Chondrosarcoma is the third most frequently occurring bone tumor, following myeloma and osteosarc... more Chondrosarcoma is the third most frequently occurring bone tumor, following myeloma and osteosarcoma; it accounts for around 20% of all malign bone tumors. They are usually localized in the long bones and the bones of the pelvis; only 2% to 5% are located in the head and neck, mainly in the maxillary bone. Initial symptoms are usually very bizarre and sometimes only a sensation of having a neck mass means that a patient goes to see a doctor. Due to the larynx's intimate relationship with the thyroid gland, this tumor may give a false diagnostic impression. As happened in this case, a patient consulted due to level 4 mass (central neck area), echography of the thyroid nodule and fine needle aspiration (FNA) having proved positive for thyroid goiter. The presence of an invasive thyroid carcinoma was suspected in the TAC due to infiltration of the cricoid cartilage; a well-differentiated diagnosis of chondrosarcoma (grade 1) was only made during surgical intervention orientated by biopsy following intraoperation exposure and the definitive study of the pathology. This case has been reported and the topic reviewed as it was difficult case to diagnose and involved a very infrequently occurring pathology.
... Laryngeal chondrosarcoma: a very unusual pathology. Enrique Cadena-Piñeros 1 , Alfredo Ernest... more ... Laryngeal chondrosarcoma: a very unusual pathology. Enrique Cadena-Piñeros 1 , Alfredo Ernesto Romero-Rojas 2 , Saúl Enrique Vargas 3. ... [ Links ]. 12. Moerman M, Kreps B, Forsyth R. Laryngeal chondrosarcoma: An exceptional localization of a not unfrequent bone tumor. ...
Las neoplasias cutáneas son un motivo de consulta cada día mayor; especialmente, en las regiones ... more Las neoplasias cutáneas son un motivo de consulta cada día mayor; especialmente, en las regiones del trópico. Para los profesionales que atienden a pacientes con este tipo de patologías, resulta de vital importancia tener claro el manejo de ellas; sobre todo, el melanoma y el carcinoma escamocelular de piel de cabeza y cuello. No solo se debe tratar el sitio primario, sino también los relevos ganglionares que podrían estar afectados, dependiendo de los factores de riesgo de la enfermedad. Como no está claro el uso de intervenciones conservadoras para tratar los ganglios del cuello en estos pacientes, ha surgido en el Instituto Nacional de Cancerología (INC) la necesidad de implementar el uso de la linfogammagrafía con tomografía computarizada de emisión de fotón único más tomografía computada (SPECT/ CT), para definir cuáles grupos ganglionares del cuello deben ser retirados. Con el fin de aclarar tópicos de esta técnica, se revisa el tema. Palabras clave: neoplasias cutáneas, disección del cuello, biopsia del ganglio linfático centinela, tomografía computarizada de emisión de fotón único, tomografía computarizada de emisión
Squamous cell carcinoma of the head and neck affects very significant number of people worldwide,... more Squamous cell carcinoma of the head and neck affects very significant number of people worldwide, as is now being seen more often in those less than 40 years-old. They have traditionally been managed with surgery of the primary tumor plus selective dissection of neck nodes, particularly in T1 and T2 tumors. The lymphatic anatomy of the neck is complicated and the compromised areas usually have more than one drainage site; therefore it is important to remove the nodes with micrometastases by selective neck dissection. This can be now done by radioguided super-selective node dissection by prior lymphatic mapping with SPECT/CT, with a lower morbidity and with oncological safety. Using this, and as far as we know, for the first time in our Institute and in Colombia, a 38 year-old patient with oral squamous cell carcinoma of the tongue (T1 N0 M0, EI) has been treated using this technique.
Multiple endocrine neoplasia type 2 is a syndrome characterized by medullary thyroid carcinoma an... more Multiple endocrine neoplasia type 2 is a syndrome characterized by medullary thyroid carcinoma and pheochromocytomas. The identification of RET proto-oncogene mutations in multiple endocrine neoplasia type 2 has provided a precise method for identifying gene carriers. Additionally, the identification of these mutations has allowed characterizing the clinical expression and the severity of medullary thyroid carcinoma and proper prophylactic treatment and follow-up. This review provides a concise discussion of the use of genetic testing in the management of hereditary medullary thyroid carcinoma with an emphasis on early intervention to prevent death or serious morbidity from it.
