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1.
Isr Med Assoc J ; 22(1): 53-59, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31927807

RESUMO

BACKGROUND: Primary retroperitoneal neoplasms (PRN) arise from diverse retroperitoneal tissues. Soft tissue sarcomas (STS) comprise the majority and are well studied. Other non-sarcomatous PRN are very rare and less familiar. OBJECTIVES: To evaluate the clinicopathologic and radiologic features of non-sarcomatous PRN, as well as the outcome of complete tumor resection (TR). METHODS: Retrospective data were collected on consecutive patients (June 2006 to January 2015) who underwent resection of retroperitoneal lesions at our department. Final pathology of non-sarcomatous PRN was included. RESULTS: The study population included 36 patients (26% with PRN). PRN were neurogenic (17%), fat-containing (3%), and cystic (6%). The preoperative diagnosis was correct in only 28%. All patients underwent TR via laparotomy (72%) or laparoscopy (28%), for mean operative time of 120 ± 46 minutes. En bloc organ resection was performed in 11%. Complete TR was achieved in 97%. Intra-operative spillage occurred in 8%. Intra-operative, 90-day postoperative complications, and mortality rates were 11%, 36%, and 0%, respectively. The mean length of stay was 6.5 ± 5.5 days. The median overall survival was 53 ± 4.9 months. CONCLUSIONS: Familiarity with radiologic characteristics of PRN is important for appropriate management. Counter to STS, other PRN are mostly benign and have an indolent course. Radical surgery is not required, as complete TR confers good prognosis. Expectant management is reserved for small, asymptomatic, benign neoplasms.


Assuntos
Neoplasias Retroperitoneais/diagnóstico , Idoso , Feminino , Ganglioneuroma/diagnóstico , Ganglioneuroma/diagnóstico por imagem , Ganglioneuroma/patologia , Ganglioneuroma/cirurgia , Humanos , Lipoma/diagnóstico , Lipoma/diagnóstico por imagem , Lipoma/patologia , Lipoma/cirurgia , Masculino , Pessoa de Meia-Idade , Neurilemoma/diagnóstico , Neurilemoma/diagnóstico por imagem , Neurilemoma/patologia , Neurilemoma/cirurgia , Neurofibroma/diagnóstico , Neurofibroma/diagnóstico por imagem , Neurofibroma/patologia , Neurofibroma/cirurgia , Paraganglioma/diagnóstico , Paraganglioma/diagnóstico por imagem , Paraganglioma/patologia , Paraganglioma/cirurgia , Neoplasias Retroperitoneais/diagnóstico por imagem , Neoplasias Retroperitoneais/patologia , Neoplasias Retroperitoneais/cirurgia , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
2.
World Neurosurg ; 133: e97-e104, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31505279

RESUMO

BACKGROUND: Intraspinal tumors are 10 to 15 times less common than brain tumors. The midline approach with extensive laminectomies represents the current gold-standard for resection, causing instability, muscle damage, and kyphosis among other well-known complications. Minimally invasive series reported their results using retractor-based systems. We analyzed a patient series treated with a non-expansile tubular approach, describing the technique, grade of resection, and clinical outcomes. METHODS: A series of consecutive cases operated between 2016 and October 2018 were analyzed retrospectively. The database included age, sex, clinical presentation, intraspinal location (intra/extradural), number of laminotomies, grade of resection, surgical time, bleeding, and follow-up. The initial and follow-up clinical condition was analyzed using the Frankel scale. RESULTS: A total of 13 patients underwent surgery: 3 intraspinal/extradural (23%), 8 intradural/extramedullary (61.5%), and 2 intramedullary tumors (15.3%); these were classified as 5 meningiomas (38.4%), 4 neurofibromas (30.7%), 2 schwannomas (15.3%), 1 hemangioblastoma (7.6%), and 1 astrocytoma (7.6%). Eleven (84.61%) patients had complete motor improvement, 1 patient had partial improvement, and 1 patient had no improvement (7.6% each). An 18-mm working channel tube was used for extramedullary lesions and 20-mm tubes for intramedullary injuries. Total tumor resection was achieved in 11 patients (84.6%) and subtotal in 2 patients (15.38%) corresponding to intramedullary tumors. CONCLUSIONS: Although this study consisted of a small series, we have shown the possibility of resecting intraspinal tumors (some intradural-intramedullary) with non-expansile tubes in a safe and effective way with no complications. Most of the patients had complete neurological improvement at the end of follow-up.


