[Epithelioma of the submaxillary region in an eleven-year-old girl].
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Duplication cysts developed from the intra-oral digestive tract are exceedingly rare lesions of which only 15 cases have previously been reported. We report an additional case in a neonate with a large cystic lesion in the right submandibular area. Clinico-pathologic findings are described and the literature is reviewed. Criteria for the diagnosis of digestive tract duplication are recalled. Differential diagnosis and etiopathogenic theories are discussed.
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In the clinic of the P. A. Herzen Research Institute of Oncology, under observation were 227 patients with regional metastases of thyroid cancer. 135 of 227 patients were primarily treated in the clinic. Ninety two patients were admitted to the clinic after nonradical surgical interventions on the thyroid and jugular lymph apparatus. The main groups of regional lymph nodes, where metastases were localized, were as follows: deep jugular group (upper--51.1%, median--80.3%, lower--79.7%); supra-clavicular region--33.8%, paratracheal zone--41.4%. Lymph nodes of the submaxillary region were involved only in 1.3%. Sheath-fascial dissection of lymph nodes and jugular cellular tissue with the removal of paratracheal cellular tissue seems to be the operation of choice for regional metastases. The Kreil operation is indicated only in metastatic proliferation of the internal jugular vein and sterno-cleidomastoid muscle. Such operation was employed in 5 patients (2.5%). 166 patients were followed for 3 years and longer, 117 of them being alive (70.4%). The survival over 5 years was noted in 55 patients (57.9%).
Swellings of the submaxillary region are very frequent in otorhinolaryngology clinical practice. The authors of this study analyzed 106 cases of submaxillary gland excision under their observation, emphasizing their epidemiological, clinical and anatomopathological aspects which could be useful during the diagnostic and therapeutic phase of the submaxillary gland affections. They also made a comparison with the data already published on the same subject.
Irradiation of the salivary glands results in the generation of free radicals from metal ions present in the secretory granules of acinar cells, a process that is believed to exacerbate radiation damage to the salivary glands. We therefore conducted a comparative investigation of radiation damage to the acinar cells of murine submaxillary glands in which granule secretion had been induced, and used autoradiography to visualize the pathological changes. Male BALB/c mice, at 8 weeks of age, were divided into four groups: a no-isoproterenol (IPR) and no-irradiation group (group I), a no-IPR, irradiated group (group II), an IPR, no-irradiation group (group III), and an IPR, irradiated group (group IV). Intraperitoneal injections of IPR were used, and 3 h later, the submaxillary region was irradiated with X-rays at a dose of 10 Gy. Three days after the irradiation, 3H-leucine was administered, and submaxillary glands were removed at predetermined times. Thin sections were prepared, and light- and electron-microscope autoradiography was performed. The number of reduced silver particles per unit acinar cell area was determined by light-microscopic autoradiography, and the proportion of reduced silver particles in the rough endoplasmic reticulum, the Golgi apparatus, and secretion granules was determined by electron-microscopic autoradiography. The result indicated that the effects of the radiation on the secretory potential of the submaxillary glands were diminished in acinar cells with a higher secretory granule content.
We review various incisions for treatment of tumors of the face and parotid and submaxillary regions, as well as for radical neck surgery. A contribution to this field is made in the form of facial and cervical incisions that not only provide broad exposure of the region affected by the tumor, but also involve incision traces based on plastic surgery criteria. In this respect, we describe plastic modeling of the facial, submaxillary, and neck contours, resorting to the sternocleidomastoid and trapezius muscles.
A cell line was established from a transplantable adenocarcinoma, containing viral particles of the A and B type, drived from a tumor appearing spontaneously in the submaxillary region of a male mouse of the C3H/He strain. This line, after 480 days in vitro, did not change the original epithelial-like morphology, the viral expression, the membrane immunofluorescence and the degree of agglutination by various plant lectins. After 208 days of culture, the presence of up to 3 pairs of metacentric chromosomes appeared in about 55% of the cells. However, this change in the chromosomal pattern was not sufficient, at least within the limits of our observation, to modify significantly the other parameters investigated, with the possible exception of the oncogenicity, which showed a modest decrease after 296 days of culture.
