scholarly journals Mucoepidermoid Carcinoma of the Lacrimal Sac: Clinical-Pathologic Analysis, Including Molecular Genetics

2019 ◽  
Vol 6 (2) ◽  
pp. 138-144 ◽  
Author(s):  
Kalla A. Gervasio ◽  
Paul J.L. Zhang ◽  
Robert B. Penne ◽  
Mary A. Stefanyszyn ◽  
Ralph C. Eagle Jr. ◽  
...  
Keyword(s):  
Salivary Gland ◽  
Mucoepidermoid Carcinoma ◽  
Gene Fusion ◽  
Case Series ◽  
Radical Resection ◽  
Clinical Findings ◽  
Lacrimal Sac ◽  
Egfr Amplification ◽  
Pathologic Analysis

Purpose: The aim of this study was to assess whether mucoepidermoid carcinoma of the lacrimal sac is a counterpart of CRTC1/3-MAML2 gene fusion-related salivary gland mucoepidermoid carcinoma. Methods: In this retrospective observational case series, pathology records were searched for all cases of lacrimal sac mucoepidermoid carcinoma diagnosed between 1990 and 2018. Data collected included demographics, clinical findings, management, and follow-up. Pathologic parameters assessed included tumor morphology, immunohistochemistry, and MAML2 and EGFR fluorescence in situ hybridization (FISH) studies. Results: Six patients with mucoepidermoid carcinoma of the lacrimal sac, 5 males and 1 female, with a median age of 63 years (range 24–66) were identified. Five tumors were managed with radical resection and 1 patient underwent orbital exenteration. None of the patients developed recurrence or metastases with an average follow-up of 18 months (range 13–23). All tumors had morphologic and immunohistochemical features of mucoepidermoid carcinoma and overexpressed EGFR. MAML2 FISH was negative for MAML2 rearrangement in all tumors. EGFR FISH demonstrated EGFR amplification in 1 tumor. Conclusions: Mucoepidermoid carcinoma of the lacrimal sac is not a lacrimal sac counterpart of CRTC1/3-MAML2 gene fusion-related salivary gland mucoepidermoid carcinoma. EGFR pathway activation and EGFR amplification in a subset of these neoplasms suggest the potential role for anti-EGFR agents.

scholarly journals Mucoepidermoid Carcinoma in a Minor Salivary Gland in a Child

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Fatih Sengul ◽  
Sera Simsek ◽  
Binali Cakur
Keyword(s):  
Salivary Gland ◽  
Parotid Gland ◽  
Mucoepidermoid Carcinoma ◽  
Minor Salivary Gland ◽  
Differential Diagnoses ◽  
Common Site ◽  
Radiological Findings ◽  
Pathologic Lesions ◽  
A Minor

Mucoepidermoid carcinoma (MEC), one of the most common salivary gland malignancies, is rare in children. MEC mainly occurs in the parotid gland, along with minor glands being the second common site, particularly in palate. Clinical, histological, and radiological findings of palatal MEC in a 12-year-old girl are presented with three-year follow-up. Pathologic lesions must be considered in differential diagnoses of intraoral asymptomatic lesions, and their detailed inspection should be taken into consideration.

scholarly journals Use of computed tomography imaging during long-term follow-up of nine feline tuberculosis cases

2017 ◽  
Vol 20 (2) ◽  
pp. 189-199 ◽  
Author(s):  
Alison Major ◽  
Conor O’Halloran ◽  
Andrea Holmes ◽  
Stephanie Lalor ◽  
Rebecca Littler ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Treatment Protocol ◽  
Case Series ◽  
Clinical Findings ◽  
Response To Treatment ◽  
Ct Findings ◽  
Long Term Follow Up ◽  
Diagnostic Investigations

Case series summary Feline tuberculosis is an increasingly recognised potential zoonosis of cats. Treatment is challenging and prognosis can vary greatly between cases. Pulmonary infection requires extended courses of antibiotics, but methodologies for sensitively monitoring response to treatment are currently lacking. In this case series, we retrospectively examined the serial computed tomography (CT) findings in nine cats that had been diagnosed with tuberculosis. Changes in pathology (where applicable to tuberculosis) were correlated with the clinical presentation of each of the cats, the treatment protocol, and previous and contemporary diagnostic investigations. This study found that changes in CT findings during the medium- to long-term management of feline tuberculosis were highly variable between cats. The majority of cats had reduced pathology at re-examination during anti-tuberculous therapy, but pathology only resolved in a minority of cases. In some cases recurrence of pathology detected by CT imaging preceded clinical deterioration, allowing for rapid therapeutic intervention. Relevance and novel information When considered in combination with clinical findings, CT studies can aid in decision making regarding tapering of antibiotic protocols, or reintroduction of therapy in cases of recurrence or reinfection. This series also highlights that, in some cases, persistent abnormalities can be detected by CT, so complete resolution of CT pathology should not always be a goal in the management of feline tuberculosis.

