ABSTRACT
INTRODUÇÃO: O nevus congênito gigante (NCG) possui diversas modalidades de tratamento. A abordagem cirúrgica inclui a ressecção parcial seriada ou excisão total. Objetivo: Demonstrar as principais modalidades terapêuticas utilizadas para o tratamento do NCG e avaliar a incidência da localização, idade e tamanho destas lesões no Serviço de Cirurgia Plástica e Reparadora do Hospital de Clínicas da Universidade Federal do Paraná. MÉTODOS: Estudo retrospectivo dos pacientes submetidos a tratamento cirúrgico do NCG no período de janeiro de 2004 a janeiro de 2010. Foram coletados dados como: idade, gênero, tratamento realizado, número de cirurgias realizadas, evolução e complicações. RESULTADOS: Foram avaliados 11 pacientes, sendo 8 mulheres e 3 homens. A média de idade foi de 12,4 anos (3 a 25 anos). O subtipo mais encontrado foi o nevus melanocítico intradérmico correspondendo a 90,9% dos casos e 9,1% com nevus melanocítico composto. Não foram identificados casos de melanoma. A localização mais comum foi a região da cabeça e pescoço. O diâmetro médio das lesões foi de 9,1 cm.As técnicas utilizadas para reconstrução foram: sutura primária, retalhos locais, enxerto de pele e uso de expansores. No seguimento, 63,6% dos pacientes apresentavam ainda nevus residual, 27,3% apresentaram ressecção completa e 9,1% perderam seguimento. CONCLUSÃO: Foi observada maior incidência de NCG na faixa etária de 3 a 25 anos, sendo a localização mais comum na face e com tamanho médio de 9,1cm. O principal tratamento instituído para os pacientes com NCG foi a ressecção parcelada, com bons resultados.
INTRODUCTION: Several modalities are available for the treatment of giant congenital nevus (GCN). The surgical approach includes partial serial resection or total excision. Objective: To demonstrate the main therapeutic modalities in the treatment of GCN and to assess the incidence of location, age, and size of this lesion at the Plastic and Reconstructive Surgery Service of the Hospital de Clínicas, Federal University of Paraná. METHODS: This retrospective study included patients who had undergone surgical treatment for GCN between January 2004 and January 2010. We collected data such as age, sex, treatment performed, number of surgeries carried out, evolution, and complications. RESULTS: We evaluated 11 patients (8 female and 3 male). The average age was 12.4 years (range, 3-25 years). The GCN subtype most commonly found was intradermal melanocytic nevus, which accounted for 90.9% of cases, with melanocytic nevus accounting for the remaining 9.1%. No cases of melanoma were identified. The most common location was the head and neck. The average diameter of the lesions was 9.1 cm. The techniques used for the reconstruction included primary suture, local flaps, skin graft, and the use of expanders. In the follow-up period, 63.6% of the patients still presented a residual nevus, 27.3% underwent complete resection, and 9.1% were not monitored. CONCLUSION: A higher incidence of GCN was observed in patients aged 3-25 years. The most common location was the face, and the average size was 9.1 cm. The main treatment of patients with GCN was splitting resection, which resulted in satisfactory outcomes.
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Adult , History, 21st Century , Silicones , Wounds and Injuries , Tissue Expansion Devices , Medical Records , Cross-Sectional Studies , Review , Plastic Surgery Procedures , Evaluation Study , Margins of Excision , Head and Neck Neoplasms , Nevus , Silicones/therapeutic use , Skin Neoplasms , Skin Neoplasms/surgery , Skin Neoplasms/pathology , Wounds and Injuries/surgery , Wounds and Injuries/therapy , Tissue Expansion Devices/adverse effects , Tissue Expansion Devices/standards , Medical Records/standards , Cross-Sectional Studies/standards , Plastic Surgery Procedures/methods , Head and Neck Neoplasms/surgery , Head and Neck Neoplasms/congenital , Head and Neck Neoplasms/pathology , Nevus/surgery , Nevus/congenital , Nevus/pathology , Nevus/therapyABSTRACT
: The branchial apparatus consists of six arches that are separated from each other by branchial clefts and pharyngeal pouches. Its development is complex and multiple congenital defects can occur; including branchial cleft cysts, sinuses and fistulas, thymic cysts, aberrant thymic tissue and parathyroid cysts. The majority arises from the second branchial arch and they correspond to vestigial remnants from incomplete obliteration of the branchial apparatus or buried epithelial cell rests. Imaging studies are very helpful in the diagnosis and characterization of these anomalies, and require a good understanding of the embryogenesis. Considering the anatomical location and the radiological appearance the diagnosis could be precised in most cases. The purpose of this presentation is to show the appearance of some of the most frequent congenital anomalies of the branchial apparatus using different imaging modalities and emphasizing the normal embryologic development.
