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Vilanilam GK, Nayar D, Pandey I, Vattoth S. Recurrent sporadic malignant triton tumor in the carotid sheath in the absence of neurofibromatosis. Neuroradiol J 2024; 37:376-380. [PMID: 37608426 PMCID: PMC11138328 DOI: 10.1177/19714009231196476] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/24/2023] Open
Abstract
Malignant Triton Tumors (MTTs) are a rare and aggressive subtype of malignant peripheral nerve sheath tumors (MPNSTs), often associated with neurofibromatosis type 1. This case report describes a unique instance of recurrent sporadic MTT within the carotid sheath in a 33-year-old male without any personal or familial history of neurofibromatosis. The patient initially presented with a biopsy-confirmed MTT in the right neck, involving the carotid body and brachial plexus, and underwent partial resection, radiation therapy, and chemotherapy. Six months later, the patient presented with recurrent MTT, and subsequently underwent radical tumor resection, segmental right carotid artery resection, and deep femoral vein interposition. Recovery was complicated by hematoma formation, and the patient developed vocal fold paralysis and a left vocal fold cyst, necessitating further surgeries. Yearly follow-ups for 8 years revealed no recurrence. This case emphasizes the importance of comprehensive patient evaluation, including clinical history, imaging, and biopsy findings, for accurate diagnosis and prompt surgical intervention in managing such rare and aggressive tumors. Further research is needed to identify novel therapies and improve survival rates for patients with MTTs.
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Affiliation(s)
- George K Vilanilam
- Division of Neuroradiology, Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Divya Nayar
- Department of Neurology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | | | - Surjith Vattoth
- Division of Neuroradiology, Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
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Li G, Liu C, Liu Y, Xu F, Su Z, Wang Y, Ren S, Deng T, Huang D, Tian Y, Qiu Y. Analysis of clinical features and prognosis of malignant triton tumor: A report of two cases and literature review. Oncol Lett 2015; 10:3551-3556. [PMID: 26788168 DOI: 10.3892/ol.2015.3762] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2014] [Accepted: 06/22/2015] [Indexed: 11/06/2022] Open
Abstract
Malignant triton tumor (MTT) is a malignant peripheral nerve sheath tumor with rhabdomyoblastic differentiation. The prognosis of patients is poor, and due to its rarity, large case studies are lacking. The aim of this study is to describe the clinical features and identify potential prognostic factors. Two patients with MTT in the head and neck treated at our department are reported. A literature search revealed another 198 published cases. All of these cases then went through a retrospective analysis. The ratio of male-to-female incidence was 1.5:1, and the median age at diagnosis was 29 years. In 41.7% of cases it occurred in patients with neurofibromatosis type 1. The five-year survival of MTT was found to be just 35%. Cox proportional hazards analysis revealed that complete resection (hazard ratio, 0.396; P=0.032) and metastases (hazard ratio, 3.188; P=0.004) were associated with mortality, indicating that complete resection may lead to a longer life span, and that the existence of metastasis suggested a worse prognosis for patients with MTT.
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Affiliation(s)
- Guo Li
- Department of Otolaryngology and Head-Neck Surgery, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China; Otolaryngology Major Disease Research Key Laboratory of Hunan, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China
| | - Chao Liu
- Department of Otolaryngology and Head-Neck Surgery, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China; Otolaryngology Major Disease Research Key Laboratory of Hunan, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China
| | - Yong Liu
- Department of Otolaryngology and Head-Neck Surgery, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China; Otolaryngology Major Disease Research Key Laboratory of Hunan, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China
| | - Fang Xu
- Department of Otolaryngology and Head-Neck Surgery, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China; Otolaryngology Major Disease Research Key Laboratory of Hunan, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China
| | - Zhongwu Su
- Department of Otolaryngology and Head-Neck Surgery, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China; Otolaryngology Major Disease Research Key Laboratory of Hunan, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China
| | - Yunyun Wang
- Department of Otolaryngology and Head-Neck Surgery, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China; Otolaryngology Major Disease Research Key Laboratory of Hunan, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China
| | - Shuling Ren
- Department of Otolaryngology and Head-Neck Surgery, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China; Otolaryngology Major Disease Research Key Laboratory of Hunan, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China
| | - Tengbo Deng
- Department of Otolaryngology and Head-Neck Surgery, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China; Otolaryngology Major Disease Research Key Laboratory of Hunan, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China
