Meningiomas With Rhabdoid Features Lacking Other Histologic Features of Malignancy: A Study of 44 Cases and Review of the Literature.

Meningiomas With Rhabdoid Features Lacking Other Histologic Features of Malignancy: A Study of 44 Cases and Review of the Literature.

J Neuropathol Exp Neurol. 2016 Jan;75(1):44-52

Authors: Vaubel RA, Chen SG, Raleigh DR, Link MJ, Chicoine MR, Barani I, Jenkins SM, Aleff PA, Rodriguez FJ, Burger PC, Dahiya S, Perry A, Giannini C

Abstract
The behavior of rhabdoid meningiomas otherwise lacking malignant features remains unknown as most of the originally reported aggressive cases showed anaplastic histologic features independently of rhabdoid phenotype. We studied 44 patients with rhabdoid meningiomas lacking anaplastic features. Median age at diagnosis was 48.6 years (range 10-79). Location was supratentorial in 28 (63.6%), skull base in 15 (34.1%), and spinal in 1 (2.3%). Tumor grade was otherwise World Health Organization grade I (n = 22, 50%) or II (n = 22, 50%). Rhabdoid cells represented <20% of the tumor in 12 cases (27.3%), 20% to 50% in 18 (40.9%), and >50% in 14 (31.8%). Median clinical follow-up, available for 38 patients, was 5.0 years (range 0.17-14.2). Recurrence occurred in 9 patients (5-year recurrence-free survival, 73.7%) with a significantly higher risk in subtotally resected tumors (p = 0.043). Rhabdoid cell percentage was not associated with recurrence. Six patients died (4 of disease, 2 of unclear causes); 5-year overall survival was 86.7%, a mortality in excess of that expected in grade I-II meningiomas but much lower than originally reported. Review of 50 similar previously reported cases confirmed our findings. We suggest that rhabdoid meningiomas be graded analogously to nonrhabdoid tumors, with caution that some may still behave aggressively and close follow-up is recommended.

PMID: 26705409 [PubMed - in process]

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Additional Prone 18F-FDG PET/CT Acquisition to Improve the Visualization of the Primary Tumor and Regional Lymph Node Metastases in Stage II/III Breast Cancer.

Additional Prone 18F-FDG PET/CT Acquisition to Improve the Visualization of the Primary Tumor and Regional Lymph Node Metastases in Stage II/III Breast Cancer.

Clin Nucl Med. 2015 Dec 22;

Authors: Teixeira SC, Koolen BB, Vogel WV, Wesseling J, Stokkel MP, Vrancken Peeters MT, van der Noort V, Rutgers EJ, Valdés Olmos RA

Abstract
PURPOSE: To prospectively compare prone and supine acquired F-FDG PET/CT for visualization of primary tumors and regional lymph nodes in stage II/III breast cancer patients.
MATERIALS AND METHODS: One hundred ninety-eight patients were included consecutively from August 2010 to April 2012. One hour after administration of 180-240 MBq F-FDG, PET/CT images of the thorax were firstly acquired in prone position. Subsequently, a standard PET/CT in supine position from skull base to thighs was made. Both sets of images were tested in a univariate and a multivariate analysis for the number of lesions per breast or lymph node (LN) region and anatomical mismatch between PET and CT images.
RESULTS: Images in prone position showed less compression of breast tissue, more primary tumor (PT) multifocality (P < 0.001) and more avid axillary LNs (P < 0.001) compared with supine position. Anatomical mismatch of the axillary LN metastases was found more often on supine PET/CT images compared with prone (P = 0.004). Prone images showed a smaller PT functional volume compared with supine position (P < 0.001).
CONCLUSIONS: Prone position PET/CT improved the visualization of PT multifocality and the number of detected axillary lymph nodes. Therefore, it is a valuable addition to standard supine PET/CT in the protocol for locoregional assessment in stage II/III breast cancer patients.

PMID: 26704731 [PubMed - as supplied by publisher]

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Value of cephalic part of lateral crus in functional rhinoplasty.

Value of cephalic part of lateral crus in functional rhinoplasty.

Eur Arch Otorhinolaryngol. 2015 Dec 24;

Authors: Sazgar AA, Amali A, Peyvasty MN

Abstract
Reshaping of the nasal tip is the most difficult part of rhinoplasty. Over the years, there have been many advances in the field of rhinoplasty, including tip plasty. The goal of these continuous refinements in existing procedures has been to improve both aesthetic and functional outcomes. The cephalic part of the lateral crus of the lower lateral cartilage is what mainly contributes to nasal tip deformity. Various surgical techniques have been reported that used the cephalic part of lateral crus to refine the nasal tip and preserve alar integrity and nasal breathing function. In this review article, we have attempted to show the evolution of these methods while focusing on development of approaches that are basic for "modern rhinoplasty" and presenting our personal preferences. We have also endeavored to categorize these methods and clarify some misconceptions and inaccuracies in their descriptions.

PMID: 26704927 [PubMed - as supplied by publisher]

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Traumatic arteriovenous fistula of the superficial temporal artery.

Traumatic arteriovenous fistula of the superficial temporal artery.

