Complete Surgical Excision with Keeping Drain Tube in Situ for 2 to 3 Weeks in the Treatment of Cystic Hygroma: A study of 5 years

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

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A clinicopathological study and management of odontogenic keratocyst

Update Dental College Journal ◽

10.3329/updcj.v9i1.41200 ◽

2019 ◽

Vol 9 (1) ◽

pp. 8-15

Author(s):

Mohammad Asifur Rahman ◽

Tarin Rahman ◽

Ismat Ara Haider

Keyword(s):

Conservative Treatment ◽

Recurrence Rate ◽

Surgical Resection ◽

Treatment Options ◽

Anatomical Structure ◽

Odontogenic Keratocyst ◽

High Recurrence Rate ◽

Odontogenic Cysts ◽

Odontogenic Keratocysts ◽

Surgical Methods

Odontogenic Keratocyst is an aggressive odontogenic cyst with a high recurrence rate. After radicular and follicular cysts, odontogenic keratocysts are the third most common cyst of the jaws and approximately 12-14% of all odontogenic cysts. It has been retermed to Keratocystic odontogenic tumour (KCOT) as it better reflects its neoplastic nature but recently it has been re classified and retermed into the cystic category. Various surgical methods have been proposed but comparatively, conservative treatment options such as Dredging methods might be the treatment of choice due to preservation of anatomical structure. Objective: The aim of this study was to analyse the clinical, radiological and histopathological characteristics of Odontogenic Keratocyst and provide a proper management system affected by this type of lesions. Materials and methods: The prospective study was performed in Dhaka Dental College and Hospital from a period of January 2014 to January 2018. A total number of 75 patients were selected for this study based on clinical, radiological and histopathological confirmation of odontogenic keratocysts. The treatment options were enucleation, enucleation with curettage, enucleation with peripheral ostectomy, Dredging method and surgical resection. After treatment patients were followed up 1months, 3 months and 6 months in every year at least for 5 years. Results: Among 75 patient of odontogenic keratocyst; the mean age was 27.69±13.35 and age range was 11 to 66 years. Male were 53(71%) and 22 (29%) were female patients. 53 (70.67%) cases were found in the mandible, 15(20%) cases in the maxilla and in 7(9.33%) cases were involved in both maxilla and mandible; mandibular posterior region was the most specific region involved 37(69.81%).The most common clinical features revealed pain and swelling. Radiologically, 70.66% unilocular, 96% well defined and 94.66% radiolucent area were prominent. Bone expansion 37.38%, root resorption 30.00% and 36% were associated with an impacted tooth. Regarding treatment options enucleation with curatage 12%, enucleation, curettage & peripheral ostectomy 29.33%, Dredging 52% and surgical resection 6.6% was done. Recurrence occurred in 18 patients with recurrence rate of 24%. Conclusion: Odontogenic keratocyst is an aggressive cyst, male predominant, posterior mandible is the commonest site and well defined unilocular radiolucency are commonest radiological feature. Radical treatment options such as resection reduced the recurrences of the tumour but higher morbidity and jaw deformity. Comparatively, conservative treatment options such as Dredging methods might be the treatment of choice due to preservation of anatomical structure. A long term follow up is paramount importance for the research and understanding the clinical pattern, behavior, treatment and recurrence of the lesion. Update Dent. Coll. j: 2019; 9 (1): 8-15

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Surgical excision: an effective initial therapeutic option in the management of giant macrocystic lymphatic malformations in children

Annals of Pediatric Surgery ◽

10.1186/s43159-019-0013-9 ◽

2020 ◽

Vol 16 (1) ◽

Cited By ~ 1

Author(s):

Moaied A. Hassan ◽

Hasan K. Gatea ◽

Thura K. Ja’afar

Keyword(s):

Therapeutic Option ◽

Surgical Excision ◽

Functional Results ◽

The Body ◽

Lymphatic Malformations ◽

Therapeutic Modalities ◽

Complete Surgical Excision ◽

Cystic Tumors ◽

Cystic Cavity ◽

Embryologic Development

Abstract Background Lymphatic malformations are rare benign cystic tumors that result from localized disordered embryologic development of the lymphatic system and can develop anywhere in the body, predominantly in the head and neck. These lesions are classified according to the diameter of the largest cystic cavity within the lesion into microcystic and macrocystic types. Historically, surgical excision has been considered the mainstay of treatment and still remains the first therapeutic option of choice for many surgeons particularly for giant macrocystic lesions. Several alternative therapeutic modalities emerged including intralesional sclerotherapy and laser therapy with encouraging results. The study is designed to assess the effectiveness and safety of surgical excision as an initial therapeutic option in the management of these malformations. Results Asymptomatic mass with parental cosmetic and functional concerns was the mode of presentation in six (66.7%) patients. Seven (77.8%) patients were presented before the age of 2 years. Six (66.7%) of the patients had their lesions in the neck. Complete surgical excision was achieved in eight (88.9%) patients without any evident significant injury to vital neurovascular structures. None of the patients had any difficulties with breathing, swallowing, or phonation and cosmetic results were satisfactory in the majority (88.9%) of them. Conclusion Radical surgical excision of giant macrocystic lymphatic malformations in children is possible in experienced hands. It is an effective and safe initial therapeutic option and gives satisfactory esthetic and functional results.

