1/95. Operative strategies for resection of pulmonary sarcomas extending into the left atrium.Pulmonary sarcomas may extend into the left atrium through the pulmonary veins, requiring the use of cardiopulmonary bypass for resection. The operative strategy for these complicated resections must account for the laterality of the tumor, the extent of atrial involvement, the severity of local invasion within the hemithorax, and intrinsic surgical heart disease, if present. We discuss these issues using an illustrative case of a patient with a right pulmonary sarcoma extending from the lateral chest wall into the left atrium.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
2/95. role of radical surgery for intracranial melanotic neuroectodermal tumor of infancy: case report.OBJECTIVE AND IMPORTANCE: Melanotic neuroectodermal tumor of infancy (MNTI) is a rare, locally aggressive tumor that arises most commonly from the maxilla or mandible. Infrequently, it originates from the cranial vault, and recent reports have described a favorable outcome after radical surgery. Some lesions are particularly problematic, such as those located along the cranial midline or cranial base and those with significant intracranial extension. Currently, there is no effective adjuvant therapy for MNTI; radiation is precluded by the patients' young age, and chemotherapy trials have not demonstrated long-term efficacy. CLINICAL PRESENTATION: A 2-month-old infant boy presented with a firm, immobile subcutaneous mass behind the right ear. The mass had been present at birth and enlarged with time. INTERVENTION: Initial resective surgery down to the dura resulted in massive tumor recurrence within weeks. Successful management required repeat surgery including excision of the dura and dural venous sinuses. CONCLUSION: This patient's large MNTI of the cranial base was successfully managed by radical surgery. Although MNTI is a rapidly growing tumor that is locally highly invasive, radical surgery may be associated with a favorable outcome and offers the potential for long-term cure.- - - - - - - - - - ranking = 3.8516792378923keywords = behind (Clic here for more details about this article) |
3/95. breast cancer invasion into the chest wall with resection and reconstruction.Despite the advent of limited resections and radiation therapy in the treatment of breast cancer, a substantial number of women experience recurrence or persistent disease that invades the skin, soft tissues, and musculoskeletal layers of the chest wall. This problem, which can compromise local control of the tumor, can also involve pleura, lung tissue, and mediastinal structures. This article will cover some of the pertinent clinical decisions related to these lesions, their prognosis, and management by chest wall resection and reconstruction.- - - - - - - - - - ranking = 6keywords = chest (Clic here for more details about this article) |
4/95. Malignant large cell calcifying sertoli cell tumor of the testis (LCCSCTT). Report of a case in an elderly man and review of the literature.Malignant Large Cell Calcifying sertoli cell tumor of the testis (LCCSCTT) is a rare histological variant of sex cordstromal tumors. It usually arises in young males, sometimes is associated with endocrine abnormalities and has a benign course. It is exceptional in elderly men and the outcome is rarely fatal. We report a case of LCCSCTT in a 73 year-old man with fatal outcome. The tumor involved the right testis and several areas of the tunica albuginea were grossly invaded. serum levels of HCG, LH and testosterone were normal. Lymphoangiography performed after orchiectomy showed an involvement of the iliac and preaortic lymph nodes. X-ray of the chest showed no lung metastases. A thorough study of the light microscopic, immunohistochemical and ultrastructural appearances was performed. immunohistochemistry revealed positivity to vimentin, S-100 and NSE. Our observations confirm the previous findings concerning malignant LCCSCTT and point out the histogenesis of the tumor from sertoli cells.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
5/95. A long-term survival case of thymic squamous cell carcinoma, performed complete extirpation with vascular reconstruction of the superior vena cava.A 59-year-old woman who complained of anterior chest pain exhibited an abnormal shadow on chest X ray and was admitted to our hospital. The chest X ray showed a demarcated tumor at the anterosuperior mediastinum and she was diagnosed as having a mediastinal tumor. After the midsternotomy was performed, the mediastinal tumor derived from the thymic tissues was discovered to have invaded the right upper lung, pericardium and superior vena cava. After excising the tumor, anastomosis between the right brachiocephalic vein and superior vena cava, followed by that between the left brachiocephalic vein and right cardiac auricle was performed using expanded polytetrafluoroethylene-ringed vascular grafts (phi 10 mm) for reconstruction. The tumor was diagnosed as a thymic carcinoma (squamous cell carcinoma) pathologically. After surgery, she was treated by cobalt irradiation. One month and again 3 months after the operation, venography showed patency. The patient has not demonstrated recurrence for 9 years and 6 months.- - - - - - - - - - ranking = 3.5401543649798keywords = chest, chest pain (Clic here for more details about this article) |
