1/533. Free fibula osteoseptocutaneous-pedicled pectoralis major myocutaneous flap combination in reconstruction of extensive composite mandibular defects.Lateral composite mandibular defects resulting from excision of advanced oral carcinoma often require mandible, intra-oral lining, external face, and soft-tissue bulk reconstruction. Ignorance of importance soft-tissue deficit in those patients may cause significant morbidity and functional loss. Such defects, therefore, can be reconstructed best with a double free flap technique. However, this procedure may not be feasible for every patient or surgeon. An alternative procedure is a free fibula osteoseptocutaneous flap combined with a pedicled pectoralis major myocutaneous flap. This combination was used in reconstruction of extensive composite mandibular defects in 14 patients with T3/T4 oral squamous cell carcinoma. All patients were men, and the average age was 54.3 years. The septocutaneous paddle of the fibula flap was used for the mucosal lining of the defects while the bony part established the rigid mandibular continuity. The pectoralis major flap then covered the external skin defect in the face and cheek, and the dead spaces left by the extirpated masticator muscles, buccal fat, and parotid gland. One free fibula flap failed totally, and one pectoralis major flap developed marginal necrosis. At the time of final evaluation, nine patients (64.3 percent) were alive, surviving an average of 25.7 months. All patients eventually regained their oral continence and an acceptable cosmetic appearance. In conclusion, the fibula osteoseptocutaneous flap plus regional myocutaneous flap choice is a successful and technically less demanding alternative to the double free flap procedures in reconstruction of extensive lateral mandibular defects.- - - - - - - - - - ranking = 1keywords = mandible (Clic here for more details about this article) |
2/533. leg ulcers: a common problem with sometimes uncommon etiologies.In the U.S., leg ulcers present a significant clinical problem, occurring at a rate of approximately 600,000 new cases per year. In most cases, the cause of ulceration is venous or arterial in nature. One uncommon but significant cause of leg ulcers is sqaumous cell carcinoma (SCC). Although the incidence of SCC is higher in white than black populations, blacks with SCC typically exhibit involvement of areas of the skin that are not chronically sun-exposed, especially the lower extremeties. Predisposing factors include burn scars, chronic infection or ulceration, and chronic discoid lupus erythematosus. leg ulcers of atypical presentation or those that fail to heal should alert the clinician to consider uncommon etiologies.- - - - - - - - - - ranking = 0.061678785157353keywords = lower (Clic here for more details about this article) |
3/533. Squamous cell carcinoma and keratoacanthoma of the lower lip associated with "Goza" and "Shisha" smoking.BACKGROUND: A positive correlation between lip and buccal cancers and pipe smoking has been suggested. Various types of crude and manufactured tobacco products are consumed by smoking, chewing, and snuff dipping habits. 'Shisha" and 'Goza' smoking are widely practiced in the middle east. The 'hubble-bubble' method and apparatus are used. These smoking habits are hazardous to health, causing obstructive lung disease, and may be important predisposing factors for the development of oral cancers. case reports: Two cases of squamous cell carcinoma and a case of keratoacanthoma localized to the lower lip are presented in well-known 'Shisha' and 'Goza" smokers. CONCLUSIONS: "Shisha" and 'Goza' smoking have adverse effects on general health and may predispose to oral cancer. An extensive epidemiological study should be performed to determine whether this type of smoking habit is associated with a statistically increased incidence of squamous cell carcinoma and keratoacanthoma of the lips.- - - - - - - - - - ranking = 0.30839392578677keywords = lower (Clic here for more details about this article) |
4/533. Rapid progression of squamous cell carcinoma of the cervix after hyperbaric oxygenation.The role of hyperbaric oxygenation in the treatment of radiation-induced sequelae and chronic ulcer is well established. On the contrary, a possible cancer-causing or growth-enhancing effect by hyperbaric oxygenation was highly controversial. Herein, we present a 55-year-old Chinese woman with recurrent squamous cell carcinoma of the cervix on her left inguinal area. She received concurrent chemoradiation therapy followed by radical inguinal lymphadenectomy due to persistent tumor mass. The patient was complicated with severe radiation fibrosis and unhealed wounds, so she was treated with hyperbaric oxygenation (HBO). However, the patient died of complications of the disease after completing HBO therapy I month later and autopsy of the patient showed carcinomatosis of the abdominal cavity and lower abdominal wall. Because previous studies have been inconclusive regarding the effect of HBO on tumor cells, we reviewed the possible relation between the HBO and tumor cells.- - - - - - - - - - ranking = 0.061678785157353keywords = lower (Clic here for more details about this article) |
5/533. Double cancers of the lung and esophagus associated with a sarcoid-like reaction in their regional lymph nodes: report of a case.A case of double cancers of the lung and esophagus associated with a sarcoid-like reaction in their regional lymph nodes is reported. A 73-year-old man with hemosputum was found to have a mass in his right lower lung field on a chest X-ray. Based on a diagnosis of lung cancer, a right middle and lower lobectomy with a dissection of the lymph nodes was performed. Microscopically, a well developed granulomatous reaction was seen in the dissected mediastinal and hilar lymph nodes. Three years after the pulmonary resection, he was admitted to our hospital because of dysphagia. A diagnosis of lower esophageal cancer was made. A lower esophagectomy with a total gastrectomy was performed. A sarcoid-like reaction comprising epithelioid cells and giant cells was seen in the regional lymph nodes. No clinical findings indicative of systemic sarcoidosis were observed. This rare condition may therefore help to improve our overall understanding of the relationship between malignant neoplasms and sarcoid-like reactions in the regional lymph nodes.- - - - - - - - - - ranking = 0.24671514062941keywords = lower (Clic here for more details about this article) |