J Surg Case Rep. 2015;2015(12)

Authors: Asai K, Tani S, Imai Y, Mineharu Y, Sakai N

Abstract
Traumatic arteriovenous fistula (AVF) of the superficial temporal artery (STA) is rare. We report a case of surgically treated, histopathologically confirmed traumatic AVF of the STA. A 24-year-old male was admitted to our hospital after a traffic accident. Computed tomography scan on admission showed an acute epidural hematoma on the right surface of frontal lobe, which was emergently treated by surgical evacuation. One month later, he was aware of pulsatile tinnitus around the left ear. Digital subtraction angiogram showed an AVF, mainly fed by the left STA. After total removal of the fistula, his tinnitus immediately disappeared. Histopathological examination demonstrated that the artery was connected to the vein through the thin-walled vessels lacking internal elastic lamina and muscularized media, suggesting that the connecting vessels were newly formed.

PMID: 26703929 [PubMed]

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Microvascular Decompression Surgery for Hemifacial Spasm.

Microvascular Decompression Surgery for Hemifacial Spasm.

J Craniofac Surg. 2015 Dec 16;

Authors: Qi H, Zhang W, Zhang X, Zhao C

Abstract
OBJECTIVE: This study aims to investigate the operative efficacy, surgical complication rate, and surgical strategy of microvascular decompression (MVD) for hemifacial spasm (HFS).
METHODS: Clinical data of 46 patients with HFS who underwent MVD were retrospectively analyzed.
RESULTS: During surgery, it was found that the facial nerve root exit zone was compressed by the following arterial vessels: anterior inferior cerebellar artery in 24 patients (52.17%); posterior inferior cerebellar artery in 14 patients (30.43%); vertebral artery and a small artery in 7 patients (15.22%); and vertebral artery in 1 patient (2.18%). Symptoms of 38 patients were immediately remitted completely after surgery and symptoms of 8 patients were significantly reduced. Main complications included dizziness and tinnitus in 9 patients, hearing loss in 5 patients, cerebrospinal fluid leakage in 1 patient, and infection in 2 patients. No patient died during surgery.
CONCLUSIONS: MVD is the preferred choice for treating idiopathic hemifacial spasm, and hearing impairment is the main complication. Skilled microsurgical techniques, as well as identifying and completely decompressing offending vessels, are the key to ensuring a successful microvascular decompression.

PMID: 26703065 [PubMed - as supplied by publisher]

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Features and prognostic utility of biopsy in oral squamous cell carcinoma.

Features and prognostic utility of biopsy in oral squamous cell carcinoma.

Head Neck. 2015 Dec 24;

Authors: Dhanda J, Uppal N, Chowlia H, Opie N, Al-Qamachi L, Shelat D, Aslam A, Yuffa A, Martin T, Risk J, Triantafyllou A, Shaw R, Parmar S, Mehanna H

Abstract
BACKGROUND: Traditional approaches in oral squamous cell carcinoma (OSCC) management utilize biopsy tissue for diagnostic purposes only. Adverse prognostic features, such as the tumor depth, are usually determined from final resection specimens, but are seldom studied in biopsy tissue.
METHODS: A preliminary study of 139 consecutive biopsies compared biopsy size with T classification, tumor site, and operator grade, and biopsy tumor depth with the true tumor depth.
RESULTS: This study demonstrated that biopsy size is independent of T classification (p = .44), subsite (p = .86), and operator grade (p = .10). The biopsy tumor depth significantly underrepresented true tumor depth (2.5 mm, 95% confidence interval [CI] = 2.4-2.9 vs 8.2 mm, 95% CI = 6.5-9.9; p < .001), confirming the limited prognostic utility of biopsies in OSCC.
CONCLUSION: A future clinical trial will compare the routine biopsy technique with standardized deeper biopsy techniques using punch biopsy to sample invasive fronts and investigate opportunities for up-front staging using a combination of histological features and epithelial and stromal molecular biomarkers in OSCC. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

PMID: 26705271 [PubMed - as supplied by publisher]

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Role of perioperative antibiotic treatment in parotid gland surgery.

Role of perioperative antibiotic treatment in parotid gland surgery.

Head Neck. 2015 Dec 24;

Authors: Shkedy Y, Alkan U, Roman BR, Hilly O, Feinmesser R, Bachar G, Mizrachi A

Abstract
BACKGROUND: The value of routine prophylactic antibiotic treatment in parotid gland surgery remains undetermined.
METHODS: A retrospective analysis was conducted of all patients who underwent parotidectomy at a university-affiliated tertiary care center between 1992 and 2009. Patients with insufficient data, specifically regarding postoperative complications and antibiotic administration were excluded from the study cohort.
RESULTS: A total of 593 patients underwent parotidectomy during the study period. After exclusion, 464 patients were eligible for the study. Perioperative antibiotic treatment was given to 206 patients (45%). There was no difference in wound infection rates between patients who received perioperative antibiotic therapy and those who did not (p = .168). Multivariate analysis showed that female sex, neck dissection, and drain output >50 cc/24 hours were predictive of postoperative wound infection.
CONCLUSION: Routine prophylactic antibiotic treatment has no role in parotid gland surgery. Perioperative antibiotic treatment is recommended for patients undergoing extensive parotid gland surgery with neck dissection. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

PMID: 26702565 [PubMed - as supplied by publisher]

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