Unique presentation of a giant mediastinal tumor as kyphosis: a case report

<p>Abstract</p> <p>Introduction</p> <p>Although posture distortion is a common problem in elderly patients, spinal deformity caused by a thymoma has not been previously reported. Thymomas are slowly growing tumors that predominantly cause respiratory symptoms.</p> <p>Case presentation</p> <p>We report the case of an 83-year-old woman who was admitted with a giant mediastinal mass that had caused progressive spinal distortion and weight loss to our department. The clinical and laboratory investigations that followed revealed one of the largest thymomas ever reported in the medical literature, presenting as a mass lesion placed at the left hemithorax. She underwent complete surgical excision of the tumor via a median sternotomy. Two years after the operation, she showed significant improvement in her posture, no pulmonary discomfort, and a gain of 20 kg; she remains disease free based on radiographic investigations.</p> <p>Conclusions</p> <p>In this case, a chronic asymmetric load on the spine resulted in an abnormal vertebral curvature deformity that presented as kyphosis.</p

Primary parotid gland lymphoma: a case report

<p>Abstract</p> <p>Introduction</p> <p>Mucosa associated lymphoid tissue lymphomas are the most common lymphomas of the salivary glands. The benign lymphoepithelial lesion is also a lymphoproliferative disease that develops in the parotid gland. In the present case report, we describe one case of benign lymphoepithelial lesion with a subsequent low transformation to grade mucosa associated lymphoid tissue lymphoma appearing as a cystic mass in the parotid gland.</p> <p>Case presentation</p> <p>A 78-year-old Caucasian female smoker was referred to our clinic with a non-tender left facial swelling that had been present for approximately three years. The patient underwent resection of the left parotid gland with preservation of the left facial nerve through a preauricular incision. The pathology report was consistent with a low-grade marginal-zone B-cell non-Hodgkin lymphoma (mucosa associated lymphoid tissue lymphoma) following benign lymphoepithelial lesion of the gland.</p> <p>Conclusions</p> <p>Salivary gland mucosa associated lymphoid tissue lymphoma should be considered in the differential diagnosis of cystic or bilateral salivary gland lesions. Parotidectomy is recommended in order to treat the tumor and to ensure histological diagnosis for further follow-up planning. Radiotherapy and chemotherapy should be considered in association with surgery in disseminated forms or after removal.</p

Eyelid melanoma: Our experience a propos of 23 cases [Le mélanome palpébral : Notre expérience à propos de 23 cas]

Introduction: Eyelid melanoma is a rare condition corresponding to less than 1% of all eyelid malignancy. The aim of the current study is to present the experience of our department. Patients and methods: From 1986 to 2009, 972 patients with a melanoma have been studied retrospectively. Each patient was evaluated in relation with age, sex, location of the tumor, histology (Breslow and Clark included), surgical treatment, recurrence, and finally with follow up. Results: Twenty-three patients with eyelid melanoma and a strong female incidence (69.5%) were identified. Median age was 68.3 years. In most cases (71.4%), tumor was located on the right inferior eyelid in continuity with the malar region. LMM had the higher incidence (60.8%), followed by the nodular melanoma (21, 7%) and the SSM. The median Breslow was 0.77 while the median Clark 1.68. Surgery was the treatment of choice including direct closure, the use of full thickness skin graft and local or regional flaps. Three patients had local recurrence associated to nodular metastases in one of them. Conclusion: Surgical treatment of eyelid melanoma is a challenge for every reconstructive surgeon. Early detection remains the &quot; gold standard&quot; for every reconstructive option respecting the esthetic and function of this precious anatomic location. © 2011 Elsevier Masson SAS

Unique presentation of a giant mediastinal tumor as kyphosis: A case report

Introduction. Although posture distortion is a common problem in elderly patients, spinal deformity caused by a thymoma has not been previously reported. Thymomas are slowly growing tumors that predominantly cause respiratory symptoms. Case presentation. We report the case of an 83-year-old woman who was admitted with a giant mediastinal mass that had caused progressive spinal distortion and weight loss to our department. The clinical and laboratory investigations that followed revealed one of the largest thymomas ever reported in the medical literature, presenting as a mass lesion placed at the left hemithorax. She underwent complete surgical excision of the tumor via a median sternotomy. Two years after the operation, she showed significant improvement in her posture, no pulmonary discomfort, and a gain of 20 kg; she remains disease free based on radiographic investigations. Conclusions: In this case, a chronic asymmetric load on the spine resulted in an abnormal vertebral curvature deformity that presented as kyphosis. © 2012 Spartalis et al; licensee BioMed Central Ltd