6/533. Squamous cell carcinoma in chronic ulcerative lesions: a case report and literature review.A case report and literature review are presented involving a fatal case of squamous cell carcinoma of the lower extremity. The unique aspects of this patient include the young age at presentation (35 years old), and the association with both a burn scar (Marjolin's) ulcer and a draining osteomyelitis fistulus tract. Epidemiologic data for Marjolin's ulcers as well as squamous cell carcinoma associated with draining sinus tracts of osteomyelitis are reviewed, in addition to the recommended management of such patients. The case presented is a reminder of the need to maintain a high index of suspicion for malignant transformation within ulcerative lesions.- - - - - - - - - - ranking = 0.061678785157353keywords = lower (Clic here for more details about this article) |
7/533. A case of central carcinoma of the mandible arising from a recurrent odontogenic keratocyst: delineation of surgical margins and reconstruction with bilateral rectus abdominis myocutaneous free flaps.A case of central carcinoma of the mandible arising from a recurrent odontogenic keratocyst is reported. A 38-year-old man was admitted to the Tokai University Hospital due to postoperative infection of a recurrent odontogenic keratocyst of the left mandible. He had had a cystectomy for an odontogenic keratocyst 4 years ago. The lesion revealed bony destruction of the mandible with worm-eating shaped margins with extension to the facial skin. A biopsy specimen revealed squamous cell carcinoma. The mandible was resected with facial skin and the sublingual space was dissected to preserve the lingual nerve. The oral and the facial resections were reconstructed with a titanium plate and bilateral rectus abdominis myocutaneous free flaps. The plate was removed due to infection around the margins and readjustment of the flaps was conducted 5 months after the surgery. He has not had a local relapse, metastasis, or incisional hernia for 8 months following surgery. Good occlusion has been attained by the residual mandible, and he is able to eat without any problems.- - - - - - - - - - ranking = 9keywords = mandible (Clic here for more details about this article) |
8/533. Use of a vertical rectus abdominis myocutaneous flap in bilateral groin dissection for recurrent carcinoma of the penis.We present a 42-year-old man requiring bilateral groin dissection for recurrent squamous cell carcinoma of the penis. Tissue cover was obtained using a pedicled vertical rectus abdominis myocutaneous flap. This case is made interesting by the use of a unilateral flap to cover a large bilateral lower abdominal tissue defect, enabling minimal weakening of the abdominal wall, primary skin closure, and allowing early mobilization and hospital discharge.- - - - - - - - - - ranking = 0.061678785157353keywords = lower (Clic here for more details about this article) |
9/533. Reconstruction of full-thickness lower eyelid defects using a blepharoplasty technique with a hard palate mucosal graft.The authors report a method of reconstruction of a full-thickness lower eyelid defect using a blepharoplasty technique utilizing excess skin of the lower eyelid with a hard palate mucosal graft. In all patients the hard palate mucosa took well, and good functional and aesthetic results were obtained. The most suitable indication of this technique might be for the defect occurring horizontally (for which direct closure is difficult to apply) and located in the lateral side of the lower eyelid (when a large amount of excess skin can be utilized). The authors conclude that although the shape and size of the defect to which this method can be applied is restricted, this is a useful option in the reconstructive methods of a full-thickness lower eyelid defect.- - - - - - - - - - ranking = 0.49343028125883keywords = lower (Clic here for more details about this article) |
10/533. Clinical delivery of intensity modulated conformal radiotherapy for relapsed or second-primary head and neck cancer using a multileaf collimator with dynamic control.BACKGROUND AND PURPOSE: Concave dose distributions generated by intensity modulated radiotherapy (IMRT) were applied to re-irradiate three patients with pharyngeal cancer. patients, MATERIALS AND methods: Conventional radiotherapy for oropharyngeal (patients 1 and 3) or nasopharyngeal (patient 2) cancers was followed by relapsing or new tumors in the nasopharynx (patients 1 and 2) and hypopharynx (patient 3). Six non-opposed coplanar intensity modulated beams were generated by combining non-modulated beamparts with intensities (weights) obtained by minimizing a biophysical objective function. Beamparts were delivered by a dynamic MLC (Elekta Oncology Systems, Crawley, UK) forced in step and shoot mode. RESULTS AND CONCLUSIONS: Median PTV-doses (and ranges) for the three patients were 73 (65-78), 67 (59-72) and 63 (48-68) Gy. Maximum point doses to brain stem and spinal cord were, respectively, 67 Gy (60% of volume below 30 Gy) and 32 Gy (97% below 10 Gy) for patient 1; 60 Gy (69% below 30 Gy) and 34 Gy (92% below 10 Gy) for patient 2 and 21 Gy (96% below 10 Gy) at spinal cord for patient 3. Maximum point doses to the mandible were 69 Gy for patient 1 and 64 Gy for patient 2 with, respectively, 66 and 92% of the volume below 20 Gy. A treatment session, using the dynamic MLC, was finished within a 15-min time slot.- - - - - - - - - - ranking = 1keywords = mandible (Clic here for more details about this article) |
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