scholarly journals CHONDROSARCOMAS OF THE HAND: A REPORT OF THREE CASES

2021 ◽  
Vol 9 (02) ◽  
pp. 56-60
Author(s):  
Chaouqui Yassine ◽  
◽  
El Haoury Hanane ◽  
Chafik Rachid ◽  
Madhar Mohamed ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Conservative Treatment ◽  
Local Recurrence Rate ◽  
Metastatic Potential ◽  
Wide Resection ◽  
Malignant Bone Tumor ◽  
X Rays ◽  
Digital Amputation ◽  
Made In

Chondrosarcoma of the hand is very rare. We report three observations of chondrosarcoma of the hand, which enable us to make a review of its pathology. The follow-up was up to 2 years.There were two women and one man with an average age of 48 years old (30, 85 and 31). The localisation was phalangeal in two cases and metacarpal in one case, one case followed for chondroma. The three cases were central. X-rays were characterized by the presence of lytic areas with calcifications and in one case, we showed a calcification in the peripheral tissue. Histological diagnosis was made by biopsy (grade 2 in two cases and grade 1 in one case). Treatment consisted of amputation of the finger in two cases. In the case of metacarpal localization, wide resection of concerned ray. The patients showed no local recurrence and no metastatic spread after 2 years.The chondrosarcoma in the hand may due to malignant change in a pre-existing chondroma. He is the most common malignant bone tumor of the hand. This shows that the diagnosis of a chondrosarcoma can only be made in the synopsis of the radiological, histological and clinical findings.The metastasis of hand chondrosarcomas is very rare but has been described. With regard to the local recurrence rate, the data in the literature varies between 11% and 50%. Conservative treatment is difficult due to the small size of the hand, which allows easy spread of the tumor from compartment to compartment.Despite the low metastatic potential of chondrosarcomas of the hand in comparison with other sites, ray resection or digital amputation is recommended to avoid local recurrence. In cases with only local excision, close follow-up is recommended.

Local recurrence of diminutive colorectal polyps after cold forceps polypectomy with jumbo forceps followed by magnified narrow-band imaging: a multicenter prospective study

Endoscopy ◽  
2019 ◽  
Vol 51 (03) ◽  
pp. 253-260 ◽  
Author(s):  
Toshio Kuwai ◽  
Takuya Yamada ◽  
Tatsuya Toyokawa ◽  
Hiroaki Iwase ◽  
Tomohiro Kudo ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Recurrence Rate ◽  
Local Recurrence Rate ◽  
Narrow Band ◽  
Narrow Band Imaging ◽  
Therapeutic Option ◽  
Colorectal Polyps ◽  
Delayed Bleeding ◽  
Immediate Bleeding

Background Cold polypectomy has been increasingly used to remove diminutive colorectal polyps. We evaluated the local recurrence rate of diminutive polyps at the 1-year follow-up after cold forceps polypectomy (CFP). Methods In a prospective, multicenter, observational cohort study, patients with diminutive colorectal polyps ( ≤ 5 mm) were treated by CFP using jumbo forceps followed by magnified narrow-band imaging (NBI). Patients were assessed for local recurrence at 1-year follow-up. Risk factors associated with local recurrence were analyzed using logistic regression analysis. Results Overall, 955 lesions were resected in 471 patients who completed the 1-year follow-up. The endoscopic complete resection rate was 99.4 %. Immediate and delayed bleeding occurred in 0.8 % and 0.2 % of cases, respectively, with no perforations observed. Local recurrence occurred in 2.1 % of cases at the 1-year follow-up. Univariable analyses indicated that polyps > 3 mm (P < 0.01) and immediate bleeding (P = 0.04) were significantly associated with local recurrence. A trend was observed for patients ≥ 65 years (P = 0.06) and fractional resection (P = 0.09). Multivariable analyses confirmed that lesions > 3 mm were significantly associated with local recurrence (odds ratio 3.4, P = 0.02). Conclusions CFP with jumbo forceps followed by NBI-magnified observation had a low local recurrence rate and is an acceptable therapeutic option for diminutive colorectal polyps. Although we recommend limiting the use of CFP with jumbo forceps to polyps ≤ 3 mm in size, future comparative studies are needed to make recommendations on cold polypectomy using either forceps or snares as the preferred approach for diminutive polyp resection.

