Background: Cervical schwannoma is a relatively rare disease, and it is difficult to experience many surgical cases because it may be followed up without surgery. We examined 100 patients who underwent inter-capsular ...Background: Cervical schwannoma is a relatively rare disease, and it is difficult to experience many surgical cases because it may be followed up without surgery. We examined 100 patients who underwent inter-capsular resection for cervical schwannomas at our center and classified the patients according to the nerve of origin. Methods: We retrospectively reviewed 100 patients who underwent inter-capsular resection for cervical schwannoma at our center from April 2005 to September 2019. We examined the patient’s characteristics including age, sex, tumor size (maximum diameter), origin nerve, preoperative symptoms, and postoperative neurological deficits for all cases. We classified the cases according to the nerve of origin and the occurrence of postoperative neurological deficits. Results: The occurrence of postoperative neurological deficit for all cases was as follows: “none” was 73%, “temporary paralysis” was 21%, and “permanent paralysis” was 6%. In the case of vagus nerve: “none” was 65.4%, “temporary paralysis” was 23.1%, “permanent paralysis” was 11.5%. In the case of sympathetic nerve: “none” was 64.7%, “temporary paralysis” was 29.4%, “permanent paralysis” was 5.9%. In the case of brachial plexus: “none” was 87.0%, “temporary paralysis” was 13.0%, “permanent paralysis” was 0%. In the case of cervical and accessory nerves: “none” was 86.4%, “temporary paralysis” was 13.6%, “permanent paralysis” was 0%. In the case of facial nerve: “none” was 0%, “temporary paralysis” was 80.0%, “permanent paralysis” was 20%. In the case of lingual nerve: “none” was 80.0%, “temporary paralysis” was 20.0%, “permanent paralysis” was 0%. Conclusions: Inter-capsular resection is useful for the treatment of cervical schwannoma and a simple comparison is difficult, but probably with good results. This study provides information that will be useful for the treatment of cervical schwannoma.展开更多
Metastatic lung tumours rarely lead to development of pneumothorax, and no case of bilateral secondary pneumothorax due to lung metastases arising from tongue cancer has been reported. Here, we report a case of a pati...Metastatic lung tumours rarely lead to development of pneumothorax, and no case of bilateral secondary pneumothorax due to lung metastases arising from tongue cancer has been reported. Here, we report a case of a patient with tongue cancer with lung metastases complicated by bilateral secondary pneumothorax soon after the completion of concurrent chemoradiotherapy. A 39-year-old man with cervical lymph node metastases originating from pT2N0M0 tongue cancer underwent neck dissection and postoperative concurrent chemoradiotherapy. Shortly after the completion of chemoradiotherapy, he developed bilateral secondary pneumothorax. Subsequently, he underwent partial lung resection for the pulmonary fistulae for diagnostic and therapeutic purposes;nodular lesions found in both the lungs. The diagnosis of secondary pneumothorax was based on histopathological findings. Although all pulmonary fistulae disappeared after partial lung resection, he died of the primary disease despite our best efforts to control the metastatic pulmonary lesions.展开更多
Clear-cell variants of follicular carcinoma are rare subtypes of thyroid cancer. There is no unified view of the histopathological features of clear cell variants, but follicular carcinomas composed predominantly of c...Clear-cell variants of follicular carcinoma are rare subtypes of thyroid cancer. There is no unified view of the histopathological features of clear cell variants, but follicular carcinomas composed predominantly of clear cells are distinguished from clear cell variants. In clinical practice, it is important to determine whether clear cell variants arise primarily from the thyroid gland or are thyroid metastases of other clear cell carcinomas, such as renal cell carcinoma. We present a case in which a patient with initially suspected anaplastic thyroid carcinoma due to a rapidly progressive anterior neck mass was diagnosed with a clear cell variant of follicular carcinoma after a tissue biopsy. The patient was treated with lenvatinib, then his performance status improved, and he was discharged from the hospital. On day 188 after discharge, a contrast-enhanced computed tomography (CECT) scan of the neck showed further shrinkage of the tumor. However, a CECT scan of the chest revealed multiple lung metastases. On day 233 after discharge, the patient developed severe pneumonia resulting from tracheal rupture due to intratumoral necrosis. It was difficult to decide whether lenvatinib should have been discontinued or reduced when lung metastasis appeared. It is necessary to accumulate additional cases to make informed decisions about continuing lenvatinib therapy.展开更多
