scholarly journals Gastrointestinal Stromal Tumours: A 10 Year Multicenter Audit

2016 ◽  
Vol 6 (1) ◽  
pp. 1
Author(s):  
Geoffrey Alan Watson ◽  
D. Kelly ◽  
E. Malone ◽  
J. Gleeson ◽  
G. McEntee ◽  
...  
Keyword(s):  
Imatinib Mesylate ◽  
Progressive Disease ◽  
Surgical Excision ◽  
Primary Treatment ◽  
Gi Tract ◽  
Gastrointestinal Stromal Tumours ◽  
First Line ◽  
Primary Treatment Modality ◽  
Tertiary Hospitals ◽  
Personalised Treatment

Background: Gastrointestinal stromal tumours (GISTs) are unique neoplasms of the gastrointestinal (GI) tract. The development of targeted therapeutic agents such as imatinib mesylate (Glivec) has altered the way on how we now manage these rare malignancies. The aim of this study was to evaluate the management of GISTs in three Irish tertiary hospitals. Methods: We performed a retrospective, multicenter audit of patients diagnosed with gastrointestinal stromal tumours over a ten year period (2005-2015). Results: 110 patients were included in the study. Abdominal pain was the most common presenting symptom, reported in 30% of patients, while 31% were incidental findings. The stomach was the most common primary site of disease, observed in 77% of cases. 15 patients had metastatic disease at the time of diagnosis (14%), and 10 of these patients had liver involvement. More than half of patients (61%) were managed with surgical excision alone (61%), while 24 were managed with surveillance and 28 patients treated with adjuvant Glivec, which was generally well tolerated. 18 patients (20%) demonstrated recurrent or progressive disease after first line treatment. 102 patients (93%) are alive today. Conclusion: While surgery is widely regarded as the primary treatment modality for GISTs the addition of imatinib mesylate has enabled physicians to deliver more personalised treatment while optimising patient outcomes.

scholarly journals Endoscopic Management of Branchial Fistula: Diagnostic and Therapeutic.

2021 ◽  
Vol 20 (4) ◽  
Author(s):  
Mark Paul ◽  
Bee See Goh
Keyword(s):  
Surgical Excision ◽  
Neck Surgery ◽  
Typical Feature ◽  
Primary Treatment ◽  
Treatment Modalities ◽  
Endoscopic Management ◽  
First Line ◽  
Primary Treatment Modality ◽  
Branchial Fistula ◽  
Endoscopic Assessment

Recurrent neck abscess is a typical feature of branchial anomaly. Open surgical excision has been the primary treatment modality for past decades however several alternative treatment modalities such as endoscopic electrocauterization has recently gained popularity and acceptance universally. This series aims to introduce endoscopic assessment as the first line diagnostic and therapeutic management for branchial fistula. 5 patients underwent examination under general anesthesia via direct laryngoscopy, endoscopic assessment and cauterization in our centre from 2016 to 2019. They were then followed up at our clinic to assess disease progression. Comparison between open neck surgery and endoscopic cauterization of internal sinus tract opening as the primary treatment has reported similar recurrence rate. Proposal of endoscopic assessment as the first line investigation and diagnostic tool  with the aim of therapeutic cauterization at the same setting. MRI may be needed in scenarios such as failed endoscopic treatment or when open surgery is required.

scholarly journals Role of Adjuvant Radiosurgery after Thoracoscopic Microsurgical Resection of a Spinal Schwannoma

2012 ◽  
Vol 2012 ◽  
pp. 1-4
Author(s):  
Toba N. Niazi ◽  
Christian A. Bowers ◽  
Meic H. Schmidt
Keyword(s):  
Stereotactic Radiosurgery ◽  
Treatment Modality ◽  
Surgical Excision ◽  
Primary Treatment ◽  
Benign Tumors ◽  
Noninvasive Treatment ◽  
Thoracic Spinal ◽  
Primary Treatment Modality ◽  
Microsurgical Resection ◽  
Spinal Schwannoma

