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Zárate-García JP, Ortega-Porcayo LA, Tejada-Pineda MF, Moscardini-Martelli J, Romano-Feinholz S, Ponce-Gómez JA, Osuna-Zazueta MA, Zárate-García AN, Guillén-Camacho ME, Jiménez SM. Perineural Invasion of Cranial Nerves in Cutaneous Squamous Cell Carcinoma: Unraveling Its Complexities, Diagnostic Challenges, and Multifaceted Treatment Approaches. Cureus 2024; 16:e61854. [PMID: 38978946 PMCID: PMC11227979 DOI: 10.7759/cureus.61854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2024] [Indexed: 07/10/2024] Open
Abstract
Cutaneous squamous cell carcinoma is the second most common neoplasm among non-melanoma skin cancers. When associated with perineural invasion of the cranial nerves, with clinical features often observed in trigeminal and facial nerves due to their cutaneous extension, it may lead to a worse prognosis. This paper introduces a rare case of an 81-year-old male, with a history of a moderately differentiated invasive carcinoma of the left frontal region with perineural invasion on the left trigeminal cranial nerve. The case underscores the aggressive nature of the intraneural infiltration by squamous cell carcinoma and the challenges in managing such advanced malignancies.
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Affiliation(s)
| | | | | | - Júlia Moscardini-Martelli
- Department of Neurosurgery, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Mexico City, MEX
| | - Samuel Romano-Feinholz
- Department of Neurosurgery, American British Cowdray (ABC) Medical Center, Mexico City, MEX
| | - Juan Antonio Ponce-Gómez
- Department of Neurosurgery, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Mexico City, MEX
| | | | - Alexa Natalia Zárate-García
- School of Medicine and Health Sciences, Facultad Mexicana de Medicina Universidad La Salle, Mexico City, MEX
| | | | - Sergio M Jiménez
- Radiosurgery Unit, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suarez, Mexico City, MEX
- Department of Neurosurgery-Radiosurgery, American British Cowdray (ABC) Medical Center, Mexico City, MEX
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2
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Caldarella C, De Risi M, Massaccesi M, Miccichè F, Bussu F, Galli J, Rufini V, Leccisotti L. Role of 18F-FDG PET/CT in Head and Neck Squamous Cell Carcinoma: Current Evidence and Innovative Applications. Cancers (Basel) 2024; 16:1905. [PMID: 38791983 PMCID: PMC11119768 DOI: 10.3390/cancers16101905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 05/08/2024] [Accepted: 05/13/2024] [Indexed: 05/26/2024] Open
Abstract
This article provides an overview of the use of 18F-FDG PET/CT in various clinical scenarios of head-neck squamous cell carcinoma, ranging from initial staging to treatment-response assessment, and post-therapy follow-up, with a focus on the current evidence, debated issues, and innovative applications. Methodological aspects and the most frequent pitfalls in head-neck imaging interpretation are described. In the initial work-up, 18F-FDG PET/CT is recommended in patients with metastatic cervical lymphadenectomy and occult primary tumor; moreover, it is a well-established imaging tool for detecting cervical nodal involvement, distant metastases, and synchronous primary tumors. Various 18F-FDG pre-treatment parameters show prognostic value in terms of disease progression and overall survival. In this scenario, an emerging role is played by radiomics and machine learning. For radiation-treatment planning, 18F-FDG PET/CT provides an accurate delineation of target volumes and treatment adaptation. Due to its high negative predictive value, 18F-FDG PET/CT, performed at least 12 weeks after the completion of chemoradiotherapy, can prevent unnecessary neck dissections. In addition to radiomics and machine learning, emerging applications include PET/MRI, which combines the high soft-tissue contrast of MRI with the metabolic information of PET, and the use of PET radiopharmaceuticals other than 18F-FDG, which can answer specific clinical needs.
