Cases reported "Polyps"

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1/107. Report of a rare case of vocal fold carcinoma that was obscured by a prominent vocal fold polyp.

    We report the case of a 56-year-old man who was evaluated for hoarseness. Telescopic and fiberoptic examination revealed a huge, pedunculated polyp that obscured the vocal folds. Upon further examination, microlaryngoscopy revealed a coexisting superficial irregular lesion on the upper surface of the left vocal fold, which was identified as a microinvasive carcinoma. This unusual presentation emphasizes the importance of a microlaryngoscopic examination.
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ranking = 1
keywords = upper
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2/107. Giant esophageal polyp: a rare and benign neoplasm.

    Giant esophageal polyp is a very rare neoplasm, usually benign but often demanding both for diagnostic and/or therapeutical procedures and for dramatic symptomatologic onset in the patient (regurgitation and asphyxia). The authors present a brief clinical report of a patient with a 20 cm.-long esophageal polyp removed by left lateral cervicotomy and esophagotomy for 8 cm. below the upper esophageal sphincter (histologic examinations showed a pedicled polypoid fibrolipoma with a remarkable presence of myxoid and vascular components). The authors also describe diagnostic and therapeutic methods to manage this rare disease and they gave a brief review of recent literature.
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ranking = 1
keywords = upper
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3/107. Treatment of subtotal medial rectus myectomy complicating functional endoscopic sinus surgery.

    During the past 2 decades, the introduction of functional endoscopic sinus surgery (FESS) has dramatically improved the treatment of sinus disorders. However, a variety of orbital complications have been reported, including optic nerve damage, hemorrhage, infection, compromise of the lacrimal drainage apparatus, and strabismus. At least 10 cases have reported damage to the medial rectus muscle. (1-8) Treatment options for such patients have been limited, especially because most are adults at risk for anterior segment ischemia after transposition of vertical rectus muscles. We describe 2 patients whose medial rectus myectomies were repaired by using nonabsorbable "hang-back" sutures in combination with a botulinum toxin (Botox) injection of the antagonist lateral rectus muscle. Good primary position alignment was achieved in both patients, and one patient was able to regain binocular function. We recommend this surgical approach, especially in patients at increased risk for anterior segment ischemia.
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ranking = 0.018559939789181
keywords = back
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4/107. Bilateral tension pneumothorax during jet ventilation: a case report.

    Jet ventilation (JV) involves high-pressure ventilation for upper laryngeal laser procedures. Anesthetic management for the patient undergoing JV can be challenging, as complications of JV can include subcutaneous emphysema and tension pneumothorax. A 52-year-old woman with a diagnosis of vocal cord polyps presented for direct microlaryngoscopy and laser laryngoplasty with JV. Intraoperatively, the patient developed lack of bilateral chest movement and an audible change in jet-ventilatory sounds. The patient was reintubated with a standard endotracheal tube. Subsequent attempts to ventilate the patient failed. A diagnosis of bilateral tension pneumothorax was made. Immediate pleural decompression resulted in improved ventilatory and hemodynamic status. The purpose of this case report is to discuss the pathophysiology related to tension pneumothorax and anesthetic implications for management of cases involving JV.
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ranking = 1.0393230023514
keywords = upper, chest
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5/107. Brunner's adenoma, esophageal reflux and gastric ulcer. A case report.

    In this work the authors report a clinical case of Brunner's adenoma, which was responsible for the onset of other pathologies in the upper gastrointestinal tract, such as gastroesophageal reflux (GER), esophagitis and ulcerations of the antral mucosa. The preoperative diagnostic procedure (endoscopy, esophageal manometry, gastric emptying) and the follow-up at 3, 6 and 12 months from the surgery confirmed the relationship between the Brunner's adenoma and the alterations of the lower esophageal sphyncter (LES) tone and the gastric emptying. After a review of the international literature and a short analysis of the physiopathologic alterations, the authors point out the different therapeutical approach, in according to the size and implantation (sessile or peduncolated) of the lesion and to the related pathologies.
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ranking = 1
keywords = upper
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6/107. Fibrovascular esophageal polyp as a diagnostic challenge.

