◽  
Randomized Trial ◽  
Primary Tumour ◽  
Mature Teratoma ◽  
Cell Cancer ◽  
Residual Tumor ◽  
Stage I ◽  
Testicular Atrophy ◽  
Preliminary Evaluation

5087 Background: There is evidence that early andropause due to testicular atrophy may be playing a role in the increased metabolic syndrome and cardiac deaths seen with follow up of GCC patients even those on surveillance. In a randomized trial of 1,477 stage I seminomas a single course of carboplatin produced a 78% reduction of contra lateral testicular GC. This, has increased awareness of the effectiveness of chemotherapy on primary tumours This abstract updates our experience.assessing chemo-response of primary GCC in past 30 years. Methods: Testicular GCC patients receiving chemotherapy with primary tumour in situ during 1978–2001 have been reviewed. 62 had advanced disease and 20 had stage I. Results: In 30/82 (37%) the testis normalised and was retained. Median follow-up is 132 months. 7 of these patients developed second GCC. Actuarial 5, 10, and 15 year relapse free survival was 81% and 76%. All relapses are new tumours without evidence of metastasis and are disease free after orchidectomy alone (15, 17, 35, 45, 48, 72, and 156 months). 22 additional patients (28%) who underwent orchidectomy for apparent treatment failure had necrotic tissue/mature teratoma involving less than 50% of the testis and could have been candidates for tumour enucleation. Patients with stage 1 tumours and seminoma histology showed significantly higher preservation rate that approached 100% if one included those showing necrosis or mature teratoma involving less than 50% of the testis. There have been 6 pregnancies to date in wives of 3 patients. 5 of 6 patients studied in detail have recovered sperm, the highest count (100x106) being the only patient who was successfully treated for bilateral testis tumours. Conclusions: This preliminary study suggests that up to 50% of all cases and 90% of stage I seminoma cases with tumours small enough for tumour enucleation for incomplete responders could have successful testis preservation after chemotherapy safely up to 10 years though in the future a randomized patient preference driven trial is needed to establish its acceptability, safety and value in reducing androgen deficiency. No significant financial relationships to disclose.

scholarly journals Long-term follow-up of a cat with an undetermined osteoporotic bone disease managed with multiple intramedullary pins

2020 ◽  
Vol 6 (2) ◽  
pp. 205511692096401
Author(s):  
Dongwook Kim ◽  
Hyejong Oh ◽  
Ki-Jeong Na ◽  
Dongwoo Chang ◽  
Gonhyung Kim
Keyword(s):  
Surgical Repair ◽  
Histopathological Examination ◽  
Clinical Signs ◽  
Osteoporotic Bone ◽  
Mineral Density ◽  
Trabecular Bone Mineral Density ◽  
Intramedullary Pinning ◽  
Long Term Follow Up

Case summary Osteogenesis imperfecta (OI) is an inherited disorder related to the synthesis of type 1 collagen. Clinical signs of pain from the fracture of fragile bones are common. A 3-month-old male Chinchilla cat was presented for lameness and pain from a right femoral fracture. After surgical repair using intramedullary pins, and since repeated fractures occurred and there is little information about genes causing OI in cats, various examinations were performed to discriminate other diseases that could cause the pathological fracture. Primary hyperparathyroidism and nutritional or renal secondary hyperparathyroidism were ruled out through blood tests and ultrasonography. Quantitative CT confirmed low trabecular bone mineral density compared with normal cats. Radiography and histopathological examination revealed thin cortical bone. OI was tentatively diagnosed and long-term follow-up of the surgical repair was reviewed. Fractures were treated using intramedullary Kirschner wires. The same method of intramedullary pinning was then applied preventively to protect several other long bones by improving stress distribution and bending resistance. Follow-up was performed for 3 years until the patient’s death due to undetermined reasons. Relevance and novel information Although the patient underwent repeated fractures and bone unions, and needed medication for pain management sometimes, it was generally able to live as a companion cat. Therefore, palliative preventive intramedullary pinning could be used for long-term management of patients suspected of OI.

scholarly journals Intramural duodenal hematoma: clinical course and imaging findings

2019 ◽  
Vol 8 (4) ◽  
pp. 205846011983625 ◽  
Author(s):  
Stefan M Niehues ◽  
Timm Denecke ◽  
Christian Bassir ◽  
Bernd Hamm ◽  
Matthias Haas
Keyword(s):  
Clinical Signs ◽  
Rare Condition ◽  
Duodenal Wall ◽  
Imaging Findings ◽  
Ultrasound Computed Tomography ◽  
Long Term Follow Up ◽  
Duodenal Hematoma ◽  
The Mean

Background Intramural duodenal hematoma is a rare condition. Different imaging modalities are at hand for diagnosis. Purpose To identify patients with intramural duodenal hematoma and report imaging findings and clinical courses. Material and Methods Typical imaging patterns using ultrasound, computed tomography, and magnetic resonance imaging were carried out on 10 patients. Results The mean patient age was 7.5 years. The average disease duration was 13 months. Clinical signs of improvement were observed within 16 days. Residues were still detectable at long-term follow-up. Conclusion For patients with intramural duodenal wall hematoma, diagnosis should be considered early. Typical imaging findings should be known to ensure optimal treatment.