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Affiliation(s)
- Carmelo Caldarella
- Nuclear Medicine Unit, Department of Radiology and Oncologic Radiotherapy, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (C.C.); (M.D.R.); (L.L.)
| | - Marina De Risi
- Nuclear Medicine Unit, Department of Radiology and Oncologic Radiotherapy, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (C.C.); (M.D.R.); (L.L.)
| | - Mariangela Massaccesi
- Radiation Oncology Unit, Department of Radiology and Oncologic Radiotherapy, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy;
| | - Francesco Miccichè
- Radiation Oncology Unit, Ospedale Isola Tiberina—Gemelli Isola, 00186 Rome, Italy;
| | - Francesco Bussu
- Otorhinolaryngology Operative Unit, Azienda Ospedaliero Universitaria Sassari, 07100 Sassari, Italy;
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Jacopo Galli
- Otorhinolaryngology Unit, Department of Neurosciences, Sensory Organs and Thorax, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy;
- Section of Otolaryngology, Department of Head-Neck and Sensory Organs, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Vittoria Rufini
- Nuclear Medicine Unit, Department of Radiology and Oncologic Radiotherapy, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (C.C.); (M.D.R.); (L.L.)
- Section of Nuclear Medicine, Department of Radiological Sciences and Hematology, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Lucia Leccisotti
- Nuclear Medicine Unit, Department of Radiology and Oncologic Radiotherapy, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (C.C.); (M.D.R.); (L.L.)
- Section of Nuclear Medicine, Department of Radiological Sciences and Hematology, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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3
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Denaro N, Succo G, Ostellino O, Airoldi M, Merlano MC, Badellino S, Solinas C, Garrone O, Iorio GC. The oligometastatic setting in HNSCC: A critical review by the Rete Oncologica Piemonte e Valle d'Aosta multidisciplinary team. Crit Rev Oncol Hematol 2023; 185:103968. [PMID: 36965646 DOI: 10.1016/j.critrevonc.2023.103968] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 02/21/2023] [Accepted: 03/22/2023] [Indexed: 03/27/2023] Open
Abstract
INTRODUCTION The oligometastatic disease is a low burden metastatic disease that might still benefit from curable treatment. Squamous cell carcinoma of the head and neck (HNSCC) is a complex group of malignancies, with high rates of loco-regional recurrences. Distant metastases are less frequent, and a single or few deposits are often observed (oligometastatic disease). The optimal management of oligometastatic HNSCC remains to be defined. MATERIALS AND METHODS Key references were derived from a PubMed query. Hand searching and clinicaltrials.gov were also used. RESULTS This paper contains a narrative report and a critical discussion of the available evidence on the management of oligometastatic HNSCC patients, with a focus on metastasis-directed therapy (MDT), particularly stereotactic ablative radiotherapy (SABR). CONCLUSIONS in line with literature data, the multidisciplinary evaluation emerged as the key element in the management of oligometastatic HNSCC patients.
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Affiliation(s)
- Nerina Denaro
- Department of Medical Oncology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy
| | - Giovanni Succo
- Oncology Department, Head & Neck Surgery, University of Turin, Turin, Italy
| | - Oliviero Ostellino
- Oncology Unit 2, Città della Salute e della Scienza di Torino, Turin, Italy
| | - Mario Airoldi
- Oncology Unit 2, Città della Salute e della Scienza di Torino, Turin, Italy
| | - Marco Carlo Merlano
- Scientific Direction, Candiolo Cancer Institute, FPO-IRCCS Candiolo, 10060 Torino, Italy
| | - Serena Badellino
- Department of Oncology, University of Torino, 10125 Torino, Italy
| | - Cinzia Solinas
- Oncology Department AOU Cagliari, Policlinico di Monserrato, Monserrato (CA) Italy
| | - Ornella Garrone
- Department of Medical Oncology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy
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4
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Identity matters: cancer stem cells and tumour plasticity in head and neck squamous cell carcinoma. Expert Rev Mol Med 2023; 25:e8. [PMID: 36740973 DOI: 10.1017/erm.2023.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Head and neck squamous cell carcinoma (HNSCC) represents frequent yet aggressive tumours that encompass complex ecosystems of stromal and neoplastic components including a dynamic population of cancer stem cells (CSCs). Recently, research in the field of CSCs has gained increased momentum owing in part to their role in tumourigenicity, metastasis, therapy resistance and relapse. We provide herein a comprehensive assessment of the latest progress in comprehending CSC plasticity, including newly discovered influencing factors and their possible application in HNSCC. We further discuss the dynamic interplay of CSCs within tumour microenvironment considering our evolving appreciation of the contribution of oral microbiota and the pressing need for relevant models depicting their features. In sum, CSCs and tumour plasticity represent an exciting and expanding battleground with great implications for cancer therapy that are only beginning to be appreciated in head and neck oncology.
