296 resultados para Ressecção extramusculoperiostal


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Pós-graduação em Anestesiologia - FMB

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Introduction: The Keratocystic Odontogenic Tumor (KCOT) is a benign odontogenic tumor with an infiltrative and potentially aggressive behavior with high recurrence rates. The KCOT occurs more often in men than women, with a frequency of 2:1, being more frequent in the mandible with a predilection for the body and branch. Treatment of KCOT remains controversial. Treatment usually includes enucleation, marsupialization, peripheral ostectomy, curettage associated with Carnoy solution and resection. Objective: To report a case of a KCOT located in the mandible. Case report: male patient, 15 years, with a KCOT on the right side of the mandible treated by enucleation and peripheral ostectomy, with four years of preservation, with no signs of recurrence. Final Comments: The treatment by enucleation associated with peripheral ostectomy reduces the relapse rate, preserves anatomical structures and can avoid a second surgical procedure for reconstruction of bone defects generated in surgery en bloc resection.

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The pyogenic granuloma, a lesion considered hyperplastic regenerative inflammatory reaction is a finding commonly found in the oral cavity, affecting large numbers of individuals, being more prevalent in females. But its pathogenesis is not well defined and may be associated with numerous factors that stimulate tissue proliferation. Correct diagnosis and treatment plan are essential for success in approach, restoring function and aesthetics to the periodontal tissues. In agreement with the literature, the most common treatment and greater predictability is surgical removal, which involves resection of the lesion, together with its base inserted into the underlying tissue, periosteum and bone tissue. However, the excision can promote aesthetic defects, particularly in anterior regions where it is most affected. This article reports on the importance of a correct surgical approach for removal of pyogenic granuloma in the region of the interdental papilla between teeth 42 and 43, resulting in a good anatomical result and aesthetic.

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Objective and Case report: The purpose of this paper is to describe the neutral zone technique in a patient with oral deformity on the right labial commissure due to the resection of an oral cancer, enhancing the difficulty resulting from mouth limited opening and the use of tissue conditioner material to determine the neutral zone. Complete denture was obtained through this technique, providing good retention and stability which made functional rehabilitation feasible to patient of his or her masticatory function. Final considerations: The neutral zone technique in complete dentures will determine a specific intraoral area for tooth position and denture base contour where the forces generated by lips, cheeks and tongue are neutralized. The objective of this technique is to provide an alternative approach for patients who presented an historic instability of lower complete denture: atrophic ridge, oral deformities and also with disorder problems. An oral rehabilitation using this technique improves comfort to the patient providing retention and stability of mandibular complete dentures.

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Pós-graduação em Bases Gerais da Cirurgia - FMB

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Kassabach-Merritt syndrome is a combination of capillary hemangioma and thrombocytopenia that predisposes to bleeding with petechiae, ecchymosis and spontaneous bruising. Treatment is generally started with corticosteroids, interferon alpha or chemotherapy. We present the case of a child (aged 1 year and 9 months) with a giant hemangioma, from the root of the thigh to the knee, and thrombocytopenia. Treatment was started with corticosteroids, without improvement, and then intra-tumor and cutaneous bleeding appeared spontaneously. The patient’s clinical condition precluded prescription of vincristine and interferon and emergency tumor resection was conducted because of extreme thrombocytopenia and bleeding. The child then began to develop sepsis with hypotension and ischemia of remnant tissues. This case presented a therapeutic challenge, which is the subject of this article.

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Crohn’s disease is a chronic infl ammatory bowel disease with segmental transmural infl ammation, which complicate with formation of fi stulas and abscesses. The hidradenitis suppurativa (HS) is characterized by recurrent abscesses, with a predilection for areas rich in apocrine glands such as the axillary, inguinal and perineal. The differential diagnosis between these diseases is diffi cult and may compromise treatment. Report case: C.R.M.A., 40 year-old, female, white, ileal and colonic Crohn’s disease complicated with perianal and rectovaginal fi stula for 12 years, treated with biological therapy since May 2010. In Sep/2010 presented with an abscess in the buttock D with purulent discharge refractory to the use of ciprofl oxacin and metronidazole. USG: collection of 30 cm3 in buttock D. The diagnosis was HS and the patient underwent extensive surgical removal of the affected areas (10 x 2 cm) with healing by secondary intention. Skin graft performed unsuccessfully in Dec/2010. The patient returned in jan/2011 with a new fi stula at the site of resection, consistent with Crohn’s disease. In fev/2011 underwent drainage of abscesses and placement of setons in perianal fi stulas. Currently in therapy with good biological evolution of fi stulas. The prevalence of HS varies from 0.3 to 4% of the population in general. The axilla is the region most affected and perianal lesions are associated with greater weakness. There are published reports of association between HS and Crohn’s disease sporadically and further studies are needed to assess a common pathogenesis. The differential diagnosis should be performed in all cases planning immediate treatment, avoiding complications and worsening of the patient’s quality of life.

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There are only 10 reported cases of pancreatic hemangiomas in adults, only one of them causing digestive bleeding. We present a case of variceal bleeding and portal hypertension caused by a pancreatic hemangioma. The patient had 19 year-old and was received at her 16th week of pregnancy. She had massive hematemesis, controlled after variceal band ligation. Her image exams revealed a cystic lesion of 164 cm³ in the pancreas tail and signs of portal hypertension. Two months after, the ultrassonographic exam documented the lesion growth, achieving 200 cm³ at that time. The patient was submitted to distal pancreatectomy, and the histopathological analysis revealed a pancreatic hemangioma of 11 x 9 x 8 cm. Therefore, we report the second case of digestive bleeding caused by a pancreatic hemangioma, which had a well documented growth during the pregnancy. Additionally, we review the previous reports of pancreatic hemangiomas and discuss the hypothesis of hormonal infl uence on the natural history of these tumors.

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The mast cell tumor (MCT) is the second most common type of tumor in dogs. It is characterized by uncontrolled proliferation of mast cells in the skin. Treatment involves surgical resection, chemotherapy and radiotherapy. Recently, new treatment protocols have been developed, such as the use of tyrosine kinase inhibitors. With the increasing knowledge about the genome and the evolution of methods in molecular genetics, drugs with specific molecular targets are surely going to become promising therapeutic modalities in the near future. Besides being involved in the normal cell cycle, some studies suggest that tyrosine kinases have a fundamental role in neoplastic processes. Therefore, some strategies such as the development of antibodies anti-receptors for tyrosine kinases and small-molecule tyrosine kinase receptor inhibitors have been developed in an attempt to inhibit tumor development. The purpose of this review is to describe the use of tyrosine kinase inhibitors in the treatment of mast cell tumors in dogs.