    Fibrovascular polyps are rare benign esophageal tumors that usually arise from the proximal third of the esophagus. We present the case of a 48-year-old man with a history of dysphagia and 7-kg weight loss over a period of 2 months. A barium swallow showed a distended esophagus with a tumor extending from the upper esophageal sphincter to the cardia. On a thoracic computed tomographic scan, a homogeneous intramural mass with a density of 22 Hounsfield units was seen, which extended throughout the entire esophagus. Fiberoptic endoscopy confirmed the presence an intramural tumor beginning at the upper esophageal sphincter and reaching to the cardia. The tumor was completely covered with mucosa, except for an ulcerated area at its distal end, which herniated into the stomach. On endoscopic ultrasound, the tumor appeared to grow submucosally and to respect the muscularis propria. Endoscopic biopsies from the ulcerated distal aspect of the tumor suggested a leiomyoma. None of the imaging modalities used revealed evidence of a polyp or intraluminal esophageal tumor. Rather, a potentially malignant extensive intramural tumor was suspected, and an esophagectomy was performed. Only at the time of removal of the specimen did it become evident that the tumor mass was located intraluminally with a pedicle in the region of the upper esophageal sphincter. The final pathological diagnosis was a giant fibrovascular polyp of the esophagus.
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ranking = 3
keywords = upper
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7/107. Fibrovascular polyp of the esophagus in infant.

    A five month female was referred complaining of intermittent vomiting with protrusion of a sausage-like mass through the oral cavity. Esophageal endoscopy and esophagogram revealed a mass in the upper esophagus, which was diagnosed as a fibrovascular polyp. Under general anesthesia, the mass was grasped through the oral cavity with a forcep and ligated and excised at the base, where a stump arose from the posterior wall of the cervical esophagus. The pathology was confirmed as a fibrovascular polyp, which is a rare benign esophageal lesion occurring mostly in adult males, and has not been reported in infancy.
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ranking = 1
keywords = upper
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8/107. Acute cholecystitis caused by a cholesterol polyp.

    A 39-year-old man hospitalized with upper abdominal pain had been found to have a 3mm polyp in the body of the gallbladder 3 years previously. Laboratory tests on admission showed mild liver dysfunction. ultrasonography depicted a dilated gallbladder with increased wall thickness; the polyp could no longer be seen. Computed tomography with drip infusion cholangiography again showed a dilated gallbladder, and also stenosis of the distal cystic duct. The resected specimen obtained by laparoscopic cholecystectomy showed disappearance of the polyp from the body of the gallbladder. A cholesterol stone was incarcerated in the cystic duct, representing an impacted detached cholesterol polyp causing acute cholecystitis. Spontaneous detachment of a cholesterol polyp from the gallbladder mucosa, then, can result in acute cholecystitis.
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ranking = 1.6643740297336
keywords = upper, abdominal pain
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9/107. Gastric stromal tumor--a rare cause of an upper gastrointestinal bleeding.

    gastrointestinal stromal tumors (GISTs) are rare neoplasms arising from connective tissue elements of the gastrointestinal wall. They show a great heterogeneity with respect to their histogenetic, morphologic and prognostic characteristics. GISTs are known with myoid, neural or mixed features of differentiation. Clinical findings are gastrointestinal bleeding, abdominal pain and weight loss. We report on the case of a 50-year-old male patient who presented with melena and acute anemia (hemoglobin 10.5 g/dl). Esophagogastroduodenoscopy revealed a broad-based, centrally ulcerated polypoid formation of 3 cm in the gastric corpus as the cause of the upper gastrointestinal bleeding. Multiple endoscopic biopsies were negative for neoplastic changes. Because of no tendency of healing after triple eradication therapy of helicobacter pylori and following proton pump inhibitor medication, the patient underwent distal gastrectomy with gastrojejunostomy. GIST of combined smooth muscle and neural type was diagnosed by histological and immunohistochemical examination. The features with increased mitotic activity and cellularity were those of a borderline stromal tumor. 6 months after surgery the patient is well with no signs of residual malignancy. This case demonstrates that rare stromal neoplasms have to be taken into account in the differential diagnosis of gastrointestinal tumors even if endoscopic biopsies are negative for neoplastic changes. Because of the uncertain biological behavior of the GISTs an early surgical intervention is recommended.
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ranking = 5.6643740297336
keywords = upper, abdominal pain
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10/107. Endoscopic treatment of a long fibroepithelial ureteral polyp.

    A case is reported of a 30-year-old woman with a long fibroepithelial polyp in the middle ureter treated with the Ho-YAG laser endoscopically. She presented with an intermittent macroscopic hematuria and lower abdominal pain lasting for 1 year. The filling defect on urography occupying one-third of the ureter was migratory depending on the patient position. Transurethral flexible ureterorenoscopy showed a large pedunculated tumor with a small base at the middle ureter. About 1 month after the endoscopic irradiation of the Ho-YAG laser to the base of tumor, the tumor was spontaneously discharged and pathologic examination revealed it to be a fibroepithelial polyp without malignant component. Postoperatively, the patient remained asymptomatic and follow-up excretory urographs showed no abnormal findings.
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ranking = 0.6643740297336
keywords = abdominal pain
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