Cases reported "Hypertrophy"

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1/53. Excessive nodular hyperplasia of brunner glands associated with gastric hypersecretion and lipomatous atrophy of the pancreas.

    The case of a 34-year-old woman complaining of diarrhoea and abdominal pain is presented. Contrast radiography and endoscopy showed multiple polypoid tumours in the second part of the duodenum. Moreover, a severe fatty infiltration of the pancreas was shown by magnetic resonance and computed tomography scans. Due to pain, pancreatoduodenectomy (Whipple operation) was performed, and subsequent histopathologic examinations showed excessive Brunner gland hyperplasia of the duodenum and severe lipomatous atrophy of the pancreas. The occurrence of these two rare conditions in one patient has not been described previously, and it is conceivable that the lipomatous atrophy and exocrine insufficiency of the pancreas may have caused a compensatory stimulation of the submucosal structures of the duodenum.
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2/53. The development of hypertrophic pyloric stenosis in a patient with prostaglandin-induced foveolar hyperplasia.

    BACKGROUND: Hypertrophic pyloric stenosis (HPS) has been described in association with several obstructive antropyloric lesions including idiopathic foveolar hyperplasia (gastric mucosal hypertrophy), feeding tubes, eosinophilic gastroenteritis, and hypertrophic antral polyps. Non obstructive antral webs have also been described with HPS. PATIENT AND methods: We present a case of gastric-outlet obstruction in association with HPS, namely, prostaglandin-induced foveolar hyperplasia. This entity has been previously described, but rarely in association with HPS. We report a female infant requiring prostaglandin therapy for pulmonary atresia who developed dose-related prostaglandin-induced foveolar hyperplasia and symptoms of progressive non-bilious vomiting. RESULTS: Initially, ultrasonography demonstrated evidence of antral mucosal hypertrophy as the cause for gastric-outlet obstruction. The patient subsequently developed progressive thickening of the antropyloric muscle, resulting in sonographic appearances of hypertrophic pyloric stenosis. Pyloromyotomy was eventually required for treatment of HPS. CONCLUSION: A common denominator of most of the above-described entities is thickening and/or hypertrophy of the antral mucosa. We suggest that the antropyloric musculature may hypertrophy in an effort to overcome the gastric-outlet obstruction caused by the adjacent thickened antral mucosa. In other words, these entities may represent examples of "secondary" hypertrophic pyloric stenosis.
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3/53. Proportion of cells with paternal 11p15 uniparental disomy correlates with organ enlargement in Wiedemann-beckwith syndrome.

    "Genetic mosaicism" describes the presence of two or more populations of cells within a single individual that differ in their genomic constitution. Although the occurrence of asymmetric overgrowth in Wiedemann-Beckwith syndrome (WBS) suggests that mosaicism has some role in the WBS phenotype, no direct evidence for this has been published. WBS is a congenital overgrowth syndrome with variable phenotype linked to the imprinted gene cluster on chromosome region 11p15. We have performed a molecular survey of multiple organs and tissues in a case of WBS with a high degree of mosaic paternal 11p15 uniparental disomy (UPD). The organs most severely affected were those with the highest percentage of cells with UPD. In particular there was a striking difference in the degree of mosaicism for 11p15 UPD between the extremely enlarged left adrenal and non-enlarged right adrenal gland. This result indicates that the proportion of paternal 11p15 UPD cells correlates with the tissue phenotype of WBS. Our results suggest that high proportions of abnormal cells result from a combination of stochastic events and cell selection. mosaicism may explain the variable phenotypes including hemihyperplasia and predisposition to childhood cancers in WBS patients.
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4/53. A child with adrenocortical adenoma accompanied by congenital hemihypertrophy: report of a case.

    We report herein the findings of a 7-year-old male child with a ruptured adrenocortical adenoma and congenital hemihypertrophy which was incidentally detected after suffering a trauma. A review of 21 pediatric cases of adrenocortical neoplasms in the literature was made. The patient showed precocious puberty such as pubis and advanced bone age, but an endocrinological examination revealed no definite abnormalities. The right adrenal tumor with hematoma was resected after these evaluations. adrenocortical adenoma is considered to occur more frequently in female children. However, the incidence of adrenocortical tumors accompanied by congenital hemihypertrophy does not differ between males and females. The outcomes were relatively good, although the observation periods were short in some patients. A large number of patients presented with a tumor and hemihypertrophy on the same side. This finding is of interest when considering the possible association between hemihypertrophy of the organs and tumor proliferation. However, their association in terms of development was unclear. It is necessary for patients with hemihypertrophy to have regular examinations for the possible development of malignant tumors, especially in the kidney, adrenal gland, and liver.
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5/53. Adenomatoid hyperplasia of the palate mimicking clinically as a salivary gland tumor.