Soft tissue eosinophilic granuloma or Kimura's disease is a chronic inflammatory disorder of unknown etiology. It is endemic in the Far East but can occur sporadically in other populations especially Middle Eastern peoples as illustrated by the present case involving a 55-year-old man. Examination 8 years after an initial episode revealed masses in the cheek and submaxillary regions with hypereosinophilia and characteristic histological findings. The usual clinical presentation of Kimura's disease includes subcutaneous nodules with lymph node involvement or presence of tumor in the salivary glands. These clinicopathological findings require differential diagnosis with Hodgkin's lymphoma, dermopathic lymphoma, or Castelman's disease. However, the most difficult distinction involves angiolymphoid hyperplasia with eosinophilia. Final diagnosis requires anatomopathological study. The most frequently encountered histological criteria are preservation of node structure, highly developed germinal centers, eosinophilic infiltration, and presence of numerous postcapillary veinlets. Prognosis is favorable but multiple relapses are possible. Corticosteroid therapy is usually effective but radiation treatment may be necessary in patients with recurrent disease.
We report the case of a 63-year-old man with bilateral parotid gland sarcoidosis. Giant, elastic, hard, subcutaneous tumors had been present on the right parotic and submaxillary regions for 11 years and on the left for 1 year. The patient had had diabetes mellitus for 8 years. Noncaseating epithelioid cell granulomata were revealed histopathologically in the periductal area of the parotid gland. Bilateral hilar lymphadenopathy was noted on chest x-ray studies. Serum levels of lysozyme were increased. Levels of serum angiotensin-converting enzyme were within normal limits. Tuberculin skin reaction was positive. The tumors gradually improved after treatment with oral minocycline. Giant parotomegaly, as it occurred in this case, is very rare.
Because of the risk of haemorrhage related to their resection, deep angiomas of the face are often considered to be inaccessible to treatment. The use of cardiopulmonary bypass with profound hypothermia allows the surgeon to operate in a bloodless field, enabling almost oncological resection of the tumour. The authors report a case of venous angioma of the submaxillary region treated in this way after failure of limited surgery and embolisation. Complete resection of the lesion was achieved and the defect was repaired with a pectoralis major flap and a latissimus dorsi flap. The authors stress the value of a multidisciplinary approach: a cardiac surgeon for CPB, an ENT surgeon for resection and a plastic surgeon for reconstruction.
The authors treated 324 patients with postburn scar deformations of the lower third of the face. It was established that the postburn deformation of a face should be eliminated after conservative treatment and "scar maturation" in one step, removing the scars along the intermediate layer without damaging the subcutis. When performing this, it is necessary to restore the filtrum, mental fossa and commissures of the mouth slit with the trapeziform flaps. The best plastic material is the intact skin of the submaxillary region and neck, the deltopectoral and brachiopectoral fasciocutaneous flaps can be used. It is necessary to perform strictly a number of technical manoeuvres at all the stages of operation.
Altogether 162 cases of tonsillitis were registered in two military units during the period of May 11-16. The disease took an acute course with short-time fever, symptoms of acute intoxication, sore throat, pronounced inflammatory changes in tonsils and swelling of regional (submaxillary and anterocervical) lymph nodes. In some of the patients (1.1%) sickness and vomiting and in 0.2% diarrhea were registered. In 6.7% of the patients scarlatiniform eruptions were observed on days 2-3 of the disease. In the course of the bacteriological examination of the patients group A streptococci, serovar T II, were isolated. The dynamic study of paired sera showed a considerable increase in the number of patients with a high level of antibodies to streptolysin 0 and group A polysaccharide. All patients were fed at the same canteen. The factor of the transmission of this infection could be butter, stored without observation of the required temperature conditions and apportioned by the soldiers of the kitchen police. Experimental study revealed that group A streptococci are capable for proliferation and accumulation in butter.