RESUMO
INTRODUCTION: Melanotic neuroectodermal tumor of infancy (MNT1) is a rare congenital pigmented neoplasm of neural crest origin, locally aggressive, and rapidly growing that develops during the first year of life. It most commonly arises from the maxilla, the cranial vault, and the mandible. Early diagnosis and radical surgery are critical for a long-term outcome. METHODS: A literature search through PUBMED revealed 43 cases of MNT1 arising in the skull. We reviewed the available literature and studied the presenting symptoms, diagnostic procedures, treatment, rates of recurrences, malignancy, and data of follow-up. We report two further cases of infants aged 4 and 10 months, respectively, with MNT1 arising from the cranial vault who underwent radical excision of the lesion. CONCLUSION: Melanotic neuroectodermal tumor of infancy should be included in the differential diagnosis of skull lesions in infants. Radical surgery must be considered as the treatment of choice and close follow-up for at least 2 years is necessary.
Assuntos
Neoplasias de Cabeça e Pescoço/patologia , Tumor Neuroectodérmico Melanótico/patologia , Neoplasias Cranianas/patologia , Crânio/patologia , Biomarcadores Tumorais/análise , Biomarcadores Tumorais/metabolismo , Biópsia , Terapia Combinada/métodos , Terapia Combinada/normas , Diagnóstico Diferencial , Neoplasias de Cabeça e Pescoço/fisiopatologia , Neoplasias de Cabeça e Pescoço/cirurgia , Humanos , Imuno-Histoquímica/métodos , Lactente , Masculino , Invasividade Neoplásica/patologia , Invasividade Neoplásica/fisiopatologia , Invasividade Neoplásica/prevenção & controle , Recidiva Local de Neoplasia/prevenção & controle , Tumor Neuroectodérmico Melanótico/fisiopatologia , Tumor Neuroectodérmico Melanótico/cirurgia , Procedimentos Neurocirúrgicos/métodos , Radioterapia/métodos , Radioterapia/normas , Crânio/fisiopatologia , Crânio/cirurgia , Neoplasias Cranianas/fisiopatologia , Neoplasias Cranianas/cirurgia , Células-Tronco/metabolismo , Células-Tronco/patologiaRESUMO
The aim of this study is to present a novel use of Dextranomer/hyaluronic acid copolymer (Deflux) for the treatment of a complicated iatrogenic chronic urethral injury. A 12-year-old boy with a neuropathic bladder presented a groove in the urethral mucosa due to chronic clean intermittent catheterizations (CICs) and suffered a posterior urethral injury during a failed catheterization for a routine examination. The defect on the urethral wall was repaired using Deflux, a technique that is not described in the literature. After the intervention the patient is continuing CICs without further complications.