Biomedical subjects

Ivo Stárek

Publications and source records attributed to Ivo Stárek.

5 recordsLinked to original sources

PubMed2006

Sentinel lymph node biopsy: A new perspective in head and neck mucosal melanoma?

Sentinel lymph node biopsy in patients with head and neck mucosal melanomas has not been performed so far. Therefore, this method as a staging tool was tested in a pilot study. In two consecutive patients, a lymphoscintigraphy, elective neck dissection with radio-guided sentinel lymph node identification, and resection of the primary were performed. The histopathological status of the sentinel lymph node was compared with the lymphadenectomy specimen and with the clinical course. Patient no. 1, in whom both the sentinel lymph node and the lymphadenectomy specimen were found to be free of tumour, is well and with no evidence of disease, the follow-up interval being 19 months. Patient no. 2, with the sentinel lymph node and remaining lymphatic basin being positive and negative, respectively, developed hematogenous dissemination 3 months after the primary treatment, and he was started on palliative chemotherapy. In mucosal melanoma, the prognostic significance of clinical nodal status is controversial, resulting in the lack of an official, applicable TNM classification and also of therapeutic guidelines. The presence of microscopic metastatic focus in the sentinel lymph node was associated with an early hematogenous dissemination. Therefore, sentinel lymph node biopsy, which represents a potentially efficient staging tool, warrants further investigation.

Adult↗

PubMed2006

Sentinel lymph node biopsy in parotid gland carcinoma.

Indications for elective neck dissection (ELND) and its extent in N0-staged patients with parotid gland carcinoma are inconsistent. Therefore, a pilot study was performed to test the feasibility and efficacy of radioguided sentinel lymph node biopsy (SLNB) in these tumors. A total of 6 patients underwent lymphoscintigraphy, SLNB, and level II-IV ELND. In 2 patients, the latter was extended to level V because the scans had revealed an additional sentinel lymph node (SLN) in this atypical nodal region. In all cases, the SLNs were detected intraoperatively. The SLNB exactly reflected the positive and negative histopathologic status of the remaining lymphatic basin in patients 1 and 4, respectively. One case of false negativity of SLNB could be explained by distortion of the lymphatic outflow resulting from intraparotid localization of lymphatic metastasis. The authors believe that the SLNB could provide reliable information on the status of regional lymph nodes, making it possible to base the neck dissection on the actual presence of the micrometastases and to detect metastatic tumors at unusual nodal levels.

Humans↗

PubMed2004

Pediatric tumors of the parapharyngeal space. Three case reports and a literature review.

Three cases of pediatric primary parapharyngeal space tumors, namely a Burkitt's lymphoma, lipoblastoma and a ganglioneuroma are described here, along with a literature review. These disorders are very rare, accounting for less than 20% of all parapharyngeal neoplasms. In comparison to adults, there are differences in pathomorphologic spectrum of pediatric parapharyngeal tumors. The authors describe the prevalence of malignant tumors, mainly soft tissues sarcomas. The salivary gland tumors and paragangliomas which dominate in adult populations, are extremely rare in pediatric populations where the most common benign tumor to be encountered is that of neurogenic origin. It follows that these features modify the diagnostic and therapeutic approach.

Burkitt Lymphoma↗

PubMed2004

Ulcerating Warthin's tumour.

We report the clinical course of a 63-year-old man with a Warthin's tumour in the right parotid gland that had ulcerated the overlying skin. The ulceration may have been due to the malignant transformation of either the epithelial or lymphoid component or, as in very rare cases, it may have resulted from inflammatory alterations crossing the capsule of the tumour into the adjacent parotid parenchyma and surrounding skin. Only two similar cases of the latter have been reported to date. The main clinical pitfall of such an inflammatory skin disruption of an otherwise benign Warthin's tumour is that it may be mistaken for an infiltratively growing malignant lesion.

Adenolymphoma↗

PubMed2002

Histopathologic changes in parotid gland parenchyma after fine needle aspiration biopsy of a Warthin's tumour. A case report.

Fine needle aspiration biopsy of a non-tender tumour in the right parotid gland was performed in a 63-year-old man. A cytological diagnosis of Warthin's tumour was made. Six weeks later, the tumor was removed by a formal parotidectomy. During dissection of the marginal mandibular branch of the facial nerve, significant fibrosis in the surrounding soft tissues was noted, requiring resection of the nerve. We also found a metaplastic (infarcted) Warthin's tumour with focal necrosis surrounded by metaplastic squamous epithelium. There was extensive fibrosis within the adjacent atrophic parotid parenchyma, striated muscle and around peripheral nerves. Small arteries at the periphery of the tumour were occluded by thrombi. The authors believe that the fibrosis of the tissue adjacent to the tumour was more likely due to the ischemia than to a direct puncture trauma caused by the fine needle aspiration.

Adenolymphoma↗