Biomedical subjects
Publications and source records attributed to F de Miguel García.
We present one case of a neuroendocrine carcinoma of nasal fossa and paranasal sinuses, of aggressive behavior, which has been controlled with chemo-radiotherapy after a double postsurgical recurrence. We do a literature revision emphasizing the anatomopathologic differentiation of these tumors with the olfactory neuroblastomas, and the therapeutic controversies in advanced stages.
Kikuchi-Fujimoto's disease (KFD), Histiocytic Necrotizing lymphadenitis, is a rare self-limiting condition characterized by lymphadenopathy, fever and neutropenia. The aetiology of KFD is controversial, and its diagnosis is confirmed histologically. Although KFD has rarely been reported associated to Systemic lupus erythemotosus (SLE) should be ruled out given its different prognosis and management. We present the clinical, histological and evolution the two cases of patients with Kikuchi's disease; one case had evolution classic and the other case were associated with SLE.
Tosillectomy or palatine tonsils removal was by far as the very middle of the twenty century the commonest surgery in childhood, but owing to the abstinence behavior in past decades this operation has dropped considerabily and in consequence numerous grown up presents frequently tonsillar pathology requiring its removal in middle adult life.
We decided to review the results of cordectomy in our surroundings over the 22 years of existence of our Service. 631 clinic histories of patients undergoing surgery for laryngeal cancer in our Department, between 1974 and 1990, were reexamined, and from those selected 56 pertaining to T1 tumors treated with cordectomy. In this reduced group were studied epidemiology, clinical and pathologic data, complications, survival and death causes as well. The 58 considered were of male sex, middle aged (58-86) excepting 9 patients under 50. Their relation with tobacco eas clear, although less than in our general series (87.93% smokers). Of the 58 patients group 4 of then disappear during the 5 years follow-up term (8.62%). Three died: one from ganglion disease, other from local recurrence and the last one from other condition. In brief, global survival are accounted for 94.34% and the adjusted survival was 96.1%.
After 20 years of existence of this Department we decided to carry out a review of the characteristics of our series and also of the results of treatment, according to the protocol elaborated and followed in agreement with the Tumour Committee if the Hospital. 631 medical histories of patients diagnosed and operated for cancer of larynx between 1974 and 1990 were reviewed. 83 of which (13.154%) disappeared during the 5 year follow-up period. Epidemiological, clinical, location, extension and treatment fdata were considered as well as the survival results and a single descriptive statistical analysis performed. The mean age of our study was 59.02 years, showing a clear relation to exposure to tobacco (91.44% were smokers and 63.39% of more than 20 cigarettes per day). The predominant location of the growth was supraglottic (64.05% of cases) followed by glottic in 33.76%. The most frequently used surgical technique was the total laryngectomy and total and extended to either the pharynx or tongue basis in 76.28%, followed by supraglottic laryngectomy in 13m5%. The stages were rather advanced with predominance of stage III /40.60%) and stage IV (21.17%). Global survive rate of our series accounted for 68.61% while the adjusted survival rate was 71.4%.
Inverted papilloma (PI) is a benign neoplasm of nose and paranasal sinuses. IP's pathophysiology is characterized by its capacity to be locally destructive, its ability to grow rapidly and its tendency to recur. IP's association with carcinoma is about 13 percent of cases. The surgical treatment of IP has evolved over the years, with a progression toward more radical en bloc extirpation. The paper reports an inverted papilloma case of nasal cavities, with destruction of frontal sinus roof and intracranial extension aside frontal lobe displacement.
UNLABELLED: The causes of death were studied in a series of 171 patients who died in a 5-year follow-up period, out of a total of 631 patients who underwent different surgical techniques for cancer of the larynx. MATERIAL AND METHODS: The case histories of 631 patients who had undergone surgery between 1974 and 1990 were reviewed; 83 did not have a 5-year follow-up and were excluded from the study. A descriptive and inferential statistical study was made of the remaining cases to determine the relation between cause of death and tumoral extension, primary location, degree of tumoral differentiation, surgical technique and other data. RESULTS: Ninety-one patients died from local or regional recurrence, 50 from distant metastases, 20 from diseases other than the tumor, and 10 from postoperative complications. These findings were studied with regard to factors such as tumor extension, location, surgical technique, etc. CONCLUSIONS: The main cause of death in surgery for cancer of the larynx was recurrence, either local, on the tumor bed (62 patients) or regional (29 patients). The mortality rate was higher in older patients, patients with lymph-node involvement in the postoperative histological study, and patients with less differentiated histological forms.
This is a retrospective study dealing with 719 primary stapedectomies and 48 reoperations done between 1975 and 1993 by the AA. of the paper. They consider the audiometric tracings before and after surgery (6 and 12 months). Frequencies analyzed were 250 Hz, 500 Hz, 1000 Hz, 2000 Hz and 4000 Hz; the air-bone gap; and modifications of bone thresholds. The patients were ranged in groups according the ages and previous bone thresholds. Thereafter an analysis aiming to a comparison of surgery results en each group was contemplated. The age resulted without influence on the postoperative gap neither in modifications of bone conduction. The previous bone thresholds nor influencing the final gap. Conversely there are significative differences (P > 0.01) regarding the modifications of bone conduction.
