RESUMO
We report the case of a 32-year-old basketball player who presented with an acute flatfoot deformity after performing a unipodal power jump. Rupture of the posterior tibial tendon within the foot was diagnosed and then treated by hamstring tendon transfer combined with application of autologous biologic preparations. The functional outcome at 18 months was good. To our knowledge, this is the first reported case of posterior tibial tendon rupture treated by hamstring tendon transfer.
Assuntos
Atletas , Tendões dos Músculos Isquiotibiais/transplante , Ruptura/cirurgia , Traumatismos dos Tendões/cirurgia , Transferência Tendinosa/métodos , Adulto , Basquetebol , Moldes Cirúrgicos , Pé Chato/etiologia , Pé Chato/cirurgia , Humanos , Imageamento por Ressonância Magnética , Masculino , Transplante de Células-Tronco Mesenquimais , Plasma Rico em Plaquetas , Traumatismos dos Tendões/complicações , Tendões/patologiaRESUMO
Scientific understanding of how the immune microenvironment interacts with renal cell carcinoma (RCC) has substantially increased over the last decade as a result of research investigations and applying immunotherapies, which modulate how the immune system targets and eliminates RCC tumor cells. Clinically, immune checkpoint inhibitor therapy (ICI) has revolutionized the treatment of advanced clear cell RCC because of improved outcomes compared to targeted molecular therapies. From an immunologic perspective, RCC is particularly interesting because tumors are known to be highly inflamed, but the mechanisms underlying the inflammation of the tumor immune microenvironment are atypical and not well described. While technological advances in gene sequencing and cellular imaging have enabled precise characterization of RCC immune cell phenotypes, multiple theories have been suggested regarding the functional significance of immune infiltration in RCC progression. The purpose of this review is to describe the general concepts of the anti-tumor immune response and to provide a detailed summary of the current understanding of the immune response to RCC tumor development and progression. This article describes immune cell phenotypes that have been reported in the RCC microenvironment and discusses the application of RCC immunophenotyping to predict response to ICI therapy and patient survival.
RESUMO
A 31-year-old lady presented to the otorhinolaryngology clinic complaining of right exophtalmus. Imaging studies revealed a right frontal sinus mass, suggestive of a mucocele, and fronto-ethmoidal ground glass opacification. In the operating room, the frontal sinuses were exposed through an osteoplastic flap, and connected to the nasal cavity through a Lothrop-like drainage pathway. The pathologic analysis revealed a frontal sinus mucocele and fibro-osseous and respiratory epithelial hamartoma of the fronto-ethmoid region. In this case report, this rare pathology is discussed, in addition to a thorough elaboration upon the surgical options as dictated by the anatomic complexity of the region.