Desmoid tumor (DT) is a relatively uncommon, cytologically bland fibrous neoplasm that is associated with possibility of local recurrence but without the potential to spread to other parts of the body. This disease af...Desmoid tumor (DT) is a relatively uncommon, cytologically bland fibrous neoplasm that is associated with possibility of local recurrence but without the potential to spread to other parts of the body. This disease affects mostly younger adults and is the most common cause of abdominal wall masses in women 20 - 35 years of age. However, it may involve nearly every body part, including the extremities, head and neck, trunk, and abdominal cavity;as such, patients with DT may present to a range of general and subspecialty radiologists. The consensus for treatment has changed over the past decade, with most centers moving away from primary radical surgery towards a front-line “wait-and-see” policy. Here, we present a case of a tumor mass that induced hip joint contracture. DT does not usually cause functional disorder. Oncologists should be aware that a desmoid tumor can cause hip joint contracture if the mass occurs in the gluteal region. Moreover, DT resulting in such a functional disorder should be treated by resection.展开更多
Intramuscular hemangioma usually involues only a single muscle,but it may demonstrate regional involvement and can occasionally grow extremely large.In the latter condition,resection can be very difficult and occasion...Intramuscular hemangioma usually involues only a single muscle,but it may demonstrate regional involvement and can occasionally grow extremely large.In the latter condition,resection can be very difficult and occasionally lead to fatal uncontrollable bleeding during surgery.展开更多
Background: Pleomorphic adenoma constitutes the most common benign parotid gland tumor. Local recurrence after surgery has been described in 1%-5% of cases, and malignant evolution in 2%-9% of cases. Metastasizing ple...Background: Pleomorphic adenoma constitutes the most common benign parotid gland tumor. Local recurrence after surgery has been described in 1%-5% of cases, and malignant evolution in 2%-9% of cases. Metastasizing pleomorphic adenomas has rarely been reported. No histologic or molecular parameters exist at the present time that could predict the development of metastasis in these neoplasms. Methods and Results: A 54-year-old woman had a superficial left parotidectomy with facial nerve preservation for pleomorphic adenoma. She developed two recurrences in 2000 and 2001, but 25 years later the first operation she presented a metastasis in her right gluteal region with evidence of local recurrence. Conclusion: Metastatizing pleomorphic adenoma is a rare pathologic situation but, in case of swelling or lump appearance in patients with pleomorphic adenoma history, it should be taken in mind.展开更多
Background Perforator flaps are used extensively in repairing soft tissue defects. Superior gluteal artery perforator flaps are used for repairing sacral defects, but the tension required for direct closure of the don...Background Perforator flaps are used extensively in repairing soft tissue defects. Superior gluteal artery perforator flaps are used for repairing sacral defects, but the tension required for direct closure of the donor area after harvesting of relatively large flaps carries a risk of postoperative dehiscence. This research was to investigate a modified superior gluteal artery perforator flap for repairing sacrococcygeal soft tissue defects. Methods From June 2003 to April 2010, we used our newly designed superior gluteal artery perforator flap for repair of sacrococcygeal soft tissue defects in 10 patients （study group）. The wound and donor areas were measured, and the flaps were designed accordingly. Wound healing was assessed over a follow-up period of 6-38 months. From January 1998 to February 2003, twelve patients with sacrococcygeal pressure sores were treated with traditional methods, VY advancement flaps or oblong flaps, as control group. Results After debridement, the soft tissue defects ranged from 12 cm× 10 cm to 26 cm× 22 cm （mean 16.3 cm× 13.5 cm）. Four patients were treated using right-sided flaps ranging from 15 cm × 11 cm to 25 cm × 20 cm （mean 18.2 cm × 14 cm）. Four patients were treated using left-sided flaps, and two were treated using both right- and left-sided flaps. Suction drains were removed on postoperative Days 3-21 （mean 5.9） and sutures were removed on postoperative Days 12-14. Each flap included 1-2 perforators for each of the donor and recipient sites. Donor sites were closed directly. All flaps survived. In eight patients, the wounds healed after single-stage surgery. After further debridement, the wounds of the remaining two patients were considered healed on postoperative Days 26 and 33, respectively. The rate of first intention in the study group （80%, 8/10） significantly increased than that of control group （（25%, 3/12）, X2=4.583, P=0.032）. Follow-up examinations found that the flaps had a soft texture without ulceration. In the two patients without paraplegia, the range of motion of the hip joints was not affected. Conclusion The use of the quadrilobed superior gluteal artery perforator flap can overcome the disadvantages of traditional perforator flaps and represents an improved approach for repairing soft tissue defects in the sacrococcygeal region.展开更多
文摘Desmoid tumor (DT) is a relatively uncommon, cytologically bland fibrous neoplasm that is associated with possibility of local recurrence but without the potential to spread to other parts of the body. This disease affects mostly younger adults and is the most common cause of abdominal wall masses in women 20 - 35 years of age. However, it may involve nearly every body part, including the extremities, head and neck, trunk, and abdominal cavity;as such, patients with DT may present to a range of general and subspecialty radiologists. The consensus for treatment has changed over the past decade, with most centers moving away from primary radical surgery towards a front-line “wait-and-see” policy. Here, we present a case of a tumor mass that induced hip joint contracture. DT does not usually cause functional disorder. Oncologists should be aware that a desmoid tumor can cause hip joint contracture if the mass occurs in the gluteal region. Moreover, DT resulting in such a functional disorder should be treated by resection.
