1/54. Pleomorphic lipoma: case report and literature review.BACKGROUND: Pleomorphic lipoma is a rare, benign, pseudosarcomatous, soft tissue neoplasm typically involving the subcutis of the neck and shoulder in middle-aged to elderly men. It is characterized histologically by atypical, multinucleated giant cells and grossly as a well-circumscribed mass. Since this neoplasm can resemble a sarcoma, histopathologic diagnosis is critical in preventing unnecessary surgery. OBJECTIVE: To describe a case of pleomorphic lipoma in the neck and to review the clinical and histopathologic characteristics of this neoplasm. methods: We present a case report and review of the literature. RESULTS: Local excision to completely extirpate this neoplasm has proven curative at 10 months of follow-up. CONCLUSION: Pleomorphic lipoma is superficially located and may be encountered in a dermatologic setting. Thus the dermatologist should become familiar with its clinical presentation and microscopic appearance.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/54. The ex utero intrapartum treatment procedure for a large fetal neck mass in a twin gestation.BACKGROUND: Large fetal neck masses can make it difficult or impossible to secure airways at birth, with associated risks of hypoxia, brain injury, and death. Based on a medline search from 1966 to June 1998, using the keywords EXIT procedure, placental support, twins, and neck mass, we report the first ex utero intrapartum treatment procedure performed in a twin gestation complicated by a large fetal neck mass. CASE: A giant fetal cervical mass was diagnosed in one fetus of a 20-week twin gestation by sonography and magnetic resonance imaging. At 35 weeks' gestation, the ex utero intrapartum treatment procedure was performed successfully for delivery of the normal twin, followed by intrapartum airway access of the twin with the neck mass. CONCLUSION: Even in twin gestations, the ex utero intrapartum treatment procedure is the delivery method of choice for fetuses with giant neck masses.- - - - - - - - - - ranking = 2keywords = giant (Clic here for more details about this article) |
3/54. Prenatal MRI in a fetus with a giant neck hemangioma: a case report.We report a fetus with a giant neck hemangioma which was examined by MRI in utero. The initial diagnosis was made by ultrasonography. The sonolucent aspect of the mass, together with the presence of pulsating Doppler flow signals, was highly suggestive of a fetal hemangioma. In late pregnancy, fetal MRI revealed the location, size and characteristics of the neck tumor. Following prenatal corticosteroid treatment and premature delivery of the pregnancy due to fetal cardiac failure, the newborn received angiography and coil embolization of the tumor vessels. Despite vigorous treatments, the newborn died 12 h after birth. Evaluation of a fetal neck hemangioma by MRI is recommended late in pregnancy for precise information on the tumor and adjacent organs since the image is valuable for planning optimal perinatal treatment.- - - - - - - - - - ranking = 5keywords = giant (Clic here for more details about this article) |
4/54. radiation-induced malignant fibrous histiocytoma of the neck in a patient with laryngeal carcinoma.Fibrohistiocytomas are soft tissue tumors of histiocytic origin that have a variety of histological patterns. Although cases of malignant fibrous histiocytoma (MFH) of the head and neck have been reported with increasing frequency in recent years, they are considered rare. We report a case of the giant cell variant of MFH of the neck in which the patient had been given radiotherapy for T1 glottic cancer. prognosis of MFH, the use of radiation as primary treatment, and its role in the development of secondary primary tumors in the head and neck region are reviewed. [editorial comment: The authors stress the important relationship between prior radiation therapy and the induction of new tumors.]- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
5/54. Extensive cerebral invasion of a basal cell carcinoma of the scalp.Basal cell carcinomas (BCC) are the most common cutaneous malignant neoplasms affecting fair-skinned human beings. They may progressively enlarge and spread by peripheral extension. Intracranial invasion is very rare. A case of a giant BCC of the scalp invading directly into the left hemisphere through the frontal and parietal lobe and meninges is presented. Brain invasion along Virchow-Robin's spaces is demonstrated histopathologically. A review of literature failed to disclose a previous report of similar extensive and fatal cerebral invasion from a basal cell carcinoma of the scalp. copyright Harcourt Publishers Limited.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
6/54. The giant dermoid cyst of the scalp mimicking skull tumour. Case report.Dermoid cysts are common benign tumours mainly observed in the hairy skin of head. We present the case of cyst with untypical course of disease, diagnosed and treated in our hospital. The initial diagnosis with use of computed tomography (CT) scanner suggested a neoplasm of the skull.- - - - - - - - - - ranking = 4keywords = giant (Clic here for more details about this article) |
