scholarly journals Large hibernoma of the neck: A case report

2019 ◽  
Vol 76 (3) ◽  
pp. 341-344
Author(s):  
Anton Mikic ◽  
Miljan Folic ◽  
Ivan Boricic ◽  
Nenad Arsovic
Keyword(s):  
Case Report ◽  
Tumor Resection ◽  
Cranial Nerves ◽  
The Body ◽  
Preoperative Embolization ◽  
Surgical Removal ◽  
Histopathological Analysis ◽  
Illustrative Case ◽  
Brown Adipose ◽  
Supraclavicular Fossa

Introduction. A hibernoma is a rare benign tumor derived from vestigial remnants of brown adipose tissue. In neonates this tissue makes up about 5% of the body mass and its amount greatly decreases after birth, persisting only in scattered subcutaneous areas. In rare cases, brown fat continues to grow leading to a hibernoma that may be located in the head and neck. We present an illustrative case of a large hibernoma of the neck with infraclavicular extension and discuss about diagnostic and treatment difficulties. Case report. A 29-year-old male presented with large, slowly progressive, painless neck mass that was noticed 6 months earlier. Computed tomography (CT) and magnetic resonance (MR) showed a well-vascularized, soft tissue tumor of the lateral region of the neck and supraclavicular fossa with extension below clavicle. Treatment included arterial embolization followed by challenging surgical removal of the tumor. Dissection was performed at III, IV and V levels of the neck, making complete resection possible without the tumor fragmentation or major blood vessels and cranial nerves injuries. The final diagnosis of the hibernoma was made by histopathological analysis. The patient had no signs of recurrence during three-year follow-up. Conclusion. Although the CT scan and MR may raise the suspicion, hibernoma is definitely diagnosed by a pathologist. It is very important to exclude the malignant processes, foremost liposarcoma. The tumor fragmentation during surgery should be avoided because the high vascularity of the tumor tissue carries a substantial risk for hemorrhage. Our experience with preoperative embolization and complete tumor resection in this case showed positive impact on the final outcome.

scholarly journals Cavernous Sinus Chondromas

2018 ◽  
Vol 26 (3) ◽  
pp. 211-217
Author(s):  
Jonathan Polo Valdez ◽  
Ricardo Ramina ◽  
Luis Fernando Moura Da Silva Jr ◽  
Mauricio Coelho Neto
Keyword(s):  
Cavernous Sinus ◽  
Clinical Symptoms ◽  
Tumor Resection ◽  
Cranial Nerves ◽  
The Body ◽  
Neurological Deficits ◽  
Surgical Approaches ◽  
Benign Tumors ◽  
Surgical Removal ◽  
Adequate Knowledge

Background: Chondromas are benign tumors with slow growth pattern that may develop along the body. Intracranial chondromas are rare, 0.1 to 0.3% of all intracranial tumors, usually in parasellar region. Few papers reported cavernous sinus chordomas. Case Description: We reported two cases of cavernous sinus chondromas. Two patients presented diplopia, one facial hypoesthesia and one presented extension to the petroclival region. Surgical approaches were frontotemporal combining presigmoid/middle fossa. Literature was reviewed concerning incidence, clinical symptoms, treatment and outcome. Both cases achieved complete tumor resection without postoperative complication. Preoperative deficits improved. Literature review confirms their rarity, clinical symptoms are related to deficits of cranial nerves passing through the cavernous sinus and cure can be achieved through radical surgical removal. Conclusion: Cavernous sinus chondromas are rare benign lesions with insidious growth. Adequate knowledge of cavernous sinus anatomy, microsurgical experience, intraoperative monitoring of cranial nerves and neuronavigation allows radical tumor removal with no additional neurological deficits.

scholarly journals Pleural effusion caused by polyostotic fibrous dysplasia involving the ribs, the sternum and the thoracic spine associated with multiple cystic degenerations – a case report

2019 ◽  
Vol 72 (1-2) ◽  
pp. 39-42
Author(s):  
Ivan Ergelasev ◽  
Ivan Kuhajda ◽  
Dejan Djuric ◽  
Danijela Kuhajda ◽  
Sinisa Maksimovic
Keyword(s):  
Case Report ◽  
Pleural Effusion ◽  
Fibrous Dysplasia ◽  
The Body ◽  
Bone Involvement ◽  
Cystic Degeneration ◽  
Histopathological Analysis ◽  
Daily Routine ◽  
Polyostotic Fibrous Dysplasia ◽  
Chest Wall Injury