Assuntos
Descompressão Cirúrgica/métodos , Fixadores Internos , Microcirurgia/métodos , Neoplasias da Medula Espinal/cirurgia , Neoplasias da Coluna Vertebral/cirurgia , Adulto , Idoso , Descompressão Cirúrgica/instrumentação , Desenho de Equipamento , Feminino , Seguimentos , Humanos , Imagem por Ressonância Magnética , Masculino , Neoplasias Meníngeas/diagnóstico por imagem , Neoplasias Meníngeas/cirurgia , Meningioma/diagnóstico por imagem , Meningioma/cirurgia , Microcirurgia/instrumentação , Pessoa de Meia-Idade , Neurilemoma/diagnóstico por imagem , Neurilemoma/cirurgia , Neurofibroma/diagnóstico por imagem , Neurofibroma/cirurgia , Estudos Retrospectivos , Neoplasias da Medula Espinal/diagnóstico por imagem , Neoplasias da Coluna Vertebral/diagnóstico por imagem , Adulto Jovem
3.
Rev. bras. cir. plást ; 34(4): 552-556, oct.-dec. 2019. ilus
Artigo em Inglês, Português | LILACS | ID: biblio-1047925

RESUMO

A neurofibromatose tipo 1 é uma doença autossômica dominante rara, com manifestações clínicas diversas. Sua apresentação mais marcante é a presença de neurofibromas (tumores da bainha neural) cutâneos ou internos, que também podem ocorrer de forma esporádica, associados a outras manifestações sistêmicas, como manchas café com leite e lesões oculares. Por serem tumores da bainha de mielina, os neurofibromas podem acometer diversos nervos periféricos, incluindo nervos da face. Apresentamos o caso de um paciente de 1 ano, portador de neurofibromatose tipo 1, com neurofibroma em nervo infraorbital direito, com o acesso proposto para tratamento cirúrgico que fornecesse ampla visualização e acesso a lesão, sem comprometimento estético importante, permitindo preservação de partes moles e adequado crescimento facial.


Neurofibromatosis type 1 (NF1) is a rare autosomal dominant disease with multiple clinical manifestations. Its most significant presentation is cutaneous or subcutaneous neurofibromas (myelin sheath tumors), which may be associated with other systemic manifestations such as caféau- lait spots and eye involvement. Neurofibromas can affect several peripheral nerves, including the facial nerves. This report presents a case of a 1-year-old patient with NF1 with right infraorbital nerve neurofibroma in which the proposed access for surgical treatment allowed adequate visualization of the tumor with good aesthetic results, preservation of the soft tissues, and normal facial growth.


Assuntos
Humanos , Masculino , Lactente , História do Século XXI , Órbita , Procedimentos Cirúrgicos Operatórios , Pseudotumor Orbitário , Neurofibromatoses , Neoplasias da Bainha Neural , Face , Neurofibroma , Órbita/anormalidades , Órbita/cirurgia , Procedimentos Cirúrgicos Operatórios/métodos , Pseudotumor Orbitário/cirurgia , Pseudotumor Orbitário/imunologia , Pseudotumor Orbitário/terapia , Neurofibromatoses/cirurgia , Neurofibromatoses/diagnóstico , Neoplasias da Bainha Neural/cirurgia , Neoplasias da Bainha Neural/terapia , Face/cirurgia , Neurofibroma/cirurgia , Neurofibroma/terapia
4.
Pan Afr Med J ; 33: 199, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31692754

