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  • 文章类型: Case Reports
    背景:原发性乳腺癌引起的甲状腺转移是一种罕见的现象,只有少数案例记录在国内和国际文献中。这种情况的管理方法和预后引发了争论和不确定性。
    方法:这里,我们报道了一例55岁的乳腺癌患者。她先前接受了辅助化疗和内分泌治疗的广泛切除乳腺病变。9年后,患者出现颈部不适,检查提示右侧甲状腺转移和颈部淋巴结转移。影像学显示肺和骨转移。此外,患者接受内分泌治疗.经过7个月的随访,患者存活,无任何新的远处转移.源自乳腺癌的甲状腺转移通常以一种微妙的方式展开,错综复杂的性质,使早期检测具有挑战性。它们往往不显眼地出现,与广泛的全身转移交织在一起,暗示预后较差。
    结论:鉴于异常的临床指标,识别肿瘤患者的异慢性甲状腺转移是一个独特的挑战,要求临床医生以更高的灵敏度驾驭随访过程。关键在于及时发现,及早干预,能显著提高患者整体生活质量的因素。
    BACKGROUND: Thyroid metastasis arising from primary breast cancer is a rare phenomenon, with only a handful of cases documented in both national and international literature. The management approach and prognosis of this occurrence have sparked debates and uncertainties.
    METHODS: Herein, we report the case of a 55-year-old woman with breast cancer. She previously underwent extensive excision of the breast lesion with adjuvant chemotherapy and endocrine therapy. After 9 years, she presented with neck discomfort and examination suggested right thyroid metastasis and lymph node metastasis in the neck. Imaging showed pulmonary and bone metastases. Furthermore, the patient received endocrine therapy. After 7 months of follow- up, the patient survived without any new distant metastases. Thyroid metastases originating from breast cancer often unfold with a subtle, intricate nature, making early detection challenging. They tend to emerge inconspicuously, intertwining with widespread systemic metastases, hinting at a less favorable prognosis.
    CONCLUSIONS: Given the unusual clinical indicators, identifying heterochronic thyroid metastases in patients with tumors poses a distinct challenge, requiring clinicians to navigate the follow-up process with heightened sensitivity. The key lies in timely detection and early intervention, factors that can significantly enhance the overall quality of life for patients.
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  • 文章类型: Case Reports
    Esophageal cancer (EC) is a common digestive system tumor, characterized by high invasion, apparent lethality, and poor prognosis. Direct diffusion is the major metastatic mechanism of early EC, whereas advanced EC is spread mainly by lymphatic metastasis, but also can be transferred to the liver, lungs, bones, and so on, by hematogenous metastasis. The incidence of bone metastasis in esophageal cancer is low, and maxillary metastasis of EC is more rare.
    To explore the differential diagnosis in ECMM, the rare metastasis of EC, and the possible mechanisms and predictors of bone metastasis.
    The clinical materials of a male patient with maxillary metastasis of esophageal cancer (ECMM) were analyzed. Then, the possible mechanism of the ECMM was discussed.
    ECMM may belong to the hematogenous metastasis. The early detection of rare sites of metastasis of EC should be prioritized in tumor marker detection, imaging, pathology, and other diagnostic techniques.
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  • 文章类型: Case Reports
    背景:促纤维化瘤(DF)是一种极为罕见的局部侵袭性骨肿瘤,占所有原发性骨肿瘤的0.11%。典型的临床表现是受影响区域上方的疼痛和肿胀。最常见的受累部位是下颌骨和长骨干meta端。组织学和生物学,促纤维增生性纤维瘤模仿软组织的腹外硬纤维瘤。
    一例27岁的男子,髂骨有DF,包括临床,放射学和组织学发现超过4年的时间在这里介绍。比较了手术干预前3年间隔进行的CT扫描与肿瘤扩展和皮质突破的关系。根据解剖学考虑,对患者进行刮治和移植治疗。18个月的后续CT扫描也记录在这里。此外,我们对271例病例进行了回顾和分析,包括本病例,重点介绍了MRI和CT的成像模式以及治疗方式和结果.
    结论:在纤维增生性纤维瘤患者中,CT是诊断骨内肿瘤扩展和评估皮质受累的首选成像技术。而MRI有利于评估骨外肿瘤的生长和术前计划。虽然肿瘤切除仍然是DF的首选治疗方法,刮治和移植被证明是一种可接受的替代治疗方式,当无法切除时,应密切随访。刮治和移植已显示出良好的临床效果,并且与长时间的无复发间隔有关。
    BACKGROUND: Desmoplastic fibroma (DF) is an extremely rare locally aggressive bone tumor with an incidence of 0.11% of all primary bone tumors. The typical clinical presentation is pain and swelling above the affected area. The most common sites of involvement are the mandible and the metaphysis of long bones. Histologically and biologically, desmoplastic fibroma mimics extra-abdominal desmoid tumor of soft tissue.
    UNASSIGNED: A case of a 27-year old man with DF in the ilium, including the clinical, radiological and histological findings over a 4-year period is presented here. CT scans performed in 3-year intervals prior to surgical intervention were compared with respect to tumor extension and cortical breakthrough. The patient was treated with curettage and grafting based on anatomical considerations. Follow-up CT scans over 18-months are also documented here. Additionally, a review and analysis of 271 cases including the presented case with particular emphasis on imaging patterns in MRI and CT as well as treatment modalities and outcomes are presented.
    CONCLUSIONS: In patients with desmoplastic fibroma, CT is the preferred imaging technique for both the diagnosis of intraosseus tumor extension and assessment of cortical involvement, whereas MRI is favored for the assessment of extraosseus tumor growth and preoperative planning. While tumor resection remains the preferred treatment for DF, curettage and grafting prove to be an acceptable alternative treatment modality with close follow-up when resection is not possible. Curettage and grafting have been shown to provide good clinical results and are associated with long recurrence free intervals.
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  • 文章类型: Case Reports
    腰椎骨折脱位是罕见的。英文文献报道了超过73例。我们报告了患有单侧创伤性L5-S1脱位并伴有后韧带复合体严重破坏的患者的影像学发现和手术治疗。患者使用后器械系统进行L4-S1椎骨的切开复位和稳定。由于创伤后韧带功能不全将导致异常运动,因此必须进行切开复位和内固定。手术治疗成功地产生了坚固的关节固定术并恢复了腰s交界处的稳定性。后续行动显示出优异的结果。这项研究报告了一种罕见的腰骶交界处损伤,有关这种异常情况的文献得到了广泛的回顾。
    Lumbosacral fracture-dislocation is a rare occurrence. There are more than 73 cases reported in the English literature. We report on the imaging findings and surgical treatment in a patient suffered of unilateral traumatic L5-S1 dislocation associated with severe disruption of the posterior ligamentous complex. The patient underwent open reduction and stabilization of L4-S1 vertebrae with posterior instrumentation system. Open reduction and internal fixation was mandatory as post-traumatic ligamentous insufficiency would lead to abnormal motion. Operative treatment managed to produce a solid arthrodesis and restore stability of the lumbosacral junction. Follow-up revealed excellent results. This study reports a rare injury of the lumbosacral junction, and the literature concerning this unusual condition is extensively reviewed.
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