RESUMO
Diced cartilage grafts are used to increase and refine the nasal contour, providing easy molding and versatility when compared with block grafts. However, all grafts present the possibility of visibility, distortion, and absorption. The aim of this study is to evaluate, through a systematic review, the outcome of the use of the free diced graft cartilage in rhinoplasty. A systematic search of the literature was performed in the databases (PubMed, Lilacs, Scielo, Cochrane) with the terms "diced cartilage" and "rhinoplasty." Studies were selected according to the inclusion and exclusion criteria and data extracted and grouped for analysis. Six eligible studies were included. In total, 4,044 patients underwent rhinoplasty with free diced cartilage graft, with 61 (1.51%) of them requiring reoperation. The main reasons were overcorrection and irregularities of the nasal dorsum. The infection rate was reported in three studies, with 2 (0.06%) of 3,252 patients presenting infection at the graft site. Two cases of displacement were treated with external molding, without reoperation. The graft resorption was reported in four articles, which described 22 (0.67%) cases of partial resorption in 3,288 patients. Therefore, the available evidence suggests that resorption of the graft and unfavorable outcomes are rare.
Assuntos
Rinoplastia , Transplantes , Cartilagem/transplante , Humanos , Nariz/cirurgia , ReoperaçãoRESUMO
Objective: to assess the prevalence of abnormalities found by computed tomography (CT) of the chest in patients with squamous cell carcinoma of the head and neck. Methods: we retrospectively analyzed chest CT exams of 209 patients with squamous cell carcinoma of the head and neck. The CT findings were stratified as inflammatory / infectious, parenchymal, nodular uncharacteristic and nodular metastatic / tumoral Results: alterations were diagnosed in 66.6% of patients. Of these, 25.3% represented emphysema; 18.8%, uncharacteristic micronodules; 12.9%, metastases; 11.9%, thoracic lymph node enlargements; and in 6.6% we detected active pulmonary tuberculosis or its sequelae, pneumonia or inflammatory / infectious signs and pleural thickening or effusion. Conclusion: the prevalence of exams with alterations and the considerable rate of detected metastases indicate that chest CT should be required for diagnostic and / or staging in cases of head and neck cancer.
Objetivo: avaliar a prevalência de alterações encontradas na tomografia computadorizada (TC) de tórax em pacientes com carcinoma epidermóide de cabeça e pescoço. Métodos: Foram analisadas retrospectivamente 209 TC de tórax de pacientes com carcinoma epidermoide de cabeça e pescoço. As alterações tomográficas foram estratificadas como: inflamatórias/infecciosas, parenquimatosas, nodulares incaracterísticas e nodulares metastáticas/tumorais Resultados: foram diagnosticadas alterações em 66,6 % dos exames. Destes, 25,3% representaram enfisema pulmonar; 18,8% micronódulos incaracterísticos; 12,9% metástases; 11,9% de linfonodomegalias torácicas; e, em 6,6%, foram detectadas tuberculose pulmonar ativa ou sequela, pneumonia ou sinais inflamatórios/infecciosos e espessamento ou derrame pleural. Conclusão: a prevalência de exames com alteração e o considerável índice de metástases detectadas, indicam que a TC de tórax deve ser solicitada para complementação diagnóstica e/ou estadiamento nos casos de câncer de cabeça e pescoço.
Assuntos
Humanos , Carcinoma de Células Escamosas/metabolismo , Neoplasias de Cabeça e Pescoço/patologia , Metástase Neoplásica/diagnóstico por imagem , Radiografia Torácica , Tomografia Computadorizada por Raios X , PrevalênciaRESUMO
OBJECTIVE: to assess the prevalence of abnormalities found by computed tomography (CT) of the chest in patients with squamous cell carcinoma of the head and neck. METHODS: we retrospectively analyzed chest CT exams of 209 patients with squamous cell carcinoma of the head and neck. The CT findings were stratified as inflammatory / infectious, parenchymal, nodular uncharacteristic and nodular metastatic/tumoral. RESULTS: alterations were diagnosed in 66.6% of patients. Of these, 25.3% represented emphysema; 18.8%, uncharacteristic micronodules; 12.9%, metastases; 11.9%, thoracic lymph node enlargements; and in 6.6% we detected active pulmonary tuberculosis or its sequelae, pneumonia or inflammatory / infectious signs and pleural thickening or effusion. CONCLUSION: the prevalence of exams with alterations and the considerable rate of detected metastases indicate that chest CT should be required for diagnostic and / or staging in cases of head and neck cancer.
