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.

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 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 Inverted mesiodens: case report

2016 ◽  
Vol 64 (1) ◽  
pp. 83-86
Author(s):  
Eneane MIRANDA ◽  
Luciene Dornas MENDES ◽  
Sérgio Milton Martins de Oliveira PENIDO ◽  
Cláudia Valéria de Sousa Resende PENIDO
Keyword(s):  
Case Report ◽  
Oral Cavity ◽  
Early Identification ◽  
Clinical Case ◽  
Buccal Cavity ◽  
Supernumerary Teeth ◽  
Supernumerary Tooth ◽  
Adjacent Structures ◽  
The Aesthetic

ABSTRACT Mesiodens is the term used for describing the supernumerary tooth that occurs in the maxilla, between the central incisors, in the midline region. These may erupt in the oral cavity or keep themselves impacted. Their presence causes cleaning inadequate, impossibility or difficult of the eruption of the regular teeth and having the aesthetic compromised. This paper aims at showing that early identification of supernumerary teeth, planning and correct approach, allow the preservation of the teeth and adjacent structures. This article presents the clinical case of a seven-year-old child, male, who sought for treatment complaining that teeth 11 didn't appear in the buccal cavity. Clinical and radiographic exams were done and they demonstrated the presence of the supernumerary tooth. The plan of treatment aimed at the correct localization, extraction of this supernumerary tooth and continuous follow up of the case.

Large congenital bladder diverticula in children

2021 ◽  
pp. 039156032110150
Author(s):  
Ayşe Başak Uçan ◽  
Arzu Şencan
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Postoperative Infection ◽  
Recurrent Reflux ◽  
Main Complaint ◽  
Long Term Follow Up ◽  
Bladder Diverticula ◽  
Transvesical Approach

Objective: Large congenital bladder diverticula (LCBD), congenital bladder diverticula (CBD) larger than 2 cm diameter, is a rare anomaly. The aim of this study was to report long-term surgical and clinical outcomes of children with LCBD. Methods: Medical charts of all children who were diagnosed with LCBD at our institution between April 2005 and December 2017, with at least 2 year follow-up were retrospectively reviewed. Patients’ demographics, symptoms, operative technique, diverticulum size and localization, surgical outcomes and complications were recorded. Results: Fourteen patients with 18 LCBD, all male and age between 7 and 240 months (mean age: 53.5 months) were included in the study. Urinary tract infection was the main complaint in 10. Vesicoureteral reflux was detected in eight patients. Diverticula were 2–5.5 cm (mean 3.3 cm) in size. All diverticulectomies were performed transvesically and ureteroneocystostomy was added in 12 patients, 5 of whom were bilateral. No postoperative infection or recurrent reflux were observed. The median follow-up period was 4.5 years (2–12 years). Conclusion: Treatment of LCBD is mostly surgical and transvesical approach for diverticulectomy was found to be a safe and effective surgical procedure in long term follow-up.

scholarly journals Influence of Smoking Habits on the Prevalence of Dental Caries: A Register-Based Cohort Study

2021 ◽  
Author(s):  
Miguel A. de Araújo Nobre ◽  
Ana M. Sezinando ◽  
Inês C. Fernandes ◽  
Andreia C. Araújo
Keyword(s):  
Dental Caries ◽  
Proportional Hazards ◽  
Smoking Habit ◽  
Cox Proportional Hazards ◽  
Radiographic Examination ◽  
Rank Test ◽  
Significance Level ◽  
Cumulative Survival ◽  
Caries Lesions

Abstract Objective The study aimed to evaluate the influence of smoking habit on the prevalence of dental caries lesions in a follow-up study. Materials and Methods A total of 3,675 patients (2,186 females and 1,489 males) with an average age of 51.4 years were included. Outcome measures were the incidence of dental caries defined as incipient noncavitated, microcavitated, or cavitated lesions which had been diagnosed through clinical observation with mouth mirror and probe examination evaluating change of texture, translucency, and color; radiographic examination through bitewing radiographs; or secondary caries through placement of a new restoration during the follow-up of the study. Statistical Analysis Cumulative survival (time elapsed with absence of dental caries) was estimated through the Kaplan–Meier product limit estimator with comparison of survival curves (log-rank test). A multivariable Cox proportional hazards regression model was used to evaluate the effect of smoking on the incidence of dental caries lesions when controlled to age, gender, systemic status, frequency of dental hygiene appointments, and socioeconomic status. The significance level was set at 5%. Results Eight hundred sixty-three patients developed caries (23.5% incidence rate). The cumulative survival estimation was 81.8% and 48% survival rate for nonsmokers and smokers, respectively (p < 0.001), with an average of 13.5 months between the healthy and diseased state diagnosis. Smokers registered a hazard ratio for dental caries lesions of 1.32 (p = 0.001) when controlled for the other variables of interest. Conclusion Within the limitations of this study, it was concluded that smoking habit might be a predictor for dental caries.

