By Vijay P. Khatri MD FACS
This detailed case-based evaluate of surgical oncology deals first-class education for oral board examinations, which emphasize either common wisdom and case administration. The booklet offers ninety one instances dependent to mirror the surgeon's decision-making procedure. each one case starts off with a sufferer presentation and imaging reports or pathology effects and proceeds via a chain of choice points—differential prognosis, requests for added exams, prognosis, surgical procedure, dialogue of strength pitfalls, and follow-up. instances are grouped by means of organ method and every part ends with a remedy set of rules summarizing the choice issues. approximately four hundred radiologic photographs and different appropriate illustrations accompany the text.
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Additional resources for Clinical Scenarios in Surgical Oncology
Neck dissection classification update. Arch Otolaryngol Head Neck Surg 2002; 128(7): 751–758. 4961_Khatri_ch03_pp008-011 7/21/05 11:12 AM Page 8 case 3 Endoscopy Report Presentation A 38-year-old man of Southern Chinese ancestry presents to your office with a 3-month history of a progressively enlarging left neck mass associated with intermittent right nasal obstruction. He is otherwise well with no other symptoms. He has no significant past medical or family history and is a nonsmoker. On physical examination, the only significant finding is an enlarged, firm left upper cervical lymph node measuring 4 ϫ 3 cm in diameter.
A variety of primary parotid malignancies may be the cause; mucoepidermoid carcinoma and adenoid cystic carcinoma are the most common, and both are frequently associated with perineural tumor involvement. Nonepithelial primary malignancies such as sarcoma and lymphoma are less likely, but should be considered. Most parotid tumors are benign, but these are rarely associated with facial nerve weakness. A primary neurogenic tumor or an inflammatory lesion involving the nerve is possible, as is a synchronous benign tumor and unrelated neuropathy; however, active steps should be taken to exclude malignancy even if these diagnoses are suggested.
Antibodies against EBV capsid antigen and neutralizing antibodies against EBV-specific DNase), are commonly elevated at the time of diagnosis. However, these markers are of little value in posttreatment surveillance, unlike tumor-derived plasma EBV DNA, which is an important prognostic and diagnostic marker for newly diagnosed or recurrent NPC. Using the technique of quantitative real-time polymerase chain reaction, plasma EBV DNA has a sensitivity of 96% and specificity of 93% in the primary diagnosis of NPC.
Clinical Scenarios in Surgical Oncology by Vijay P. Khatri MD FACS