    This report describes an illustrative case of adenomatoid hyperplasia (AH) of the minor salivary glands on the palate of a 31-year-old man. The clinical features of the present lesion corresponded with those of pleomorphic adenoma, but histologically large lobules of normal-appearing mucous acini were found. The cell proliferative activity demonstrated in histological sections, by an immunohistochemical staining of proliferating cell nuclear antigen and Ki-67, showed no statistically significant differences among AH and a matched control group of normal palatal salivary glands. This case suggests that AH apparently exhibits an idiopathic, focal hypertrophic lesion of intraoral mucous glands with limited growth potential.
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6/53. Revisiting a controversial surgical technique in the treatment of bulimic parotid hypertrophy.

    bulimia nervosa is a recognized cause of bilateral parotid gland enlargement that may not be appreciated by most otolaryngologists. Classically the parotid enlargement is transient but may be permanent and spectacular. Our review of the published literature revealed only 2 previous cases that have been considered for superficial parotidectomy, along with much debate as to the efficacy of such treatments. Neither case reported any postoperative complications. We present a bulimic patient who developed bilateral postoperative fistulae after surgery for marked, permanent enlargement of her parotids. Both fistulas closed spontaneously. However, a year later she has relapsed into bulimic behavior and developed further parotid gland hypertrophy. Because of this complication, we believe surgery has no role to play in the overall treatment of these severe cases unless the patients show a prolonged cessation of their bulimic behavior.
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7/53. The management of well-differentiated thyroid cancer with end-stage renal disease.

    The occurrence of thyroid cancer in patients with endstage renal disease is rare. We have had the experience of treating two such patients. The problems, encountered in these patients, were the enlarged parathyroid glands at the time of total thyroidectomy and the treatment of these patients with 131I when the biologic halflife of radioiodine increases after hemodialysis. Both patients were treated by total thyroidectomy and postoperative administration of 131I, either empirically or dosimetrically, and are living and well, 9 yr and 7 yr after operations, respectively.
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8/53. A developmental anomaly of the mammary glands - gigantomastia. A case report.

    Developmental anomalies of the breast are frequently observed in women. The most serious pathology is gigantomastia. This type of breast hypertrophy may be caused by hypersensitivity of the breast oestrogen and progesterone receptors, by disturbances of the normal balance of oestrogen and androgen hormones, by hyperthyroidism or by hormonal activity of the neoplasm. In most cases gigantomastia produces pathological changes in the vertebral column which become manifest as discopathia, scoliosis or scoliokyphosis. A case of gigantomastia treated with surgery is presented and the effect of plastic operation is demonstrated. Surgery may be recommended as an excellent therapeutic treatment of gigantomastia.
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9/53. Lacrimal location of sinus histiocytosis (Rosai-Dorfman-Destombes disease).

    A 7-year-old West African male patient presented with recurrence of multiple cervical lymphadenopathy. Cervical node biopsy disclosed a sinus histiocytosis with massive lymphadenopathy (Rosai-Dorfman-Destombes disease). During follow-up, the patient developed a left orbital mass corresponding to an enlarged lacrimal gland shown by CT. The histologic features of the gland were consistent with the diagnosis, and with steroid treatment, the gland decreased in size. Although rare, the diagnosis of sinus histiocytosis with massive lymphadenopathy has to be considered in cases of lacrimal gland enlargement.
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10/53. role of CO2 laser in the management of obstructive ectopic lingual thyroids.

    Ectopic lingual thyroid glands may occasionally undergo massive hypertrophy and be a source of airway obstruction. Securing the airway prior to surgery in such cases may be difficult. In the present paper, we report on two cases of obstructive ectopic lingual thyroids which were successfully managed endoscopically using CO(2) laser. The use of CO(2) laser for removal of ectopic lingual thyroid tissue offers advantages over traditional surgical techniques. In our opinion, removal of an appropriate amount of gland to secure an adequate airway is all that is required in most cases.
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