El aparato branquial, formado por seis arcos separados por hendiduras extemas y bolsas faríngeas en su parte interna, tiene un complejo desarrollo del cual pueden derivar anomalías como senos, fístulas o quistes y alteraciones del timo o glándula paratiroi-des. La mayoría de las malformaciones derivan del segundo componente branquial. Los estudios de imagen son útiles para el diagnóstico y caracterización de estas lesiones que será más exacta con un adecuado conocimiento del desarrollo embriológico. El objetivo de esta presentación es revisar la embriología y el aspecto más común en imágenes de algunas de estas anomalías.
Subject(s)
Humans , Child , Branchial Region/abnormalities , Branchial Region/diagnostic imaging , Parathyroid Glands/abnormalities , Parathyroid Glands/diagnostic imaging , Congenital Abnormalities , Thymus Gland/abnormalities , Thymus Gland/diagnostic imaging , Branchial Region/embryology , Branchioma/congenital , Branchioma/diagnostic imaging , Bronchial Fistula/congenital , Bronchial Fistula/diagnostic imaging , Head and Neck Neoplasms/congenital , Head and Neck Neoplasms/diagnostic imagingSubject(s)
Fatal Outcome , Female , Head and Neck Neoplasms/congenital , Humans , Infant, Newborn , Teratoma/congenitalABSTRACT
We report a case of congenital benign cervical teratoma in a female child. The unusual asymptomatic nature of the tumour and its relationship with the thyroid is highlighted.
Subject(s)
Branchioma/diagnosis , Child , Diagnosis, Differential , Female , Head and Neck Neoplasms/congenital , Humans , Teratoma/congenitalABSTRACT
Se hace una revisión retro y prospectiva en 14 pacientes (8 mujeres, 6 hombres) con lesiones quísticas congénitas a nivel del cuello. Los autores analizan las lesiones más frecuentes encontradas a nivel del cuello supra e infrahioideo y que incluyen quiste del conducto tirogloso, quiste del segundo arco branquial, linfangioma o higroma quístico, sus manifestaciones clínicas correlacionadas con las características observadas a través de los métodos de imagen
Subject(s)
Child, Preschool , Child , Adolescent , Adult , Humans , Male , Female , Branchioma/etiology , Cystic Fibrosis/physiopathology , Head and Neck Neoplasms/congenital , Lymphangioma, Cystic/etiology , Neck , Thyroglossal Cyst/etiology , UltrasonographyABSTRACT
Este es el caso de una paciente prematura que presentó una masa faciocervical derecha que le provocó dificultad respiratoria severa. La bebé fue sometida a excisión subtotal de la masa de cuyo tejido se realizó un estudio patológico donde se informó tejido cerebral heterotópico compatible con encefalocele. Por tomografía computadorizada de cabeza no se evidenció conección de la masa con la cavidad craneal, por lo que se descarta encefalocele. Falleció a los 4 meses con dificultad respiratoria. En la autopsia realizada se informó tejido cerebral heterotópico en cuello y paladar; neumonía pulmón derecho e infección por citomegalovirus. El tejido cerebral heterotópico a pesar de que se informa como benigno, en este caso se comportó como maligno por lo agresivo de su crecimiento