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Sukumaran R, Kattoor J, Valsalamony J, Varghese BT. Initial presentation of hepatocellular carcinoma as pharyngeal mass mimicking advanced hypopharyngeal carcinoma. J Cancer Res Ther 2024; 20:438-440. [PMID: 38554358 DOI: 10.4103/jcrt.jcrt_1655_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 08/27/2022] [Indexed: 04/01/2024]
Abstract
Hepatocellular carcinoma (HCC) is a highly malignant tumor with frequent intrahepatic and extrahepatic metastases. Extrahepatic metastasis occurs in one-third of patients with HCC and indicates a dismal prognosis. The head and neck region is an extremely uncommon site of metastatic HCC. Extrahepatic metastasis at first presentation, although uncommon, indicates advanced disease with a poor prognosis. Herein, we present the case of a 68-year-old male patient with a neck mass. Clinical examination and initial radiology were suggestive of an advanced primary pharyngeal malignancy. Biopsy showed neoplasm with large polygonal cells with clear/granular cytoplasm. The neoplastic cells showed positivity for Hep Par1, CD10, and CEA. A diagnosis of metastatic HCC was given. Subsequently, serum alpha-fetoprotein level was found to be markedly elevated and further imaging showed multiple mass lesions in the liver. It is necessary to recognize that the pharyngeal region is a potential site of HCC metastasis. Accurate diagnosis and risk stratification can help in avoiding unnecessary costs and delay in treatment.
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Affiliation(s)
- Renu Sukumaran
- Department of Pathology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India
| | - Jayasree Kattoor
- Department of Pathology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India
| | - Jiji Valsalamony
- Department of Imageology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India
| | - Bipin T Varghese
- Department of Surgical Oncology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India
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Morozov II. [Schwannoma of the parapharyngeal space]. Vestn Otorinolaringol 2023; 88:86-89. [PMID: 37450397 DOI: 10.17116/otorino20228803186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
Schwannoma is a benign neoplasm that develops from the Schwann cells of the nerve sheath. The share of neurogenic tumors of the parapharyngeal space accounts for 0.5% of all neoplasms of this localization. The article demonstrates a case from practice, presents the clinical features, diagnostics and methods of treatment for patients with pharyngeal neuromas. The peculiarity of the presented clinical observation is due to the rare occurrence of this pathology and the large size of the schwannoma in the long-term asymptomatic course of the disease.
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Affiliation(s)
- I I Morozov
- Main Clinical Hospital of the Ministry of Internal Affairs of the Russian Federation, Moscow, Russia
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Milano AF. Cancers of the Oral Cavity and Pharynx: 20-Year Comparative Survival and Mortality Analysis by Age, Sex, Race, Stage, Grade, Cohort Entry Time-Period and Disease Duration: A Systematic Review of 218,066 Cases for Diagnosis Years 1973-2014: (SEER*Stat 8.3.5). J Insur Med 2022; 49:147-171. [PMID: 36378890 DOI: 10.17849/insm-49-3-147-171.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 04/30/2019] [Indexed: 06/16/2023]
Abstract
This article summarizes the results of a retrospective population-based cohort study using the statistical database of SEER*Stat 8.3.54 (produced 3/5/2018 for diagnosis years 1973-2014) to assess, determine, compare, and summarize the occurrence, long-term survival, and mortality indices of 218,066 patients with oral cavity and pharynx cancers by age, sex, race, stage, grade, and disease duration.
