Recurrent Anterior Skull Base Plasmocytoma
Notice bibliographique
Résumé
CASE HISTORY A 53-year-old man was referred for treatment of a mass that invaded the posterior nasal cavity, ethmoid sinuses, both posterior orbits, and anterior skull base. Eighteen years earlier, he had been diagnosed with a solitary plasmacytoma of the paranasal sinuses. Despite treatment with 4500 cGy radiation therapy, the tumor continued to grow and was subtotally resected 3 years later through a transfacial approach. Two years before his current referral, he underwent a second operation for a massive recurrent tumor. On that occasion, the highly vascularized tumor was completely removed anterolaterally through a subcranial approach. The patient elected not to have the pericarotid and perichiasmatic extensions of the tumor removed to spare these vital structures. The anterior skull base was reconstructed with the use of fascia lata, biological glue, and titanium miniplates. After surgery, the patient returned to his native country with the recommendation to undergo a complementary course of radiation therapy and chemotherapy. The patient experienced intermittent epistaxis and nasal obstruction for 3 months before his current referral. He had received no radiological or chemotherapeutic intervention during the intervening 2 years. On examination he appeared well. His speech and gait were normal, and he suffered no visual disturbances. Transnasal endoscopic examination showed that the anterior cavity was clean. A reddish mass obstructed the posterior nasal cavity and choana. Mirror laryngoscopy revealed normal vocal fold function and no suspicious lesions of the oropharynx, hypopharynx, or larynx. The oral cavity and tongue were normal. The neck was without adenopathy. Cranial nerves function was intact. The remainder of the physical examination revealed no musculoskeletal or cardiovascular abnormalities. His erythrocyte sedimentation rate was 50 mm/h and his blood count was normal. Electrolytic, calcium, glucose, albumin, and liver functions were normal. Serum electrophoresis was normal, with serum globulin of 22 g/L and no monoclonal peak. Urinalysis was normal, and a test for Bence-Jones protein was negative. Pathological examination of the bone marrow aspirate showed a normal number of mature plasma cells with no evidence for monoclonal heavy or light chains. Computed tomography (CT) and magnetic resonance imaging (MRI) of the skull base, paranasal sinuses, and orbits showed a 3- × 4-cm vascularized tumor involving the ethmoid cells and sphenoid sinus, eroding both orbits and invading the anterior cranial fossa. Posteriorly, the tumor impinged on both the carotid arteries and optic nerves (Fig. [ 1 ]). Histopathological examination of the previous biopsy showed diffuse sheets of immature-appearing plasma cells (Fig. [ 2 ]). Immunohistochemical staining confirmed the diagnosis of plasmacytoma.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,007 | 0,003 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; les deux têtes enseignantes s’accordent sur ce qui est montré ici.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».