11/149. Long-term survival after gastric cancer and liver and paraaortic lymph node metastases: report of a case.We report the case of a 46-year-old man in whom successful resection of carcinoma of the stomach with liver and paraaortic lymph node metastases was carried out. The carcinoma was removed completely with combined resection of the lower esophagus, total stomach, distal pancreas, spleen, two metastatic liver nodes, and groups 1 and 2 and abdominal paraaortic lymph nodes. Adjuvant chemotherapy was administered postoperatively. The patient is currently well with a grade 1 performance status and no signs of recurrence 12 years after his operation. This experience suggests that even the presence of metastatic paraaortic lymph nodes and liver metastases is not necessarily a contraindication to surgery when the carcinoma can be resected curatively and safely.- - - - - - - - - - ranking = 1keywords = lower (Clic here for more details about this article) |
12/149. Distraction osteogenesis in functional reconstruction of mandible--report of 6 cases.OBJECTIVE: To study the application of distraction osteogenesis in mandibular function reconstruction. methods: Three types of mandibular distractors were used in 6 patients with different mandibular defects due to tumor resection. For 2 cases with ramus defects, specially designed distractors were used to restore the normal height of the ramus. In 1 case, the trifoci distraction principle was used and a trifoci distractor was designed. In 3 cases, vertical distractors made in germany or china were used. The patient average age was 31.5 years old (ages ranged from 8 to 54). RESULTS: In 5 cases the mandibular lengthenings were successful according to the direction and distance chosen before distraction. In 1 case, the trifoci distraction principle was applied and a proximal 23 mm mandibular defect was successfully corrected; however, the 23 mm distal mandibular defect was not corrected because the screws for fixation of the transport block were loosened. infection and dysosteogenesis did not occur in any cases. CONCLUSION: Distraction osteogenesis can successfully be used in mandibular functional reconstruction and is more advantageous than traditional techniques. The most favorable time for distraction osteogenesis in mandibular reconstruction is at the time of tumor resection.- - - - - - - - - - ranking = 62.570361558898keywords = mandible (Clic here for more details about this article) |
13/149. Intracranial metastatic parathyroid carcinoma: case report.OBJECTIVE AND IMPORTANCE: Parathyroid carcinoma is a rare entity, and fewer than 200 cases have been described. It is a slowly progressive disease characterized by frequent recurrences and local metastases. Most patients with parathyroid carcinoma die from metabolic complications of hyperparathyroidism. Five-year survival rates range from 25 to 50%. Functional parathyroid carcinoma is a rare cause of hyperparathyroidism that affects only 0.32 to 5% of all patients who undergo surgery for hypercalcemia. A review of the literature revealed only one other reported case of metastatic intracranial parathyroid carcinoma, in a patient who experienced local recurrence and metastatic disease when she was diagnosed with an intracranial lesion. CLINICAL PRESENTATION: We report the case of a 44-year-old African-American man with recent-onset, right lower-extremity weakness and hypercalcemia 4 years after he underwent a parathyroidectomy for parathyroid carcinoma. At presentation, his parathyroid level was 467 pg/ml, and his serum calcium level was 15.2 mg/dl. Imaging studies revealed an isolated enhancing left mesial frontoparietal mass. A systemic Cardiolite study demonstrated a single focus of radiotracer uptake in this region. No abnormal uptake was demonstrated in the neck or elsewhere. INTERVENTION: The patient underwent a frameless stereotactic interventional magnetic resonance imaging-guided resection via a parasagittal interhemispheric approach. Pathological findings were consistent with parathyroid carcinoma. After resection, his right lower-extremity weakness and secondary hyperparathyroidism resolved. CONCLUSION: The typical natural history of parathyroid carcinoma concludes with death from complications of hyperparathyroidism. This case report supports aggressive surgical management to eliminate all parathyroid hormone-secreting malignant tissue and prevent metabolic complications. In this patient, intraoperative magnetic resonance imaging was helpful to ensure complete resection.- - - - - - - - - - ranking = 2keywords = lower (Clic here for more details about this article) |
14/149. Clear cell odontogenic carcinoma. Report of two cases and review of the literature.This study reviews the literature and reports on the morphologic and immunophenotypic features of 2 clear cell odontogenic carcinomas occurring in the mandible of elderly women, showing extensive infiltration into adjacent tissues. The tumor cells were large, with clear cytoplasm, and arranged in irregular sheets. Some of the latter demonstrated a peripheral rim of cells with eosinophilic cytoplasm or included duct-like structures. There was no evidence of ameloblastic differentiation. Most cells contained glycogen granules and were immunoreactive for cytokeratins and epithelial membrane antigen. In the differential diagnosis other clear cell odontogenic, salivary gland, and metastatic tumors should be considered. Both cases were treated with surgical excision, and the patients are free of disease after 3 and 5 years, respectively. In the literature, however, variable behavior of these tumors has been reported, including recurrence and metastases. It is recommended that terms such as clear cell ameloblastoma and clear cell odontogenic tumor not be used to describe such tumors.- - - - - - - - - - ranking = 15.642590389724keywords = mandible (Clic here for more details about this article) |