RESUMO

Spinal schwannomas are benign tumors accounting for 30% of all spinal tumors. They originate from the shwann cells of the spinal roots. We report our experience in managing patients with spinal shwannomas, from diagnosis to treatment modalities, in the Department of Neurosurgery at the University Hospital Hassan II in Fez over a period of 13 years. The patients with spinal shwannomas accounted for 19.5% of those with spinal cord compression treated surgically over the same period. The average age of patients was 45 years, with a discreet female predominance. Spinal schwannomas had an insidious onset, then the median of consultation time was 18 months. The main symptoms were spinal and radicular pain. Half of our patients had neurological deficits. Medullary MRI was performed in all of our patients. Spinal schwannomas occurred predominantly in the chest (40%); 62% of shwannomas were intradural lesions, rarely extradural lesions (8%) and mixed lesions(4%). Complete Surgical resection was performed in 96% of cases with osteosynthesis in two cases and arthrodesis in a single case. Histological examination confirmed the diagnosis of benign neurinoma in 23 cases, malignant shwannoma in one case and neurofibroma in one case. Outcome was favorable in the majority of cases, two patients had complications, an infection of the wall and neurological worsening. The interest in the subject of our study is to highlight the features of these lesions and to compare the results of our case series with the data in the literature.


Assuntos
Neurilemoma/diagnóstico , Compressão da Medula Espinal/etiologia , Neoplasias da Coluna Vertebral/diagnóstico , Adolescente , Adulto , Idoso , Criança , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Neurilemoma/patologia , Neurilemoma/cirurgia , Neurofibroma/diagnóstico , Neurofibroma/cirurgia , Estudos Retrospectivos , Compressão da Medula Espinal/cirurgia , Neoplasias da Coluna Vertebral/patologia , Neoplasias da Coluna Vertebral/cirurgia , Adulto Jovem
5.
BMC Oral Health ; 19(1): 197, 2019 08 29.
Artigo em Inglês | MEDLINE | ID: mdl-31464607

RESUMO

BACKGROUND: Neurofibromas (NF) are benign tumors of the peripheral nerves that are composed of Schwann cells, perineural-like cells and fibroblasts. The differential diagnosis for a solitary intraneural variant of neurofibroma arising in the floor of the mouth is broad and includes a submandibular gland neoplasm and adenopathy, among others. The intraoral approach is the best choice for a medium-sized lesion. CASE PRESENTATION: We report a rare case of a solitary neurofibroma of the floor of the mouth in a 31-year-old male. The patient consulted the dental emergency department for acute pain of the left mandible. Systematic clinical examination revealed the presence of a mass in the left mouth floor. The panoramic x-ray was not conclusive and the magnetic resonance imaging (MRI) revealed a well-defined soft tissue lesion with homogenous isosignal intensity on the T1-weighted image, high intensity signal on the T2-weighted image and heterogeneous enhancement following contrast-enhancement on the T1-weighted Fast Sat image. The surgical excision of the soft-tissue neoplasm was accomplished by an intraoral approach. The specimen was sent for histopathologic analysis and Immunohistochemical studies which confirmed the diagnosis of a myxoid predominant intraneural solitary neurofibroma. CONCLUSION: The diagnosis of neurofibroma was confirmed by histopathological evaluation and immunohistochemical studies which also excluded other entities in the histopathologic differential diagnosis including schwannoma and a malignant peripheral nerve sheath tumor among other. Localized (solitary) neurofibromas most often occur as sporadic lesions, however; diagnosis of a solitary neurofibroma prompts clinical evaluation to exclude the remote possibility of neurofibromatosis. The purpose of this case report is to raise awareness of the uncommon presentation of neurofibroma and to document the successful management of such a lesion using an intraoral approach.


Assuntos
Nervo Lingual , Neurofibroma , Adulto , Diagnóstico Diferencial , Humanos , Nervo Lingual/diagnóstico por imagem , Nervo Lingual/cirurgia , Imagem por Ressonância Magnética , Masculino , Neurofibroma/diagnóstico por imagem , Neurofibroma/cirurgia , Exame Físico
6.
S Afr J Surg ; 57(3): 58, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31392870

