scholarly journals Surgical debridement of infected necrobiotic xanthogranuloma: a case report and review of the literature

2020 ◽  
Vol 7 (12) ◽  
pp. 4172
Author(s):  
Jasmine J. Mui ◽  
Martin Jones

Necrobiotic xanthogranuloma (NXG) is a rare skin disorder characterized by the development of large violaceous plaques all over the body. Rarely, these plaques become infected and require surgical debridement. The current literature is lacking on outcomes of surgical intervention in this patient population. Hence this case report aims to describe surgical management for a patient with NXG presenting to The Shoalhaven District Memorial Hospital and review the literature on the pathophysiology and current treatment modalities for this condition. A 61-year-old man presented to The Shoalhaven District Memorial Hospital with an infected NXG plaque on his left calf unresponsive to intravenous antibiotics. He has had a previously infected lesion on his right shin debrided by our surgical team in 2015, with plaque recurrence on the superior-medial aspect. His current infection was managed with surgical excision of the necrotic core of the NXG plaque while sparing the healthy surrounding plaque tissue. This is in accordance to the current literature which demonstrates poor cosmetic outcomes with complete surgical resection of healthy plaques, with a 42% recurrence with increased size and nodularity.1, 2 NXG appears to be related to autoimmune monoclonal paraproteinemia and associated with hematological malignancy. Therefore, management is primarily medical with surgical resection only indicated in cases of severe infection. NXG presents a rare challenge to the general surgeon given the lack of evidence for surgical debridement. Understanding the underlying pathophysiology, treatment options and healing patterns in this disorder will allow the surgeon to assess and manage infected lesions with minimal cosmetic disfigurement

2018 ◽  
Vol 6 (02/03) ◽  
pp. 118-121
Author(s):  
Suruchi Jatol-Tekade ◽  
Satyajit Tekade ◽  
Sachin Sarode ◽  
Vishal Patni ◽  
Vihang Naphde

AbstractTandem appliance is preferred over face mask mainly because of compliance reasons. In the given case report, clinicians have used tandem appliance for correcting skeletal class III malocclusion patient in later stage of growth. Operators utilized residual growth. Facial harmony was achieved by gaining positive overjet. Adolescent class III malocclusion is challenging to treat. Occurrence of class III malocclusion is just 5% in India. If patient reports in growing stage, clinicians get many relevant treatment options. Lack of knowledge about growth modulation therapy causes loss of growing stage of patients. This situation reduces available treatment modalities. Here is a case of female patient with class III malocclusion who is near completion of her growth; maxillary growth was stimulated in forward direction taking anchorage from overgrown mandible with the help of tandem appliance.


2018 ◽  
Vol 19 (12) ◽  
pp. 3877 ◽  
Author(s):  
Suchithra Poilil Surendran ◽  
Myeong Ju Moon ◽  
Rayoung Park ◽  
Yong Yeon Jeong

Currently, immunotherapy is considered to be one of the effective treatment modalities for cancer. All the developments and discoveries in this field up to the recent Nobel Prize add to the interest for research into this vast area of study. Targeting tumor environment as well as the immune system is a suitable strategy to be applied for cancer treatment. Usage of nanoparticle systems for delivery of immunotherapeutic agents to the body being widely studied and found to be a promising area of research to be considered and investigated further. Nanoparticles for immunotherapy would be one of the effective treatment options for cancer therapy in the future due to their high specificity, efficacy, ability to diagnose, imaging, and therapeutic effect. Among the many nanoparticle systems, polylactic-co-glycolic acid (PLGA) nanoparticles, liposomes, micelles, gold nanoparticles, iron oxide, dendrimers, and artificial exosomes are widely used for immunotherapy of cancer. Moreover, the combination therapy found to be the more effective way of treating the tumor. Here, we review the current trends in nanoparticle therapy and efficiency of these nanosystems in delivering antigens, adjuvants, therapeutic drugs, and other immunotherapeutic agents. This review summarizes the currently available bioactive nanoparticle systems for cancer immunotherapy.


