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ABSTRACT: To assess the incidence and impact on treatment and prognosis of occult lymph node metastasis in laryngeal cancer.
A retrospective study was performed on 164 patients treated for laryngeal cancer, initially classified as N0, with cervical lymph node dissection.
Occult metastases were found in 41 neck specimens (12.5%) from 32 patients (19.5%). Involvement per neck level was: 7% level IIa, 2.4% IIb, 4.2% III and 2.7% IV. Lymph node involvement was significantly increased in case of T3T4 tumor or invasion of the pre-epiglottic space or cartilage. Survival was significantly influenced by pN status (pN- = 12 years, vs pN+ = 9 years; P = 0.006).
Level IIb or IV involvement is rare. Superselective neck dissection (IIa, III) seems to be indicated in T1T2 N0 tumor. In case of advanced tumor or pre-epiglottic space or cartilage invasion, functional neck dissection is mandatory.
European Annals of Otorhinolaryngology, Head and Neck Diseases 11/2010; 127(5):173-6.
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ABSTRACT: Langerhan's cell histiocytosis is defined as an abnormal proliferation of Langerhans cells in various organs and tissues (bone, skin, lymph nodes...). Among facial locations, mandibular involvement is the most frequent and occurs in young people less than 20 years. The aim of this report is to review the characteristic features of this disease, the current means of diagnosis and treatment through two case reports.
Two male patients aged 10 and 55 years respectively presented with single mandibular location of Langerhans cell histiocytosis. The diagnosis was confirmed by histological examination of the biopsy specimen. The first patient underwent surgical resection of the tumor. No recurrence was observed. In the second patient, the postoperative course was marked by the appearance of an inflammatory phenomenon in the adjacent skin and mucosa, successfully treated by intralesional corticosteroid therapy.
Langerhan's cell histiocytosis is a rare disease. The mandibular location has variable clinical expressions which can vary from dental mobility to tumor development in the gingiva. The radiological appearance is also variable; histological proof is required for diagnosis. Treatment depends on the number and locations of the lesions. In case of a single location, the treatment options may vary from a "wait and see" attitude to a non aggressive surgery, with a possible local corticosteroid therapy or radiothe-rapy. For multiples locations, chemotherapy is indicated.
Revue de Stomatologie et de Chirurgie Maxillo-faciale 01/2007; 107(6):465-9. · 0.25 Impact Factor
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ABSTRACT: Myofibroblastic tumours or pulmonary pseudotumours are rare and, though benign, they may become invasive and recur after excision.
We report the case of a child aged 14, presenting with mild haemoptysis, who had a solitary nodule at the base of the left lung. CT scanning suggested a hypervascular tumour. Fibreoptic bronchoscopy was normal and it was not possible to perform percutaneous biopsy on account of its proximal situation. A lobectomy was performed via a postero-lateral thoracotomy with a successful outcome. Histological examination revealed a myofibroblastic tumour.
Recourse to primary surgery is essential to confirm the diagnosis of a myofibroblastic pulmonary tumour. Complete resection is the only guarantee to prevent recurrence.
Revue des Maladies Respiratoires 01/2006; 22(6 Pt 1):1043-7. · 0.59 Impact Factor
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ABSTRACT: IntroductionMyofibroblastic tumours or pulmonary pseudotumours are rare and, though benign, they may become invasive and recur after excision.Case reportWe report the case of a child aged 14, presenting with mild haemoptysis, who had a solitary nodule at the base of the left lung. CT scanning suggested a hypervascular tumour. Fibreoptic bronchoscopy was normal and it was not possible to perform percutaneous biopsy on account of its proximal situation. A lobectomy was performed via a postero-lateral thoracotomy with a successful outcome. Histological examination revealed a myofibroblastic tumour.Conclusion
Recourse to primary surgery is essential to confirm the diagnosis of a myofibroblastic pulmonary tumour. Complete resection is the only guarantee to prevent recurrence.
Revue des Maladies Respiratoires. 22(6):1043-1047.
