Conservative surgical treatment of tongue hemangiopericytoma.

Hemangiopericytoma is a vascular tumor that is believed to arise from the Zimmermann's pericytes, smooth muscles cells localized around the blood vessels. This tumor presents as a slowly enlarging painless mass with a clear predilection for the musculoskeletal system. The aim of this work was to introduce a peculiar case of a tongue hemangiopericytoma managed by conservative surgical treatment.

Surgical technique of the transoral approach to remove a lipoma of the buccal fat pad.

BACKGROUND: In 1727, Heister (Compendium anatomicum. Altdorf, Guill, Koleshii: editio tertia 1727: 134, table VIII and figs. 36-37) described the buccal fat pad (BFP) as an independent anatomic structure of the face; in 1801, Bichat (Anatomie generale appliquee a la physiologie et a la medecine. Paris, France: Brosson, Gabon et Cie Libraires, 1801:60) reported his fatty histologic finding. According to the literature, several pathologic tumorous conditions can arise from BFP, such as lipoma, lipoblastomatosis, liposarcoma, hemangioma, arteriovenous malformation, and nodular fasciitis; all of which are rare. After a revision of the English literature performed through PubMed between 1948 and 2008, we found 10 cases of lipomas arising from the BFP (7 cases are simple subtype, 2 are spindle cell lipoma, and 1 is fibrolipoma). The aims of this study were to introduce our clinical report of this rare pathologic entity, describe the surgical technique of the transoral approach, and discuss the potential pitfalls regarding the preoperative diagnosis and the close interrelation among the BFP, the facial buccal branches (FBBs), and the parotid duct (PD). CLINICAL REPORT: A 43-year-old man was referred to the Maxillofacial Unit of the Novara Major Hospital with a 6-month history of a painless swelling in the right cheek. Clinical examination revealed a clearly visible, tender, slightly fluctuant mass, situated anterior to the masseter muscle and extended to the submandibular region. The patient underwent an ultrasound, a computed tomography, and a magnetic resonance imaging. Under general anesthesia with nasotracheal intubation, the patient underwent intraoral resection of BFP lipoma. DISCUSSION: The 2 major areas of discussion are the potential pitfall regarding the preoperative diagnosis and the close anatomic interrelation among the BFP, the FBB, and the PD. First, the spindle cell lipoma, one of the most common BFP lipoma variant, can be histologically and clinically similar to a well-differentiated liposarcoma, which can be recurrent and metastatic. This issue warrants that a careful workup of the tumorous mass of the buccal space and a BFP origin must be considered in every situation. Finally, according to the recent literature, the anatomic variations of the interrelation between the FBB and the BFP are classified into 2 groups: (1) FBB passing lateral to the BFP and (2) branches crossing inside the BFP. The anatomic variations of the interrelation between the PD and the BFP are classified into 3 groups: (1) PD passing lateral to the BFP, (2) PD crossing deep to the BFP, and (3) PD running along the superior border of the BFP.

[Hydrological indications in the therapy of pharyngitis]. / Indicazioni idrologiche nella terapia delle faringiti.

Pharyngitis is an inflammatory disease of the mucosal and submucosal structures of the throat. Infection may or may not be a component of the disease. Pharyngitis is one of the common illness for which patients visit primary care physicians. Most of them are diagnosed by clinical evaluation and usually respond to treatment with antibiotics, but exceptions occur when pharyngitis is caused by non bacterial inflammatory processes like virus, mycoses, reflux of gastric juices, tobacco or alcohol abuse. In these cases, as alternative and preventive, could be indicated the thermal therapy. For many centuries thermal waters have been used in the treatment of chronic inflammations of the upper respiratory airway, such as pharyngitis, with good results. Different thermal waters are currently used, in particular sulfur or sulfur- salty- bromine-, iodine- or sulfur-sulfate-bicarbonate-carbonate alkaline or sulfur-arsenical-ferruginous, normally utilized by inhalation or irrigation or aerosol-therapy. The principal pharmacological activity of these waters is connected to the concentrations of H2S, halogens (Iodine e Bromine), sulfates, arsenic and the level of radioactivity, concerning their antimicrobial power and the mucolytic effect of sulphur.

[Deep neck infections: a retrospective study]. / Le infezioni profonde del collo.

A retrospective study was carried out on 79 patients with deep neck infections (DNI) admitted to our Department between 1990 and 2005 in order to review our experience with DNI and verify if diabetic and immunocompromised patients have more aggressive infections and poorer prognosis. Demographics, clinical presentation, etiology, site of infection, associated systemic diseases (26.6%-21/79), microbiology, treatment and complications were considered.

Percutaneous Sclerotherapy With OK-432 of a Cervicomediastinal Lymphangioma.

The present study reports a case of percutaneous sclerotherapy of a giant cystic cervicomediastinal lymphangioma using OK-432. To the best of our knowledge, percutaneous sclerotherapy of a mediastinal lymphangioma using OK 432 has not previously been reported in the English literature.