Reconstruction after big nasal tumors

This article comes as a presentation of the clinical experience in the plastic surgery department. Gather the experience of 3 clinical cases, more representative, with different histopathological tumors, of important dimensions that occupied a large part of the facial anatomical unit, the nose. The article is structured by presenting the risk factors that are the causes of malignant lesions and by recalling the therapeutic options and general principles of addressing large lesions. Malignant lesions that occur most frequently in the nose are reviewed. We consider that it is a serious health problem, with various consequences, of a functional nature, which can affect the airways and aesthetically that can lead to a reconsideration of self-respect and the perception of the affected person towards his peers. The approach of the cases was done sequentially. The first surgical stage involved the excision of the lesion with the oncological safety limit, the defect being larger than the lesion and the more elaborate therapeutic options on the reconstruction scale. The first operative stage ended each time with covering the defect with a graft to have the confirmation of the histopathological examination, free of the tumor. The second stage of the treatment involved lifting the flap and accommodating it. The last surgical stage involved the sectioning of the pedicle and its reintegration into the donor area.

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A prospective observational study on the effectiveness of risk of malignancy index score (RMI 3) in a tertiary care centre in Eastern India

Asian Journal of Medical Sciences ◽

10.3126/ajms.v11i5.29548 ◽

2020 ◽

Vol 11 (5) ◽

pp. 54-60

Author(s):

Apurba Mandal ◽

Shibram Chattopadhyay ◽

Sushanta Mondal ◽

Arunava Biswas

Keyword(s):

Ovarian Cancer ◽

Adnexal Mass ◽

Malignant Tumors ◽

Histopathological Examination ◽

Tertiary Care ◽

Ca 125 ◽

Tertiary Care Centre ◽

Gynecology And Obstetrics ◽

Risk Of Malignancy ◽

Malignant Lesions

Background: Adnexal mass is a common presentation in today’s gynecological practice. The incidence of ovarian cancer is increasing day by day and diagnosis is often difficult to be made pre operatively with inadequate surgical exploration is a regular occurrence. Aims and Objectives: To assess and validate the importance of RMI-3 score as pre-operative diagnostic tool of differentiating benign from malignant adnexal mass for starting first line therapy of ovarian cancer and to find out the incidences of ovarian malignancy among study population. Material and Methods: The study was conducted in the Department of Gynecology and Obstetrics on (n=115) patients attending GOPD and indoor with adnexal mass fulfilling the inclusion and exclusion criteria using purposive sampling technique. All the selected cases underwent ultrasonography and serum CA- 125 level estimation necessary for calculating RMI score. A score of >200 was taken as suggestive of malignancy and confirmatory diagnosis was performed by histopathological examination obtained from staging laparotomy of adnexal mass. The individual scores were then correlated with final outcomes with statistical analyses. Results: The study revealed benign ovarian tumors are more under 50 years (78.46%) and patients with normal BMI are diagnosed with maximum of malignancy (n = 28). History of tubal ligation carried less risk of malignancy (p<0.0001). Histologically malignant tumors found mostly in 71.4% postmenopausal group whereas 94.1% benign pathology were present in perimenopausal group and there is no association found between parity and histopathology (p=0.058). Bilateral (p=0.013), multilocular (p=0.000) tumors with solid areas (p<0.0001) and thick papillary projections (p<0.0001) had statistically significant association with malignant lesions. RMI score (>200) had more efficacy than serum CA-125 level (>46) in differentiating malignant lesions from benign one in terms of specificity (96% vs 83.87%) and positive predictive value (95% vs 79.17%). Conclusions: RMI-3 score is a simple, reliable and effective tool in differentiating benign from malignant adnexal masses thereby help in quick referral and management of cases with increase chances of survival of the patients.