International Journal of Radiology & Radiation Therapy, Jun 27, 2017
Parathyroid carcinoma is the cause of only 1% of hyperparathyroidism cases. The incidence of acut... more Parathyroid carcinoma is the cause of only 1% of hyperparathyroidism cases. The incidence of acute pancreatitis in patients with hyperparathyroidism was reported to be only 1.5%. The occurrence of pancreatitis in patients with parathyroid carcinoma is unusual, ranging from 0% to 15%. Here, we report a very rare case of parathyroid carcinoma presenting as an acute pancreatitis in a 45years old woman, who was suspected for hypercalcemia and higher levels of intact parathyroid hormone. The parathyroid carcinoma was verified with ultrasound, CT Scan, and single-photon emission computed tomography. The pathological anatomy report showed a minimally invasive parathyroid carcinoma. Following surgery, the patient was free after almost a 4years follow up.
Hypopharyngeal cysts are very uncommon pathology. They are presented in adult people over 60 year... more Hypopharyngeal cysts are very uncommon pathology. They are presented in adult people over 60 years. Although oncocytic cysts are benign tumors, an incomplete resection causes recurrence. The symptoms are not specific, but the more frequent are dyspnea and foreign body sensation upon swallowing. Diagnosis usually is under general anesthesia during intubation. A flexible fiberoptic laryngoscopy could be insufficient; the trumpet maneuver during this examination can reveled occult cysts. To perform a total resection, the surgeon must have a complete exposition of the operative field. We present a new case of a patient with a symptomatic hypopharyngeal cyst successfully treated with transoral robotic extirpation; our view was tridimensional magnified and the robotic instruments provided great range of movement that permitted complete and safe removal hypopharyngeal lesion.
Vallecular cyst is more frequent in neonatal life, but could be present in adults. Frequently it ... more Vallecular cyst is more frequent in neonatal life, but could be present in adults. Frequently it is asymptomatic although some people has foreign body sensation upon swallowing and obstructive problems to sleep. The best treatment for these cases is complete resection, as recurrence is usual with any cyst remnant wall causing re-accumulation. We present the case of a patient with symptomatic vallecular cyst treated with transoral robotic surgery. The technique confirmed the advantages related with tridimensional vision close to the cyst, associated with multi-articulated 5 mm EndoWrist® instruments that made real safe and efficient surgery.
Chondrosarcoma is the third most frequently occurring bone tumor, following myeloma and osteosarc... more Chondrosarcoma is the third most frequently occurring bone tumor, following myeloma and osteosarcoma; it accounts for around 20% of all malign bone tumors. They are usually localized in the long bones and the bones of the pelvis; only 2% to 5% are located in the head and neck, mainly in the maxillary bone. Initial symptoms are usually very bizarre and sometimes only a sensation of having a neck mass means that a patient goes to see a doctor. Due to the larynx's intimate relationship with the thyroid gland, this tumor may give a false diagnostic impression. As happened in this case, a patient consulted due to level 4 mass (central neck area), echography of the thyroid nodule and fine needle aspiration (FNA) having proved positive for thyroid goiter. The presence of an invasive thyroid carcinoma was suspected in the TAC due to infiltration of the cricoid cartilage; a well-differentiated diagnosis of chondrosarcoma (grade 1) was only made during surgical intervention orientated by biopsy following intraoperation exposure and the definitive study of the pathology. This case has been reported and the topic reviewed as it was difficult case to diagnose and involved a very infrequently occurring pathology.
... Laryngeal chondrosarcoma: a very unusual pathology. Enrique Cadena-Piñeros 1 , Alfredo Ernest... more ... Laryngeal chondrosarcoma: a very unusual pathology. Enrique Cadena-Piñeros 1 , Alfredo Ernesto Romero-Rojas 2 , Saúl Enrique Vargas 3. ... [ Links ]. 12. Moerman M, Kreps B, Forsyth R. Laryngeal chondrosarcoma: An exceptional localization of a not unfrequent bone tumor. ...
