benign tumors

良性肿瘤
  • 文章类型: Case Reports
    单纯性骨囊肿(SBC)是儿童最常见的溶骨性病变,通常导致非负重骨骼的病理性骨折。这些良性肿瘤主要出现在肱骨近端,股骨,或者跟骨.囊腔充满浆液性或浆液性液体,并由薄的纤维血管结缔组织膜衬砌。病因包括骨骼生长障碍,局部静脉阻塞,滑膜起源疾病,和遗传倾向。SBC最常见于从出生到20岁的个体中。该报告介绍了一例12岁的男性患者,该患者因左上臂肿块病史入院。肿块急性发作,并在三到四周内逐渐发展到目前的大小,之后,它变得不进步。病人一直健康到四岁,之后,他经历了轻微的创伤后,左臂频繁骨折。多发性创伤导致肱骨上部逐渐形成弥漫性肿块。放射成像模式,如X射线和磁共振成像,对于诊断骨囊肿和评估其临床状况至关重要。治疗可以包括将骨髓或类固醇注射到囊肿中以促进愈合过程。
    Simple bone cysts (SBCs) are the most common osteolytic lesions in children, often leading to pathological fractures of non-weight-bearing bones. These benign tumors primarily arise in the proximal humerus, femur, or calcaneus. The cystic cavity is filled with serous or serosanguineous fluid and lined by a thin fibrovascular connective tissue membrane. The etiological factors include disturbances in bone growth, local venous obstruction, synovial origin disorders, and genetic predispositions. SBCs are most frequently observed in individuals from birth to 20 years of age. The report presented a case of a 12-year-old male patient who was admitted to the hospital with a history of a mass on his left upper arm. The mass had an acute onset and gradually progressed to its current size over three to four weeks, after which it became nonprogressive. The patient had been healthy until the age of four, after which he experienced frequent fractures of the left arm following trivial trauma. Multiple traumas led to the gradual formation of a diffuse mass over the upper part of the humerus. Radiological imaging modalities, such as X-ray and magnetic resonance imaging, are crucial in diagnosing bone cysts and evaluating their clinical conditions. Treatment can involve the injection of bone marrow or steroids into the cyst to facilitate the healing process.
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  • 文章类型: Case Reports
    血管瘤是以扩张的血管增生为特征的良性肿瘤,典型的毛细血管和静脉。它们主要发生在婴儿期和儿童期,大部分影响头部和颈部。口腔血管瘤,虽然相对罕见,会影响嘴唇等部位,舌头,颊粘膜,和味觉。尽管它们是良性的,由于潜在的功能丧失和终生的美学问题,治疗血管畸形至关重要.该病例报告涉及一名76岁的妇女,她的舌头背侧有一个柔和的红蓝色肿块,导致功能损害。虽然口腔血管畸形存在各种治疗选择,包括硬化疗法和冷冻手术,在这种情况下选择了手术切除,考虑患者的年龄和相关的疾病风险。
    Hemangiomas are benign tumors characterized by the proliferation of dilated blood vessels, typically capillaries and veins. They primarily occur in infancy and childhood, with the majority affecting the head and neck region. Oral hemangiomas, though relatively rare, can affect areas such as the lips, tongue, buccal mucosa, and palate. Despite their benign nature, managing vascular malformations is crucial due to potential functional loss and lifelong aesthetic concerns. This case report involves a 76-year-old woman presenting with a soft reddish-blue mass on the dorsal aspect of her tongue, causing functional impairment. While various treatment options exist for oral vascular malformations, including sclerotherapy and cryosurgery, surgical excision was chosen in this case, considering the patient\'s age and the associated risks of the condition.
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  • 文章类型: Case Reports
    我们介绍一个成年病人,一个39岁的女性,主要抱怨脐带区域疼痛。通过放射学检查对患者进行了进一步评估,并诊断为由粘膜下脂肪瘤引起的小肠套叠。她接受了回肠切除和受影响段的吻合。术后时间并不复杂,患者继续定期口服。组织病理学分析显示其为脂肪组织,无异型特征。此病例显示由于粘膜下脂肪瘤引起的小肠套叠的罕见表现。它强调了诊断成像工具对诊断的重要性以及对手术进行适当管理的需求。
    We present an adult patient, a 39-year-old female, with chief complaints of pain in the umbilical region. The patient was further evaluated by radiological investigations and was diagnosed with small bowel intussusception caused by submucosal lipoma as the lead point. She had undergone ileal resection and anastomosis of the affected segment. The postoperative period was uncomplicated, and the patient continued with regular oral intake. The histopathological analysis revealed it to be adipose tissue with no features of atypia. This case shows the rare presentation of small bowel intussusception due to a submucosal lipoma. It emphasizes the significance of diagnostic imaging tools for diagnosis and the need for surgery for proper administration.
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  • 文章类型: Case Reports
    脂肪瘤是自然界中普遍存在的良性软组织肿瘤。现有文献表明,良性肿瘤是无害的,除非它们的大小增加,导致重要结构的压缩。此病例报告讨论了一名52岁男子的病例,他无痛地出现在诊所,在他的嘴的右侧增长肿块。患者的症状包括吞咽困难和说话困难,这导致医生建议手术切除肿块。在肿块切除手术期间没有问题,切口愈合而不损害舌神经或舌下神经或沃顿氏管,正如在后续访问中观察到的那样。患者病史,症状,术前检查,治疗策略,手术技术都包括在这个案例研究中,专注于口腔脂肪瘤的极不寻常发展,特别是在嘴巴的地板上。
    Lipomas are benign soft tissue tumors that are ubiquitous in nature. Available literature suggests that benign tumors are harmless unless they increase in size, resulting in compression of vital structures. This case report discusses the case of a 52-year-old man who presented to the clinic with a painless, growing lump on the right side of his mouth. The patient\'s symptoms included difficulty swallowing and speaking, which led the doctors to recommend surgical excision of the mass. There were no issues during the mass removal surgery, and the incision healed without compromising the lingual or hypoglossal nerves or Wharton\'s duct, as observed during follow-up visits. Patient history, symptoms, preoperative examination, treatment strategy, and surgical technique are all included in this case study, which focuses on the extremely unusual development of lipomas in the oral cavity, particularly on the floor of the mouth.
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  • 文章类型: English Abstract
    肝脏和胆道的良性肿瘤是罕见的实体,其中一些需要手术治疗以防止其恶性转化。具有恶性潜能的胆道肿瘤可通过肝切除术治疗,粘液性囊性肿瘤和纤毛肝前肠囊肿,或者通过胆道切除术,用于胆道乳头状肿瘤和I型和IV型胆总管囊肿。需要预防性胆囊切除术的病理是大于10毫米的息肉,瓷质胆囊和胰胆管合流异常。最后,肝细胞腺瘤超过5cm,发生在男性患者中,或外显子3突变的β-连环蛋白,应通过肝段切除术进行预防性切除。本文介绍了这些不同的病理及其管理。
    Benign tumors of the liver and biliary tract are rare entities, and some of them require surgical management to prevent their malignant transformation. Tumors from the biliary tract with malignant potential are treated either by hepatic resection, for mucinous cystic neoplasm and ciliated hepatic foregut cysts, or by biliary resections, for biliary papillary neoplasm and type I and IV choledochal cysts. The pathologies requiring prophylactic cholecystectomy are polyps larger than 10 mm, porcelain gallbladder and pancreaticobiliary maljunction. Finally, hepatocellular adenoma over 5cm, occurring in male patients, or exon 3 mutated beta-catenin, should lead to prophylactic resection by hepatic segmentectomy. This article describes these different pathologies and their management.
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  • 文章类型: Journal Article
    泪小管腺瘤(CA)是一种罕见的唾液腺良性肿瘤,主要影响老年女性,对上唇有强烈的偏爱。虽然CA通常出现在小唾液腺,它在腮腺的发生是非常罕见的。在这份报告中,我们在腮腺出现了一个独特的CA病例,增加了只有8个记录在案的文献。病人,一位57岁的亚洲男性,表现为持续8年的左腮腺无痛肿胀。临床检查和影像学检查发现了一个分叶状肿块,提示手术干预。病人接受了浅表腮腺切除术,切除组织的病理检查证实了CA的诊断,没有恶性肿瘤的迹象.此案例说明了与CA、特别是考虑到它在腮腺的罕见表现。准确的诊断依赖于手术活检,仔细的手术计划势在必行,尤其是考虑到面神经的距离.我们的案例强调需要提高对CA独特演示的认识,特别是在亚洲人口中。考虑到复发的可能性,长期随访至关重要。需要进一步的研究来阐明CA的生物学行为,并完善管理策略以获得最佳患者结果。
    Canalicular adenoma (CA) is a rare benign tumor of the salivary glands, predominantly affecting elderly females, with a strong predilection for the upper lip. While CA commonly arises in the minor salivary glands, its occurrence in the parotid gland is exceptionally rare. In this report, we present a unique case of CA in the parotid gland, adding to the scant literature with only 8 documented instances. The patient, a 57-year-old Asian male, presented with a painless swelling in the left parotid gland that had been persisting for 8 years. Clinical examination and imaging studies identified a lobulated mass, prompting surgical intervention. The patient underwent a superficial parotidectomy, and pathological examination of the excised tissue confirmed the diagnosis of CA, with no signs of malignancy. This case illustrates the diagnostic and management challenges associated with CA, particularly given its rare presentation in the parotid gland. Accurate diagnosis is reliant on surgical biopsy, and careful surgical planning is imperative, especially considering the proximity of the facial nerve. Our case underscores the need for heightened awareness of CA\'s unique presentations, particularly within the Asian population. Given the potential for recurrence, long-term follow-up is essential. Further research is needed to elucidate the biological behavior of CA and to refine management strategies for optimal patient outcomes.
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  • 文章类型: Journal Article
    目的:全面回顾治疗Warthin肿瘤(WTs)的非手术方法,并评估其作为手术干预替代方法的安全性和有效性。方法:在PubMed进行系统的文献检索,WebofScience,科克伦图书馆,和Embase数据库使用与WT和非手术治疗相关的特定关键字。2012年之前发表的研究,非英文出版物,并排除了混合方法学文章。选择过程涉及标题和摘要筛选,然后根据纳入和排除标准对其余文章进行全面评估.有关研究特征的数据,参与者,干预措施,并收集结果。结果:共分析1582条记录,6项研究符合纳入标准.这些研究评估了不同的非手术干预措施对WT管理,包括微波消融,射频消融,超声引导下的乙醇硬化治疗。研究结果表明,微波消融和射频消融可显著减少肿瘤大小,改善外观。超声引导下的乙醇硬化疗法还导致肿瘤大小显着减小,而没有并发症。纳入的研究支持这些非手术治疗的安全性和有效性。结论:非手术入路,如微波消融,射频消融,超声引导下的乙醇硬化治疗,已成为外科手术治疗的可行替代方法。这些干预措施在肿瘤大小减小和美容改善方面提供了有希望的结果。有必要进行更大样本量和长期随访的进一步研究,以验证这些发现并建立非外科手术治疗的标准化方案。
    Objective: To provide a comprehensive review of nonsurgical approaches for the management of Warthin\'s tumors (WTs) and evaluate their safety and efficacy as alternatives to surgical intervention. Methods: A systematic literature search was conducted in PubMed, Web of Science, Cochrane Library, and Embase databases using specific keywords related to WT and nonsurgical treatments. Studies published before 2012, non-English publications, and mixed methodology articles were excluded. The selection process involved title and abstract screening, followed by a thorough assessment of the remaining articles based on inclusion and exclusion criteria. Data regarding study characteristics, participants, interventions, and outcomes were collected. Results: A total of 1582 records were analyzed, and 6 studies met the inclusion criteria. These studies evaluated different nonsurgical interventions for WT management, including microwave ablation, radiofrequency ablation, and ultrasound-guided ethanol sclerotherapy. The findings demonstrated that microwave ablation and radiofrequency ablation led to a significant reduction in tumor size and improved cosmetic appearance. Ultrasound-guided ethanol sclerotherapy also resulted in a notable decrease in tumor size without complications. The included studies supported the safety and efficacy of these nonsurgical options for the treatment of WTs. Conclusion: Nonsurgical approaches, such as microwave ablation, radiofrequency ablation, and ultrasound-guided ethanol sclerotherapy, have emerged as viable alternatives to surgical intervention for the management of WTs. These interventions offer promising outcomes in terms of tumor size reduction and cosmetic improvement. Further research with larger sample sizes and long-term follow-up is warranted to validate these findings and establish standardized protocols for nonsurgical management of WTs.
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  • 文章类型: Journal Article
    背景:动脉瘤性骨囊肿(ABCs)是溶骨性的,非恶性,骨的血管病变。病理性骨折可能是ABCs的表现,发生在约8%的ABC中。文献中已经描述了不同的治疗方法,但是,如今,ABCs患者病理性骨折的最佳治疗仍存在争议,目前尚无标准的治疗指南,也没有关于最佳手术干预的共同指征.我们研究的目的是回顾有关此问题的现有文献,探索和面对ABC中病理性骨折的不同手术治疗方法,以阐明这些患者的手术方法。方法:对PubMed索引的文献进行系统回顾,MEDLINE,并进行了Cochrane图书馆数据库。遵循系统审查和荟萃分析(PRISMA)的首选报告项目。结果:共有37篇相关文章最终纳入研究。总的来说,我们达到了140名患者。在纳入审查的140名患者中,124例患者(88.6%)接受了刮宫手术,15例(10.7%)患者行整块切除手术。共有47%的患者(70)接受了钢板的综合手术,螺钉,钉,或外固定器。8.6%的患者使用辅助治疗(12)。并发症涉及20.7%的患者(29)。结论:总之,动脉瘤性骨囊肿病理性骨折的治疗需要仔细的患者评估,考虑到年龄等因素,开放生长板的存在,病变的位置,和外科医生的专业知识。
    Background: Aneurysmal bone cysts (ABCs) are osteolytic, non-malignant, vascular lesions of the bone. Pathological fractures can be a manifestation of the ABCs, which occur in about 8% of ABCs. Different treatments have been described in the literature, but, nowadays, an optimal management of the pathological fractures in patients with ABCs is still a matter of debate and there are no standard guidelines for treatment nor any shared indication about the best surgical intervention. The aim of our study is to review the current literature available on this matter exploring and confronting different surgical treatments for pathological fractures in ABC in order to clarify the surgical approach to these patients. Methods: A systematic review of the literature indexed in PubMed, MEDLINE, and Cochrane Library databases was carried out. The Preferred Reporting Items for Systematically Reviews and Meta-Analyses (PRISMA) were followed. Results: A total of 37 articles were relevant and were finally included in the study. In total, we reached a population of 140 patients. Of the 140 patients included in the review, 124 patients (88.6%) underwent curettage surgery, 15 patients (10.7%) underwent en bloc resection surgery. A total of 47% of patients (70) underwent synthesis surgery with a plate, screw, nail, or external fixator. Adjuvant treatments were used in 8.6% of patients (12). Complications involved 20.7% of the patients (29). Conclusions: In conclusion, the treatment of pathological fractures in aneurysmal bone cysts requires careful patient assessment, considering factors such as age, the presence of open growth plates, the location of the lesion, and the surgeon\'s expertise.
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  • 文章类型: Case Reports
    肾母细胞瘤(WT)占儿童肾脏肿瘤的绝大多数(92%)。然而,有许多非典型或罕见的肾癌,当然,在成像中有一个诊断方向来区分不同的诊断是有用的,指导治疗管理。我们报告了根据放射学数据(通过PACS搜索)最初诊断为肾母细胞瘤的3例患者的病例,接受术前化疗,然后进行肾切除术,其解剖病理学证据支持良性肾肿瘤。肾母细胞瘤是儿童最常见的肾脏肿瘤,但其他良性肿瘤也不容忽视,应考虑可能指向该实体的放射迹象,这样可以避免新辅助化疗的副作用。
    Wilm\'s tumor (WT) accounted for the vast majority of renal tumors in children (92%). However, there are many atypical or rare forms of kidney cancer, and it is certainly useful to have a diagnostic orientation in imaging to differentiate between the different diagnoses, guiding that way the therapeutic management. We report the cases of 3 patients who were initially diagnosed with nephroblastoma on the basis of radiological data (via PACS search), underwent pre-operative chemotherapy and then nephrectomy, and whose anatomopathological evidence came back in favor of benign renal tumors. Nephroblastoma is the most common renal tumor in children, but other benign tumors should not be neglected, radiological signs that may point to this entity should be taken into account, so that neoadjuvant chemotherapy with its enfeebling side effects can be avoided.
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  • 文章类型: Journal Article
    背景:手术是目前对不涉及任何特定器官的腹膜后肿瘤的唯一有效治疗方法。使用机器人切除良性和恶性腹膜后肿瘤被认为是安全可行的。然而,没有足够的证据来确定机器人腹膜后肿瘤切除术(RMBRs)是否优于开放式腹膜后恶性切除术(OMBRs).这项研究比较了机器人切除良性和恶性腹膜后肿瘤与开放切除相同大小肿瘤的短期结果。
    方法:该研究比较了2018年3月至2022年12月期间接受机器人切除术(n=54)和开放切除术(n=54)的腹膜后肿瘤患者的人口统计学和结局。进行1:1匹配分析以确保公平的比较。
    结果:研究发现RBMR导致手术时间(OT)减少,估计失血量(EBM),与OBMR相比,术后住院时间(PSH)。此外,RBMR降低了EBL,PHS,恶性肿瘤累及主要血管的患者为OT。肿瘤大小无明显差异,输血率,RBMR组和OBMR组之间的发病率。
    结论:将RMBR与OMBR进行比较时,据观察,人民币R与较低(EBL)相关,术后住院时间短(PHS),并减少了特定组的良性和恶性肿瘤患者的手术时间(OT)。
    BACKGROUND: Surgery is currently the only effective treatment for retroperitoneal tumors that do not involve any specific organ. The use of robots for removing both benign and malignant retroperitoneal tumors is considered safe and feasible. However, there is insufficient evidence to determine whether robotic retroperitoneal tumor resection (RMBRs) is superior to open retroperitoneal malignant resection (OMBRs). This study compares the short-term outcomes of robotic excision of benign and malignant retroperitoneal tumors with open excision of the same-sized tumors.
    METHODS: The study compared demographics and outcomes of patients who underwent robotic resection (n = 54) vs open resection (n = 54) of retroperitoneal tumors between March 2018 and December 2022. A 1:1 matching analysis was conducted to ensure a fair comparison.
    RESULTS: The study found that RBMRs resulted in reduced operative time (OT), estimated blood loss (EBM), and postoperative hospital stay (PSH) when compared to OBMRs. Additionally, RBMRs reduced EBL, PHS, and OT for patients with malignant tumor involvement in major vessels. No significant differences were found in tumor size, blood transfusion rate, and morbidity rate between the RBMRs and OBMRs groups.
    CONCLUSIONS: When comparing RMBRs to OMBRs, it was observed that RMBR was associated with lower (EBL), shorter postoperative hospital stays (PHS), and reduced operative time (OT) in a specific group of patients with both benign and malignant tumors.
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