scholarly journals Sarcomas of the extremities and the pelvis: comparing local recurrence after incisional and after core-needle biopsy

2022 ◽  
Vol 20 (1) ◽  
Author(s):  
Alexander Klein ◽  
Christof Birkenmaier ◽  
Julian Fromm ◽  
Thomas Knösel ◽  
Dorit Di Gioia ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Local Recurrence ◽  
Core Needle Biopsy ◽  
Needle Biopsy ◽  
Tumor Resection ◽  
Soft Tissue Sarcomas ◽  
Wide Resection ◽  
Incisional Biopsy ◽  
Core Needle

Abstract Background The degree of contamination of healthy tissue with tumor cells during a biopsy in bone or soft tissue sarcomas is clearly dependant on the type of biopsy. Some studies have confirmed a clinically relevant contamination of the biopsy tract after incisional biopsies, as opposed to core-needle biopsies. The aim of our prospective study was to evaluate the risk of local recurrence depending on the biopsy type in extremity and pelvis sarcomas. Methods We included 162 patients with a minimum follow-up of 6 months after wide resection of extremity sarcomas. All diagnostic and therapeutic procedures were performed at a single, dedicated sarcoma center. The excision of the biopsy tract after an incisional biopsy was performed as a standard with all tumor resections. All patients received their follow-up after the conclusion of therapy at our center by means of regional MRI studies and, at a minimum, CT of the thorax to rule out pulmonary metastatic disease. The aim of the study was the evaluation of the influence of the biopsy type and of several other clinical factors on the rate of local recurrence and on the time of local recurrence-free survival. Results One hundred sixty-two patients with bone or soft tissue tumors of the extremities and the pelvis underwent either an incisional or a core-needle biopsy of their tumor, with 70 sarcomas (43.2%) being located in the bone. 84.6% of all biopsies were performed as core-needle biopsies. The median follow-up time was 55.6 months, and 22 patients (13.6%) developed a local recurrence after a median time of 22.4 months. There were no significant differences between incisional and core-needle biopsy regarding the risk of local recurrence in our subgroup analysis with differentiation by kind of tissue, grading of the sarcoma, and perioperative multimodal therapy. Conclusions In a large and homogenous cohort of extremity and pelvic sarcomas, we did not find significant differences between the groups of incisional and core-needle biopsy regarding the risk of local recurrence. The excision of the biopsy tract after incisional biopsy in the context of the definitive tumor resection seems to be the decisive factor for this result.

scholarly journals Therapeutic dilemma and clinical issues in management of the button battery ingestion: a case report and literature review

2021 ◽  
Vol 69 (1) ◽  
Author(s):  
Olsi Agolli ◽  
Arjola Agolli ◽  
Namrata Hange ◽  
Kuchalambal Agadi
Keyword(s):  
Surgical Removal ◽  
X Rays ◽  
Gi Tract ◽  
Mortality And Morbidity ◽  
Button Battery ◽  
Asymptomatic Children ◽  
Mucosal Lining ◽  
Button Batteries ◽  
Made In

