Malignant Peripheral Nerve Sheath Tumor of the Infraorbital Nerve.

The objective of this study is to report a large, rare, and ulcerative infiltrated skin lesion. Its diagnosis, therapeutic management, and progress are described. The patient is a 78-year-old white man, who presented with a 12-month ulcerative perforated lesion that had affected and infiltrated the skin, with easy bleeding.

Pedicled adipofascial infraclavicular flap: Elevation technique and its use for maintaining neck contour and vessel coverage after radical and modified radical neck dissection.

Background: The pedicled adipofascial infraclavicular flap (ICF) is based on the anterior perforator of the supraclavicular artery and supplies the fasciocutaneous tissue of the upper chest. This flap may be used to address neck contour defects and vessel coverage after radical and modified radical neck dissections (MRNDs).

Methods: We described the pedicled adipofascial ICF elevation technique and its use immediately after neck dissections in order to maintain soft tissue volume and vessel coverage.

Risk factors for recurrence in patients with papillary thyroid carcinoma undergoing modified radical neck dissection.

Background: This study evaluated the impact of lymph node-related factors on the risk of and site of recurrence in patients who had papillary thyroid carcinoma with lymph node metastasis in the lateral compartment (classified as pN1b).

Methods: Patients underwent total thyroidectomy with unilateral modified radical neck dissection for classical papillary thyroid carcinoma. Risk factors for recurrence were evaluated according to the pattern of recurrence.

A Rare Presentation of Autonomously Functioning Papillary Thyroid Cancer: Malignancy in Marine-Lenhart Syndrome Nodule.

Objective. Marine-Lenhart Syndrome (MLS) is defined as concomitant occurrence of autonomously functioning thyroid nodule (AFTN) with Graves' disease (GD). Malignancy in a functional nodule is rare.

Complications of Neck Dissections in Papillary Thyroid Carcinoma: A Modified Procedure to Reduce Parathyroid Morbidity.

Background/aim: Hypoparathyroidism is the most significant morbidity after neck dissection for thyroid cancer. Addition of lateral neck dissection (ND) to central ND combined with total thyroidectomy (TT) increases the risk of postoperative hypoparathyroidism compared to TT plus central ND. The aim of this study was to verify if a modified procedure and different access to the neck for lateral ND may improve safety.

Three-Dimensional Imaging in Neurosurgical Research and Education.

Objective: We describe the setup and use of different 3-dimensional (3-D) recording modalities (macroscopic, endoscopic, and microsurgical) in our laboratory and operating room and discuss their implications in neurosurgical research and didactics. We also highlight the utility of 3-D images in providing depth perception and discernment of structures compared with 2-dimensional (2-D) images.

Methods: The technical details for equipment and laboratory setup for obtaining 3-D images were described.

Dissection of Levels II Through V Is Required for Optimal Outcomes in Patients with Lateral Neck Lymph Node Metastasis from Papillary Thyroid Carcinoma.

Background: Completeness of surgical resection is an important determinant of outcomes in patients with papillary thyroid carcinoma and regional lymph node metastasis. The extent of therapeutic lateral neck dissection remains controversial. This study aims to assess the impact of modified radical neck dissection of levels II to V in a large patient series.

The use of SPECT-CT improves accuracy of post-radioiodine therapy imaging and changes the management strategy in a case of advanced follicular thyroid carcinoma.

This is a case of follicular thyroid carcinoma with extensive lung, bone and brain metastases. Multi-modality treatments including total thyroidectomy, modified radical neck dissection, cranial radiotherapy and Iodine-131 (RAI) therapy were instituted. Post RAI therapy planar whole body scan showed RAI avid metastases in the skull, cervical spine, bilateral lungs and abdomen.

A Vessel-Preserving Surgical Hip Dislocation Through a Modified Posterior Approach: Assessment of Femoral Head Vascularity Using Gadolinium-Enhanced MRI.

Background: Surgical hip dislocation allows circumferential access to the femoral head and acetabulum and is utilized in the treatment of intra-articular hip disorders. Surgical hip dislocation is currently performed with a trochanteric osteotomy that reliably preserves the femoral head arterial supply; however, trochanteric nonunion or painful hardware requiring removal may occur. In a cadaveric model, using gadolinium-enhanced magnetic resonance imaging (MRI) and gross dissection, we evaluated whether modifications to the posterior approach preserve the femoral head arterial supply after a posterior surgical hip dislocation.