scholarly journals SEOM clinical guideline for management of adult medulloblastoma (2020)

2021 ◽  
Author(s):  
R. Luque ◽  
M. Benavides ◽  
S. del Barco ◽  
L. Egaña ◽  
J. García-Gómez ◽  
...  
Keyword(s):  
Residual Tumor ◽  
Large Cell ◽  
High Dose Chemotherapy ◽  
High Dose ◽  
Molecular Alterations ◽  
Adult Medulloblastoma ◽  
Group 4 ◽  
Risk Patients ◽  
Standard Risk

AbstractRecent advances in molecular profiling, have reclassified medulloblastoma, an undifferentiated tumor of the posterior fossa, in at least four diseases, each one with differences in prognosis, epidemiology and sensibility to different treatments. The recommended management of a lesion with radiological characteristics suggestive of MB includes maximum safe resection followed by a post-surgical MR < 48 h, LCR cytology and MR of the neuroaxis. Prognostic factors, such as presence of a residual tumor volume > 1.5 cm2, presence of micro- or macroscopic dissemination, and age > 3 years as well as pathological (presence of anaplastic or large cell features) and molecular findings (group, 4, 3 or p53 SHH mutated subgroup) determine the risk of relapse and should guide adjuvant management. Although there is evidence that both high-risk patients and to a lesser degree, standard-risk patients benefit from adjuvant craneoespinal radiation followed by consolidation chemotherapy, tolerability is a concern in adult patients, leading invariably to dose reductions. Treatment after relapse is to be considered palliative and inclusion on clinical trials, focusing on the molecular alterations that define each subgroup, should be encouraged. Selected patients can benefit from surgical rescue or targeted radiation or high-dose chemotherapy followed by autologous self-transplant. Even in patients that are cured by chemorradiation presence of significant sequelae is common and patients must undergo lifelong follow-up.

An isolated primary Rathke's cleft cyst in the cerebellopontine angle

2014 ◽  
Vol 121 (4) ◽  
pp. 846-850 ◽  
Author(s):  
Jun Fan ◽  
Songtao Qi ◽  
Yuping Peng ◽  
Xi-an Zhang ◽  
Binghui Qiu ◽  
...  
Keyword(s):  
Cerebellopontine Angle ◽  
Imaging Features ◽  
Good Recovery ◽  
Suprasellar Region ◽  
Adjacent Structures ◽  
Facial Numbness ◽  
History Of ◽  
Rathke's Cleft Cysts ◽  
Rathke's Cleft

Rathke's cleft cysts (RCCs) are benign cysts typically located in the sellar or suprasellar region; ectopic isolated lesions are extremely rare. The authors describe the case of a 25-year-old man with a giant symptomatic RCC arising primarily at the cerebellopontine angle (CPA), only the second case reported thus far. The patient presented with a 2-year history of right hearing impairment and tinnitus accompanied by vertigo and headache and a 2-week history of right facial numbness. Subsequently, he underwent total cyst removal via retrosigmoid craniotomy with a good recovery. He experienced no recurrence during a 64-month follow-up period. The possible pathogenesis, differential diagnosis, and surgical treatment of such cysts are discussed in this article. Isolated ectopic RCCs can arise from the ectopic migration of Rathke's pouch cells during the embryonic period. It is still difficult to distinguish ectopic RCCs from other cystic lesions of the CPA given the lack of specific imaging features. Aggressive resection of the cyst wall is not recommended, except when lesions do not closely adhere to adjacent structures.