15/149. Urachal carcinoma with metastasis to the maxilla: the first reported case.A case is reported for the first time of a urachal carcinoma with metastasis to the maxilla. The patient presented with a hard swelling along the left upper jaw in the region of 24-27. At the time of onset there were skin changes and signs of metastasis to the brain. The patient died 13 months after the onset of symptoms.- - - - - - - - - - ranking = 0.74859601262488keywords = jaw (Clic here for more details about this article) |
16/149. A rare case of advanced ovarian carcinoma who developed difficulty walking 25 days after treatment with weekly paclitaxel.Although taxol has shown significant activity in advanced ovarian cancer, peripheral neuropathy is likely to become the major dose-limiting toxicity. We describe a case of advanced ovarian carcinoma who developed difficulty walking because of marked pain in the lower extremities and loss of proprioception 25 days after treatment with weekly taxol (80 mg/m(2)x3).- - - - - - - - - - ranking = 1keywords = lower (Clic here for more details about this article) |
17/149. Sustained remission of metastatic adrenal carcinoma during long-term administration of low-dose mitotane.We present our experience with two female patients suffering from metastatic, recurrent adrenocortical carcinomas, to whom o,p'-DDD (mitotane) was administered for unusually long duration. The first patient received mitotane as monotherapy after relapse (in doses ranging from 3 to 6 g/day initially and 1 g/day thereafter, for 13 yr). The second patient presented with metastatic disease and underwent radical surgical excision of the adrenal. mitotane was administered initially at 2.5 g/day, and the dose was gradually lowered over 8 yr to 1 g/day, without interruption. Both patients tolerated the medication well, regardless of the daily dosage, with complaints limited to epigastric pain and nausea, while their disease has been kept under control for 14 and 16 yr, respectively. The blockade of steroid synthesis with mitotane resulted in hypercholesterolemia in both patients and in premature menopause in the second patient; however, these abnormalities were taken care of with the appropriate therapy. The excellent follow-up of these patients suggests that even in hopeless cases with metastatic adrenocortical carcinoma, mitotane should be administered for very long periods of time as it can be well-tolerated and may be beneficial in the long run.- - - - - - - - - - ranking = 1keywords = lower (Clic here for more details about this article) |
18/149. Case of metastatic carcinoma from end of the 8th-early 9th century slovakia.The first case of metastatic carcinoma ever detected in slovakia comes from a Slavonic cemetery at Borovce, in the district of Piest'any, which is dated from the end of the 8th to the middle of the 12th century AD. The disease afflicted a 50-60-year-old male, buried in a grave from the older phase of inhumation (8th-early 9th century AD). A number of osteolytic metastases were found in all bones of the skull and postcranial skeleton except for the forearms, hands, lower legs, and feet. They were studied macroscopically by standard x-rays, and by scanning electron microscopy and laser scanning confocal microscopy. Analogous finds from Central European countries were also obtained. They are discussed in relation to their chronology, which shows a tendency of increasing occurrence culminating in the Middle Ages. Some demographic and paleopathological characteristics of the burials in the Borovce cemetery are also provided.- - - - - - - - - - ranking = 1keywords = lower (Clic here for more details about this article) |
19/149. A case of familial isolated hyperparathyroidism with ectopic parathyroid cancer.We report the kindred with familial isolated hyperparathyroidism with parathyroid cancer. The proband was diagnosed as having primary hyperparathyroidism at age 43. The same disorder was also found in his daughter who had low bone mass. His son was found to have primary hyperparathyroidism by family screening. The pathological diagnosis of the resected parathyroid in both father and daughter was parathyroid cancer, and that in son was parathyroid adenoma. The right lower gland of the proband and the left lower gland of the son were present in thymus. No mutations were found in the sequences of MEN1 gene, hence gene(s) other than MEN1 gene may have contributed to the malignant potency in our cases.- - - - - - - - - - ranking = 2keywords = lower (Clic here for more details about this article) |
20/149. Primary tuberculous stricture of the oesophagus mimicking carcinoma.A middle-aged woman presented with progressive dysphagia and weight loss was investigated. A stricture involving the lower third of oesophagus was identified but precise histology of the lesion could not be obtained even after multiple biopsies. The resected specimen showed histology consistent with oesophageal tuberculosis.- - - - - - - - - - ranking = 1keywords = lower (Clic here for more details about this article) |
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