RESUMEN
INTRODUCTION: Chondrosarcomas of the larynx are usually slow-growing tumours. Their prognosis is reportedly unaffected by local tumour recurrence. Nevertheless, total laryngectomy is often performed in fear that resection of the posterior lamina of the cricoid cartilage may cause laryngeal collapse and stenosis. Transoral laser surgery (TLS) is not considered among the treatment options. This case report supports the feasibility of a radical yet organ- and function-preserving tumour excision using TLS. CASE REPORT: A female patient presented with dyspnoea due to an extensive low-grade laryngeal chondrosarcoma. TLS treatment involved total resection of the posterior lamina of the cricoid cartilage. The patient was decannulated 8 months later with normal swallowing and satisfactory voice quality, which allowed her to have a normal personal and social life. CONCLUSION: TLS excision of the posterior lamina of the cricoid cartilage seems to be a feasible and radical yet function- and organ-preserving technique with minimal morbidity.
Asunto(s)
Condrosarcoma/cirugía , Cartílago Cricoides/cirugía , Neoplasias Laríngeas/cirugía , Laringectomía/métodos , Adulto , Femenino , Humanos , BocaRESUMEN
SRIH and GH secretions by GH-secreting adenomatous human pituitary cells were analyzed in vitro in a perifusion system. Of the 13 adenomas studied, 7 secreted SRIH, in variable amounts (50 to 700 pg/ml/2 min., corresponding to 600 10,700 pg for the total experiment. SRIH secretion increased during the perifusion, the highest levels being observed at the end of the perifusion. GH secretion also varied from one adenoma to the other (6 to 500 ng/ml). In most cases, the secretion profiles were negatively correlated, GH secretion decreasing while SRIH secretion was increasing. In the presence of 10(-7) M TRH, GH secretion increased while that of SRIH decreased. The hypothesis of a paracrine and/or an autocrine role for SRIH as well as its possible in situ synthesis are discussed.