1.Effectiveness of temporal island flap pedicled with perforating branch of zygomatic orbital artery to repair the defects after periocular malignant tumor resection.
Qi ZHANG ; Xiujun TANG ; Haoyu WANG ; Feng LI ; Yan LONG ; Hang LIU ; Xiaojin MO
Chinese Journal of Reparative and Reconstructive Surgery 2023;37(4):469-472
OBJECTIVE:
To summarize the effectiveness of the temporal island flap pedicled with the perforating branch of zygomatic orbital artery for repairing defects after periocular malignant tumor resection.
METHODS:
Between January 2015 and December 2020, 15 patients with periocular malignant tumors were treated. There were 5 males and 10 females with an average age of 62 years (range, 40-75 years). There were 12 cases of basal cell carcinoma and 3 cases of squamous carcinoma. The disease duration ranged from 5 months to 10 years (median, 2 years). The size of tumors ranged from 1.0 cm×0.8 cm to 2.5 cm×1.5 cm, without tarsal plate invasion. After extensive resection of the tumors, the left defects in size of 2.0 cm×1.5 cm to 3.5 cm×2.0 cm were repaired with the temporal island flap pedicled with the perforating branch of zygomatic orbital artery via subcutaneous tunnel. The size of the flaps ranged from 3.0 cm×1.5 cm to 5.0 cm×2.0 cm. The donor sites were separated subcutaneously and sutured directly.
RESULTS:
All flaps survived after operation and the wounds healed by first intention. The incisions at donor sites healed by first intention. All patients were followed up 6-24 months (median, 11 months). The flaps were not obviously bloated, the texture and color were basically the same as the surrounding normal skin, and the scars at recipient sites were not obviously. There was no complication such as ptosis, ectropion, or incomplete closure of the eyelids and recurrence of tumor during follow-up.
CONCLUSION
The temporal island flap pedicled with the perforating branch of zygomatic orbital artery can repair the defects after periorbital malignant tumors resection and has the advantages of reliable blood supply, flexible design, and good morphology and function.
Male
;
Female
;
Humans
;
Middle Aged
;
Plastic Surgery Procedures
;
Skin Transplantation
;
Soft Tissue Injuries/surgery*
;
Treatment Outcome
;
Surgical Flaps
;
Arteries/surgery*
;
Carcinoma, Squamous Cell/surgery*
;
Skin Neoplasms/surgery*
;
Perforator Flap/blood supply*
2.Clinical and imaging features of phosphaturic mesenchymal tumors.
Cheng CHANG ; Aihong YU ; Yuhua YOU ; Xiaoxin PENG ; Xiaoguang CHENG ; Xintong LI ; Wei LIANG ; Lihua GONG ; Wei DENG
Chinese Medical Journal 2023;136(3):351-353
4.EWSR1-SMAD3 positive fibroblastic tumor: a clinicopathological analysis.
Hai Yan SU ; Lu ZHAO ; Gang JI ; Qian Lan YAO ; Qian Ming BAI ; Xiao Yan ZHOU ; Jian WANG
Chinese Journal of Pathology 2023;52(1):19-24
Objective: To investigate the clinicopathological features, immunophenotypes and molecular genetics of EWSR1-SMAD3 positive fibroblastic tumor (ESFT) with an emphasis on differential diagnosis. Methods: The clinicopathological data, immunohistochemical profiles and molecular profiles of 3 ESFT cases diagnosed at the Department of Pathology, Fudan University Shanghai Cancer Center from 2018 to 2021were analyzed. The related literature was also reviewed. Results: There were two males and one female. The patients were 24, 12 and 36 years old, respectively. All three tumors occurred in the subcutis of the foot with the disease duration of 6 months to 2 years. The tumors were presented with a slowly growing mass or nodule, accompanied with pain in 1 patient. The tumors ranged in size from 0.1 to 1.6 cm (mean, 1.0 cm). Microscopically, the tumors were located in the subcutaneous tissue with a nodular or plexiform growth pattern. They were composed of cellular fascicles of bland spindle cells with elongated nuclei and fine chromatin. One of the tumors infiltrated into adjacent adipose tissue. There was no nuclear atypia or mitotic activities. All three tumors showed prominent stromal hyalinization with zonal pattern present in one case. Focal punctate calcification was noted in two cases. The immunohistochemical studies showed that tumor cells were diffusely positive for ERG and negative for CD31 and CD34, with Ki-67 index less than 2%. Fluorescence in situ hybridization on the two tested cases identified EWSR1 gene rearrangement. The next generation sequencing analysis demonstrated EWSR1-SMAD3 fusion in all three cases. During the follow up, one patient developed local recurrence 24 months after the surgery. Conclusions: ESFT is a benign fibroblastic neoplasm and has a predilection for the foot, characterized by ERG immunoreactivity and EWSR1-SMAD3 fusion. Local recurrence might occur when incompletely excised. Familiarity with its clinicopathological features is helpful in distinguishing it from other spindle cell neoplasms that tend to occur at acral sites.
Adult
;
Child
;
Female
;
Humans
;
Male
;
Biomarkers, Tumor/analysis*
;
China
;
In Situ Hybridization, Fluorescence
;
Neoplasms, Fibrous Tissue/pathology*
;
RNA-Binding Protein EWS/genetics*
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Smad3 Protein/genetics*
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Soft Tissue Neoplasms/surgery*
7.A case of low-grade fibromyxoid sarcoma of the temporal bone.
