Cases reported "Pharyngeal Neoplasms"

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1/24. Pharyngo-oesophageal haemangioma with a positive cough impulse.

    Benign tumours of both the pharynx and oesophagus are rarely seen, cavernous haemangiomas even less so. We present a case in which a large lesion was the cause of non-specific symptoms but which only appeared intermittently on nasendoscopic examination of the pharynx.
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keywords = esophagus
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2/24. Extended esophagolaryngeal resection with parathyroid autotransplantation.

    Esopharyngolaryngeal resection for carcinoma of the cervical esophagus must be accompanied by resection of the thyroid gland, parathyroid bodies, and regional lymph nodes. In order to reduce long-term morbidity associated with the procedure, we performed parathyroid autotransplantation in two patients who underwent esophagolaryngeal resections. Grafting of the upper two parathyroid glands into the sternocleidomastoid muscle was carried out successfully in both cases. Graft function was rapidly restored. During the third postoperative week, blood levels of intact parathormone (PTH) reached 20 pg ml(-1) in the first case and 15 pg ml(-1) in the second, and the patients were successfully weaned off calcium and vitamin d supplementation. Parathyroid autotransplantation should be attempted in all cases of esophagolaryngeal resections provided that parathyroid glands are free of malignancy.
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ranking = 1
keywords = esophagus
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3/24. Resection of a large benign pharyngo-oesophageal submucous mesenchymoma via laterocervical approach.

    Two rare cases of benign submucosal pharyngo-oesophageal mesenchymoma are presented in this paper. One patient was treated by tumour removal via a combined thoracic and laterocervical approach and the other by resection through a laterocervical approach. The paper discusses the pathology and diagnosis of benign mesenchymomas. The authors suggest that for large tumours located in the pharynx and extending down the oesophagus without adhesion to the oesophageal wall, the laterocervical approach can avoid complications associated with the thoracic approach. The new technique caused less tissue damage and provided a quicker recovery and shorter hospitalization.
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keywords = esophagus
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4/24. 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.
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ranking = 1
keywords = esophagus
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5/24. A simplified design of a dual island fasciocutaneous free flap for simultaneous pharyngoesophageal and anterior neck reconstruction.

    Reconstruction of the pharyngoesophagus and pharynx can be especially challenging in patients with prior irradiation, recurrent disease, and compromised or deficient anterior neck skin. The authors report their experience with seven patients who underwent pharyngoesophageal reconstruction with a new flap design that addresses both the concerns of monitoring the internal skin tube and replacing the external neck skin with one flap. This design has two skin islands, one that is tubed and the other left flat. The authors call this design "the paddle flap" because together its two components resemble a paddle. The tubed portion resembles the "handle" of a paddle that is used for esophageal reconstruction, and the cutaneous paddle is then folded over the "handle" to provide external skin. The external skin portion of the flap not only provides an external monitoring segment but releases tension on the neck apron incision and may replace compromised native neck skin. The length of esophageal defects ranged from 4 to 11 cm and the anterior cervical skin requirements ranged from 4 x 2 cm to 10 x 12 cm. Follow-up has been between 18 months and 4 years. There were no partial or complete flap losses. All patients are currently tolerating an oral diet. There was one case of partial donor-site skin graft loss which was treated with re-grafting. There were two cases of stricture formation which were treated successfully with neo-esophageal dilatation. This new simple, versatile design of a cutaneous free flap addresses both concerns of monitoring the internal skin tube and dealing with compromised overlying skin in patients undergoing pharyngoesophageal reconstruction. The paddle flap design can be utilized with any thin cutaneous free flap and may offer an advantage when an external monitor is desired and anterior neck skin requires supplementation or replacement.
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ranking = 1
keywords = esophagus
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6/24. Tumor of the hypopharynx: free jejunal transfer with conservation of the larynx: a case report.

    Resection of the hypopharynx or cervical esophagus for malignancy is always quite mutilating if reconstruction cannot be achieved with a one-stage procedure. Several techniques have been described, but they are often associated with laryngectomy. In the case reported, a free split jejunal segment transfer allowed reconstruction of the hypopharynx without laryngectomy, as the malignancy did not involve the larynx.
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keywords = esophagus
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7/24. Large hypopharyngeal polyp producing intermittent dysphagia and acute airway obstruction.

    A 65-yr-old man who developed sudden respiratory arrest was found to have a long, smooth, esophageal filling defect on esophagogram. endoscopy eventually proved this to be a large esophageal polypoid lesion that had arisen in the hypopharynx and extended to the midesophagus. He was successfully treated with a lateral pharyngotomy and excision of the hypopharyngeal polyp.
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ranking = 1
keywords = esophagus
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8/24. Zenker's diverticulum- carcinoma of the esophagus?

    Malignant change may occur in a pharyngo-esophageal diverticulum and although it is rare, a small number of cases has been reported. A similar case is reported here to contribute to the awareness of the existence of such an entity.
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ranking = 4
keywords = esophagus
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9/24. Extrapulmonary oat cell carcinoma.

    Primary extrapulmonary tumors with histologic features indistinguishable from bronchogenic oat cell carcinoma are appearing with increasing frequency in the literature. These tumors have been described in the esophagus, stomach, pancreas, larynx, hypopharynx, salivary glands, nasal cavity and paranasal sinuses, thymus, small and large bowel, uterine cervix, endometrium, breast, prostate, urinary bladder, and skin. It is now widely believed that oat cell carcinoma is a poorly differentiated counterpart of carcinoid tumor and that both originate from an endocrine cell system. In this article, the authors review all cases of extrapulmonary oat cell carcinomas, which they were able to find in the English literature, and report personally studied examples of these tumors, occurring in the esophagus, stomach and urinary bladder. A closely related, if not identical, tumor arising in the skin is also described. It is emphasized that a wider recognition of these tumors is likely to lead to their more frequent diagnosis and possible treatment.
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ranking = 2
keywords = esophagus
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10/24. Combined treatment of advanced cancer of the laryngopharynx and cervical esophagus.

    Advanced cancer of the laryngopharynx and cervical esophagus is difficult to treat because of the malnutrition produced by pain and obstruction and the problems related to reconstruction. This paper presents the initial results of a regimen used in 14 patients in which there is rapid reversal of nutritional deficiencies, radical resection, and reconstruction using the gastric pull-up technique and administration of postoperative radiotherapy. Excellent overall palliation and decreased hospitalization have been achieved using this regimen without diminishing chances for cure.
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ranking = 5
keywords = esophagus
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