Radiosurgery for Treatment of Recurrent Intracranial Hemangiopericytomas

Neurosurgery ◽  
2002 ◽  
Vol 51 (4) ◽  
pp. 905-911 ◽  
Author(s):  
Jason Sheehan ◽  
Douglas Kondziolka ◽  
John Flickinger ◽  
L. Dade Lunsford
Keyword(s):  
Stereotactic Radiosurgery ◽  
Survival Rates ◽  
Gamma Knife Radiosurgery ◽  
Residual Tumor ◽  
Local Tumor Control ◽  
Tumor Control ◽  
Local Tumor ◽  
University Of Pittsburgh ◽  
Kaplan Meier

Abstract OBJECTIVE Hemangiopericytomas are highly aggressive meningeal tumors with tendencies for recurrence and metastasis. The purpose of this retrospective, single-institution review was to evaluate the efficacy and role of stereotactic radiosurgery in the management of recurrent hemangiopericytomas. METHODS We reviewed data for patients who underwent stereotactic radiosurgery at the University of Pittsburgh between 1987 and 2001. Fourteen patients underwent radiosurgery for 15 discrete tumors. Prior treatments included transsphenoidal resection (n = 1), craniotomy and resection (n = 27), embolization (n = 1), and conventional radiotherapy (n = 7). Clinical and radiological responses were evaluated. Follow-up periods varied from 5 to 76 months (mean, 31.3 mo; median, 21 mo). The mean radiation dose to the tumor margin was 15 Gy. RESULTS Seventy-nine percent of patients (11 of 14 patients) with recurrent hemangiopericytomas demonstrated local tumor control after radiosurgery. Twelve of 15 tumors (i.e., 80%) dramatically decreased in size on follow-up imaging scans. Regional intracranial recurrences were retreated with radiosurgery for two patients (i.e., 15%); neither of those two patients experienced long-term tumor control. Local recurrences occurred 12 to 75 months (median, 21 mo) after radiosurgery. Local tumor control and survival rates at 5 years after radiosurgery were 76 and 100%, respectively (Kaplan-Meier method). We could not correlate prior irradiation or tumor size with tumor control. Twenty-nine percent of the patients (4 of 14 patients) developed remote metastases. Radiosurgery did not seem to offer protection against the development of intra- or extracranial metastases. CONCLUSION Gamma knife radiosurgery provided local tumor control for 80% of recurrent hemangiopericytomas. When residual tumor is identified after resection or radiotherapy, early radiosurgery should be considered as a feasible treatment modality. Despite local tumor control, patients are still at risk for distant metastasis. Diligent clinical and radiological follow-up monitoring is necessary.

En Plaque Sphenoid Wing Meningiomas: Recurrence Factors and Surgical Strategy in a Series of 71 Patients

2009 ◽  
Vol 65 (suppl_6) ◽  
pp. ons100-ons109 ◽  
Author(s):  
Giuseppe Mirone ◽  
Salvatore Chibbaro ◽  
Luigi Schiabello ◽  
Serena Tola ◽  
Bernard George
Keyword(s):  
Cavernous Sinus ◽  
Residual Tumor ◽  
Complete Removal ◽  
Subtotal Resection ◽  
Presenting Symptoms ◽  
Time To Recurrence ◽  
Clinical Records ◽  
Mean Time ◽  
Case Basis

Abstract Objective: En plaque sphenoid wing meningiomas are complex tumors involving the sphenoid wing, the orbit, and sometimes the cavernous sinus. Complete removal is difficult, so these tumors have high rates of recurrence and postoperative morbidity. The authors report a series of 71 patients with sphenoid wing meningiomas that were managed surgically. Methods: The clinical records of 71 consecutive patients undergoing surgery for sphenoid wing meningiomas at Lariboisière Hospital, Paris, were prospectively collected in a database during a 20-year period and analyzed for presenting symptoms, surgical technique, clinical outcome, and follow-up. Results: Among the 71 patients (mean age, 52. 7 years; range, 12–79 years), 62 were females and 9 were males. The most typical symptoms recorded were proptosis in 61 patients (85.9%), visual impairment in 41 patients (57.7%), and oculomotor paresis in 9 patients (12.7%). Complete removal was achieved in 59 patients (83%). At 6 months of follow-up, magnetic resonance imaging scans revealed residual tumor in 12 patients (9 in the cavernous sinus and 3 around the superior orbital fissure). Mean follow-up was 76.8 months (range, 12–168 months). Tumor recurrence was recorded in 3 of 59 patients (5%) with total macroscopic removal. Among the patients with subtotal resection, tumor progression was observed in 3 of 12 patients (25%; 2 patients with grade III and 1 patient with grade IV resection). Mean time to recurrence was 43.3 months (range, 32–53 months). Conclusion: Surgical management of patients with sphenoid wing meningiomas cannot be uniform; it must be tailored on a case-by-case basis. Successful resection requires extensive intra- and extradural surgery. We recommend optic canal decompression in all patients to ameliorate and/or preserve visual function.

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