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5
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Shah I, Razzak AN, Janardan A, Laing B, Zwagerman NT. A Rare Case of Neck Sarcomatoid Squamous Cell Carcinoma With Brain Metastases. Cureus 2022; 14:e26179. [PMID: 35891819 PMCID: PMC9304508 DOI: 10.7759/cureus.26179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2022] [Indexed: 11/12/2022] Open
Abstract
Squamous cell carcinoma (SCC) is the second most prominent form of skin malignancy. It occurs most frequently in older males with fair skin complexion that have extensive sun exposure most commonly in their childhood. The metastatic presentation of SCC is rare and is most common in the lung. In this paper, we present the unique case of a 73-year-old patient with sarcomatoid squamous cell carcinoma in their posterior neck that metastasized to the brain.
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6
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Jahns H, McElroy MC. Bovine intracranial neoplasia: A retrospective case series. Vet Pathol 2022; 59:824-835. [PMID: 35638647 PMCID: PMC9358308 DOI: 10.1177/03009858221100433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This case series describes the clinical and pathological findings of intracranial
neoplasms in cattle, a rare entity. Data and archived tissues from 24
intracranial tumors were reviewed and investigated by immunohistochemistry for
S100, glial fibrillary acidic protein, synaptophysin, pancytokeratin, vimentin,
neuron-specific enolase, oligodendrocyte transcription factor 2, and isocitrate
dehydrogenase 1. Ages of affected cattle ranged from 6 months to 14 years (5.7 ±
3.6 years; mean ± SD). Predominant clinical signs were altered mental state,
central vestibular dysfunction, and cerebellar incoordination. Twelve gliomas,
all high grade, were the most common tumors observed: oligodendrogliomas (n =
6), astrocytomas (n = 4), and undefined gliomas (n = 2). The oligodendrogliomas
were located in the brainstem and extended into the ventricles, whereas all
astrocytomas were located in the forebrain. Isocitrate dehydrogenase 1 gene
mutation as described in humans was not detected. The 5 meningiomas exhibited
microcystic, chordoid, atypical, papillary, and anaplastic subtypes. Metastatic
carcinomas (n = 4) were the only secondary tumor type present, and these were
located at the level of the medulla with infiltration of cranial nerves and in
one case leptomeningeal carcinomatosis. In addition, 2 medulloblastomas and 1
choroid plexus carcinoma were diagnosed. Immunohistochemistry for vimentin and
pancytokeratin was particularly useful to distinguish meningiomas and choroid
plexus carcinoma (positive for vimentin only) from mestastatic carcinomas
(positive for cytokeratin only) as all showed a papillary growth pattern.
Overall, the morphological features were comparable with other species and the
human and canine classifications could be applied.
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Affiliation(s)
| | - Maire C McElroy
- Department of Agriculture, Food and the Marine, Celbridge, Ireland
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Tran D, Rahman Q, Weed M, Chow B. Differential diagnosis of a ring-enhancing brain lesion in the setting of metastatic cancer and a mycotic aneurysm. Radiol Case Rep 2021; 16:3850-3854. [PMID: 34745401 PMCID: PMC8551469 DOI: 10.1016/j.radcr.2021.09.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 09/12/2021] [Accepted: 09/16/2021] [Indexed: 11/26/2022] Open
Abstract
A diagnostic challenge arises when a patient presents with a ring-enhancing lesion of the brain in the setting of both metastatic cancer and a source of infection. We report a case depicting this dilemma in an 80-year-old man with a history of metastatic oral squamous cell carcinoma who presented for left-sided hemiparesis. Computed tomography and magnetic resonance imaging revealed a ring-enhancing lesion of the right parietal vertex without signs of stroke. He was also found to have an aneurysm of the right common carotid artery with abnormal surrounding soft tissue density and gas, findings suspicious for a mycotic aneurysm. The likelihood of the brain lesion being an abscess formed by septic embolization was raised, leading to the recommendation to surgically explore the brain lesion and repair the aneurysm. Nevertheless, a high index of suspicion for a brain abscess and mycotic aneurysm is necessary in this type of clinical scenario.
