Human papillomavirus and tonsillar and base of tongue cancer

papilomatoza laringiana | Forumul Medical ROmedic

Dup stabilirea cu certitudine a diagnosticului de chist hidatic algoritmul din fig. Cu toate c metodele nechirurgicale au human papillomavirus and tonsillar and base of tongue cancer o dezvoltare fr precedent, tratamentul chirurgical rmne cel de elecie.

Se caut mijloace de evaluare ct mai corect i sigur a viabilitii parazitului dup aceste tratamente noninvazive. Acest fapt are implicaii deosebite n terapie, viabilitatea fiind cel mai important criteriu prin care se stabilete indicaia de tratament []. Actualmente, cel mai utilizat algoritm de tratament recomand administrarea albendazolului minim 10 zile postoperator i 3 luni postoperator Fig. Protocolul poate fi extrapolat la tratamentul videoscopic, sigurana fiind maxim ntruct toate manevrele se efectueaz la vedere i se pot lua msuri n caz de scurgeri hidatice intraperitoneale sau de leziuni viscerale.

Facing such a scenario, the only solution is following a sequence of investigations and therapy steps towards a correct and complete diagnosis if possible. We review the current literature data and present a personal case. There are many controversies regarding the primitive metastatic neck lymph nodes related to the optimum management, balanced with benefit for the patient. Keywords unknown, primary, metastatic, lymph, nodes Rezumat Metastazele primare de la nivelul ganglionilor cervicali sunt de­fi­nite în contextul unei tumori primare necunoscute de la ni­velul tractului respirator superior.

Algoritmul este perfect superpozabil n ambele tehnici i poate fi aplicat n orice spital cu dotare necesar. Nu este standardizat protocolul videoscopic dar cea mai practicat tehnic att n procedeul clasic, ct i n cel laparoscopic este perichistectomia parial. Introducerea tehnicilor percutane i n cazul chisturilor multiveziculare este un salt tehnic deosebit.

"HPV 101" Straight talk on HPV-related cancers

Riscul de fistul biliar este un risc asumat de ambii parteneri ai interveniei pacient i terapeut - att n tehnica percutan ct i n cea videoscopic, n condiii de consimmnt informat. Dac acestea apar atunci este nevoie de sfincterotomie endoscopic, sau chiar intervenie chirurgical. Protocolul PAIR unanim acceptat la nivel mondial necesit o dotare care s permit efectuarea manoperelor medicale n condiii de siguran. Indicaiile acestuia sunt variabile. Acest mod de abordare a condus la rezultate foarte bune, la o scurtare semnificativ a spitalizrii i estetic deosebit.

Consimmntul informat al pacientului 2. RMN doar n scop de cercetare. Prezena anestezistului.

human papillomavirus and tonsillar and base of tongue cancer

Pacient cu linie venoas. Puncie ecoghidat cu sau fr cateter. Aspirarea lichidului intrachistic ml human papillomavirus and tonsillar and base of tongue cancer examen parazitologic i biochimic.

Dac protoscoleci sunt prezeni i nc viabili aspirarea lichidului hidatic 8. Introducerea intrachistic a substanei de contrast i reaspirare Aspirarea soluiei de alcool dup 15 minute Repetarea examenului parazitologic pentru a verifica viabilitatea protoscolecilor Evaluarea alcoolemiei Gascromatografia. Nu se mai utilizeaz, nc de la primul pacient tratat rezultatele au fost constant negative. Monitorizare parazitologic, biochimic, serologic, imunologic i ecografic sptmnal pn la 1 lun, lunar pn la 6 luni i anual pn la 5 ani.

Radiografie toracic dup 1 an i dup 2 ani de la procedur. CT complet dup 5 ani. Articole de sintez Jurnalul de Chirurgie, Iai,Vol. Bolnavul trebuie dispensarizat postoperator pentru descoperirea precoce a recidivelor care pot raspunde la tratamentul cu Albendazol. Rdulescu S, Mezer E. Parazitologie medical. All,p. Intrabiliary Rupture of a Hepatic Hydatid Cyst. Gasless vs gaseous laparoscopy in the treatment of hepatic hydatid disease. Surg Endosc.

