1/4. radiation-induced rectal cancer originating from a rectocutaneous fistula: report of a case.This report describes a patient with radiation-induced rectal cancer with an unusual history. A 51-year-old man was admitted in 2000 because of ichorrhea of the skin on the left loin. The patient had received irradiation for a suspicious diagnosis of a malignant tumor in the pelvic cavity in 1975. A subcutaneous abscess in the right loin appeared in 1989, and rectocutaneous fistula was noted in 1992. Moreover, radiation-induced rectal cancer developed in 2000. Plain computed tomography and magnetic resonance imaging of the pelvis demonstrated a presacral mass and tumor in the rectum. Finally, we diagnosed the presacral mass to be an abscess attached to the center of the rectal cancer. The rectum was resected by Miles' operation and a colostomy of the sigmoid colon was also performed. Many cases of radiation-induced rectal cancer have been reported. However, this is a rare case of radiation-induced rectal cancer originating from a presacral abscess and rectocutaneous fistula.- - - - - - - - - - ranking = 1keywords = radiation-induced (Clic here for more details about this article) |
2/4. Management of radiation-induced tracheocutaneous tissue defects by transplantation of an ear cartilage graft and deltopectoral flap.patients suffering from head and neck cancer often require temporary tracheostomy during therapy. The tracheostomy can usually be closed when postoperative swelling decreases and swallowing ability recovers. However, some patients, especially after adjuvant radiotherapy, may develop severe chronic wounds resulting in persistent tracheocutaneous fistula. Local wound care and plastic reconstruction strategies are required in such cases. We present two patients with head and neck cancer treated with primary surgical regimen including temporary tracheostomy and adjuvant radiotherapy. Both patients developed a persistent, poorly healing wound with persistent tracheocutaneous tissue defect. After local debridement and wound care, the peristomal necrotic tissue was excised down to the level of the trachea. The defect of the anterior tracheal wall was closed with a autogenous ear cartilage graft. The graft was harvested from the cavum conchae and sutured to the tracheal defect. The soft tissue defect was covered by transposition of a well-vascularized, fasciocutaneous deltopectoral flap. In both cases, the flaps healed satisfactorily. The donor defect was closed primarily. Complications were not observed in these two cases. A flexible tracheo-bronchoscopy showed no stenosis of the trachea at the site of cartilage graft transplantation. In conclusion, treatment of persistent radiated tracheocutaneous defects by cartilage graft and deltopectoral flap turned out to be a safe and reliable procedure which can be performed as a one-stage method with low morbidity at the donor site.- - - - - - - - - - ranking = 1keywords = radiation-induced (Clic here for more details about this article) |
3/4. Case study: the role of surgical debridement and dural patching in the prevention of a recurrent radiation-induced sacral ulcer.The effects of radiation are not tissue selective. Changes are consistent with thermal injury, but evolve in a more insidious manner. erythema, edema, itching, and osteonecrosis can occur. These changes, over the sacrum, can lead to a spinal cutaneous fistula with persistent cerebrospinal fluid (CSF) leak in association with ulceration. Soft tissue coverage alone appears to be inadequate treatment. Aggressive bony debridement with dural patching have prevented recurrence of the fistula in a recent case.- - - - - - - - - - ranking = 1keywords = radiation-induced (Clic here for more details about this article) |
4/4. MRI in radiation-induced myelopathy and pharyngocutaneous fistula.A patient developed a cervical myelopathy 20 months after radiotherapy for a carcinoma of the larynx. MRI showed an intramedullary lesion at C7. Although radiation myelopathy was suspected, tumour recurrence could not be excluded. A radiation-induced pharyngocutaneous fistula, confirmed histologically, appeared a month later. The fistula lay just anterior to the level of the spinal cord lesion, a finding useful in supporting a diagnosis of simultaneous radiation myelopathy.- - - - - - - - - - ranking = 1.25keywords = radiation-induced (Clic here for more details about this article) |