Our study confirmed a dramatic increase in thyroid cancer incidence in Canada. Thyroid cancer incidence was significantly higher in higher InQs and in cities. These data support the theory that increased access to imaging is largely responsible for this increased incidence.
BackgroundInfantile myofibromatosis is the most common benign fibrous tumor in infants. Three different types have been reported in the literature. The most commonly affected areas are the head, the neck and the trunk. Our patient showed a very high level of mandibular destruction resistant to all mandibular sparing treatment strategies requiring segmental mandibulectomy and complex reconstruction.Case presentationWe describe a rare case of multicentric infantile myofibromatosis with mandibular bone destruction. The treatment required a succession of chemotherapy, a subtotal transoral resection and a hemi-mandibulectomy. The mandibular reconstruction was staged with initial bridging titanium plate with a submental flap, followed later by a fibula free flap.ConclusionMandibular involvement by myofibromatosis is rare, and the extend of bone destruction and reconstruction make this case unique. To our knowledge, this is the only reported case of fibula free flap mandibular reconstruction in a patient with infantile myofibromatosis , as well as one of the youngest reported submental island flaps for any pathology. We describe the clinical presentation and management, including relevant imaging, histopathology, medical and surgical treatment as well as a review of relevant literature.
<p class="abstract">High-flow nasal oxygen (HFNO) has brought new opportunities in shared airway surgery. Contemporary challenges with its use in severely obstructive conditions such as laryngeal tumors still need to be addressed as there is discrepancy in its use and access among centres. We reported a case in which the use of HFNO allowed laryngeal tumor debulking while avoiding tracheotomy in a stridulous patient. The patient described was a 70 year old patient with stridor at rest secondary to a laryngeal tumor diagnosed five days before surgery. Tumor debulking could be safely initiated under general anaesthesia, which would not have been possible without HFNO. This report served as an example of an alternative to awake tracheotomy in the management of severely obstructive laryngeal pathology We wish to discuss through this case management of severely obstructive laryngeal pathology in the era of HFNO, while encouraging discussion on its potential benefits and limits.</p>
<p>Lymphomatoïd granulomatosis is a rare lymphoproliferative disease caused by Epstein-Barr virus described in 1972 by Liebow. The most common primary localization is the lungs. Other systems are affected occasionally such as the skin, central nervous system, renal and gastrointestinal system. Some cases have been described at the laryngeal level in immunosuppressed patients. This is a case report of supraglottic lymphomatoid granulomatosis in an immunocompetent patient. A literature review on lymphomatoid granulomatosis will be detailed and the clinical case will be described including investigations, treatment and follow-up. The differential diagnosis of this pathology as well as the importance of histopathology will also be discussed. Several radiological imaging and histopathology slides will be presented. Emphasis will be placed on the difficulty of diagnosis given the frequent multisystem involvement and on the importance of the multidisciplinary team approach including otolaryngology, haematology-oncology, nephrology, pathology and radiology. We will end with a discussion about the case with reference to the current literature on the subject.</p>
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