1/89. The role of radiation in delayed hearing loss in nasopharyngeal carcinoma.Although radiation damage to the inner ear can be induced experimentally in animals, its incidence in humans as a complication of therapy for nasopharyngeal carcinoma (NPC) remains a matter of conjecture due to inadequate histological validation. A case of advanced NPC with a mixed conductive and neurosensory hearing loss is presented that at necropsy showed tumour invasion of the VIIIth cranial nerve in the internal auditory meatus with associated infection. The architecture of the organ of corti was well-preserved despite heavy doses of radiation but degeneration, the cause of which could not be substantiated, was present in the auditory nerve pathway. A diagnosis of radiation damage to the end-organ of hearing in the absence of supporting histological evidence should be made with caution.- - - - - - - - - - ranking = 1keywords = nerve, organ (Clic here for more details about this article) |
2/89. Anti-CD20 monoclonal antibody therapy in Epstein-Barr Virus-associated B cell lymphoma following lung transplantation.Post-transplant lymphoproliferative disease is a complication of bone marrow and solid organ transplantation, mostly associated with Epstein-Barr virus infection and chronic immunosuppression. Even if spontaneous resolution after cessation of immunosuppressive therapy can be observed, the prognosis of this disorder is usually poor with a low response to specific treatment. We describe a case of B-cell lymphoma of the nasopharynx occurring 6 months after double-lung transplantation. In spite of its monoclonal nature, anti-CD 20 monoclonal antibody given in the presence of reduced immunosuppression resulted in a complete response. The patient also received "consolidation" radiation therapy to prevent the recurrence. The treatment was well tolerated with minimal side effects. The patient was asymptomatic and had a well functioning graft more than 1 year after therapy.- - - - - - - - - - ranking = 0.028134256515342keywords = organ (Clic here for more details about this article) |
3/89. Nasopharyngeal carcinoma with leptomeningeal dissemination: case report.Nasopharyngeal carcinoma (NPC) is a highly prevalent malignancy in southeast china, hong kong, and taiwan. Spread of this tumor is known to occur via three main routes, i.e., local invasion of adjacent structures, regional metastasis to neck nodes, and hematogenous metastasis to distant organs. In this report, we describe a rare case of NPC disseminated via the leptomeninges, so called meningeal carcinomatosis (MC). The patient was a 62 year-old man who presented with multiple cranial nerve palsies and a headache, and was diagnosed with NPC in August 1988. The primary tumor regressed completely after induction chemotherapy and radiation therapy. Computerized tomography (CT) 17 months after radiation therapy showed multiple enhanced nodules scattered along the temporal meninges. The nodules increased in number and size in the subsequent CT scan 4 months later. The patient declined further invasive procedures and oncologic treatments, and he expired at home 9 months after the development of MC. It is speculated that perineural invasion and access to the subarachnoid space was the major cause of MC in this case. The case, although rare, possibly highlights a rare route of tumor dissemination in NPC.- - - - - - - - - - ranking = 0.5keywords = nerve, organ (Clic here for more details about this article) |
4/89. The use of intensity modulated radiotherapy for the treatment of extensive and recurrent juvenile angiofibroma.These case series are presented to describe the application and advantages of intensity modulated radiotherapy (IMRT) for the treatment of extensive and/or recurrent juvenile angiofibroma. Two patients were diagnosed with recurrence at 11 and 13 months postoperatively, and one was surgically unresectable. The affected areas included the base of skull, cavernous sinus, pterygopalatine fossa, infratemporal fossa, posterior orbit and nasopharynx. Highly conformal IMRT was delivered with limited radiation doses to the optic nerves, optic chiasm, brainstem, brain, spinal cord, lens, retina, mandible, and parotid. The total dose delivered to the tumor varied from 3400 to 4500 cGy. The tumor shrunk radiographically in all three cases and there was no endoscopic evidence of disease in two cases at 15 months and 40 months. There was no acute toxicity. Late toxicity was limited to one episode of epistaxis and persistent rhinitis in one patient. In conclusion, IMRT provides several advantages over conventional radiotherapy in the treatment of recurrent juvenile angiofibroma.- - - - - - - - - - ranking = 0.47186574348466keywords = nerve (Clic here for more details about this article) |
5/89. Cranial neuropathy following curative chemotherapy and radiotherapy for carcinoma of the nasopharynx.Cranial nerve damage following head and neck radiotherapy is an unusual event. Cranial neuropathy following concurrent chemotherapy and radiotherapy is unreported. The authors report a case of a 54-year-old man treated with curative chemotherapy and radiotherapy for a stage III nasopharyngeal carcinoma who developed an unilateral hypoglossal nerve palsy five years after therapy. Follow-up examination and magnetic resonance imaging (MRI) show no evidence of recurrent disease. hypoglossal nerve injury occurring after head and neck radiotherapy is an indirect effect due to progressive soft tissue fibrosis and loss of vascularity. This process develops over years leading to nerve entrapment and permanent damage. Cranial nerve palsies, including damage to the hypoglossal nerve, can develop years after therapy with no evidence of tumour recurrence. Chemotherapy and radiotherapy have improved progression-free and overall survival in advanced nasopharyngeal cancer. As more patients achieve long-term tumour control following chemotherapy and radiotherapy, we must be cognizant of potential late injury to cranial nerves.- - - - - - - - - - ranking = 3.3030602043926keywords = nerve (Clic here for more details about this article) |
