摘要:

AbstractThe nose is the most common site of skin cancer on the human body. This review was compiled to enumerate the many reconstructive techniques which are available and to discuss the advantages and disadvantages of each technique. Five hundred twenty‐one patients with nasal cancer were treated at Roswell Park Memorial Institute from 1964 to 1981. Four hundred five patients were treated by cryotherapy, electrocautery, chemosurgery, radiation therapy, or local excision with primary closure. Forty‐six patients were treated with simple nasolabial flaps. The remaining 70 patients underwent more extensive resections and reconstructions. Their records were reviewed. At 5 years the local recurrence rate was 3% for basal cell carcinoma and 20% for squamous cell carcinoma. The multiple reconstructive techniques which were utilized in these patients are discussed. Skin‐grafting procedures were used to manage 51% of the patients. Prostheses were used in 9%. Multiple different reconstructive flaps were used for the remaining 40% of the patients. The management of large nasal carcinomas must be individualized with therapeutic decisions being made by a practitioner who is familiar with the many reconstructive options. This will ensure the optimal functional and aesthetic result for each pa

ISSN:0022-4790    

DOI:10.1002/jso.2930390102

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1988

数据来源: WILEY

摘要:

AbstractEight patients with sciatic nerve and sacral plexus nerve sheath tumors, seen at Louisiana State University Medical Center in Shreveport, are presented. These cases illustrate the broad spectrum of pathology and modes of presentation of patients with nerve sheath tumors in this region. Patients can be divided into 4 groups. Group I includes subgluteal and/or thigh lesions with a well‐defined mass on CT. Group II patients have neuroforaminal enlargement (defined by CT) and usually have radicular leg pain. Patients in group III have intrapelvic tumors with extension into the thigh.They usually have a poorly defined mass on CT. Group IV includes patients that have an intrapelvic mass (usually well defined) with radicular leg pain and/or mass effect.CT scanning proved to be the diagnostic procedure of choice. It delineated the location and extent of the tumor and thus was important in determining resectability. The variable course of these tumors is emphasized. A conservative nonoperative approach should be considered in asymptomatic and/or neurologically stable patient

ISSN:0022-4790    

DOI:10.1002/jso.2930390103

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1988

数据来源: WILEY

摘要:

AbstractTwo cases of neuroma of the common bile duct (CBD) associated with jaundice and cholangitis both 15 years after cholecystectomy are presented. The surgical treatment, excision of the diseased CBD, followed by Roux‐en‐Y biliary drainage in one case and excision of the tumor with T‐tube drainage in the other, was curative. A review of the world literature revealed 20 prior cases of CBD neuromas, 19 associated with jaundice. None was diagnosed prior to operation or autopsy. Mortality of treatment was 15% and all deaths were associated with a failure to excise the ne

ISSN:0022-4790    

DOI:10.1002/jso.2930390104

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1988

数据来源: WILEY

摘要:

AbstractAn original surgical method for gonadal protection in young women given pelvic radiation for Hodgkin's disease is presented. Lateral high ovarian transposition (LHAO) consists of the transposition of the ovaries into the paracolic gutter during staging laparotomy, after disconnecting the gonads from the fallopian tubes by dividing the tubo‐ovarian vessels.The technique's effectiveness was assessed by a study using clinical investigation, radioimmunoassay (RIA) determination of sex hormones, and dosimetry; of 18 patients treated, 10 participated in the study. All but one have normal menses and hormone values, and one pregnancy occurred. We also calculated the doses absorbed by the ovaries and proved that, during inverted Y irradiation following LHAO, the ovaries are exposed to nearly one‐half the dose they receive after traditional medial transposition. During subtotal nodal irradiation after LHAO, the irradiation dose is higher than after medialisation, but absolute values are minimal and castration is not indu

ISSN:0022-4790    

DOI:10.1002/jso.2930390105

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1988

数据来源: WILEY

摘要:

AbstractNine cases of primary malignant melanoma of the nasal cavity are presented. All the patients had epistaxis and nasal obstruction at admission. Gross aspect of the neoplasia showed a fungating mass located in the right nasal cavity in six cases and in the left nasal cavity in three. Eight tumors were formed by polygonal cells and one tumor by spindle cells. Melanosis of the adjacent mucosa was found in only 1 case. S‐100 protein was demonstrated by indirect immunoperoxidase in all cases. The mean survival rate was 23.8 months. Prognosis was not related to the histologic pattern, cell atypia, necrosis, pigment secretion, or mitotic index. Radiotherapy seemed to have some beneficial influence on the survival but did not influence the local recurrence and metastatic spread of the diseas

