Effectiveness of acridine-binding method in screening for oral, pharyngeal, and laryngeal cancer.
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Six patients with malignant head and neck tumors are shown to have required electron microscopy for accurate diagnosis. In all of these tumors, there were ultrastructural features of cytodifferentiation that were not discernible by light microscopy, such as neurosecretory granules, desmosomes, cytoplasmic processes, tonofibrils, and myofilaments. Electron microscopy is helpful in the differential diagnosis of tumors in general, but its effectiveness is particularly apparent in small-cell "undifferentiated" tumors such as neuroblastoma, rhabdomyosarcoma, Ewing's sarcoma, undifferentiated squamous-cell carcinoma of the lymphoepithelioma type, and malignant lymphoma. It has also been helpful in the identification of amelanotic melanoma and spindle-cell carcinoma.
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All cancer cases diagnosed in Puerto Rico are analyzed and registered in the Central Cancer Registry. The incidence of oral cancer in Puerto Rico is fourth-highest in the world. (In 1972 oral cancer accounted 72% of all cancers in males in Puerto Rico.) A review of the data revealed important contrasts with reported statistics from the continental United States (e.g., 75.6% of the cases in Puerto Rico were initially treated by radiation, compared with 15.3% of the cases in Western New York States.
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Free grafts, regional or myocutaneous flaps, microvascular tissue transfer and prosthetic rehabilitation are essential techniques required for modern reconstruction of defects in the head and neck. The myocutaneous flaps and the microvascular grafts especially offer a wide variety of tissues useful for reconstruction. It is our belief that a microsurgical team should be organized in every major ENT department for interdisciplinary cooperation depending on the local situation.
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Fifteen cases of soft-tissue myxoma of the paraoral-oral structures have been presented. Eleven cases were garnered from an extensive review of the literature, and four previously unreported cases are described. The myxomas were slow-growing, insidious, infiltrative tumors which occurred in all age groups, with an average patient age of 38 years. Most frequent locations were the cheek, floor of the mouth, and palate. The lesions were present from 2 weeks to 6 years prior to treatment. In this series all the myxomas were treated by surgical excision, with no evidence of recurrences or metastases. The recommended therapy is surgical resection with adequate margins. Other myxomatous lesions which may mimic a myxoma are mentioned.
The names of 102 patients with histologically confirmed squamous cell carcinoma of the oral cavity were checked against Cancer Registry data for the Trent Region. The study was carried out to determine the accuracy of site recording and the failure rate of registration. Although 94 of the patients were registered, 38 per cent of these were incorrectly coded with respect to site. The way in which such errors may occur is discussed and the procedure for registration of oral cancer is explained.
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