scholarly journals Prognosis of spinal infections managed by minimal debridement: A case series in two tertiary centers

2021 ◽  
Vol 12 ◽  
pp. 83
Author(s):  
Ahmed Ali Mohamed ◽  
Hussein Mohammed Soffar ◽  
Hazem Hassan El Zayat ◽  
Hashem Mohamed Aboul-Ela
Keyword(s):  
Epidural Abscess ◽  
Vertebral Osteomyelitis ◽  
Case Series ◽  
Clinical Findings ◽  
Low Back ◽  
Thoracic Region ◽  
Limb Pain ◽  
Lower Limb Pain ◽  
Spinal Infections

Background: Spinal infections can be challenging in their management and include spondylitis, epidural abscess, and spondylodiscitis. Usual treatment is conservative through antimicrobials or surgery to decompress neural tissue, debride all infected tissues, and fix if needed. We propose the concept of surgery without formal debridement aiming at neural protection. Methods: The study was performed at two tertiary centers on 25 patients with clinical findings. One patient was treated conservatively and the rest surgically by laminectomy and fixation if needed. Evacuation of fluid pus was performed. In the cervical and the thoracic region, if the granulation tissue was anterior to the cord, only decompression by laminectomy was done. Results: Low back pain was present in 22 cases (88%), 16 cases (64%) had lower limb pain, and 12 cases (48%) had weakness. The level of spinal infection was lumbar in 15 cases (60%), thoracic in 9 cases (36%) cases, and cervical in 1 case (4%). The type of infection was epidural abscess in 20 cases (80%), discitis in 16 cases (64%), and vertebral osteomyelitis in 12 cases (48%). Laminectomy was performed in 20 cases (80%) and fixation in 17 cases (68%). The symptoms improved in all cases. On follow-up, the lesion was reduced in 14 patients (56%) and disappeared in 11 cases (44%). One case required ventriculoperitoneal shunt placement due to postinfectious hydrocephalus. Conclusion: Dealing with spinal infections surgically through decompression or fixation with minimal debridement of infected tissue appears to be a safe and effective method of management.

scholarly journals Endoscopic approaches to orbital lesions: case series and systematic literature review

2020 ◽  
pp. 1-13 ◽  
Author(s):  
Matteo Zoli ◽  
Giacomo Sollini ◽  
Laura Milanese ◽  
Emanuele La Corte ◽  
Arianna Rustici ◽  
...  
Keyword(s):  
Web Of Science ◽  
Tumor Resection ◽  
Case Series ◽  
Radical Resection ◽  
Common Symptom ◽  
Review Of The Literature ◽  
Surgical Morbidity ◽  
The Mean ◽  
Orbital Lesions

OBJECTIVESurgical treatment of orbital lesions is challenging because complex approaches with a high risk of postoperative sequelae are required. Recently, minimally invasive endoscopic approaches through endonasal (EEA) and transpalpebral (ETP) routes have been proposed. The objective of this study was to assess outcomes of EEA and ETP in the authors’ series of patients with orbital lesions.METHODSData from all patients who underwent operations for an orbital tumor through an endoscopic approach at the authors’ institution from 2002 to 2018 were retrospectively collected. All patients underwent preoperative MRI and ophthalmological evaluation, which was repeated 3 months after surgery and then at regular follow-up intervals. A systematic review of the literature was also performed using Medline, Embase, and Web of Science databases.RESULTSThe series includes 23 patients (14 males); the mean patient age was 48 ± 23.9 years. Most of the lesions were intraconal (n = 19, 83%). The more frequent histotype was cavernous hemangioma (n = 5, 22%). Exophthalmos was the most common symptom (21 of 23 patients). EEA was performed in 16 cases (70%) and ETP in 7 (30%). The aim of the surgery was achieved in 94% of the cases after an EEA (successful biopsy in 5 of 6 cases and radical resection in all 10 remaining patients), and in 86% after an ETP (successful biopsy in 2 cases and radical tumor resection in 4 of 5 cases). Complications consisted of 3 cases (13%) of transitory diplopia. One recurrence (4%) was observed at follow-up (mean 59 ± 55 months).CONCLUSIONSThe EEA and ETP have demonstrated to be safe and effective for tumors located respectively in medial and lateral quadrants, permitting one to approach orbital lesions endoscopically at 360°. Innovative surgical tools, including intraoperative ultrasonography, may be useful to potentially reduce surgical morbidity. Larger series are needed to validate these preliminary suggestions.

