Two hundred cates of nasopharyngeal carcinoma (NPC) admitted to this department from Feb. 1985 to May. 1988 were analysed according to the CT scanning and clinical findings of the primary lesions prior to radiotherapy...Two hundred cates of nasopharyngeal carcinoma (NPC) admitted to this department from Feb. 1985 to May. 1988 were analysed according to the CT scanning and clinical findings of the primary lesions prior to radiotherapy. The results showed that involvement of parapharyngeal space was very common in NPC, about 80% (160/200 cases) ; particularly unilateral or bilateral retro-styloid spaces, about 69.5% (139/200 cases). It was proposed that patients with NPC had a high Incidence of ipsilateral cervical node metastasis. Contralateral cervical node metastasis was rare. The development of cervical node metastasto in NPC has two modes: one Is direct Infiltration of the retro-stylold space by the lesion; the other Is along the nasopharyngeal lymphatic rete. The data also showed that patients with NPC who presented symptoms of Ⅸ- Ⅲ cranial nerve paralyses always had ipsilateral or bilateral retro- styloid space Infiltrations.展开更多
BACKGROUND Thyroid cancer is a common malignancy,often found in women.It is the second most common malignant tumor,second only to breast cancer,and it most frequently occurs as papillary thyroid carcinoma(PTC),represe...BACKGROUND Thyroid cancer is a common malignancy,often found in women.It is the second most common malignant tumor,second only to breast cancer,and it most frequently occurs as papillary thyroid carcinoma(PTC),representing over 90%of cases.PTC frequently presents with lymph node metastases,though in rare cases,patients may experience dysphagia,dyspnea,or hoarseness.In PTC and other differentiated thyroid cancers,direct invasion into major local veins is uncommon,and simultaneous involvement of the vagus nerve is even rarer.Herein,we report a case involving a 50-year-old male patient with a complete invasion of the vagus nerve and the internal jugular vein.CASE SUMMARY A 50-year-old male discovered a mass on the left side of his neck one year ago.Initially,the mass was approximately 3 cm,but it gradually grew to approximately 6.5 cm in the past month and caused hoarseness.There is no family history of note.On physical examination,a firm,non-tender mass approximately 6.5 cm in diameter was palpated along the lateral border of the left sternocleidomastoid muscle.The mass was irregular in shape,immobile,and did not move with swallowing.The patient has a 5-year history of hypertension with hypokalemia controlled with oral antihypertensive medications(nifedipine and spironolactone).His blood pressure has been maintained between 165-185/112-132 mmHg,and he often reports dizziness.Upon hospitalization,he was diagnosed with primary hyperaldosteronism.Ultrasound-guided fine needle aspiration biopsy of the left neck mass was performed,and the pathology report confirmed a diagnosis of PTC,with a clinical diagnosis of left-sided metastatic PTC.CONCLUSION The postoperative survival rate for PTC patients is generally good.If clinical signs suggest PTC with recurrent laryngeal nerve involvement,fiberoptic laryngoscopy should be conducted to assess the vocal cords,and intraoperative nerve monitoring is crucial.Preoperative evaluation of the involvement of major neck blood vessels is necessary.Therefore,surgeons should examine signs of large vein damage,as vascular resection and repair or reconstruction are often required.Surgery should be the first choice for differentiated thyroid cancer and radioactive iodine treatment(I-131)should be administered to patients with extrathyroidal invasion or metastasis following total thyroidectomy,followed by TSH suppression therapy.展开更多
Simultaneous shoulder and elbow dislocation is an uncommon condition, with only about ten cases reported in the literature. It is also called bipolar humeral dislocation or floating humerus. Nerve involvement is somet...Simultaneous shoulder and elbow dislocation is an uncommon condition, with only about ten cases reported in the literature. It is also called bipolar humeral dislocation or floating humerus. Nerve involvement is sometimes associated but radial nerve impairment is yet to be described. We report a case of bipolar dislocation of the humerus associated with radial nerve impairment occurring on a young 22 years old. Non-surgical treatment was undertaken with a reduction of the elbow followed by a reduction of the shoulder under general anaesthesia. Nerve and functional recovery were achieved at two and ten months respectively.展开更多
文摘Two hundred cates of nasopharyngeal carcinoma (NPC) admitted to this department from Feb. 1985 to May. 1988 were analysed according to the CT scanning and clinical findings of the primary lesions prior to radiotherapy. The results showed that involvement of parapharyngeal space was very common in NPC, about 80% (160/200 cases) ; particularly unilateral or bilateral retro-styloid spaces, about 69.5% (139/200 cases). It was proposed that patients with NPC had a high Incidence of ipsilateral cervical node metastasis. Contralateral cervical node metastasis was rare. The development of cervical node metastasto in NPC has two modes: one Is direct Infiltration of the retro-stylold space by the lesion; the other Is along the nasopharyngeal lymphatic rete. The data also showed that patients with NPC who presented symptoms of Ⅸ- Ⅲ cranial nerve paralyses always had ipsilateral or bilateral retro- styloid space Infiltrations.