6/89. Congenital nasopharyngeal teratoma (epignathus).The case report of a congenital nasopharyngeal teratoma presented as an intra-amniotic sac mass was described. Histologically, the tumor was composed of highly differentiated tissue derived from three germ layers. Those tissues were partially developed as infant organs with a central core made up by bone. Haphazardly arrangement of such tissues with disorganized sketal axis helped in differentiating the mass from an asymmetric twins. The evidence of tumor attachment was seen at the retro-uvular region.- - - - - - - - - - ranking = 0.056268513030684keywords = organ (Clic here for more details about this article) |
7/89. brain abscess formation in radiation necrosis of the temporal lobe following radiation therapy for nasopharyngeal carcinoma.BACKGROUND: radiation necrosis is a known complication following radiation therapy for extracranial as well as intracranial tumours. However, brain abscess formation in radiation necrosis has not been reported in the literature. We report the clinical data of 6 patients suffering from this condition. METHOD: Twenty-eight patients with radiation necrosis of the temporal lobe following radiotherapy for nasopharyngeal carcinoma were treated surgically at the Department of neurosurgery, Queen Elizabeth Hospital, hong kong between January 1992 and July 1999. Of these, 6 cases were complicated by brain abscess formation. The clinical data of these 6 patients are retrospectively reviewed. FINDINGS: The patients were 5 males and 1 female, ranging in age from 41 to 67 years. Three patients had previous treatment with steroids for the symptomatic radiation necrosis. A history of nasal infection or otitis media was recognised in all 6 patients. All patients were treated surgically by temporal lobectomy and excision of the necrotic tissue together with the abscess cavity. Intra-operatively, a bony defect was observed between the middle cranial fossa and the sphenoid sinus in 3 patients and the bony defect was repaired with a temporalis muscle flap. The species of organisms could only be identified in 3 patients. In 3 patients, the pus smear was positive but the culture was negative. Subsequently, 4 patients recovered and 2 patients died. INTERPRETATION: Cerebral radiation necrosis is a predisposing cause of brain abscess formation. Surgical excision is recommended as the treatment of choice in this group of patients.- - - - - - - - - - ranking = 0.028134256515342keywords = organ (Clic here for more details about this article) |
8/89. Metastatic tumors in the sellar and parasellar regions: clinical review of four cases.Metastatic tumors in the sellar and parasellar regions are uncommon and rarely detected in clinical practice. We present four cases of sellar and parasellar metastatic tumors, which metastasized from distant organ in one case and extended directly from adjacent structures in three. Common presenting symptoms were cranial neuropathies, headache and facial pain. Invasion into the cavernous sinus was noted in all cases. We report rare cases of sellar and parasellar metastases. Also, we should consider the possibility of metastasis in these regions for patients who showed the above clinical presentations in systemic cancer patients. In extensive diseases, transient symptomatic relief could be obtained by direct surgical management, even in restricted degree.- - - - - - - - - - ranking = 0.028134256515342keywords = organ (Clic here for more details about this article) |
9/89. Hamartomatous gastric polyposis in a patient with tuberous sclerosis.A 42-year-old female diagnosed with tuberous sclerosis was found to have multiple polyps in the fundus of stomach. On histologic examination, the lesions were hamartomatous polyps. In tuberous sclerosis, many lesions occur in multiple organs and there are several reports about the frequent association of hamartomatous polyps of the colon. However, gastric manifestation of tuberous sclerosis has not been established probably due to its asymptomatic nature. This is the first report of multiple gastric hamartomatous polyposis in patient with tuberous sclerosis.- - - - - - - - - - ranking = 0.028134256515342keywords = organ (Clic here for more details about this article) |
10/89. Late sequelae of radiation therapy in cancer of the head and neck with particular reference to the nasopharynx.Sequlae of radiation therapy may be late in occurring and varied in their manifestations. Although some are untreatable and progressive, the risk of development of some other sequelae can be minimized by careful application of radiotherapy or by ancillary measures, such as dental decay prophylaxis. Some of the serious sequelae secondary to radiation therapy of the nasopharynx have been summarized. These include radiation myelitis, paralysis of the cranial nerves, stricture of the pharynx, radiation-induced cancer, and necrosis with fatal hemorrhage.- - - - - - - - - - ranking = 0.47186574348466keywords = nerve (Clic here for more details about this article) |
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