Assuntos
Carcinoma de Células Escamosas/metabolismo , Neoplasias de Cabeça e Pescoço/patologia , Metástase Neoplásica/diagnóstico por imagem , Humanos , Prevalência , Radiografia Torácica , Tomografia Computadorizada por Raios XRESUMO
UNLABELLED: Despite the low incidence, diagnostic and therapeutic advances, hypopharyngeal cancer still has high mortality. OBJECTIVE: To evaluate retrospectively the epidemiological profile and response to surgery and radiation/chemotherapy of patients with hypopharyngeal cancer. METHOD: We reviewed the medical records of 114 patients treated between 2002 and 2009 in a tertiary hospital with histopathological diagnosis of squamous cell carcinoma. RESULTS: The mean age of the patients was 57 years, 94.7% were males and 5.3% females, 98.2% were smokers and 92% consumed alcohol; 72% are illiterate or did not complete first grade schooling. The main complaints were: neck node (28%), pain and dysphagia (22%), odynophagia (12.2%), dysphonia (7.8%). The clinical staging was: I (1.7%), II (3.5%), III (18.4%), IV (76.3%). The treatment was carried out with radiotherapy and chemotherapy alone in 35%, with mean 2-year survival of 20% and 5-year survival of 18%; surgery followed by radiotherapy and chemotherapy in 22.8% with 2-year survival of 60.0% and 5 years of 55.0%; chemotherapy alone in 2.6%, and 39.4% without treatment. CONCLUSION: Most patients already had advanced clinical stages and independent of the treatment option, had a low survival rate, confirming the poor prognosis of this neoplasm.
Assuntos
Carcinoma de Células Escamosas/terapia , Neoplasias Hipofaríngeas/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/mortalidade , Terapia Combinada/métodos , Intervalo Livre de Doença , Feminino , Humanos , Neoplasias Hipofaríngeas/mortalidade , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Estadiamento de Neoplasias , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Resultado do TratamentoRESUMO
Apesar da baixa incidência, avanços diagnóstico e terapêutico, o câncer de hipofaringe ainda possui elevada mortalidade. OBJETIVO: Avaliar retrospectivamente o perfil epidemiológico e a resposta bà cirurgia e rádio/quimioterapia de pacientes portadores de câncer de hipofaringe. MÉTODO: Foram analisados prontuários de 114 pacientes atendidos entre 2002 e 2009 em um hospital terciário com o diagnóstico histopatológico de carcinoma epidermoide. RESULTADOS: A idade média dos pacientes foi 57 anos; 94,7% eram do sexo masculino e 5,3%, do feminino; 98,2% eram tabagistas e 92% etilistas; 72% analfabetos ou com 1º grau incompleto. As queixas principais foram: nódulo cervical (28%), dor e disfagia (22%), odinofagia (12,2%), disfonia (7,8%). O estádio clínico foi: I (1,7%), II (3,5%), III (18,4%), IV (76,3%). O tratamento foi realizado com rádio e quimioterapia exclusivas em 35%, com sobrevida média em 2 anos de 20% e 5 anos de 18%, cirurgia seguida de rádio e quimioterapia em 22,8% com sobrevida em 2 anos de 60,0% e 5 anos 55,0%, quimioterapia exclusiva em 2,6%, e 39,4% sem tratamento. CONCLUSÃO: A maioria dos pacientes já apresentava estádios clínicos avançados e, independentemente da opção terapêutica, apresentam baixa sobrevida, confirmando mau prognóstico desta neoplasia.
Despite the low incidence, diagnostic and therapeutic advances, hypopharyngeal cancer still has high mortality. OBJECTIVE: To evaluate retrospectively the epidemiological profile and response to surgery and radiation/chemotherapy of patients with hypopharyngeal cancer. METHOD: We reviewed the medical records of 114 patients treated between 2002 and 2009 in a tertiary hospital with histopathological diagnosis of squamous cell carcinoma. RESULTS: The mean age of the patients was 57 years, 94.7% were males and 5.3% females, 98.2% were smokers and 92% consumed alcohol; 72% are illiterate or did not complete first grade schooling. The main complaints were: neck node (28%), pain and dysphagia (22%), odynophagia (12.2%), dysphonia (7.8%). The clinical staging was: I (1.7%), II (3.5%), III (18.4%), IV (76.3%). The treatment was carried out with radiotherapy and chemotherapy alone in 35%, with mean 2-year survival of 20% and 5-year survival of 18%; surgery followed by radiotherapy and chemotherapy in 22.8% with 2-year survival of 60.0% and 5 years of 55.0%; chemotherapy alone in 2.6%, and 39.4% without treatment. CONCLUSION: Most patients already had advanced clinical stages and independent of the treatment option, had a low survival rate, confirming the poor prognosis of this neoplasm.