AbstractThe incidence of button battery ingestion in children less than 6 years, from year 1985 to 2019 was 59,000 and it is still a clinical challenge for pediatricians. Objects which are commonly ingested are large amounts of food, coins, toy parts, jewels, batteries, sharp materials and non-metallic sharp objects. It is an increased incidence of mortality and morbidity due to button battery ingestion, compared to accidental ingestion of other objects, due to its small size, and because of its potent source of energy. A literature search was carried out to evaluate the challenges in diagnosing, treatment, and follow-up of button battery ingested cases in children. A total of 36 original articles were included for the review.Conclusions: Button batteries can quickly cause severe damage to the mucosal lining of the GI tract. Esophageal button batteries require emergency removal because they can cause serious complications leading to hemorrhage, and death. In children, where the button battery has passed the esophagus watchful management should be made. In the majority of cases, the button batteries with a diameter less than 2 cm lodged in the stomach will pass spontaneously with no complications. However, asymptomatic children may be followed up with X-rays to assess progression up to 10–14 days after ingestion. Endoscopic or surgical removal may be required to prevent intestinal perforation with peritonitis. Symptomatic children will always need a consultation with a pediatric surgeon for surgery no matter where the button battery is placed in the GI tract. Developing countries shall adopt surveillance and reporting systems for BBI ingestion and related complications and it is recommended as essential to have management protocols in place for button batteries ingestion.

Prognostic factors for local recurrence in the conservatively treated breast cancer patient: a cautious interpretation of the data.

1991 ◽  
Vol 9 (6) ◽  
pp. 997-1003 ◽  
Author(s):  
B G Haffty ◽  
D Fischer ◽  
M Rose ◽  
M Beinfield ◽  
C McKhann
Keyword(s):  
Local Recurrence ◽  
Adjuvant Therapy ◽  
Recurrence Rate ◽  
Systemic Therapy ◽  
Local Recurrence Rate ◽  
Adjuvant Systemic Therapy ◽  
Node Positive ◽  
Breast Recurrence ◽  
Lower Local Recurrence Rate

Between 1962 and 1984, a total of 433 patients were treated at Yale-New Haven Hospital with conservative surgery and radiation therapy (CS + RT) to the intact breast. As of January 1990, with a minimum assessable follow-up of 5 years and a median follow-up of 8.21 years, there have been a total of 50 breast recurrences resulting in a 5-year actuarial breast recurrence rate of 8%. Of all clinical factors tested, young age was the most significant prognostic factor for local recurrence (P less than .03). In addition, patients with pathologically involved lymph nodes were noted to have a lower local recurrence rate than patients with pathologically negative axillae (P less than .05). These findings were especially notable given the fact that the node-positive group had a higher percentage of T2 tumors and a higher percentage of patients in the young age group. These paradoxical findings, however, may be explained by the fact that 88% of the node-positive patients underwent adjuvant systemic therapy in the form of either systemic chemotherapy or hormonal therapy, while only 8% of node-negative patients underwent any adjuvant systemic therapy. When analyzed as a function of adjuvant therapy, those patients receiving adjuvant therapy had a lower local recurrence rate than those patients not receiving adjuvant therapy (P less than .08). We conclude that adjuvant systemic therapy impacts on the ipsilateral breast recurrence rate in patients treated with CS + RT. The implications of this study in light of the widespread use of adjuvant systemic therapy are discussed.

scholarly journals Laparoscopic Versus Robot-Assisted Versus Transanal Low Anterior Resection: 3-Year Oncologic Results for a Population-Based Cohort in Experienced Centers

2021 ◽  
Author(s):  
T. A. Burghgraef ◽  
J. C. Hol ◽  
M. L. Rutgers ◽  
R. M. P. H. Crolla ◽  
A. A. W. van Geloven ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Local Recurrence Rate ◽  
Laparoscopic Resection ◽  
Cox Regression ◽  
Population Based ◽  
Robot Assisted ◽  
Oncologic Results

