1/3. leiomyosarcoma in the maxilla: a case report.We describe a rare case of leiomyosarcoma of the maxilla arising in a 71-year-old Japanese woman. The lesion was treated successfully by surgical resection with external irradiation of 70 Gy. No sign of recurrence or distant metastasis was present 3 years after operation. Histogenetically, this maxillary leiomyosarcoma apparently arose from the medial muscle of blood vessels or from primitive mesenchyme in the maxilla.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/3. Importance of additional microvascular anastomosis in esophageal reconstruction after salvage esophagectomy.Esophageal reconstruction after salvage esophagectomy in patients who have undergone curative-intent chemoradiotherapy for esophageal cancer is associated with a significant risk of perioperative morbidity and mortality. In particular, anastomotic leakage can cause severe and potentially fatal complications, including mediastinitis and pneumonia. The authors performed esophageal reconstruction with a pedicled right colon graft after salvage esophagectomy in eight patients. To decrease the rate of anastomotic leakage, the authors performed an additional microvascular anastomosis at the distal end of the graft. The distal stumps of the ileocolic artery and vein were anastomosed to the cervical vessels. After surgery, aspiration pneumonia and localized wound infection were observed in two patients each, but slight anastomotic leakage was observed in only one patient. Postoperative swallowing function was satisfactory in all patients. Although the incidence of anastomotic leakage is reportedly high, the authors observed anastomotic leakage in only one of eight patients. The authors believe that additional microvascular anastomosis helps prevent anastomotic leakage, especially in patients who have undergone salvage esophagectomy after curative chemoradiotherapy.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/3. Necrotizing brainstem leukoencephalopathy six weeks following radiotherapy.A 71-year-old male with a null cell pituitary macroadenoma was given peripituitary region radiotherapy (4,346 Gy units) over a 1-month-period and 6 weeks later developed the rapid onset of blurred vision, diplopia, ataxia, incoordination, cranial nerve palsy, somnolence, and respiratory distress. His fixed neurologic deficits required ventilatory support, feeding tube placement, and chronic hospitalization until his death 1 year later. At autopsy, necrotic foci with dystrophic axonal calcification were found throughout the brainstem, associated with mild focal vascular hyalinization but without fibrinoid necrosis, telangiectasias or large vessel abnormalities. This unusual case of fatal "early delayed" radiation injury is compared to previous literature cases.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |