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1.
Cancer Radiother ; 25(2): 155-160, 2021 Apr.
Artículo en Francés | MEDLINE | ID: mdl-33402291

RESUMEN

PURPOSE: To describe the clinical, therapeutic and prognostic features of ductal carcinomas of the parotid gland. MATERIAL AND METHODS: Five patients with ductal carcinoma of the parotid gland (primary and secondary carcinoma) treated, between 2007 and 2019, in our ENT department, were reviewed. RESULTS: Four men and one woman were included. The mean age was 61,4 years. One patient had a history of an invasive ductal carcinoma of the breast. Four patients consulted for swelling in the parotid region. One patient referred to our department for dysfunction of facial nerve. Skin invasion was found in one case. Four patients underwent total parotidectomy with sacrifice of the facial nerve (three cases). One patient underwent extended parotidectomy involving the skin. An ipsilateral selective neck dissection was performed in four cases. One patient had a parotid gland biopsy. Ductal carcinoma was primary in four cases and metastatic from breast origin in one case. Four patients were treated with postoperative radiotherapy. Remission was obtained in three cases. One patient had a local and meningeal recurrence. The patient with metastatic carcinoma had pulmonary, bone, hepatic and brain progression. CONCLUSION: Ductal carcinoma is a rare and aggressive tumor of the parotid gland. It can be primary or secondary. The treatment is based on surgery and radiotherapy. The prognosis is poor.


Asunto(s)
Carcinoma Ductal/cirugía , Neoplasias de la Parótida/cirugía , Adulto , Anciano , Anciano de 80 o más Años , Neoplasias de la Mama/patología , Carcinoma Ductal/diagnóstico por imagen , Carcinoma Ductal/patología , Carcinoma Ductal/secundario , Carcinoma Ductal de Mama/patología , Carcinoma Ductal de Mama/secundario , Nervio Facial/cirugía , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Disección del Cuello/estadística & datos numéricos , Invasividad Neoplásica , Glándula Parótida/diagnóstico por imagen , Glándula Parótida/cirugía , Neoplasias de la Parótida/diagnóstico por imagen , Neoplasias de la Parótida/patología , Neoplasias de la Parótida/secundario , Pronóstico , Estudios Retrospectivos , Neoplasias Cutáneas/patología
2.
Med Mycol Case Rep ; 27: 68-71, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32082981

RESUMEN

Saksenaea vasiformis is a species of the order Mucorales rarely reported as a cause of human mucormycosis. We report an unusual case of S. vasiformis otitis occurring in a diabetic woman after penetration of an insect in the right ear. Direct microscopic examination of the clinical sample showed hyaline and non septate hyphae belonging to the order Mucorales. Fungal identification was performed by sequencing the ITS region of the rDNA. To our knowledge, this is the first report of S. vasiformis infection in Tunisia.

3.
J Appl Microbiol ; 128(6): 1793-1801, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31965685

RESUMEN

OBJECTIVES: Rhizopus arrhizus is recognized as an emergent agent of superficial and invasive mucormycosis. Despite an increasing number of these infections, the molecular epidemiology of Rhizopus species has not been well studied. MATERIALS AND METHODS: In this study, 43 R. arrhizus strains (25 environmental and 18 clinical isolates) were genotyped using six novel panels of microsatellite markers. RESULTS: Upon the analysis of 43 isolates, 4-8 distinct alleles were detected for each marker. The discriminatory power for the individual markers ranged from 0·522 to 0·830. The combination of all six markers yielded 33 different haplotypes with a high degree of discrimination (0·989 D value). A four-marker combination were selected as the most parsimonious panel achieving D > 0·95. One clinical isolate and one environmental isolate shared the same genotype suggesting the possible nosocomial outbreak of mucormycosis in hospitalized patients. We have noted that the strains isolated from cutaneous mucormycosis were different from the strains isolated from rhino-orbito-cerebral mucormycosis. Then, the hypothesis of particular tropism of infectious strains for a given site is not excluded. The standardized indices of association IA and rBarD were significantly different from zero (P < 0·01), suggesting a prevailing clonal reproduction. The environmental population was significantly differentiated from clinical populations (Fst = 0·2249). CONCLUSIONS: Microsatellite typing method described in our study showed an excellent degree of discriminatory power. It is a promising tool for illuminating the molecular epidemiology of R. arrhizus species, including strain relatedness and transmission pathways.


Asunto(s)
Repeticiones de Microsatélite/genética , Mucormicosis/epidemiología , Rhizopus/genética , ADN de Hongos/genética , Microbiología Ambiental , Femenino , Genotipo , Humanos , Masculino , Epidemiología Molecular , Mucormicosis/microbiología , Rhizopus/clasificación , Rhizopus/aislamiento & purificación
4.
J Med Vasc ; 42(6): 388-391, 2017 Dec.
Artículo en Francés | MEDLINE | ID: mdl-29203046

RESUMEN

The neck, being not protected by skeleton, is vulnerable to external trauma and injury which can involve blood vessels, muscles, nerves, and trachea. Carotid injuries can be potentially life-threatening by hemorrhage and stroke. We present a case of a 26-year-old manual worker who presented a neck injury caused by a metallic projectile. The injury involved the right common carotid artery with an internal jugular vein fistula, and tracheal damage. The patient was managed with surgical repair of the tracheal lesion, reconstruction of the carotid section using a PTFE graft bypass, and ligation of the internal jugular vein. In the immediate postoperative period, the patient presented with no neurological deficits, but he did develop a pulmonary infection that resolved with antibiotic therapy. The follow-up is now 3months. The patient is doing well without any neurological disorder.


Asunto(s)
Fístula Arteriovenosa/etiología , Traumatismos de las Arterias Carótidas/complicaciones , Venas Yugulares/lesiones , Traumatismos Ocupacionales/complicaciones , Adulto , Fístula Arteriovenosa/diagnóstico por imagen , Fístula Arteriovenosa/cirugía , Traumatismos de las Arterias Carótidas/diagnóstico por imagen , Traumatismos de las Arterias Carótidas/cirugía , Humanos , Venas Yugulares/diagnóstico por imagen , Venas Yugulares/cirugía , Masculino , Traumatismos Ocupacionales/diagnóstico por imagen , Traumatismos Ocupacionales/cirugía
6.
Arch Pediatr ; 24(8): 743-746, 2017 Aug.
Artículo en Francés | MEDLINE | ID: mdl-28689684

RESUMEN

INTRODUCTION: Ectopic cervical thymus (ECT) is a rare embryological abnormality in children. It can be revealed by a compressive neck mass mistaken for a malignant tumor. Through a new case of ECT, we review the embryopathogenesis, diagnostic difficulties and therapeutic features. CLINICAL OBSERVATION: A 19-month-old girl presented a right cervical mass that quickly increased in size, causing intermittent dyspnea. The physical examination objectified a 6-cm, soft and compressible, painless right cervical tumefaction, extending from the mastoid area to the ipsilateral supraclavicular fossa. The diagnosis suggested based on CT was a cervicomediastinal cystic lymphangioma. The diagnoses discussed based on MRI were a collection of necrotic lymphadenopathy, rhabdomyosarcoma or neurofibroma debris. The mass was surgically excised through a laterocervical incision. A whitish multilobular tissular mass was found, adherent to the neurovascular axis of the neck. Pathological examination concluded in normal ectopic thymus tissue. The postoperative course was uneventful. CONCLUSION: Although ECT is a rare benign anomaly, it should be considered as a possible cause of a neck mass in children. Surgery is the curative treatment. Before surgery, the presence of a mediastinal thymus must be confirmed to avoid the risk of a total thymectomy in children. MRI is helpful in delineating thymic ectopia compared to the mediastinal thymus.


Asunto(s)
Coristoma/diagnóstico por imagen , Cuello , Timo , Obstrucción de las Vías Aéreas/etiología , Obstrucción de las Vías Aéreas/cirugía , Coristoma/complicaciones , Coristoma/cirugía , Diagnóstico Diferencial , Femenino , Humanos , Lactante , Imagen por Resonancia Magnética/métodos , Cuello/patología , Cuello/cirugía , Resultado del Tratamiento
7.
Rev Med Interne ; 38(1): 61-64, 2017 Jan.
Artículo en Francés | MEDLINE | ID: mdl-27083335

RESUMEN

INTRODUCTION: Parathyromatosis is a rare cause of recurrent hyperparathyroidism. It results from hyperfunctioning parathyroid tissue scattered throughout the thyroid bed region. CASE REPORT: A 51-year-old man with a history of parathyroidectomy, presented 18 years later with recurrent primary hyperparathyroidism. Surgical exploration identified a single parathyroid gland. The act was completed by a central compartment dissection and ipsilateral lobectomy. The patient was free of recurrence after a one-year follow-up. CONCLUSION: Parathyromatosis a rare cause of recurrent hyperparathyroidism. Its management is challenging. Extensive surgery is required with clearance of the central neck compartment and homolateral lobectomy. Medical therapy could be used to decrease parathormone level in recurrent parathyromatosis.


Asunto(s)
Hiperparatiroidismo Secundario/etiología , Glándulas Paratiroides/patología , Humanos , Hiperparatiroidismo Secundario/patología , Hiperplasia/complicaciones , Masculino , Persona de Mediana Edad , Glándulas Paratiroides/metabolismo , Hormona Paratiroidea/metabolismo , Recurrencia
8.
Bull Environ Contam Toxicol ; 95(5): 654-60, 2015 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-26067701

RESUMEN

Solid-phase extraction (SPE) procedure followed by derivatization and gas chromatography electron capture detection was evaluated for the determination of trace amounts of chlorophenols (CPs) in waters samples. Different parameters affecting extraction efficiency such as, volume of elution solvent, volume and pH of water sample, quantity of sorbent phase were studied and optimized. SPE was carried out on polystyrene-divinylbenzene (Bond Elut ENV) and high recoveries were obtained using 1000 mg of this cartridge for the treatment of 500 mL of acidified water sample. The described method was then tested on spiked tap, mineral, ground and surface water samples. The overall procedure provided limits of detection lower than 20 ng L(-1), recoveries of 70%-106% and an enrichment factor of 500 for the examined CPs in 500 mL water samples. Among the studied compounds, pentachlorophenol was detected in tap water at a concentration level of 0.06 µg L(-1).


Asunto(s)
Clorofenoles/análisis , Cromatografía de Gases/métodos , Extracción en Fase Sólida/métodos , Contaminantes Químicos del Agua/análisis , Acetilación , Agua Dulce/química , Agua Subterránea/química , Concentración de Iones de Hidrógeno , Límite de Detección , Estándares de Referencia
9.
Rev Stomatol Chir Maxillofac Chir Orale ; 116(3): 129-31, 2015 Jun.
Artículo en Francés | MEDLINE | ID: mdl-26001347

RESUMEN

INTRODUCTION: Pleomorphic adenoma is the most common benign tumor of the parotid gland. It has a tendency of recurrence and malignant transformation. The surgical excision of this lesion continues to be the subject of a major debate. In this study, we discuss optimal surgical options for pleomorphic adenoma. MATERIALS AND METHODS: We reviewed clinical records of 82 patients who underwent surgery. RESULTS: The tumor was localized in the superficial lobe in 81.7% of cases. Tumors of the deep lobe were removed by total parotidectomy. Those of the superficial lobe underwent partial exofacial parotidectomy (7 cases), exofacial parotidectomy (44 cases), or total parotidectomy (16 cases). Transitory facial paralysis was higher after total parotidectomy. Only one patient developed a recurrence, his tumor showed capsule infiltration. DISCUSSION: Conventional or partial superficial parotidectomy may be a good compromise with fewer complications and low incidence of recurrence.


Asunto(s)
Adenoma Pleomórfico/cirugía , Neoplasias de la Parótida/cirugía , Adenoma Pleomórfico/epidemiología , Adenoma Pleomórfico/patología , Adolescente , Adulto , Anciano , Parálisis Facial/epidemiología , Parálisis Facial/etiología , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia/epidemiología , Neoplasias de la Parótida/epidemiología , Neoplasias de la Parótida/patología , Complicaciones Posoperatorias/epidemiología , Estudios Retrospectivos , Adulto Joven
11.
Arch Pediatr ; 22(5): 476-9, 2015 May.
Artículo en Francés | MEDLINE | ID: mdl-25817175

RESUMEN

BACKGROUND: Idiopathic facial palsy is the most common cause of facial nerve palsy in children. Controversy exists regarding treatment options. The objectives of this study were to review the epidemiological and clinical characteristics as well as the outcome of idiopathic facial palsy in children to suggest appropriate treatment. PATIENTS AND METHODS: A retrospective study was conducted on children with a diagnosis of idiopathic facial palsy from 2007 to 2012. RESULTS: A total of 37 cases (13 males, 24 females) with a mean age of 13.9 years were included in this analysis. The mean duration between onset of Bell's palsy and consultation was 3 days. Of these patients, 78.3% had moderately severe (grade IV) or severe paralysis (grade V on the House and Brackmann grading). Twenty-seven patients were treated in an outpatient context, three patients were hospitalized, and seven patients were treated as outpatients and subsequently hospitalized. All patients received corticosteroids. Eight of them also received antiviral treatment. The complete recovery rate was 94.6% (35/37). The duration of complete recovery was 7.4 weeks. DISCUSSION: Children with idiopathic facial palsy have a very good prognosis. The complete recovery rate exceeds 90%. However, controversy exists regarding treatment options. High-quality studies have been conducted on adult populations. Medical treatment based on corticosteroids alone or combined with antiviral treatment is certainly effective in improving facial function outcomes in adults. In children, the recommendation for prescription of steroids and antiviral drugs based on adult treatment appears to be justified. CONCLUSION: Randomized controlled trials in the pediatric population are recommended to define a strategy for management of idiopathic facial paralysis.


Asunto(s)
Parálisis de Bell/diagnóstico , Parálisis de Bell/tratamiento farmacológico , Adolescente , Corticoesteroides/uso terapéutico , Atención Ambulatoria , Antivirales/uso terapéutico , Parálisis de Bell/clasificación , Parálisis de Bell/epidemiología , Niño , Preescolar , Estudios Transversales , Quimioterapia Combinada , Femenino , Francia , Hospitalización , Humanos , Masculino , Pronóstico , Resultado del Tratamiento
12.
Rev Laryngol Otol Rhinol (Bord) ; 136(4): 149-53, 2015.
Artículo en Francés | MEDLINE | ID: mdl-29400036

RESUMEN

Introduction: Endoscopic sinus surgery has become the treatment of choice in the surgical management of patients with nasal polyposis. The aim of our study is to identify the role of some epidemiological, clinical and therapeutic factors in recurrence after surgery of nasal polyposis. Materials and methods: We conducted a retrospective study over a period of 11 years (between 2000 and 2010) including 184 patients operated for nasal polyposis after failure of prolonged medical treatment. We evaluated the impact of epidemiological and clinical factors (age, sex, asthma, Widal disease, allergy and stage of nasal polyposis at the time of surgery) and treatment (surgical technique, observance of postoperative topical steroids ) on postoperative recurrence. Results: Nasal poly­posis recurred in 26.6% of patients after an average period of 23 months. Widal disease, asthma and bad observance of the intranasal steroid therapy were significantly associated with postoperative recurrence in the univariate analysis. In multi­variate analysis the bad observance of the intranasal steroid therapy was the only factor significantly associated with recurren­ce. Conclusion: Postoperative steroids prescribed routi­nely in our practice can effectively prevent recurrence after endonasal surgery and this result was found in both uni­variate and multivariate analysis.


Asunto(s)
Pólipos Nasales/cirugía , Adolescente , Adulto , Anciano , Asma/epidemiología , Niño , Femenino , Estudios de Seguimiento , Glucocorticoides/uso terapéutico , Humanos , Masculino , Persona de Mediana Edad , Cooperación del Paciente , Cuidados Posoperatorios , Recurrencia , Estudios Retrospectivos , Túnez/epidemiología , Adulto Joven
13.
Cancer Radiother ; 18(7): 678-80, 2014 Nov.
Artículo en Francés | MEDLINE | ID: mdl-25284635

RESUMEN

Low-grade sinonasal adenocarcinomas are uncommon and recently described entities. Its histologic diagnosis is challenging. This tumour is characterized by a tendency to local invasion, and rare distant metastases. Well treated, the prognosis is excellent. We describe a case of low-grade nasal cavity adenocarcinoma and discuss the anatomoclinical, therapeutic and evolutionary characteristics of this malignant tumour. A 54-year-old female patient presented with a 10 years history of right-sided nasal obstruction and recurrent epistaxis. On examination the patient had a large, firm mass in the right nasal cavity. Endoscopic sinonasal surgery was performed. The lesion was found to originate from the posteriolateral wall of the right nasal cavity. Histopathology analysis identified a low-grade sinonasal adenocarcinoma. Upon follow-up 4 years after surgery, the patient exhibited no clinical evidence of recurrence. Low-grade sinonasal adenocarcinomas are poorly defined neoplasms, accounting for 4 to 20% of all sinonasal malignancies. The nasal cavity is the most frequently involved site. Low-grade sinonasal adenocarcinomas pose a diagnostic challenge for the pathologist because they must be distinguished from benign tumours, especially adenomas. The primary treatment of sinonasal adenocarcinoma is complete surgical excision.


Asunto(s)
Adenocarcinoma/patología , Neoplasias del Seno Maxilar/patología , Neoplasias Nasales/patología , Adenocarcinoma/cirugía , Epistaxis/etiología , Femenino , Humanos , Neoplasias del Seno Maxilar/cirugía , Persona de Mediana Edad , Obstrucción Nasal/etiología , Neoplasias Nasales/cirugía
14.
Bull Environ Contam Toxicol ; 93(3): 375-82, 2014 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-24902648

RESUMEN

The particle-phase concentrations of polycyclic aromatic hydrocarbons (PAH) were determined in 13 air samples collected in an urban area of Bizerte (Tunisia) during 2009-2010. Atmospheric particulate samples were extracted by ultrasonic bath and analyzed by high-performance liquid chromatography with fluorescence detection. PAH were found in all the analyzed air samples and the most abundant compounds were pyrene, fluoranthene, benzo[g,h,i]perylene, benzo[b]fluoranthene, chrysene and benzo[a]pyrene. ∑14-PAH concentrations ranging from 9.38 to 44.81 ng m(-3) with mean value of 25.39 ng m(-3). PAH diagnostic ratio source analysis revealed gasoline and diesel vehicular emissions as major sources. The mean total benzo[a]pyrene toxicity equivalent calculated for samples was 3.66 ng m(-3) and the mean contribution of the carcinogenic potency of benzo[a]pyrene was determined to be 55.8 %. Concentrations of particulate PAH in Bizerte city atmosphere were approximately eight times greater than sampled at a nearby rural site.


Asunto(s)
Contaminantes Atmosféricos/análisis , Material Particulado/análisis , Hidrocarburos Policíclicos Aromáticos/análisis , Atmósfera/análisis , Carcinógenos/análisis , Crisenos/análisis , Ciudades , Gasolina/análisis , Humanos , Pirenos/análisis , Túnez , Emisiones de Vehículos/análisis
15.
Med Mal Infect ; 43(6): 226-9, 2013 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-23619288

RESUMEN

OBJECTIVES: We had for aim to describe the epidemiologic and clinic characteristics of murine typhus in a series of 43 serologically confirmed cases, in our region. PATIENTS AND METHODS: Serologic screening for IgG and IgM against Rickettsia typhi was performed in 1024 patients during three years (2006-2008). The characteristics of patients with a positive serology were examined retrospectively. One hundred and seventy sera obtained from blood donors were tested to detect IgG against R. typhi to determine the seroprevalence of the infection. RESULTS: There was evidence of recent R. typhi infection in 43 patients (4.2%) during the study period, and 3.7% of blood donors had IgG against R. typhi. The mean age of patients was 43.1 years and the sex-ratio was 1.04. Among the patients, 58.1% were from rural areas. No patient reported any exposure to rats or rat-fleas. There were more cases during the summer and fall. The most frequent complaint was fever as a single symptom (67.5%). A cutaneous rash was reported in 44.1% and headache in 60.5% of patients. Among the patients, 44.1% presented with thrombopenia and 47.2% with elevated liver enzymes. CONCLUSION: Murine typhus seems to be frequent in Tunisia. This infection could be a threat for travellers. Serology should be performed systematically in patients with fever as a single symptom since its clinical presentation is non-specific.


Asunto(s)
Fiebre/etiología , Tifus Endémico Transmitido por Pulgas/epidemiología , Animales , Antibacterianos/uso terapéutico , Donantes de Sangre/estadística & datos numéricos , Exantema/etiología , Humanos , Humedad , Inmunoglobulina G/sangre , Inmunoglobulina G/inmunología , Inmunoglobulina M/sangre , Inmunoglobulina M/inmunología , Insectos Vectores , Ratas , Estudios Retrospectivos , Rickettsia typhi/inmunología , Estaciones del Año , Estudios Seroepidemiológicos , Encuestas y Cuestionarios , Evaluación de Síntomas , Temperatura , Túnez/epidemiología , Tifus Endémico Transmitido por Pulgas/complicaciones , Tifus Endémico Transmitido por Pulgas/diagnóstico , Tifus Endémico Transmitido por Pulgas/tratamiento farmacológico , Xenopsylla/microbiología
16.
Mediterr J Hematol Infect Dis ; 4(1): e2012050, 2012.
Artículo en Inglés | MEDLINE | ID: mdl-22973494

RESUMEN

A 22-year-old man was admitted to our hospital because of fever, skin rash and epistaxis. Physical examination revealed fever (39.5°C), generalized purpura, lymphadenopathy and splenomegaly. Blood tests showed pancytopenia. Bone marrow aspiration and biopsy showed hemophagocytosis with no evidence of malignant cells. Anti rubella IgM antibody were positive and the IgG titers increased from 16 to 50 UI/mL in 3 days. Therefore, he was diagnosed to have rubella-associated hemophagocytic syndrome. We report herein the first case in a man and the sixth case of rubella-associated hemophagocytic syndrome in the literature by search in Pub Med till March 2012.

18.
Arch Pediatr ; 19(6): 670-4, 2012 Jun.
Artículo en Francés | MEDLINE | ID: mdl-22503598

RESUMEN

INTRODUCTION: Inhalation of foreign body in children is a serious accident that may compromise the vital prognosis of the child. The diagnostic was difficult in the absence of a recognizable penetration syndrome. Bronchoscopy is still recommended as the appropriate diagnostic and treatment of foreign bodies. The purpose of this study was to analyze the diagnostic and the treatment result of bronchoscopy and discuss its indications. MATERIAL AND METHODS: [corrected] A retrospective study analyzing data related to 223 children undergoing bronchoscopy due to suspicion of foreign body aspiration over a period of 10 years (2000-2009). The average age of the children was 29 months (range: one month-13 years). Approximately, two thirds of these patients were boys. The penetration syndrome was reported in 79.8% of cases. RESULTS: During bronchoscopy, the foreign body was confirmed only in 57.4%. Foreign bodies were found in the bronchus in 79.7% of cases. Among the foreign bodies, 78.1% were of vegetal origin. The average time of stay of the foreign body was of 16.1 days. Penetration syndrome and abnormal physical exam were the most sensitive parameters (79.7% and 82.8%, respectively) but with low specificity (24.2% and 35.8%, respectively). The combination of clinical and radiological signs suggestive of foreign body was the most specific sign (74.7%). Similarly, we found a statistically significant correlation between positive bronchoscopy and simultaneous suggestive clinical and radiological signs (P=0.03). The multivariate study showed that predictors factors of positivity of the bronchoscopy were: abnormal physical exam (P=0.016), abnormal radiological exam (P=0.003) and type of indication (P=0.005). DISCUSSION: The diagnosis of laryngotracheobronchial foreign body recures an array of arguments. It is suspected on the clinical interview specially penetration syndrome and on the clinical and radiological presentation. Any suspicion should lead to a bronchoscopy.


Asunto(s)
Bronquios , Broncoscopía , Cuerpos Extraños/terapia , Laringe , Tráquea , Adolescente , Niño , Preescolar , Femenino , Humanos , Lactante , Inhalación , Masculino , Estudios Retrospectivos
19.
Eur Ann Otorhinolaryngol Head Neck Dis ; 129(1): 47-50, 2012 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-21600866

RESUMEN

INTRODUCTION: Primary meningiomas of the sinonasal tract are rare tumors. Their positive diagnosis is difficult to establish. From one case observation, we report the clinical features, the diagnosis difficulties and the therapeutic modalities of primary meningioma of the sinonasal tract. CASE REPORT: A seventeen-year-old girl consulted for a left unilateral nasal obstruction with progressive evolution without episodes of epistaxis, smell disorder or headaches over a year. Physical examination revealed a grayish polypoid tumor in the left nasal fossa. CT scan evidenced an isodense lesion of the left nasal fossa slightly enhanced pushing back the lateral nasal wall without invasion or intracranial connection. Biopsy was in favour of an inverted papilloma. The tumor was resected via endoscopic approach. Pathological examination established the diagnosis of meningothelial menigioma. The prognosis was favourable without recurrence after a six-month follow-up. CONCLUSION: The positive diagnosis of primary sinonasal meningioma is difficult to establish because of their infrequent occurrence in this ectopic site and of their non-specific clinical appearance. The final diagnosis rests on the histological examination. Immunohistochemical studies are helpful to establish the accurate diagnosis. Imaging confirms the primitive nature of these tumors. Prognosis is excellent after complete surgical extirpation without the necessity of adjuvant therapy.


Asunto(s)
Meningioma , Neoplasias de los Senos Paranasales , Adolescente , Femenino , Humanos , Meningioma/diagnóstico , Meningioma/cirugía , Neoplasias de los Senos Paranasales/diagnóstico , Neoplasias de los Senos Paranasales/cirugía
20.
Rev Stomatol Chir Maxillofac ; 113(1): 9-13, 2012 Feb.
Artículo en Francés | MEDLINE | ID: mdl-21943496

RESUMEN

OBJECTIVES: Para-pharyngeal tumors are located deeply. Imaging is mandatory for their management. We conducted a retrospective study to determine the contribution of imaging for their diagnosis and treatment. PATIENTS AND METHODS: Imaging was performed for 20 cases of primary para-pharyngeal tumors between 1986 and 2008. We compared the imaging to the anatomic and histological features of these tumors. RESULTS: Computed tomography and MRI confirmed the para-pharyngeal location of tumors. Tumors were located in the prestyloid compartment in eight cases, in the retrostyloid compartment in five cases, and in the retropharyngeal compartment in one case. Six tumors had filled all the para-pharyngeal space. Salivary gland tumors had filled the prestyloid space in two cases, and in two other malignant cases all para-pharyngeal space were invaded. MRI failed to differentiate the nature of tumor and its malignancy except when there was obvious bone erosion. The treatment was mainly surgical. The mean follow-up was 5 years 6 months. DISCUSSION: Imaging contributes to the etiological diagnosis and assesses tumor extension, thus helping to choose the surgical approach. MRI is the most contributive examination; its resolution is more adapted to the diagnosis of deep tumors. CT scan is contributive when studying the bone structure.


Asunto(s)
Adenoma/diagnóstico por imagen , Imagen por Resonancia Magnética , Neoplasias Faríngeas/diagnóstico por imagen , Faringe/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Adenoma/diagnóstico , Adenoma/epidemiología , Adenoma/patología , Anciano , Carcinoma/diagnóstico , Carcinoma/diagnóstico por imagen , Carcinoma/epidemiología , Carcinoma/patología , Diagnóstico Diferencial , Femenino , Neoplasias de Cabeza y Cuello/diagnóstico , Neoplasias de Cabeza y Cuello/diagnóstico por imagen , Neoplasias de Cabeza y Cuello/epidemiología , Neoplasias de Cabeza y Cuello/patología , Humanos , Masculino , Persona de Mediana Edad , Neoplasias Faríngeas/diagnóstico , Neoplasias Faríngeas/epidemiología , Neoplasias Faríngeas/patología , Faringe/patología , Estudios Retrospectivos
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