ISSN:0022-4790    

DOI:10.1002/jso.2930390106

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1988

数据来源: WILEY

摘要:

AbstractThe autopsy of hepatocellular carcinoma at Hines VA Hospital was reviewed for a 33‐year period, between 1954 and 1986. The neoplasm is uncommon and bone involvement was observed in 7.3% or in ten of 137 cases. A clinical presentation of osseous metastasis in hepatocellular carcinoma is rare. A brief literature review is also include

ISSN:0022-4790    

DOI:10.1002/jso.2930390107

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1988

数据来源: WILEY

摘要:

AbstractA clinico‐pathologic and immunologic case study of a 57‐year‐old woman who has shown progressive lymphoid proliferations and lymphocyte dysfunction over the course of 10 years is presented. Early in the course ofher disease, she presented with recurrent benign nasopharyngeal lymphoid tumors. She subsequently developedbenign lymphoepithelial lesions involving both a submandibular and then a parotid salivary gland. She eventually underwent pneumonectomy for lymphocytic interstitial pneumonitis with marked cystic degeneration and lung destruction. Although frank malignancy has not been demonstrated review of her nasopharyngeal biopsies andof her pulmonary pathology shows a tendency toward distinct cellular uniformity with loss of follicles and germinal centers. Concurrently, immunologic studies have demonstrated abnormalities of cell mediated (T cell)fun

ISSN:0022-4790    

DOI:10.1002/jso.2930390108

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1988

数据来源: WILEY

摘要:

AbstractFrom 1945 through 1985, 32 cases of primary lymphoma of bone were treated at the University of Iowa Hospitals and Clinics. Sixteen cases (50%) demonstrated the lesion in the long tubular bones with a predilection for the lower and upper extremities. The frequently involved flat bones (six cases) were the bones of the pelvis. There were only three cases (9%) where the mandible was the primary site. In this report, the literature is reviewed and three cases with primary lymphoma of the mandible are presented.

ISSN:0022-4790    

DOI:10.1002/jso.2930390109

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1988

数据来源: WILEY

摘要:

AbstractThe clinical experience is reviewed in 597 Norwegian testicular cancer patients (age range: 15–45 years) treated from 1979 to 1986. During this period, computer tomography, determination of serum AFP/HCG, and cisplatin‐based chemotherapy represented the modern diagnostic and therapeutic mcdalities. Before orchiectomy 67% of the patients had elevated AFP/HCG. An abnormal postorchiectomy serum tumour marker decrease and the presence of small vessel infiltration in the histological sections of the primary tumour significantly predicted microscopic retroperitoneal metastases in patients with clinical stage I (CSI) nonseminoma. One‐third of these patients had a pathological stage II (PSII). After radiotherapy 99% of 90 seminoma patients (CSI/IIa) survived for 5 years. After cisplatin‐based chemotherapy (+ radiotherapy/surgery) the 5‐year survival rate in 25 patients with advanced seminoma was 81 %. The survival rate in 148 nonseminoma patients PSI/IIa was 100% and 87% in 94 patients with advanced nonseminoma (≥CSIIb). Nausea, general exhaustion, myelosuppression, peripheral neuropathy, and Raynaud‐like phenomena were the main acute treatment‐related side effects. Slight gastrointestinal problems, slight peripheral neuropathy, Raynaud‐like phenomena, and fertility disturbances were frequent late side effects. The sexual life in testicular cancer patients did not seem to be significantly impaired as compared to the normal population. Most of the patients reported no or only slight emotional problems during and after treatment. The need of thorough information at the time of diagnosis was stressed by most of them.Secondary cancer was diagnosed in 27 of 795 patients (1970–1982) (Testicular: 15; pulmonary: 4; sarcoma: 2; others: 6).Testicular cancer is today a curable malignancy. Future clinical research has to concentrate on the identification of high‐risk and low‐risk patients, the avoidance of overtreatment, and the reduction of toxicity (especially of

ISSN:0022-4790    

DOI:10.1002/jso.2930390110

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1988

数据来源: WILEY

摘要:

AbstractRenal angiomyolipomas are generally benign tumors which are composed of smooth muscle, fat, and blood vessels. Classically these have been diagnosed with the use of arteriograms; however, since ultrasound and CAT scans have come into use these now are the common modalities for diagnosis. All angiomyolipomas generally can be followed conservatively, whereas larger ones have a tendency to bleed and require intervention. This paper reviews the diagnosis, treatment, and prognosis of patients with angiomyolipomas.

ISSN:0022-4790    

DOI:10.1002/jso.2930390111

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1988

数据来源: WILEY