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At least 127 records · Page 7Linked to original sources
PubMed1989

Non-neurogenic soft tissue tumours of the axilla: prospective review of 16 cases.

Sixteen consecutive patients entered in a prospective study of non-neurogenic soft tissue tumours had lesions in the axilla. Delayed diagnosis and inappropriate biopsy prior to referral to a surgical oncologist were frequent findings. Sarcoma and fibromatosis were diagnosed in 14 cases, and the approaches used for these two diseases were fundamentally different. The functional outcome with limb salvage surgery in these patients is presented.

Adolescent↗
PubMed1992

Breast carcinoma: periodicity in presentation of metastatic tumour growth in the axilla.

The clinical value of assessment of tumour load in the axilla in the treatment of breast cancer patients has stood the test of time. Much information is available on its extent and characteristic distribution but, in contrast, little is known of the biological factors that may control the timing of the metastatic phenomenon. There is recent circumstantial evidence that such factors may exist and this prompted the present detailed study of axillary metastases from a series of 437 consecutive cases of breast carcinoma. Evidence of such factors was found here also: the excess of micrometastases in cases coming to operation in the second half of the year was highly significant (P less than 0.001) and is consistent with a synchronized start to the metastatic process. The total metastatic pattern in the material further indicated that the process may show periods of inactivity, i.e. periods when new colonies are not recruited. Mechanisms controlling this periodicity could theoretically be light-mediated, opening up new possibilities in the development of anti-metastatic treatment regimes.

Axilla↗
PubMed1992

Reassessment of tumour-load in the axilla in patients with breast cancer: a preliminary report.

The tumour-load in the axilla of breast cancer patients is classically measured from the number of tumour-bearing nodes present, which is then used to assess prognosis. This preliminary morphometric study on 73 cases of breast carcinoma for which standardized axillary dissection specimens were available shows that the total tumour load, measured from the sum of the tumour area (cm2) in hilar nodal sections, gives a redistribution of the patients; one that may provide better prognostic information in particular in women with a high tumour load. In those with four or more nodes involved the actual number is said to give little prognostic discrimination at 4 years post-operatively, as was demonstrated in this series. In contrast, using data from the same patients, the risk of death by this time increased steadily with increasing tumour area.

Axilla↗
PubMed1980

A case of severe scoliosis associated with cerebral palsy showing remarkable improvement following soft tissue release around the hip and axilla and transfer of m. tensor fasciae latae to the ribs.

A 21 year old Japanese male of normal intelligence with severe athetosis, scoliosis with pelvic obliquity, and a positive Galant's reflex was seen with complaint of difficulty in maintaining a sitting posture. After release of the soft tissues around the hip and axilla, followed by physiotherapy, he underwent ipsilateral transfer of the tensor fasciae latae to the rib cage. Six years after the final operation there has been remarkable improvement of his scoliosis and pelvic obliquity but also diminution of Galant's reflex. In addition his daily activities have been improved by the muscle transferred. He can sit for more than one hour.

Adult↗
PubMed1998

A sweat-gland tumor metastasizing to the axilla: report of a case.

Sclerosing sweat-duct carcinoma is a rare malignancy of the skin. We herein present the case of a 68-year-old Japanese man who developed sclerosing sweat-duct carcinoma 2 years after undergoing local excision of a primary tumor in his right arm. Firm nodules appeared in the right axilla, which were revealed by surgical resection to be metastases. This rare tumor grows slowly but usually metastasizes to the regional lymph nodes, whereupon they are often associated with a poor prognosis. As the effectiveness of chemotherapy and radiotherapy against this neoplasm remains unclear, we recommend that the disease should initially be aggressively treated by surgery, which would also be indicated for any metastatic lesions.

Adenocarcinoma↗
PubMed2002

Hibernoma of the left axilla; a case report and review of MR imaging.

