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Biomedical subjects

H-G Kempf

Publications and source records attributed to H-G Kempf.

5 recordsLinked to original sources

[Salivary duct carcinoma of the sublingual gland--a case report].

RATIONALE: Pleomorphic adenoma is the most common neoplasm of major and minor salivary gland origin, followed by infectious reasons and sialolithiasis. Less common are adenocarcinomas presented. The salivary duct carcinoma represents a rare variant of the group of adenocarcinomas originated from the salivary glands, especially extremely rare from minor salivary gland origin. CASE REPORT: We report about a 52 year old male patient presenting with painless, non-ulcerating tumor at the floor of the mouth. Since 2 weeks ingestion was painful. Further ENT-investigations including endoscopy and scans (MRT, ultrasound) showed no pathology. In particular, growth of cervical lymph nodes and distant metastases were not revealed. A biopsy showed a rare salivary duct carcinoma of comedo-type originated from the left sublingual salivary gland. The patient underwent an operation: the tumor was extirpated in toto, and, as the pathohistological investigation confirmed, in sano. Additionally a neck dissection at the left side was performed, followed by the radiation of the tumor region and the lymphatic neck regions, after sufficient reconvalescence. The tumor-classification was pT3, pN0. Since 3 years no recurrence of the tumor was confirmed. DISCUSSION: Salivary duct carcinoma is a rare, high-grade malignant epithelial neoplasm, which occurs almost exclusively in the parotid. As presented, it can also occur in minor salivary glands. Histologically it is composed of structures that resemble expanded salivary glands. Comedonecrosis of these structures is a frequent feature. There is some histologic similarity to intraductal carcinoma of the breast. Differential diagnosis comprises adenoid cystic carcinoma, metastases of other adenocarcinomas, such as the carcinoma of the thyroid gland and the comedocarcinoma of the breast. Because of its poor prognosis a rapid and radical therapy is recommended. CONCLUSION: A rare case of a salivary duct carcinoma of sublingual salivary gland origin is presented. Usually the prognosis is poor. The adequate therapy is the complete surgical extirpation including the surgery of the regional lymphatic nodes and the additional radiotherapy.

Biopsy↗

[Choristoma in the vocal fold].

Choristoma in the larynx is rare and related to thyroid or glial tissue. The manifestation of salivary gland tissue in the larynx has not been reported to date. We present the case of an 80 year old male complaining of hoarseness and productive coughing. A left side tumourous swelling was seen in the larynx with intact vocal cord mobility. Using microlaryngoscopy the mass was resected without any intra- or postoperative problems. Histologically, a choristoma-heterotopic salivary gland tissue in the muscle and fat tissue--was found. The mucosa was intact and there were no signs of malignancy. Differential diagnosis of such masses in the larynx include benign lesions as well as specific infections, e.g. tuberculosis, sarcoidosis, amyloidosis and Wegener's granulomatosis. Especially in non-smokers, sarcoma, lymphoma and melanoma should be separated from the frequent squamous cell carcinoma of the laryngeal tissue. In rare cases, heterotopic tissue can mimic a tumourous mass. Intralaryngeal resection is the therapy of choice and should be recommended to the patient.

Aged, 80 and over↗

[The interesting case -- case no. 70].

We will report two cases of newborn girls, who could not be breast fed because of a benign tumour in their oral cavity. These polypoid lesions were located in both cases in the labial aspect of the dental ridge. Tumours were fleshy, firm, dark-brown with a broad-based attachment to the alveolar ridge. The underlying bone was not affected. The size of neoplasm was in one case 3 x 2 cm, in the other one 2 x 1.5 cm. Excision was performed in both cases at the day after birth. The postoperative course was uncomplicated. A regular oral feeding was immediately possible. Histological findings showed large tumour cells with abundant granular eosinophilic cytoplasm and a prominent vascularity. Cells did not show immunostaining for laminin or S-100 protein. All these findings are characteristic of congenital granular cell tumour and its synonym congenital epulis. There is a strong predilection for newborn females. It differs from adult granular cell tumours by its prominent vascularity, the presence of scattered remnants of odontogenic epithelium, and the strong phosphatase activity. These lesions are always cured by local excision. The exact nature of this condition is still not clear, and there is little support for its originating from odontogenic epithelial cells.

Age Factors↗

[Cochlear implants in adults: indications and realizations. Part I: Diagnosis, operation techniques and results].

From the technical point of view, cochlear implant (CI) surgery in adults is a well established procedure. Pre- and postoperative evaluation, surgical approach and rehabilitation programs are standardized, presenting CI as a low risk procedure with rare complications similar to those of middle ear surgery. Modern advanced CI devices offer technical reliability and multiple speech encoding strategies and recently, even small processors which are worn behind the ear. Further technical advances are continuously available, even for implanted patients. Upgrading is usually easy because the outer parts of the implant are exchangeable and software upgrades can be transmitted transcutaneously to the implant. Assuming that medical and rehabilitation requirements are available, there are only very few indications against CI in adults. Candidate patients should therefore be transferred to CI-centres where a decision can be taken depending on presurgical evaluation results.

Adult↗

[Cochlear implants in adults: indications and realization. Special cases and technical parameters of the implantation systems].

From the technical point of view, cochlear implant (CI) surgery in adults is a well established procedure. Pre- and postoperative evaluation, surgical approach and rehabilitation programs are standardized, presenting CI as a low risk procedure with rare complications similar to those of middle ear surgery. Part 1 described the diagnostics, surgical procedure and possible complications. The second part will cover the contraindications, special cases as well as the technical parameters of the modern implant system.

Adult↗