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Nasomaxillary swellings: our experience at tertiary care hospital

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20210680 ◽

2021 ◽

Vol 7 (3) ◽

pp. 469

Author(s):

Mukesh Rawat ◽

Archana Lall ◽

Kavita Sachdeva

Keyword(s):

Tertiary Care Hospital ◽

Histopathological Examination ◽

Tertiary Care ◽

Final Diagnosis ◽

Inverted Papilloma ◽

Nasal Endoscopy ◽

Common Symptom ◽

Fungal Sinusitis ◽

Care Hospital ◽

Malignant Lesions

Background: A wide spectrum of lesions may present as nasomaxillary swellings ranges from benign to malignant lesions including fungal sinusitis and fibro vascular lesions example: JNA (Juvenile nasopharyngeal angiofibroma) and Inverted papilloma. Many Pathologies ranging from benign to malignant tumors may mimic a simple Nasomaxillary mass. It is diagnostic challenge to determine pathology behind it. A detailed clinical evaluation with nasal endoscopy and relevant pre-operative investigations including radiological imaging and histopathological examination is essential to reach up to final diagnosis. The aim of the study was to do clinicopathological evaluation of patients presenting with nasomaxillary swelling and correlation of clinical, radiological and Histopathological findings.Methods: This was a prospective observational study on 50 nasomaxillary swelling patients who are presented in the Department of ENT and Head and Neck Surgery of N.S.C.B. MCH Jabalpur, a tertiary care Hospital, between March 2018 to August 2019. A detailed history taking and clinical examination with nasal endoscopy and relevant preoperative investigations including CECT Nose and PNS and histopathological examination was done in all patients.Results: 50 Nasomaxillary swelling patients were selected for this study. 30 patients were male and 20 were females. Ages of patients were varied from 12 years to 72 years. 23 patients (46%) were malignant and 27 (54%) were benign. Histopathological examination results shows benign lesions like JNA (6 cases), fungal sinusitis (6 cases), dermoid cyst (1 case), inverted papilloma (3 cases), sebaceous cyst (1 case), jaw lesions (10 cases), (odontogenic like radicular/ infected cyst, dentigerous cyst, cystic ameloblastoma and non-odontogenic like fibrous dysplasia) and malignant lesions like SCC (squamous cell carcinoma) (12 cases), spindle cell sarcoma (2 cases), undifferentiated carcinoma (3 cases), adenocarcinoma (3 cases), adenoid cystic carcinoma (1 case), Invasive pleomorphic sarcoma (1 case) and malignant melanoma (1 case). SCC was most common lesion f/b JNA and fungal sinusitis. Well differentiated SCC was most common histological type (10 out of 12 cases of SCC). Most common symptom was nasal obstruction (66% cases) f/b epistaxis (52% cases) but epitasis was most common symptom among malignant and JNA cases. In 6 cases (3 JNA, 1 inverted papilloma, 1 malignancy and 1 radicular cyst) radiological diagnosis were not correlated with histological findings.Conclusions: Most our cases were malignant nasomaxillary lesions followed by fungal sinusitis and JNA. Most patients presented in advanced stage of disease so rapidly evaluation including nasal endoscopy should be done. CECT scan is essential to determine tumors extent and bony lesions. All patients should undergo hisotopatholigical examination. The final diagnosis should be made on the basis of clinical, radiological and histopathological findings.

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A histopathological review of nephrectomy specimens with an emphasis on pathological assessment of prognostic indicators in malignant lesions

Biomedicine ◽

10.51248/.v40i4.327 ◽

2021 ◽

Vol 40 (4) ◽

pp. 492-501

Author(s):

Shubha P. Bhat ◽

Krishna Prasad H.V. ◽

Rajeev T.P. ◽

Kishan Prasad H.L. ◽

Teerthanath Srinivas ◽

...