N Eng J Med. Oropharyngeal Cancer Linked to Human Papillomavirus www. Kreimer commented, both by showing the strength of the association and by suggesting a mode of transmission for the virus. The data from the study suggest that oral HPV infection is sexually acquired and specifically that it may be transmitted during oral sex. Oral HPV Infection Acquired Sexually: The current study compared patients with newly diagnosed oropharyngeal cancer with matched case controls.

Randomised controlled trial of efficacy of albendazole in intra-abdominal hydatid disease. Digestive Surgery. Belghiti J.

human papillomavirus and tonsillar and base of tongue cancer

Traitement des kystes hydatiques du foie. Arch Surg. Liver hydatid disease: long term results of percutaneous treatment. A new percutaneous approach for the treatment of hydatid cysts of the liver. Am J Gastroenterol. Morris DL. Echinococcosis of the liver. Percutaneous treatment of hydatid cysts of the liver: long term results. Percutaneous treatment of hepatic hydatid cysts: an alternative to surgery.


Percutaneous drainage compared with surgery for hepatic hydatid cysts. N Eng J Med. Percutaneous drainage versus albendazole therapy in hepatic hydatidosis: a prospective randomized study. King CH. Cecil textbook of medicine. Saunders; ; p. Harrison's priciples of internal medicine 14th edition, Mc Graw-Hill; Amman RW, Eckert J. Gastroenterology clinics of North American ; Percutaneous aspiration-injection-reaspiration drainage plus albendazole or mebendazole for hepatic cystic echinococcosis: a meta-analysis.

Clin Infect Dis. Hydatid liver cyst: an year experience of treatment with percutaneous aspiration and ethanol injection. J Ultrasound Med.

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PAIR as percutaneous treatment of hydatid liver cysts. Acta Trop. Diagnosis and treatment of unilocular hydatid disease Echinococcus granulosus infection. Ned Tijdschr Geneeskd. Percutaneous treatment of hepatic cysts by aspiration and sclerotherapy. Cardiovasc Intervent Radiol. Percutaneous aspiration and drainage of hydatid cysts in the liver. Percutaneous sonographically guided treatment of hydatid cysts in sheep: direct injection of hpv virus and squamous cell carcinoma and albendazole.

Ivermectin used in percutaneous drug injection method for the treatment of liver hydatid disease in sheep.

papilomatoza laringiana

Percutaneous treatment of abdominal hydatid cysts with hypertonic saline and alcohol. An experimental study in sheep. Invest Radiol. Results of alcohol and albendazole injections in hepatic hydatidosis: experimental study. J Gastroenterol Hepatol. Percutaneous Treatment of Liver Hydatid Cysts: Comparison of direct injection of Albendazole and hypertonic saline solution.

Adenopatia metastatică primitivă cervicală din perspectiva medicului ORL

Fertility assessment of hydatid cyst by proton MR spectroscopy. J Surg Res. Effect of hypertonic saline and alcohol on viability of daughter cysts in hepatic hydatid disease. Eur J Surg. Intracystic pressure and viability in hydatid disease of the liver.

Int Surg.

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Preoperative albendazole and scolices viability in patients with hepatic echinococcosis. World J Surg. Akhan AO, Yalin R. Preoperative albendazole treatment for liver hydatid disease decreases the viability of the cyst. Eur J Gastroenterol Hepatol. Puncture, Aspiration, Injection, Re-Aspiration an option for the treatment of cystic echinococcosis. Bull World Health Organization. International classification of ultrasound images in cystic echinococcosis for application in clinical and field epidemiological settings - WHO Informal Working Group.

Who Informal Working Group on Echinococcosis. Guidelines for treatment of cystic and alveolar echinococcosis in human. Bull WHO. These treatment modalities are frequently complicated by suboptimal control of locoregional disease and significant longterm functional deficits. It is very difficult to define the optimal therapeutic approach to the oropharyngeal cancer, because no single therapeutic regimen offers a superior survival over other regimens.

Although specific indications for primary surgical resection exist, there are studies that confirm that the concurrent use of multiagent chemotherapy and radiation has become the standard of care for the management of patients with late-stage disease, and surgery is often reserved for salvage of those patients who fail definitive nonoperative treatment.

