Surgical excision

手术切除
  • 文章类型: Case Reports
    胃肠道间质瘤(GIST)是罕见的间质肿瘤,发生在胃肠道,特别是胃或小肠,起源于Cajal间质细胞。该病例报告描述了一名50岁的绝经后女性,腹部肿块逐渐增加,临床上被认为是起源于卵巢的肿瘤。进行了原发性卵巢恶性肿瘤的临床和影像学诊断,但在剖腹手术中,观察到恶性肿瘤的肠系膜成分以及双侧卵巢囊肿。小心去除肿块,组织病理学分析证实其为GIST。对患者进行了三年的随访,患者没有任何疾病的迹象,并且她的术后时间不复杂。这个案例描述了GIST诊断的复杂性,术中详细分析的意义,和适当的术后监测。与其他类似病例的差异和相似之处揭示了此类患者如何进行治疗。鼓励差异化护理。因此,监督护理对于长期监测患者并检查任何复发至关重要。
    Gastrointestinal stromal tumors (GISTs) are rare mesenchymal tumors occurring in the gastrointestinal tract particularly the stomach or small intestine originating from interstitial cells of Cajal. This case report describes a 50-year-old postmenopausal female presenting with a gradually increasing abdominal mass which clinically was thought to be a neoplasm originating in the ovaries. A clinical and imaging diagnosis of primary ovarian malignancy was made but during laparotomy, a mesenteric component to the malignancy as well as bilateral ovarian cysts were seen. The mass was removed with care and histopathological analysis confirmed it to be GIST. Follow-up of the patient was done for three years and there was no sign of any disease in the patient and she had an uncomplicated postoperative period. This case describes the intricacy of GISTs\' diagnosis, the significance of detailed intraoperative analysis, and appropriate postoperative surveillance. Differences and similarities with other similar cases shed light on how such patients present themselves for treatment, thus encouraging differentiated care. Supervisory care is therefore vital in the monitoring of the patient for prolonged periods and to check for any relapse.
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  • 文章类型: Case Reports
    Pilomatrixoma,也被称为Malherbe钙化上皮瘤,是一种起源于毛囊基质细胞的罕见良性皮肤肿瘤。它通常作为一家公司,无痛皮下结节,最常见于头部,脖子,和上肢。Pilomatrixoma偶尔会出现在不典型的位置,由于其非特异性临床表现,构成了诊断挑战。一名43岁的女性出现了无痛,她左脚踝外侧的肿块慢慢扩大,已经存在了大约一年。体检显示,界限清楚的皮下结节,直径约2厘米,正常覆盖皮肤。左脚踝的MRI显示界限清楚,具有不同信号强度的皮下肿块,与钙化一致,提示毛结肠瘤.细针穿刺活检证实了基底细胞的存在,阴影细胞,和钙化区域。手术切除了病灶,和组织病理学检查证实了毛心房瘤的诊断。病人术后进展顺利,在6个月的随访中没有复发。该病例强调了在皮下结节的鉴别诊断中考虑毛房瘤的重要性,即使在不寻常的地方。全面的诊断方法,包括临床评估,成像,和组织病理学检查,对准确诊断至关重要。切缘清晰的手术切除是首选治疗方法,确保低复发率和良好的患者预后。本报告增强了对毛心房瘤的理解,并强调了有效管理这种罕见疾病的多模式诊断策略的必要性。
    Pilomatrixoma, also known as calcifying epithelioma of Malherbe, is a rare benign skin tumor originating from hair follicle matrix cells. It typically presents as a firm, painless subcutaneous nodule, most commonly found in the head, neck, and upper extremities. Pilomatrixoma can occasionally appear in atypical locations, posing a diagnostic challenge due to its nonspecific clinical presentation. A 43-year-old female presented with a painless, slowly enlarging mass on the lateral side of her left ankle, which had been present for approximately one year. Physical examination revealed a firm, well-circumscribed subcutaneous nodule measuring about 2 cm in diameter with normal overlying skin. An MRI of the left ankle demonstrated a well-circumscribed, subcutaneous mass with heterogeneous signal intensity, consistent with calcifications, suggesting pilomatrixoma. A fine-needle aspiration biopsy confirmed the presence of basaloid cells, shadow cells, and areas of calcification. The lesion was surgically excised, and histopathological examination validated the diagnosis of pilomatrixoma. The patient had an uneventful postoperative course, with no recurrence at the six-month follow-up. This case underscores the importance of considering pilomatrixoma in the differential diagnosis of subcutaneous nodules, even in unusual locations. A comprehensive diagnostic approach, including clinical evaluation, imaging, and histopathological examination, is essential for an accurate diagnosis. Surgical excision with clear margins is the treatment of choice, ensuring low recurrence rates and excellent patient outcomes. This report enhances the understanding of pilomatrixoma and highlights the necessity for a multimodal diagnostic strategy in managing this rare condition effectively.