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Affiliation(s)
- Daniel Tran
- Department of Diagnostic Radiology, Santa Barbara Cottage Hospital, 400 W. Pueblo St, Santa Barbara, CA 93105, USA
| | - Qasim Rahman
- Department of Diagnostic Radiology, Santa Barbara Cottage Hospital, 400 W. Pueblo St, Santa Barbara, CA 93105, USA
| | - Michael Weed
- Department of Diagnostic Radiology, Santa Barbara Cottage Hospital, 400 W. Pueblo St, Santa Barbara, CA 93105, USA
| | - Bernard Chow
- Department of Diagnostic Radiology, Santa Barbara Cottage Hospital, 400 W. Pueblo St, Santa Barbara, CA 93105, USA
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Sundaraiya S, Rajendran A, Sulaiman A, Pradeep S, Vidhyadharan S, Hedne N. Metabolically Active Subacute Infarct Masquerading as Metastasis: A Finding not to be overlooked in Asymptomatic Oncology Patients. Indian J Nucl Med 2021; 36:85-87. [PMID: 34040309 PMCID: PMC8130700 DOI: 10.4103/ijnm.ijnm_171_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 08/04/2020] [Accepted: 09/07/2020] [Indexed: 11/07/2022] Open
Abstract
A 50-year-old man with carcinoma of the right buccal mucosa underwent staging whole-body 18F-fluorodeoxyglucose positron emission tomography–computed tomography, which revealed a hypermetabolic heterogeneously enhancing lobulated primary lesion in the right buccal region and an incidental finding of subacute stroke. The case highlights the importance of discriminating brain neoplasms mimicking stroke from true ischemic stroke, which is crucial for appropriate management of patients in an oncology setting.
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Affiliation(s)
- Sumati Sundaraiya
- Department of Nuclear Medicine, Apollo Proton Cancer Centre, Chennai, Tamil Nadu, India
| | - Adhithyan Rajendran
- Department of Radiology, Apollo Proton Cancer Centre, Chennai, Tamil Nadu, India
| | - Abubacker Sulaiman
- Department of Radiology, Apollo Proton Cancer Centre, Chennai, Tamil Nadu, India
| | - Sivakumar Pradeep
- Department of Head and Neck Surgical Oncology Apollo Proton Cancer Centre, Chennai, Tamil Nadu, India
| | - Sivakumar Vidhyadharan
- Department of Head and Neck Surgical Oncology Apollo Proton Cancer Centre, Chennai, Tamil Nadu, India
| | - Naveen Hedne
- Department of Head and Neck Surgical Oncology Apollo Proton Cancer Centre, Chennai, Tamil Nadu, India
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Messing I, Goyal S, Sherman JH, Thakkar P, Siegel R, Joshi A, Goodman J, Ojong-Ntui M, Rao YJ. Incidence and Prognosis of Brain Metastases in Head and Neck Cancer Patients at Diagnosis. Laryngoscope 2021; 131:E2543-E2552. [PMID: 33599979 DOI: 10.1002/lary.29448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 01/26/2021] [Accepted: 01/31/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVES Limited data is available on head and neck cancer (HNC) patients presenting with brain metastases (BM) at initial diagnosis. We sought to evaluate the incidence, management, and treatment outcomes of these patients using the National Cancer Database (NCDB). METHODS We identified 465,925 patients diagnosed with HNC between 2010 and 2015 in the NCDB. 14,583 of these patients presented with metastatic disease to any site. 440 of these patients had BM at the time of initial diagnosis. Overall survival was compared using the Kaplan-Meier method. Cox proportional hazard modeling, propensity score matching, and subgroup analyses were performed. RESULTS The median age overall was 62.0 years. Nasopharynx NOS (13.2%) and Parotid Gland (10.9%) were the most common anatomical sites with the highest frequency of BM. The overall median survival time was 7.1 months. Predictors for the presence of BM included distant metastasis to the bone, liver, or lung on univariate analysis, and bone or lung on multivariate analysis. High-risk Human Papilloma Virus status was associated with a lower chance of BM. No pattern was determined when comparing lymph node level involvement and BM. The median survival for patients receiving radiation therapy and multi-agent chemotherapy was 8.4 and 11.7 months, respectively. Immunotherapy administered as first course therapy did not influence median survival. Most patients received radiation (62.7%) therapy and chemotherapy (50.2%). CONCLUSIONS The data extracted and analyzed from the NCDB should work to aid in the surveillance and management of BM in patients with HNC. LEVEL OF EVIDENCE 4 Laryngoscope, 131:E2543-E2552, 2021.
