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2.
Medicine (Baltimore) ; 98(44): e17784, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31689849

RESUMO

RATIONALE: Congenital pyriform sinus fistula (CPSF) is a branchial abnormality originating from the third or fourth branchial pouch and is an important cause of anterior cervical abscess in children. Here we present a case of neck abscess in a newborn that was diagnosed as CPSF. PATIENT CONCERNS: A male infant with a birth weight of 3660 g was admitted to hospital 25 minutes after birth after discovery of a cystic mass with extensive skin swelling in the left side of the neck. B-mode ultrasonography of the left neck showed an anterior cervical cystic mass of indeterminate nature. DIAGNOSIS: Congenital pyriform sinus fistula. INTERVENTIONS: The neck abscess was incised and drained under general anesthesia. Examination under suspension laryngoscopy revealed a pyriform sinus fistula. Laser cauterization was performed simultaneously. The wound was dressed and anti-inflammatory treatment was provided. OUTCOMES: The neck wound healed uneventfully. After 3 months, the fistula was confirmed to be closed by laryngoscopy under general anesthesia. No recurrence was detected during 9 months of follow-up. LESSONS: CPSF should be strongly suspected in a patient with an unexplained neck abscess or recurrent acute suppurative thyroiditis, especially on the left side.


Assuntos
Abscesso/congênito , Fístula/congênito , Pescoço/patologia , Doenças Faríngeas/congênito , Seio Piriforme/anormalidades , Humanos , Recém-Nascido , Masculino
3.
Medicine (Baltimore) ; 98(44): e17800, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31689859

RESUMO

RATIONALE: Human papillomavirus (HPV)-related oropharyngeal cancer is becoming more common, the primary cancer AQ4 usually occult and appearing only as cystic cervical lymph node (LN) metastasis. Distinguishing between a benign cystic lesion and cystic LN metastasis is challenging given their similar radiologic and histologic appearances. PATIENT CONCERNS: A 54-year-old man presented with a bulging cystic mass measuring 6.4cm on the right side of neck. DIAGNOSES: Postexcision diagnosis was second branchial cleft cyst. After 2 years, the cystic mass recurred, and HPV-related tonsillar squamous cell carcinoma with cystic metastatic LNs was confirmed after wide tonsillectomy and neck dissection. The previous cystic lesion proved to be a cystic metastatic LN from the same malignancy with additional p16 immunostain. INTERVENTIONS: The patient was treated with adjuvant concurrent chemoradiation therapy. OUTCOMES: The patient was followed up in the outpatient department with no evidence of recurrence after 1 year. LESSONS: When an adult has a cystic mass in the upper neck, we must rigorously exclude it as a cystic metastatic LN of occult HPV-related oropharyngeal cancer. Additional p16 staining might be helpful.


Assuntos
Branquioma/diagnóstico , Carcinoma de Células Escamosas/diagnóstico , Metástase Linfática/diagnóstico , Neoplasias Císticas, Mucinosas e Serosas/diagnóstico , Neoplasias Primárias Desconhecidas/diagnóstico , Neoplasias Orofaríngeas/diagnóstico , Carcinoma de Células Escamosas/secundário , Carcinoma de Células Escamosas/virologia , Diagnóstico Diferencial , Humanos , Linfonodos/patologia , Linfonodos/virologia , Masculino , Pessoa de Meia-Idade , Pescoço/patologia , Pescoço/virologia , Esvaziamento Cervical , Neoplasias Císticas, Mucinosas e Serosas/secundário , Neoplasias Císticas, Mucinosas e Serosas/virologia , Neoplasias Primárias Desconhecidas/patologia , Neoplasias Primárias Desconhecidas/virologia , Neoplasias Orofaríngeas/secundário , Neoplasias Orofaríngeas/virologia , Papillomaviridae , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/virologia , Neoplasias Tonsilares/diagnóstico , Neoplasias Tonsilares/patologia , Neoplasias Tonsilares/virologia
4.
Medicine (Baltimore) ; 98(41): e17567, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31593142