Keyword(s):

Histopathological Examination ◽

Malignant Tumour ◽

Prognostic Indicators ◽

Wilms Tumour ◽

Malignant Tumours ◽

Neoplastic Lesions ◽

Kidney Lesion ◽

Microscopic Features ◽

Malignant Lesions ◽

Pathological Assessment

Introduction and Aim: Various non-neoplastic and neoplastic lesions occur in the kidney. Pathological assessment of gross and microscopic features in nephrectomy specimens is essential for diagnosis and predicts the prognosis in malignant tumours. Materials and Methods: Case records of 46 nephrectomy specimens received between two-year periods were retrieved. Detailed gross and histopathological and immunohistochemical features were studied, and malignant tumours were analysed using CAP protocol. Results: Out of 46 nephrectomy specimens, 17 were non-neoplastic and 29 neoplastic. Males constituted 32 cases and females 14 cases. The commonest non-neoplastic kidney lesion was chronic pyelonephritis with hydronephrosis (29%). The mixed epithelial and stromal tumour was the frequently encountered benign tumour (50%). Renal cell carcinoma was the most common malignant tumour in adults (70%) and Wilms tumour in children (4%). Conclusion: Histopathological examination of nephrectomy specimens helps in diagnosing, staging, and planning the management.

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HISTOPATHOLOGICAL STUDY OF UTERINE LEIOMYOMA IN HYSTERECTOMY SPECIMENS

10.36106/ijsr/9133056 ◽

2021 ◽

pp. 77-79

Author(s):

Satyendra Kumar ◽

Archana Jha ◽

[Prof.] Ravi Kant Mishra ◽

Debarshi Jana

Keyword(s):

Uterine Leiomyoma ◽

Histopathological Examination ◽

Benign Neoplasm ◽

Reproductive Age ◽

Degenerative Changes ◽

Histopathological Study ◽

Age Group ◽

Common Location ◽

Proliferative Endometrium ◽

Malignant Lesions

Background: Uterine leiomyoma is the most common benign neoplasm in women of reproductive age group. Hysterectomy is a mode of therapy in uterine Leiomyoma. The objective of this study was to evaluate the histopathological changes in hysterectomy specimens with uterine leiomyomas. This is a retrospective study of one hundred sixty eight patients w Methods: ho underwent hysterectomy for uterine leiomyoma. Results: Uterine leiomyoma was most common in the age group of 41-50 years (54.76%). Most common location of leiomyoma was intramural (51.2%). Degenerative changes were seen in 10.72% cases. Hyaline degeneration was the most common type of degenera-tion (7.14%). Proliferative endometrium was the most common endometrial pattern (63.1%) in uterine leiomyoma. Associated malignant lesions were observed in 1.8 % cases of uterine leiomyoma. Uterine leiomyoma is associated wi Conclusion: th degenerative changes and coexistent benign and malignant patholologies. Histopathological examination of hysterectomy specimens should be done to conrm the diagnosis and rule out other pathologies, especially malignant lesions.

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Incidental gynaecological malignancy in women who underwent hysterectomy for utero-vaginal prolapse: a 3-year institutional case study

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20183765 ◽

2018 ◽

Vol 7 (9) ◽

pp. 3625

Author(s):

Fathima M. Seles ◽

Rajavelu Indira

Keyword(s):

Pap Smear ◽

Histopathological Examination ◽

Transvaginal Ultrasound ◽

Endometrial Adenocarcinoma ◽

Lower Abdominal Pain ◽

Cervical Squamous Cell Carcinoma ◽

Endometrial Biopsy ◽

Vaginal Prolapse ◽

Screening Tests ◽

Malignant Lesions

Background: Pelvic organ prolapse is common is almost 50% of women over the age of 50years. The objective of the present study was to estimate the number of incidental gynaecological malignancies in women who underwent hysterectomy for utero-vaginal prolapse.Methods: 354 women who presented with asymptomatic utero-vaginal prolapse were included in this study. Women who were symptomatic with bleeding per vaginum, lower abdominal pain or excessive white discharge and preoperative screening tests such as VIA/VILI, colposcopy, Pap smear and radio-imaging showing any gynaecological lesions were excluded from this study.Results: Histopathological examination of the hysterectomy specimen showed premalignant lesion in 13 cases accounting to 3.7% (11 cases of CIN I, 1 case of CIN II, 1 case of CIN III) and malignant lesions in 5cases accounting for 1.4% (4 cases of endometrial adenocarcinoma and 1 case of cervical squamous cell carcinoma).Conclusions: Asymptomatic women with utero-vaginal prolapse may have pre-existing premalignant and malignant lesions. Therefore, all women undergoing hysterectomy should be preoperatively screened with transvaginal ultrasound, endometrial biopsy and pap smear to rule out malignancy, as the management differs for patients with co-existing gynecological malignancies.