A Parapharyngeal Soft Tissue Chordoma Presenting with Synchronous Cervical Lymph Node Metastasis: An Unusual Presentation.

A 63 year old male presented with a three month history of dysphagia, neck swelling and an oropharyngeal swelling on examination. Initial fine needle aspiration cytology and magnetic resonance imaging (done at a peripheral hospital) suggested a salivary gland neoplasm with lymph node metastasis. An infra-temporal approach was employed to excise the tumour mass and a modified radical neck dissection undertaken to remove the cervical metastasis.

Variant anatomy of internal jugular vein branching.

The knowledge of both normal and abnormal anatomy of the veins of the neck is important for clinicians performing catheterization and surgeons operating in the region of the neck. The presence of such anomalous communications may also be important for radiologists performing angiographic and sonographic studies. This study presents three cases of variant anatomy in posterior branching and abnormal branching of internal jugular vein found during our routine neck dissection.

Topographical and functional anatomy of trapezius muscle innervation by spinal accessory nerve and C2 to C4 nerves of cervical plexus.

The aim of this study was to determine the existence and the frequency of communicating branches between the spinal accessory nerve (SAN) and the C2, C3 and C4 roots of the cervical plexus. The present study also aimed to elucidate whether these branches contain motor fibers or not. Dissection of the cervical region was performed on twelve adult cadavers.

Papillary thyroid microcarcinoma in Graves' disease presenting as a cystic neck mass.

The presentation of papillary thyroid microcarcinoma (PTMC) as a solitary cystic neck mass is uncommon. Additionally, its association with Graves' disease is very rare. We report a case of occult PTMC, who presented with a cystic neck mass in the background of Graves' disease without any goiter.

Predictive Factors of Superior Mediastinal Nodal Metastasis from Papillary Thyroid Carcinoma--A Prospective Observational Study.

Objectives: The purpose of this study was to demonstrate the incidence rates and predictive factors of superior mediastinal lymph node (SMLN) metastasis in PTC (papillary thyroid carcinoma) patients.

Methods: A prospective observational study was performed between January 2009 and January 2011. PTC patients who had tumors with a maximal diameter greater than 1 cm and clinically negative SMLNs were included in this study.

Dissecting pseudoaneurysms: predictors of symptom occurrence, enlargement, clinical outcome, and treatment.

OBJECTIVE Dissection of the carotid and vertebral arteries can result in the development of aneurysmal dilations. These dissecting pseudoaneurysms can enlarge and cause symptoms. The objective of this study is to provide insight into the progression of dissecting pseudoaneurysms and the treatments required to manage them.

[Surgical treatment of intracranial aneurysms via the pterional keyhole approach].

Objective: Modify the pterional approach for intracranial aneurysms clipping with minimally invasive concept to reduce the risk of iatrogenic surgical trauma.

Methods: A 4.0 cm skin incision was made along the temporal hairline and centered on the pterion, temporal muscle was incised along the sylvian fissure.

Intra-Operative Lymphatic Mapping and Sentinel Node Biopsy in Laryngeal Carcinoma: Preliminary Results.

Introduction: Sentinel node mapping has been used for laryngeal carcinoma in several studies, with excellent results thus far. In the current study, we report our preliminary results on sentinel node mapping in laryngeal carcinoma using intra-operative peri-tumoral injection of a radiotracer.

Materials And Methods: Patients with biopsy-proven squamous cell carcinoma of the larynx were included in the study.

Approaches of robot-assisted neck dissection for head and neck cancer: a review.

Robot-assisted surgery is being increasingly used by surgeons because of its enhancement of visualization, precision, and articulation compared with conventional minimally invasive techniques. In recent years, robot-assisted neck dissection (RAND) has begun to be used as an alternative method of neck dissection, one of the classic surgical procedures in the area of head and neck surgery. Currently, there are four kinds of approaches for RAND: (1) modified facelift or retroauricular incision, (2) combined transaxillary and retroauricular incision, (3) transaxillary incision, and (4) transoral incision.