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Affiliation(s)
- Ian Messing
- George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, U.S.A
| | - Sharad Goyal
- Division of Radiation Oncology, Department of Radiology, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, U.S.A
| | - Jonathan H Sherman
- Department of Neurosurgery, West Virginia University School of Medicine, Morgantown, West Virginia, U.S.A
| | - Punam Thakkar
- Department of Otolaryngology, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, U.S.A
| | - Robert Siegel
- Department of Medicine, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, U.S.A
| | - Arjun Joshi
- Department of Otolaryngology, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, U.S.A
| | - Joseph Goodman
- Department of Otolaryngology, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, U.S.A
| | - Martin Ojong-Ntui
- Division of Radiation Oncology, Department of Radiology, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, U.S.A
| | - Yuan James Rao
- Division of Radiation Oncology, Department of Radiology, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, U.S.A
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10
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Brain metastasis in head and neck squamous cell carcinoma after immune check point inhibitors treatment. Oral Oncol 2020; 116:105138. [PMID: 33390267 DOI: 10.1016/j.oraloncology.2020.105138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 12/02/2020] [Accepted: 12/05/2020] [Indexed: 11/20/2022]
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Bollig CA, Newberry CI, Galloway TLI, Zitsch RP, Hanly EK, Zhu VL, Pagedar N, Nallani R, Bur AM, Spanos WC, Jorgensen JB. Prognostic Impact of Metastatic Site and Pattern in Patients with Metastatic Head and Neck Cancer. Laryngoscope 2020; 131:E1838-E1846. [PMID: 33098338 DOI: 10.1002/lary.29208] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 09/24/2020] [Accepted: 10/13/2020] [Indexed: 01/11/2023]
Abstract
OBJECTIVES/HYPOTHESIS Investigate the relationship between site and pattern of distant metastasis (DM) and overall survival (OS) in a multi-institutional cohort of patients with DM head and neck cancer (HNC). STUDY DESIGN Retrospective review. METHODS 283 patients treated at 4 academic centers in the Midwest HNC Consortium between 2000 and 2015 were retrospectively reviewed. Disease patterns were divided between solitary metastatic versus polymetastatic (≥2 sites) disease. Survival functions for clinically relevant variables were estimated using Kaplan-Meier and Cox proportional hazards models. RESULTS Median OS for all patients was 9.0 months (95% confidence interval [CI]: 7.4-10.6). Lung (n = 220, 77.7%) was the most common site of DM, followed by bone (n = 90, 31.8%), mediastinal lymph nodes (n = 55, 19.4%), liver (n = 41, 14.5%), and brain (n = 17, 6.0%). Bone metastases were independently associated with the worst prognosis (hazard ratio [HR] = 1.6, 95% CI: 1.3-2.1). On univariate analysis, brain metastases were associated with improved prognosis (HR = 0.5, 95% CI: 0.3-0.9), although this was not statistically significant on the multivariate analysis. Polymetastatic disease was present in the majority of patients (n = 230, 81.3%) and was associated with a worse prognosis compared to solitary metastatic disease (HR = 1.4, 95% CI: 1.0-2.0). CONCLUSION Our large, multi-institutional review indicates that both the metastatic pattern and site of DM impact OS. Polymetastatic disease and bone metastasis are associated with worse prognosis, independent of treatment received. LEVEL OF EVIDENCE 4 Laryngoscope, 131:E1838-E1846, 2021.