2020 ◽  
Vol 11 (3) ◽  
pp. 9-16
Author(s):  
Amrallah A. Mohammed ◽  
Hani EL-Tanni ◽  
Hani M. EL-Khatib

Abstract Background Desmoid tumors/aggressive fibromatosis (DTs/AF) are cytological bland fibrous neoplasms originating from the musculoaponeurotic structures throughout the body. The exact cause still remains unknown, however, they may present sporadically or as a manifestation of a hereditary syndrome called familial adenomatous polyposis (FAP). Although they lack the capacity to establish metastases, DTs/AF may be devastated and occasionally fatal. As a result of the heterogeneity of DTs/AF, treatment needs to be individualized to improve local tumor control and maintain patients’ quality of life. Therefore, after a multidisciplinary approach, all treatment options should be discussed with patients. Where systemic chemotherapy has been shown to be unsuccessful with marked side effects in case of advanced DTs/AF, new therapeutic options are needed. Methods A Medline search was conducted and published articles in different studies from 2000 to the present were reviewed. Conclusion More research is needed to illustrate both the prognostic and predictive factors of the targeted therapy and the value of their combinations with or without other treatment modalities to get the best result for the treatment of advanced DTs/AF.


2009 ◽  
Vol 54 (2) ◽  
pp. 58-58
Author(s):  
V Genç ◽  
A Çakmak ◽  
C Akyol ◽  
S Baskan ◽  
SM Hazinedaroglu

Liposarcomas are the most common soft-tissue sarcomas in adults. Soft tissue sarcomas can be seen almost every localisation in the body, 10-15% of these are located in the retroperitoneum. Due to their slow growth and lack of specific anatomical compartments, retroperitoneal liposarcomas frequently reach an enormous size long before diagnosis. We describe a case of giant retroperitoneal liposarcoma successfully treated by surgical resection. The interest of our report is that the dimension alone should not be considered a contraindication for surgery and to remind the effectiveness of the first operation is the most important part of the therapy.


2020 ◽  
Vol 27 (4) ◽  
pp. 319-322
Author(s):  
Teodora SPATARU ◽  
Lucian NEGREANU

We present the case of a 71 year old female that was endoscopically diagnosed with type III neuroendocrine gastric tumor (NET). NETs are rare, slowly growing neoplasm originating in the neuroendocrine cells, that can occur anywhere in the body. Gastrointestinal forms account for more than a half of them. If type I and II gastric neuroendocrine tumors can be managed endoscopically, type III and IV have sugery as their main therapy. Because type III lessions have the greatest potential to generate metastasis, we did a CT scan on the patient and found distant metastasis located in the liver and also to the lymph nodes. Treatment options depend on the type of tumor, its location, signs and symptoms experienced by the patient, due to excess hormones produced by the tumor, and also if there is resectable metastatic disease or not. Altough our patient had a voluminous tumor, surgical resection was possible, followed by chemotherapy, with good evolution.


2021 ◽  
Vol 7 (4) ◽  
pp. 363-366
Author(s):  
Kashish Tyagi ◽  
Sheilly Kapoor ◽  
Ishani Mohapatra ◽  
Komal Sharma

Alopecia areata, an auto-immune disorder characterised by the appearance of non-scarring bald patches affecting the hair bearing areas of the body, it can be extremely difficult to treat and has a poor prognosis despite many therapeutic options. Platelet Rich Plasma (PRP) has been previously used to treat variety of alopecia including alopecia areata. A 21-year old girl presented with asymptomatic loss of hair from the scalp for the last more than two years. On examination, there was diffuse loss of hair all over the scalp with few small, thin light-coloured hair in the occipital region. Histopathological examination showed miniaturised hair follicles surrounded by variable inflammatory lymphohistiocytic infiltrate with a marked reduction in terminal-vellus hair ratio to 1:1.The response to previous treatments was poor at the end of 1 year. A trial of PRP was given with no adjuvant treatment with a total of eight sessions of PRP. Dramatic response was noted after 2 sessions in the form of improvement in hair diameter and total volume. Resistant areas also started showing hair growth. There are a few studies assessing the role of PRP therapy in AA. First report to establish the efficacy of PRP as a treatment modality in AA, showed PRP therapy to be superior to TCA and Placebo in growing pigmented hair in AA patches. A case report with ophiasis type AA resistant to intralesional steroid injections showed excellent response to PRP therapy. Previous studies have demonstrated beneficial role of PRP therapy in cases of patchy alopecia areata, in contrast ours was a case of chronic diffuse AA. Inspite of many treatment modalities tried for more than a year, the response was unsatisfactory. PRP therapy yielded amazing results in the form of hair growth over resistant areas and overall increase in pigmented hair which were sustained at one and a half year follow up. Our case was unique in the way that excellent response to PRP treatment was noted (a) In a case of diffuse alopecia areata. (b) In a case non- responsive to standard modalities. (c) In a case with no other supportive treatment.


