1/5. head and neck cancers associated with Madelung's disease.BACKGROUND: Madelung's disease is a rare lipodystrophy that presents with multiple fatty masses in the neck, trunk, and upper extremities. The fatty accumulation is considered a benign disease, but compression of the aerodigestive tract may occur in long-standing disease. methods: Eight Chinese patients with Madelung's disease were reviewed. All were male, aged 48 to 67 years, with a history of disease ranging from 4 to 20 years. Two of the eight patients developed aerodigestive symptoms and were subsequently found to have head and neck cancers. These two patients are described. RESULTS: The possible mechanism that may account for an increase in malignant tumors of the airway in this group of patients is the synergistic effect of smoking and alcohol abuse as risk factors for both Madelung's disease and malignant tumors of the airway. Currently it is recommended that these patients should have their fatty lesions removed surgically. The removal of fat facilitates examination of the neck for signs of cervical lymphadenopathy in malignant disease. CONCLUSIONS: patients with Madelung's disease should be followed regularly. The development of aerodigestive symptoms should be fully investigated with endoscopy and imaging. The cause of symptoms should not be attributed to fatty compression until a carcinoma of the upper airway has been excluded.- - - - - - - - - - ranking = 1keywords = endoscopy (Clic here for more details about this article) |
2/5. A case of cancer on the pharyngoesophageal junction treated by ambulatory endoscopic mucosectomy.A 52-year-old man underwent endoscopy because of discomfort in the hypopharyngeal region, and a 1.5-cm tumor was found on the pharyngoesophageal junction. In 1992, the patient was treated for advanced cervicothoracic esophageal cancer by preoperative chemotherapy and esophagectomy with radical lymph adenectomy and right thoracotomy. Reconstruction with a gastric substitute by cervical esophagogastrostomy was performed and postoperative adjuvant radiotherapy followed. Histologically, the esophageal tumor had invaded the adventitia and showed metastases to regional lymph nodes and vascular involvement with a free surgical margin. hypopharynx was also included in the irradiation field. Therefore, we tried to resect another primary tumor on the pharyngoesophageal junction by the endoscopic mucosectomy technique with an esophageal multipurpose tube (np-EEM). The tumor was resected on August 21, 1996, but follow-up endoscopy revealed residual or another primary tumor on the pharyngoesophageal junction in October 1996. The first resected specimen revealed a positive cut margin that might indicate incomplete resection. Three months later we performed a second mucosectomy. No problems occurred during or after tumor resection. Both treatments were performed without hospitalization, and the patient returned to his normal daily life on the day following tumor resection. Follow-up examinations have shown no sign of cancer recurrence on the pharyngoesophageal junction for more than 4 years.- - - - - - - - - - ranking = 2keywords = endoscopy (Clic here for more details about this article) |
3/5. Balloon cell nevus of the pharynx.BACKGROUND: Mucosal melanotic lesions are rare, and the still rarer balloon cell variant has not been reported in the upper aerodigestive tract mucosa. We report a case of balloon cell nevus of the pharynx. methods: A 35-year-old woman was seen with complaints of a black color in her mouth. physical examination revealed a diffusely pigmented posterior pharyngeal wall. The pigmentation extended superiorly to the posterior edge of the palate, and laterally, it stopped short of the posterior tonsillar pillars. The overlying mucosa was smooth, with no swelling. Flexible endoscopy showed that the lesion extended to the cricopharynx. Findings on histopathologic examination were consistent with balloon cell nevus of the pharynx. Complete excision was not possible, because the lesion was very diffuse. RESULTS: After 2 years of conservative management and regular follow-up examinations, no change in the symptoms and no increase in the lesion have been seen. CONCLUSION: Melanotic lesions in the upper aerodigestive tract mucosa are rare. This case is reported for its rarity, unusual presentation, and characteristic histopathologic features.- - - - - - - - - - ranking = 1keywords = endoscopy (Clic here for more details about this article) |
4/5. Multiple synchronous fibrovascular polyps of the hypopharynx.PURPOSE OF THE STUDY: To evaluate the clinical, radiological presentation and surgical management of fibrovascular polyps of the hypopharynx. methods: Retrospective medical analysis of a case report. We report the case of a 66-year-old man, who presented with an incarcerated left inguinal hernia, vomiting and regurgitation of a large mass into the oral cavity resulting in syncope. MRI and cine-esophagram demonstrated a large mass in the cervical esophagus. At the time of herniorrhaphy, endoscopy revealed an 11.8-cm hypopharyngeal mass that completely obstructed the oropharynx. RESULTS: The airway was secured by tracheostomy and the lesion was subsequently removed via open pharyngotomy. Postoperatively, a second polyp was found ball-valving into the airway, and an endoscopic resection was performed prior to decannulation. Histopathology of both lesions confirmed the diagnosis of a fibrovascular polyp. CONCLUSION: Fibrovascular polyps are rare benign intraluminal esophageal lesions resulting in mild symptoms of dysphagia that may also cause significant morbidity such as syncope and asphyxia. This is the first report of synchronous fibrovascular polyps of the hypopharynx.- - - - - - - - - - ranking = 1keywords = endoscopy (Clic here for more details about this article) |
5/5. Pharyngeal pouch carcinoma.Malignant change occurs in 0.3-10% of pharyngeal pouches, with longstanding pouches most at risk. Contrast radiology and endoscopy can detect large and medium sized tumors but are inadequate for small lesions and carcinoma in situ. Expectant treatment and conservative surgery fail to provide an excised pouch for histological analysis and small lesions may be missed. Consequently, careful consideration must be given to radical excision, particularly if the pouch has been longstanding. The role of radiotherapy in conjunction with surgery remains unproven.- - - - - - - - - - ranking = 1keywords = endoscopy (Clic here for more details about this article) |