Nonunion of a Fracture of the Lateral Malleolus: A Case Report and Review of the Literature

1997 ◽  
Vol 18 (1) ◽  
pp. 50-52 ◽  
Author(s):  
Nahshon Rand ◽  
Ram Mosheiff ◽  
Meir Liebergall
Keyword(s):  
Internal Fixation ◽  
Clinical Signs ◽  
Rare Condition ◽  
Autologous Bone Graft ◽  
Male Gender ◽  
Lateral Malleolus ◽  
Review Of The Literature ◽  
Weber Type ◽  
Type C

Nonunion of a fracture of the lateral malleolus is a rare condition. We present a case of established nonunion of a fracture of the lateral malleolus confirmed and treated surgically, using debridement and internal fixation with autologous bone graft. At 5-year follow-up, the fracture was united but the patient still showed clinical signs of reflex sympathetic dystrophy. Male gender, supination fractures, Weber type C fractures, and primary internal fixation are cited as possible risk factors. Prognosis is variable.

scholarly journals Sequelae of congenital oropharyngeal teratoma in the oral cavity of the child

2021 ◽  
Vol 9 (7) ◽  
pp. 173-183
Author(s):  
Letícia Bruno Qualhato ◽  
Ana Carolina Candelas Peixoto ◽  
Késia Lara dos Santos Marques ◽  
Celia Regina Moreira Lanza ◽  
Luiz Roberto da Silva ◽  
...  
Keyword(s):  
Oral Cavity ◽  
Bone Growth ◽  
Mature Teratoma ◽  
Residual Tumor ◽  
Female Child ◽  
Main Complaint ◽  
Adjacent Structures ◽  
Palate Bone ◽  
Caries Lesions

Congenital oropharyngeal teratoma is a rare tumor subtype with cells from the three germ layers, majorly being benign. Whereas teratoma develops early in intrauterine life, thus affecting the growth and development of adjacent structures, the purpose of this case report is to present the sequelae of this tumor in a child's oral cavity. Female child, 2 years and 3 months old referred by the otorhinolaryngologist for dental evaluation. The mother´s main complaint was the the child could not close her mouth. According to the child's medical record, at 34th week of gestation, during the routine ultrasound examination, the presence of the anechoic tumor mass was observed without Doppler signal, presenting a 3.2cm x 2.4cm diameter outside through the oral cavity. At 17 and 32 days of life, respectively, the excision of the largest and residual tumor located on the floor of the mouth was performed. Upon anatomopathological examination, the tumor with was classified as a mature teratoma. In the intraoral examination, a deep and atresia palate incomplete cleft palate, bone growth in the region of the posterior alveolar ridge of the maxilla, and in the posterior region of the mandible on the left side, "V" shaped mandible and microglossia, crowding were observed dental agenesis of the lower lateral incisors, absence of caries lesions, gingivitis and enamel development defects. The child will remain under the regular dental pediatric follow-up. Several sequelae were observed in the child's oral cavity and the need for multi-professional follow-up after excision of congenital oropharyngeal teratoma.

State-of-the-art aortic imaging: Part II - applications in transcatheter aortic valve replacement and endovascular aortic aneurysm repair

VASA ◽  
2014 ◽  
Vol 43 (1) ◽  
pp. 6-26 ◽  
Author(s):  
Fabian Rengier ◽  
Philipp Geisbüsch ◽  
Paul Schoenhagen ◽  
Matthias Müller-Eschner ◽  
Rolf Vosshenrich ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Transcatheter Aortic Valve Replacement ◽  
Surgical Repair ◽  
Imaging Modality ◽  
Open Surgical Repair ◽  
Cross Sectional ◽  
Transcatheter Aortic Valve ◽  
Cross Sectional Imaging ◽  
Sectional Imaging

Transcatheter aortic valve replacement (TAVR) as well as thoracic and abdominal endovascular aortic repair (TEVAR and EVAR) rely on accurate pre- and postprocedural imaging. This review article discusses the application of imaging, including preprocedural assessment and measurements as well as postprocedural imaging of complications. Furthermore, the exciting perspective of computational fluid dynamics (CFD) based on cross-sectional imaging is presented. TAVR is a minimally invasive alternative for treatment of aortic valve stenosis in patients with high age and multiple comorbidities who cannot undergo traditional open surgical repair. Given the lack of direct visualization during the procedure, pre- and peri-procedural imaging forms an essential part of the intervention. Computed tomography angiography (CTA) is the imaging modality of choice for preprocedural planning. Routine postprocedural follow-up is performed by echocardiography to confirm treatment success and detect complications. EVAR and TEVAR are minimally invasive alternatives to open surgical repair of aortic pathologies. CTA constitutes the preferred imaging modality for both preoperative planning and postoperative follow-up including detection of endoleaks. Magnetic resonance imaging is an excellent alternative to CT for postoperative follow-up, and is especially beneficial for younger patients given the lack of radiation. Ultrasound is applied in screening and postoperative follow-up of abdominal aortic aneurysms, but cross-sectional imaging is required once abnormalities are detected. Contrast-enhanced ultrasound may be as sensitive as CTA in detecting endoleaks.

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