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12 results on '"Oren Tepper"'

1. Case Report: Treatment of the rare B-cell lymphoblastic lymphoma with scalp lesion using rotation flap

Author

Timothy Kim, Geena Jung, Emery Buckner-Wolfson, Ryan Fatemi, Genesis Liriano, Adit Tal, Yanhua Wang, Oren Tepper, and Andrew Kobets

Subjects
scalp lesion, B-cell lymphoblastic lymphoma, acute lymphoblastic leukemia, rotation flap, non-Hodgkin’s lymphoma, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

IntroductionLeukemia is the most frequently occurring cancer in children, and lymphoblastic lymphoma (LBL) is a rare subtype. LBL are lymphoid neoplasms of B or T cell origin and are primarily treated with chemotherapy. Although cure rates among children are excellent, these patients must be monitored for relapse. Cutaneous lesions involving B-cell LBL (B-LBL) are extremely rare and here we present a patient with a worsening B-LBL scalp mass who required radical surgical excision.Case reportA 6-year-old female patient with a history of a nontender scalp mass discovered at approximately 2-3 years of age was evaluated for resection of the nodule due to its size and treatment history. The patient was originally diagnosed with follicular lymphoma by punch biopsy; excision was successfully performed on this 4 cm lesion and upon examination of the skin biopsy did we get a diagnosis of B-LBL. Reconstruction of the scalp was done through the rotation flap method. The patient’s scalp healed well, and adjuvant chemotherapy was continued. There has been no reoccurrence.DiscussionHere we report the rarity of B-LBL cases involving extranodal involvement in the scalp. The most common reconstruction of scalp lesions has been using free flap from the anterolateral thigh (ALT) and latissimus dorsi (LD). Our case used the rotation flap, which has its functional and cosmetic benefits. The importance of monitoring this patient is emphasized due to the dangerous consequences of B-LBL relapse. Ultimately, our successful treatment and care of this rare case can be used as guidance for similar patients in the future.

Published
2023
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12. Optimizing Reconstruction in Craniosynostosis: Review of Nonsyndromic Patients Treated With a Novel Technique

Author

James T. Goodrich, Carrie S. Stern, Kamilah Dowling, David A. Staffenberg, Oren Tepper, Hayeem L. Rudy, and Sean Herman

Subjects
Novel technique, Male, Reoperation, medicine.medical_specialty, Blood transfusion, medicine.medical_treatment, Operative Time, Article, Craniosynostosis, Craniosynostoses, Postoperative Complications, Blood loss, Suture (anatomy), Cranial vault, Medicine, Humans, Blood Transfusion, Postoperative Period, Retrospective Studies, business.industry, Skull, Infant, Retrospective cohort study, General Medicine, Plastic Surgery Procedures, medicine.disease, Surgery, Treatment Outcome, Otorhinolaryngology, Operative time, business
Abstract

PURPOSE: Open cranial vault remodeling (CVR) with autologous split calvarial bone grafts redistributes and recontours an abnormal calvarium to create an expanded cranial vault in patients with craniosynostosis. We report a 12-year retrospective review of 162 nonsyndromic patients who underwent operative repair using our previously-described technique which portends excellent surgical outcomes and can be applied to patients of any age group and with any variety of suture fusion. METHODS: Data was gathered on patients who underwent CVR from 2005 to 2016. Surgical records for each patient were analyzed and included operative time, estimated blood loss, and intraoperative transfusion volumes. Intraoperative and postoperative complications, the need for revision surgery, postoperative length of stay, and follow-up records were also reviewed. Syndromic patients were excluded, as well as patients with incomplete data sets. Patients who underwent either anterior or posterior vault remodeling were compared. RESULTS: A total of 162 patients were included in this case series. Patients undergoing anterior CVR were significantly older than those undergoing posterior CVR (13.3 versus 11.0 months, P < 0.015) and also had significantly greater intraoperative red blood transfusion volumes (20.3 versus 15.3cc/kg, P < 0.0207) and longer operative time than posterior CVR patients (274.9 versus 216.7 minutes, P < 0.0001). No patients required reoperation for resorption or recurrence or persistent contour irregularities. There were no visual or neurological complications. Calvarial bone was successfully split in 100% of cases. CONCLUSIONS: This surgical approach to CVR results in good surgical outcomes with a low recurrence rate, while also maximizing operative efficiency, and minimizing total blood loss and transfusion volume. This technique can be applied to any affected suture in a patient with craniosynostosis and in patients of any age group.

Published
2020

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