RESUMO

RATIONALE: Pediatric-type follicular lymphoma (PTFL) is a rare neoplasm with features that differ from those of adult-type follicular lymphoma. Compared to patients with adult-type follicular lymphoma, PTFL patients often show an excellent response. Preoperative diagnosis is challenging and, therefore, an accurate diagnosis is based on the findings of postoperative pathological examination and immunohistochemistry. PATIENT CONCERNS: A 13-year-old boy presented with a slow-growing mass on the right side of his neck. DIAGNOSES: The patient was diagnosed with PTFL based on the findings of histopathological examination and immunohistochemistry. INTERVENTION: The mass was completely resected. OUTCOMES: After 12 months of postoperative follow-up, the patient achieved good recovery without recurrence. LESSONS: The optimal treatment for PTFL has not yet been defined. However, patients with PTFL always show satisfactory prognoses, regardless of treatment strategy (targeted radiotherapy, multiagent chemotherapy, or "watch and wait" strategy). Clinically, pathological and immunohistochemical analyses are necessary in the diagnoses of PTFL cases, especially for distinguishing PTFL from reactive follicular hyperplasia, to avoid unnecessary treatment.


Assuntos
Linfoma de Células B/patologia , Linfoma Folicular/imunologia , Linfoma Folicular/patologia , Pescoço/patologia , Adolescente , Assistência ao Convalescente , Humanos , Imuno-Histoquímica/métodos , Linfoma de Células B/diagnóstico , Linfoma de Células B/imunologia , Linfoma de Células B/cirurgia , Linfoma Folicular/diagnóstico , Linfoma Folicular/cirurgia , Masculino , Pescoço/diagnóstico por imagem , Pescoço/cirurgia , Resultado do Tratamento , Ultrassonografia
6.
Anticancer Res ; 39(8): 4463-4465, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31366545

RESUMO

This case report describes a patient with a rare occurrence of primary spinal intramedullary Ewing's sarcoma (ES) in the cervical and thoracic spine. The older age of disease occurrence, uncommon location in the cervical and thoracic spine, and EWSR1 gene fusion as the basis of diagnosis are unique features of this case. There is no clear protocol for treatment of primary extraskeletal ES of the spine, with controversy between evidence for pursuing surgery versus a combination of radiation and chemotherapy. Our patient was treated with temozolomide chemotherapy for recurrent metastatic disease of primary ES of the spine.


Assuntos
Tumores Neuroectodérmicos Primitivos/tratamento farmacológico , Proteína EWS de Ligação a RNA/genética , Sarcoma de Ewing/tratamento farmacológico , Temozolomida/administração & dosagem , Adulto , Idoso , Humanos , Masculino , Pescoço/patologia , Tumores Neuroectodérmicos Primitivos/genética , Tumores Neuroectodérmicos Primitivos/patologia , Sarcoma de Ewing/genética , Sarcoma de Ewing/patologia , Coluna Vertebral/efeitos dos fármacos , Coluna Vertebral/patologia , Parede Torácica/efeitos dos fármacos , Parede Torácica/patologia
7.
Medicine (Baltimore) ; 98(31): e16670, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31374044

RESUMO

RATIONALE: Fetal giant cervical cyst (FGCC) is a rare congenital anomaly. Sometimes FGCC may extend into the mediastinum, and result in severe tracheal compression, which is a life-threatening event at birth. PATIENT CONCERNS: We present a rare case of FGCC, which extended from the right neck into the superior mediastinum, and resulted in severe tracheal compression. DIAGNOSES: An FGCC was observed by ultrasonography and magnetic resonance imaging (MRI) at 27+4 weeks' gestation (WG). Fetal MRI at 35+1 WG showed that the FGCC was 3.3 × 8.2 × 7.5 cm and extended from the right neck into the superior mediastinum. Severe tracheal compression was observed and the inside diameter of the narrowest section of tracheostenosis appeared thread-like and measured only 0.1 cm. INTERVENTIONS: Cervical cyst reduction was performed prenatally under ultrasound guidance to alleviate the tracheal compression and maximize the chance of fetal survival 2 days before birth. At 36+3 WG, cesarean section was performed, and a female neonate was immediately delivered and intubated (3.5-mm tube) by an experienced anesthesiologist. Neonatal intralesional sclerotherapy and cystic component aspiration as guided by digital subtraction angiography were performed under general anesthesia. Anesthesia was maintained only with sevoflurane 3% in 2 L/min oxygen. Extubation was performed soon after surgery. OUTCOME: The neonate recovered uneventfully and was discharged 2 days postoperatively. After 140 days of follow-up, the neonate had recovered completely. LESSONS: If an FGCC is suspected by abdominal ultrasound, a fetal MRI is recommended to assess the severity of tracheal compression before birth, if feasible. An anesthesiologist should assess the risk of intubation failure at birth according to those results. If fetal severe tracheal compression is detected and it may result in inability of intubation at birth, prenatal cervical cyst reduction under ultrasound guidance may be effective for alleviating tracheal compression at birth, if feasible. This could maximize the chance of fetal survival. Improvement of fetal short- and long-term outcomes is important.