Introduction. Fibrous dysplasia is a noninherited benign skeletal disorder associated with abnormal bone development. Single bone involvement, the monostotic form, accounts for 70 ? 80% of cases, while the polyostotic form, with multiple bone involvement, accounts for 20 ? 30% of cases. Cystic degeneration and occasional aneurysmal bone cyst formation may be found in fibrous dysplasia lesions, particularly in the costal lesions. Case Report. A 51-year-old man presented with acute shortness of breath after sustaining simple chest wall injury. Chest computed tomography showed multiple massive osteolytic rib lesions, as well as a massive left-sided pleural effusion with compression atelectasis of the lung parenchyma. Osteolytic lesions of the anterior 2nd and 7th thoracic vertebral body were found, along with a well defined osteolytic lesion in the body of the sternum. Video-assisted thoracoscopy of the left pleural space was performed and frozen sections, collected using endoscopic biopsy forceps of the cystic wall and solid parts of the tumors, were sent for ex tempore histopathological analysis. Results showed fibrous dysplasia with suspected malignancy. Talc pleurodesis was performed based on the obtained results. At present, the patient is asymptomatic with his daily routine uninterrupted by his medical condition. Conclusion. Treatment of pleural effusion caused by a cyst rupture of unresectable degenerated polyostotic fibrous dysplasia of the ribs represents a surgical challenge. Surgical drainage of the cysts followed by chemical pleurodesis seems to be a reasonable solution in cases where pulmonary functions are impacted by combined effects of pleural effusion and cystic compression.

scholarly journals Total resection of a giant retroperitoneal and mediastinal ganglioneuroma—case report and systematic review of the literature

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Patrick Kirchweger ◽  
Helwig Valentin Wundsam ◽  
Ines Fischer ◽  
Christiane Sophie Rösch ◽  
Gernot Böhm ◽  
...  
Keyword(s):  
Case Report ◽  
Abdominal Cavity ◽  
Positive Family History ◽  
Malignant Degeneration ◽  
Benign Tumors ◽  
Surgical Removal ◽  
Histopathological Analysis ◽  
Review Of The Literature ◽  
Total Resection ◽  
Initial Symptoms

Abstract Background Ganglioneuromas (GNs) are extremely rare, slowly growing, benign tumors that can arise from Schwann cells, ganglion cells, and neuronal or fibrous tissues. Due to their origin from the sympathetic neural crest, they show neuroendocrine potential; however, most are reported to be hormonally inactive. Nevertheless, complete surgical removal is recommended for symptom control or for the prevention of potential malignant degeneration. Case Report A 30-year-old female was referred to our oncologic center due to a giant retroperitoneal and mediastinal mass detected in computed tomography (CT) scans. The initial symptoms were transient nausea, diarrhea, and crampy abdominal pain. There was a positive family history including 5 first- and second-degree relatives. Presurgical biopsy revealed a benign ganglioneuroma. Total resection (TR) of a 35 × 25 × 25 cm, 2550-g tumor was obtained successfully via laparotomy combined with thoracotomy and partial incision of the diaphragm. Histopathological analysis confirmed the diagnosis. Surgically challenging aspects were the bilateral tumor invasion from the retroperitoneum into the mediastinum through the aortic hiatus with the need of a bilateral 2-cavity procedure, as well as the tumor-related displacement of the abdominal aorta, the mesenteric vessels, and the inferior vena cava. Due to their anatomic course through the tumor mass, the lumbar aortic vessels needed to be partially resected. Postoperative functioning was excellent without any sign of neurologic deficit. Conclusion Here, we present the largest case of a TR of a GN with retroperitoneal and mediastinal expansion. On review of the literature, this is the largest reported GN resected and was performed safely. Additionally, we present the first systematic literature review for large GN (> 10 cm) as well as for resected tumors growing from the abdominal cavity into the thoracic cavity.

scholarly journals Aggressive, Multidisciplinary Staged Microsurgical Resection of a Giant Cervicomedullary Junction Chordoma

