سال:1400 | دوره: | شماره: |تعداد مقالات:5

Introduction: Multiple synchronous neoplasms were first described in a study by Billroth in 1889. Since then, many researches have been conducted in this field till 1932 when Warren and Gates published their criteria for the diagnosis of two synchronous tumors. Synchronous colorectal and renal blastomas are rare. The number of case reports published so far is relatively small. Case presentation: We report a case of a 63-years old male patient who was admitted to our clinic with symptomatic, histologically confirmed rectal adenocarcinoma located near the anorectal line. Contrast-enhanced CT showed evidence of synchronous lesion in the left kidney area. Laparoscopic left nephrectomy was performed, followed by abdominoperineal resection of the rectum with total mesorectal excision and para-aortic lymph dissection. Both resectates were extracted through the perineal access with no need for additional abdominal incision. No similar case was found in our literature review without using abdominal incision. Conclusion: The simultaneous multi-visceral laparoscopic resection of synchronous neoplasms is a reliable and safe method in certain patients. When performed by an experienced surgical team, the oncological outcomes are comparable to those achieved; using a conventional approach. A specific advantage is that this is a one-stage surgery that provides quick recovery with lower risk of postoperative complications.

Introduction: Necrotizing sialometaplasia is a rare, benign, and self-limiting inflammatory lesion that commonly involves minor salivary glands. It is theoretically associated with ischemia. It is commonly found in the palate, and laryngeal presentation is a very unusual entity. Almost half of such cases have an underlying malignancy; therefore, suspicion of a malignant lesion should be high when this entity is found at any laryngeal level. Case presentation: The present case was a 59-year-old male presenting a necrotizing sialometaplasia in the larynx, which obscured a malignancy, delaying the diagnosis until a positive metastatic cervical lymph node emerged. Conclusion: Necrotizing sialometaplasia is an extremely rare pathology at the larynx, with only five cases reported in the literature. The current case was the 6th to date. Almost half of such cases presented a malignancy beneath the lesion; therefore, it is crucial to perform a close follow-up in such patients.

Introduction: This study aims to evaluate the parameters that might have an impact on swallowing performance after a total glossectomy with laryngeal preservation (TGLP). Methods: Among 39 patients who underwent surgery with curative intent for squamous cell carcinoma of the tongue, our retrospective analysis focused on 18 patients treated by TGLP and flap reconstruction. The flap was positioned using three points of suspension: mandible (anteriorly), remaining suspensor muscles (cranially), and hyoid bone (inferiorly). Videofluoroscopic swallowing studies were performed after surgery, and the movements of the hyoid bone on the horizontal and vertical plane were measured on a frame-by-frame basis, and the velopharyngeal contact was recorded. Swallowing was studied at consecutive time-intervals using the Gugging Swallowing Screen (GUSS), and patients were categorized into three groups according to their swallowing ability (good, intermediate, and bad). The relationship between categorical and continuous variables and the swallowing ability were investigated using the chi-squared or Fischer exact test and Mann-Whitney test or t-student test respectively. Results: Swallowing ability at 6-8 months was good in 13 patients and intermediate or bad in five patients. Swallowing improved in 1 and 3 patients at 12 and 18 months, respectively. The hyoid bone movement in the y-axis and extension of surgery to the tonsil were statistically associated with swallowing (P=0. 002 and P=0. 04, respectively). Velopharyngeal contact was obtained in the entire cohort. Conclusions: Flap suspension using three points of attachment, could allow the restoration of an active hyoid movement and the velopharyngeal closure, thereby achieving valid swallowing.

Cardiac paragangliomas (PGs) are rare neuroendocrine tumors comprising less than 1% of cardiac tumors. Few cardiac PG case reports and series are described in the literature. Cardiac PGs may be sporadic or arise from a syndromic association. Clinical presentations vary depending on the biochemical activity and location of the tumor. The left atrium, the right atrium, AP window, left ventricle, and atrioventricular groove are the most common sites for cardiac PGs, respectively. Many cardiac PGs are associated with succinate dehydrogenase (SDH) gene mutations. SDH-mutated PGs have aggressive histologic and clinical behavior. Therefore, PG patients should be screened for SDH mutations and provided with appropriate genetic counseling. SDH immunostaining can be used as a substitute diagnostic modality for SDH gene mutation and negative staining is associated with SDH mutation. Biochemical analysis, anatomical imaging, and functional imaging are also used for diagnostic workup of the tumor. Surgery is the only curative treatment for this tumor. Adrenoceptor blockers should be administered in functional PGs. PGs are highly vascular and frequently situated close to vital vessels. Accordingly, surgical complications such as bleeding are a leading cause of mortality in PGs. Metastatic PGs are only seen in a small subset of patients and are associated with poor clinical outcomes. Herein, we summarize clinical and pathological advances in cardiac PGs.

Breast cancer (BC) is still a common malignancy among women and is the cause of many deaths. Many factors can increase the risk of breast carcinoma and its related mortality. Among these risk factors, some epidemiological studies support the idea that thyroid hormones contribute to many body functions and thyroid regulatory pathways are related to the risk of BC. Although some studies stated that thyroid hormones, whether at high or low levels, increase the risk of BC, controversial evidence is investigated. The current study aimed at investigating different possible associations between thyroid function and BC, after reviewing some general subjects on BC, and thyroid function and hormones.