Published reports of benign nerve sheath tumors of the oropharynx especially at tongue base are extremely rare. They may slowly growing but represent a potential threat to the airway, prompt diagnosis and treatment are vital. To our knowledge, this case presents the rare clinical condition and the first giant one. Due to the rarity, awareness of the possibility of a schwannoma in various otolaryngological conditions is an important step in making a correct clinical diagnosis. Here we represent a rare case of a giant schwannoma that arose from valleculae projecting to supraglottis to cause swallowing difficult but no breathing problem. The mass was completely removed, and no recurrence during next 2 years follow-up.
Humans ; Male ; Middle Aged ; Neurilemmoma ; Tongue Neoplasms

Objective To explore the efficacy and feasibility of laparoscopy-assisted radical total gastrectomy in the treatment of cancer of the cardia and fundus. Methods The clinical data of 176 patients with cancer of the cardia and fundus who received total gastrectomy at the Union Hospital of Fujian Medical University from April 2007 to April 2009 were retrospectively analysed. Among the patients, 81 received laparoscopic total gastrectomy ( LATG group) and 95 received open total gastrectomy ( OTG group). The patients' intra- and postoperative conditions, clearance of lymph nodes, morbidity and mortality were analysed using the chi-square test and t test. Results All the operations were successfully carried out. The intraoperative blood loss was (98 ± 84) ml in the LATG group and (339±245) ml in the OTG group. Three patients in the LATG group and 19 in the OTG group received blood transfusion. The time to first flatus and postoperative hospital stay were (3.9 ± 1.1) days and (13 ± 5) days in the LATG group, and (5.0 ± 1.6) days and (15 ± 5) days in the OTG group, respectively.There were significant differences in the time to first flatus and postoperative hospital stay between the LATG group and OTG group (t = 4.16, x2 = 6.82, t = 4. 57, 2. 83, P ＜ 0. 05). The mean number of lymph nodes dissected was 28 ± 12 in the LATG group and 29 ± 11 in the OTG group, with no significant differences between the two groups (t = 0. 42, P ＞0.05). The number of lymph nodes dissected in patients with T1, T2 and T3 stages were 21 ±8, 25 ±7 and 29 ± 11 in the LATG group, and 29 ± 12, 31 ±9 and 28 ± 11 in the OTG group, respectively,with no significant differences between the two groups (t = 1.53, 1.90, 0. 65, P ＞ 0.05). The morbidity and mortality rates of the LATG group were 11%( 9/81 ) and 0, and 19% ( 18/95 ) and 1% ( 1/95 ) in the OTG group, with no significant differences between the two groups (x2 = 2.07, 1.18, P ＞ 0.05). Conclusion The efficacy of laparoscopy-assisted radical total gastrectomy is similar to that of open gastrectomy. Laparoscopy-assisted radical total gastrectomy is a safe and feasible procedure that leads to quick postoperative recovery.

Objective To analyze the magnetic resonance images (MRI) of patients with spinal epidural lipomatosis (SEL) in high-altitude areas and to determine the optimal cut-off value for diagnosis with epidural fat thickness. Methods This retrospective study included patients who underwent lumbosacral MRI examination for lumbosacral pain in Ping’an District Hospital of Traditional Chinese Medicine, Haidong City, China from January 1, 2021 to December 31, 2022. The epidural fat thickness in vertebral segments T12/L1 to L5/S1 was compared between the SEL group and the non-SEL group. The diagnostic efficacy with different cut-off values at each vertebral segment was evaluated. Between-group comparisons were performed using the t-test, Mann-Whitney U test, chi-square test, or modified chi-square test. The area under the receiver operating characteristic (AUC) was used to evaluate the diagnostic efficiency. The DeLong test was used to compare AUC between the two groups. Results A total of 370 patients were included (60 in the SEL group and 310 in the non-SEL group). There were no significant differences in age, sex, height, body weight, and body mass index between the two groups (all P > 0.05). At different vertebral segments, the epidural fat thickness was significantly higher in the SEL group than in the non-SEL group (all P < 0.05). The cut-off values for SEL diagnosis with epidural fat thickness in segments T12/L1 to L5/S1 were 2.23, 4.25, 4.85, 5.57, 7.21, and 8 mm, respectively. The AUC of MRI SEL diagnosis with epidural fat thickness in segment L5/S1 was the highest (0.945, 95% confidence interval [CI]: 0.916-0.966, P < 0.001). SEL diagnosis with epidural fat thickness > 8 mm in segment L5/S1 was the most accurate, with an AUC of 0.931 (95% CI: 0.901-0.955, P < 0.001), a sensitivity of 95.0%, and a specificity of 91.3%; this AUC was significantly higher than those of diagnosis with other cut-off values (all P < 0.05). Conclusion SEL patients have significantly increased epidural fat in the spinal canal. Epidural fat thickness > 8 mm in segment L5/S1 can be used for diagnosis of SEL with improved efficiency and accuracy.