scholarly journals Efficacy of intralesional bleomycin in treatment of lymphangiomas in children: an observational study

2017 ◽  
Vol 5 (1) ◽  
pp. 238
Author(s):  
Arun M. Ainippully ◽  
Ranjit P. ◽  
Arun Preeth V. ◽  
Prathap S.
Keyword(s):  
Observational Study ◽  
Lymphatic Vessels ◽  
Neck Region ◽  
Poor Response ◽  
Surgical Excision ◽  
Ultrasound Measurement ◽  
P Value ◽  
Paediatric Surgery ◽  
Excellent Response ◽  
Pediatric Age Group

Background: Lymphangioma, a benign slow growing tumor of lymphatic vessels, common to the pediatric age group usually presents as swelling with cosmetic deformity. Commonly affecting the head and neck region it may present with compressive symptoms like airway obstruction or dysphagia. Previously surgical excision was the treatment of choice but it involves significant risks and so sclerotherapy has gained popularity. We conducted this prospective observational study to hava a quantitative analysis of the effect of intralesional bleomycin in reducing the size of lymphangiomas in children in our setup.Methods: This observational study was conducted in the paediatric surgery department between 2014 and 2016. A total of 34 children who presented with swellings which were diagnosed to be lymphangiomas based on clinical and sonological basis were included in the study and underwent intralesional bleomycin sclerotherapy. Details like dimensions of the lesion before and after the treatment, ultrasound measurement, residual size, characteristic of the cyst like presence or absence of septation, micro or macrocytic were recorded along with demographic details like age and sex. Outcome after 4 weeks was evaluated and classified into 3 groups as in excellent response, good response or poor response. Statistical analysis was done using R statistical software.Results: Of the 34 patients 59% were males. The median age was 18 months with inter-quartile range 4-36 months. 88% of patients had macrocystic lesions. 4 weeks after bleomycin sclerotherapy excellent response was seen in 23 (68%) of the patients, good in 8 (26%) and poor in 3 (9%) of the patients. There was statistically significant association between post procedure swelling, type of cysts and presence of septations and the number of sittings required to the outcome (p value <0.05).Conclusions: Present study shows that intralesional bleomycin sclerotherapy is very effective in the treatment of lymphangiomas in children, with macrocystic lesions showing a significantly better response.

scholarly journals Lymphangioma Circumscriptum in an Adult: An Unusual Oral Presentation

2013 ◽  
Vol 3 ◽  
pp. 44 ◽  
Author(s):  
C. Ganesh ◽  
G. S. Sangeetha ◽  
Vivek Narayanan ◽  
T. N. Umamaheswari
Keyword(s):  
Case Report ◽  
Color Doppler ◽  
Lymphatic Vessels ◽  
Neck Region ◽  
Color Doppler Imaging ◽  
Surgical Excision ◽  
Complete Removal ◽  
Doppler Imaging ◽  
Posterior Triangle ◽  
Lymphangioma Circumscriptum

Lymphangioma is a benign hamartomatous tumor of lymphatic vessels. This lymphatic malformation is characterized by an abnormal proliferation of lymphatic vessels. Extra-oral lymphangiomas occur more frequently in the neck region predominantly in the posterior triangle, while intra-oral lymphangiomas are commonly seen in the tongue mainly on the dorsum surface. Various imaging modalities such as ultrasound and color Doppler are very useful in viewing the extent of the lesion. In most of the cases, surgical excision is the treatment of choice. The prognosis is good for most patients, but recurrence has also been reported in some cases, presumably because the lesion is interwoven between muscle fibers, preventing complete removal. This case report discusses the clinical features, color Doppler imaging, histopathology, and treatment of lymphangioma.

scholarly journals Cervicofacial lymphatic malformations: diagnosis and management

