A carregar...
Publicação
Correlação anatomo-imagiológica e patológica dos tumores da laringe
| Nome: | Descrição: | Tamanho: | Formato: | |
|---|---|---|---|---|
| 3.92 MB | Adobe PDF |
Orientador(es)
Resumo(s)
Objectivos: Rever a anatomia, epidemiologia e clínica dos tumores da laringe e correlacionar o estadiamento imagiológico e anatomo-patológico dos carcinomas pavimento-celulares da laringe, discutindo os principais desafios atuais da TC e RM no seu estadiamento TNM.
Materiais e métodos: Estudo retrospectivo da TC e/ou RM de estadiamento dos doentes submetidos a laringectomia total, no Hospital de Santa Maria, entre 2011 e 2014. Comparação entre o estadiamento por imagem e o da anatomia-patológica.
Discussão dos principais desafios imagiológicos.
Resultados: Vinte doentes cumpriram critérios de inclusão no estudo. Dois doentes apresentaram discordância na classificação do estadiamento tumoral local e 5 doentes no envolvimento ganglionar. Assumiu-se como gold standart o resultado da anatomia patológica. Foram ilustrados 11 casos exemplificativos para discussão dos principais desafios no estadiamento por imagem.
Conclusões: O conhecimento anatómico da laringe é a base para o estadiamento imagiológico pré-terapêutico. Na correlação imagio-patológica, verificou-se uma menor sensibilidade no estadiamento ganglionar imagiológico, provavelmente devido à dificuldade de distinção de adenopatias benignas e malignas na TC/RM. Constatou-se que os doentes com adenopatias e perda da integridade capsular apresentaram pior prognóstico, por maior taxa de recidiva local e/ou metastização da neoplasia.
Considerou-se importante a inclusão de TC de tórax como parte do estadiamento inicial.
Objectives: To review the anatomy, epidemiology and clinical aspects of larynx tumors and relate the imagiologic results with the pathologic, in order to discuss the current challanges in staging squamous cell carcinomas (SCC) according to TNM classification. Methods and Materials: Retrospective study of the imagiologic and pathologic staging records of patients that were submitted to total laryngectomy, between 2011 and 2014, in Santa Maria Hospital. Describe the cross-sectional imaging findings of those tumors and provide clinical and pathologic-anatomic correlation. Results: Twenty patients exhibited the required criteria to be included in the study. Two of them presented local tumar staging (T) discordance and 5 demonstrated ganglionar discordance (N). The gold standart for the analysis was the pathologic result. 11 ilustratives cases are presented with the most importante pitfalls. Conclusion: Knowledge of the anatomy of the larynx is crucial to imagiological staging. The imagio-pathologic correlation of the tumors showed a minor sensibility in ganglionar staging, probably dued to difficult distintion of benign and malign adenopathies by TC/RM. This study also confirms that patients with lymph nodes’ extracapsular spread present worst prognosis, reflected by a higher rate of locoregional and distant metastasis. The inclusion of thorax CT in initial staging was considered important.
Objectives: To review the anatomy, epidemiology and clinical aspects of larynx tumors and relate the imagiologic results with the pathologic, in order to discuss the current challanges in staging squamous cell carcinomas (SCC) according to TNM classification. Methods and Materials: Retrospective study of the imagiologic and pathologic staging records of patients that were submitted to total laryngectomy, between 2011 and 2014, in Santa Maria Hospital. Describe the cross-sectional imaging findings of those tumors and provide clinical and pathologic-anatomic correlation. Results: Twenty patients exhibited the required criteria to be included in the study. Two of them presented local tumar staging (T) discordance and 5 demonstrated ganglionar discordance (N). The gold standart for the analysis was the pathologic result. 11 ilustratives cases are presented with the most importante pitfalls. Conclusion: Knowledge of the anatomy of the larynx is crucial to imagiological staging. The imagio-pathologic correlation of the tumors showed a minor sensibility in ganglionar staging, probably dued to difficult distintion of benign and malign adenopathies by TC/RM. This study also confirms that patients with lymph nodes’ extracapsular spread present worst prognosis, reflected by a higher rate of locoregional and distant metastasis. The inclusion of thorax CT in initial staging was considered important.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2015
Palavras-chave
Laringe Neoplasias Laríngeas Epidemiologia