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A Case of Incidental Schwannoma Mimicking Necrotic Metastatic Lymph Node from Bladder Cancer

Medicina ◽

10.3390/medicina57070728 ◽

2021 ◽

Vol 57 (7) ◽

pp. 728

Author(s):

Jeong-Hyouk Choi ◽

Koo-Han Yoo ◽

Dong-Gi Lee ◽

Gyeong-Eun Min ◽

Gou-Young Kim ◽

...

Keyword(s):

Histopathological Examination ◽

Metastatic Lymph Node ◽

Imaging Study ◽

Surgical Excision ◽

The Body ◽

Pathological Examination ◽

Cystic Tumor ◽

Complete Surgical Excision ◽

Ultrasound Computed Tomography ◽

Retroperitoneal Schwannoma

Background and Objectives: Retroperitoneal schwannoma is a very rare case of schwannoma which commonly occurs in the other part of the body. However, it is difficult to distinguish schwannoma from other tumors before pathological examination because they do not show specific characteristics on imaging study such as ultrasound, computed tomography (CT), and magnetic resonance image (MRI). Case summary: A 60-year-old male showed a retroperitoneal cystic tumor which is found incidentally during evaluation of coexisted bladder tumor. Neurogenic tumor was suspicious for the retroperitoneal tumor through pre-operative imaging study. Finally, a schwannoma was diagnosed by immunohistochemical examination after complete surgical excision laparoscopically. Conclusion: As imaging technology is developed, there may be more chances to differentiate schwannoma from other neoplasm. However, still surgical resection and histopathological examination is feasible for diagnosis of schwannoma.

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Branchial Cysts in Quito, Ecuador

International Archives of Otorhinolaryngology ◽

10.1055/s-0039-1695023 ◽

2020 ◽

Vol 24 (03) ◽

pp. e347-e350

Author(s):

Luis Pacheco-Ojeda ◽

Andrés Ayala-Ochoa ◽

Karla Salvador

Keyword(s):

General Hospital ◽

Surgical Resection ◽

Adult Population ◽

Tertiary Care ◽

Surgical Excision ◽

Branchial Cleft Cyst ◽

Complete Surgical Excision ◽

Branchial Cleft ◽

Lower Neck ◽

Clinical Records

Introduction Branchial cleft anomalies are the second most common congenital anomaly in children. However, some lesions may not develop clinically and are not diagnosed until adulthood. The recent literature of branchial cysts (BCs) in the adult population is really scanty. For this reason, we analyzed the clinical and surgical management of the adult population treated for a BC at a tertiary care general hospital. Methods A retrospective review of the clinical records of all the patients with histological diagnosis of BC who were surgically treated at the Social Security Hospital in Quito, Ecuador, was performed. Fifty-one patients (27 women) with congenital anomalies of the 2nd (43 patients with cysts) and 3rd (6 patients with cysts and 2 with fistula) branchial arches were diagnosed and treated. Diagnosis was made on clinical grounds and by computed tomography scan. Results The 43 patients with a 2nd branchial cleft cyst underwent complete surgical excision through a wide mid-neck transverse cervicotomy. The 6 cases of 3rd branchial cleft cyst underwent surgical resection through a lower-neck transverse incision, and the 2 patients with clinical fistula in the lower aspect of the neck were operated on via an elliptical incision around this external fistula opening. Postoperative evolution was uneventful in all patients. Conclusions Branchial cysts can occasionally be diagnosed in adult patients in the setting of a general hospital population. A correct clinical and imaging assessment was diagnostic in most patients. Complete surgical resection was curative in all our patients, and postoperative complications were exceptional.

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A rare presentation of superficial, inter-muscular, cystic, extra-spinal schwannoma over upper back.