RESUMO

BACKGROUND: Intradural extramedullary (IDEM) spinal masses are common lesions with varying histological diagnoses often associated with significant neurological deficits. This study aimed to describe the epidemiology, management and perioperative outcome of IDEM tumours seen at the teaching hospitals of the University of the Witwatersrand, Johannesburg, between 2014 and 2017. RESULTS: 92 patients were included in the study. The ages ranged from 21 to 87 years, sex ratio was M:F 1:1.4, and duration of symptoms prior to diagnosis ranged between 3 days to 18 months. Local and radicular type pain as well as motor weakness were the commonest symptoms. 67% had severe neurological deficit McCormick Grade III and IV. Schwannoma (26) Neurofibromas (21) and Meningiomas (16) and were the most frequent tumour types. Meningiomas predominantly occurred at the cranio-cervical and thoracic levels. Nerve sheath tumours were mostly found at the cervical and lumbar levels while filum terminale ependymomas occurred at the thoracolumbar area. Laminectomy was the commonest surgical approach employed, and the extent of resection varied, with total excision in half the cases. Neurological function was regained in 3 patients, deteriorated in two and was unchanged in the remainder. CONCLUSION: IDEM tumours are an important subset of spinal cord compressive lesions Presentation with severe neurological deficit is common and though resection is feasible neurological deficit remains in the vast majority. Earlier detection should improve the results of surgery.


Assuntos
Meningioma/cirurgia , Neurilemoma/cirurgia , Neurofibroma/cirurgia , Neoplasias da Medula Espinal/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Dor nas Costas/etiologia , Feminino , Hospitais de Ensino , Humanos , Laminectomia , Masculino , Meningioma/complicações , Meningioma/epidemiologia , Pessoa de Meia-Idade , Debilidade Muscular/etiologia , Neurilemoma/complicações , Neurilemoma/epidemiologia , Neurofibroma/complicações , Neurofibroma/epidemiologia , Radiculopatia/etiologia , África do Sul/epidemiologia , Compressão da Medula Espinal/etiologia , Neoplasias da Medula Espinal/complicações , Neoplasias da Medula Espinal/epidemiologia , Adulto Jovem
7.
World Neurosurg ; 130: 264-266, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31323411

RESUMO

A 41-year-old woman presented with a 16-year history of lumbar pain and right leg paresthesia. Twenty-four years previously, she had been diagnosed with neurofibromatosis type 1 syndrome. Magnetic resonance imaging showed a heterogeneous mass extending through widened lumbar neural foramina to the psoas muscles bilaterally, with a dumbbell-like appearance. Biopsy led to the diagnosis of a malignant peripheral nerve sheath tumor, an uncommon soft tissue sarcoma of neural origin that may occur in the context of neurofibromatosis type 1 syndrome. Given the aggressive behavior of these tumors, prompt and accurate diagnosis is critical to improve patient outcomes.


Assuntos
Neoplasias da Bainha Neural/patologia , Neoplasias da Bainha Neural/terapia , Neurofibroma/patologia , Neurofibroma/cirurgia , Adulto , Feminino , Humanos , Região Lombossacral/patologia , Neoplasias da Bainha Neural/diagnóstico , Neurilemoma/diagnóstico , Neurilemoma/patologia , Neurofibroma/diagnóstico , Neurofibromatose 1/diagnóstico , Neurofibromatose 1/patologia , Neoplasias do Sistema Nervoso Periférico/diagnóstico , Neoplasias do Sistema Nervoso Periférico/patologia , Neoplasias do Sistema Nervoso Periférico/cirurgia
9.
World Neurosurg ; 130: 1-6, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31254713

RESUMO

BACKGROUND: Cases of multiple intracranial tumors are common; however, cases of multiple intraspinal tumors are rare. Except for cases of neurofibromatosis, it is very rare for tumors of different pathological types to exist concurrently at the same spinal level. Only 9 cases have been reported to date, with meningioma found with schwannoma in 7 cases and with neurofibroma in 2 cases. CASE DESCRIPTION: We have reported another rare case in which neurofibroma and meningioma were identified within a single dumbbell-shaped tumor at the same cervical level without neurofibromatosis. The preoperative magnetic resonance imaging findings indicated a single extra- and intradural extramedullary dumbbell-shaped neurogenic tumor on the left ventral side of the cervical spine. Intraoperatively, we found that the mass consisted of 2 pathologically different tumors. The results of surgical resection were mostly satisfactory. CONCLUSIONS: To the best of our knowledge, the present case is the first reported case of intradural neurofibroma (not meningioma) and extradural meningioma growing mixed together at the same spinal level without neurofibromatosis. The precise mechanism underlying the formation of the tumor is unknown, and multidirectional differentiation of a common progenitor cell is one possibility. Intra- and extradural exploration and component biopsies are useful for treatment planning, especially when the magnetic resonance imaging is not sufficiently sensitive for the diagnosis of coexisting tumor types.


