The treatment of 102 patients with squamous cell carcinoma of the pyriform sinus seen at the University of Virginia Medical Center from 1958 through 1977 is reviewed. Eight-seven cases form the basis for this report. Surgery alone, radiation alone and combination of the two were the treatment modalities utilized for the patients in this study. The overall 3 year, no evidence of disease determinate survival was (37%). Recent literature has suggested that preoperative radiation obscures tumor margins with a decrease in survivals as compared to postoperative irradiation. Though the number of patients in both the preoperative (27) and postoperative (7) groups are small, our data suggests similar survivals. In addition, when pathology was examined, no tumor margins were transected in the preoperative irradiation group and only 5/23 patients had margins classified as close. The incidence of postoperative complications was not significantly difference between the combination therapy and surgery only groups. It is concluded that preoperative irradiation does not compromise the resection of adequate tumor margins nor significantly increase postoperative complications.
ternal cleft is a rare congenital malformation caused by complete or partial failure of the sternum to fuse during the third month of embryologic development. Cleft sternums can be classified as superior, inferior, or complete. Sternal clefting is also associated with the PHACES syndrome, a neurocutaneous syndrome consisting of posterior fossa malformations, hemangiomas, arterial anomalies, coarctation of the aorta, cardiac defects, eye abnormalities, and sternal clefting with or without abdominal raphae. We present the case of a 1-day-old girl who was born at our institution with a variant of the PHACES syndrome. Although the sternal cleft was evident clinically, sonography provided additional information compared with plain radiography in showing the extent of the anterior chest wall abnormalities. The literature on this rare condition is reviewed.
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