head and neck tumors

头颈部肿瘤
  • 文章类型: Case Reports
    黑色素瘤是黑色素细胞的恶性肿瘤,它们是神经c细胞产生的黑素细胞的前体。黑色素瘤可以发生在皮肤等不同部位,眼睛,上食管,和脑膜由于神经c细胞的迁移。通常,预后因素根据Breslow指数决定。该病例报告描述了一名61岁的女性,她的脸左侧出现粉红色不规则肿胀,持续六个月。病人做了手术切除,经磁共振成像(MRI)和组织学检查确认后,确定病情为侵袭性黑色素瘤。通过我们的病例报告,我们的目标是阐明现有的恶性黑色素瘤治疗方案,同时探索新的介绍和多学科行动.
    Melanoma is a malignant neoplasm of melanoblasts, which are the precursors of the melanocytes arising from the neural crest cells. Melanomas can occur at various sites like the skin, eyes, upper esophagus, and meninges due to the migration of neural crest cells. Usually, the prognostic factors are decided based on the Breslow index. This case report describes a 61-year-old female who presented with the complaint of pinkish irregular swelling over the left side of her face for six months. The patient had a surgical resection, and the condition was determined to be invasive melanoma following confirmation by magnetic resonance imaging (MRI) and histological examination. Through our case report, we aim to shed light on the existing protocol for managing malignant melanoma while also exploring new aspects of presentation and multidisciplinary action.
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  • 文章类型: Case Reports
    滑膜肉瘤是一种罕见且高度侵袭性的肉瘤。通常,它们从四肢的软组织开始,尽管在极少数情况下它们可能在头颈部发展。当他们这样做的时候,他们通常在受影响的地区出现局部症状。我们的患者是一名20岁的男性,没有病史,他抱怨有三个月的左侧精神下肿胀,可触及的5厘米质量。最初被认为是一个暴跌的牧场,患者接受了经口切除颈部左耳下颌下软组织肿块,鼻子,和喉部(ENT)专家。肿块的病理分析证实存在低分化的滑膜肉瘤。进行了术后颈部成像,与以前的成像相比,它显示出质量大小的显著减少;然而,弥撒仍然存在。这是少数描述的位于口底的低分化滑膜肉瘤病例之一。因此,它强调了将其视为头颈部病变的可能鉴别诊断的重要性。
    Synovial sarcomas are uncommon and highly aggressive sarcomas. Typically, they start in the soft tissues of the extremities, although they may develop in the head and neck region in rare cases. When they do, they usually present with localized symptoms in the affected area. Our patient is a 20-year-old man without a medical history who complained of a three-month history of submental swelling of the left side with a non-tender, palpable 5 cm mass. Initially believed to be a plunging ranula, the patient underwent transoral excision of the left submandibular soft tissue mass in the neck by the ear, nose, and throat (ENT) specialist. The pathological analysis of the mass confirmed the presence of a poorly differentiated synovial sarcoma. A postoperative neck imaging was performed, which showed a significant decrease in mass size compared to the previous imaging; however, the mass was still present. This is one of the few described cases of a poorly differentiated synovial sarcoma located on the floor of the mouth. Therefore, it highlights the importance of considering it as a possible differential diagnosis of head and neck pathologies.
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  • 文章类型: Case Reports
    一种罕见的局部侵袭性血管肿瘤,青少年鼻咽血管纤维瘤(JNA)主要影响男性青少年。本文描述了一名14岁的男性患者,他表现为嗜睡和复发性鼻出血,这是JNA的症状。CT和MRI扫描证实血管肿块具有明显的局部侵袭,起源于蝶腭孔。CT血管造影后,这揭示了肿瘤的大量血液供应,并有助于有效切除,设计了一个有针对性的手术策略。组织病理学证实了肿瘤的良性性质,手术成功,患者顺利康复。这个案例增加了关于JNA的小文献。它强调了医疗保健专业人员在管理疾病时需要了解早期识别和仔细的术前准备的要求。
    A rare and locally aggressive vascular tumor, juvenile nasopharyngeal angiofibroma (JNA) mostly affects male teenagers. This paper describes a 14-year-old male patient who presented with lethargy and recurrent nasal bleeding, which are symptoms of JNA. CT and MRI scans confirmed a vascular mass with a significant local invasion originating from the sphenopalatine foramen. After a CT angiography, which revealed the tumor\'s large blood supply and helped with efficient excision, a focused surgical strategy was designed. Histopathology verified the benign nature of the tumor, and the operation was successful and the patient had a smooth recovery. This case adds to the little literature on JNA. It highlights the need for healthcare professionals to be aware of the requirement of early identification and careful presurgical preparation in managing the illness.
