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J C Watkinson

Publications and source records attributed to J C Watkinson.

62 records · Page 4Linked to original sources

99Tcm(v)-DMSA planar scintigraphy: does it have a role in the management of patients with head and neck squamous carcinoma?

99Tcm(v)-DMSA is a new tumour-imaging agent which has recently been proposed as a scintigraphic marker for head and neck squamous cell carcinoma (SCC). Seventy-seven patients were studied prospectively, of whom 58 had a history and diagnosis of head and neck SCC. All patients were examined, imaged using 99Tcm(v)-DMSA planar scintigraphy and then followed up clinically. In addition, 35 patients were followed up with scintigraphy (81 studies). Scintigraphy was less sensitive and less accurate than clinical examination for the overall detection of patients with SCC, for the detection of patients with SCC at presentation and for the detection of patients with primary tumours, possible nodal disease and with residual and recurrent disease following surgery and irradiation. Approximately 50% of patients exhibited positive uptake of 99Tcm(v)-DMSA in the salivary glands following radiotherapy. Although 99Tcm(v)-DMSA is accumulated at sites of head and neck SCC, its inability to detect low volume disease and apparent low specificity following surgery and irradiation means it has no role to play in the routine evaluation of patients with head and neck SCC.

Adult↗

Cat scratch disease: an unusual cause of acute parotid pain (a case report with a literature review).

CSD is a well recognised cause of cervical lymphadenopathy, and parotid involvement occurs in 3 per cent of cases. Parotid lymphadenopathy is usually asymptomatic or tender but acute parotid pain treated successfully by surgery is previously undescribed. In our case excision of the primary lesion with parotid biopsy provided an immediate diagnosis and decompression of the parotid capsule resulted in dramatic relief of the patient's pain. We would therefore recommend that, in all cases of obscure cervical lymphadenopathy, CSD should be considered and a documentation of domestic pets actively sought. We would also advise that in those cases of parotid CSD in which either the diagnosis is equivocal, CS antigen is unavailable or intense parotid pain is a predominant feature, excision of the primary lesion together with surgical decompression of the parotid capsule should be performed.

Acute Disease↗

Traumatic nasal arterio-venous malformation: a case report.

Traumatic arterio-venous malformations of the nasal bones represent a rare but well defined clinical entity. We have described a case of a traumatic soft-tissue nasal arterio-venous malformation and commented on its investigation, pathophysiology and subsequent management. As far as we are aware this represents a hitherto unrecognised complication of nasal trauma.

Adult↗

An evaluation of the uptake of technetium-99m (v) dimercaptosuccinic acid in patients with squamous carcinoma of the head and neck.

A new imaging agent, Technetium-99m (Tc99m) (v) Dimercaptosuccinic acid (DMSA), has recently been developed which has been used to evaluate head and neck tumours. Twenty-four patients were studied of whom 21 had histologically proven SCC of the head and neck. The remaining 3 had benign lesions. Planar imaging of patients with primary disease revealed a sensitivity of 83% and a 75% specificity. The results of planar imaging of patients with cervical metastases yielded a 92% sensitivity and 100% specificity. Seven patients also had single photon emission computerized tomography (SPECT) which improved the image quality, spatial resolution and sensitivity of the investigation. Tc99m (v) DMSA imaging provides a cheap and rapid means of investigating head and neck SCC. This study suggests further work is indicated to assess its role in diagnosis and subsequent management.

Adult↗