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At least 1,009 records · Page 56Linked to original sources
PubMed2004

Cervical sympathetic chain schwannoma.

OBJECTIVES: Schwannomas are benign, slow-growing tumors that arise from nerves. Those originating from the sympathetic cervical chain are rare. We describe our experience with the clinical presentation, surgical management, and outcomes of patients with this pathology. STUDY DESIGN: Retrospective chart review of a case series in a tertiary referral center. METHODS: Four cases of cervical sympathetic chain schwannomas were reviewed. Patients presented with either an asymptomatic neck mass discovered on routine physical examination (1 patient), an enlarging neck mass (2), or an acute onset of a Horner's syndrome (1). All patients underwent preoperative imaging (magnetic resonance imaging, computed tomography, or both). RESULTS: The location and soft-tissue characteristics of the mass, along with displacement of the carotid sheath vessels, were typical of a cervical sympathetic chain schwannoma. All patients underwent surgical excision of the mass. Postoperative Horner's syndrome was encountered in all patients. First bite syndrome was encountered in two patients. CONCLUSIONS: Cervical sympathetic chain schwannomas are rare tumors. Preoperative imaging characteristics facilitate the diagnosis. First bite syndrome can occur and may be debilitating postoperatively. Long-term prognosis is excellent.

Aged↗
PubMed1988

Spontaneous isolated mesenteric fibromatosis. Report of a case.

A rare case of spontaneous isolated mesenteric fibromatosis (mesenteric desmoid) unassociated with Gardner's syndrome or prior abdominal surgery is presented. Computed tomography revealed a nonenhancing, well-defined, large, soft-tissue mass in the mesentery. The clinical and radiographic features of mesenteric fibromatosis are reviewed and the differential diagnosis is discussed.

Adult↗
PubMed2006

Cholecystocolocutaneous fistula: a case report.

BACKGROUND: Cholecystocolocutaneous fistula (CCCF) is a rare complication of gallstone disease resulting from spillage of gallstones from perforation of an empyema of the gallbladder, which can pose diagnostic dilemmas. We describe a patient, who presented initially with a swelling followed by discharging sinuses on her right flank where a diagnosis of CCCF was made and was treated surgically with satisfactory outcome. METHODS: A computed tomography (CT) scan showed an ill-defined soft tissue mass in the right subhepatic space and a fistulogram demonstrated passage of contrast into the gallbladder fossa and hepatic flexure of colon. At laparotomy, a cutaneous fistula containing two pigment stones led to the gallbladder fossa and hepatic flexure of colon. RESULTS: Debridement of infected granulation tissues which had replaced the gallbladder, closure of the cystic duct stump and colonic fistula followed by excision of the fistula tract led to complete resolution. CONCLUSIONS: CCCF is a rare complication of perforated gallbladder with spillage of calculi, and a fistulogram is helpful in establishing the diagnosis. This case highlights the importance of retrieving spilled stones following interventions in the gallbladder to prevent the complication.

Aged↗
PubMed1998

[Accuracy of computerized aid diagnosis, surgical simulation and facial appearance prediction in orthognathic surgery].

OBJECTIVE: The purpose of this report is to evaluated the accuracy and potential advantages of the computer system in orthognathic surgery. METHODS: The accuracy of computer prediction was evaluated in 31 patients by using the orthognathic surgery prediction expert system (OSPES) in the preoperative analysis, diagnosis, surgical simulation and preoperative facial appearance predication. RESULTS: This system could accurately predict the postoperative changing. The prediction accuracy for single-jaw surgery was over 95%; double-jaw 85%. The prediction for hard tissue was more accurate than that for soft tissue. CONCLUSION: The results of this study suggest that computer system is an acceptable tool for facial appearance prediction.

Computer Simulation↗
PubMed1989

[Radiologic techniques for the evaluation of the T.M.J].

A large number of techniques are available for the soft and hard tissue evaluations of the temporomandibular joint. For an initial hard tissues examination conventional methods are indicated. If a more particular evaluation of the hard tissues is necessary conventional tomography, and especially hypocycloidal variety may be used. Of course modern tomographic techniques like computed tomography and magnetic resonance imaging afford more particular imaging of the hard mainly and the soft tissues of the temporomandibular joint. In cases where soft tissues (disc, posterior ligament) evaluation of the joint is necessary, arthrographic techniques as methods of choice are indicated. In addition computed tomography and magnetic resonance imaging may be used as they image hard and soft tissues synchronously, something which is important as the osteoarthritis frequency increases with meniscal disorders. In this study, we are discussing the radiologic techniques we use for T.M.J. radiologic evaluation and show cases that we have examined and diagnosed.

Arthrography↗
PubMed2002

Imaging the cerebrovascular tree in the cadaveric head for planning surgical strategy.