文摘Intramuscular hemangioma usually involues only a single muscle,but it may demonstrate regional involvement and can occasionally grow extremely large.In the latter condition,resection can be very difficult and occasionally lead to fatal uncontrollable bleeding during surgery.
文摘Background: Pleomorphic adenoma constitutes the most common benign parotid gland tumor. Local recurrence after surgery has been described in 1%-5% of cases, and malignant evolution in 2%-9% of cases. Metastasizing pleomorphic adenomas has rarely been reported. No histologic or molecular parameters exist at the present time that could predict the development of metastasis in these neoplasms. Methods and Results: A 54-year-old woman had a superficial left parotidectomy with facial nerve preservation for pleomorphic adenoma. She developed two recurrences in 2000 and 2001, but 25 years later the first operation she presented a metastasis in her right gluteal region with evidence of local recurrence. Conclusion: Metastatizing pleomorphic adenoma is a rare pathologic situation but, in case of swelling or lump appearance in patients with pleomorphic adenoma history, it should be taken in mind.
基金This work was supported by a grant from the National Natural Science Foundation of China （No. 30971128）.
文摘Background Perforator flaps are used extensively in repairing soft tissue defects. Superior gluteal artery perforator flaps are used for repairing sacral defects, but the tension required for direct closure of the donor area after harvesting of relatively large flaps carries a risk of postoperative dehiscence. This research was to investigate a modified superior gluteal artery perforator flap for repairing sacrococcygeal soft tissue defects. Methods From June 2003 to April 2010, we used our newly designed superior gluteal artery perforator flap for repair of sacrococcygeal soft tissue defects in 10 patients （study group）. The wound and donor areas were measured, and the flaps were designed accordingly. Wound healing was assessed over a follow-up period of 6-38 months. From January 1998 to February 2003, twelve patients with sacrococcygeal pressure sores were treated with traditional methods, VY advancement flaps or oblong flaps, as control group. Results After debridement, the soft tissue defects ranged from 12 cm× 10 cm to 26 cm× 22 cm （mean 16.3 cm× 13.5 cm）. Four patients were treated using right-sided flaps ranging from 15 cm × 11 cm to 25 cm × 20 cm （mean 18.2 cm × 14 cm）. Four patients were treated using left-sided flaps, and two were treated using both right- and left-sided flaps. Suction drains were removed on postoperative Days 3-21 （mean 5.9） and sutures were removed on postoperative Days 12-14. Each flap included 1-2 perforators for each of the donor and recipient sites. Donor sites were closed directly. All flaps survived. In eight patients, the wounds healed after single-stage surgery. After further debridement, the wounds of the remaining two patients were considered healed on postoperative Days 26 and 33, respectively. The rate of first intention in the study group （80%, 8/10） significantly increased than that of control group （（25%, 3/12）, X2=4.583, P=0.032）. Follow-up examinations found that the flaps had a soft texture without ulceration. In the two patients without paraplegia, the range of motion of the hip joints was not affected. Conclusion The use of the quadrilobed superior gluteal artery perforator flap can overcome the disadvantages of traditional perforator flaps and represents an improved approach for repairing soft tissue defects in the sacrococcygeal region.