基金Supported by Sichuan Provincial Health and Health Commission Science and Technology Project(First Batch)Collaborative University-City Project,No.24WXXT06.
文摘BACKGROUND Thyroid cancer is a common malignancy,often found in women.It is the second most common malignant tumor,second only to breast cancer,and it most frequently occurs as papillary thyroid carcinoma(PTC),representing over 90%of cases.PTC frequently presents with lymph node metastases,though in rare cases,patients may experience dysphagia,dyspnea,or hoarseness.In PTC and other differentiated thyroid cancers,direct invasion into major local veins is uncommon,and simultaneous involvement of the vagus nerve is even rarer.Herein,we report a case involving a 50-year-old male patient with a complete invasion of the vagus nerve and the internal jugular vein.CASE SUMMARY A 50-year-old male discovered a mass on the left side of his neck one year ago.Initially,the mass was approximately 3 cm,but it gradually grew to approximately 6.5 cm in the past month and caused hoarseness.There is no family history of note.On physical examination,a firm,non-tender mass approximately 6.5 cm in diameter was palpated along the lateral border of the left sternocleidomastoid muscle.The mass was irregular in shape,immobile,and did not move with swallowing.The patient has a 5-year history of hypertension with hypokalemia controlled with oral antihypertensive medications(nifedipine and spironolactone).His blood pressure has been maintained between 165-185/112-132 mmHg,and he often reports dizziness.Upon hospitalization,he was diagnosed with primary hyperaldosteronism.Ultrasound-guided fine needle aspiration biopsy of the left neck mass was performed,and the pathology report confirmed a diagnosis of PTC,with a clinical diagnosis of left-sided metastatic PTC.CONCLUSION The postoperative survival rate for PTC patients is generally good.If clinical signs suggest PTC with recurrent laryngeal nerve involvement,fiberoptic laryngoscopy should be conducted to assess the vocal cords,and intraoperative nerve monitoring is crucial.Preoperative evaluation of the involvement of major neck blood vessels is necessary.Therefore,surgeons should examine signs of large vein damage,as vascular resection and repair or reconstruction are often required.Surgery should be the first choice for differentiated thyroid cancer and radioactive iodine treatment(I-131)should be administered to patients with extrathyroidal invasion or metastasis following total thyroidectomy,followed by TSH suppression therapy.
文摘Simultaneous shoulder and elbow dislocation is an uncommon condition, with only about ten cases reported in the literature. It is also called bipolar humeral dislocation or floating humerus. Nerve involvement is sometimes associated but radial nerve impairment is yet to be described. We report a case of bipolar dislocation of the humerus associated with radial nerve impairment occurring on a young 22 years old. Non-surgical treatment was undertaken with a reduction of the elbow followed by a reduction of the shoulder under general anaesthesia. Nerve and functional recovery were achieved at two and ten months respectively.