Assuntos
Vértebras Cervicais/diagnóstico por imagem , Neoplasias Meníngeas/diagnóstico por imagem , Meningioma/diagnóstico por imagem , Neurofibroma/diagnóstico por imagem , Neurofibromatoses , Neoplasias da Coluna Vertebral/diagnóstico por imagem , Vértebras Cervicais/cirurgia , Feminino , Humanos , Neoplasias Meníngeas/complicações , Neoplasias Meníngeas/cirurgia , Meningioma/complicações , Meningioma/cirurgia , Pessoa de Meia-Idade , Neurofibroma/complicações , Neurofibroma/cirurgia , Neoplasias da Coluna Vertebral/complicações , Neoplasias da Coluna Vertebral/cirurgia
11.
Clin Plast Surg ; 46(3): 347-350, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31103079

RESUMO

Nerve sheath tumors of the upper extremity are among the common neoplastic pathologies encountered by hand surgeons. A majority of these tumors are benign schwannomas or neurofibromas and may be associated with neurofibromatosis. Clinical signs of malignant transformation include new onset of pain and rapid growth. Imaging characteristics, such as standardized uptake value greater than 4.0 on PET scan, may aid in the diagnosis of a malignant tumor. Surgical excision, often with intrafascicular dissection with nerve preservation, is recommended treatment of benign lesions. Wide surgical excision is recommended for malignant lesions.


Assuntos
Neoplasias da Bainha Neural/cirurgia , Procedimentos Ortopédicos/métodos , Humanos , Neoplasias da Bainha Neural/diagnóstico , Neurilemoma/diagnóstico , Neurilemoma/cirurgia , Neurofibroma/diagnóstico , Neurofibroma/cirurgia , Neurofibromatoses/complicações
12.
BMJ Case Rep ; 20182018 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-30297491

RESUMO

An occurrence of vallecular neurofibroma with airway obstruction is extremely rare and to the best of our knowledge, no case report has been documented in the literature to date. Although microlaryngeal surgery with cold knife excision is the standard surgical procedure offered to patients of vallecular lesions, it can be successfully managed with the help of endoscopic coblation as later can provide a bloodless surgical field preventing the unmet need for the tracheostomy and reducing the postoperative morbidities.


Assuntos
Neoplasias Laríngeas/diagnóstico , Neurofibroma/diagnóstico , Adulto , Obstrução das Vias Respiratórias/etiologia , Transtornos de Deglutição/etiologia , Diagnóstico Diferencial , Endoscopia , Feminino , Humanos , Neoplasias Laríngeas/complicações , Neoplasias Laríngeas/diagnóstico por imagem , Neoplasias Laríngeas/cirurgia , Laringoscopia , Neurofibroma/complicações , Neurofibroma/diagnóstico por imagem , Neurofibroma/cirurgia , Tomografia Computadorizada por Raios X
13.
J Laryngol Otol ; 132(8): 748-752, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29996959

RESUMO

OBJECTIVE: Various surgical approaches have been described to remove tumours in the parapharyngeal space. This study investigated the feasibility of a transoral approach in the surgical management of parapharyngeal space benign tumours located in the medial portion of the carotid sheaths and extending toward the skull base. METHODS: Thirty-two patients were selected and underwent a transoral or an endoscope-assisted transoral approach in the surgical management of parapharyngeal space benign tumours located in the medial portion of the carotid sheaths. Medical photographs were used. RESULTS: All patients underwent complete resection of their lesions via a transoral or endoscope-assisted transoral approach. None of the patients demonstrated residual or recurrent neoplasms, either clinically or radiographically, during their follow up. CONCLUSION: Based on our studies, we assert that transoral and endoscope-assisted transoral approaches are suitable in managing parapharyngeal space benign tumours located in the medial portion of the carotid sheaths and extending toward the skull base.