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  • 文章类型: Case Reports
    该病例报告描述了在34岁的非裔美国囚犯中复发的浸润性转移性扁桃体头颈部鳞状细胞癌(HNSCC)的独特表现。无视传统风险因素的预期。此案强调了在非典型HNSCC场景中细微差别护理的重要性。该患者于2021年10月出现双侧淋巴结肿大和吞咽困难,这导致了扁桃体鳞状细胞癌的诊断。患者的治疗轨迹包括同步顺铂放疗,随后的右颈彻底解剖,和免疫疗法。并发症,包括脓肿形成,中性粒细胞减少症,贫血,需要采用多学科方法,并进入接待和医疗中心医院。培养物显示出明显的颈部肿块,对各种细菌均呈阳性培养。通过战略干预和细致的日常伤口护理,患者的病情得到了显著改善。这个案例提示探索导致HNSCC发展的未知因素,在一个看似低风险的个体中,挑战传统的风险概况。治疗挑战,包括辐射,手术,和免疫疗法,强调需要采取多方面的方法。强化伤口护理在减轻并发症和改善患者生活质量方面的核心作用至关重要。患者的肿瘤和感染凸显了改善监狱卫生的紧迫性。加强卫生和健康检查可以减轻患者病情的严重程度,强调惩教设施需要采取全面的卫生措施。此外,专门的伤口护理有可能改善结果并降低被监禁人群的健康风险.
    This case report describes a distinctive presentation of invasive metastatic tonsillar head and neck squamous cell carcinoma (HNSCC) that recurred in a 34-year-old African American inmate, defying the expectations of conventional risk factors. This case underscores the significance of nuanced care in atypical HNSCC scenarios. The patient presented in October 2021 with bilateral lymphadenopathy and dysphagia, which led to the diagnosis of tonsillar squamous cell carcinoma. The patient\'s treatment trajectory included radiation therapy with concurrent cisplatin, a subsequent radical right neck dissection, and immunotherapy. Complications, including abscess formation, neutropenic fever, and anemia, necessitated a multidisciplinary approach and admission to Reception and Medical Center Hospital. Cultures revealed a distinct neck mass that cultured positively for a variety of bacteria. The patient\'s condition was significantly improved by strategic interventions and meticulous daily wound care. This case prompts exploration into unknown factors contributing to HNSCC development in a seemingly low-risk individual, challenging conventional risk profiles. Treatment challenges, including radiation, surgery, and immunotherapy, underscore the need for a multifaceted approach. The central role of intense wound care in mitigating complications and improving the patient\'s quality of life is pivotal. The patient\'s tumor and infection highlight the urgency of improving prison sanitation. Enhanced hygiene and health screenings could have lessened the severity of the patient\'s condition, underscoring the need for comprehensive health measures in correctional facilities. Moreover, specialized wound care has the potential to improve outcomes and reduce health risks within incarcerated populations.
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  • 文章类型: Journal Article
    巨细胞瘤是局部侵袭性原发性骨良性肿瘤,有复发倾向。转移和恶性转化。由于下颌骨罕见的疾病,没有明确的治疗指南。手术治疗是巨细胞瘤的首选治疗方法。由于它靠近包括颅底在内的重要结构,与侵入性较小的手术相关的复发性疾病可能难以管理,而侵入性较大的手术将导致更高的发病率和复杂的重建。在无法手术切除的疾病中,提倡使用denosumab或唑来膦酸进行医疗管理。我们介绍了一例罕见的下颌骨巨细胞瘤。患者是一名33岁的女士,其表现为下巴逐渐进行性疼痛性肿胀。在通过F-18FDGPET扫描排除远处转移后,她接受了用游离腓骨皮瓣重建的肿瘤整块切除。在6个月的随访期间,患者没有复发。
    Giant cell tumor is locally aggressive primary benign neoplasm of bone with tendency of frequent recurrence, metastasis and malignant transformation. Because of the rarity of the disease involving mandible, no definite treatment guideline is established. Surgical treatment is the treatment of choice for giant cell tumor. Due to its proximity to vital structures including skull base, the recurrent disease associated with less invasive procedure could be difficult to manage while more invasive procedure will result in higher morbidity and complex reconstruction. Medical management with denosumab or zoledronic acid has been advocated in surgically unresectable disease. We present a rare case of giant cell tumor of mandible. Patient was a 33 years old lady who presented with gradually progressive painful swelling in chin. After exclusion of distant metastasis by F-18 FDG PET scan, she underwent en-bloc resection of the tumor with free fibula flap reconstruction. During 6 months of follow up visit patient had no recurrence.