Colorectal Adenocarcinoma Metastasis to the Tongue.

This case presentation examines a rare clinical entity: colorectal adenocarcinoma (CRC) metastasis to the tongue. CRC is among the least common tumors to metastasize to the oral cavity. Objectives for this case report are to (1) maintain a high index of suspicion for oral cavity tumors representing metastatic disease, (2) consider appropriate surgical and adjunctive interventions, and (3) recognize the significance of identifying the primary tumor via immunohistochemical staining.

Neck muscle atrophy and soft-tissue fibrosis after neck dissection and postoperative radiotherapy for oral cancer.

Late complications of head and neck cancer survivors include neck muscle atrophy and soft-tissue fibrosis. We present an autopsy case of neck muscle atrophy and soft-tissue fibrosis (sternocleidomastoid, omohyoid, digastric, sternohyoid, sternothyroid, and platysma muscles) within the radiation field after modified radical neck dissection type I and postoperative radiotherapy for floor of mouth cancer. A 70-year-old man underwent primary tumor resection of the left floor of mouth, left marginal mandibulectomy, left modified radical neck dissection type I, and reconstruction with a radial forearm free flap.

Neck dissection for oral squamous cell carcinoma: our experience and a review of the literature.

Objectives: This article describes our experience with neck dissection in 10 patients with oral squamous cell carcinoma.

Materials And Methods: Between January 2007 and October 2009, 10 patients underwent primary surgery for the treatment of squamous cell carcinoma of the oral cavity. For patients with N0 disease on clinical exam, selective neck dissection (SND [I-III]) was performed.

[Analyses of therapeutic and prognostic factors for rN3 neck recurrence of nasopharyngeal carcinoma after primary radiotherapy].

Objective: To investigate the treatment and prognosis for rN3 neck recurrence of nasopharyngeal carcinoma (NPC) after primary radiotherapy.

Methods: A total of 37 cases with rN3 neck recurrence after radiotherapy in NPC between October 2003 and August 2013 were retrospectively analyzed. Of them 19 cases presented with lymph node (LN) metastasis in supraclavicular fossa, 18 cases had metastasis LN > 6 cm, 10 cases received chemoradiotherapy, and 27 cases underwent neck dissection including modified radical neck dissection (MRND) for 9 cases, radical neck dissection (RND) for 18 cases.

Patterns of lymph node metastasis of parotid cancer.

Objective: To define the incidence and pattern of spread of lymph node metastasis from parotid cancers and to clarify the risk factors and appropriate extent of neck dissection (ND) for individual patient with parotid cancer.

Methods: A total of 72 patients with parotid gland cancer treated by surgery between 1994 and 2013 were analyzed retrospectively by reference to medical records. In line with our protocol, patients with clinically positive lymph nodes and/or cT3/T4 disease were generally selected to undergo ND.

Clinical significance of SUVmax in (18)F-FDG PET/CT scan for detecting nodal metastases in patients with oral squamous cell carcinoma.

To retrospectively investigate the diagnostic accuracy of FDG-PET/CT relative to CT for detection of cervical node metastases in patients with oral squamous cell carcinoma (OSCC), using histologic evaluation of dissected cervical nodes as the reference standard. Thirty-six patients with OSCC who underwent neck dissection (4 bilateral, 32 unilateral; 250 nodal levels) after FDG-PET/CT. Two observers consensually determined the lesion size and SUVmax of visible cervical nodes and compared the results with pathologic findings at the nodal level.

Clinicopathological and Targeted Exome Gene Features of a Patient with Metastatic Acinic Cell Carcinoma of the Parotid Gland Harboring an ARID2 Nonsense Mutation and CDKN2A/B Deletion.

We describe the presentation, treatment, clinical outcome, and targeted genome analysis of a metastatic salivary acinic cell carcinoma (AciCC). A 71-year-old male presented with a 3 cm right tail of a parotid lesion, first detected as a nodule by the patient seven months earlier. He had a right total parotidectomy with cranial nerve VII resection, right facial nerve resection and grafting, resection of the right conchal cartilage, and right modified radical neck dissection.