Assuntos
Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Carcinoma de Células Escamosas/terapia , Neoplasias Hipofaríngeas/terapia , Carcinoma de Células Escamosas/mortalidade , Terapia Combinada/métodos , Intervalo Livre de Doença , Neoplasias Hipofaríngeas/mortalidade , Recidiva Local de Neoplasia , Estadiamento de Neoplasias , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Resultado do TratamentoRESUMO
UNLABELLED: Thyroid cancer is the most common endocrine cancer, accounting for about 1% of all cancers. Sarcomas, lymphomas and metastases to the thyroid gland are rare and only with a handful of descriptions in the literature. OBJECTIVE: To describe rare histological types of thyroid cancer found in a reference center. METHODS: Medical chart review from admitted patients diagnosed with thyroid cancer in the period from 1977 to 2010. Demographic, diagnostic, therapeutic and histopathological information were collected. RESULTS: 3,018 records of patients admitted with thyroid disease were reviewed. Among the cases diagnosed with rare tumors there was a predominance of: anaplastic carcinoma: 22 cases (0.7%), followed by 11 cases of medullary carcinoma (0.36%); 2 cases of sarcoma (0.07%), 2 cases of lymphoma (0.07%) and one case of metastatic carcinoid tumor (0.03%). There were more females diagnosed (57%) as well as Caucasians (84%). The most frequent clinical presentation was a palpable thyroid nodule. All patients with lymphoma, sarcoma and anaplastic carcinoma died. CONCLUSION: Sarcomas, lymphomas and thyroid metastases are uncommon and tend to worse outcomes.
Assuntos
Carcinoma/patologia , Linfoma/patologia , Doenças Raras/patologia , Sarcoma/patologia , Neoplasias da Glândula Tireoide/patologia , Feminino , Humanos , Masculino , Estudos RetrospectivosRESUMO
O câncer da tireoide é a neoplasia endócrina mais comum, correspondendo a cerca de 1% de todos os tipos de câncer. Sarcomas, linfomas e metástases para a glândula tireoide são raros e pouco descritos na literatura. OBJETIVO: Descrever tipos histológicos raros de câncer de tireoide em serviço de referência. MÉTODOS: Revisão de prontuários de pacientes admitidos com diagnóstico de câncer de tireoide no período de 1977 a 2010. Foram coletadas informações demográficas, diagnósticas, terapêuticas e histopatológicas. RESULTADOS: Foram revisados 3018 prontuários de pacientes admitidos com doença tireoidiana. Dos casos com diagnóstico de tumores raros, predominou o tipo histológico carcinoma anaplásico, com 22 casos (0,7%), seguido por 11 casos de carcinoma medular (0,36%), dois de sarcoma (0,07%), dois de linfoma (0,07%) e um de tumor carcinoide metastático (0,03%). Houve predomínio do gênero feminino (57%) e de caucasianos (84%). A apresentação clínica com nódulo tireoídeo palpável foi a mais frequente. Todos os casos de linfoma, sarcoma e carcinoma anaplásico evoluíram a óbito. CONCLUSÃO: Sarcomas, linfomas e metástases em tireoide são incomuns e tendem à evolução desfavorável.
Thyroid cancer is the most common endocrine cancer, accounting for about 1% of all cancers. Sarcomas, lymphomas and metastases to the thyroid gland are rare and only with a handful of descriptions in the literature. OBJECTIVE: To describe rare histological types of thyroid cancer found in a reference center. METHODS: Medical chart review from admitted patients diagnosed with thyroid cancer in the period from 1977 to 2010. Demographic, diagnostic, therapeutic and histopathological information were collected. RESULTS: 3,018 records of patients admitted with thyroid disease were reviewed. Among the cases diagnosed with rare tumors there was a predominance of: anaplastic carcinoma: 22 cases (0.7%), followed by 11 cases of medullary carcinoma (0.36%); 2 cases of sarcoma (0.07%), 2 cases of lymphoma (0.07%) and one case of metastatic carcinoid tumor (0.03%). There were more females diagnosed (57%) as well as Caucasians (84%). The most frequent clinical presentation was a palpable thyroid nodule. All patients with lymphoma, sarcoma and anaplastic carcinoma died. CONCLUSION: Sarcomas, lymphomas and thyroid metastases are uncommon and tend to worse outcomes.