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Rachida Bouatay ◽  
Badii Hmida ◽  
Malek Hajjej ◽  
Amira Farhati ◽  
Khaled Harrathi ◽  
...  
Keyword(s):  
Head And Neck ◽  
Lymphatic Vessels ◽  
Neck Region ◽  
Surgical Excision ◽  
Primary Treatment ◽  
Benign Tumors ◽  
Lymphatic Malformations ◽  
Therapeutic Modalities ◽  
Sclerosing Agents ◽  
Primary Treatment Modality

Abstract Background Lymphatic malformations are rare benign tumors that result from congenital and acquired alterations of the lymphatic vessels. They occur most commonly on the head and neck region. The aim of this study is to describe clinical profiles of lymphatic malformations of the head and neck (LMHN) as well as to study therapeutic modalities through our series and review of the literature. Results This is a retrospective record-based descriptive study conducted in the ENT and the Radiology departments over a 17-year period. Our study included twelve patients, aged between 8 months and 52 years. Two swellings were present at birth and had not been prenatally diagnosed in both cases. One patient was affected by TRISOMY 21. All patients consulted for a painless mass of the head or neck. Seven masses were located in the suprahyoid region and five in the infrahyoid region. Ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI) were realized to establish the diagnosis and assess the extent of the lesions. Surgical excision was performed in 7 patients. It was complete in 6 patients. Five patients were treated with sclerotherapy. The sclerosing agents used were Aetoxisclerol 2%, hypertonic saline, and absolute alcohol. One patient had a reversible paresis of the left mental nerve after surgery. An excellent response to sclerotherapy with complete resolution was obtained in 3 cases with no recurrence of the disease. Conclusions Surgical excision has been the management option of choice for LMHN. The recent advances in sclerotherapy make it safe and effective as a primary treatment modality for these lesions.

scholarly journals POS0441 DEVELOPMENT OF RHEUMATOID ARTHRITIS AMONG ANTI-CITRULLINATED PROTEIN ANTIBODIES POSITIVE ASYMPTOMATIC INDIVIDUALS: A PROSPECTIVE OBSERVATIONAL STUDY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 449.1-449
Author(s):  
S. Mizuki ◽  
K. Horie ◽  
K. Imabayashi ◽  
K. Mishima ◽  
K. Oryoji
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Observational Study ◽  
Rheumatoid Factor ◽  
Prospective Observational Study ◽  
Enzyme Linked Immunosorbent Assay ◽  
P Value ◽  
Healthy Population ◽  
Asymptomatic Individuals ◽  
Citrullinated Protein

Background:In the idividuals with genetic and enviromental risk factors, immune events at mucosal surfaces occur and may precede systemic autoimmunity. Anti-citrullinated protein antibodies (ACPA) are present in the serum for an average of 3-5 years prior to the onset of rheumatoid arthritis (RA) during an asymptomatic period. In ACPA-positivite individuals, the additional presence of RA-related risk factors appears to add significant power for the development of RA. To date, there have been few reports in which clinical courses of ACPA-positive asymptomatic individuals were investigated prospectively.Objectives:To observe the clinical time course of ACPA-positive healthy population for the development of RA.Methods:Healthy volunteers without joint pain or stiffness, who attended the comprehensive health screening of our hospital, were enrolled in this prospective observational study. The serum ACPA levels were quantified by Ig-G anti-cyclic citrullinated peptide enzyme-linked immunosorbent assay with levels > 4.4 U/mL considered positive. ACPA-positive subjects were followed by rheumatologists of our department clinically or a questionnaire sent by mail for screening to detect arthritis.Results:5,971 healthy individuals without joint symptons were included. Ninty-two (1.5%) were positive for ACPA. Of these, 19 (20.7%) developed RA and two were suspected as RA by mail questionnaire. Their average age were 58-years, and women were 68%. The average duration between the date of serum sampling and diagnosis was 10.7 months. ACPA-positive individuals who developed to RA had higher serum ACPA and Ig-M rheumatoid factor levels than ACPA-positive individuals who did not (P value by Mann-Whitney U test: 0.002, 0.005, respectively).Conclusion:Among ACPA-positive asymptomatic individuals, 20% developed RA. The higher titer of ACPA and Ig-M rheumatoid factor levels are risk factors for devoloping RA.Disclosure of Interests:None declared

scholarly journals Helicobacter pylori eradication in patients with type 2 diabetes mellitus: Multicenter prospective observational study