OBJECTIVE: The objective of the study was to identify whether an integration of cadaveric dissections with preoperative imaging information may enable a better understanding of pathological anatomy, especially vascular lesions, and thus allow for greater precision in surgical planning. METHODS: We selected a computed tomographic contrast agent and experimentally determined the proportion of it that could mix compatibly with the silicone compound. The resultant mixture was injected into the cerebrovascular systems of six fresh human cadaveric heads. The specimens underwent computed tomography for the purpose of digital virtual exposures in parallel with laboratory dissections performed on these specimens. RESULTS: The 1:8 ratio of contrast agent to silicone rubber was determined to be appropriate for both computed tomography and subsequent laboratory dissection of the specimens. The blood vessels in computed tomographic scans demonstrated a higher attenuation than surrounding soft tissues. The opacity consistency of the injected vessels was a critical parameter for a clear three-dimensional rendering of the vascular structures in the natural surroundings of the skull base. Static and dynamic three-dimensional images of the cadaveric vascular tree were obtained as viewed through surgical corridors of various skull base approaches. CONCLUSION: We demonstrated a new cadaveric preparation model for imaging and dissection. This model allows for static and dynamic three-dimensional examination of the surgical anatomy from a neurosurgeon's perspective. It may facilitate the study of cerebrovascular system morphology/pathology in relation to the skull base as a tool for surgical planning.

Brain↗
PubMed2005

CT and MRI findings of a solitary extramedullary plasmacytoma of the oropharynx: case report.

We report a case of solitary extramedullary plasmacytoma (SEP) of the oropharynx. A 53-year-old man presented who had had bloody phlegm and a sore throat for a few days. A mass was endoscopically detected in his right posterior oropharyngeal wall, and biopsy revealed a neoplasm consisting of a uniform population of plasma cells. Computed tomography (CT) showed a broad-based papillary soft tissue density mass projecting into the oropharynx from the right posterior wall of the pharynx, and post-contrast CT showed marked enhancement of the tumor. The tumor showed slightly higher signal intensity compared with surrounding muscle on MR Tl-weighted images (T1WI) and high signal intensity on MR T2-weighted images (T2WI). The mass showed homogeneous enhancement on post-contrast T1WI. Further clinical examination showed an absence of multiple myeloma (MM). The patient was diagnosed as having SEP. Following radiation therapy, a reduction in tumor size was observed. Although SEP is a rare tumor, it should be included in the differential diagnosis of tumors of the oropharynx because of its imaging similarities to other, more common malignant tumors, such as squamous cell carcinoma and lymphoma.

Humans↗
PubMed1999

Comparison of various rhenium-188-labeled diphosphonates for the treatment of bone metastases.

In the past, many diphosphonates were introduced as bone scan radiopharmaceuticals. In addition, diphosphonates have been labeled with beta-emitted isotopes and developed into useful therapeutic drugs for bone metastases. However, it is not clear which diphosphonate is the best choice when labeling with Re-188. In this study, we labeled methylene diphosphonate (MDP), hydroxyethylidene diphosphonate (HEDP), and hydroxymethane diphosphonate (HDP) with Re-188. Each radiopharmaceutical was further evaluated in two conditions (with and without carrier). Twenty-four rabbits were used (four in each group) for the analysis of the biodistributions and bone uptakes of these radiopharmaceuticals to assess their potential for clinical applicability. Four hours after intravenous injection of approximately 37 MBq (1 mCi) Re-188-labeled diphosphonate preparations, whole body scans were performed using a large-field gamma camera equipped with a high resolution collimator. Bone-to-soft tissue ratios (B/S ratio) were calculated using a computer program. Our data showed that Re-188 HEDP with carrier (10(-4) M carrier) could accumulate in the skeletal system whereas very little absorption by bone was observed in the rabbits that were injected with carrier-free Re-188 HEDP. In addition, no significant bone uptake was demonstrated for Re-188 MDP or Re-188 HDP, with or without carrier. The B/S ratio was 25.06 in the Re-188 HEDP with carrier group but less than 3 in the other groups. In conclusion, HEDP is the best choice among these three bone-seeking drugs when labeled with Re-188. But, it is necessary to add carrier when preparing Re-188 HEDP for the treatment of bone metastases.

Animals↗
PubMed1985

Surgical treatment of spinal cord compression in patients with lung cancer.

We analyzed the clinical features, radiological findings, and results of surgical treatment in a series of 25 patients with lung cancer and invasion of the spine. In 12 of the 25 (40%) patients, involvement of the spine was present at the time of initial presentation of malignancy. Computed tomography revealed the presence of a large paravertebral soft tissue mass with destruction of adjacent ribs in the majority. The surgical approach consisted of an anterolateral exposure through a formal thoracotomy in 22 patients and a thoracoabdominal flank approach in the 3 patients with lumbar lesions. All gross tumor was resected from the involved paravertebral tissues, vertebral body, and epidural space. Immediate stabilization of the spine was then achieved with methyl methacrylate. Local brachytherapy (iridium-192 implants) was used in 19 patients. After treatment, 87% were ambulatory, and 67% maintained ambulation for more than 6 months. Our data suggest that compression of the spinal cord in many patients with lung cancer results from direct extension of tumor through the chest wall. Because the majority of such patients often have localized disease involving the spine, aggressive surgical treatment is indicated.

