Reconstruction of Oromandibular Defect After Tumor Resection by Sternomastoid-clavicular Flap.

ABSTRACT: The study aims to evaluate sternocleidomastoid-clavicular osteo-myocutaneous flap (SCM-OMCF) for reconstruction of mandibular defects after tumor resection. In the period between 2010 and 2018, thirteen patients with primary mandibular tumors underwent mandibular resection and reconstruction with SCM-OMCF. Patients were followed up for 10 to 66 months. Hospital was 13 ±â€Š4 days. All patients started fluid in the 2nd day. The mean time to start oral fluid was 7.5 ±â€Š0.8 day. Four (30.8%) patients suffered from complications (infection and salivary leak in 1 case due to partial flap loss, donor wound dehiscence in 1 case, deep venous thrombosis in 1 case and chest infection in 1 case). None of our cases experienced motor disability. Two cases (15.9%) underwent reoperations. The overall aesthetic outcome was found excellent in 5 cases, satisfactory in 5 cases and fair in 3 cases. The functional outcomes were satisfactory. Tumor recurrences were detected in 2 (15.9%) patients. Two patients died during follow up within 2 years after 1st surgery due to local and distant recurrences. SCM-OMCF is a versatile, safe and simple technique for reconstructing mandibular defects less than 11 cm.

The Prognostic Significance of Lymph Node Status and Lymph Node Ratio (LNR) on Survival of Right Colon Cancer Patients: a Tertiary Center Experience.

BACKGROUND: Colon cancer is a major health problem and is one of the most frequent cancers all over the world. In Egypt, the incidence of colon cancer is relatively low, but its mortality rate is high. Lymphatic spread of colon cancer is one of the most important factors affecting the prognosis of patients. Recently, the lymph node ratio (LNR) has been evaluated as a prognostic parameter for survival. This study aimed at evaluation of nodal status of resected specimens and LNR, as well as its impact on the disease-free survival (DFS) and overall survival (OS) after curative resection of right colon cancer. METHODS: The institutional registry of the Oncology Center Mansoura University (OCMU) was revised for node-positive right colon cancer cases that were operated in the period between January 2010 and January 2015. Fifty-three patients met the inclusion criteria and were followed up till January 2020. RESULTS: A total of 766 lymph nodes were excised from the patients. Thirty-two patients (60.4%) had a LN yield of ≥12 LNs with a mean LNR of 0.257 ± 0.27. Multivariate analysis of outcomes showed that LNR was significantly correlated with both DFS (p = 0.015) and OS (p = 0.024). Moreover, the number of resected LNs was also associated with statistically significant relationship with the DFS and OS. CONCLUSION: Our study confirms the validity of LNR as a prognostic tool that correlates with the survival of patients. Moreover, LNR cutoff values may help predict those of high chance of tumor recurrence. TRIAL REGISTRATION: MS/20.03.1087 (Institutional IRB), date of registration: March 10, 2020, "retrospectively registered".

Significance of Omental Infiltration in Gastric Cancer Patients: a Retrospective Cohort Study.

BACKGROUND: Stomach cancer is a curative disease in early stages. The optimal extent and approach for gastric resection are still evolving. PATIENTS AND METHODS: In this study, we examined the value, as well as, the predictors of omental disease spread, retrospectively, in a group of patients with gastric cancer who attended the Oncology Center, Mansoura University, in the period between January 2006 and April 2017. RESULTS: Nodal metastasis, especially heavy disease (N2 and beyond), and advanced stage are predictors of the presence of omental disease. However, neither overall nor disease-free survival is affected by omental infiltration. CONCLUSION: Omental resection will continue being an integral part of gastric resection, but the level of omental cutting needs further studies.

Gigantic submandibular pleomorphic adenoma: A rare case report.

INTRODUCTION: Pleomorphic adenoma (PA) is the most common benign salivary gland tumor. When neglected on some occasions, its size and weight can enormously augment. CASE PRESENTATION: We report a case of a giant submandibular pleomorphic adenoma in a 75 years old female patient which measured 34 × 26 × 20 cm and weighed 8.1 kg. CONCLUSION: Neglecting such tumors without treatment, can cause severe facial disfigurement and can even hinder the airway.