Assuntos
Adenoma Pleomorfo/cirurgia , Fibromatose Agressiva/cirurgia , Cirurgia Endoscópica por Orifício Natural , Neurilemoma/cirurgia , Neurofibroma/cirurgia , Neoplasias Faríngeas/cirurgia , Adenoma Pleomorfo/patologia , Adolescente , Adulto , Artérias Carótidas , Criança , Feminino , Fibromatose Agressiva/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Neurilemoma/patologia , Neurofibroma/patologia , Neoplasias Faríngeas/patologia , Estudos Retrospectivos , Base do Crânio , Adulto Jovem
14.
Am J Med Sci ; 356(1): 79-83, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-30049332

RESUMO

Solitary laryngeal neurofibromas are exceedingly rare with only 14 cases reported in the previous literature. Herein, we reported a case of solitary laryngeal neurofibroma and reviewed all the published cases of this disease on the clinical manifestations and management options. Patients with solitary laryngeal neurofibromas can present with a variety of respiratory symptoms. Immunohistochemical examination of tumor specimen is critical for pathologic diagnosis and complete surgical resection is the optimal therapy. Endoscopic microsurgeries followed by CO2 laser management of the surgical border may be effective on preventing recurrence. Depending on the location, size and invasiveness of the lesions, the management and prognosis vary among patients. Long-term follow-up is highlighted owing to the possibility of recurrence during a long period of time after surgery.


Assuntos
Neoplasias Laríngeas , Laringoscopia , Terapia a Laser , Recidiva Local de Neoplasia , Humanos , Imuno-Histoquímica , Neoplasias Laríngeas/diagnóstico , Neoplasias Laríngeas/metabolismo , Neoplasias Laríngeas/cirurgia , Recidiva Local de Neoplasia/diagnóstico , Recidiva Local de Neoplasia/mortalidade , Recidiva Local de Neoplasia/cirurgia , Neurofibroma/diagnóstico , Neurofibroma/metabolismo , Neurofibroma/cirurgia
15.
J Cancer Res Ther ; 14(3): 712-715, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29893349

RESUMO

Neurofibroma is a benign tumor of nerve tissue origin, derived from the cells that constitute the nerve sheath. It is commonly found in soft tissues, but the intraosseous occurrence of solitary neurofibroma in the head and neck is comparatively rare, with the most common site being mandible. This article presents a case report of neurofibroma on the posterior right side of the mandible of a 13-year-old boy who is the youngest patient in the series along with a review of literature.


Assuntos
Neoplasias Mandibulares/diagnóstico , Neurofibroma/diagnóstico , Adolescente , Humanos , Masculino , Neoplasias Mandibulares/cirurgia , Neurofibroma/cirurgia , Prognóstico
16.
Agri ; 30(2): 93-96, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29738061

RESUMO

Neurofibromatosis type 1 is an autosomal dominant condition characterized by cutaneous and/or plexiform neurofibromas and hyperpigmented café-au-lait spots. It affects multiple endocrine and visceral organs and can be associated with several difficulties such as potential airway (ventilation/intubation) problems, abnormal spinal anatomy, and peripheral neurofibromas. Therefore, anesthesia technique selection becomes more of an issue in terms of avoiding complications and decreasing morbidity and mortality. In the present case, we describe the use of ultrasound and the successful performance of supraclavicular brachial plexus block for surgery on the arm and forearm in a patient with neurofibromatosis type 1.


Assuntos
Bloqueio do Plexo Braquial , Manchas Café com Leite/cirurgia , Neurofibroma/cirurgia , Neurofibromatose 1 , Dor Pós-Operatória/prevenção & controle , Neoplasias Cutâneas/cirurgia , Braço , Feminino , Humanos , Ultrassonografia de Intervenção , Adulto Jovem
17.
Laryngoscope ; 128(11): 2525-2528, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-29602216

RESUMO

This case report describes the novel use of transoral robotic surgery (TORS) with delayed transoral laser microsurgery (TLM) for residual disease in the resection of a pediatric neurofibroma with supraglottic and parapharyngeal space extension. Postoperatively, the patient had excellent functional outcomes. This case demonstrates that pediatric TORS is feasible, safe, and complementary to TLM. Neurofibroma is just one of the diverse pathologic processes of the pediatric airway that can be managed via transoral surgery, and applications of TORS with TLM will continue to broaden as our experience develops. Laryngoscope, 2525-2528, 2018.