Aggressive radiation therapy with concurrent multiagent chemotherapy have consistently demonstrated a survival and locoregional control benefit. This treatment approach emphasizes organ preservation and functionality. It human papillomavirus and tonsillar and base of tongue cancer also very important to understand that the ultimate therapeutic choice will depend on a careful review of each individual case, paying attention to the staging of the neoplasm, the general physical condition of the patient, the emotional status of the pacient, the experience of the treating team, and the available treatment facilities.

Spiridon, Bulevardul Independenei nr. De obicei, cancerul orofaringian se ntlnete la pacienii aflai n decadele de via, brbaii fiind de ori mai afectai dect femeile [1,2].

human papillomavirus and tonsillar and base of tongue cancer

Ca i n cazul altor cancere ale segmentelor cap i gt, fumatul i consumul abuziv de alcool reprezint cei mai semnificativi factori de risc n dezvoltarea cancerului orofaringian [2,3,4].

Ali factori de risc includ: - dieta srac n fructe i legume; - mestecatul nucii de Betel obicei ntlnit n unele pri ale Asiei [5]; - infecia cu papilomavirusul uman HPVn special tipul 16 HPV [6,7]. Eliminarea defectuoas a acetaldehidei, un carcinogen generat de metabolizarea alcoolului, reprezint un factor de risc adiional pentru cancerele orofaringiene.

Din punct de vedere anatomic, orofaringele se situeaz ntre palatul moale superior i osul hioid inferior. Se continu anterior cu cavitatea oral, comunic superior cu nazofaringele iar inferior cu laringele supraglotic i hipofaringele. Orofaringele este mprit n urmtoarele segmente [9]: - baza vierme, care include i pliurile faringoepiglotice i cele glosoepiglotice; - regiunea amigdalian, care cuprinde fosa amigdalian i pilierii anterior i posterior ; - palatul moale inclusiv uvula ; - pereii faringieni posterior i laterali.

Reeaua limfatic regional a capului i gtului conine ganglionii limfatici care sunt situai paralel cu vena jugular intern, nervul spinal accesoriu, artera facial precum i n triunghiul submandibular. Cunoaterea acestui aspect anatomic dar i statusul nodulilor limfatici regionali sunt eseniale n tratamentul pacienilor cu cancere ale capului i gtului [2,10].

Regiunile capului i gtului sunt mprite n cinci nivele I-Vpentru a facilita nelegerea anatomiei ganglionilor limfatici: - nivelul I: conine ganglionii submentali i submandibulari; - nivelul Human papillomavirus and tonsillar and base of tongue cancer conine ganglionii limfatici jugulari superiori, deasupra muchiului digastric; - nivelul III: conine ganglionii limfatici jugulari mijlocii, ntre muchiul omohioidian i muchiul digastric; - nivelul IV: conine ganglionii limfatici jugulari inferiori; - nivelul V: conine ganglionii limfatici ai triunghiului posterior.

Din punct de vedere histologic, aproape toate cancerele orofaringiene sunt carcinoame human papillomavirus and tonsillar and base of tongue cancer celule scuamoase [2]. Alte cancere ale acestei arii includ: carcinoame ale glandelor salivare minore, limfoame i limfoepitelioame acestea din urm fiind dezvoltate la nivelul amigdalelor. Clinic, cancerele bazei limbii sunt insidioase.

Acestea pot crete att dup modelul infiltrativ human papillomavirus and tonsillar and base of tongue cancer i dup cel exofitic. Simptomatologia acestor cancere poate include: durere, disfagie, scdere n greutate, otalgie reflex secundar interesrii nervilor cranieni, trismus consecutiv invaziei muchiului pterigoid, imobilitatea limbii prin infiltrare muscular profund i o mas tumoral la nivelul gtului [2,9].

Metastazele ganglionare sunt obinuite datorit bogiei drenajului limfatic al bazei limbii. Simptomele leziunilor amigdaliene cuprind: durerea, disfagia, pierderea n greutate, otalgia reflex ipsilateral i masa tumoral cervical [2, 9].

Pilierul amigdalian anterior i amigdala reprezint localizarea cea mai comun pentru o tumor primar a orofaringelui [9].