10.21203/rs.3.rs-38097/v2 ◽

2020 ◽

Author(s):

Srinjoy Saha

Keyword(s):

Signs And Symptoms ◽

Surgical Excision ◽

The Body ◽

Thoracic Vertebrae ◽

Rare Presentation ◽

Complete Surgical Excision ◽

Rare Tumours ◽

S 100 ◽

Diagnostic Signs ◽

Upper Thoracic

Abstract Schwannomas are rare tumours arising from peripheral nerve sheath and are usually related to the spinal cord and spinal nerves. Contrast magnetic resonance imaging (MRI) usually helps in establishing a pre-operative diagnosis. Rarely, their manifestation may be surprisingly new. Here, a 44-year-old lady came to our clinic with a painless asymptomatic progressively enlarging swelling over her upper back. It was fluctuant, with absent neural signs and symptoms. MRI showed a benign, purely-cystic, superficial-intermuscular, extra-spinal swelling near the upper thoracic vertebrae. However, classical diagnostic signs of schwannoma were absent. Complete surgical excision was performed with smooth dissection through a well-defined plane between the lesion and surrounding muscles. A 6.5x5.0x2.5 cm oval lesion with a glistening whitish-grey capsule was excised, and the deep wound was reconstructed in multiple layers. Interestingly, it was not attached to any identifiable nerves. Histopathology showed typical hallmarks like Antoni A regions and Verocay bodies. Positive S-100 staining during immunohistochemistry established its diagnosis as schwannoma. The postoperative one-and-half-year follow-up period was uneventful. Cystic schwannomas can surprise and confuse clinicians by arising anywhere in the body and with atypical manifestations. Surgeons need to consider it in the differential diagnoses of any undiagnosed slowly-growing swelling, including purely-cystic ones and perform careful surgical dissection to avoid any inadvertent nerve damage.

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Spinal osteoid osteoma: Surgical resection and review of literature

Surgical Neurology International ◽

10.25259/sni_510_2020 ◽

2020 ◽

Vol 11 ◽

pp. 308

Author(s):

Abhinandan Reddy Mallepally ◽

Rajat Mahajan ◽

Sandesh Pacha ◽

Tarush Rustagi ◽

Nandan Marathe ◽

...

Keyword(s):

Surgical Resection ◽

Osteoid Osteoma ◽

Surgical Excision ◽

Presenting Symptoms ◽

Complete Surgical Excision ◽

Rare Benign Tumor ◽

The Common ◽

Optimal Approach ◽

Posterior Elements

Background: Osteoid osteoma (OO) is a rare benign tumor of the spine that involves the posterior elements with 75% tumors involving the neural arch. The common presenting symptoms include back pain, deformity like scoliosis, and rarely radiculopathy. Methods: From 2011 to 2017, we evaluated cases of OO managed by posterior surgical resection while also reviewing the appropriate literature. Results: We assessed five patients (three males and two females) averaging 36.60 years of age diagnosed with spinal OOs. Two involved the lumbar posterior elements, two were thoracic, and one was in the C3 lateral mass. All patients underwent histopathological confirmation of OO. They were managed by posterior surgical resection with/without stabilization. No lesions recurred over the minimum follow-up period of 24 months. Conclusion: Surgical excision is the optimal treatment modality for treating spinal OOs. The five patients in this study demonstrated good functional outcomes without recurrences. Further, the literature confirms that the optimal approach to these tumors is complete surgical excision with/without radiofrequency ablation.

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Nasolabial hamartoma: a rare case report

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20202805 ◽

2020 ◽

Vol 6 (7) ◽

pp. 1397

Author(s):

D. Senthamarai Kannan ◽

G. Soundara Rajan ◽

Veerasigamani Narendrakumar ◽

V. K. Sathiya

Keyword(s):

Case Report ◽

Soft Tissue ◽

Rare Case ◽

Surgical Excision ◽

The Body ◽

Nasolabial Fold ◽

Tissue Development ◽

Inborn Errors ◽

Complete Surgical Excision ◽

Rare Case Report

Nasolabial cysts are rare, nonodontogenic soft tissue developmental cysts occur in the maxillary lip and nasal alar regions. Patients usually presents with an asymptomatic soft swelling with obliteration of the nasolabial fold. Due to it's origin from entrapped epithelium in an embryonic fusion plane developmentally, this cyst is considered to be a Hamartoma. Hamartomas are non-neoplastic malformations, or inborn errors of tissue development. They are characterized by an abnormal mixture of tissues indigenous to that area of the body. Complete surgical excision is the accepted method of treatment. This report aimed to present a case of nasolabial cyst hamartoma, which is rare in presentation.

