1/6. Four case reports of families with esophageal cancer in a high-risk region on the Guangdong Chaoshan coast of china.Four families with a history of esophageal cancer were studied and their family trees analyzed. All the families had lived in Chaoshan for about 20 generations, speak Chanshan dialect, and generally have a predilection for drinking scalding Gong Fu tea and eating pickled Chinese cabbage. The majority of the esophageal cancer patients of the first generation were diagnosed 40 or 50 years ago after presenting with the typical symptom of dysphagia, whereas patients of the second and third generations were diagnosed mainly by means of radiography and pathology. The ratio of male to female patients was 14:5, which corresponds to that in the general population. The average age at occurrence of esophageal carcinoma in the patients studied was lower than in the general population and had progressively decreased from generation to generation.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
2/6. Posterior stabilisation of a malignant cervico-thoracic vertebral bone defect.Oesophageal cancer is frequently complicated by malignant fistulae. necrosis of the tumour following radiotherapy or chemotherapy may lead to the development of fistulae between the oesophagus and adjacent tissues and organs. We report the expansion of an extra-luminal oesophageal cancer after resection, invading the cervico-thoracic spine, fortunately without neurological deficit, and leading to instability and formation of a malignant fistula linking the tracheo-bronchial tree to the subarachnoidal space. To prevent imminent paraplegia and to alleviate severe pain, we rigidly stabilised the spine at the cervico-thoracic junction using an angle-stable system through a single posterior approach. Further postoperative follow-up revealed no signs of neurological deterioration. Cervico-thoracic stability was preserved until the patient died nearly five months postoperatively. This case shows that posterior stabilisation and decompression may be a palliative option for patients with imminent paraplegia and severe pain due to advanced tumour infiltration of the cervico-thoracic spine.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
3/6. Resection of the carina and oesophagus for malignant tumours of the oesophagus or tracheobronchial tree.Resection of the oesophagus together with the bifurcation of the trachea has been performed in three patients with oesophageal carcinoma or mucoepidermoid carcinoma of bronchial origin. Two patients had an uneventful recovery and survived five and 10 months but one patient died in the immediate postoperative period from aspiration pneumonia and respiratory failure. There has been no report of combined resection of the oesophagus and carina since Thompson's paper in 1973, but it appears to be indicated occasionally in patients with tracheobronchial or oesophageal malignancy, particularly when it is associated with an oesophagobronchial fistula.- - - - - - - - - - ranking = 4keywords = tree (Clic here for more details about this article) |
4/6. Erosion of the right mainstem bronchus by an esophageal stent.Self-expanding metallic stents (SEMSs) are used to palliate malignant esophageal strictures. We describe a patient who had an extensive mediastinal tumor for which he was receiving irradiation therapy; chest pain, hemoptysis, and recurrent Gram-negative pneumonia developed in this patient after stent placement. Fiberoptic bronchoscopy revealed protrusion of the SEMS into the tracheobronchial tree, a novel complication for this new type of stent.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
5/6. Repair of tracheal defect with Goretex graft during resection of carcinoma of the esophagus.Repair options for tracheal defects secondary to tumor or trauma have been unsatisfactory for emergent cases. We report a case in which the tracheobronchial tree was entered during resection of carcinoma of the esophagus and emergently repaired with a Goretex graft. The patient did well for 22 months after esophagectomy, at which time the graft was found to be infected and was removed. The patient continues to remain free of tumor 4 years after initial resection.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
6/6. Tracheal and oesophageal stenting for carcinoma of the upper oesophagus invading the tracheo-bronchial tree.Two cases of combined tracheal and oesophageal stenting for carcinoma of the upper oesophagus invading the tracheo-bronchial tree are described. Case 1 describes the complication of respiratory distress following insertion of a high oesophageal stent. This caused severe stridor which required tracheal stenting. In case 2 prophylactic stenting of the airway prior to oesophageal stenting was performed as a staging CT demonstrated severe compromise of the distal trachea/bronchus in a patient who was experiencing both dysphagia and dyspnoea. In both cases the respiratory and dyspnoeic symptoms were relieved. These cases illustrate the effective use of tracheal/bronchial and oesophageal metal stents in palliating patients with combined respiratory and dysphagic symptoms secondary to oesophageal malignancy. When treating high oesophageal tumours tracheal compromise should be considered and prophylactic stenting of the airway prior to oesophageal stenting performed to avoid further airway compromise when the oesophageal stent expands.- - - - - - - - - - ranking = 5keywords = tree (Clic here for more details about this article) |