We present a case of a hibernoma arising from the left axilla in a 24-year-old woman. The imaging characteristics on both contrast-enhanced CT (attenuation similar to surrounding skeletal muscle) and T1-weighted MR imaging (signal intensity intermediate between those of skeletal muscle and subcutaneous fat) were inconsistent with a fatty mass. The diagnosis of hibernoma was only made after marginal excisional biopsy, which confirmed the presence of brown fat on histologic analysis. We briefly present the imaging findings in our case and compare the imaging characteristics of previously reported hibernomas. Although hibernomas classically contain brown fat, imaging characteristics on T1-weighted images typically demonstrate a mass that is hypointense to adjacent subcutaneous fat. Knowledge of its MR imaging characteristics may help to suggest hibernoma in the preoperative diagnosis, although other tumors should still be considered in the differential diagnosis

Adult↗
PubMed2003

Microinvasive resectional sympathectomy using the harmonic scalpel. A more effective procedure with fewer side effects for treating essential hyperhidrosis of the hands, face or axillae.

Compensatory sweating remains one of the most unpredictable and debilitating complications of sympathectomy for hyperhidrosis. There appears to be a significant difference in compensatory sweating rates seen between the different techniques utilized to treat hyperhidrosis. Resectional techniques have historically resulted in excellent symptom relief with relatively low levels of severe post-op compensatory sweating. The advent of video-assisted approaches to the treatment of hyperhidrosis has led to other procedures including ablation/cautery, cutting and clipping of the nerve all of which report compensatory sweating rates between 70 and 100%. We have developed a minimally invasive video-assisted approach to sympathetic nerve resection. We studied 486 patients with severe essential hyperhidrosis affecting the hands, feet, axillae and face in variable combinations, who underwent bilateral resection of T2 and T3 for hand, facial or head sweating. 100% relief of sweating was noted in all cases. For axillary sweating the addition of T4 resection has resulted in complete relief of axillary hyperhidrosis symptoms. In this patient population our overall compensatory sweating rate has been approximately 18% with significant compensatory sweating occurring in less than 2% of patients.

Adaptation, Physiological↗
PubMed2005

An axilla scoring system to predict non-sentinel lymph node status in breast cancer patients with sentinel lymph node involvement.

BACKGROUND: Axillary lymph node dissection (ALND) is the current standard of care for breast cancer patients with sentinel lymph node (SN) involvement. However, the SN is the only involved axillary node in a significant proportion of these patients. Here we examined factors predictive of non-SN involvement in patients with a metastatic SN, in order to develop a scoring system for predicting non-SN involvement. MATERIALS AND METHODS: This study was based on a prospective database of 337 patients who underwent SN biopsy for breast cancer, of whom 81 (24%) were SN-positive; we examined factors predictive of non SN involvement in the 71 of these 81 women who underwent complementary ALND. All clinical and histological criteria were recorded and analysed according to non-SN status, by using Chi-2 analysis, Student's t-test, and multivariate logistic regression. RESULTS: Univariate analysis showed a significant association between non-SN involvement and histological primary tumor size (p=0.0001), SN macrometastasis (p=0.01), the method used to detect SN metastasis (H&E versus immunohistochemistry) (p=0.03), the number of positive SNs (p=0.049), the proportion of involved SNs among all identified SNs (p=0.0001) and lymphovascular invasion (p=0.006). Histological primary tumor size (p=0.006), SN macrometastasis (p=0.02) and the proportion of involved SNs among all identified SNs (p=0.03) remained significantly associated with non-SN status in multivariate analysis. Based on the multivariate analysis, we developed an axilla scoring system (range 0-7) to predict the likelihood of non-SN metastasis in breast cancer patients with SN involvement. CONCLUSION: In patients with invasive breast cancer and a positive SN, histological primary tumor size, the size of SN metastases, and the proportion of involved SNs among all identified SNs were independently predictive of non-SN involvement.

Adult↗
PubMed2005

Short versus long-term postoperative drainage of the axilla after axillary lymph node dissection. A prospective randomized study.