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Histopathological study of endometrium in abnormal uterine bleeding

Journal of Pathology of Nepal ◽

10.3126/jpn.v2i4.6882 ◽

2012 ◽

Vol 2 (4) ◽

pp. 297-300 ◽

Cited By ~ 3

Author(s):

S Bhatta ◽

AK Sinha

Keyword(s):

Histopathological Examination ◽

Abnormal Uterine Bleeding ◽

Uterine Bleeding ◽

Common Finding ◽

Histopathological Study ◽

Endometrial Sampling ◽

Proliferative Endometrium ◽

Malignant Lesions ◽

Hematoxylin And Eosin ◽

Hematoxylin And Eosin Stain

Background: Histopathological evaluation of endometrial samples is essential in the workup of abnormal uterine bleeding. This study was carried out to evaluate patterns of endometrial histological findings in women with abnormal uterine bleeding and to correlate histopathological findings with clinical features.Materials and Methods: One hundred and twenty two patients with diagnosis of abnormal uterine bleeding underwent endometrial sampling. The slides stained with Hematoxylin and Eosin stain were studied.Results: The predominant endometrial histopathological finding was proliferative endometrium 32 cases (26.23%) followed by simple hyperplasia without atypia 22 cases (18.03%). Malignant lesions were more common in patients more than 40 years of age and comprised of 7 cases (5.74%) of all cases. Atrophic endometrium was most common finding in postmenopausal bleeding 8 cases (28.6%) followed by endometrial carcinoma 5 cases (17.9%).Conclusion: Histopathological examination of endometrium should be done generously in women presenting with abnormal uterine bleeding especially after the age of 40 years to rule out malignant pathology.Journal of Pathology of Nepal (2012) Vol. 2, 297-300DOI: http://dx.doi.org/10.3126/jpn.v2i4.6882

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The predictive value of videostroboscopy in the assessment of premalignant lesions and early glottis cancers

Otolaryngologia Polska ◽

10.5604/01.3001.0010.2243 ◽

2017 ◽

Vol 71 (4) ◽

pp. 14-18 ◽

Cited By ~ 1

Author(s):

Anna Rzepakowska ◽

Ewelina Sielska-Badurek ◽

Ewa Osuch-Wójcikiewicz ◽

Michał Sobol ◽

Kazimierz Niemczyk

Keyword(s):

Predictive Value ◽

Vocal Fold ◽

Histopathological Examination ◽

High Sensitivity ◽

Vocal Folds ◽

Invasive Cancer ◽

Premalignant Lesions ◽

Good Tool ◽

Malignant Lesions ◽

Sensitivity Specificity

Objective: To assess the sensitivity and specificity of larngovideostroboscopy (LVS) in the diagnosis of precancerous and malignant lesions of the vocal folds. Material and methods: In 175 patients (128 men and 47 women), aged 19-88 years, mean age 61.5, who were admitted to the clinic with diagnosed premalignant conditions of vocal fold mucosa (leukoplakia, chronic hypertrophic inflammatory lesions) and thickening or tumor on the vocal fold, there was performed LVS before the laryngeal microsurgery. The LVS study included: localization of the leasion, movement of the vocal folds, mucosal wave, shape of glottis clousure, amplitude and symmetry of vocal fold vibration. In the evaluation, a point scale was applied for the individual functional parameters. The scale ranged from 0 to 14. Patients with impaired vocal fold motion or absent mucosal wave were positive on LVS for malignant lesions. Those with limitted mucosal wave were positive on LVS for dysplastic lesions. The results were compared with the final histopathological examination and the sensitivity, specificity, accuracy, positive (PPV) and negative (NPV) predictive value were calculated. Results: On the basis of histopathological examination, benign lesions (normal or inflammatory mucosa) accounted for 20% of diagnoses, hypertrophy and parakeratosis for 28%, low and middle grade dysplasia accounted for 10% and malignant lesions (high-grade dysplasia, pre-invasive cancer, Invasive cancer) was diagnosed in 42% of patients. The overall mean score for LVS was 4.5 and 8.0, respectively for benign and malignant lesions. Sensitivity, specificity, accuracy, PPV and NPV of LVS in detecting malignant lesions were respectively - 95.6%, 23.8%, 61.1%, 57.6% and 83.3% and in detecting both premalignant and malignant lesions were respectively – 90.7%, 31.4%, 78.9%, 84.1% and 45.8%. Conclusions: Because of the high sensitivity of LVS in detecting precancerous and malignant lesions, this method is a very good tool for screening of pathology within the larynx.

