Cases reported "Lip Neoplasms"

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11/43. Neurotropic melanoma invading the inferior alveolar nerve.

    BACKGROUND: Desmoplastic neurotropic melanoma (DNM) and neurotropic melanoma (NM), rare lesions of the head and neck, often present as a benign-appearing nodule which later progresses to cranial nerve involvement. OBJECTIVE: To discuss treatment and outcome of 3 cases of DNM/NM of the lower lip. methods: Three case reports with 12- to 54-month follow-up and literature review. RESULTS: The first case had an initial excision of melanoma of his lower lip and presented 16 years later with severe bilateral atrophy of his muscles of mastication with NM and underwent intensity modulated radiation therapy but no further resection. We also report two other cases of DNM of the lip, one of which received gamma knife radiosurgery for intracranial extension. LIMITATIONS: Small retrospective case series. CONCLUSIONS: Locoregional recurrences from DNM are more common than distant metastasis warranting vigilant surveillance following resection of the initial lesion. radiation therapy and gamma knife radiosurgery may be used for cases of unresectable recurrences.
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keywords = neck
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12/43. Small facial haemangioma and supraumbilical raphe--a forme fruste of PHACES syndrome?

    We report two female infants with congenital midline supraumbilical raphes who subsequently developed haemangiomas on the lower lip and gingiva within the first 2 months of life. One was found to have a subglottic haemangioma during laryngoscopy. The infants were otherwise well and had normal chest X-ray, echocardiogram, cranial ultrasound, magnetic resonance imaging/angiography (head, neck, chest) and ophthalmological examination. Both received oral prednisolone 1-2 mg kg(-1) daily and four sessions of flashlamp pulsed-dye laser therapy to the lip lesions, with significant improvement. The initial presentation of these two infants with supraumbilical raphes, who were otherwise healthy and without other cutaneous stigmata, suggested the diagnosis of isolated congenital sternal malformation. However, lower lip and gingival haemangiomas developed 4-6 weeks later, consistent with the diagnosis of PHACES syndrome. Children with sternal malformation and haemangioma may also have intracranial and/or cardiovascular anomalies. All previously reported patients were females who had either craniofacial and/or multiple haemangiomas. We propose guidelines for the evaluation and management of a neonate presenting with a sternal fusion defect at birth.
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keywords = neck
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13/43. Proximal forearm flap based on a septocutaneous vessel from the radial artery.

    BACKGROUND: The radial forearm flap has been a workhorse flap for soft-tissue or coverage reconstruction in the head and neck area. Although it has several major advantages, it requires sacrifice of the radial artery. In this article, the authors present their modification of harvesting a forearm flap based on a large septocutaneous branch of the radial artery in the proximal forearm with or without sacrificing the main radial artery. They name it the proximal radial forearm flap. methods: From September of 2003 to March of 2004, a total of 14 free proximal radial forearm flaps were used for head and neck reconstruction in 12 patients. There was one female patient and 11 male patients. Their ages ranged from 32 to 85 years. The skin flap size ranged from 2.0 x 6.0 cm to 4.5 x 18 cm. RESULTS: All free proximal radial forearm flap reconstructions had immediate success. There were one delayed flap loss caused by wound infection and one death attributable to advanced medical disease. Six flaps were harvested with preservation of the radial artery trunk. Six of the eight radial arteries that were killed during flap harvest were repaired with a short segment (3 to 4 cm) of vein graft. The average diameter and length of the septocutaneous vessel of the proximal radial forearm flap was 0.73 mm and 3.3 cm, respectively. Two flaps were harvested in conjunction with the conventional free radial forearm flaps. Nine donor sites were closed primarily and five donor sites required skin grafts. CONCLUSIONS: The proximal radial forearm flap can be used successfully in head and neck reconstruction with the advantages of moving the donor site to the proximal forearm for better scar concealment and possible preservation of the radial artery trunk. The disadvantages of this flap are short pedicle length and small pedicle diameter when the radial artery is to be preserved.
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ranking = 3
keywords = neck
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14/43. Merkel cell carcinoma of the tongue and head and neck oral mucosal sites.

    Merkel cell carcinoma (MCC) is an uncommon primarily dermal malignancy of relatively aggressive biologic course. Several presentations in the mucosa of the head and neck region have been reported in the literature, and 3 such patients have recently been seen at our institution. We review this recent experience and present the first reported primary lingual MCC in a 57-year-old caucasian man. We provide a review of oral mucosal MCC and guidelines for histopathologic and immunohistochemical diagnosis. Merkel cell carcinoma should be included in the differential diagnosis of head and neck mucosal lesions, especially if the tumor is submucosal, and MCC may involve the tongue. Mucosal MCC is aggressive, and there is a high risk for local recurrence and regional and distant metastasis. Fulminating courses are often seen. We discuss our treatment policies based on the current literature.
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ranking = 6
keywords = neck
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15/43. Leptomeningeal carcinomatosis from perineural invasion of a lip squamous cell carcinoma.