Assuntos
Fetoscopia/métodos , Hidropisia Fetal/patologia , Hidropisia Fetal/cirurgia , Linfangioma Cístico/patologia , Linfangioma Cístico/cirurgia , Pescoço/patologia , Pescoço/cirurgia , Adulto , Cesárea , Feminino , Idade Gestacional , Humanos , Hidropisia Fetal/diagnóstico por imagem , Recém-Nascido , Intubação Intratraqueal , Linfangioma Cístico/complicações , Linfangioma Cístico/diagnóstico por imagem , Imagem por Ressonância Magnética , Pescoço/diagnóstico por imagem , Pescoço/embriologia , Gravidez , Doenças da Traqueia/diagnóstico por imagem , Doenças da Traqueia/etiologia , Ultrassonografia Pré-Natal
9.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 54(7): 481-486, 2019 Jul 09.
Artigo em Chinês | MEDLINE | ID: mdl-31288329

RESUMO

Objective: To investigate the feasibility and application value of toluidine bule-dextran-40 (TB-Dex-40) as the tracer for lymphatic system in head and neck region. Methods: Twenty healthy adult New Zealand white rabbits were equally divided into two groups: the experimental group (TB-Dex-40 group, n=10) and the control group (TB group, n=10). Rabbits in experimental group received submucosal injection of 1.0% (0.14 mOsm/L) TB-Dex-40, and the control group received injection of 1.0% (32.60 mOsm/L) TB.The staining time and fading time of lymphatic vessels and lymphnodes in the neck region were recorded, and the diffusion ranges of the two dyes in the tongue region were measured. Lymph nodespecimen were collected for pathological examination after 10 min, 1 hour and 4 weeks of staining. The experimental animals were sacrificed before and 4 weeks after the experiment. After death, organs of heart, lung, liver and kidney were examined pathologically. Results: TB-Dex-40 reached sentinel lymph node (SLN) and stained lymphatic vessels at an average of (21.67±0.19) s after injection, while in control group was(3.22±0.34) s (P<0.01). The time difference between the two dyes reaching sentinel lymph nodes was statistically significant.The durations from lymphatic staining to marked fading were (19.70±1.34) min in experimental group and (14.30±0.95) min in control group, respectively.The difference was statistically significant (P<0.01). SLN staining by TB-Dex-40 was still evident after 4 weeks, while TB staining has completely faded after 2 d.The average ranges of diffusionin tongue were (10.50±1.08) mm in experimental group and (20.00±1.05) mm in controlgroup, respectively. The difference was statistically significant (P<0.01).No abnormalities were found in blood test and pathological examination of main organs. Conclusions: TB-Dex-40 has high specificity forstaining lymphatic vessels and is a good tracer with potential clinical value.


Assuntos
Dextranos , Linfonodos , Vasos Linfáticos , Pescoço , Cloreto de Tolônio , Animais , Dextranos/química , Dextranos/metabolismo , Cabeça/patologia , Linfonodos/metabolismo , Linfonodos/patologia , Vasos Linfáticos/metabolismo , Vasos Linfáticos/patologia , Pescoço/patologia , Coelhos , Fatores de Tempo , Cloreto de Tolônio/química , Cloreto de Tolônio/metabolismo
10.
Clin Nucl Med ; 44(8): 657-659, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31274616

RESUMO

F-Fluoro-ethyl-choline (F-FCH) PET/CT is widely used to study patients affected by prostate cancer. However, F-FCH may be taken-up by other neoplastic diseases, infections, and non-infective inflammatory processes. While this behavior may be an opportunity to study different diseases, on the other hand, this condition brings with it the source of error in the evaluation of the images. Here we present the case of a meningeal inflammatory pseudotumor evidenced by F-FCH.