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Wu TT, Bao YY, Zhou SH, Wang QY, Shen LF. Basal cell adenoma in the parapharyngeal space resected via trans-oral approach aided by endoscopy: Case series and a review of the literature. Medicine (Baltimore) 2018; 97:e11837. [PMID: 30142775 PMCID: PMC6113027 DOI: 10.1097/md.0000000000011837] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
RATIONALE Basal cell adenoma (BCA) is a rare benign salivary gland tumor. It is difficult to be completely resected when arising in parapharyngeal space. A contemporary trend is to develop minimally invasive approaches on the premises of safety and complete resection. PATIENT CONCERNS Three patients were referred to our ENT Outpatient Department with the chief complaint of an uncomfortable throat. CT or MRI revealed a unilateral mass in the parapharyngeal space, round or oval in shape, with well-defined borders. DIAGNOSES CT and MRI provided useful information for the preoperative evaluation. The appearance of large-scale cystic components may be an important clue for the diagnosis of BCA. PET/CT images were also available in one case. The final diagnoses were all basal cell adenomas (tubular type) in parapharyngeal space according to the regular histopathological examination after surgery. INTERVENTIONS All three cases were completely resected by a trans-oral approach. The average operative time and estimated blood loss were 86 (range, 61-106) min and 116.7 (range, 50-200) mL, respectively. Endoscopy was used in the largest case to further assess the residual cavity after the complete resection and hemostasis. OUTCOMES Postoperative recovery courses were quick and uneventful, with no neurovascular complication. Patients were discharged on the 3-5 day after surgery on an oral diet. One patient reported symptoms of velopharyngeal incompetence, manifested as mild slurred speech and nighttime salivation, for up to 3 months, which recovered spontaneously thereafter. There was no evidence of recurrence in the follow-up period. LESSONS In our experience, the trans-oral approach appeared to be effective, safe, and less invasive for extirpation of selected basal cell adenomas in the parapharyngeal space. An assistance of endoscopy facilitates the surgery.
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Jiang YL, Peng HS, Wu SH, Xie XH, Zhu XH, Liu YH. [Pharyngeal space carcinoma ex pleomorphic adenoma:a case report]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2018; 32:710-712. [PMID: 29771093 DOI: 10.13201/j.issn.1001-1781.2018.09.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Indexed: 06/08/2023]
Abstract
Carcinoma ex pleomorphic adenoma is an epithelial malignant tumor of pleomorphic adenoma. This may be due to the accumulation of genetic instability caused by long-term pleomorphic adenomas. There are few reports of parapharyngeal space carcinoma ex pleomorphic adenoma in the literature study both at home and abroad. This article retrospectively summarized the clinical data of 1 case of pharyngeal space carcinoma ex pleomorphic adenoma and reviewed the literature. We strengthened the understanding of parapharyngeal space carcinoma ex pleomorphic adenoma, improve the accuracy of diagnosis and reduce misdiagnosis and mistreatment.
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Affiliation(s)
- P D Phelps
- Department of Radiology, Royal National Throat, Nose and Ear Hospital, London
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Sánchez-Acuña JG, Franco-Garrocho LE, Durán-Macías OE, Peralta-Mata A. [Parapharyngeal space lipoma, resection under transmandibular approach]. Rev Med Inst Mex Seguro Soc 2018; 56:194-197. [PMID: 29906036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Lipoma is a benign entity with a poor incidence in craniofacial region. The most frequent tumors in the maxillo pharyngeal space are those that occur in the major and minor salivary glands, with a higher incidence of pleomorphic adenoma, also consider a benign entity. The transmandibular approach offers a great advantage in terms of visibility during the surgery. Achieving a lower morbidity, due to the fact that anatomic structures of anterior (prestyloid) and posterior (retrostyloid) compartments are involved. Our case report has important implications: clinical, pathologic and surgical, with a good prognosis for life and good for function at 2 year of postoperatively without any recurrence reported.
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Affiliation(s)
- Deniz Demir
- Department of ORL, Faculty of Medicine, Istanbul University, Istanbul, Turkey.