Anterior sitting is the most frequent localisation of frontal or ethmoidal mucocele. Generally its evolution is slow, but some times they evolve as acute inflammatory processes. The AA. report 2 paradigmatic cases of each course. The CAT shows the thinning out of the bone and the spreading of the disease. Comments on the symptomatology, exploratory means and differential diagnosis with other sinusal or orbital conditions.
A case of Extramedullary Plasmacytoma of nasopharynx is reported in a 41 years old man. The presenting symptom was bilateral nasal obstruction. Multiple Myeloma was excluded. The treatment was surgical excision and postsurgical radiotherapy. At present the patient is well.
Lymphangioma is a benign, congenital type of tumour which can be classified as a malformation of the lymphatic vessels with an enlargement and a proliferation of same. It is divided, depending on the calibre of the vessels, into Capillary, Cavernous and cystic. 80% of these lesions are located in the neck; 50% of these cases are already evident at the moment of birth and 90% prior to the 2nd year of life. Its treatment is surgical but, due to the large number of digitations present, its complete removal is difficult to achieve, thereby giving rise to frequent relapses. We are submitting the case of a three and a half-year-old girl who was operated on in our department. With this, we would like to contribute to a greater knowledge of this pathology.
The inflammatory pseudotumor of the head and of the neck is a lesion of unknown etiology which affects the orbita more frequently but cases have also been described in the paranasal sinuses, larynx, mouth, cervical column and by direct extension from the orbita in the Central Nervous System. In the majority of cases, it behaves as a limited benignant inflammation within the osseous walls of the area where it is to be found; other times it destroys the osseous limits and invades the surrounding areas, behaving as a neoplasia. It must be distinguished from sinusitis, granulomatous inflammations, vasculitis, diseases of the collagen, sarcoidosis, neoplasias and benignant tumours. We present a case of inflammatory pseudotumour, occupying the right maxillary sinus, nasal fossa and rhinopharynx. Surgical extirpation has been the treatment used.
We present the case of a 14 years old male with juvenile nasopharyngeal angiofibroma, treated in our Department with radiotherapy due to the patient having declined surgery. In the control carried out 2 years after finishing radiotherapy the tumour had disappeared. Up to now, we have not found important secondary effects of the treatment. We go over what has been published during the last few years about this disease.
The neoplasms from the modified apocrine glands of the external auditory canal are usually included under the term ceruminoma without any reference to their histology, clinical course or prognosis. It seems better to classify them according to their histologic pattern in the following types: 1.--Ceruminous adenoma, 2.--Adenoid-cystic carcinoma, 3.--Adenocarcinoma, and 4.--Pleomorphic adenoma (mixed tumour). We describe a case of adenoid-cystic carcinoma originated at postero-superior wall of the external auditory canal which presented as an otitis of long duration, and was treated surgically and received post-operative radiotherapy. The patient is at present free of disease. We review the literature on this group of tumours of the EAC.
Thirty four cases of patients with nasopharyngeal cancer, all white people, are reviewed. The more frequent clinical signs are, in order of frequency: nasal obstruction, which is presented in 65% of patients, transmission deafness, in 59%; adenomegalies in 44%; epistaxis in 26% and migraine in 21% of cases. The mean time evolution between the first clinical symptom and the treatment was four and a half months. The pathologic study was: epidermoid carcinoma in 31 cases (91.9% and non-Hodgkin lymphoma in 3 cases 8.9%). The 31 cases of epidermoid carcinoma were treated with radiotherapy and the 5 years survival was 38%. In 62% of cases, the tumor recurred locally, in lymph nodes or were distant metastasis.
We presented a case of a 60 years old woman, with a previous history of an intervention upon the frontal sinus 35 years ago, who was diagnosed and operated at our service from mucocele of frontal sinus. We profit this occasion to carry through a revision of bibliography, to contribute at better knowledge of mucoceles about their clinic, pathogenic, diagnostic and therapeutic aspects.
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A retrospective review was made of 719 primary stapedectomies and 48 re-operations carried out between 1975 and 1993. Preoperative and postoperative audiograms (6-12 months) were studied, analyzing 250, 500, 1000, 2000 and 4000 Hz, auditory gain and closure of the air-bone gap < or = 10 dB. Ninety percent had an auditory gain of > or = 10 dB at conversational frequencies. Age, the surgeon, and average preoperative pure tone did not influence the final result. Polyethylene prostheses (70.9%) and steel and teflon pistons (21.1%) were the prostheses used most often. Neurosensorial hearing loss (> 10 dB) occurred in 24 cases (3.3%). In revision stapedectomy, 66.6% of patients had air-bone gap closure of < or = 20 dB and 71% had a hearing gain of < or = 10 dB. Prosthesis displacement (43.7%) and incus necrosis (18.7%) were the most common findings in revision stapedectomy.