These patients should be addressed with additional work-up and surgery if metastatic thyroid cancer is documented in the lymph node. We offer a diagnostic algorithm that may aid in further work-up and treatment in these unusual cases.
On the basis of the findings of this case series, lymphatic malformations that are found to be nonencapsulated and infiltrative by intraoperative or histologic assessment are more likely to recur.
We have established independent models of nasal obstruction and ostial occlusion in the same animal. Our findings suggest that ostiomeatal complex dysfunction might not be the sole underlying factor in the pathogenesis of sinus disease in all individuals. Integrity of nasal airflow seems to have a significant effect on the maintenance of the aerobic antral environment, essential to the maintenance of normal sinus function. Modulation of maxillary sinus gas composition by nasal airflow, independent of ostial patency, may be explained by the possible presence of flow-sensitive receptors in the upper respiratory tract mucosa. Work to identify such receptors is currently in progress.
Preservation of the "peritracheal fold" in the dog model of tracheal transplantation is critical to the onset and maintenance of vascular perfusion in a long tracheal segment. Furthermore, the use of large-bodied dogs is necessary to provide for a usable venous efflux component.
Ganglioneuromas are rare. benign. neurogenic tumors arising from central or peripheral components of the sympathetic nervous system. They most commonly present in patients younger than 20 years of age in the posterior mediastinum or retroperitoneurn.! When these tumors present in alternative locations. a definitive clinical diagnosis is difficult because of a paucity of specific signs and symptoms. It has been reported that in a majority of cases these tumors exhibit clinically detectable evidence of production of adrenergic hormones. however. few patients actually manifest a sympathetic response. I Ganglioneuromas are slow growing, noninvasive lesions that are often only detectable incidentally as a painless mass or because of a mass effect on neighboring structures.Evaluation with CT imaging can reveal the size. extent, and composition of such tumors; however. a biopsy is necessary for definitive diagnosis. The most characteristic histologic feature of ganglioneuromas is the presence of mature ganglion cells. Approximately 25% of ganglioneuromas will also have histologic elements of immature neurogenic tumors; it has been hypothesized that tumors of neural crest origin have the propensity to mature from malignant forms (ie, neuroblastoma) into the benign ganglioneuroma.' Complete cure is possible with surgical excision. depending on the location of the tumor. Significant morbidity may occur as a result of the intraoperative sacrifice of structures intimately associated with the tumor such as neural structures or vasculature.We report on the case of a 2 1 / z-year-old female patient with a parapharyngeal space ganglioneuroma.
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