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  • 文章类型: Case Reports
    皮肤鳞状细胞癌(SCC)是一种常见的非黑色素瘤皮肤癌(NMSC)。虽然大多数皮肤SCC在皮肤色素沉着较浅的人由于阳光伤害,患有基础疾病如皮肤溃疡和慢性炎症(包括寻常型狼疮(LV)和慢性盘状红斑狼疮)的患者也容易发生SCC.在这里,我们报告了一例继发性SCC的病例,该病例诊断为患有20年寻常型狼疮的54岁患者,之前没有正式的全身治疗。在临床实践中很少见。两个月前,患者右脸颊出现丘疹,溃疡并排出脓性液体。实验室检查显示TSPOT结果阳性,组织病理学检查证实肉芽肿性病变,支持SLE的诊断。然而,组织活检意外显示角化型的中度分化SCC。在这种情况下,我们对病灶进行手术切除,然后进行美容闭合和辅助光动力治疗(PDT).同时,患者接受了全身抗结核治疗.治疗后6个月,未观察到肿瘤复发,与红斑狼疮相关的皮疹也已消退.患者对治疗结果感到满意。
    Cutaneous squamous cell carcinoma (SCC) is a common non-melanoma skin cancer (NMSC). Although most cutaneous SCC in people with lighter skin pigmentation as a result of sun damage, patients with underlying conditions such as skin ulcers and chronic inflammation-including conditions such as lupus vulgaris (LV) and chronic discoid lupus erythematosus-are also predisposed to developing SCC. Here we report a case of secondary SCC diagnosed in a 54-year-old patient with 20 years of lupus vulgaris without prior formal systemic treatment, a rarity in clinical practice. Two months ago, the patient developed papules on the right cheek that ulcerated and discharged purulent fluid. Laboratory tests revealed a positive TSPOT result and histopathological examination confirmed granulomatous lesions, supporting the diagnosis of SLE. However, a tissue biopsy unexpectedly revealed a moderately differentiated SCC of the keratinizing type. In this case, we performed surgical excision of the lesion followed by cosmetic closure and adjuvant photodynamic therapy (PDT). Concurrently, the patient underwent systemic anti-tuberculosis treatment. At 6 months post-treatment, no tumour recurrence was observed and the rash associated with lupus erythematosus had also resolved. The patient was satisfied with the treatment outcome.
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  • 文章类型: Case Reports
    背景:血淋巴管瘤是临床上由血管异常引起的一种非常罕见的良性肿瘤。其临床特征往往不典型,很容易漏诊和误诊。当核磁T1的时间显著减少时,应考虑血管瘤的诊断。因此,我们报告这个病例是希望提高临床医生对这种疾病的认识。
    方法:一名37岁男性患者表现为巨大的腹膜后淋巴管瘤。计算机断层扫描和磁共振成像表明可能存在大的肾周淋巴囊肿。术后病理诊断为腹膜后血淋巴管瘤。患者在充分引流后接受了手术切除。术后恢复顺利,无并发症发生。随访半年无复发。
    结论:本病例重申,大的腹膜后囊性肿块具有明显缩短的核T1时间应被视为血淋巴管瘤。这些疾病的诊断和治疗需要具体的临床依据和经验。
    BACKGROUND: Hemolymphangioma is a very rare benign tumor in clinical practice caused by abnormalities of the vasculature. Its clinical features are often atypical, and it is easy to miss and misdiagnose. When the time of nuclear magnetic T1 is significantly reduced, the diagnosis of hemangioma should be considered. Therefore, we report this case in the hope of raising clinicians\' awareness of the disease.
    METHODS: A 37-year-old man presented with a giant retroperitoneal hemolymphangioma. Computed tomography and magnetic resonance imaging indicated the possibility of a large perirenal lymphatic cyst. The postoperative pathological diagnosis is retroperitoneal hemolymphangioma. The patient underwent surgical excision after adequate drainage. The postoperative recovery was smooth and there were no complications. There was no recurrence during half a year of follow-up.
    CONCLUSIONS: This case reiterates that large retroperitoneal cystic masses with significantly shortened nuclear T1 time should be considered hemolymphangioma. Specific clinical basis and experience for the diagnosis and treatment of these diseases is necessary.