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  • 文章类型: Journal Article
    腺样囊性癌(ACC)是一种罕见的肿瘤,记录在案的年发病率为每百万3至4.5例。它约占所有头颈部恶性肿瘤的1%,约占唾液腺肿瘤的10%。必须采取多学科方法,以确保最适当的治疗结果。治疗策略通常涉及多学科方法,可能包括手术,放射治疗,化疗,或这些的各种组合。在这种情况下,我们介绍了一例起源于女性上颚的ACC的临床病例。在这篇文章中,我们将详细说明实施的诊断挑战和多学科治疗策略,强调在palACC病例中采取综合方法的重要性。此外,我们将讨论康复过程和随访过程中观察到的结果。
    Adenoid cystic carcinoma (ACC) is a rare tumor, with a documented annual incidence ranging from 3 to 4.5 cases per million. It constitutes approximately 1% of all head and neck malignancies and around 10% of salivary gland tumors. It is imperative to adopt a multidisciplinary approach to ensure the most appropriate therapeutic outcome. Treatment strategies usually involve a multidisciplinary approach and may include surgery, radiotherapy, chemotherapy, or various combinations of these. In this context, we present a clinical case of ACC originating in the palate of a woman. Throughout this article, we will detail the diagnostic challenges and multidisciplinary treatment strategies implemented, emphasizing the importance of a comprehensive approach in cases of palatal ACC. In addition, we will discuss the rehabilitation process and the outcomes observed during the follow-up of this case.
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  • 文章类型: Case Reports
    多形性腺瘤(PA)是最常见的唾液腺肿瘤。这些生长缓慢的良性肿瘤通常累及腮腺,但有时可发生在非典型部位,如颌下腺或小唾液腺。我们描述了一个非典型的多形性腺瘤伴腮腺多中心受累的病例,颌下腺,以及一名35岁男性的咽旁间隙,该男性在磁共振成像(MRI)上模仿了慢流畸形。诊断通过细针穿刺细胞学检查得到证实,考虑到围手术期的风险,患者选择了保守方法.该病例突出了PA的不常见的多中心和非典型表现,基于MRI特征的初始鉴别诊断具有挑战性。它还强调了考虑非典型表现并利用诸如细胞学的准确诊断工具来管理复杂的唾液腺肿瘤的重要性。
    Pleomorphic adenomas (PA) are the most common type of salivary gland tumors. These slow-growing benign tumors most commonly involve the parotid gland, but can sometimes occur at atypical sites such as the submandibular or minor salivary glands. We describe an atypical case of pleomorphic adenoma with multicentric involvement of the parotid, the submandibular gland, and the parapharyngeal space in a 35-year-old male which mimicked a slow-flow malformation on magnetic resonance imaging (MRI). Diagnosis was confirmed on fine needle aspiration cytology, and conservative approach was opted for the patient in view of perioperative risks. This case highlights the uncommon multicentricity and atypical presentation of PA, challenging the initial differential diagnosis based on MRI features. It also underscores the importance of considering atypical presentations and utilizing accurate diagnostic tools like cytology for managing complex salivary gland tumors.
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  • 文章类型: Case Reports
    畸胎瘤是一种罕见的生殖细胞肿瘤,由来自胚胎所有三个胚层的结构组成,比例不同。虽然大多数是良性的,有些会变成恶性。畸胎瘤最常见的位置是骶尾部,而它们在颈部区域的发生是非常罕见的。广义分类,未成熟畸胎瘤含有低分化组织,而成熟的组织分化良好。这里,作者介绍了一例12个月大的儿童颈部肿块。进行放射学成像研究。在多学科的团队方法下,这个孩子被手术切除成功治疗。组织病理学显示肿块为III级未成熟畸胎瘤。术后,没有发现复发.
    Teratoma is a rare type of germ cell tumor that consists of structures derived from all three germ layers of the embryo with varying proportions. While most of these are benign, some can turn malignant. The most common location of teratomas is the sacrococcygeal region, while their occurrence in the neck region is very rare. Broadly classified, immature teratomas contain poorly differentiated tissues, while mature ones have well-differentiated tissues. Here, the authors present a case of a 12-month-old child who presented with a huge neck mass. Radiological imaging studies were performed. Under a multidisciplinary team approach, the child was treated successfully with surgical excision. Histopathology revealed the mass to be an immature teratoma of grade III. Postoperatively, no recurrence has been noted.