7/54. Prenatal and perinatal aspects of a giant fetal cervicothoracal lymphangioma.A massive cervicothoracal lymphangioma was diagnosed in a fetus at 25 weeks of gestation. On ultrasound study, the mass showed septated, cystic components and extended from the right submandibular region to the right anterolateral thoracic wall including the right axilla and right scapula. Close sonographic follow-up revealed an increase in the size of the lymphangioma without fetal hydrops. An interdisciplinary approach including a pediatric surgeon, neonatologist, perinatologist and anesthesiologist was chosen. Elective cesarean section under general anesthesia was planned at 37 0 weeks of gestation. Surgical correction of the lymphangioma was successfully performed on the 4th day of life. Possible differential diagnoses and the obstetrical management are presented.- - - - - - - - - - ranking = 4keywords = giant (Clic here for more details about this article) |
8/54. Course and outcome of a pregnancy with a giant fetal cervical teratoma diagnosed prenatally.We report the course and outcome of a pregnancy involving a giant fetal neck teratoma which was diagnosed at 23 weeks of gestation. Sonographic surveillance of the fetal neck revealed continuing growth of the tumor with development of polyhydramnios. Three-dimensional ultrasound provided additional detailed information on the external extent of the lesion. color Doppler ultrasound showed intense arterial and venous flow with low resistance indices. cesarean section under general anesthesia was planned in close cooperation with the neonatologist, pediatric surgeon and anesthesiologist because the size of the neck mass precluded vaginal delivery. cesarean section was performed at 34 weeks of gestation following preterm rupture of the membranes. Orotracheal intubation was not successful because of compression of the airway and a tracheostomy could not be performed because of the risk of severe fetal hemorrhage from the tumor. The neonate died from respiratory insufficiency 66 min after birth.- - - - - - - - - - ranking = 5keywords = giant (Clic here for more details about this article) |
9/54. Epithelioid hemangioendothelioma with osteoclast-like giant cells.Epithelioid hemangioendothelioma is an unusual entity of intermediate malignant vascular tumors and rarely admixes with multinucleated osteoclast-like giant cells. We describe such a case in a 50-year-old woman with an 1-year follow-up period. When the patient was 39 years old, a 0.7 x 1-cm firm mass was found in the left neck. She developed ascites three years later. At that time, the specimen from the neck mass was excised and found to be composed of cords of epithelioid cells in a myxoid hyaline stroma. Scattered intracytoplasmic vacuoles were seen. Immunohistochemical studies confirmed the diagnosis of epithelioid hemangioendothelioma. Abdominal ultrasonography and computed tomographic scan revealed multiple low density areas in the liver. Eleven years later, a metastatic lesion was found in the thoracic spine at the level of Th7-8. The histologic findings were basically similar to those of the left neck mass. However, because of the presence of Kp-1-positive multinucleated osteoclast-like giant cells throughout the tumor, the thoracic lesion was diagnosed as an epithelioid hemangiothelioma with osteoclast-like giant cells. This unique form of epithelioid hemangioendothelioma is extremely rare and should be distinguished from other benign and malignant tumors with osteoclast-like giant cells.- - - - - - - - - - ranking = 8keywords = giant (Clic here for more details about this article) |
10/54. A multidisciplinary team approach for management of a giant congenital cervical teratoma.Congenital cervical teratomas are associated with a high rate of perinatal mortality due to airway obstruction. We describe a multidisciplinary management of a neonate with prenatal diagnosis of giant cervical teratoma. An 'operation on placenta support' (OOPS) technique was carried out during delivery, and intubation was successfully performed with no perinatal anoxic damage. Postnatal computed tomography and angiography showed a huge teratoma covering both sides of the neck with agenesis of the big blood vessels on the left side. A rapidly developing third space phenomenon and deterioration in the general status of the neonate, required early surgical intervention. During surgical excision, the left carotid artery and internal jugular vein, the left lobe of the thyroid gland and the left recurrent laryngeal nerve were not detected. The left vagus, accessory and hypoglossal nerves were positioned between the skin and the tumor, at a distance from their normal anatomical location. Pathologic examination confirmed the diagnosis indicating immature teratoma with no signs of malignancy. The postoperative period was complicated by neurological deterioration, pharyngo-cutaneous fistula and paresis of the left hypoglossal nerve. However, all the symptoms resolved spontaneously. tracheotomy was performed when the baby was 6 weeks old due to paralysis of the left vocal cord and to severe laryngo-tracheomalacia. She was decannulated when she was 3 years old. Today, she is suffering only from dysphonia. This report confirms the efficacy of a multidisciplinary team-approach and the usefulness of the OOPS technique in prenatally diagnosed cervical masses. It emphasizes the extraordinary characteristics of this case, mainly the development of a third space phenomenon and the unusual surgical findings.- - - - - - - - - - ranking = 5keywords = giant (Clic here for more details about this article) |
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