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  • 文章类型: Case Reports
    口腔底部的皮样囊肿是相对罕见且异常的位置异常部位,据推测是由沿胚胎融合线的生发上皮截留引起的。它呈现为柔软,不痛苦,在下颌和舌骨分支弓闭合期间,沿着融合线缓慢增长肿胀。这些囊肿在发育和组织病理学上分为三种类型:表皮样,皮样,和畸胎瘤.我们报告了一例罕见的病例,一名32岁的女性在门诊部就诊,两年来一直抱怨口底无痛肿胀,提示良性舌下肿块.此病例报告强调了临床表现的重要性,诊断检查,和手术方法在实现成功的结果舌下肿块。
    Dermoid cysts in the floor of the mouth are a relatively rare and unusual site of location anomalies presumed to be caused by entrapment of germinal epithelium along the lines of embryonic fusion. It presents as soft, non-painful, and slowly growing swelling along the lines of fusion during the closure of mandibular and hyoid branch arches. These cysts are developmental and histopathologically classified into three types: epidermoid, dermoid, and teratoid. We are reporting a rare case of a 32-year-old female who presented in the outpatient department with complaints of painless swelling over the floor of the mouth for two years, suggesting a benign sublingual mass. This case report underscores the importance of clinical presentation, diagnostic workup, and surgical approach in achieving successful outcomes for sublingual mass.
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  • 文章类型: Case Reports
    产生类似牙齿特征的良性牙源性肿瘤被称为复合牙瘤。本病例报告描述了一个独特的病例,即患者上颌骨出现的复合牙瘤,前线区域。这个例子强调了尽快诊断和治疗牙瘤是多么重要,以避免可能的后果,如牙齿移位或失败的爆发。它还强调了成像方法对于准确定位和计划牙源性肿瘤的手术的重要性。这种情况的有效处理为牙瘤患者诊断所需的多学科方法提供了重要的见解,治疗,和后续行动。
    Benign odontogenic tumors that produce features resembling teeth are known as compound odontomas. This case report describes a unique case of a compound odontoma presenting in the patient\'s maxillary, the front region. This example highlights how crucial it is to diagnose and treat odontomas as soon as possible in order to avoid possible consequences like tooth displacement or failed eruption. It also emphasizes how important imaging methods are to accurately localizing and planning surgery for odontogenic tumors. The effective handling of this case offers important insights into the multidisciplinary approach needed for odontoma patient diagnosis, treatment, and follow-up.
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  • 文章类型: Journal Article
    背景:我们介绍了我们用于乳腺非侵入性三维肿瘤定位的原始技术的详细描述和初步结果,这是在新辅助系统治疗(NAST)之前作为标准侵袭性肿瘤标记的替代方案而创建的,目的是在肿瘤完全消退后进行充分的手术。方法:在正文中提供了该技术的详细描述。该技术的可行性和精度在单臂中进行了评估,基于完全消退的肿瘤床切除的充分性和合理性的组织学参数的前瞻性研究。结果:在94名招募的患者中,15(16%)被认为不合适,主要是由于肿瘤超声能见度不足。在79名经过处理的患者中,31(39%)在NASH后临床完全消退,并使用我们的技术进行了手术。手术精度的组织学参数(肿瘤消退的迹象:24/31;显微镜下的癌症残留物:7/31)在所有切除的标本(100%精度)中进行了验证。7例镜下残留无阳性切缘,表明我们的技术能够在NAST手术后实现肿瘤安全。结论:所提出的技术在确定消退肿瘤的位置方面是可行的,并且令人满意。因此代表了侵袭性肿瘤标记的替代方法,特别是在缺乏训练有素的人员和设备的外科中心进行侵入性标记。该技术的局限性主要与肿瘤的超声能见度不足有关。
    Background: We present a detailed description and the preliminary results of our original technique for non-invasive three-dimensional tumor localization in the breast, which was created as an alternative to standard invasive tumor marking before neoadjuvant systemic therapy (NAST), aiming to enable adequate surgery after complete tumor regression. Methods: A detailed description of the technique is provided in the main text. The technique\'s feasibility and precision were assessed in a single-arm, prospective study based on the histological parameters of the adequacy and rationality of the excision of completely regressed tumor beds. Results: Out of 94 recruited patients, 15 (16%) were deemed unsuitable, mainly due to the tumors\' inadequate ultrasound visibility. Among the 79 processed patients, 31 (39%) had complete clinical regression after NAST and were operated on using our technique. The histological parameters of surgical precision (signs of tumor regression: 24/31; microscopic cancer residues: 7/31) were verified in all excised specimens (100% precision). There were no positive margins in seven cases with microscopic residues, indicating our technique\'s capacity to enable oncologically safe post-NAST surgery. Conclusions: The proposed technique is feasible and satisfactorily accurate in determining the location of regressed tumors, thus representing an alternative to invasive tumor marking, especially in surgical centers lacking trained staff and equipment for invasive marking. The technique\'s limitations are mainly related to the inadequate ultrasound visibility of the tumor.