Endoscopic transnasal dacryocystorhinostomy with nasal mucosal and posterior lacrimal sac flap

2008 ◽  
Vol 123 (3) ◽  
pp. 320-326 ◽  
Author(s):  
N Sonkhya ◽  
P Mishra
Keyword(s):  
Success Rate ◽  
Symptom Relief ◽  
Case Series ◽  
Cost Effective ◽  
Nasolacrimal Duct ◽  
Sinus Surgery ◽  
Lacrimal Sac ◽  
Endoscopic Endonasal ◽  
Lost To Follow Up

AbstractObjective:To describe a new endonasal dacryocystorhinostomy technique and to assess its efficacy.Design:Prospective, non-randomised, interventional case series.Patients and methods:Patients with primary nasolacrimal duct obstruction were included. A prospective series of 226 consecutive endoscopic transnasal dacryocystorhinostomies performed between January 2003 and December 2006 were entered into the study. Patients who had undergone previous lacrimal surgery were excluded. The surgical technique involved the creation of nasal mucosal and large posterior lacrimal flaps at the medial lacrimal sac wall. The two flaps were placed in close apposition. The technique also involved creation of a large bony ostium.Main outcome measures:Success was defined as the resolution of symptoms, or unobstructed lacrimal irrigation and endoscopic visualisation of a patent rhinostomy.Results:A total of 226 consecutive endoscopic transnasal dacryocystorhinostomy procedures performed between January 2003 and December 2006 were reviewed. The main presentation was with epiphora (95 per cent) and/or mucocele (13 per cent). Septoplasty was performed in 36 per cent of cases at the time of surgery. In 18 per cent of cases, endoscopic sinus surgery was also added to the procedure. The follow-up period ranged from six months to two years. Of the 226 patients, eight were lost to follow up and were thus excluded from the series. The procedure achieved a 92 per cent success rate, in terms of symptom relief and anatomical success.Conclusion:The described technique of endoscopic endonasal dacryocystorhinostomy had a success rate comparable to that of external dacryocystorhinostomy. The procedure is simple and cost-effective because it does not require sophisticated equipment such as lasers, optical fibres, silicone stents or a microdebrider.

Changes in the 7th Edition of the AJCC TNM Classification and Recommendations for Pathologic Analysis of Lacrimal Gland Tumors

2009 ◽  
Vol 133 (8) ◽  
pp. 1268-1271 ◽  
Author(s):  
Jack Rootman ◽  
Valerie A. White
Keyword(s):  
Salivary Gland ◽  
Recent Work ◽  
Lacrimal Gland ◽  
Tnm Classification ◽  
Staging System ◽  
Cancer Staging ◽  
7Th Edition ◽  
Data Points ◽  
Pathologic Analysis

Abstract In our recent work to update the American Joint Committee on Cancer's AJCC Cancer Staging Manual, we brought the staging system in line with that of salivary gland malignancies to better describe the range of these tumors. In addition, we have suggested that information be collected on biomarkers and clinical and histologic data points. This revised staging, along with careful histologic analysis and patient follow-up, may provide information that helps develop more targeted management for these lesions.

scholarly journals Clinical Features of Primary and Systemic Metastatic Intraocular Lymphomas in Spanish Patients

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Victor Llorenç ◽  
Carla Fuster ◽  
Carmen Alba-Linero ◽  
Aina Moll-Udina ◽  
Alba Serrano ◽  
...  
Keyword(s):  
Flow Cytometry ◽  
Marginal Zone ◽  
Cell Lymphoma ◽  
Case Series ◽  
B Cell Lymphoma ◽  
Clinical Findings ◽  
Large B Cell Lymphoma ◽  
Pathologic Features ◽  
Primary Uveal Lymphoma

Objectives. To describe and compare clinical findings in different subtypes of biopsy-proven intraocular lymphomas (IOLs). Design. Retrospective, observational case series. Methods. The clinical and pathologic features in IOLs at the Hospital Clinic of Barcelona from 1995 to 2018 were retrospectively studied. Results. Twenty-one patients, 12 men (57%), median age 60 (interquartile range, IQR: 18 years), and a median follow-up of 30 (IQR 60) months were included. Eleven patients had primary vitreo-retinal lymphoma (PVRL, 52%), 4 had primary uveal lymphoma (PUL, 19%), and 6 had systemic metastatic retinal lymphomas (SMRLs, 28%). Diffuse large B-cell lymphoma was the main IOL subset in PVRL (91%) and in SMRL (83%), whereas extranodal marginal zone lymphoma was the only type in PUL (100%). Survival rate was 44% in PVRL and 20% in SMRL at 5 years (p=0.047). One patient had flow cytometry of two different vitreous humour samples. With them, flow cytometry was performed in a total of 11 samples, yielding 7 positive samples. Conclusions and Relevance. Even though PVRL is the most frequent IOL subtype, our findings suggest that PUL and SMRL should be considered as potential IOL causes. Overall survival was poor in PVRL and even shorter in SMRL patients.

