RESUMEN
OBJECTIVES: The aim of this retrospective study was to determine the incidence and the clinical outcome of tongue cancer (TC) in patients affected by Fanconi anemia (FA) who received an allogeneic hematopoietic cell transplantation (HCT). MATERIALS AND METHODS: The patient database from the Bone Marrow Transplant Center of Pescara was reviewed to enroll FA patients. Patients', donors', HCT's, and screening's data were collected as well to look for the incidence and the treatment of TC. RESULTS: Twelve patients affected by FA were identified. Three patients died for transplant-related causes. Five of nine surviving patients were diagnosed with TC at a median of 21.7 years since transplantation and at a median age of 32.10 years. Interestingly, no patient manifested graft-versus-host-disease (GvHD). The 28-year cumulative incidence function of TC was 46.9% (95% CI, 36.9-56.9%). Two patients were treated with chemotherapy alone, two patients were treated with surgery alone, and one with surgery followed by chemotherapy. Overall, 4 patients with TC showed a clinical course characterized by a marked aggressiveness of the tumor disease which led to death due to cancer progression between 2 and 13 months. One patient is surviving 8 months after diagnosis of TC. CONCLUSIONS: Our study confirms the high incidence of tumors and in particular tongue tumors in allotransplanted FA patients. A careful screening has to be life-long maintained. CLINICAL RELEVANCE: Considering the rarity of FA and the frailty of FA patients, this study may add important information for the cancer management of these patients.
Asunto(s)
Anemia de Fanconi , Enfermedad Injerto contra Huésped , Trasplante de Células Madre Hematopoyéticas , Neoplasias de la Lengua , Adulto , Anemia de Fanconi/complicaciones , Anemia de Fanconi/terapia , Enfermedad Injerto contra Huésped/epidemiología , Enfermedad Injerto contra Huésped/etiología , Enfermedad Injerto contra Huésped/prevención & control , Trasplante de Células Madre Hematopoyéticas/efectos adversos , Humanos , Estudios Retrospectivos , Neoplasias de la Lengua/terapiaAsunto(s)
Fosa Craneal Media/patología , Tumor Óseo de Células Gigantes/patología , Neoplasias de la Base del Cráneo/patología , Trastornos de la Articulación Temporomandibular/patología , Articulación Temporomandibular/patología , Anciano , Fosa Craneal Media/diagnóstico por imagen , Fosa Craneal Media/cirugía , Tumor Óseo de Células Gigantes/diagnóstico por imagen , Tumor Óseo de Células Gigantes/cirugía , Humanos , Masculino , Procedimientos Neuroquirúrgicos , Radiografía , Neoplasias de la Base del Cráneo/diagnóstico por imagen , Neoplasias de la Base del Cráneo/cirugía , Articulación Temporomandibular/diagnóstico por imagen , Articulación Temporomandibular/cirugía , Trastornos de la Articulación Temporomandibular/diagnóstico por imagen , Trastornos de la Articulación Temporomandibular/cirugía , Resultado del TratamientoRESUMEN
AIM: Today, cranioplasty is performed using different procedures. Numerous materials may be used to reconstruct the cranial vault including autologous bone and different types of synthetic resins. When plastic materials are used, the main requirement for an effective cranioplasty is the preoperative shaping of the implant to fit the bony defect precisely. In this paper, experience with a new method for cranioplasty using an acrylic cranial implant is presented. MATERIAL AND METHODS: In this new technical procedure an acrylic implant, precisely shaped to the defect, is fabricated preoperatively using CT data. The study consists of 15 cases in whom cranioplasty was performed using this method. In all these, reconstruction was at least 3 months after the initial operation that lead to the cranial bony defect. RESULTS: No major complications occurred and the final functional and aesthetic results were good in all cases. The acrylic implant manufacture does not require the use of complex computer interface software or high-tech equipment, but involves simple, cheap, repeatable processes.