Stereotactic radiosurgery to benign tumors of the spine has not been advocated as a primary treatment modality because of the favorable prognosis for these lesions after gross-total resection. There is even less evidence regarding its use as an adjuvant to neurosurgical resection of benign recurrent spinal disease. We describe the case of a 30-year-old man with a thoracic spinal schwannoma who had an interval increase of his lesion five months after thoracoscopic microsurgical resection. The patient opted for noninvasive stereotactic radiosurgery in lieu of additional surgical excision and has had stable disease 15 months after radiosurgical treatment with the linear accelerator (LINAC) system. In this setting, stereotactic radiosurgery provided a useful adjunct to thoracoscopic microsurgical resection. Future Class I and II evidence should be sought to evaluate the utility of stereotactic radiosurgery as a primary treatment modality or as an adjuvant for microneurosurgical resection of benign spinal lesions in patients who want noninvasive treatment after disease recurrence or who harbor medical comorbidities that would preclude them from being safe surgical candidates.

Treatment of temporal artery pseudoaneurysms

Vascular ◽  
2013 ◽  
Vol 22 (4) ◽  
pp. 274-279 ◽  
Author(s):  
Irene Thomassen ◽  
Elisabeth G Klompenhouwer ◽  
Edith M Willigendael ◽  
Joep AW Teijink
Keyword(s):  
Superficial Temporal Artery ◽  
Surgical Excision ◽  
Temporal Artery ◽  
Primary Treatment ◽  
Treatment Modalities ◽  
Diagnostic Process ◽  
Thrombin Injection ◽  
Invasive Treatment ◽  
Artery Pseudoaneurysm ◽  
Primary Treatment Modality

Purpose To give an overview of the etiology and diagnostic process of superficial temporal artery pseudoaneurysms and to evaluate different treatment modalities. Basic methods PubMed was used for searching multiple databases for relevant clinical studies. Principal findings A total of 62 studies were included, harboring 82 patients. Surgical excision is the most frequently described treatment, but less invasive treatment modalities as coiling and thrombin injections are gaining popularity. Surgical treatment was successful in all cases (67/67). Endovascular treatment was successful in 69% (9/13); the five cases treated with thrombin injection were all successful. Complementary, a description of our experience with thrombin injection is given. Conclusions Limited evidence of minimal invasive treatment for superficial temporal artery pseudoaneurysm is available. Based on this review combined with our limited experience, we suggest thrombin injections to be considered as the future primary treatment modality. In the case of unsuccessful exclusion of the aneurysm, surgical excision can be performed.

scholarly journals Cervicofacial lymphatic malformations: diagnosis and management

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Rachida Bouatay ◽  
Badii Hmida ◽  
Malek Hajjej ◽  
Amira Farhati ◽  
Khaled Harrathi ◽  
...  
Keyword(s):  
Head And Neck ◽  
Lymphatic Vessels ◽  
Neck Region ◽  
Surgical Excision ◽  
Primary Treatment ◽  
Benign Tumors ◽  
Lymphatic Malformations ◽  
Therapeutic Modalities ◽  
Sclerosing Agents ◽  
Primary Treatment Modality

Abstract Background Lymphatic malformations are rare benign tumors that result from congenital and acquired alterations of the lymphatic vessels. They occur most commonly on the head and neck region. The aim of this study is to describe clinical profiles of lymphatic malformations of the head and neck (LMHN) as well as to study therapeutic modalities through our series and review of the literature. Results This is a retrospective record-based descriptive study conducted in the ENT and the Radiology departments over a 17-year period. Our study included twelve patients, aged between 8 months and 52 years. Two swellings were present at birth and had not been prenatally diagnosed in both cases. One patient was affected by TRISOMY 21. All patients consulted for a painless mass of the head or neck. Seven masses were located in the suprahyoid region and five in the infrahyoid region. Ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI) were realized to establish the diagnosis and assess the extent of the lesions. Surgical excision was performed in 7 patients. It was complete in 6 patients. Five patients were treated with sclerotherapy. The sclerosing agents used were Aetoxisclerol 2%, hypertonic saline, and absolute alcohol. One patient had a reversible paresis of the left mental nerve after surgery. An excellent response to sclerotherapy with complete resolution was obtained in 3 cases with no recurrence of the disease. Conclusions Surgical excision has been the management option of choice for LMHN. The recent advances in sclerotherapy make it safe and effective as a primary treatment modality for these lesions.

