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Clinical course of patients with squamous cell carcinoma of the upper respiratory and digestive tracts with no evidence of disease 5 years after initial treatment.

Eleven hundred sixty-three patients with squamous cell carcinoma of the upper respiratory and digestive tracts, treated from January 1948 through December 1965, had no evidence of disease five years after the initial treatment and no other manifestation of squamous cell carcinoma within the first five years. After five years, the incidence of disease at the initial location, in the vicinity, or in remote sites was found to be identical in the surgical and irradiation groups. There is a correlation between severe late complications in the irradiated patients and the volume of tissue irradiated.

Carcinoma, Squamous Cell↗

Epidemiology of oral cavity cancer in taiwan with emphasis on the role of betel nut chewing.

This article reports the epidemiological characteristics and the possible contributing etiology of oral cavity cancer in Taiwan. Data on oral cavity cancer from the period between 1986 and 1997 were compiled from the Taiwan Cancer Registry Annual Report. The amount of average annual consumption per person of cigarettes, alcohol and betel nut were extracted from the Annual Report of Taiwan Tobacco and Wine Monopoly Bureau and the Agriculture Counsel of Taiwan. The incidence of oral cavity cancer increased annually. Both the total and male incidence have increased substantially since 1993. Regarding the peak incidence, most cases were seen in the sixth to eighth decades of life. Multiple regression models indicated that 86.2% variation in the incidence of oral cavity cancer was explained by the annual average betel nut consumption per person. These results imply that those who chew betel nut belong to a high-risk group and require special consideration and attention regarding health education and health promotion.

Adult↗

Immunohistochemical study of mononuclear cell infiltrates in squamous cell carcinoma of oral cavity and paranasal sinus.

Serial frozen sections were prepared from 22 squamous cell carcinomas of oral cavity and paranasal sinus. Mononuclear cell infiltrates were stained by the biotin-avidin-horseradish peroxidase method using a panel of 10 mouse monoclonal antibodies to human leukocyte antigens. The degree of infiltration was graded from + + + (marked) to - (absent). The infiltration of anti-Leu-4-reactive cells (Leu-4+ cells) was grade + + or + + + in 14 of 22 cases. In 13 of 22 cases, infiltration of Leu-3a + 3b+ cells (helper/inducer T lymphocytes) was grade + + (moderate). In 5 of 20 cases, infiltration of Leu-2a+ cells (cytotoxic/suppressor T lymphocytes) was grade + +. As for B lymphocytes, infiltration of Leu-12+ cells was grade + + in only 2 of 19 cases. In conclusion, T lymphocyte infiltrates were commonly seen in squamous cell carcinoma in oral cavity and paranasal sinus and the number of patients with grade + + infiltration of helper/inducer T lymphocytes significantly predominated over that of patients with infiltration of cytotoxic/suppressor T lymphocytes grade + +.

Adult↗

Heterotopic brain tissue of the soft palate.

Heterotopic brain tissue is an unusual substance which is very difficult to diagnose correctly preoperatively. We report on a 7-month-old male infant with heterotopic brain tissue of the soft palate, and describe the results of preoperative examinations including brain scintigraphy, angiography, brain computed tomography and magnetic resonance imaging (MRI). MRI was found useful to show that the tumor had no junction with the intracranial space. The patient was treated successfully without complication or recurrence after 1.5 years follow-up.

Brain↗

Carcinosarcoma of the palate: report of a case with a diagnosis of sarcomatoid metastasis by fine needle aspiration cytology.

BACKGROUND: Carcinosarcoma (sarcomatoid carcinoma) is a rare tumor with a high predilection for the aerodigestive tract. Cytologic diagnosis of metastatic carcinosarcoma has been reported in very few cases. CASE: An 84-year-old woman presented with a 2-cm-diameter, right cervical lymph node that was referred for fine needle aspiration cytology (FNAC). She had received radiotherapy for a palatal squamous cell carcinoma 2 years earlier. The FNAC smears had a sarcomatoid appearance. Repeat fine needle aspiration was performed, with cytologic and immunocytochemical staining. Careful consideration of the cytologic and immunophenotypic features led to an impression of carcinosarcoma. Histologic sections of the palatal biopsy that had been previously diagnosed as squamous cell carcinoma were reviewed, and a final diagnosis of carcinosarcoma was established. CONCLUSION: Metastasis of rare lesions, such as carcinosarcoma may be confusing and difficult to diagnose on FNAC, especially when the cytologic sample shows a predominantly sarcomatoid component. The difficulty is compounded when the sarcomatoid component happens to have been overlooked on the initial histologic assessment. With representative cytologic sampling, immunocytochemical staining and review of the histologic material, the correct diagnosis was achieved in this case.

Aged, 80 and over↗

Giant cell tumor of the spenoid bone.

The clinical features of the giant cell tumor of the sphenoid bone have been discussed and a case report has been added to the fourteen cases reported in the literature. Such cases may first report to an ophthalmologist, an otolaryngologist, a neurologist, or an internist. They should consider this condition in a patient who complains of headache, ocular symptoms such as diplopia, and diminution of vision progressing to complete blindness. The presence of multiple cranial nerve palsies involving II, III, IV, V, and VI nerves in various combinations and the sellar erosion in the lateral x-ray of the skull are quite suggestive of this tumor which should be confirmed by biopsy. The telecobalt therapy appears to give the best results.

Adult↗

Necrotizing sialometaplasia. A self-limited pseudotumoral palatal ulcer.