BACKGROUND: Axillary lymph node dissection (ALND) is a standard procedure in the treatment of breast cancer. Current practice following ALND involves several days of drainage of the axilla to reduce the formation of seroma. The aim of this study is to investigate the feasibility of 24 h drainage. STUDY DESIGN: A prospective randomized trial was performed comparing 24 h drainage to long-term drainage. The primary outcome measure was duration of hospital stay. Formation of seroma and wound related complications were secondary outcome measures. RESULTS: Fifty patients were randomised to the 24 h drainage group and 50 patients to the long-term drainage group. 24 h drainage was associated with a shorter hospital stay (2.5 versus 4.6 days, p < 0.001). Seroma aspiration was required in 76% of the patients after 24 h drainage and in 64% after long-term drainage (p = 0.19). The number of wound related complications was higher after long-term drainage (13 versus 9, p = 0.33). Infectious complications were seen in 11 patients after long-term drainage versus 6 after 24 h drainage (p = 0.18). CONCLUSION: These results indicate that 24 h drainage following ALND is feasible and facilitates early hospital discharge. Furthermore, 24 h drainage is not associated with excess wound related complications compared to long-term drainage.

Axilla↗
PubMed1982

Reconstruction of the axilla with a pectoralis major myocutaneous island flap.

The pectoralis major myocutaneous island flap is useful for axillary reconstruction following resection of tumour and skin in the axilla. It is a useful alternative to the latissimus dorsi flap, particularly when the vascular pedicle of the latissimus dorsi muscle is infiltrated by tumour or has been sacrificed by previous surgery.

Adult↗
PubMed1994

Extramammary Paget's disease of the axilla.

A case of extramammary Paget's disease of the axilla in an 84-year-old patient is presented. No underlying carcinoma was found and the lesion was treated successfully by wide local excision. Immunohistochemical staining showed nuclear immunoreactivity for c-myc and cytoplasmic staining for CEA, EMA, CAM 5.2, EGRF, c-erbB-2 and pan-cytokeratin in all the Paget cells. No immunoreactivity of the lesion was observed for S-100 protein, pan-ras, H-ras, K-ras, and p53 oncoproteins. Further research is needed to establish whether oncoprotein overexpression plays a role in the pathogenesis of extramammary Paget's disease and can be used as a diagnostic or prognostic marker.

Aged↗
PubMed1991

The axilla: not a no-go zone.

Many surgeons, particularly in the UK, give inadequate primary treatment to patients with operable breast cancer. For spurious reasons they regard axillary clearance as unnecessarily extensive surgery and rely instead upon total mastectomy or tumour excision and node sampling, with or without postoperative radiotherapy. But it is now clear that relapse-free and overall survival can be improved by appropriate adjuvant therapy. Thus inadequate exploration of the axilla is doubly unjustified. Not only is there the obvious risk of failure to remove nodes that contain metastases--so that some patients are deprived of cure by primary treatment--but the extent of tumour spread will be inadequately assessed in many more patients, with the risk that they may not receive appropriate adjuvant treatment.

Axilla↗
PubMed1990

Fasciocutaneous flaps for burn contractures of the axilla.

Fasciocutaneous flaps do not compromise the function of joints, are less bulky and are easier to dissect. Their use prevents the uncomfortable prolonged splintage of the axilla with the shoulder in abduction which follows split skin grafting. Fasciocutaneous flaps are reliable and failure is minimal, if at all, unlike split skin grafting. Parascapular, lateral thoracic and cervicohumeral fasciocutaneous flaps have been used in 23 patients (aged 8-36 years) with a total of 30 flaps. The mean hospital stay was 12 days and no recurrence of the contracture was observed in the follow-up period of 3-18 months.

Adolescent↗
PubMed2006

Myxoid solitary fibrous tumour of the axilla.