Assuntos
Granuloma de Células Plasmáticas/diagnóstico por imagem , Meninges/diagnóstico por imagem , Pescoço/diagnóstico por imagem , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Colina/análogos & derivados , Humanos , Masculino , Meninges/patologia , Pessoa de Meia-Idade , Pescoço/patologia , Neoplasias da Próstata/diagnóstico por imagem , Compostos Radiofarmacêuticos
11.
J Stroke Cerebrovasc Dis ; 28(9): 2517-2524, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31296477

RESUMO

BACKGROUND: The purpose of this study was to validate and pilot the use of the four-variable screening tool (4V) and modified 4V tools to identify acute ischemic stroke and transient ischemic attack (TIA) patients at high risk of obstructive sleep apnea (OSA). METHODS: Two modified scales, 4V-1 (ie, using neck circumference instead body mass index, regardless of gender) and 4V-2 (ie, as above but scored differently according to gender) were designed. These tools were used in a consecutive cohort of 124 acute ischemic stroke/TIA patients, together with the 4V-1, 4V-2, 4V, as well as the STOP-BANG, the Berlin questionnaire, and the Epworth Sleepiness Scale (ESS). Objective level 2 or level 3 polysomnography was used to confirm OSA and its severity. Both questionnaires and polysomnography were completed within 1 week from symptom onset. RESULTS: Area under the curve (AUC) of 4V was 0.807 (P< .0001) while AUC of STOP-BANG, Berlin Questionnaire and ESS were .701 (P< .0001), .704 (P< .0001) and .576 (P = .1556), respectively. AUC of 4V was greater than of STOP-BANG (z = 2.200, P = .0220), Berlin (z = 2.024, P = .0430) and ESS (z = 3.363, P = .0003). AUC of modified 4V-1 and modified 4V-2 were .824 (P< .001) and .835 (P< .001), respectively. Performance of modified 4V-2 was higher versus modified 4V-1 (z = 2.111, P = .0348) and higher but not significantly so to regular 4V (z = 1.784, P = .0744). CONCLUSIONS: Neck circumference scored by gender is a useful substitution to body mass index in the 4V when screening OSA at early stages of ischemic stroke/TIA patients.


Assuntos
Isquemia Encefálica/diagnóstico , Técnicas de Apoio para a Decisão , Ataque Isquêmico Transitório/diagnóstico , Pescoço/patologia , Apneia Obstrutiva do Sono/etiologia , Acidente Vascular Cerebral/diagnóstico , Idoso , Pressão Sanguínea , Índice de Massa Corporal , Isquemia Encefálica/complicações , Isquemia Encefálica/fisiopatologia , Feminino , Humanos , Ataque Isquêmico Transitório/complicações , Ataque Isquêmico Transitório/fisiopatologia , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Polissonografia , Valor Preditivo dos Testes , Prognóstico , Reprodutibilidade dos Testes , Medição de Risco , Fatores de Risco , Índice de Gravidade de Doença , Fatores Sexuais , Apneia Obstrutiva do Sono/diagnóstico , Apneia Obstrutiva do Sono/fisiopatologia , Ronco/fisiopatologia , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/fisiopatologia , Inquéritos e Questionários
12.
Indian J Pathol Microbiol ; 62(3): 454-456, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31361239

RESUMO

Simultaneously triple head and neck malignancies are extremely rare. We report a case who had epithelial and mesenchymal malignant tumor with lymphoid malignancy in head and neck area. A patient who is 74 year old male patient presented to the otorhinolaryngology department with severe breathing difficulty due to laryngeal mass. The result of laryngeal biopsy was invasive SCCs, so patient underwent total larygectomy and bilateral level 2,3,4 neck disection operation. Primary 3 different type head and neck tumors were observed with histopathological examination. These were orderly invasive SCCs in larynx, B-cell Non-Hodgkin's lymphoma in tongue root and one lymph node of left neck dissection material, Kaposi's sarcoma in one lymph node of right neck dissection material. Although synchronous head and neck tumors occurs very rare with laryngeal carcinoma, the neck dissection materials should be researched for synchronous tumors.


