Tumors of the trachea and central bronchi can be benign or malignant. Clinical presentation may be confusing, particularly in benign tumors that can be misdiagnosed as asthma or chronic bronchitis. Chest radiography has many limitations and is often considered unremarkable in patients with tumors of the central airways; therefore, multidetector CT (MDCT) has become the most useful noninvasive method for diagnosing and assessing the central airways. The purpose of this article is to provide a review of imaging of the tumors of the trachea and central bronchi. We emphasize the crucial role of MDCT and postprocessing techniques in assessing neoplasms of the central airways.
We describe a case of
extramedullary tracheal plasmacytoma that was
incidentally discovered in a 73-year-old man on a PET
scan performed for assessing the extent of colon
cancer. CT scan showed the tumor; multiplanar
reformation coupled with virtual bronchoscopy allowed
proper treatment planning. The tracheal tumor was
resected during rigid bronchoscopy. Relevant
investigations excluded multiple myeloma. Follow-up CT
showed persistent thickening of the tracheal wall, but
there has been no recurrence after one-year
followup.
Midline cysts of the neck are the most common congenital malformations of the neck. They arise along the thyroglossal duct. The presence of a fistula is the result of either spontaneous (suppuration) or surgical fistulisation (simple incision or incomplete excision). The cyst and/or fistula are located between the base of the tongue and the thyroid gland, predominantly adjacent to the hyoid bone. This midline site can be explained by embryological development of the thyroid gland. Treatment is surgical. Many techniques have been described, but Sistrunck procedure (described in 1920), based on embryological studies, remains the reference technique with a recurrence rate of less than 3%, provided surgery is performed correctly, comprising resection of the body of the hyoid. Risk factors for recurrence are: surgery during the inflammatory phase, cyst rupture during dissection, multiple thyroglossal ducts and a technical error during the surgical procedure.
Background
The aim of the study was to evaluate the benefits of the combination of Gadolinium‐based nanoparticles AGuIX and radiotherapy on the recurrence free survival after tumor resection in a head and neck animal orthotopic model.
Methods
Human head and neck CAL33 orthotopic tumors were implanted in female NMRI nude mice. The biodistribution of AGuIX was studied by fluorescence imaging. Tumor resection was performed 19 days after tumor implantation. Radiotherapy was performed 23 days after resection (10 Gy), 1 hour after AGuIX IV injection.
Results
After systemic administration, AGuIX passively accumulated in the orthotopic tumors. After tumor surgery, the combination of AGuIX with radiotherapy significantly improved the recurrence free survival and the median survival time (196 days) compared to irradiated only mice (75 days).
Conclusion
This study demonstrated the improvement of the recurrence free survival following combination of AGuIX injection with radiotherapy after Head and neck tumor resection.
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