Ming Yang MAO ; Guo Dong FENG ; Yu CHEN ; Xiao Hua SHI ; Xu TIAN ; Tong SU ; Hui Ying SUN ; Zhen Tan XU ; Wen Sheng REN ; Zhu Hua ZHANG ; Zhi Qiang GAO ; Zheng Yu JIN
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2023;58(1):64-67
8.Advances in the treatment of infantile hemangiomas of the larynx.
Xing GAO ; Xiaojun ZHAN ; Qinglong GU
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2023;37(12):972-976
Infantile hemangiomas are relatively common soft tissue tumors in infants and young children, with a prevalence of about 4.5% in full-term newborns. Subglottic Hemangioma (SGH) is a relatively rare type of hemangioma, and its special location often causes respiratory distress and potentially life-threatening conditions in infants. Therefore, it is necessary for clinicians to make an accurate diagnosis and formulate a detailed treatment plan based on the clinical manifestations, the auxiliary examinations, the medical history and the vital signs evaluation of patients.This review describes the pathophysiological mechanism of infantile hemangioma and provides a detailed discussion on commonly used treatment methods in detail.
Child, Preschool
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Humans
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Infant
;
Infant, Newborn
;
Hemangioma/diagnosis*
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Hemangioma, Capillary
;
Laryngeal Neoplasms/surgery*
;
Larynx/pathology*
;
Soft Tissue Neoplasms
9.A case report of nasopharyngeal inflammatory myofibroblastoma in infant.
Chao CHENG ; Jianwen ZHONG ; Shuncheng WANG ; Dabo LIU
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2023;37(12):989-992
Inflammatory myofibroblastic tumor (IMT) is a rare mesenchymal soft tissue tumor characterized by borderline or low-grade malignancy. It is rare childhood tumor with an average age of onset of 10 years old. It is even rarer in infants and toddlers, and the etiology and pathogenesis of this tumor are still unclear. The clinical presentation of IMT is non-specific and are related to the location of the tumor. When the tumor compresses adjacent organs, it can cause pain and functional impairment. According to the current literature, IMT is most commonly found in the digestive and respiratory systems, but also occasionally occur in the genitourinary system, head and neck, and limbs. At present, there have been no reports of nasopharyngeal IMT involving nasal cavity of infants and toddlers at home and abroad.This article reports a case of a massive inflammatory myofibroblastic tumor involving the nasal cavity and nasopharynx in an infant. Plasma-assisted minimally invasive surgery was performed through multiple surgical approaches and achieved satisfactory therapeutic results. This case report may provide valuable reference for the treatment of similar diseases.
Humans
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Infant
;
Granuloma, Plasma Cell/pathology*
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Nasopharynx/pathology*
;
Neoplasms, Muscle Tissue
;
Soft Tissue Neoplasms
10.Clinical analysis of diversity of defect repair with supraclavicular island flap after head and neck tumor surgery.
Yue GUAN ; Guohua HU ; Zhihai WANG ; Wei MA ; Xiaoqiang WANG ; Min PAN ; Jiang ZHU ; Quan ZENG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2023;37(12):1005-1010
Objective:To investigate the diversity and clinical effect of supraclavicular island flap in repairing the defect after head and neck tumor surgery. Methods:A retrospective analysis was performed on 30 patients who received the repair of head and neck defects with supraclavicular island flaps at Department of Otorhinolaryngology Head and Neck Surgery of the First Affiliated Hospital of Chongqing Medical University from January 2017 to March 2023. The sites and types of defects, intraoperative blood loss, time of flaps preparation, areas of flaps, survival of the flaps and other complications were recorded. Results:A total of 30 patients were enrolled, including 26 males and 4 females, aged 36-82 years. Among them, 22 patients with hypopharyngeal partial defect were repaired (19 patients with ipsilateral defect and 3 patients with contralateral defect). In addition, 2 patients were repaired with contralateral pectoralis major musculocutaneous flap around the hypopharynx, the neck skin defect was repaired in 2 patients, the parotid skin defect was repaired in 2 patients, the temporal bone skin defect was repaired in 1 patient, and the cervical esophageal defect was repaired in 1 patient. The average blood loss during the operation was 8 ml, and the average time was 32 min. The flap areas ranged from 5.0 cm×4.0 cm to 20.0 cm×8.0 cm. 27 of 30 flaps survived(90.0%), and pharyngeal fistula occurred in 6 patients after operation(4 flaps survived after local dressing). One patient was complicated with venous thrombosis(the flap necrosis after local dressing). Shoulder and neck functions(lift, internal rotation and abduction) were not significantly affected in 29 patients, and the function of 1 patient with shoulder infection was not affected after treatment. Conclusion:Supraclavicular island flap is a highly vascularized axial fascial flap. It is easy to make, thin, and soft in texture, and can be used to repair different sites and types of postoperative head and neck tumor defects with a low donor site complication rate. Good results in post-operative repair of head and neck tumors are worth promoting.
Male
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Female
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Humans
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Plastic Surgery Procedures
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Retrospective Studies
;
Skin Transplantation
;
Soft Tissue Injuries/surgery*
;
Treatment Outcome
;
Surgical Flaps
;
Head and Neck Neoplasms/surgery*

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