Epidemiology and survival of colon cancer among Egyptians: a retrospective study / Epidemiologia e sobrevida para o câncer de cólon entre egípcios: estudo retrospectivo

ABSTRACT Introduction: Colorectal cancer is the 4th commonest cancer in the world. Studies had shown different tumor behavior depending on the site, pathology and stage. However the characters of Egyptian colon cancer patients are not well addressed. Method: Computerized registry of a tertiary cancer hospital in Egypt was searched for colon cancer cases. Demographic, pathologic and treatment data were collected and analyzed using SPSS program. Results: About 360 colon cancer patients attended our center in the last 12 years. Tumor characters showed great diverse from that of developed countries, with especially different prognosis and survival. Conclusion: Egyptians have unique tumor characters and behavior, and different compliance with treatment regimens. Multicenter prospective studies, as well as evolving Egyptian treatment guidelines are needed to address this.

RESUMO Introdução: Câncer colorretal é a quarta neoplasia mais comum a nível mundial. Estudos demonstraram diferentes comportamentos do tumor, dependendo do local, da patologia e do estágio. Contudo, ainda não estão devidamente definidas as características dos pacientes egípcios com câncer de cólon. Métodos: Foi realizada pesquisa no registro computadorizado de um hospital terciário para pacientes com câncer, à busca de casos de câncer de cólon. Foi feita coleta de dados demográficos, patológicos e terapêuticos. Tais dados foram então submetidos à análise com o programa SPSS. Resultados: Nos últimos 12 anos, cerca de 360 pacientes portadores de câncer de cólon foram atendidos em nosso Centro. As características dos tumores demonstraram grandes diferenças em comparação com os achados de países desenvolvidos e, em especial, com relação ao prognóstico e à sobrevida. Conclusão: Os egípcios exibem características e comportamentos singulares com relação aos tumores, além de diferentes graus de cooperação com os regimes terapêuticos. Para que tais aspectos sejam sanados, há necessidade de mais estudos prospectivos multicêntricos, bem como de um aprimoramento das diretrizes terapêuticas para os egípcios.

Primary ovarian carcinoid: A report of two cases and a decade registry.

OBJECTIVES: This study aims at reporting 2 cases of primary ovarian carcinoid tumor, and providing an adequate registry of such cases and how they were managed. METHODS: 2 female patients with primary ovarian carcinoid were diagnosed and treated in our center. Discussion of their presentation, pathology and treatment is entitled. Also a thorough search of all published registries and case reports of ovarian carcinoid was done with analysis of reported data. RESULTS: 164 cases of primary ovarian carcinoid tumor were detected since 2005 with the predominance of the insular variant. Carcinoid syndrome occurs in nearly 14% of these cases. Most of the cases were treated with hysterectomy. Unfortunately, the prognosis was not documented in most series. CONCLUSION: Primary ovarian carcinoid is a relatively rare disease with an indolent course and excellent outcome. Carcinoid syndrome, especially carcinoid heart disease may worsen the prognosis. Total abdominal hysterectomy with bilateral salpingo-oophorectomy has been commonly used as the treatment of choice of primary ovarian carcinoid tumors.

Meckel's diverticulum complicated with gastro-intestinal stromal tumor: Case report.

INTRODUCTION: Meckel's diverticulum is a common congenital anomaly, mostly asymptomatic. Tumors may arise rarely in these diverticulae. We claim presenting a new problem to the medical staff in Egypt. CASE PRESENTATION: We report a case of a 49year old male patient who attended our center with pelvic mass insinuated between the bladder and the rectum. On exploration the mass was found arising at the tip of a Meckel's diverticulum, Gastro-intestinal stromal tumor (GIST) was confirmed by pathology. DISCUSSION: In review of recently published cases most of these tumors were presented with vague abdominal pain as in our case. Tumors were treated by resection with or without adjuvant Imatinib. CONCLUSION: Surgeons and oncologists should bear in mind this rare diagnosis and know how to treat it.