Assuntos
Carcinoma de Células Escamosas/diagnóstico , Neoplasias Laríngeas/diagnóstico por imagem , Linfoma não Hodgkin/diagnóstico , Neoplasias Primárias Múltiplas/diagnóstico , Sarcoma de Kaposi/diagnóstico , Idoso , Biópsia , Humanos , Neoplasias Laríngeas/patologia , Neoplasias Laríngeas/radioterapia , Laringe/patologia , Imagem por Ressonância Magnética , Masculino , Pescoço/patologia , Neoplasias Primárias Múltiplas/patologia , Língua/patologia , Resultado do Tratamento
13.
J Craniofac Surg ; 30(5): e415-e418, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31299798

RESUMO

Kimura's disease (KD) is a benign, rare and chronic inflammatory disorder of unknown etiology and it affects subcutaneous tissues, lymph nodes, and salivary glands. The clinical manifestation of cases reported is mainly small neoplasms or enlarged lymph nodes, while cases for large masses are rarely reported. This case reveals a female patient of KD with large masses in the head and neck region. The scope of the tumor is huge, which seriously affects the facial shape and psychology of the patient, thereby affecting the daily life of the patient. Although the patient had surgically removed the same site tumor 8 years ago, it was not possible to determine whether it was a recurrent case because the postoperative pathological diagnosis of first treatment was not confirmed. Under the general anesthesia, the right head and neck masses were removed. During the operation, the facial nerve branches were wrapped by the masses. After consulting the family members, it was agreed that the facial nerve should not be preserved for maximum extent removal of the tumor. Although the patient has facial paralysis symptoms after surgery, the facial shape and patient's psychology are greatly improved, and the patient is satisfied with the treatment effect. Surgical treatment is one of the effective ways to treat huge tumors in the head and neck of KD. This study has certain guiding significance for clinicians to treat huge tumors of head and neck in KD.


Assuntos
Hiperplasia Angiolinfoide com Eosinofilia/diagnóstico por imagem , Face , Pescoço , Hiperplasia Angiolinfoide com Eosinofilia/complicações , Hiperplasia Angiolinfoide com Eosinofilia/patologia , Face/patologia , Nervo Facial/patologia , Paralisia Facial/etiologia , Feminino , Humanos , Pessoa de Meia-Idade , Pescoço/patologia
14.
Ticks Tick Borne Dis ; 10(5): 1142-1145, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31213411

RESUMO

BACKGROUND: Tick-borne rickettsioses are infectious diseases caused by obligate intracellular Gram-negative bacteria belonging to the spotted fever groupof Rickettsia. METHODS: We describe an unusual case of SENLAT (Scalp eschar and neck lymphadenopathy after tick bite), caused byRickettsia slovaca, associated with a cellulitis of the face in a 70-year-old woman, and diagnosed using qPCR on a scalp eschar swab. We review the literature regarding cases of SENLAT-associated-cellulitis and case of SENLAT diagnosed by qPCR on scalp eschar swabs. RESULTS: We found only one previous report of SENLAT associated with a cellulitis of the face. It was a nine-year-old French girl diagnosed by seroconversion for Rickettsia sp. Our review of the literature showed that qPCR on eschar swab samples is a less invasive method than performing cutaneous biopsy of the eschar and has good sensitivity and specificity (90% and 100%, respectively). CONCLUSIONS: We report the second case of cellulitis of the face associated with the SENLAT syndrome. Detection of Rickettsia by qPCR on swab sample of the scalp eschar is a simple, noninvasive technique allowing rapid diagnosis and treatment when SENLAT is suspected.


Assuntos
Celulite (Flegmão)/diagnóstico , Linfadenopatia/diagnóstico , Pescoço/patologia , Infecções por Rickettsia/diagnóstico , Rickettsia/isolamento & purificação , Couro Cabeludo/patologia , Idoso , Celulite (Flegmão)/microbiologia , Feminino , França , Humanos , Linfadenopatia/microbiologia , Linfadenopatia/patologia , Infecções por Rickettsia/microbiologia , Infecções por Rickettsia/patologia , Picadas de Carrapatos/microbiologia , Doenças Transmitidas por Carrapatos/diagnóstico , Doenças Transmitidas por Carrapatos/microbiologia , Doenças Transmitidas por Carrapatos/patologia
15.
BMC Surg ; 18(Suppl 1): 112, 2019 Apr 24.
Artigo em Inglês | MEDLINE | ID: mdl-31074393