6/95. Hepatocellular carcinoma with mediastinal and pericardial invasion: report of two cases.Mediastinal invasion with pericardial involvement in hepatocellular carcinoma (HCC) is rarely described. We report two patients with hepatitis-C-related HCC, who, after several courses of transcatheter arterial chemoembolization (TACE), developed mediastinal and pericardial neoplastic growth. Both patients presented with clinical manifestations of exertional dyspnea, chest pain and orthopnea. The diagnosis of HCC with pericardial involvement, through direct invasion of the anterior mediastinum, was established by computerized tomography and magnetic resonance imaging. These patients' symptoms were relieved after they received radiotherapy with a total dosage of 3,000 and 4,000 cGy over a three-week and four-week period, respectively. We suggest that direct mediastinal invasion with pericardial involvement should be considered when evaluating patients with advanced HCC who developed precordial distress following palliative TACE. Early recognition of this unusual complication is important in the management of HCC.- - - - - - - - - - ranking = 1.5401543649798keywords = chest, chest pain (Clic here for more details about this article) |
7/95. Cavernous hemangioma of the internal auditory canal arising from the inferior vestibular nerve: case report and review of the literature.OBJECTIVE: To describe a case of cavernous hemangioma arising from the inferior vestibular nerve, limited to the internal auditory canal. STUDY DESIGN: Retrospective case review and review of literature. SETTING: A tertiary referral clinic. INTERVENTIONS: Extended middle cranial fossa surgery. RESULTS: The hemangioma was completely resected through the extended middle cranial fossa approach. No serious complications occurred, and the hearing and the facial nerve function were preserved. CONCLUSIONS: Originating from the capillary plexus surrounding Scarpa's ganglion, this hemangioma has to be differentiated from intratemporal hemangioma at the geniculate ganglion. Because of extrinsic growth pattern, the potential for preservation of the facial nerve function is high if surgery is performed early. Complete resection through the extended middle fossa approach is the treatment of choice for cavernous hemangioma with limited extension into the cerebellopontine angle. It remains difficult to distinguish preoperatively from the more common tumors, and surgery is usually planned on assumption of vestibular schwannoma.- - - - - - - - - - ranking = 1.4675661866651keywords = plexus (Clic here for more details about this article) |
8/95. Malignant evolution of choroid plexus papilloma.choroid plexus tumors are rare CNS neoplasms. The distinction between choroid plexus papilloma (CPP) and choroid plexus carcinoma (CPC) is made on the basis of clinical and histological criteria. Malignant evolution of CPP may occur, and the presence of mitotic figures in CPP may predict the likelihood of recurrence or malignant evolution. Close surveillance is mandated for these patients. We report on two such cases of CPP that transformed to CPC at the time of recurrence.- - - - - - - - - - ranking = 10.272963306656keywords = plexus (Clic here for more details about this article) |
9/95. Great auricular nerve: anatomy and imaging in a case of perineural tumor spread.We present the imaging and clinical findings of a case of recurrent cutaneous squamous cell carcinoma of the face in which CT and MR imaging revealed perineural tumor spread along the great auricular nerve. The great auricular nerve is a superficial cutaneous branch of the cervical plexus, providing sensory innervation to the skin of the parotid and periauricular region. Our purpose was to familiarize the reader with the anatomy of this nerve and imaging's potential role in the diagnosis of perineural tumor spread along this seldom seen structure.- - - - - - - - - - ranking = 1.4675661866651keywords = plexus (Clic here for more details about this article) |
10/95. Combined approach to intrathoracic lesions invading the spinal cord.The treatment of intrathoracic lesions invading the spine has two main issues: the surgical route to be preferred and the incidence of complications following the operation. As a matter of fact surgical treatment, performed in two stages, has a higher risk of cord accidents. Some authors have proposed a combined thoraco-vertebral surgical route which allows the exposition of both the spine and the chest. We experienced the utility of such a surgical approach in the treatment of two endothoracic lesions invading the thoracic spine and requiring the stabilization of the rachis. Satisfactory results were achieved without morbidity.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
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