Necrotizing sialometaplasia of the palate, an enigmatic pseudomalignant penetrating ulcer, is a benign lesion which heals spontaneously in three to ten weeks. Relative painlessness contributes to patient delay in seeking medical attention, and suggest that many cases are subclinical. Clinically, the patient age group and morbid gross appearance mimic malignant palatal tumors. Lack of awareness of this entity has led to the misdiagnosis of carcinoma in several previous cases. However, the histopathologic features of sialadenitis, focal lobular necrosis with mucosal ulceration and glandular squamous metaplasia, are distinctly benign. A typical case and literature review are presented.

Adult↗

Infantile vomiting due to a disappearing hairy polyp.

Infantile vomiting can occur from many causes. A mass in the nasopharynx is an obscure reason for emesis. Maternal detection of an intermittently visible mass secured a diagnosis that had eluded observation, even after the patient had been hospitalized. "Hairy polyp" has received almost no attention in the Pediatrics literature. This report is both for information about the unusual tumor and for reaffirmation of the value of parental observation.

Cysts↗

Primary reconstruction of palatal defects.

Removal of the soft palate can cause marked functional deficit in deglutition and phonation. Most commonly, treatment of this deformity with prosthetic obturation has been less than ideal. Numerous reconstructive techniques have met with only partial success, while deforming distant structures. We will present a technique of reconstruction of the soft palate by use of a superiorly based pharyngeal flap. It has been used successfully in five patients who underwent soft palatectomy for malignant disease. The flaps have been the full width of the pharynx and extended down to the esophageal inlet. Viability of the flap is excellent, and the donor site is allowed to heal by secondary intention. Excellent function has been achieved in all cases with no compromise of oncological principles.

Female↗

Squamous cell carcinoma of the soft palate, uvula, and anterior faucial pillar.

This retrospective study concerns 188 patients with squamous cell carcinoma of the soft palate, uvula, and anterior faucial pillar treated for cure between 1970 and 1983. Men predominated in the group (1.9:1) and 55% of the patients were between 60 and 70 years old. Mean duration of followup was 56.7 months. TNM stage distribution was 29, 67, 37, and 49 patients for stages I, II, III, and IV respectively; six patients were unstaged because of previous excisional biopsy. Treatment to the primary site consisted of radiotherapy for 150 patients, surgery alone for 28 patients, and combined therapy for 10 patients. Primary control for T stages 1 through 4 was: 91% (31 of 34), 77% (71 of 92), 77% (30 of 39), and 35% (6 of 17), respectively. One hundred twenty-eight patients were N0 at presentation, as compared to 60 patients with regional nodal metastasis. Regional control was obtained in 87.5% of patients with N0 necks and in 76.7% of those with nodal involvement. In patients with primary control, these figures were 89% and 81%. Overall determinant survival was 80% at 2 years, but fell to 67% at 5 years. In addition to advanced tumor stage, the survival rate was reduced by regional lymph node metastasis. Tumor extension to the tongue base diminished survival. Survival was poorer among patients with midline tumors or tumors that extended across the palatine arch (37 patients) than for those with unilateral primary tumors (151 patients) (p less than 0.05). Despite similar T-stage distribution, the incidence of regional nodal metastasis was 49% in the former group, compared with 28% in the latter.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Feline melanoma: a comparative study of ocular, oral, and dermal neoplasms.

Melanomas diagnosed in 29 cats over an 11 year period included 19 ocular (16 intraocular, three palpebral), five oral, and five dermal melanomas. Intraocular melanomas involved the ciliary body and iris in 12; the whole eye was involved in four. The average age of cats with intraocular melanomas was 11 years; the female : male ratio was 9 : 7. Histologically, eight intraocular tumors were mixed, six were epithelioid, and two were spindle cell. Ten of 16 cats (62.5%) with intraocular melanomas were killed because of the tumor at a mean of 156 days; four are living with no evidence of disease (average, 255 days). The mean time of death in cats with palpebral melanoma was 409 days. Metastasis occurred in 63% of cats with intraocular melanoma and all cats with palpebral melanoma. Four cats with oral melanoma were killed at a mean of 61 days; all had metastasis. Of five cats with cutaneous melanoma, one was killed with metastasis at 90 days; three cats were alive without evidence of recurrence or metastasis greater than 365 days after surgery. Results of this study indicate that in the cat, ocular melanomas are more common than oral and dermal melanomas, and ocular and oral melanomas are more malignant than dermal melanomas, with higher rates of mortality and metastasis.

Animals↗

Cisplatin-induced bradycardia.

A patient who had repeated episodes of bradycardia while on cisplatin therapy is described. Cisplatin-induced bradycardia has not been reported previously. Deposition of cisplatin in the sinoatrial-node area might explain this cardiotoxic effect.

Bradycardia↗

Fanconi anemia manifesting as a squamous cell carcinoma of the hard palate: a case report.

Fanconi anemia is a rare autosomal recessive disorder characterized by various congenital malformations, progressive bone marrow failure at a very young age and of solid tumors development. The authors present a rare case of a squamous cell carcinoma of the hard palate in a Fanconi Anaemia patient. The atypical clinical manifestation rendered the diagnosis more difficult. This case, for age of appearance, sex and localization, is unique in international literature. We recommend a quarterly follow up of the oral-rhino-pharynx complex in FA patients and to consider as carcinomas, all oral lesions that last more than two weeks.

Adult↗