Mohamed T Hafez

Metastatic rhabdomyosarcoma of the thyroid gland, a case report

The thyroid gland is a known but an unusual site for metastatic tumors from various primary sites. Despite the fact that it is one of the largest vascular organs in the body, clinical and surgical cases have given an incidence of 3 % of secondary malignances of the organ. Nevertheless, thyroid metastases are not an exceptional finding at autopsy, they are encountered in 2 % to 24 % of the patients with malignant neoplasm.Soft tissue sarcomas metastatic to the thyroid are extremely rare as the majority of thyroid metastasis are caused by tumors of the kidneys, lungs, mammary glands, ovaries , and colon or by melanomas.We report a case of 22-years-old woman with right leg rhabdomyosarcoma metastatic to the thyroid gland.

Pharyngoesophageal reconstruction after resection of hypopharyngeal carcinoma: a new algorithm after analysis of 142 cases

BackgroundThe aim of this study is to define an algorithm for the choice of reconstructive method for defects after laryngo-pharyngo-esophagectomy for hypopharyngeal carcinoma.MethodsOne hundred and forty two cases of hypopharyngeal carcinoma were included and operated on by either partial pharyngectomy, total pharyngectomy or esophagectomy. The reconstructive method was tailored according to the resected segment.ResultsPectoralis flap was used in 48 cases, free jejunal flap in 28 cases, augmented colon bypass in 4 cases, gastric pull up in 32 cases and gastric tube in 30 cases. Mean hospital stay was 12 days. Mortality rate was 10.6% and morbidity rate was 31.7%. Total flap failure occurred in 3 cases of free flap and one case of pectoralis flap. There were 23 cases of early fistula. Late stricture occurred in 19 cases, being highest with myocutaneous flap (early fistula 12/50 and late stricture 13/50).ConclusionFree jejunal flap was the flap of choice for reconstruction when the safety margin is still above the clavicle. In cases with added esophagectomy, we recommend gastric tube as a method of choice for reconstruction.

Axillary lymph nodes metastasis in a patient with recurrent papillary thyroid cancer: a case report

IntroductionThyroid cancer is the most common endocrine malignancy; the most common type of thyroid cancer is papillary thyroid cancer which accounts for approximately 90% of all thyroid cancers. Previously defined prognostic factors of papillary thyroid cancer include age, gender, tumor size, extrathyroidal extension, and distant metastasis. Cervical lymph node metastases are very common in patients with papillary thyroid cancer. Although papillary thyroid cancer has an excellent prognosis, lymphatic spread is associated with an increased risk of locoregional recurrence.Axillary metastasis is not a common finding in the classic type of papillary carcinoma; hence, a limited number of case reports have described the exceptional and rare metastatic spread of papillary thyroid carcinomas to the axilla.Case presentationWe report a case of metastatic axillary lymphadenopathy in a 61-year-old Egyptian man with a recurrent papillary thyroid cancer. He had a history of total thyroidectomy with right radical neck dissection 18 months ago. He presented to our cancer clinic at the Oncology Centre –Mansoura University with recurrent mass at the right lower parotid region, left cervical lymphadenopathy and left axillary lymphadenopathy.Removal of the recurrent right intraparotid mass, left comprehensive neck dissection and left axillary dissection were performed and the postoperative pathology report showed infiltration of the cervical and axillary lymph nodes by metastatic papillary thyroid cancer.ConclusionsAxillary lymph node enlargement in a patient with papillary thyroid cancer should be considered metastatic from thyroid until proved otherwise. Careful thorough examination of patients with recurrent thyroid cancer is essential to address any unusual metastasis.

Versatility in Mandibular Reconstruction after Ablative Tumor Surgery, Single Center Experience

Introduction Mandibular reconstruction using vascularized osteocutaneous flaps is necessary to improve functional outcomes, such as jaw movement and mastication, and aesthetics after the wide resection of the mandible [1].

Retro-Molar Trigonal Reconstruction and Oncologic Outcomes after Resection of Large Malignant Ulcers in Elderly Patients

Background: Buccal mucosa carcinoma represents 3 to 5% of oral-cavity cancer. Retromolar buccal trigon affected in one third of patients with buccal mucosal cancers. Squamous cell carcinoma is the commonest pathological finding.