BACKGROUND. Synovial sarcomas of the soft tissue are a particular type of sarcomas that rarely appear in the head and neck region.
CASE REPORT AND COMMENTS. We present the case of a 27-year-old patient diagnosed in 2017 with soft palate biphasic synovial sarcoma who presented with recurrent microepistaxis, nasal obstruction, left cephalalgia and aural fullness in the left ear. The clinical examination showed a tumor with approximately 4/6 cm in diameter, covered with sero-sanguinolent secretions, pulsating in nature, completely obstructing the left choana. The surgical treatment consisted of complete removal of the tumor under endoscopic guidance with electrocauterization of the insertion area, without further postoperative radiotherapy. The histopathological aspect was suggestive for pleomorphic sarcoma, poorly differentiated, confirming the local recurrence of the tumor. The patient also presented lung metastasis from undifferentiated malignant tumor.
CONCLUSION. The particularity of this case is represented by the extremely rare occurrence of synovial sarcoma in the head and neck region, especially at the level of the soft palate. Complete resection of the tumor with negative margins represent the mainstay of treatment, associated with adjuvant radiotherapy, with an important role in improving disease-specific survival.
BACKGROUND. Coronavirus disease 2019 (COVID-19) is one of the main global health problems of the twenty-first century, with more than one-hundred million people infected and more than two million deaths. The immunosuppression caused by SARS-CoV-2 infection along with steroidal treatment, hyperglycaemia and elevated ferritin levels creates the perfect environment for opportunistic infections such as mucormycosis. COVID-19-associated mucormycosis carries a high mortality rate. Therefore, in addition to antifungal therapy and aggressive surgical debridement of necrotic tissue, strategies to improve glycaemic index is the key factor in order to obtain a favourable outcome.
MATERIAL AND METHODS. For the purpose of this article, the PubMed databases were searched using MeSH descriptors and the Boolean operator “AND” for the terms “rhinosinusal” and “mucormycosis” and “diabetes”, between February 2019 – December 2021. Clinical characteristics, therapy and outcome data were gathered and compared to what has previously been reported in the literature. Also, we report the case of a 68-year-old patient with uncontrolled type 2 diabetes mellitus, who developed mucormycosis during post-COVID period, to underline the need of early detection of this potentially deadly fungal illness.
RESULTS. The clinical and imaging evaluation revealed no evidence of disease recurrence, at one- and two-months’ follow-ups.
CONCLUSION. In this context, we would like to emphasize the importance of a high index of suspicion for mucormycosis in patients with COVID-19 infection, with pre-existing medical disorders, presenting with rhino-orbital or rhino-cerebral symptomatology.
Recurrent implantation failure is represented by the failure to achieve a clinical pregnancy after transfer of at least 4 good-quality embryos in a minimum of 3 fresh or frozen cycles in a woman under the age of 40 years. One of the recent approaches in studying the window of implantation was building the expression profile of the genes of the endometrial cells. We performed a retrospective study which investigated if endometrial receptivity tests improved the outcomes of IVF procedures in patients with recurrent implantation failure. We enrolled 47 couples with RIF and divided them in 2 groups: the first group of 22 couples performed the ERA test and the embryo transfer according to the result of the test; the second group of 27 couples had the embryo transfer done without the ERA test. Our conclusion was that the ERA test did not improve the outcomes for patients with recurrent implantation failure.
Objectives: Single umbilical artery (SUA), the most common malformation in humans, 1% incidence in singletons, may be an isolated finding in normal fetuses (75%) or associated with chromosomal (5%) and/or other congenital anomalies (20%). The cause is either primary agenesis or secondary thrombotic atrophy of one umbilical artery. The aim of the study was to establish the management of pregnancies with SUA and to evaluate their obstetric outcome.
Methods:We performed a retrospective study on a series of singletons detected with SUA. The study group consisted of all pregnancies followed-up 2011-2021 by a single obstetrician. Multiple pregnancies and those obtained after human reproductive technologies were excluded. The detection of the SUA was done at the first trimester screening ultrasound in a transverse view of the fetal pelvis searching the intra-abdominal segment of the umbilical arteries running alongside and around the fetal bladder using colour Doppler.After the detection of SUA, the fetus was carefully monitored for structural anomalies and serial fetal growth scans were performed. Postnatally all cases were followed-up until de age of 1. Results: The incidence of SUA was 0.66%. All cases of SUA were diagnosed in the first trimester and confirmed postnatally. Most were isolated SUA and did not develop IUGR, or complicate with pre-eclampsia or preterm birth. One case of Trisomy 18 was confirmed after karyotyping indicated for detection of other congenital malformations beside SUA and induced abortion was performed at 21w, the other cases of SUA delivered at term, Apgar scores > 8. None congenital malformation was detected postnatally. Conclusions: Most likely the good pregnancy outcome in the study group can be explained by the fact that the cause of SUA was due to primary agenesis of one umbilical artery and not due to thrombotic atrophy. The management and ultrasound follow up of pregnancies detected with SUA should adapt depending on the physiopathological cause of this condition.
EP29.12 Prenatal findings and follow up of a child with Trisomy 21 and congenital chylothorax
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.