    Perineural invasion resulting in leptomeningeal carcinomatosis is a rare, but well-recognized phenomenon in head and neck carcinomas. We report the rare case of a patient with a squamous cell carcinoma of the lip resulting in leptomeningeal carcinomatosis and review the relevant published work. A 51-year-old man presented with progressive facial paraesthesia after treatment for a recurrent squamous cell carcinoma of the lower lip. cavernous sinus involvement was confirmed on MRI and he received stereotactic radiotherapy. He subsequently developed progressive lower limb neurological signs. An MRI showed multiple enhancing leptomeningeal nodules in the cervical and lumbar spine consistent with leptomeningeal carcinomatosis. Whole spine radiotherapy and dexamethasone resulted in short-term stabilization of symptoms only and he rapidly succumbed to progressive neurological disease. To our knowledge, this is the first published report of a squamous cell carcinoma of the lip resulting in leptomeningeal disease of the cauda equina. It illustrates the potential aggressive natural history of squamous cell carcinomas with perineural invasion.
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keywords = neck
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16/43. Malignant peripheral nerve sheath tumors of the head and neck: two cases and a review of the literature.

    Malignant peripheral nerve sheath tumors are uncommon lesions that occasionally affect the head and neck. We describe 2 new cases of head and neck pathology. One tumor involved the parotid gland and resulted in erosion of the temporal bone, and the other affected the lower lip. A rapid diagnosis has significant implications for management because of the tumor's potential for aggressive behavior and its high rate of recurrence. To the best of our knowledge, lip involvement is rare and temporal bone involvement has not been previously described.
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ranking = 6
keywords = neck
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17/43. Repair of skin covering osteoradionecrosis of the mandible with the fasciocutaneous supraclavicular artery island flap: case report.

    INTRODUCTION: osteoradionecrosis of the mandible is a serious complication following radiotherapy for head and neck cancer. Reconstructive procedures in the head and neck region use a wide range of flaps for defect closure. The methods range from local, mostly myocutaneous flaps and skin grafts to free microsurgical flaps to ensure a satisfactory functional and aesthetic result. Moreover, the donor site defect needs to be closed, with as little as possible functional or aesthetic impairment. PATIENT AND METHOD: A 60-year-old male is presented with a history of squamous cell carcinoma of the left lower lip and chin area in whom the tumour was resected and treated by adjuvant radiotherapy. The follow-up was complicated by chronic inflammation of the left mandibular body as a sequel of radiotherapy; it resulted with partial bone destruction, and soft tissue dehiscence. He was admitted for repair and treatment of the infected mandibular osteoradionecrosis. A supraclavicular artery island flap was used to close the mandibular soft tissue defect. CONCLUSION: The shoulder provides a relatively good skin texture and match to provide cover and lining for defects in the lower part of the face, in combination with minor donor site morbidity.
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ranking = 2
keywords = neck
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18/43. leiomyosarcoma of the oral cavity: report of two cases located on the lips.

    The authors report 2 cases of leiomyosarcoma of the lips occurring in two elderly women. They review the incidence, the symptoms, the microscopic appearance, the differential diagnosis, the treatment and prognosis of this kind of tumor. It is a highly malignant neoplasm with a high rate of recurrences and metastases and should be treated with a radical resection and radical neck dissection when there is a metastatic node.
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keywords = neck
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19/43. Malignant clear cell hidradenoma of the lip.

    An interesting variety of cutaneous tumors of the head and neck, tumors of the eccrine differentiation, are seldom recognized. The most recent reports of these tumors appear in the dermatologic literature, probably due to the majority of them being located in the trunk and the extremities. Malignant varieties of these tumors do exist and must be treated as aggressively as more common tumors of the head and neck region. Tumors with eccrine differentiation are among a large variety of cutaneous tumors that present in the head and neck. These tumors are far less common than basal cell and squamous cell carcinomas of the head and neck. Malignant clear cell hidradenomas, a variant of the more common benign clear cell hidradenoma, is one such type of tumor of the eccrine differentiation. This is a rare tumor seldom reported in sites of the head and neck. A case of a 47-year-old white male with such a tumor of the lower half of his lip is presented. This report is particularly concerned with the histopathology of the tumor, its unique etiology, and the applicability of the lip switch flap (Stein-Abbe-Estlander) in the reconstruction of the surgical defect following total tumor excision.
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ranking = 5
keywords = neck
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20/43. Trichoepithelioma: report of an unusual case and review of the literature.

    Trichoepitheliomas are benign and uncommon skin tumors presenting in the head and neck region. Although they can be solitary, they occur more frequently as multiple lesions with an autosomal dominant inheritance. To the surgeon, they often present the problem of clinical differentiation from basal-cell carcinoma. An unusual case is described, and experience in the treatment of 19 patients is reviewed.
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ranking = 1
keywords = neck
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