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Clinician’s Update on the Benign, Premalignant, and Malignant Skin Tumours of the Vulva: The Dermatologist’s View

International Scholarly Research Notices ◽

10.1155/2017/2414569 ◽

2017 ◽

Vol 2017 ◽

pp. 1-10

Author(s):

Freja Lærke Sand ◽

Simon Francis Thomsen

Keyword(s):

Histopathological Examination ◽

Malignant Lesion ◽

Rapid Diagnosis ◽

Benign Lesions ◽

Skin Tumours ◽

Skin Tumour ◽

Malignant Skin ◽

Melanocytic Naevi ◽

Skin Biopsies ◽

Malignant Lesions

Correct and rapid diagnosis of skin tumours often requires biopsy and histopathological examination to differentiate benign lesions such as seborrhoeic keratoses or melanocytic naevi from premalignant and malignant lesions such as malignant melanoma. Particularly, to the untrained eye, any benign skin tumour—pigmented or nonpigmented—is easily mistaken for a malignant lesion. Qualified clinical evaluation is paramount in order to reduce the frequency of unwarranted skin biopsies. Herein, the most common benign, premalignant, and malignant vulvar skin tumours are reviewed.

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Non-malignant Oral Ulcer: A Diagnostic Challenge to Otorhinolaryngologists

Bengal Journal of Otolaryngology and Head Neck Surgery ◽

10.47210/bjohns.2019.v27i3.11 ◽

2019 ◽

Vol 27 (3) ◽

pp. 223-228

Author(s):

Neeraj Aggarwal ◽

Sirshak Dutta ◽

Avijit Choudhury ◽

Mainak Dutta ◽

Saumik Das ◽

...

Keyword(s):

Oral Cavity ◽

Clinical Diagnosis ◽

Histopathological Examination ◽

Oral Candidiasis ◽

Tertiary Care ◽

Diagnostic Challenge ◽

Erosive Lichen Planus ◽

Male Preponderance ◽

Malignant Lesions ◽

Malignant Ulcer

Introduction Apart from the malignant ulcers a wide variety of dermatological and other systemic conditions can affect oral cavity and often be a diagnostic challenge due to their similar presenting features and appearance. Despite being benign, some of them may be fatal if not diagnosed and treated timely. This study aims to assess the incidence of different non malignant ulcers in oral cavity and to estimate the need for histopathological examination for confirmation of the condition for proper management. Materials and Methods An institution based observational study was conducted over a time period of 16 months at a tertiary care institute. Total 172 cases were included in the present study irrespective of age, sex and duration. Malignant lesions were excluded from the study. Results The present study shows a slight male preponderance (M:F = 1.48:1) with majority of cases were in age group 20-40 years of age (43.02%). Most commonly encountered were recurrent aphthous stomatitis (27.9%) followed by erosive lichen planus (16.28%), oral candidiasis, angular stomatitis, traumatic ulcers and others. 78.5% were treated successfully on the basis of clinical diagnosis while 21.5% cases needed further histopathological or other investigation for confirmation of diagnosis. Conclusion Though the otolaryngologists are more concerned about malignant ulcer, there are many non malignant ulcers which can cause significant morbidity and can even be fatal and should be given similar importance like malignant lesions. Majority of them can be treated successfully on the basis of clinical diagnosis but histopathological examination may be required in some cases for proper diagnosis and appropriate management.

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