Assuntos
Neoplasias Laríngeas/cirurgia , Laringectomia/métodos , Neurofibroma/cirurgia , Broncoscopia , Criança , Meios de Contraste , Diagnóstico Diferencial , Diagnóstico por Imagem , Feminino , Humanos , Neoplasias Laríngeas/diagnóstico , Laringoscopia , Terapia a Laser , Microcirurgia , Neurofibroma/diagnóstico , Procedimentos Cirúrgicos Robóticos , Traqueostomia
19.
J Ovarian Res ; 11(1): 14, 2018 Feb 09.
Artigo em Inglês | MEDLINE | ID: mdl-29426349

RESUMO

BACKGROUND: Pelvic masses are a common gynecologic problem, and majority of them are diagnosed as ovarian tumors finally. Sometimes, it is hard to distinguish the origin of these pelvic masses. The following case is a solitary neurofibroma arising from the right-side obturator nerve, which was impressed as a right-side ovarian tumor initially. We reported this case, and also performed a PRISMA-driven systematic review to summary the similar cases in the literature. This review includes image, molecular and pathological findings and outcome of neurofibroma. CASE PRESENTATION: A 33-year-old woman with a regular menstrual period denied any symptoms or signs. During her physical check-up, image examination revealed a right-side heterogeneous pelvic mass; it was suggestive of a complex of right-side ovarian tumor. A provisional diagnosis of retroperitoneal pelvic mass, probably a benign ovarian tumor, was made. Excision of the right-side pelvic mass was performed. We sent the specimens for frozen pathology, which indicated neurofibroma and lipomatous tumor and that the possibility of liposarcoma cannot be excluded. A segment of the obturator nerve was attached to the tumor and was severed. A right-side obturator nerve tear during tumor excision was observed, and a neurosurgeon was consulted for obturator nerve grafting and repair. The patient complained of mild weakness and paresthesia affecting the right leg, and we consulted a rehabilitation doctor for neuron injury. The patient's recovery was uneventful, and she was discharged eight days after the drain was removed. Further rehabilitation treatment was arranged. CONCLUSION: A neurofibroma is an uncommon pelvic retroperitoneal tumor, and it can be misdiagnosed as an adnexal mass. To our knowledge, this is a rare case of a solitary neurofibroma arising from the obturator nerve. It usually does not have any neurological deficit. We present this case to demonstrate that pelvic neurofibroma can be mistaken for an adnexal mass. This fact should be borne in mind during the diagnosis process.


Assuntos
Doenças dos Anexos/diagnóstico , Neurofibroma/diagnóstico , Nervo Obturador/patologia , Doenças dos Anexos/cirurgia , Adulto , Biópsia , Diagnóstico Diferencial , Gerenciamento Clínico , Feminino , Histocitoquímica , Humanos , Neurofibroma/cirurgia , Exame Físico , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Ultrassonografia , Fluxo de Trabalho
20.
J Craniofac Surg ; 29(3): e314-e315, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29420386

RESUMO

Benign tumors of the nasal cavity originating from a peripheral nerve sheath are rare. The authors present a case of a 3-month-old boy with a mass in the left nasal vestibule. The surgical resection was complicated by full-thickness necrosis of more than 50% of the nasal ala. The tumor was diagnosed histopathologically as a neurofibroma with glial heterotopia. The details of the nasal reconstruction with a paramedian forehead flap in 3 stages and postoperative results are provided with satisfactory cosmetic and functional results.


Assuntos
Neurofibroma/cirurgia , Neoplasias Nasais/cirurgia , Nariz/cirurgia , Humanos , Lactente , Masculino , Procedimentos Cirúrgicos Reconstrutivos , Retalhos Cirúrgicos/cirurgia
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