Cases reported "Pharyngeal Neoplasms"

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1/473. rhabdomyoma of the hypopharynx and larynx. Report of two cases and a review of the literature.

    Two cases of extracardiac rhabdomyoma are reported in a 54-year-old man with unexplained difficulty in breathing and in a 39-year-old man with a prolonged history of hoarseness. attention is drawn to the necessity of doing hypopharyngo-and laryngoscopy in such cases. One tumour was found in the left vallecula in the hypopharynx and the other on the left vocal cord. The literature and the histological findings in 53 cases are reviewed. It appears that this rare tumour is most frequently found in muscles derived from the pharyngeal arches. A total of 40 cases have been diagnosed during the last decade, and this increase is likely to continue in the future. It may turn out that extra-cardiac rhabdomyoma is not so rare as was first presumed. ( info)

2/473. A new transfacial approach for lesions of the clivus and parapharyngeal space: the partial segmented Le Fort I osteotomy.

    Tumors of the clival and parapharyngeal areas are a challenge because of their location. They used to be considered inaccessible because the aggressive approaches employed caused elevated levels of morbidity. This fact led to more conservative approaches that attempted to preserve the exposure of the lesion. These approaches were a combination of cranial and facial procedures, thus utilizing a combined effort between neurosurgeons and maxillofacial surgeons. We described our experience with a partial segmented Le Fort I osteotomy added to a transmandibular approach to expose a chordoma of the clivus and left parapharyngeal space. A three-dimensional imaging was used as a diagnostic tool and to plan the optimal surgical approach. The operative technique was described in this case study. Some important technical details of the approach are described. The global outcome was favorable. ( info)

3/473. Synovial sarcoma in the parapharyngeal space: case report and review of the literature.

    We encountered a rare case of synovial sarcoma in the parapharynx of a 47-year-old Japanese man. This patient presented with an enlarging tumor in the right side of his neck that had grown progressively over a 4-week period. Radiological examinations revealed that the tumor arose from the parapharyngeal space. The tumor could not be completely removed at surgery. Metastasis to the lumbar vertebra was detected postoperatively. The patient underwent three courses of chemotherapy and the delivery of palliative radiation to the lumbar vertebra without success. The patient died of lung metastasis 7 months after surgery. ( info)

4/473. Neurally mediated syncope in 2 patients with extracardiac disease.

    We describe the cases of 2 patients with repetitive episodes of syncope with profound bradycardia and hypotension. In both patients, the symptoms were initially thought to be neurally mediated and idiopathic but were ultimately determined to be triggered by serious underlying pathologic processes: a massive and locally invasive tumor of the hypopharynx in 1 patient and a gangrenous gallbladder in the other. Appropriate treatment resulted in a resolution of this syndrome in both patients. These cases emphasize the importance of an appropriate evaluation and broad differential diagnoses for patients with severe bradycardia and hypotension. ( info)

5/473. Follicular dendritic cell tumor of the parapharyngeal region.

    BACKGROUND: Follicular dendritic cell (FDC) tumors are rare. A majority of the reported cases were confined to the lymph nodes. We report a case of FDC tumor occurring in the parapharyngeal region in a 45-year-old woman. methods: Characteristic histopathologic features of the excised primary and recurrent parapharyngeal tumors in conjunction with immunohistochemistry and electron microscopy helped us to arrive at a diagnosis of FDC tumor. RESULTS: Histopathology of primary excision revealed a lobulated tumor with a suggestion of ill-defined whorls. The most striking feature was regular occurrence of aggregates of lymphocytes within the tumor, especially around the blood vessels. The anatomic location together with the histology indicated the possibilities of either a meningioma, a salivary gland tumor, or a nerve sheath tumor. Immunostains for cytokeratin (CK), S-100 protein, and smooth muscle actin (SMA) were negative. However, the tumor cells showed strong immunoreactivity for epithelial membrane antigen (EMA) and vimentin. A diagnosis of parapharyngeal meningioma appeared to be the closest possibility. One year later, the patient developed a recurrence at the same site. A reexcision showed an identical tumor with an additional feature of lymphatic embolization and angioinvasion. A review of the entire case with further immunoreactivity for CD21 and CD35 confirmed the diagnosis of FDC. CONCLUSIONS: Follicular dendritic cell tumor has distinctive morphologic features and immunohistochemical profile. It is also characterized by considerable potential for recurrences. ( info)

6/473. Dysphagia secondary to invasive candidiasis of a jejunal free flap.

    The presence of a mass in a jejunal free flap that causes dysphagia less than two years after a pharyngolaryngectomy for carcinoma usually indicates tumour recurrence. We present a case of invasive candidiasis of a jejunal free flap presenting with dysphagia and a mass. To our knowledge this is previously unreported. Such a cause should always be considered in the differential diagnosis, as early recognition and treatment are likely to result in a favourable outcome. ( info)

7/473. The answer is blowing in the wind: a pedunculated tumour with saw tooth flow-volume loop.

    Obstructing tumours of the upper airways have been demonstrated to alter the flow volume loop of pulmonary function testing. These alterations could be clues to the nature and location of the obstruction. This report describes a case of a pedunculated squamous cell carcinoma arising in the pharynx whose flow volume loop showed a saw tooth pattern which reflected the location and structure of the tumour. ( info)

8/473. Successful surgical treatment of a solitary parapharyngeal metastasis from thyroid cancer, using the mandibular swing-transcervical approach: report of a case.

    A 72-year-old man presented with a right parapharyngeal mass, 4 cm in diameter, which was subsequently diagnosed as a metastasis originating from papillary carcinoma of the thyroid gland. The parapharyngeal tumor was successfully removed by the mandibular swing-transcervical approach with pharyngeal reconstruction, performed using a buccal mucosal island flap based on the facial artery. His postoperative course was uneventful, and the preoperative clinical symptoms such as dysphagia and headaches completely resolved after surgery. ( info)

9/473. Case report: extranodal non-Hodgkin's lymphoma of the parapharyngeal space.

    We report an unusual case of primary extranodal non-Hodgkin's lymphoma of the parapharyngeal space. Clinical presentation looked like right peritonsillar abscess and hypoglossal palsy. After histologic study of his biopsy, this 19-year-old man was given a diagnosis of diffuse large-cell non-Hodgkin's lymphoma. Immunohistochemical study showed cell-type B and he was determined to have Stage IIE. Treatment combined chemotherapy and radiotherapy. Extranodal lymphoma of the head and neck presents a diagnostic problem. We review various approaches to extranodal non-Hodgkin's lymphomas of the head and neck. This condition especially requires communication between the surgeon and the pathologist, essential in preventing an incorrect or delayed diagnosis. ( info)

10/473. lung and aero-digestive cancers in young marijuana smokers.

    Marijuana has been shown to be one of the commonly abused substances in the world, especially among teenagers and young adults. Although its addictive potential and psychomotor side-effects have been widely publicized, the issue of possible carcinogenicity is not as well perceived. Marijuana smoke contains many of the same organic and inorganic compounds that are carcinogens, co-carcinogens, or tumor promoters found in tobacco smoke. We have encountered several young marijuana users with no history of tobacco smoking or other significant risk factors who were diagnosed to have lung or other aero-digestive cancers in our practice. Although there are several experimental and epidemiological studies suggesting an association of marijuana use as a possible cause of cancers, this issue remains controversial. It is hoped that our case presentation can help to stimulate further awareness and research into this issue. ( info)
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