No abstract

Composite hemangioendothelioma is a rare vascular tumor; only 12 cases have been previously described in the extremities, tongue and axilla. We report the first case of composite hemangioendothelioma of the mediastinum in a 50-year-old woman. She was admitted to our hospital with dyspnea and cough lasting for two months. Her chest roentgenogram and computed tomography showed a 6 x 4 x 3 cm mass in the middle mediastinum compressing the trachea. She underwent total sternotomy and resection of the mass. Microscopically the most important feature at low power was the variability in the histological pattern. This case is presented not only for the rarity of the tumor type but also for its unusual location.

Necrotizing soft-tissue infection (NSTI) is a bacterial infection with necrosis of the cutaneous, subcutaneous tissue and fascia with sparing of the underlying muscle. The most frequent initiating factor reported, for necrotizing fasciitis, in the head and neck region is a primary odontogenic infection or postextraction infection, abrasion, and laceration of the face or scalp. Necrotizing fasciitis can progress rapidly to systemic toxicity and even death if not promptly diagnosed and treated. If the patient has any risk factors, this can worsen the prognosis. In this study, 2 cases of NSTI with dental pathology history (one with the spreading to mediastinum and the other spreading to suprahyoid) were discussed with a review of the literature. One of the cases had diabetes mellitus, but interestingly, she had a better prognosis, and she was discharged asymptomatic. In addition, the other case had no any risk factors, but he had a worse clinical cranial nerve paralysis (a rare complication of NSTI) and died. As a conclusion, despite the intensive therapy, large debridement, and antibiotics with large spectrum, the delay in the patient's diagnosis and treatment increased mortality. We aimed to attract attention to the importance of dental pathologies and early diagnosis.

No abstract

Metastatic tumour spread to the mandible is quite rare. We report a case of distant metastasis of pulmonary adenocarcinoma in the mandibular bone. The patient had pain in his left mandibular premolar-molar area caused by a mandibular metastasis from a previously undiagnosed pulmonary adenocarcinoma.

Cervical necrotizing fasciitis (CNF) is a rare, rapidly advancing infection that involves the skin, the subcutaneous fibrofatty tissue, as well as the superficial and deep fascia and can cause life-threatening complications. The most frequent initiating factors in the head and neck region are a primary odontogenic infection, a peritonsillar infection, as well as posttraumatic or iatrogenic skin and mucosal injuries. Necrotizing fasciitis (NF) can expand within hours, and the reported mortality rate is up to 75% with delay interference. If the patients have any risk factors, poor prognosis can be seen. In this study, 1 patient with CNF with a history of peritonsillar infection and 2 patients with CNF who had a history of odontogenic infection with spreading to the temporal region and the mediastinum were described, with information of the literature and a clinical experience that was gained from 5 patients with NF who were seen at our clinic in the recent year, despite the fact that CNF was not seen up to last year. None of the patients had any risk factors. One of them had a worse clinical state with ascending infection to the temporal region, cranial nerve paralysis, and descending necrotizing mediastinitis, but he recovered from NF. After the oral intake began, dyspnea due to aspiration was seen and he died because of sepsis and multiorgan dysfunction. We aimed to attract attention to the importance of dental pathologies and increased mortality in a healthy patient.

No abstract

Although completion pneumonectomy for benign causes is a high risk procedure, it can be performed in selected patients with an acceptable morbidity and mortality after an effective preoperative medical therapy for inflammation of the lungs and with careful dissection at the operation.