2019 ◽  
Vol 80 (S 04) ◽  
pp. S378-S379
Author(s):  
Sima Sayyahmelli ◽  
Ihsan Dogan ◽  
Aaron M. Wieland ◽  
Mark Pyle ◽  
Mustafa K. Başkaya
Keyword(s):  
Tumor Resection ◽  
Cranial Nerves ◽  
Surgical Removal ◽  
Retropharyngeal Space ◽  
Recurrence Rates ◽  
Recent Onset ◽  
Postoperative Mri ◽  
Swallowing Difficulties ◽  
Magnetic Resonance Imaging Mri ◽  
Two Stages

Chordomas of the cranial base are locally destructive tumors since they are surrounded by significant complex neurovascular structures. Thus, their surgical removal is challenging, recurrence rates are high, and their therapeutic strategies remain controversial.In this video, we present a 47-year-old man with a recent onset of swallowing difficulties, hoarseness, and weight loss for several weeks. In the neurological examination, he had complete paralysis of the 9th, 10th, 11th, and 12th cranial nerves. Magnetic resonance imaging (MRI) showed a heterogeneously enhancing expansile invasive mass lesion centered within the clivus and involving the C1, the occipitocervical junction, the retropharynx, and the hypoglossal canal. The decision was made to proceed with multiple staged surgeries. In the first surgical stage, we performed a mastoidectomy with the infralabyrinthine approach to perform a test clip ligation of the sigmoid sinus and to resect the tumor component that extended into the infralabyrinthine space. In the second stage, we performed a far-lateral transcondylar approach for tumor resection and occipitocervical fusion. In the third stage, we used a transoral approach with endoscopic assistance to complete the excision of the remaining tumor in the retropharyngeal space and anterior aspect of C1 and C2 bodies that were not accessible in the first two stages.The surgeries and postoperative course were uneventful. Postoperative MRI showed a gross total resection of the tumor. Histopathology indicated a chordoma. The patient subsequently received proton radiotherapy and has continued to do well without recurrence at 14 months' follow-up.The link to the video can be found at: https://youtu.be/uP9OSlKg_rE.

Right Potency Matters: A Case Report of Homoeopathic Treatment of Verruca Palmaris

2018 ◽  
Vol 31 (03) ◽  
pp. 204-208
Author(s):  
Bidyabhusan Barik ◽  
Akshaya Hati ◽  
Biswaranjan Paital ◽  
Amulya Sahoo
Keyword(s):  
Case Report ◽  
Hpv Infection ◽  
The Body ◽  
Surgical Removal ◽  
Present Case Report ◽  
Hands And Feet ◽  
Scientific Documentation ◽  
Common Manifestation ◽  
Selection Of

AbstractWarts are caused by human papilloma viruses (HPV) that can affect any part of the body including hands and feet. Verruca palmaris (VP) is a common manifestation due to HPV infection in keratinocytes of the palms. In the conventional system of medicine, VP is commonly managed through cauterisation, cryosurgery, surgical removal or topical ointments, which have many limitations. Scientific documentation for the treatment of VP by homoeopathic medicines is very scanty. In this context, the present case report is of a 40-year-old male patient, who had multiple warts on his right palm for more than 2 years. The patient was treated previously with allopathic medications and external applications, without any significant improvement. Homoeopathic remedy (i.e. Natrum mur) was initially administered in 30C potency for 30 days, but no improvement was observed in the patient. Interestingly, when the potency was increased to 200C, a speedy recovery was observed and the patient was fully cured within 3 months. Therefore, it can be concluded from the case study that VP, when treated on the basis of the totality of symptoms, with an accurately selected remedy in suitable potency results in cure. In this particular case, Natrum mur worked well for warts on the palm. Most importantly, it was observed in this case that the selection of right potency is very essential and it should match correctly with the susceptibility of the patient to result in rapid cure.

scholarly journals Solid-cystic-pseudopapillarytumor of the pancreas - case report

2004 ◽  
Vol 132 (11-12) ◽  
pp. 431-434 ◽  
Author(s):  
Aleksandar Karamarkovic ◽  
Marjan Micev ◽  
Djordje Culafic ◽  
Nada Popovic ◽  
Vladimir Djukic
Keyword(s):  
Case Report ◽  
Abdominal Mass ◽  
Good Condition ◽  
The Body ◽  
Resected Specimen ◽  
Exocrine Function ◽  
Surgical Removal ◽  
Low Grade ◽  
Imaging Features ◽  
Young Females