Lip defects due to tumor excision: Apropos of 899 cases

Reconstructive surgery of the lips after resection of tumors requires a complete understanding of the anatomy of this region. Most lip cancers remain localized and grow slowly, with a propensity for superficial rather than vertical spread. From January 1983 to December of 2005, 899 patients underwent reconstructive surgery for skin tumors involving the lips. SCCs were the most frequent skin tumors on male patients whereas BCCs were most common on the female patients. The lower lip was the anatomic zone most frequently involved in our series. Preoperative evaluation of the patients was performed in all cases. In the last five-years, we have performed preoperative fine needle aspiration (FNA) biopsy of the tumor. The FNA sample was then examined by ThinPrep technique (Cytolyt; Cytyc, Co, Boxborough, MA, USA). In our series, from the 550 patients who had a five-year follow-up we observed 62 recurrences of the primary tumor. The five-year recurrence rate was 11.28%. The aim of this retrospective study is to report our experience in the treatment of lips tumors with selective combination of treatment modalities. © 2006 Elsevier Ltd. All rights reserved

One-stage reconstruction of the antihelix and concha using postauricular island flap

Tissue defects in the antihelix and the concha due to oncological resection and trauma can be successfully repaired with a subcutaneously based postauricular island flap. Alternative methods of regional reconstruction usually need two stages or may require grafts in some patients. We present the one‐stage technique, as described by Masson, without grafts, to provide adequate reconstruction and aesthetic restoration of the area, illustrated by 62 patients. In all patients there has been a follow‐up period of 12 months. This report provides evidence for the aesthetic superiority of this method. An excellent aesthetic outcome was achieved in 46 patients, an adequate outcome in 15 patients, and a poor result in only 1 patient. No flap necrosis was observed. The method has considerable advantages for the repair of anterior conchal and antihelical defects

Reconstructive surgery for kidney transplant recipients

Many decades have passed since the first kidney transplantation, which is now the most common organ transplant performed worldwide. Despite the impressive advances, some patients may develop posttransplant complications that require proper management and treatment. The plastic and reconstructive surgeon, among others, may be called on to help resolve a number of reconstructive problems present in the immunosuppressed kidney recipients. This study presents our experience with 41 kidney recipients who needed plastic surgical treatment. Patients were placed into one of three study groups according to the type of posttransplant surgical condition. Group 1 included 17 patients with posttraumatic wound healing problems; group 2, 17 patients with skin tumors; and group 3, 7 patients with other posttransplant surgical complications. Only two of these patients had early posttransplant wound dehiscence; the remaining patients suffered late complications. In conclusion, the kidney recipient can successfully undergo minor or major reconstructive procedures. The possibility of surgical problems arising during the early posttransplant period presents increased complication rates, possibly due to high immunosuppressive drug levels

Use of the hemifrontal flap in reconstruction of the forehead

The hemifrontal flap is an efficient way of reconstructing large unilateral defects that involve the hemiforehead. Six patients had their foreheads reconstructed after the excision of neglected tumours in the frontal region. The flap was designed to provide adequate repair of large defects including the periosteum. The width of the flap above the eyebrow is almost equal to the vertical height of the forehead in the midline. Efficient reconstruction of the primary defect including surface and depth was achieved in all patients. There were no complications with the viability of the flap. The hairline and the line of the eyebrows were preserved in their original sites, with no alteration in the aesthetic landmarks of the forehead in 3 cases, where there was no invasion of tumour. © 2008 The British Association of Oral and Maxillofacial Surgeons

Reconstruction of elbow flexion with a modified Oberlin procedure: A comparative study

Introduction: In upper brachial plexus injuries (C5-C6-C7), selective nerve transfers appear as a favourable technique. For this purpose, transfer of an ulnar nerve fascicle to the biceps motor branch (Oberlin&apos;s procedure) is often used. In this paper we present our modified Oberlin technique, as well as a comparison of this method with the classic Oberlin procedure. Materials and Methods: We present two groups of patients that where operated by two different surgeons. The first group, consisting of 16 patients was treated with the classic Oberlin procedure. The second group included 5 patients treated with a modified Oberlin procedure, where two fascicles from the ulnar nerve were transferred to both the motor branch of the biceps and the motor branch of the brachialis muscles. Results: In the last follow-up of the 16 patients from the first group with the classic Oberlin procedure, 15 patients (93.75%) had Medical Research Council (MRC) grade of biceps strength 4 and 1 patient (6.25%) had MRC grade 3, whereas in the group where the modified Oberlin procedure was used the muscle strength was very durable with 4 out of 5 the patients reached MRC grade of 4+ and one MRC grade of 4, and with a mean elbow strength at 5.4 kg (3–8 kg). No sensitivity or motor problems were encountered on the ulnar territories for both groups. Conclusion: With the modified Oberlin technique, the median nerve is reserved and both elbow flexors are innervated. The results of this technique compare favourably with those of other methods. Thus, we propose using the double fascicle transfer from the ulnar nerve to both elbow flexors in order to restore a strong elbow flexion in patients with upper brachial plexus injuries. © 2019 Elsevier Lt