Las neoplasias cutáneas son un motivo de consulta cada día mayor; especialmente, en las regiones ... more Las neoplasias cutáneas son un motivo de consulta cada día mayor; especialmente, en las regiones del trópico. Para los profesionales que atienden a pacientes con este tipo de patologías, resulta de vital importancia tener claro el manejo de ellas; sobre todo, el melanoma y el carcinoma escamocelular de piel de cabeza y cuello. No solo se debe tratar el sitio primario, sino también los relevos ganglionares que podrían estar afectados, dependiendo de los factores de riesgo de la enfermedad. Como no está claro el uso de intervenciones conservadoras para tratar los ganglios del cuello en estos pacientes, ha surgido en el Instituto Nacional de Cancerología (INC) la necesidad de implementar el uso de la linfogammagrafía con tomografía computarizada de emisión de fotón único más tomografía computada (SPECT/ CT), para definir cuáles grupos ganglionares del cuello deben ser retirados. Con el fin de aclarar tópicos de esta técnica, se revisa el tema. Palabras clave: neoplasias cutáneas, disección del cuello, biopsia del ganglio linfático centinela, tomografía computarizada de emisión de fotón único, tomografía computarizada de emisión
Squamous cell carcinoma of the head and neck affects very significant number of people worldwide,... more Squamous cell carcinoma of the head and neck affects very significant number of people worldwide, as is now being seen more often in those less than 40 years-old. They have traditionally been managed with surgery of the primary tumor plus selective dissection of neck nodes, particularly in T1 and T2 tumors. The lymphatic anatomy of the neck is complicated and the compromised areas usually have more than one drainage site; therefore it is important to remove the nodes with micrometastases by selective neck dissection. This can be now done by radioguided super-selective node dissection by prior lymphatic mapping with SPECT/CT, with a lower morbidity and with oncological safety. Using this, and as far as we know, for the first time in our Institute and in Colombia, a 38 year-old patient with oral squamous cell carcinoma of the tongue (T1 N0 M0, EI) has been treated using this technique.
Multiple endocrine neoplasia type 2 is a syndrome characterized by medullary thyroid carcinoma an... more Multiple endocrine neoplasia type 2 is a syndrome characterized by medullary thyroid carcinoma and pheochromocytomas. The identification of RET proto-oncogene mutations in multiple endocrine neoplasia type 2 has provided a precise method for identifying gene carriers. Additionally, the identification of these mutations has allowed characterizing the clinical expression and the severity of medullary thyroid carcinoma and proper prophylactic treatment and follow-up. This review provides a concise discussion of the use of genetic testing in the management of hereditary medullary thyroid carcinoma with an emphasis on early intervention to prevent death or serious morbidity from it.
International Journal of Radiology & Radiation Therapy, Jun 27, 2017
Parathyroid carcinoma is the cause of only 1% of hyperparathyroidism cases. The incidence of acut... more Parathyroid carcinoma is the cause of only 1% of hyperparathyroidism cases. The incidence of acute pancreatitis in patients with hyperparathyroidism was reported to be only 1.5%. The occurrence of pancreatitis in patients with parathyroid carcinoma is unusual, ranging from 0% to 15%. Here, we report a very rare case of parathyroid carcinoma presenting as an acute pancreatitis in a 45years old woman, who was suspected for hypercalcemia and higher levels of intact parathyroid hormone. The parathyroid carcinoma was verified with ultrasound, CT Scan, and single-photon emission computed tomography. The pathological anatomy report showed a minimally invasive parathyroid carcinoma. Following surgery, the patient was free after almost a 4years follow up.
Hypopharyngeal cysts are very uncommon pathology. They are presented in adult people over 60 year... more Hypopharyngeal cysts are very uncommon pathology. They are presented in adult people over 60 years. Although oncocytic cysts are benign tumors, an incomplete resection causes recurrence. The symptoms are not specific, but the more frequent are dyspnea and foreign body sensation upon swallowing. Diagnosis usually is under general anesthesia during intubation. A flexible fiberoptic laryngoscopy could be insufficient; the trumpet maneuver during this examination can reveled occult cysts. To perform a total resection, the surgeon must have a complete exposition of the operative field. We present a new case of a patient with a symptomatic hypopharyngeal cyst successfully treated with transoral robotic extirpation; our view was tridimensional magnified and the robotic instruments provided great range of movement that permitted complete and safe removal hypopharyngeal lesion.
Vallecular cyst is more frequent in neonatal life, but could be present in adults. Frequently it ... more Vallecular cyst is more frequent in neonatal life, but could be present in adults. Frequently it is asymptomatic although some people has foreign body sensation upon swallowing and obstructive problems to sleep. The best treatment for these cases is complete resection, as recurrence is usual with any cyst remnant wall causing re-accumulation. We present the case of a patient with symptomatic vallecular cyst treated with transoral robotic surgery. The technique confirmed the advantages related with tridimensional vision close to the cyst, associated with multi-articulated 5 mm EndoWrist® instruments that made real safe and efficient surgery.
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Papers by Enrique Cadena