Solid-cystic-pseudopapillary tumor (SCPT) of the pancreas, described by Frantz (1959), is a very rare clinical pathologic entity with relatively low grade malignant potential. The tumor is more frequent in the body and tail of the pancreas. The majority of patients are young females. About 60% of patients are asymptomatic. Complications such as rupture, bleeding or secondary infections are rare. Metastases of the tumor and local recurrence after surgical treatment are also rare. Prognosis is excellent after complete surgical removal. It is difficult to make a preoperative diagnosis of pancreatic SCPT. The exact diagnosis is based on histological findings. Differential diagnosis should consider pancreatoblastoma, non neoplastic cysts, pancreatic pseudo-cysts and hydatid cyst. This is a case report of 39-year old woman who was admitted to our institution with abdominal discomfort and palpable abdominal mass in the upper abdomen. US and CT scan revealed round neoformation of 60 mm in diameter located in the body of the pancreas. Imaging features were not specific enough to allow for precise diagnosis. Curative R0 left spleno-hemipancreatectomy was performed. Histology of the resected specimen revealed solid and cystic-pseudopapillary tumor of the pancreas. The patient was discharged on postoperative day 7 in a good condition. The patient is well 48 months after the operation, with no impairment of pancreatic endocrine or exocrine function.

scholarly journals Pancreatic Leiomyosarcoma With Schistosomiasis Hematobia: A Case Report and Literature Review

2021 ◽  
Vol 11 ◽  
Author(s):  
Qiang Li ◽  
Daniel Staiculescu ◽  
Yurong Zhou ◽  
Jiang Chen
Keyword(s):  
Case Report ◽  
Tumor Resection ◽  
Clinical Manifestations ◽  
Malignant Neoplasm ◽  
The Body ◽  
Imaging Characteristics ◽  
Magnetic Resonance Imaging Mri ◽  
The Relationship ◽  
Ct And Mri

Pancreatic leiomyosarcoma (PL) is a very rare, malignant neoplasm with a very poor prognosis. Here, we examine a novel case of PL with schistosomiasis hematobia. The patient had been initially misdiagnosed by the first magnetic resonance imaging (MRI). The second imaging examination demonstrated an enlarged heterogeneous tumor mass in the body-tail of pancreas. Following image analysis, the patient underwent a pancreatectomy, splenectomy and lymph node dissections. Sixteen months after the tumor resection, follow-up computed tomography (CT) and MRI revealed tumor metastasis in the liver and lung. PL has non-specific clinical manifestations and imaging characteristics, making early diagnosis very challenging. When it is difficult to distinguish between benign and malignant pancreatic lesions, short-term imaging follow-up is preferred. In this case report, we discuss the relationship between PL and schistosomiasis hematobia.

scholarly journals Acoustic neuroma (vestibular schwannoma): surgical results on 240 patients operated on dorsal decubitus position

2007 ◽  
Vol 65 (3a) ◽  
pp. 605-609 ◽  
Author(s):  
Arquimedes Cavalcante Cardoso ◽  
Yvens B. Fernandes ◽  
Ricardo Ramina ◽  
Guilherme Borges
Keyword(s):  
Vestibular Schwannoma ◽  
Tumor Resection ◽  
Cranial Nerves ◽  
Internal Auditory Canal ◽  
Air Embolism ◽  
Cerebrospinal Fluid Leak ◽  
Surgical Removal ◽  
Venous Air Embolism ◽  
Craniotomy For Tumor Resection ◽  
Fluid Leak

OBJECTIVE: To evaluate the result of the surgical treatment of vestibular schwannoma (VS) operated in dorsal decubitus (mastoid position). METHOD: 240 patients with a VS underwent a retrosigmoid craniotomy for tumor resection in dorsal decubitus (mastoid position). The function of 7th and 8th cranial nerves was monitored during surgery and the opened internal auditory canal (IAC) was reconstructed using a vascularized dura flap, muscle and fibrin glue. RESULTS: Complete tumor removal was achieved in 99% of the cases, with a mortality of 1.6%. The facial nerve function was preserved in 85% of cases and hearing in 40% of the patients (with preoperative hearing) with tumors of up 1.5 cm in diameter. The incidence of cerebrospinal fluid leak was 5.8% and meningitis 2.9%. Venous air embolism was registered in 3% of cases; it was not associated to mortality. CONCLUSION: Surgical removal of VS in dorsal position has several advantages; the morbidity and mortality are very low.

