Alternative management of cutaneous squamous cell carcinoma in an elderly man: report of a case and review of the literature.
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Biomedical subjects
Publications and source records attributed to F Karam.
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Two cases of trabecular cell carcinoma of the skin are presented. The clinical presentation and behavior, and the histologic findings, of the tumor are described. Surgical excision of the primary lesion with regional lymph node dissection, if indicated, is the treatment of choice. Distant metastasis is treated by local irradiation.
Rhino-orbital cerebral mucormycosis is the most common manifestation of mucormycosis. In debilitated or acidotic patients, the presence of necrotic tissue should alert the examiner to the possibility of mucormycosis. Radical operation and proper management with early diagnosis should increase the patient's chance of survival.
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Experience with the use of a simple and practical nerve-excitability test in 56 cases of Bell's palsy has demonstrated its value in estimating prognosis and progress at an early stage of the disease.
Tumor involvement of the carotid artery with head and neck cancers may be present either simultaneously with the primary lesion or more often appears at a later date following resection of the primary tumor. Management of the secondary tumor consists of its resection together with the involved carotid artery with or without carotid artery reconstruction. The Authors are convinced that the best chance for cure of patients with advanced head and neck squamous cell cancers involving the carotid artery is radical extirpation with ablative surgery in the form of en block resection of the primary lesion, the secondary tumor, and the involved carotid artery followed by immediate revascularization. This bold approach was carried out in two male patients, 48 and 61 years of age, followed by chemotherapy and radiation therapy in one and radiation therapy alone in the other, with excellent results. Dermal grafts were placed over the entire length of the arterialized veins to protect them from radiation injury. Based on this limited experience and excellent results, we recommend this one-stage surgical ablative procedure in well selected patients. However, cooperation between the ENT and vascular surgeons, strict adherence to the principles and techniques of vascular surgery, and coverage of the arterialized vein with a dermal graft is absolutely essential.
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