Assuntos
Feminino , Humanos , Masculino , Carcinoma/patologia , Linfoma/patologia , Doenças Raras/patologia , Sarcoma/patologia , Neoplasias da Glândula Tireoide/patologia , Estudos RetrospectivosRESUMO
UNLABELLED: Dental lesions represent about 1% of oral cavity tumors being ameloblastoma the most common one. It is a tumor of epithelial origin that mainly affects the jaw, and less commonly the maxilla. Its clinical presentation is that of an asymptomatic slow-growing tumor. Despite being a benign tumor, it has an invasive behavior with a high rate of recurrence if not treated properly. OBJECTIVE: To describe the cases of ameloblastoma in a reference department. METHODS: Retrospective analysis of 40 cases. The variables analyzed were: age, gender, ethnicity, tumor location, type of treatment, complications and recurrence. RESULTS: The most affected gender was male - 21 cases (52.5%); with a predominance of Caucasians - 24 cases (60%). The mean age was 35.45 years; the most common location was in the jaw - 37 cases (92.5%). Facial asymmetry was the most frequent complaint. Of the 40 cases, 33 were submitted to surgery. Of those submitted to surgery, 24 (72.72%) underwent segmental resection, with recurrence in 4 (12.12%) cases. CONCLUSION: Ameloblastoma may relapse when treatment is not performed with broad surgical resection of the lesion with wide safety margins.
Assuntos
Ameloblastoma/cirurgia , Neoplasias Maxilomandibulares/cirurgia , Adolescente , Adulto , Idoso , Ameloblastoma/patologia , Feminino , Humanos , Neoplasias Maxilomandibulares/patologia , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Estudos Retrospectivos , Adulto JovemRESUMO
As lesões odontogênicas representam cerca de 1% dos tumores da cavidade bucal, sendo o ameloblastoma a afecção mais frequente. Trata-se de um tumor de origem epitelial, que afeta principalmente a mandíbula e, raramente, a maxila. Clinicamente, apresenta-se como tumor de crescimento lento, assintomático. Apesar de ser um tumor benigno, cursa com comportamento invasivo com alta taxa de recidiva, se não tratado adequadamente. OBJETIVO: Descrever os casos de ameloblastoma em serviço de referência. MÉTODOS: Análise retrospectiva de 40 casos. As variáveis analisadas foram: idade, gênero, etnia, localização do tumor, tipo de tratamento, complicação e recorrência. RESULTADOS: O gênero mais atingido foi o masculino, 21 casos (52,5%), com predomínio da etnia caucasiana - 24 casos (60%). A média de idade foi de 35,45 anos, a localização mais comum foi na mandíbula - 37 casos (92,5%). Assimetria facial a queixa mais frequente. Dos 40 casos, 33 foram submetidos a procedimento cirúrgico. Dos que tiveram tratamento cirúrgico, 24 (72,72%) foram submetidos à ressecção segmentar, com recidiva em quatro (12,12%) casos. CONCLUSÃO:O ameloblastoma apresenta possibilidade de recidiva quando o tratamento cirúrgico não é realizado com ressecção ampla da lesão com margens de segurança.
Dental lesions represent about 1% of oral cavity tumors being ameloblastoma the most common one. It is a tumor of epithelial origin that mainly affects the jaw, and less commonly the maxilla. Its clinical presentation is that of an asymptomatic slow-growing tumor. Despite being a benign tumor, it has an invasive behavior with a high rate of recurrence if not treated properly. OBJECTIVE: To describe the cases of ameloblastoma in a reference department. METHODS: Retrospective analysis of 40 cases. The variables analyzed were: age, gender, ethnicity, tumor location, type of treatment, complications and recurrence. RESULTS: The most affected gender was male - 21 cases (52.5%); with a predominance of Caucasians - 24 cases (60%). The mean age was 35.45 years; the most common location was in the jaw - 37 cases (92.5%). Facial asymmetry was the most frequent complaint. Of the 40 cases, 33 were submitted to surgery. Of those submitted to surgery, 24 (72.72%) underwent segmental resection, with recurrence in 4 (12.12%) cases. CONCLUSION:Ameloblastoma may relapse when treatment is not performed with broad surgical resection of the lesion with wide safety margins.