RESUMO

Papillary thyroid carcinoma is a slow-growing cancer with a generally good prognosis that sometimes have an aggressive behaviour. Metastases to neck lymph nodes is the first step of the diffusion. The central neck compartment is involved most commonly. The ipsilateral lateral neck compartments are usually involved afterwards, and the involvement of the contralateral one is considered a quite rare occurrence. In more rare cases, metastases to lateral neck compartment without central lymph node metastasis (so called "skip metastases") could be observed. Aim of this literature review study is to analyse the average incidence, pattern and risk factors of this occurrence.This study was performed according to PRISMA criteria. A final selection of 13 articles published in English language from 1997 to 2017 was performed. Any research article, review or meta-analysis was taken into consideration. Research was expanded considering the related references of articles.The incidence of skip metastases ranged from 1.6 to 21.8%. Risk factors such as age > 45 years, size < 5 mm and tumor located in the upper pole or isthmus of thyroid gland were found.Due to the frequency of skip metastases in thyroid cancer, a careful preoperative examination of lateral lymph nodes should be necessary.


Assuntos
Linfonodos/patologia , Câncer Papilífero da Tireoide/patologia , Neoplasias da Glândula Tireoide/patologia , Humanos , Incidência , Metástase Linfática , Pescoço/patologia , Fatores de Risco
16.
BMJ Case Rep ; 12(4)2019 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-31040139

RESUMO

Cutaneous metastasis from visceral malignancy is a relatively rare phenomenon. It is even rarer to have cutaneous lesions as the first mode of clinical presentation in such malignancies. The lesions are usually nodular, although they can have varied appearances. Common sites of primaries include breast, lung, colorectum, kidney, ovary, and headandneck. We report an unusual form of cutaneous metastasis in the neck, known as 'carcinoma en cuirasse', in an elderly man that subsequently led to the diagnosis of an occult gastric cancer. Our case highlights the importance of recognising cutaneous metastatic lesions early, as they may herald the diagnosis of an occult internal malignancy.


Assuntos
Adenocarcinoma/patologia , Pescoço/patologia , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Neoplasias Cutâneas/secundário , Neoplasias Gástricas/patologia , Adenocarcinoma/diagnóstico por imagem , Evolução Fatal , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Pescoço/diagnóstico por imagem , Neoplasias Cutâneas/diagnóstico por imagem , Neoplasias Gástricas/diagnóstico por imagem , Imagem Corporal Total
18.
J Laryngol Otol ; 133(5): 430-435, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31006395

RESUMO

OBJECTIVE: This study aimed to determine the incidence of metastatic squamous cell carcinoma in patients with an isolated cervical cystic mass, and to describe the clinical features that might predict the origin of cystic tumours. METHOD: Adult patients with isolated lateral cervical cystic masses who were scheduled for surgery from 1st January 2010 to 31st August 2016 in two tertiary care referral centres in Slovakia were analysed retrospectively. RESULTS: The incidence of cystic metastases in the whole cohort and in patients aged over 40 years were 9.9 per cent and 18.5 per cent, respectively. The incidence in patients aged over 40 years (18.5 per cent) was statistically significant (p = 0.003). CONCLUSION: The incidence of cystic squamous cell carcinoma metastases in lateral cervical cysts in patients aged over 40 years is high enough to call for excisional biopsy with frozen section, panendoscopy with direct biopsies, tonsillectomy and even neck dissection in cases of histologically confirmed carcinoma.


Assuntos
Cistos/patologia , Neoplasias de Cabeça e Pescoço/epidemiologia , Pescoço/patologia , Lesões Pré-Cancerosas/patologia , Carcinoma de Células Escamosas de Cabeça e Pescoço/epidemiologia , Adolescente , Adulto , Idoso , Feminino , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Eslováquia/epidemiologia , Carcinoma de Células Escamosas de Cabeça e Pescoço/patologia , Adulto Jovem
19.
Tidsskr Nor Laegeforen ; 139(7)2019 Apr 09.
Artigo em Norueguês, Inglês | MEDLINE | ID: mdl-30969044