Adenocarcinoma↗
PubMed2004

Long-term effects of connective tissue cancer treatment.

In 1999, we began a study to assess the long-term effect of connective tissue cancer treatment on clinical, social, and psychologic aspects of the lives of surviving patients. A specially designed computer program generated an 85-item questionnaire, which was sent to more than 2000 patients with malignant bone and soft tissue neoplasms. Twelve hundred forty-four patients responded. The data were entered into a computer system and were correlated with the clinical information already contained in the system for the individual patients. Although there are many possible uses for these data, we chose to do a study comparing the lifestyle and physical and sociologic problems for 144 patients treated with chemotherapy and surgery for high-grade osteosarcoma against a control population consisting of 61 patients treated surgically for benign giant cell tumors of bone. The data show a remarkable degree of compensation on the part of the patients with the malignant tumors in terms of some problems but some significant differences particularly in physical status and functional limitations.

Activities of Daily Living↗
PubMed1979

Squamous cell carcinoma of the soft palate.

We performed a retrospective study of 106 patients with carcinoma of the soft palate who were treated at two university hospitals. Computer analysis using a new interactive data base program called MING was made to determine Berkson-Gage survival and Gehan tests of statistical significance. Statistically significant associations with an increased survival included the following: smaller lesions, a clinically negative neck examination. well- and moderately well-differentiated histopathologic features, radiation therapy dose of less than or equal to 6,300 rads, absence of a simultaneous primary, and surgical salvage. No statistically significant differences were seen with age, sex, stage, or the number of days during which patients were treated with radiation therapy. There appears to be a need for a prospective, multi-institutional, randomized therapy study to solidify treatment policy. Consideration should be given to combine surgery-radiation vs radiation therapy alone.

Adult↗
PubMed1983

Computed tomographic imaging in cervical vertebral fractures.

Spinal computed tomography scanning was performed in five patients with different types of cervical fractures. Computed tomography scanning was superior to plain x-ray studies in determining the narrowing of the spinal canal by bone fragments or soft tissues and in determining the involvement of the intervertebral joints. The value of computed tomography was clearly demonstrated in scanning those regions that are difficult to be examined by conventional radiologic methods. A disadvantage of computed tomography scanning is the impossibility of functional diagnostic investigations and examinations after surgery of patients who underwent stabilization with plates and wires.

Adolescent↗
PubMed2003

Facial necrotizing fasciitis following acute dacryocystitis.

PURPOSE: To report a case of progressive necrotizing fasciitis of the face following acute dacryocystitis. DESIGN: Interventional case report. METHODS: A 60-year-old woman presented with left acute dacryocystitis with abscess formation that had ruptured; a small wound remained. Erythematous swelling of the left eyelid and face developed 3 days later. Clinical progression and computed tomographic findings led to the diagnosis of necrotizing fasciitis with abscess formation. Early intravenous antibiotics and repeated surgical debridements were performed. RESULTS: Soft tissue necrosis was found the fascial planes extending deep to the maxilla bone and periorbital fat. The patient was successfully treated without ocular, orbital, or facial complications. CONCLUSIONS: Necrotizing fasciitis of the eyelid and face progresses rapidly. Early diagnosis, prompt intravenous antibiotic administration, and aggressive surgical debridement will prevent the associated morbidity and mortality.

Abscess↗
PubMed1991

Transalar sphenoidal encephalocele. Uncommon clinical and radiological findings.

A case of basal encephalocele protruding through a defect in the greater wing of the sphenoid bone is presented. The transalar type of encephalocele is uncommon and unclassified. This case, documented by computed tomography and magnetic resonance imaging, is unique in that it presented with trigeminal neuralgia and was associated with an angioma of the soft palate.

Adult↗
PubMed1989

DNA cytometry of soft tissue tumours with TV image-analysis system.

We examined 69 soft tissue tumours for DNA content. Altogether 42 aspiration cytology and 27 imprint Feulgen-stained smears, each verified by histology, were analysed and the results evaluated with Böckings's algorithm. Except one false negative case (extramedullary ependymoma) 43 malignant and 25 benign soft tissue tumours could clearly be separated on the basis of their DNA content. The sensitivity of the positive cases (suspicious and malignant) came up to 97.7% with a false negative ratio of 2.2% while the sensitivity of the negative cases (benign) proved to be 75% with a 0% false positivity ratio. Cytometry is a useful aid in aspiration cytology diagnostics of soft tissue tumours particularly when their benign or malignant character is to be determined because the primary surgical therapy and consequently the further fate of patient, too, depend on the precise cytological diagnosis.

Algorithms↗