文摘Background: Cervical schwannoma is a relatively rare disease, and it is difficult to experience many surgical cases because it may be followed up without surgery. We examined 100 patients who underwent inter-capsular resection for cervical schwannomas at our center and classified the patients according to the nerve of origin. Methods: We retrospectively reviewed 100 patients who underwent inter-capsular resection for cervical schwannoma at our center from April 2005 to September 2019. We examined the patient’s characteristics including age, sex, tumor size (maximum diameter), origin nerve, preoperative symptoms, and postoperative neurological deficits for all cases. We classified the cases according to the nerve of origin and the occurrence of postoperative neurological deficits. Results: The occurrence of postoperative neurological deficit for all cases was as follows: “none” was 73%, “temporary paralysis” was 21%, and “permanent paralysis” was 6%. In the case of vagus nerve: “none” was 65.4%, “temporary paralysis” was 23.1%, “permanent paralysis” was 11.5%. In the case of sympathetic nerve: “none” was 64.7%, “temporary paralysis” was 29.4%, “permanent paralysis” was 5.9%. In the case of brachial plexus: “none” was 87.0%, “temporary paralysis” was 13.0%, “permanent paralysis” was 0%. In the case of cervical and accessory nerves: “none” was 86.4%, “temporary paralysis” was 13.6%, “permanent paralysis” was 0%. In the case of facial nerve: “none” was 0%, “temporary paralysis” was 80.0%, “permanent paralysis” was 20%. In the case of lingual nerve: “none” was 80.0%, “temporary paralysis” was 20.0%, “permanent paralysis” was 0%. Conclusions: Inter-capsular resection is useful for the treatment of cervical schwannoma and a simple comparison is difficult, but probably with good results. This study provides information that will be useful for the treatment of cervical schwannoma.
文摘Metastatic lung tumours rarely lead to development of pneumothorax, and no case of bilateral secondary pneumothorax due to lung metastases arising from tongue cancer has been reported. Here, we report a case of a patient with tongue cancer with lung metastases complicated by bilateral secondary pneumothorax soon after the completion of concurrent chemoradiotherapy. A 39-year-old man with cervical lymph node metastases originating from pT2N0M0 tongue cancer underwent neck dissection and postoperative concurrent chemoradiotherapy. Shortly after the completion of chemoradiotherapy, he developed bilateral secondary pneumothorax. Subsequently, he underwent partial lung resection for the pulmonary fistulae for diagnostic and therapeutic purposes;nodular lesions found in both the lungs. The diagnosis of secondary pneumothorax was based on histopathological findings. Although all pulmonary fistulae disappeared after partial lung resection, he died of the primary disease despite our best efforts to control the metastatic pulmonary lesions.
文摘Clear-cell variants of follicular carcinoma are rare subtypes of thyroid cancer. There is no unified view of the histopathological features of clear cell variants, but follicular carcinomas composed predominantly of clear cells are distinguished from clear cell variants. In clinical practice, it is important to determine whether clear cell variants arise primarily from the thyroid gland or are thyroid metastases of other clear cell carcinomas, such as renal cell carcinoma. We present a case in which a patient with initially suspected anaplastic thyroid carcinoma due to a rapidly progressive anterior neck mass was diagnosed with a clear cell variant of follicular carcinoma after a tissue biopsy. The patient was treated with lenvatinib, then his performance status improved, and he was discharged from the hospital. On day 188 after discharge, a contrast-enhanced computed tomography (CECT) scan of the neck showed further shrinkage of the tumor. However, a CECT scan of the chest revealed multiple lung metastases. On day 233 after discharge, the patient developed severe pneumonia resulting from tracheal rupture due to intratumoral necrosis. It was difficult to decide whether lenvatinib should have been discontinued or reduced when lung metastasis appeared. It is necessary to accumulate additional cases to make informed decisions about continuing lenvatinib therapy.