2019 ◽  
Vol 7 ◽  
pp. 205031211983209 ◽  
Author(s):  
Seung-Joo Nam ◽  
Sung Chul Park ◽  
Sang Hoon Lee ◽  
Dong Wook Choi ◽  
Sung Joon Lee ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Eradication Rate ◽  
Laboratory Data ◽  
P Value ◽  
Diabetic Patients ◽  
Multicenter Prospective Observational Study ◽  
H Pylori

Objective: To compare Helicobacter pylori ( H. pylori) eradication rate of type 2 diabetic patients with non-diabetic subjects. Methods: In this multicenter prospective observational study, H. pylori-infected subjects were enrolled from three university-affiliated hospitals. Eradication regimen was triple therapy with standard dose of proton pump inhibitors (b.i.d), amoxicillin (1.0 g b.i.d), and clarithromycin (500 mg b.i.d) for 7 days. Urea breath test was performed 4 weeks after treatment. Various clinical and laboratory data were collected for identification of factors associated with successful eradication. Results: Totally, 144 subjects were enrolled and 119 (85 non-diabetic and 34 diabetic patients) were finally analyzed. Eradication rate was 75.6% and there was no difference between diabetic patients and non-diabetic subjects (73.5% vs 76.5%, p value: 0.814). Adverse drug reactions were reported in 44.5% of patients. In multivariate analysis for predicting H. pylori eradication in diabetic patients, HbA1c (⩾7.5%) was a significant factor affecting eradication rate (adjusted odds ratio: 0.100, 95% confidence interval: 0.011–0.909, p value: 0.041). Conclusion: Diabetes itself is not a major factor affecting H. pylori eradication. However, poor glucose control may harmfully affect H. pylori eradication.

scholarly journals Basal Cell Carcinoma of the Head and Neck Region in Ethnic Chinese

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Velda Ling Yu Chow ◽  
Jimmy Yu Wai Chan ◽  
Richie Chiu Lung Chan ◽  
Joseph Hon Ping Chung ◽  
William Ignace Wei
Keyword(s):  
Neck Region ◽  
Surgical Excision ◽  
Chinese Patients ◽  
Skin Closure ◽  
Recurrence Rates ◽  
Tumour Control ◽  
Female Patients ◽  
Ethnic Chinese ◽  
Elderly Female ◽  
Tertiary Centre

Objectives.This study aims to report our experience in the management of HNBCC in ethnic Chinese over a 10-year period.Methods.A retrospective review of all ethnic Chinese patients with HNBCC treated in a tertiary centre from 1999 to 2009.Results.From 1999 to 2009, 225 patients underwent surgical excision for HNBCC. Majority were elderly female patients. Commonest presentation was a pigmented (76.2%) ulcer (64.8%) over the nose (31.6%). Median skin margin taken on tumour excision was 2.0 mm; primary skin closure was achieved in 51.8%. Postresection skin margin was clear in 75.4%. Of those with inadequate skin margins, 56.7% opted for further treatment, 43.4% for observation. Recurrence rates were 2.6% and 13.8%, respectively (). Overall recurrence rate was 5.5%.Conclusions.HNBCC commonly presented as pigmented ulcers over the nose of elderly female patients in our locality. Adequate tumour excision ± reconstruction offered the best chance of cure. Reexcision of those with inadequate skin margins improved local tumour control.

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.