RESUMO

BACKGROUND: Granulomatosis with polyangiitis (GPA), formerly known as Wegener's granulomatosis, has a predilection for the upper airways, lungs and kidneys. However, any other organ can be affected. Although cutaneous lesions are common, they have only rarely been reported as a primary manifestation of the disease. CASE PRESENTATION: We present a case of a teenage boy with pyoderma gangrenosum-like ulcerations of the neck and face. Anti-neutrophil cytoplasmic antibody with antigen specificity for proteinase 3 (PR3-ANCA) was detected. In the absence of other symptoms and organ manifestations, the ulcerations were still considered to be pyoderma gangrenosum. The ulcers started to heal during treatment with corticosteroids and infliximab. One month later the patient developed sinusitis, and eventually lost vision in his left eye. The diagnosis was changed to GPA and he started treatment with methylprednisolone, rituximab and cyclophosphamide with good response on vision, sinusitis and ulcerations. INTERPRETATION: Recognition of this rare skin presentation of GPA is essential, to prevent delays in diagnosis and treatment that can lead to organ damage.


Assuntos
Face/patologia , Granulomatose com Poliangiite , Pescoço/patologia , Úlcera Cutânea/etiologia , Adolescente , Fármacos Dermatológicos/administração & dosagem , Fármacos Dermatológicos/uso terapêutico , Diagnóstico Diferencial , Glucocorticoides/administração & dosagem , Glucocorticoides/uso terapêutico , Granulomatose com Poliangiite/complicações , Granulomatose com Poliangiite/diagnóstico , Granulomatose com Poliangiite/tratamento farmacológico , Granulomatose com Poliangiite/patologia , Humanos , Fatores Imunológicos/administração & dosagem , Fatores Imunológicos/uso terapêutico , Infliximab/administração & dosagem , Infliximab/uso terapêutico , Masculino , Prednisolona/administração & dosagem , Prednisolona/uso terapêutico , Pioderma Gangrenoso/diagnóstico , Rituximab/administração & dosagem , Rituximab/uso terapêutico , Úlcera Cutânea/tratamento farmacológico , Úlcera Cutânea/patologia
20.
J Med Case Rep ; 13(1): 110, 2019 Apr 28.
Artigo em Inglês | MEDLINE | ID: mdl-31029172

RESUMO

BACKGROUND: Cervical fasciitis is a group of severe infections with high morbimortality. Reports in the literature of patients with cases evolving with mediastinal dissemination of deep cervical abscess are common. However, cases of abdominal dissemination by contiguity are much rarer. CASE PRESENTATION: A 34-year-old Caucasian man presented to the emergency department with a 15-day history of left neck edema, local pain, and fever. Seventeen days prior to presentation, he had undergone odontogenic surgical treatment in a dental clinic. Laboratory examinations did not show meaningful changes. He underwent computed tomography of the neck, thorax, and abdomen, which showed evidence of left collection affecting the retromandibular, submandibular, parapharyngeal, vascular, and mediastinal spaces, bilateral pleural effusion, right subphrenic collection and a small amount of liquids between intestinal loops. A cervical, thoracic, and abdominal surgical approach at the same surgery was indicated for odontogenic cervical abscess, descending necrotizing mediastinitis, and subphrenic abscess. The patient remained in the intensive care unit for three days, and he was discharged on the 22nd day after surgery with no drains and no tracheostomy. His outpatient discharge occurred after 6 months with no sequelae. CONCLUSIONS: Aggressive surgical treatment associated with antibiotic therapy has been shown to be effective for improving the clinical course of cervical fasciitis. Despite the extension of the infection in our patient, a surgical approach of all infectious focus associated with a broad-spectrum antibiotic therapy led to a good clinical evolution and has significant implications for aggressive treatment.


Assuntos
Abscesso/diagnóstico , Fasciite Necrosante/diagnóstico , Mediastinite/diagnóstico , Pescoço , Abdome/diagnóstico por imagem , Abscesso/terapia , Doença Aguda , Adulto , Antibacterianos/uso terapêutico , Drenagem , Fasciite Necrosante/terapia , Humanos , Laparotomia , Masculino , Mediastinite/terapia , Pescoço/diagnóstico por imagem , Pescoço/patologia , Pescoço/cirurgia , Toracotomia , Tórax/diagnóstico por imagem
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