2016 ◽  
Vol 10 (1) ◽  
pp. 26-28 ◽  
Author(s):  
Swapan Kumar Paul ◽  
Suprotim Howlader ◽  
Diponker Kumar Saha ◽  
Abdur Rahed Khan

Lymphangiomas are benign hamartomatous lymphatic tumours characterized by multiple communicating lymphatic channels and cystic spaces. Cystic lyphangiomas may be seen anywhere in the body but are common in neck, axilla, mediastinum and groin. Treatment options are surgical resection, radiation, sclerotherapy etc but have got high recurrence rate and complications. In the present study we hypothesized that complete surgical resection along with keeping a drain for 2-3 wks, may reduce recurrence rate. This prospective study was performed from July 2008 to June 2013. Total 21 children treated during this period by the technique of complete surgical excision with keeping drain tube in situ for 2 to 3 weeks. Ultrasound performed in all patients, CT scan and Duplex study performed in some patients, histopathology done in all patients. Patients with intra-abdominal lymphangioma not included in this study. Twenty one patients were operated during the study period and average duration of keeping drain tube was 18.57 days. Among the 21 cases 2 (9.52%) patients developed mild infection, 1 (4.76%) patient developed infection with pus formation and 1 (4.76%) patient developed recurrence. Our success in the treatment warrants further verification of potential benefits of keeping drain tube in situ for 2-3 weeks after surgical excision of lymphangiomas.Faridpur Med. Coll. J. Jan 2015;10(1): 26-28


2017 ◽  
Vol 13 (2) ◽  
pp. 290-292 ◽  
Author(s):  
Pragya Regmee ◽  
Jyotsna Rimal ◽  
Iccha Kumar Maharjan ◽  
Sushma Pandey ◽  
Deepa Niroula ◽  
...  

First described by Hullihen in 1844, Pyogenic granuloma (PG) is a benign, exophytic vascular tumor. It is not infective, purulent or granulomatous but a reactive inflammatory mass of blood vessels with few fibroblasts within the mucosa or skin. Without any general agreement, there exist a variety of treatment options (complete surgical resection, cryosurgery, curettage, lasers etc). However, recurrence has been frequently reported.  Sclerotherapy in PG (a vascular tumor) is not as commonly reported as in cases of hemangioma.Herein, we present a case of twenty-eight years old female with a clinical diagnosis of PG, treated with intralesional sodium tetradecyl sulfate (STS). Intralesional injection of 0.2 ml of undiluted STS was given for three visits between 10th of January and 21st of February 2016. The lesion healed completely at the patient’s fourth visit and recurrence was not reported till the patient was followed up for one year, i.e February 2017. 


2018 ◽  
Vol 28 (1) ◽  
pp. 71-73
Author(s):  
Rona Wai Yin Law ◽  
Eric So ◽  
Anson Ka Cheung Chu ◽  
Daniel B Logan

The article offers a brief history of pitted keratolysis (PK), research regarding PK etiology, evaluation of PK, and current treatment modalities. The main objective of this article focuses on the current literature on PK, its presentation and symptomatology, prevalence, and available therapeutic options. We present a case report and review on PK of a patient treated with an over the counter antiperspirant, topical erythromycin, oral erythromycin, and proper education on hygiene, with complete resolution and without recurrence after a follow up of greater than 12 months.


Author(s):  
Nettemu Sunil Kumar ◽  
Nettem Sowmya

ABSTRACT Tissue replacement gingival prosthesis is a simple, noninvasive procedure employed to replace large volumes of lost soft tissue architecture while overcoming the pitfalls of surgical treatment modalities. A removable gingival prosthesis has a definite set of superior advantages compared to the extensive surgical treatment options or the employment of a fixed prosthesis. The removable gingival prosthesis helps to render an esthetically pleasing and functional restoration which is economical and less time-consuming for patients who report with large areas of esthetic and functional deficits. This case report highlights the fabrication of a light-weight design of removable gingival veneer to effectively mask the large area of tissue distortion whilst achieving superior esthetics.


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