Mostly occurring in pleura, solitary fibrous tumour is an unusual soft tissue neoplasm. Solitary Fibrous Tumour with abundant myxoid stroma represents a rare morphologic subtype of the already uncommon tumour. We report a myxoid solitary fibrous tumour of the soft tissue in a 42-year-old man. The patient presented with a large, movable, nontender mass at the right axilla. The MRI showed a well-defined tumour with increased signal after gadolinium injection. During surgery, the mass was found to be closely associated with the axillary vein. The tumour was completely excised. Pathological and immunohistochemical examinations identified the mass as a myxoid solitary fibrous tumour. The patient was free of tumour recurrence at 18-month follow-up. The rare tumour in an uncommon location makes the diagnosis difficult. Complete excision and long-term follow up are recommended.

Adult↗
PubMed2005

Haematological cancers in the breast and axilla: a drop in an ocean of breast malignancy.

We have reviewed imaging findings of 32 female patients with a proven haematological malignancy in the breast and axilla presenting to two breast units over a 13-year period. Nineteen patients had screen-detected lesions, and 13 presented to symptomatic services. The most common histological diagnosis was of non-Hodgkins lymphoma. Of the 12 patients who presented with disease in the breast, six (all with primary breast lymphoma) presented with a well-defined mass on mammography. The range of radiological appearances is, however, highly variable.

Aged↗
PubMed1988

Neurovascular injuries of the thoracic outlet and axilla.

In this retrospective series of 46 patients with neurovascular injury of the thoracic outlet or axilla, our management strategy emphasized prompt recognition of trauma that may be superficially innocuous. Whenever possible, the precise site of vascular injury was identified arteriographically to help plan an incision that would provide proximal vascular control as well as expedient injury exposure. Vascular reconstruction was accomplished with either end-to-end primary anastomosis (n = 17) or autogenous saphenous vein graft interposition (n = 26). No case of ischemic limb loss occurred, although two repairs failed. Primary neural repair (n = 4) was possible only with simple laceration, but decompression of a tense hematoma led to prompt resolution of neuropraxia in nine patients. Secondary neural reconstruction was largely unsuccessful, and approximately 25 percent of our patients had serious chronic disability related to neural injury. In addition, two patients died as a consequence of numerous associated injuries.

Adolescent↗
PubMed1996

Endoscopic exploration and lymph node sampling of the axilla. Preliminary findings of a randomized pilot study comparing clinical and anatomo-pathologic results of endoscopic axillary lymph node sampling with traditional surgical treatment.

OBJECTIVE: To describe the technique of endoscopic exploration of the axilla. To compare this technique to open surgical treatment by comparing the following variables: operative time, peri-operative complications, duration of hospital stay, node's histology and morphologic aspects and esthetic results. MATERIALS: Standard instruments for traditional operative laparoscopy plus a lipo-aspirator (0.8 Bar). PATIENTS: Forty patients, 20 (group A) undergoing open surgery and 20 (group B) undergoing axilloscopy. All patients with early invasive breast cancer are eligible for conservative operative treatment. METHOD: Randomized study. The technique is described and preliminary results are presented. RESULTS: The operative time for axilloscopy is approximately double that for open surgery. A comparable number of lymph nodes is collected by axilloscopy and open surgery. The nodes collected by axilloscopy are more likely to be fractured. What is the clinical consequence? Two loco-regional relapses are observed in the endoscopic group. DISCUSSION: Axillary sampling by endoscopic procedure gives the same pathologic information than surgical axillary sampling. Anatomo-pathologic aspects of nodes and possibilities of relapses were two drawbacks of this procedure. CONCLUSION: Operative time is increased for axilloscopy compared with open surgery. The techniques yield comparable anatomo-pathologic results. It is still unknown whether this endoscopic technique is as effective as traditional surgery or if the frequency or severity of lymphedema is decreased by the endoscopic approach.

Adult↗
PubMed2000

The axial bilobed flap for burn contractures of the axilla.

The axial bilobed flap, based on the transverse and descending branches of the circumflex scapular artery, was used to successfully reconstruct burn contractures of the axilla. The main advantages of this flap are that the donor site is closed primarily, it provides an adequate amount of healthy and pliable skin with an excellent blood supply and no chance of contraction, and it is an easy technique. In this paper, two cases are presented.

Adult↗