Prospective observational study of prevalence, assessment and treatment of pancreatic exocrine insufficiency (PEI) in patients with advanced pancreatic cancer (aPC): PanDA.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 196-196
Author(s):  
Angela Lamarca ◽  
Lindsay Carnie ◽  
Dinakshi Shah ◽  
Kate Vaughan ◽  
Zainul Abedin Kapacee ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
High Risk ◽  
Observational Study ◽  
Breath Test ◽  
Cox Regression ◽  
Pancreatic Enzyme ◽  
Palliative Therapy ◽  
Advanced Pancreatic Cancer ◽  
P Value ◽  
Screening Methods

196 Background: PEI in patients with advanced pancreatic cancer is well documented, but there is a lack of consensus regarding optimal screening. Methods: Eligible patients for this observational study (NCT03616431) were those diagnosed with aPC referred for consideration of palliative therapy who consented to evaluation by a research dietitian. In addition to symptom and full dietetic assessment (including Mid-Upper Arm Circumference (MUAC), handgrip and stair climb test), full nutritional blood panel, faecal elastase (FE) and 13C mixed triglyceride breath test (for diagnostic cohort (DiC)) were performed. Primary objectives: prospective assessment of PEI prevalence (dietitian-assessed; demographic cohort (DeC)), and to design (using breath test as gold standard; DiC) and validate (follow-up cohort (FuC)) the most suitable screening tool for PEI in patients with aPC. Logistic and Cox regression were used for statistical analysis (Stat v.12). Results: Between 1st July 2018 and 30th October 2020, 112 eligible patients [50 (DeC), 25 (DiC), 37 (FuC)]. Prevalence of PEI in the DeC was 64.0% (PEI-related symptoms were flatus (84.0%), weight loss (84.0%), abdominal discomfort (50.0%) and steatorrhea (48.0%)); 70.0% of patients required pancreatic enzyme replacement therapy and 74.0% had anorexia (low appetite); 44.0% and 18.0% had low vitamin D and vitamin A levels, respectively. Designed PEI screening panel (DiC; 19 patients with breath test completed) included FE [normal/missing (0 points); low (1 point)] and MUAC [normal/missing ( > percentile 25 for age/gender) (0 points); low (2 points)] and identified patients at high-risk (2-3 total points) of PEI [vs. low-medium risk (0-1 total points)]. When patients from DeC and DiC) were analysed together, those classified as “high-risk of PEI” according to the screening panel had shorter overall survival (multivariable Hazard Ratio (mHR) 1.86 (95% CI 1.03-3.36); p-value 0.040) when adjusted for other prognostic factors, including presence of PEI symptoms (mHR 2.28 (95% CI 1.19-4.35); p-value 0.013). The screening panel was tested in the FuC; 78.38% were classified as patients at “high-risk of PEI”; of these, 89.6% were confirmed to have PEI by the dietitian. The panel was feasible for use in clinical practice, (64.8% of patients completed fully the assessments required) and acceptability was high (87.5% of patients would do it again). The majority of patients (91.3%) recommended that all future patients with aPC should have dietitian input. Conclusions: PEI is present in the majority of patients with aPC, and early dietetic input is important to provide a holistic nutritional overview, including, but not limited to, PEI. This proposed screening panel could be used to prioritise patients at higher risk of PEI requiring urgent dietitian input. Its prognostic role needs further validation. Clinical trial information: NCT03616431.

Orbital Hydatid Cyst: An Interventional Case Series

2021 ◽  
Vol 37 (2) ◽  
Author(s):  
Tajamul Khan ◽  
Ibrar Hussain ◽  
Zaman Shah
Keyword(s):  
Visual Acuity ◽  
Hydatid Cyst ◽  
Teaching Hospital ◽  
Case Series ◽  
Surgical Excision ◽  
P Value ◽  
Presumptive Diagnosis ◽  
Female Ratio ◽  
Orbital Imaging

