Cases reported "Tongue Neoplasms"

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11/197. Squamous cell carcinoma of the tongue as a second malignancy in a patient previously treated for osteosarcoma.

    A 15-year-old girl was diagnosed with osteosarcoma; limb salvage surgery was performed after preoperative chemotherapy. Postoperatively, adjuvant chemotherapy was given for 2 years. One year after completion of chemotherapy, the patient was readmitted for systemic recurrence. amputation of the lower extremity and wedge resection of lung metastasis were performed followed by combination chemotherapy. Two years after cessation of chemotherapy, ulcer of the tongue was noted and cervical lymph nodes were detected by palpation. biopsy of the lesion showed squamous cell carcinoma. The patient underwent a radical partial tongue resection and postoperative irradiation, followed by chemotherapy. Six years after treatment for the second malignancy, the patient remains well without evidence of disease. Squamous cell carcinoma of the tongue as a second malignancy after treatment of osteosarcoma is quite rare. Long-term follow-up, with particular attention to the head and neck, may be warranted in children treated for osteosarcoma.
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12/197. New multilobe "accordion" flaps for three-dimensional reconstruction of wide, full-thickness defects in the oral floor.

    When reconstructing a wide, full-thickness intraoral defect, the following principles are necessary for active food transport and improved swallowing and speech. First, the flap should touch the palate and obliterate the oral cavity. Second, jaw or flap excursion should not be hindered by tethering of the flap in the neck. And third, all surfaces of the tongue and oral floor, and the dead space of the floor should be reconstructed. To accomplish these goals, two new designs, similar to an accordion, using an anterolateral thigh flap and a deep inferior epigastric perforator flap have been developed. The outlines of multilobe flaps create an accordion-type structure of the tongue and oral floor complex. The advantages of the new designs using anterior thigh or deep inferior epigastric perforator flaps are follows: First, three-dimensional intraoral reconstitution allows maximal movement postoperatively of the reconstructed tongue. Second, the donor sites are so far from the tongue that simultaneous flap elevation is possible for tumor resectioning. Third, even in obese patients, totally or partially thin flaps are available. And fourth, in most patients the donor defects can be closed directly.
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13/197. Oral carcinoma in a young man: a case of dyskeratosis congenita.

    We report a 28-year-old male with a voluminous growth of the tongue, present for 6 months. The histological examination revealed a squamous cell carcinoma. The patient was also affected by oral leukoplakia, nail dystrophy, reticulated poikiloderma of the neck and hyperkeratosis of palms and soles. On the basis of clinical features and histological findings, as well as findings from the family, the diagnosis of dyskeratosis congenita (DKC) was made.
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14/197. Radial forearm free tissue transfer for head and neck reconstruction: versatility and reliability of a single donor site.

    Since its description as a free flap, the radial forearm flap has undergone numerous modifications for reconstruction of various defects in the head and neck region. Fasciocutaneous, adipofascial, osteocutaneous, tendinofasciocutaneous, or osteotendinofasciocutaneous flaps may be designed and transferred from the radial forearm. This article illustrates the versatility and reliability of this donor site in 15 patients with a variety of head and neck oncologic defects who underwent immediate (12 patients) and delayed (3 patients) reconstruction using different free flaps from the radial forearm. skin flaps were used in 11 patients (73.3%) with floor of mouth (4 cases), hemiglossectomy (2 cases) and partial maxillectomy (2 cases) defects, and for scalp (1 case), lower lip (1 case) and a central face (anterior maxilla/upper lip/nasal) (1 case) defect. Osteocutaneous flaps were used in four patients (26.6%) for reconstruction of bilateral subtotal maxillectomy defects (2 cases), a complex forehead and nasal defect (1 case), and for mandible reconstruction (1 case). In addition, the palmaris longus tendon was included with the flap in the two patients that required oral sphincter reconstruction. One patient required reexploration due to vein thrombosis, and no flap failures were detected in this series. The donor site healed uneventfully in all patients, except one, who had partial skin graft failure. Because of their multiple advantages, free flaps from the radial forearm have a definite role for reconstruction of head and neck defects. New applications of composite flaps from this donor site may continue to emerge, as illustrated in some of our patients.
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keywords = neck
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15/197. Local treatment of AIDS-associated bulky Kaposi's sarcoma in the head and neck region.