Congenital Midline Cervical Cleft: A Variant of Tessier Number 30 Cleft Causing Micrognathia

2021 ◽  
pp. 105566562098741
Author(s):  
Cristiano Tonello ◽  
Ines Correia Pinto de Matos ◽  
Leonardo Bezerra Feitosa ◽  
Adriano Porto Peixoto ◽  
Nivaldo Alonso
Keyword(s):  
Relevant Literature ◽  
Neck Region ◽  
Surgical Excision ◽  
Female Child ◽  
Primary Treatment ◽  
Complete Surgical Excision ◽  
Primary Treatment Modality ◽  
Affected Tissue ◽  
Midline Cervical Cleft

Congenital midline cervical cleft is a rare and generally isolated malformation of the ventral neck region with no clear etiology established. Mandibular deformities, such as micrognathia, could be considered as a consequence of a cleft cervical contracture. Complete surgical excision of the subcutaneous fibrous cord at an early age is the primary treatment modality, minimizing growth development problems on surrounding affected tissue. The aim of this study is to describe the clinical, surgical, and histological findings in a female child with congenital midline cervical cleft along with a relevant literature review. Three years follow-up after surgery exhibited satisfactory functional and cosmetic results.

A rare angiosarcoma: retiform haemangioendothelioma

2011 ◽  
Vol 126 (2) ◽  
pp. 200-202 ◽  
Author(s):  
F O'Duffy ◽  
C Timon ◽  
M Toner
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Local Recurrence ◽  
Tumour Size ◽  
Surgical Excision ◽  
Primary Treatment ◽  
Low Grade ◽  
Node Metastasis ◽  
Primary Treatment Modality ◽  
High Local Recurrence Rate

AbstractObjective:We report the case of a rare angiosarcoma, retiform haemangioendothelioma, in an 18-year-old young man, which presented as a recurrent ulcerating lesion of the left pinna.Method:Case report and literature review of retiform haemangioendothelioma. This is a low grade angiosarcoma with a high local recurrence rate and low metastasis rate, and was first described in 1994 by Calonje et al.Results:This patient represents only the third report of lymph node metastasis in a case of retiform haemangioendothelioma. To date, 31 cases of the tumour have been reported. Histological diagnosis of this group of vascular neoplasms can be challenging, as their histopathological appearance is intermediate between haemangioma and angiosarcoma.Conclusion:Surgical excision remains the primary treatment modality, with adjuvant radiotherapy recommended in patients with large tumour size, local recurrence and lymph node metastasis, as seen in this case.

Para-spermatic cord proximal-type epithelioid sarcoma

2021 ◽  
Vol 14 (1) ◽  
pp. e232385
Author(s):  
Jessica Farnan ◽  
Ellen Morrison ◽  
Derek Barrry Hennessey
Keyword(s):  
Spermatic Cord ◽  
Median Overall Survival ◽  
Palliative Chemotherapy ◽  
Epithelioid Sarcoma ◽  
Palliative Radiotherapy ◽  
Surgical Excision ◽  
Radical Excision ◽  
First Line ◽  
Left Groin ◽  
Painless Mass

Proximal-type epithelioid sarcoma is an ultra-rare, high-grade soft tissue malignancy usually presenting as a deep-seated painless mass in the proximal extremities. Most patients are diagnosed as young adults, between 20 and 40 years of age. Perineal and genital masses do occur but are extremely rare and represent a challenging tumour to diagnose and treat. Early radical excision is recommended due to its aggressive behaviour and poor prognosis. Median overall survival from initial diagnosis is 30 months. We present the case of a 22-year-old man with a left groin proximal-type epithelioid sarcoma who is sadly deceased 12 months after initial presentation despite early surgical excision, completion of both first-line and palliative chemotherapy, and palliative radiotherapy.

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