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Affiliation(s)
- Craig A Bollig
- Department of Otolaryngology-Head and Neck Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, U.S.A
| | - Christopher I Newberry
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah, U.S.A
| | - Tabitha L I Galloway
- Department of Otolaryngology-Head and Neck Surgery, University of Missouri School of Medicine, Columbia, Missouri, U.S.A
| | - Robert P Zitsch
- Department of Otolaryngology-Head and Neck Surgery, University of Missouri School of Medicine, Columbia, Missouri, U.S.A
| | - Elyse K Hanly
- Department of Otolaryngology-Head and Neck Surgery, University of Iowa School of Medicine, Iowa City, Iowa, U.S.A
| | - Vivian L Zhu
- Department of Otolaryngology-Head and Neck Surgery, University of Iowa School of Medicine, Iowa City, Iowa, U.S.A
| | - Nitin Pagedar
- Department of Otolaryngology-Head and Neck Surgery, University of Iowa School of Medicine, Iowa City, Iowa, U.S.A
| | - Rohit Nallani
- Department of Otolaryngology-Head and Neck Surgery, University of Kansas School of Medicine, Kansas City, Kansas, U.S.A
| | - Andres M Bur
- Department of Otolaryngology-Head and Neck Surgery, University of Kansas School of Medicine, Kansas City, Kansas, U.S.A
| | - William C Spanos
- Sanford Cancer Center, Sanford Health, Sioux Falls, South Dakota, U.S.A
| | - Jeffrey B Jorgensen
- Department of Otolaryngology-Head and Neck Surgery and Communication Disorders, University of Louisville School of Medicine, Louisville, Kentucky, U.S.A
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12
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Isolated pituitary fossa metastasis from a primary tonsillar squamous cell carcinoma: case report. The Journal of Laryngology & Otology 2020; 134:369-371. [PMID: 32234087 DOI: 10.1017/s0022215120000602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE This paper presents a case of an isolated pituitary fossa metastasis on a background of a previously treated tonsillar squamous cell carcinoma. CASE REPORT A 64-year-old male, diagnosed with a primary p16-negative squamous cell carcinoma in the right tonsil, was treated with a course of chemoradiotherapy with curative intent. Positron emission tomography/computed tomography, performed at six months post-treatment, revealed a good local response and no distant metastases. The patient was placed on routine follow up at two-monthly intervals. Two months into follow up, he presented with a right-sided oculomotor nerve palsy and partial Horner's syndrome. Imaging and biopsy revealed a pituitary fossa metastasis (p16-negative squamous cell carcinoma), and a further positron emission tomography/computed tomography visualised this lesion. He was deemed unsuitable for further intervention and underwent palliative radiotherapy for symptom control. CONCLUSION This case represents the first reported isolated pituitary fossa metastasis from a tonsillar squamous cell carcinoma. A high degree of clinical suspicion is recommended, along with a low threshold for biopsy and a cautioned use of positron emission tomography/computed tomography, when investigating such patients.
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13
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León‐Ruiz M, Benito‐León J. Craniocerebral metastases from a supraglottic squamous cell carcinoma: A case report and literature review. Clin Case Rep 2019; 7:2316-2320. [PMID: 31893049 PMCID: PMC6935665 DOI: 10.1002/ccr3.2480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 09/02/2019] [Accepted: 09/18/2019] [Indexed: 11/06/2022] Open
Abstract
Craniocerebral metastases as the initial spread of supraglottic squamous cell carcinoma (SCC) are exceptional. The presence of several months' history of dysphagia, dyspnea, cachexia, tobacco/alcohol abuse, and seizure(s) is suspicious of craniocerebral metastases from an advanced-stage supraglottic SCC. Physicians should be aware since early diagnosis and treatment may increase patient survival.
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Affiliation(s)
- Moisés León‐Ruiz
- Department of NeurologyHospital Universitario Príncipe de AsturiasAlcalá de Henares, MadridSpain
| | - Julián Benito‐León
- Department of NeurologyHospital Universitario 12 de OctubreMadridSpain
- Department of MedicineFaculty of MedicineUniversidad Complutense de MadridMadridSpain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED)MadridSpain
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