scholarly journals Two-Stage Double Petrosal Approach for the Total Resection of Petroclival-Cavernous Meningioma: 2-Dimensional Operative Video

2021 ◽  
Author(s):  
Emad Aboud ◽  
Walid Ibn Essayed ◽  
Ossama Al-Mefty
Keyword(s):  
Cavernous Sinus ◽  
Tumor Resection ◽  
Cranial Nerves ◽  
Transverse Sinus ◽  
Jugular Bulb ◽  
Neurological Deficits ◽  
Surgical Removal ◽  
Petroclival Meningiomas ◽  
Significant Extension ◽  
Anterior Petrosectomy

Abstract The utilization of skull base approaches has markedly facilitated the safe surgical removal of challenging petroclival meningiomas.1 The anterior petrosal approach has been utilized for tumors limited to the upper clivus, above the meatus, whereas the posterior petrosal approach has been the workhorse for the resection of larger tumors in the posterior fossa extending down the clivus.2 Giant cases with extension in the middle fossa, cavernous sinus, and ventral to the brain stem would benefit from a wider exposure than each of these approaches provide. This could be achieved by total petrosectomy. However, in patients with serviceable hearing anterior and posterior petrosals can be combined while preserving the hearing apparatus.2,3 This procedure is lengthy; hence, we tend to stage it in 2 subsequent days. The first stage is focused on the soft tissue and bone work including the mastoidectomy, sigmoid transverse sinus, and jugular bulb skeletonization, as well as anterior petrosectomy. The second stage is dedicated to tumor exposure through tentorial sectioning and microsurgical resection. We report the case of a 40-yr-old woman diagnosed with large left-sided petroclival meningioma with significant extension into the cavernous sinus and Meckel's cave. The patient had neurological deficits including cranial nerves, cerebellar dysfunction, and hydrocephalus, although her hearing was intact. Total tumor resection was achieved through the double petrosal approach in 2002. Extensive anatomic knowledge and thorough preoperative clinical and radiological evaluation, particularly the venous system, are key in the successful planning of this procedure. The patient consented for surgery and publication of their image.  Figures at 2:40 and 3:47, ©Ossama Al-Mefty, used with permission.

scholarly journals Rare localisation of breast cancer metastasis to thyroid gland

2012 ◽  
Vol 69 (12) ◽  
pp. 1106-1108
Author(s):  
Daniela Kolarevic ◽  
Zorica Tomasevic ◽  
Ivan Markovic ◽  
Milan Zegarac ◽  
Gordana Pupic
Keyword(s):  
Breast Cancer ◽  
Case Report ◽  
Thyroid Gland ◽  
Lymph Nodes ◽  
Cancer Metastasis ◽  
Previous History ◽  
Radical Mastectomy ◽  
Surgical Removal ◽  
Histopathological Analysis ◽  
Axillary Lymph

Introduction. Metastases to the thyroid gland are very rare. They are usually seen in malignant melanoma, kidney, breast cancer and lung cancer. Case report. We presented a 54- years-old female patient with breast cancer diagnosed in 2002. The adequate surgical procedure was done and the tumor and axillary lymph nodes were removed. The patient also received adjuvant postoperative chemotherapy. After seven years of a disease free period, the first relapse of the disease was detected as thyroid gland tumor with axillary lymphadenopathy. The patient had a good response to systemic treatment so the surgical removal of thyroid gland and enlarged lymph nodes was performed. Histopathological analysis confirmed metastasis with breast cancer origin. Radical mastectomy was also preformed. Second relapse of the disease was detected 10 months later, while the patient was on hormonal therapy. It was manifested as the appearance of bone and skin metastases, pleural effusion and lymphadenopathy. Conclusion. This case report emphasized the importance of detailed examination of any new onset of thyroid swelling in a patient with previous history of malignancy.

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