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PubMed1981

Cowden's disease (multiple hamartoma syndrome).

Cutaneous and oral lesions appearing as verrucous papules are a regular and diagnostic finding in Cowden's disease. The lesion occur predominantly over the central portion of the face, concentrated around orifices, lips, gingiva, and tongue, and over the acral portions of the upper extremities. These skin lesions have been found to be associated with fibrocystic breast disease, carcinoma of the breast, thyroid tumors, ovarian cysts, gastrointestinal polyposis, fibromas, angiomas, and lipomas. It is important to be able to distinguish the skin lesions from simple verruca vulgaris because they serve as a cutaneous marker for existing or potential internal malignancy, especially of the breast and thyroid.

Adult↗
PubMed1980

[Therapeutic embolization in the external carotid artery region (author's transl)].

UNLABELLED: This paper reports our experience of therapeutic embolization in the external carotid artery region. Therapeutic embolization was done for the purpose of decreasing hemorrhage during operation. MATERIAL AND METHOD: Therapeutic embolization was done in 6 cases of meningioma, 1 case of capillary hemangioma of the cheek and one case of olfactory neuroblastoma. Catheterization was done through the common carotid artery in adults and done through the femoral artery in an infant. Small pieces of Gelfoam were used as emboli. Emboli, 1 X 1 X 0.5 mm in size, were instilled with normal saline. One embolus was used in one instillation as a rule. A larger embolus was used for occlusion of a larger artery. Heparin was not used through entire procedure. Four illustrative cases are presented. when a feeder of a tumor is occluded by artificial emboli, two kinds of effect can be resulted. when emboli lodge within the tumor or in a feeding artery distal to arterial anastomoses, blood is no longer supplied to the tumor (embolization effect). On the other hand, when a feeding artery is occluded by emboli at the point proximal to arterial anastomoses, blood supply to the tumor is transiently reduced but it is soon restored through arterial anastomoses (ligation effect). To minimize bleeding during surgery it is very important to gain embolization effect. For this purpose small emboli should be instilled repeatedly until embolization effect is established. Then ligation effect should be obtained, if necessary, by injection lower emboli. Operation was performed on the day following embolization in cases of meningioma. In a case of capillary hemangioma of the cheek operation was performed three days after embolization and in a case of olfactory neuroblastoma surgery was performed two days after embolization. In all cases the primary purpose to minimize bleeding during operation was achieved. No untoward side effects were encountered in this series. The ophthalmic artery may arise from the middle meningeal artery. The vertebral artery might be visualized through the collateral from the occipital artery. We should pay attention to these vascular anomalies before embolization to prevent possible catastrophe.

Aged↗
PubMed1998

Recurrent facial neuromas.

OBJECTIVE: The study aimed to present clinical, radiographic, and operative findings in cases of recurrent facial neuromas and discuss changes in demographics of primary facial neuromas since 1986. DATA SOURCES: MEDLINE search of English language literature since 1966 and bibliographies of collected articles were the data sources. STUDY SELECTION: All available reports of recurrent facial neuromas (N = 8) and case reports of primary facial neuromas since 1986 (N = 238) were selected. DATA EXTRACTION: Cases of facial neuromas confirmed by histologic and/or clinical and radiographic criteria are included. DATA SYNTHESIS: Compilation of reported anatomic and clinical data is included. CONCLUSIONS: Improved imaging techniques have documented an increased incidence of primary facial neuromas medial to the geniculate ganglion. Clinical suspicion, histologic confirmation of tumor-free margins, interspecialty cooperation in tumor resection, and routine follow-up imaging with magnetic resonance imaging are suggested to minimize recurrent facial neuromas.

Adult↗
PubMed2002

Facial paralysis caused by malignant skull base neoplasms.

OBJECT: Bell palsy remains the most common cause of facial paralysis. Unfortunately, this term is often erroneously applied to all cases of facial paralysis. METHODS: The authors performed a retrospective review of data obtained in 11 patients who were treated at a university-based referral practice between July 1988 and September 2001 and who presented with acute facial nerve paralysis mimicking Bell palsy. All patients were subsequently found to harbor an occult skull base neoplasm. A delay in diagnosis was demonstrated in all cases. Seven patients died of their disease, and four patients are currently free of disease. CONCLUSIONS: Although Bell palsy remains the most common cause of peripheral facial nerve paralysis, patients in whom neoplasms invade the facial nerve may present with acute paralysis mimicking Bell palsy that fails to resolve. Delays in diagnosis and treatment in such cases may result in increased rates of mortality and morbidity.

Adenocarcinoma↗
PubMed2003

A review of intractable facial pain secondary to underlying lung neoplasms.

We describe a 63-year-old smoker who suffered from intractable facial pain secondary to an underlying lung neoplasm. Data from 30 previously reported and similar cases are also summarized. The clinical triad of a smoker suffering from periauricular pain and an elevated ESR should alert the clinician to the possibility of an occult lung mass. In these cases a computed tomography of the chest should always be obtained. Previously refractory pain typically responds to surgical resection of the mass and/or radiation therapy.

Carcinoma, Non-Small-Cell Lung↗
PubMed2003

Candidal abscess of the parotid gland associated with facial nerve paralysis.

Facial nerve paralysis associated with parotid gland mass is usually caused by malignant neoplasms and facial nerve dysfunction due to parotid infection is exceedingly rare. A review of the literature revealed approximately 15 cases of facial nerve palsy associated with suppurative parotitis or parotid abscess. We report the first case of candidal abscess of the parotid gland associated with facial nerve paralysis in a 74-year-old insulin-dependent diabetic patient. The differential diagnosis in these unusual cases occurring in diabetic, immunodeficient patients should include Candida albicans infection.

Abscess↗