| | - Donghai Huang
- Department of Otolaryngology and Head-Neck Surgery, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China; Otolaryngology Major Disease Research Key Laboratory of Hunan, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China
| | - Yongquan Tian
- Department of Otolaryngology and Head-Neck Surgery, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China; Otolaryngology Major Disease Research Key Laboratory of Hunan, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China
| | - Yuanzheng Qiu
- Department of Otolaryngology and Head-Neck Surgery, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China; Otolaryngology Major Disease Research Key Laboratory of Hunan, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China
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Aydogan F, Aydogan A, Akkucuk S, Ustun I, Gokce C. Thyroid hemiagenesis, ectopic submandibular thyroid tissue, and apparent persistent subclinical thyrotoxicosis. Thyroid 2013; 23:633-5. [PMID: 23157170 DOI: 10.1089/thy.2012.0079] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Ectopic thyroid tissue (ETT) is a rare embryological abnormality characterized by the occurrence of thyroid tissue in a site other than its usual location. Thyroid hemiagenesis (HA) is also a very rare abnormality in which one thyroid lobe does not develop properly during embryology. We report a patient with left HA, submandibular ETT, and persistent mildly suppressed serum thyrotropin (TSH). PATIENT A 38-year-old female patient was admitted with complaints of sweating and palpitations. She had no symptoms of neck compression. Thyroid ultrasonography revealed heterogeneity and hypoechogenicity of the right lobe and absence of the left lobe, the latter being confirmed by computed tomography. There was no ETT in the neck. A thyroid Tc-99m pertechnetate scan demonstrated two distinct areas of radiotracer uptake, one in the right lobe of the thyroid gland and one in the right submandibular region and lobe, but no uptake in the left thyroid bed. The serum free triiodothyronine was 2.89 pg/mL (2.5-3.9 pg/mL), and the serum free thyroxine was 0.86 ng/dL (0.61-1.12 ng/mL). The serum TSH was 0.11 mIU/L (0.34-5.60 mIU/L). CONCLUSIONS This may be the first reported patient with HA and submandibular ETT. The patient probably also had thyroiditis with mild intermittent thyrotoxicosis based on her suppressed TSH and ultrasonography imaging of the right thyroid lobe.
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Affiliation(s)
- Fusun Aydogan
- Department of Nuclear Medicine, Mustafa Kemal University, Hatay, Turkey
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He JG, Jiang H, Yang BB, Lin PF. Liposarcoma of the retropharyngeal space with rapidly worsening dyspnea: A case report and review of the literature. Oncol Lett 2013; 5:1939-1942. [PMID: 23833671 PMCID: PMC3700895 DOI: 10.3892/ol.2013.1310] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2012] [Accepted: 04/11/2013] [Indexed: 11/16/2022] Open
Abstract
Liposarcomas represent a significant proportion of soft-tissue sarcomas. However, their occurrence in the head and neck is infrequent and they are exceedingly rare in the retropharyngeal space. The present study reports the case of a 58-year-old patient with retropharyngeal liposarcoma. Uniquely, the patient presented with rapidly worsening dyspnea. The diagnosis of liposarcoma was established following retropharyngeal tumor excision, although biopsies were performed twice. Adjuvant radiotherapy was refused by the patient. However, during the post-operative follow-up period, no sign of either local tumor recurrence or distant metastasis was observed. Previously reported cases were also reviewed to analyze the diagnosis, treatment and prognosis of this disease.
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Affiliation(s)
- Jian-Guo He
- Department of Otolaryngology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310009, P.R. China
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López Alvarez F, Llorente Pendás JL, Coca Pelaz A, Fernández García MS, Cuello Bueno G, Suárez Nieto C. Malignant triton tumor of the infratemporal fossa. J Craniofac Surg 2009; 20:1282-6. [PMID: 19625850 DOI: 10.1097/scs.0b013e3181ae180b] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Malignant triton tumor is a very aggressive type of sarcoma that comprises rhabdomyoblasts and malignant Schwann cells. It is a different entity from malignant schwannoma, characterized by their aggressiveness and poor prognosis. Head and neck location is frequent, and early diagnosis and complete resection followed by radiation therapy is important for long-term survival. However, the therapeutic plan should be individualized, taking into account the location and size of the primary tumor. The use of adjuvant chemotherapy and molecular therapies should be considered in the treatment of these tumors. We report an unusual presentation of a malignant triton tumor located in the infratemporal fossa, describing its clinical and pathologic features, and we try to update the knowledge in the management of these tumors, including the use of molecular therapies.
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Affiliation(s)
- Fernando López Alvarez
- Department of Otorhinolaryngology, Hospital Universitario Central de Asturias, IUOPA, Oviedo, Asturias, Spain.
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