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  • 文章类型: Case Reports
    来自远处原发性恶性肿瘤的腮腺转移并不常见,并且对临床医生提出了诊断挑战。我们介绍了一名65岁的男性,有肾细胞癌的透明细胞亚型病史,在右腮腺区域表现出无痛肿胀。他的病史为右侧肾细胞癌,五年前他接受了根治性肾切除术。病人的体检显示,右侧腮腺区无触痛肿块。影像学检查,包括超声和对比增强计算机断层扫描,确认腮腺内存在固体增强病变。细针穿刺活检提供了恶性细胞的组织学证据,其特征与透明的肾细胞癌细胞亚型一致。这与诊断腮腺转移性肾细胞癌一致。该病例强调了在腮腺肿胀的鉴别诊断中考虑转移性疾病的重要性。特别是有远缘恶性肿瘤病史的患者。全身靶向治疗,用酪氨酸激酶抑制剂,成为一种有效的治疗选择,强调个性化方法在管理罕见临床情景中的重要性。量身定制的管理对于优化腮腺转移患者的预后至关重要,改善他们的整体预后和生活质量。
    Parotid gland metastases from distant primary malignancies are uncommon and present diagnostic challenges for clinicians. We present the case of a 65-year-old male with a history of clear cell subtype of renal cell carcinoma who presented with a painless swelling in the right parotid region. His medical history was significant for a right-sided renal cell carcinoma, for which he had undergone a radical nephrectomy five years ago. The patient\'s physical examination revealed a firm, non-tender mass in the right parotid gland region. Imaging studies, including ultrasound and contrast-enhanced computed tomography, confirmed the presence of a solid-enhancing lesion within the parotid gland. Fine-needle aspiration biopsy provided histological evidence of malignant cells with features consistent with a clear renal cell carcinoma cell subtype. This is consistent with diagnosing metastatic renal cell carcinoma to the parotid gland. This case highlights the significance of considering metastatic disease in the differential diagnosis of parotid swellings, particularly in patients with a history of remote malignancy. Systemic targeted therapy, with a tyrosine kinase inhibitor, emerged as an effective treatment option, emphasizing the importance of personalized approaches in managing rare clinical scenarios. Tailored management is crucial in optimizing outcomes for patients with parotid gland metastases, improving their overall prognosis and quality of life.
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  • 文章类型: Case Reports
    未经证实:肉瘤是恶性间充质细胞肿瘤,占所有成人肿瘤的1%。未分化的多形性肉瘤包括非常罕见的亚型。它主要发生在男性的第六十年。然而,它们的确切发生率仍然没有很好的划分,尤其是那些发生在头皮上的。因为他们缺乏任何疾病特异性的介绍,当出现类似病例时,我们应该保持高度的临床怀疑。
    方法:这里,我们展示了一名52岁中东女性的临床病例,她出现在门诊诊所,抱怨她的头皮右侧突起逐渐长大,有一年的历史。它很痛苦,尺寸迅速增加。术前放射学评估怀疑是囊性形成。肿块完全切除,组织病理学分析诊断为原发性未分化多形性肉瘤。
    UNASSIGNED:精心手术切除是我们患者的基础治疗。除了临床怀疑外,放射影像学还用于术前评估。该患者手术后恢复成功。到目前为止,她已经被监视了6个月,没有肿瘤复发的证据,转移,或临床并发症。
    结论:在任何患者人群中都很少见到原发性未分化多形性肉瘤。更罕见的是,它发生在这样的患者人群中。因此,我们记录这种罕见的恶性肿瘤的病例是至关重要的,因为这将引导我们进行信息丰富的临床研究,使医生能够选择适当的治疗方式。
    UNASSIGNED: Sarcomas are malignant mesenchymal-cell tumors that comprise 1 % of all adult tumors. Undifferentiated Pleomorphic Sarcoma comprises a vastly rare subtype. It mostly occurs in males in their 6th decade of life. However, their exact incidence remains poorly demarcated, especially those occurring in the scalp. Since they lack any disease-specific presentations, we should maintain high clinical suspicion when presented with similar cases.
    METHODS: Herein, we demonstrate the clinical case of a 52-year-old Middle Eastern female, who presented to the outpatient clinic complaining of a one-year history of progressively growing protuberance in her right side of the scalp. It was painful and rapidly increased in size. Presurgical radiological assessment suspected a cystic formation. Utter resection of the mass was achieved, and histopathological analysis diagnosed it as a primary Undifferentiated Pleomorphic Sarcoma.
    UNASSIGNED: Meticulous surgical resection was the cornerstone treatment of our patient. Radiological imaging in addition to clinical suspicion was utilized for preoperative assessment. This patient has had a successful post-surgical recovery. She has been surveilled for 6 months so far with no evidence of tumor recurrence, metastasis, or clinical complications.
    CONCLUSIONS: It is especially rare to see a primary Undifferentiated Pleomorphic Sarcoma in any patient population. It\'s even rarer that it occurs in such a patient demographic. Hence, it\'s vital that we document cases of this rare malignancy because that would lead the way in conducting informative clinical studies which enable physicians to select the proper treatment modality.
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