RESUMO
Relatamos o caso de uma paciente do sexo feminino, de 54 anos, com diagnóstico de carcinoma mucoepidermóide de epiglote com extensäo à comissura anterior, sem limitaçäo do movimento das pregas vocais. A biópsia realizada no pré-operatório revelou carcinoma espinocelular, sendo submetida à laringectomia horizontal ampliada e esvaziamento cervical seletivo dos níveis 1, 2, 3 e 4 bilateralmente. O exame da peça cirúrgica resultou carcinoma mucoepidermóide de alto grau, com metástases para dois dos trinta e cinco linfonodos analisados. Este tumor é raramente encontrado na laringe; o tratamento é cirúrgico e a radioterapia é indicada de acordo com o grau de diferenciaçäo ou presença de metástases.
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Carcinoma Mucoepidermoide , Neoplasias Laríngeas , Epiglote/lesões , TraqueostomiaRESUMO
Of 33 children admitted within 24 hours after accidental ingestion of a caustic substance, 14 (42.5%) had evidence of upper airway lesions on direct laryngoscopy. Three patients, 10 to 12 months old, needed endotracheal intubation for acute respiratory obstruction; four patients younger than 2 years had severe dyspnea without obstruction; seven patients had mild or no respiratory symptoms. All were discharged without respiratory sequelae, although esophageal stenosis developed in six patients. Nine of 13 patients younger than 2 years, compared to five of 20 patients older than 2 years, had upper airway lesions (P less than 0.01). The frequency of respiratory tract lesions was higher in patients with severe esophagitis. Eleven of 17 patients with severe esophagitis, compared to three of 16 with mild inflammation, had respiratory tract lesions (P less than 0.025). No specific caustic substance predisposed to upper airway lesions.