    Kaposi's sarcoma (KS) is frequently seen in the head and neck regions of hiv-infected patients. We report two cases of patients with AIDS who consulted the ENT clinic. One patient came to our clinic complaining of abnormal sensations in the pharynx, and dysphasia due to a gross KS in the oropharynx. The excision of the tumor improved the difficulty of swallowing. The other patient complained of masticatory problems and tongue pain due to a bulky KS on the dorsal side of the tongue. We treated the tongue lesion with intralesional chemotherapy. The administration of intralesional vinblastine resulted in a partial response. Unless systemic chemotherapy is effective enough to improve a functional disorder, it is thought that local therapy employing excision or intralesional chemotherapy is one of the common therapeutic option of the otolaryngologist, because this treatment avoids severe side effects caused by systemic chemotherapy or radiotherapy.
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keywords = neck
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16/197. Proliferative myositis arising in the tongue.

    We describe a rare case of proliferative myositis affecting the lateral border of the tongue. The site of the lesion and its gross pathological presentation were highly suggestive of a malignant process. Subsequent biopsy and characteristic histological appearance led to the diagnosis of this benign condition. This is the first reported case of a painful presentation of proliferative myositis involving the tongue. This report serves to remind the head and neck surgeon of the need to obtain histological diagnosis of malignancy before embarking upon radical surgical treatment. We recommend careful follow-up to ensure complete resolution of the lesion.
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17/197. osteoradionecrosis of the mandible.

    osteoradionecrosis is a major complication of surgery or trauma in previously irradiated bone in the absence of tumor persistence. radiation-induced vascular insufficiency rather than infection causes bone death. It occurs most commonly in the mandible after head and neck irradiation. risk factors include the total radiation dose, modality of treatment, fraction size and dose rate, oral hygiene, timing of tooth extractions as well as the continued use of tobacco and alcohol. This condition is often painful, debilitating, and may result in significant bone loss. The recommended treatment guidelines are irrigation, antibiotics, hyperbaric oxygen therapy, and surgical techniques, including hemimandibulectomy and graft placements.
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keywords = neck
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18/197. Transient hemi-diaphragmatic paralysis following neck surgery: report of a case and review of the literature.

    Diaphragmatic paresis following trauma to the phrenic nerves is a rare complication after neck surgery. The resulting elevation of the ipsilateral hemi-diaphragm is diagnosed on post-operative chest radiography and may be confirmed by ultrasound or fluoroscopy. When unilateral, this may lead to respiratory, cardiac or gastrointestinal symptoms and atelectasis and pulmonary infiltrates on radiography. If nerve damage is bilateral a period of ventilation may be required.
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ranking = 5
keywords = neck
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19/197. Metastasis of head and neck carcinoma to the site of percutaneous endoscopic gastrostomy: case report and literature review.

    BACKGROUND: patients with head and neck cancer often need a percutaneous endoscopic gastrostomy to provide adequate nutrition because of inability to swallow after tumor radiation therapy. However, metastasis of the original tumor to the gastrostomy exit site may occur. methods: We describe the case of a 61-year-old man with stage III (T2 N1) squamous cell carcinoma of the tongue in whom a PEG tube was placed to circumvent anticipated difficulties in swallowing after radiation therapy. We also compare this case with similar cases in the literature. RESULTS: Soreness and erythema near the gastrostomy site reported by the patient were diagnosed as cellulitis, and two courses of antibiotic treatment were prescribed. However, a biopsy showed that the original squamous cell carcinoma had metastasized to the gastrostomy exit site. The "pull" method of tube placement had been used in this patient and in all 19 cases of metastasis reported in the literature. CONCLUSIONS: Metastatic cancer should be considered in patients with head and neck cancer who have unexplained skin changes at the gastrostomy site. Our experience with this case and review of the literature indicate that, in patients with head and neck cancer, "pull" procedures for placement of gastrostomy tubes may induce metastasis by direct implantation of tumor cells because of contact between the gastrostomy tube and tumor cells. methods of tube insertion that avoid such contact are preferred.
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ranking = 7
keywords = neck
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20/197. Malignant fibrous histiocytoma of the tongue.

    A case of malignant fibrous histiocytoma, which developed in the tongue of a 16-year-old girl is presented. Surgical excision with, or without, radical neck dissection is the treatment of choice of this type of lesion.
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ranking = 1
keywords = neck
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