Abstract Background Laparoscopic, robot-assisted, and transanal total mesorectal excision are the minimally invasive techniques used most for rectal cancer surgery. Because data regarding oncologic results are lacking, this study aimed to compare these three techniques while taking the learning curve into account. Methods This retrospective population-based study cohort included all patients between 2015 and 2017 who underwent a low anterior resection at 11 dedicated centers that had completed the learning curve of the specific technique. The primary outcome was overall survival (OS) during a 3-year follow-up period. The secondary outcomes were 3-year disease-free survival (DFS) and 3-year local recurrence rate. Statistical analysis was performed using Cox-regression. Results The 617 patients enrolled in the study included 252 who underwent a laparoscopic resection, 205 who underwent a robot-assisted resection, and 160 who underwent a transanal low anterior resection. The oncologic outcomes were equal between the three techniques. The 3-year OS rate was 90% for laparoscopic resection, 90.4% for robot-assisted resection, and 87.6% for transanal low anterior resection. The 3-year DFS rate was 77.8% for laparoscopic resection, 75.8% for robot-assisted resection, and 78.8% for transanal low anterior resection. The 3-year local recurrence rate was in 6.1% for laparoscopic resection, 6.4% for robot-assisted resection, and 5.7% for transanal procedures. Cox-regression did not show a significant difference between the techniques while taking confounders into account. Conclusion The oncologic results during the 3-year follow-up were good and comparable between laparoscopic, robot-assisted, and transanal total mesorectal technique at experienced centers. These techniques can be performed safely in experienced hands.

scholarly journals Low-Grade Myofibroblastic Sarcoma (LGMS) of the Extremities – A Systematic Review and Case Report

2020 ◽  
Author(s):  
Astrid Schenker ◽  
Burkhard Lehner ◽  
Ewgenija Gutjhar ◽  
Gunhild Mechtersheimer ◽  
Leila Harhaus ◽  
...  
Keyword(s):  
Systematic Review ◽  
Local Recurrence ◽  
Distant Metastasis ◽  
Cochrane Library ◽  
Wide Resection ◽  
Clinical Aspects ◽  
Low Grade ◽  
Incomplete Resection ◽  
Myofibroblastic Sarcoma

Abstract Background: Low-grade myofibroblastic sarcoma (LGMS) is a rare subtype of soft tissue sarcoma of intermediate grade often representing fibromatosis-like features with a rare metastasing behavior. This type of tumor has a predilection for the head and neck region, but also occurs in the extremities. Confirming the diagnosis is difficult and treatment strategies have to be chosen individually.Methods: The objective of this study was to conduct a systematic review for LGMS of the extremities. The electronic databases PubMed and the Cochrane Library were searched for eligible studies. 141 abstracts were screened on PubMed, while 10 studies were identified as eligible. Cases were summarized in terms of clinical aspects, therapeutic regimen with the primary endpoint of follow-up controls regarding local recurrence or distant metastasis. In addition, we present the rare case and surgical management of a 28-year-old male patient with residual LGMS of the thumb after initial incomplete resection. Results: 33 cases of LGMS in the extremities were identified on PubMed. Cochrane library didn’t show any results. All of them were surgically resected. Only two cases of LGMS in the hand were described in literature so far. Treatment options varied from local excision to wide resection without exact definition of the safety distance. 26 cases provided follow-up information with local recurrence in 6 cases (23 %), while 4 cases (15 %) showed distant metastasis. Conclusions: Wide resection should be the surgical aim to avoid local recurrence and distant metastases. While the excision of tumors of the thumb and hand often require closer resection margins, due to the close proximity of anatomical structures, tumor-free margins are elementary even if tissue transfer from a donor site is needed for reconstruction.

Long-term antiplatelet treatment for innominate vein aneurysm

VASA ◽  
2010 ◽  
Vol 39 (3) ◽  
pp. 262-264 ◽  
Author(s):  
Mikroulis ◽  
Vretzakis ◽  
Eleftheriadis ◽  
Lazarides
Keyword(s):  
Coronary Artery ◽  
Conservative Treatment ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Innominate Vein ◽  
Therapeutic Management ◽  
X Rays ◽  
Antiplatelet Treatment

Aneurysms of thoracic veins are rare lesions and their therapeutic management is not clearly determined. We present a 60-year old man with an asymptomatic right innominate vein aneurysm. The patient had been operated on 10 years ago for coronary artery bypass and was under antiplatelet treatment. In a retrospective inspection of his chest X-rays, we found that the aneurysm had been existent for at least 10 years. We suggested conservative treatment and over a 5-year follow-up, the patient has remained asymptomatic. Our patient is alive 15 years with thoracic vein aneurysm and antiplatelet treatment.

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