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Comparative Analysis of Sclerotherapy with Bleomycin Versus Surgical Resection for Cystic Hygroma in Children

10.53350/pjmhs2115103378 ◽

2021 ◽

Vol 15 (10) ◽

pp. 3378-3380

Author(s):

Abdul Rehman ◽

Tahir Mehmood Butt ◽

Rabia Waheed ◽

Usama . ◽

Muhammad Haseeb

Keyword(s):

Comparative Analysis ◽

Observational Study ◽

Wound Infection ◽

Treatment Outcomes ◽

Recurrence Rate ◽

Surgical Resection ◽

Study Design ◽

Cystic Hygroma ◽

Group I ◽

Group Ii

Objective: Main purpose of this study is to compare the outcomes of sclerotherapy with bleomycin versus surgical resection in children with cystic hygroma. Study Design: Comparative/Observational study Place and Duration: This observational study was conducted at Children Surgical Hospital, Sialkot for six months during the period from July 2020 to December 2020. Methods: Total 50 children of both genders were presented. Children were aged between 2-12 years. All the patients had cystic hygroma were included. Informed written consent was taken from parents of children for detailed demographics. Patients were equally divided into two groups, group I had 25 patients and received sclerotherapy with bleomycin and group II received surgical resection among 25 cases. Post-treatment outcomes were assessed and compared in terms of efficacy and recurrence among both groups. SPSS 22.0 version was used to analyze complete data. Results: Majority were males in group I and II (68% and 64%) and females were 8 (32%) in group I and 9 (36%) in group II. In group I 18 (72% cases) were <6years of age and in group II 19 (76%) children were < 6years of age. Neck and axilla was the most effected site of cystic hygroma followed by face and trunk. We found that effectiveness of sclerotherapy with bleomycin was higher among 21 (84%) cases as compared to surgical resection 19 (76%). Recurrence rate was higher in group II 5 (20%) as compared to group I 3 (12%). Wound infection was lower in group I 1 (4%) and in group II we found 3 (12%). Conclusion: In this research we concluded that use of sclerotherapy with bleomycin is an effective and safe treatment for cystic hygroma as compared to surgical resection in terms of less recurrence rate, wound infection and higher number of good results. Keywords: Cystic hygroma, Children, Sclerotherpay, Bleomycin, Surgical Resection

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Factors Indicating Surgical Excision in Classical Type of Lobular Neoplasia of the Breast

Breast Care ◽

10.1159/000516609 ◽

2021 ◽

pp. 1-8

Author(s):

Constanze Elfgen ◽

Christoph Tausch ◽

Ann-Katrin Rodewald ◽

Uwe Güth ◽

Christoph Rageth ◽

...

Keyword(s):

Carcinoma In Situ ◽

Ductal Carcinoma ◽

Treatment Options ◽

Lobular Carcinoma ◽

Disease Free Survival ◽

Surgical Excision ◽

Careful Consideration ◽

Lobular Neoplasia ◽

Classical Type

Purpose: Classical type of lobular neoplasia (LN) encompassing both atypical lobular hyperplasia and classical lobular carcinoma in situ of the breast is a lesion with uncertain malignant potential and has been the topic of several studies with conflicting outcome results. The aim of our study was to clarify outcome-relevant factors and treatment options of classical LN. Methods: We performed a pathological re-evaluation of the preoperative biopsy specimens and a retrospective clinical and radiological data analysis of 160 patients with LN from the Breast Center Zurich. Open surgery was performed in 65 patients, vacuum-assisted biopsy (VAB) in 79 patients, and surveillance after breast core needle biopsy (CNB) in 16 patients. Results: The upgrade rate into ductal carcinoma in situ/invasive cancer was the highest in case of imaging/histology discordance (40%). If the number of foci in the biopsy specimen was ≥3, the upgrade rate in the consecutive surgical specimens was increased (p = 0.01). The association of classical LN with histological microcalcification correlated with shortened disease-free survival (p < 0.01), whereas other factors showed no impact on follow-up. Conclusions: Surveillance or subsequent VAB after CNB of LN is sufficient in most cases. Careful consideration of individual radiological and histological factors is required to identify patients with a high risk of upgrade into malignancy. In those cases, surgical excision is indicated.

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Granular Cell Tumor over the Mons Pubis: An Uncommon Tumor

Case Reports in Obstetrics and Gynecology ◽

10.1155/2019/1279137 ◽

2019 ◽

Vol 2019 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

M. Patabendige ◽

D. J. Wickramasooriya ◽

L. Dasanayake

Keyword(s):

Soft Tissue ◽

Granular Cell Tumor ◽

Granular Cell ◽

Surgical Excision ◽

Cell Tumor ◽

The Body ◽

Complete Surgical Excision ◽

Neural Origin ◽

Labium Majus ◽

Uncommon Tumor

Granular cell tumors are uncommon, usually benign, soft tissue neoplasms of neural origin. They occur throughout the body; vulval involvement is uncommon and labium majus is the commonest site in vulva. Complete surgical excision is the preferred treatment of choice to prevent recurrence. Here, we present a benign granular cell tumor over the mons pubis of vulva in a 27-year-old woman.

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