Purpose:  To find out the demographics, presentation, and outcome of surgical treatment in patients of orbital hydatid cyst. Study Design:  Interventional case series. Place and Duration of Study:  Khyber Teaching Hospital Peshawar, Pakistan from 2009 to 2019. Methods:  This study included 11 patients with orbital hydatid cyst who presented in Khyber Teaching Hospital, Peshawar. Detailed history, ocular examination and Orbital imaging (Ophthalmic B-Scan, CT scan and/or MRI) was performed. The patients underwent Orbitotomy, cyst extirpated and sent for histopathology. Albendazole was given to the patients for 12 weeks after surgery. The preoperative and postoperative data until last follow-up was analyzed. Results:  Male to Female ratio was 5:6 and the mean age of the patients was 18.17 ± 17.4 years. Mean amount of proptosis was 26.27 ± 2.05mm and visual acuity was 0.23 ± 0.33 decimal in the affected eye at presentation. Eight patients (72.8%) had Relative Afferent Pupillary Defect with swollen discs. After imaging studies, presumptive diagnosis of hydatid cyst was made. Histopathology confirmed the diagnosis of hydatid cyst in all cases. Mean proptosis at the last follow up improved to 19.04 ± 1.45mm (P value = 0.00) and visual acuity to 0.47 ± 0.22 decimals (P value = 0.048). Only one patient (9.1%) had an associated hydatid cyst in the lung. There was no recurrence until last follow-up. Conclusion:  Hydatid cyst should be considered in differential diagnosis of proptosis in patients under 20. Surgical excision followed by a course of oral Albendazole is effective for the treatment of orbital hydatid cyst. Key Words:  Orbital hydatid cyst, Proptosis, Orbitotomy.

A RARE CASE OF RECURRENT ADENOID CYSTIC CARCINOMA OF THE BUCCAL MUCOSA

2021 ◽  
pp. 1-2
Author(s):  
Surya Rao Rao Venkata Mahipathy ◽  
Alagar Raja Durairaj ◽  
Narayanamurthy Sundaramurthy ◽  
Anand Prasath Jayachandiran ◽  
Suresh Rajendran
Keyword(s):  
Adenoid Cystic Carcinoma ◽  
Buccal Mucosa ◽  
Malignant Neoplasm ◽  
Neck Region ◽  
Surgical Excision ◽  
Minor Salivary Glands ◽  
Head And Neck Region ◽  
Adenoid Cystic ◽  
The Right ◽  
Carcinoma Buccal Mucosa

Adenoid cystic carcinoma is a malignant neoplasm most commonly originating in the minor salivary glands of head and neck region. Among intra oral adenoid cystic carcinoma, buccal mucosa is one of the rarer sites. Here, we report a case of recurrent adenoid cystic carcinoma of the right buccal mucosa in a 33 year old female. As this is an uncommon site for adenoid cystic carcinoma, it should be considered as a differential diagnosis of mass of buccal mucosa. It is imperative that we identify such cases and plan for early surgical excision with adequate margins.

scholarly journals A case report of giant anterior neck lipoma

2020 ◽  
Vol 6 (6) ◽  
pp. 1213
Author(s):  
Shalini Jain ◽  
Sahil Maingi ◽  
Ancy S. Sofia ◽  
A. K. Rai
Keyword(s):  
Case Report ◽  
Head And Neck ◽  
Neck Region ◽  
Surgical Excision ◽  
The Body ◽  
Anterior Neck ◽  
Head And Neck Region ◽  
Posterior Triangle ◽  
Common Location ◽  
Different Parts

<p class="abstract">Lipoma is a benign mesenchymal tumor with a thirteen percent incidence in head and neck region. Posterior triangle is the most common location while anterior neck lipoma is a rare one. Giant lipomas &gt;10 cm have been reported in different parts of the body but rarely in the anterior neck. Surgical excision remains the treatment of choice. We here report a case of giant anterior neck lipoma in a 50 year old male managed surgically.</p>

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