1. AbstractBackgroundRhabdomyosarcoma is a solid tumor, resulting from dysregulation of the skeletal myogenesis program. For rhabdomyosarcomas (RMS) with a predilection for the head and neck, genitourinary tract, extremities, trunk, retroperitoneum, the larynx is still an unusual site. Till now only several cases of this laryngeal tumor have been described in world literature in the adult population. The entire spectrum of genetic factors underlying RMS development and progression is unclear until today. Multiple signaling pathways seem to be involved in ERMS development and progression.Case presentationIn this paper we report an interesting RMS case in which the disease was located within the glottic region. We report an embryonal rhabdomyosarcoma of the larynx in 33 year-old man. After unsuccessful chemotherapy hemilaryngectomy was performed. In follow up CT no signs of recurrence were found. Recently patient is recurrence free for 62 months.ConclusionsConsidering the histological diagnosis and the highly aggressive nature of the lesion for optimal diagnosis positron electron tomography (PET) and computerized tomography (CT) of the neck and thorax should be performed. At this time surgical treatment with adjuvant radiotherapy seems to be the treatment of choice for this disease. Rhabdomyosarcoma of the larynx has a better prognosis than elsewhere in the body, probably because of its earlier recognition and accessibility to radical surgery.
Background: While psychological factors may play a significant role in the development and course of asthma, the availability of information on the scale of the problem and the factors associated with psychogenic asthma is limited. The aim of the study was to assess the frequency of coexistence of asthma and other diseases considered to be of psychosomatic origin, to assess the impact of stress and strong emotions on the occurrence of acute exacerbations of asthma, to measure the level of alexithymia in asthmatic patients, and to look for its association with acute exacerbations triggered by stress and strong emotions. The level of alexithymia was also assessed in the context of asthma control. Materials and methods: The study was conducted on a group of 54 patients (75.9% females) with a diagnosis of asthma (mean age: 54.37 ± 14.52 years) at the Independent Public Central Teaching Hospital in Warsaw, Poland. The patients completed a questionnaire composed of the Asthma Control Test, a list of factors that could trigger an acute exacerbation of asthma, and the Toronto Alexithymia Scale (TAS-26; translated into Polish by E. Scigala and T. Maruszewski). The patients were also asked about any co-morbidities that had been diagnosed by other doctors and that might be caused, at least in part, by psychological and behavioural factors, and co-morbidities that might be associated with stress but are characterised by somatic manifestations. The co-morbidities in question were: irritable bowel syndrome, atopic dermatitis, depression, panic disorder, and anorexia nervosa. In the remainder of this paper these disorders are collectively referred to as ‘psychosomatic disorders’. The statistical analysis was performed using SPSS 14.0 PL at the significance level p < 0.05. Non-parametric tests for independent samples were used to test the associations between the qualitative variables. Results: In 50% of the cases, at least one of the following disease entities were identified in the patients carrying the diagnosis of asthma: irritable bowel syndrome (n = 8), atopic dermatitis (n = 7), depression (n = 13), panic disorder (n = 9). Alexithymia was diagnosed in 11 cases (21.6%). The correlation of the level of alexithymia with stress and strong emotions was statistically non-significant (χ2 = 0.106, p > 0.05). Stress and/or strong emotions were identified as factors triggering acute exacerbations of asthma in 33 cases (61.1%). Poor, good, and complete asthma control was confirmed in 72.5%, 17.6% and 9.8% of the cases, respectively. No association of asthma control with the occurrence of alexithymia was identified (χ2 = 0.358, p > 0.05). No association of asthma control with gender was identified (χ2 = 0.605, p > 0.05). Conclusions: The high level of alexithymia in asthmatic patients, the frequent occurrence of disorders considered to be psychosomatic in origin, and the considerable impact of stress and strong emotions on the development of acute exacerbations of the disease confirm that asthma can be considered a psychosomatic disorder.
SSTRs are overexpressed on JNA cells. The SST analog (99m)TC-octreotide is effectively bound to JNA cells. SST analogues might be used in the diagnostics and treatment of primary, recurrent, or residual JNA.
At present, only eight cases of tracheal adenoid cystic carcinomas (ACCs) mimicking thyroid tumors have been reported. Since there are no guidelines available regarding their diagnosis and treatment, they present a significant clinical challenge. In the present study, patient treatment was analyzed to deliver the first concise summary of treatment options in patients with ACC mimicking a thyroid tumor. In addition, all available data regarding molecular abnormalities of this disease have been discussed. The current study presents a case of a 17-year-old patient with a tracheal ACC mimicking a thyroid tumor. The patient was diagnosed in 2007 with a pathological mass between the left lobe of the thyroid and the trachea, and underwent surgery and radiotherapy. In 2010, multiple lesions in the lungs were diagnosed and pulmonary metastasectomy was performed. Following surgery, the patient has been disease-free for almost 30 months. Thyroid tumor biopsy may reveal ACCs. This pathological report requires further investigation of the head and neck in order to confirm if the disease is of tracheal origin. Patients may present with a neck swelling, hoarseness of voice or dysphagia. Surgery must be considered as first-line therapy for all patients with local disease as it may be curative. For palliative treatment chemoradiotherapy based on cisplatin may be effective. The identification of cytogenetics, tumor suppressor genes, oncogenes, epigenetic alterations and mitochondrial abnormalities specific for ACCs is critical to the development of targeted therapies. Thus far, large studies have only reported the transcriptional activator Myb and mammalian target of rapamycin signaling pathway to be disrupted in ACCs.
The anterior cervical spine surgery is a common procedure to stabilize vertebrae damaged by various diseases. The plates and screws are usually used in the spine fixation. This kind of instrumentation may detach from the bones which is a rare but well-known complication. A 77-year-old male presented to the otorhinolaryngology department with throat pain, choking, and dysphagia. At first the angioedema was diagnosed and he was treated conservatively. The endoscopy revealed laryngeal edema, being more defined on the right side with right vocal fold paresis. CT scans showed the stabilizing plate with two screws attached tightly and the back-out of the third screw toward soft tissue of the neck. In the meantime, his condition deteriorated and he needed tracheotomy. In few days the surgical removal of the dislocated screw was performed successfully. Although two-month follow-up reported no obstruction of the larynx, the vocal folds paresis with gradual functional improvement was observed. Long-term complication of anterior spine surgery sometimes may suggest laryngeal angioedema at first. If the conservative treatment is ineffective and there is a history of anterior spine surgery, the clinicians should consider the displacement of the plate or screws in differential diagnosis.
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