[A new technic of enlargement plasty of tracheostomies].
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Humans↗
Biomedical subjects
L Manolopoulos
Publications and source records attributed to L Manolopoulos.
[Combined ORL and neurosurgical approach in adenocarcinoma of the ethmoid. Preliminary results apropos of 15 cases].
Fifteen cases of adenocarcinoma of the ethmoid sinus treated by a combined subfrontal and transfacial approach after induction chemotherapy are reported. The surgical technique is described precisely including a paralateronasal approach combined with a bifrontocoronal incision, a bilateral ethmoidectomy and reconstruction of the anterior base of the skull by one sheets taken-out from the inner surface of the frontal flap or more recently madreporic coralline grafts; the dura is hermetically sealed and it is lined with a large galea flap. Results were as following: one post-operative death, no clinical rhinorrhea, no recurrence from the anterior cerebral fossa, one orbital and one sphenoidal recurrences. Surgical indications are discussed according to the different extensions of the tumor and a frontal lobe extension is not a contraindication. This surgical procedure should be employed for the adenocarcinomas of the ethmoid invading the superior cells even in the absence of lysis of the cribriform plate in order to avoid the endocranial recurrences.
Adenocarcinoma↗
Burkitt's lymphoma in the base of the tongue: differential diagnosis and management.
Burkitt's lymphoma is the most common malignancy in African children but can occur sporadically in every country. It is one of the most aggressive malignancies in the human body, and in the past the prognosis was very poor. However, complex chemotherapy regimens can now cure approximately 50-80% of adult patients with Burkitt's lymphoma or small noncleaved lymphoma, and in pediatric populations the cure rate is even higher. Although the African type has a preference to the head and neck region (whereas the sporadic type to the abdomen), involvement of the base of the tongue is extremely rare as only 1 case has ever been reported in the English literature. The present study describes a patient with Burkitt's lymphoma presenting as a single mass in the base of the tongue without any abdominal or other extra-abdominal involvement. The patient was submitted to chemotherapy (intravenous and intrathecal) and skull radiotherapy. Today, 17 months after the diagnosis, the patient is disease free. Physicians should be aware of the extranodal manifestations of Burkitt's lymphoma and their differential diagnosis in order to achieve early diagnosis and treatment.
Adult↗
Topoisomerase II alpha expression in squamous cell carcinomas of the head and neck.
The aim of the present study was to examine topoisomerase II alpha (topo II alpha) expression in cancers of the head and neck and to establish a correlation with clinicopathological parameters and survival. Paraffin embedded tissue specimens (studied by immunohistochemistry), from 103 consecutive patients with squamous cell carcinoma of the head and neck regions, were examined on the primary tumor (96 patients) and on recurrence (7 patients). Immunostaining evaluation was quantified by examining at least 1,000 neoplastic cells and counting the percentage of positively stained nuclei. Topoisomerase II alpha expression was correlated with age, gender, stage, site of the disease, tumor differentiation, response to chemotherapy, disease-free survival and overall survival. More than half of the specimens had a high expression of topoisomerase II alpha (> or = 15% positive neoplastic cells). Topoisomerase II alpha expression was significantly higher in tumors of low and moderate differentiation versus tumors of high differentiation (P = 0.00001). There was also a significant difference in topo II alpha in specimens of responders to chemotherapy versus non-responders (P = 0.02), although the cytotoxic drugs used do not belong to topoisomerase II alpha antagonists. The correlation of high topoisomerase II alpha expression and stage of disease, age, gender, primary site, recurrence, disease-free survival and overall survival was not statistically significant. In conclusion, topoisomerase II alpha is highly expressed in histological specimens of the majority of patients with head and neck cancers; mainly, it is related to a significant degree to low and moderately differentiated tumors versus highly differentiated ones. High expression of topoisomerase II alpha is also significantly related to response to chemotherapy.
Adult↗
p53, p21 and p27 protein expression in head and neck cancer and their prognostic value.
Histological specimens from 62 laryngeal and 31 oral carcinomas were immunohistochemically assessed for p53, p21 and p27 proteins; cases with > 10% labelled nuclei were considered as positive. p21 showed higher expression in patients > 65-years-old (P = 0.04), in chemotherapy responders (P = 0.02), and in stage III patients with longer overall survival (P = 0.02), representing the only independent prognostic factor in the multivariate analysis. In addition, stage III patients with p53-/p21+ showed the longest survival whereas those with p53+/p21- tumors showed the shortest overall survival (P = 0.02). A significant influence on the survival of stage III patients was also found for the combinations of p21 and p27 proteins with p21+/p27- imparting the best and p21-/p27+ the worst prognosis (P = 0.04). p27 expression was significantly related to oral cancer specimens (P = 0.04) and to moderate and high tumor grade (P = 0.01). p53 expression was not significantly related to any of the examined clinicopathological characteristics. Our findings indicated that, by functionally promoting apoptosis, p21 seems to play a key role in the successful response to chemotherapy and may be considered as a predictive factor of a better prognosis in stage III patients with head and neck cancers.
Adult↗