Scandinavian Total Ankle Replacement: 15-Year Follow-up

2018 ◽  
Vol 39 (2) ◽  
pp. 135-142 ◽  
Author(s):  
Ariel Palanca ◽  
Roger A. Mann ◽  
Jeffrey A. Mann ◽  
Andrew Haskell
Keyword(s):  
Case Series ◽  
Mobile Bearing ◽  
The United States ◽  
Clinical Findings ◽  
Total Ankle Replacement ◽  
Fourth Generation ◽  
Level Of Evidence ◽  
Prosthetic Alignment ◽  
Ankle Replacement

Background: Over the past decade, total ankle arthroplasty (TAA) has become a mainstay in the treatment of end-stage ankle arthritis. Currently in its fourth generation, the Scandanavian Total Ankle Replacement (STAR) is the only 3-piece mobile bearing ankle prosthesis available in the United States. Our current study reports implant survivorship at 15 years and patient outcomes for a subset of these survivors available for study. Methods: Eighty-four TAAs were performed between 1998 and 2000. Metal component survivorship at 15 years was calculated with a Kaplan-Meier curve. Twenty-four (29%) of 84 patients were available for participation with a minimum 15-year follow-up. Any radiographic changes were documented. All additional procedures and complications were recorded. Clinical findings, self-reported performance and pain evaluations, and AOFAS ankle/hindfoot scores were noted. Results: Metal implant survival was 73% at 15 years. Of the 24 patients available for clinical evaluation, 18 of 24 patients (70.7%) had no change in prosthetic alignment from the immediate postoperative radiograph. Only 1 subtalar fusion was required for symptomatic adjacent joint arthritis. Three patients sustained a broken polyethylene component. AOFAS scores improved from an average of 39.6 points preoperatively, to an average of 71.6. More than half (52.4%) of patients with retained implants required an additional surgical procedure; 3 required 2 additional procedures. The average time to subsequent procedure was 10.2 years. Conclusion: Our small cohort demonstrated STAR ankles with retention at 9 years were highly likely to survive to 15 years, and patients continued to have significant improvement in pain relief and minimal decrease in function. At 15 years from TAA, metal survivorship was 73%. As with all ankle replacements, supplementary procedures were common. Level of Evidence: Level IV, case series.

scholarly journals Identity Crisis - Common Tumors in Exceptional Locations, A Case Series

2020 ◽  
Vol 2 (3) ◽  
pp. 7-14
Author(s):  
Thilaga Rajendran ◽  
Vanitha Palanisamy ◽  
Yabitha Vasavan ◽  
Jothi Shanmuganathan
Keyword(s):  
Salivary Gland ◽  
Mucoepidermoid Carcinoma ◽  
Case Series ◽  
Treatment Modalities ◽  
Mucous Cells ◽  
Parotid Glands ◽  
Correct Treatment ◽  
Future Studies ◽  
Key Features ◽  
Comparison Table

Mucoepidermoid carcinoma (MEC) accounts for only 5% of all salivary gland tumors and is most often seen in the parotid glands. MEC occurrence in the larynx is, however, rare. The incidence of primary squamous cell carcinoma (SCC) of salivary glands is also scarce and comprises only about 1.6% of all salivary gland malignancies. Hereby, we share our experience in managing two patients with rare and opposite variants of malignancy which were diagnosed at the same time; MEC of the larynx and SCC of the parotid. In MEC tumors, the presence of the intermediate and mucous cells with positivity in mucicarmine stain are the significant features. For SCC tumors, identification of the usual tumor markers (p40, CK 5/6 and p63) are pathognomonic. Although MEC and SCC are common in the head and neck regions, the existence of these malignancies in exceptional locations must be considered. The key features mentioned in our comparison table can help distinguish both these tumors and to deliver the correct treatment modalities. The prevalence of genomic and carcinogenic factors in the occurrence of these tumors in uncommon locations needs to be explored in future studies.

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