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  • 文章类型: Case Reports
    鼻窦癌是一种罕见但侵袭性的恶性肿瘤,起源于鼻腔和鼻旁窦。我们介绍了一个40岁的女性,她有三个月的头痛史,视力减退,和突起。影像学检查显示软组织密度,左眼眶骨侵蚀和外侧延伸。组织病理学检查证实鼻腔鼻窦癌伴间变性改变。患者接受了肿瘤的手术切除,并在神经ICU接受了术后护理。她的视力在手术后有所改善,她出院了,神经状况稳定。该病例强调了在诊断和治疗鼻窦癌方面的挑战,并强调了多学科护理对最佳结果的重要性。早期诊断和干预对于预防这种侵袭性恶性肿瘤患者的并发症和取得良好的预后至关重要。
    Sinonasal carcinoma is a rare but aggressive malignancy arising from the nasal cavity and paranasal sinuses. We present a case of a 40-year-old female who presented with a three-month history of headache, diminution of vision, and proptosis. Imaging studies revealed soft tissue density with bony erosion and extraconal extension in the left orbit. Histopathological examination confirmed sinonasal carcinoma with anaplastic changes. The patient underwent surgical excision of the tumor and received post-operative care in the neuro-ICU. Her visual acuity improved post-surgery, and she was discharged with stable neurological status. This case highlights the challenges in the diagnosis and management of sinonasal carcinoma and underscores the importance of multidisciplinary care for optimal outcomes. Early diagnosis and intervention are crucial in preventing complications and achieving favorable outcomes in patients with this aggressive malignancy.
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  • 文章类型: Case Reports
    Hibernoma是一种罕见的良性脂肪组织,由棕色脂肪引起。常误诊为脂肪肉瘤,冬眠需要活检和组织病理学检查才能准确诊断。此病例报告介绍了一位老年患者大腿后部的异常冬眠瘤,强调所涉及的诊断挑战和手术管理。
    方法:我们报告了F.D.夫人的案例,一名70岁女性,17年前有卵巢囊肿手术史,左大腿后有肿块。质量已经发展了两年多,而且很困难,无痛,测量为7×12厘米。初始成像提示脂肪肉瘤;然而,MRI显示9×19cm肿块,组织特征不均匀。手术活检证实了Hibernoma的诊断。肿瘤被完全切除,组织学检查显示典型的冬眠细胞瘤特征。
    Hibernomas,虽然罕见,软组织肿块的鉴别诊断应考虑。MRI等成像技术至关重要,但最终的诊断依赖于组织病理学.手术切除是首选的治疗方法,需要细致的技术来处理肿瘤的高血管性质。
    结论:该病例强调了在鉴别诊断中考虑冬眠瘤的重要性,并强调了活检对准确诊断的作用。完整的手术切除对于防止复发至关重要。需要进一步的研究来更好地了解冬眠的发病机理和最佳管理。
    UNASSIGNED: Hibernoma is a rare benign adipose tumor that arises from brown fat. Often misdiagnosed as liposarcoma, hibernomas require biopsy and histopathological examination for accurate diagnosis. This case report presents an unusual instance of hibernoma located in the posterior thigh of an elderly patient, emphasizing the diagnostic challenges and surgical management involved.
    METHODS: We report the case of Mrs. F.D., a 70-year-old woman with a history of ovarian cyst surgery 17 years prior, who presented with a mass in the posterior left thigh. The mass had been developing over two years and was hard, painless, and measured 7 × 12 cm. Initial imaging suggested liposarcoma; however, an MRI revealed a 9 × 19 cm mass with heterogeneous tissue characteristics. A surgical biopsy confirmed the diagnosis of hibernoma. The tumor was excised completely, and histological examination showed typical features of hibernoma.
    UNASSIGNED: Hibernomas, although rare, should be considered in the differential diagnosis of soft tissue masses. Imaging techniques such as MRI are essential, but definitive diagnosis relies on histopathology. Surgical excision is the treatment of choice, requiring meticulous technique to manage the hypervascular nature of the tumor.
    CONCLUSIONS: This case underscores the importance of considering hibernoma in differential diagnoses and highlights the role of biopsy for accurate diagnosis. Complete surgical excision is crucial to prevent recurrence. Further research is needed to better understand the pathogenesis and optimal management of hibernomas.
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  • 文章类型: Journal Article
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