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Abstract
OBJECTIVE: To describe clinical and demographic characteristics of the parapharyngeal space tumors and assess surgical approaches used to treat them at our institution. METHODS: A retrospective and descriptive study of the parapharyngeal space tumors, excluding paragangliomas, treated from June 1991 to October 2002 in a cancer center. The study population included 21 patients, 8 men and 13 women, average age of 41 years (range, 20 to 70 years). Fine needle biopsy was done in 5 (24%) patients. Computed tomography (CT) was performed in all patients, and only a few required magnetic resonance image (MRI). RESULTS: Surgical approaches included transcervical alone or in combination with parotidectomy, transoral, or transmandibular (mandibular swing) approach. Laminectomy and segmentary approaches were also performed in 1 patient each. Sixteen (76%) patients had benign lesions and 5 (24%) had malignant tumors. Neurogenic tumors represented 57% of all tumors. Mean tumor size was of 6.7 cm (range, 3 to 11 cm). Six (29%) patients received adjuvant radiotherapy. Complications occurred in 6 (29%) patients, 4 (19%) of which were nervous injuries associated with peripheral nerve sheath tumors. Median disease-free follow-up survival was 33 months (range, 2 to 184 months) despite being an heterogeneous group of histologies. CONCLUSION: Parapharyngeal space is a rare location for head and neck tumors. Cervical approach should be the first choice for large tumors; transoral approach is reserved for tumors less than 3 cm. Conversion to mandibular swing approach when the cervical approach is not offering proper exposure for tumor resection is indicated. Preoperative histologic diagnosis is not required. Nevertheless, CT scan should always be performed in order to exclude paragangliomas, distinguish prestyloid from poststyloid lesions, and to assess the extension of the tumor as well as its relationship with adjacent structures.
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Affiliation(s)
- Kuauhyama Luna-Ortiz
- Department of Head and Neck Surgery, at the Instituto Nacional de Cancerología, Tlalpan, Mexico.
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Chen Z, Xiong S, Chen F, Ma D, Li W, Lin G, Wang J. [Application of narrow band imaging in early diagnosis of pharyngolaryngeal tumors]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2016; 30:264-267. [PMID: 27373030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To investigate the application value of narrow band imaging (NBI) in early diagnosis of pharyngolaryngeal tumors. METHOD A total of 106 patients received NBI endoscopy in the endoscopic diagnosis. Lesions found under the white-light endoscopy mode and NBI endoscopy mode were compared in the morphology of capillaries on lesiorn surface and the clarity of lesion rim. Biopsy was performed in suspected areas with those two endoscopies for the lesions found under white-light endoscopy and NBI endoscopy, the morphology of capillaries on the surface of lesion and the clarity of lesion boundary were compared between both. Biopsy was performed for suspected areas under two modes, and specimens were preserved in 10% formaldehyde for pathological examination. The characteristic, position and endoscopic diagnosis under two modes were recorded. All the patients underwent corresponding laryngeal tumor resection according to the histopathological result of biopsy, and the histopathological result of resected tissues was taken as the gold standard for diagnosis. The biopsy detection rate and biopsy correct detection rate of malignant lesions in two groups were calculated and statistical compared. RESULT The diagnostic accuracy under white-light mode was 75.47%, while that under NBI mode was 96.23%, and the difference between them was statistically significant (χ² = 18.375, P < 0.01). The biopsy correct detection rate under white-light mode was 82.08%, while that under NBI mode was 95.28%, and the difference between them was statistically significant (χ² = 12.071, P < 0.01). The correct detection rate of malignant tumor under white-light mode was 48.15%, while that under NBI mode was 92.59%, and the difference between them was statistically significant (χ² = 10.083, P < 0.01). CONCLUSION Using NBI endoscopy to observe the morphological changes of capillaries on the pharyngolaryneal mucosa surface can increase the detection rate of early pharyngolaryngeal tumors, so it is worth to be widely applied.
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McNicholas E, Abdelhafiz AH. Fever, delirium and incontinence: not always a UTI. Acute Med 2016; 15:149-151. [PMID: 27759751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Unexplained fever and confusion is a common reason for emergency medical admission. When this occurs in the context of new urinary incontinence, a urinary tract infection may be considered to be the most likely cause. However it is also important to consider spinal pathology when this combination of symptoms arises. We present a case of a retropharygeal collection presenting in a patient with this combination of symptoms.
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Affiliation(s)
- Emily McNicholas
- Department of Geriatric Medicine, Rotherham General Hospital, Moorgate Road, Rotherham S60 2UD, UK
| | - Ahmed H Abdelhafiz
- Department of Geriatric Medicine, Rotherham General Hospital, Moorgate Road, Rotherham S60 2UD, UK
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M D, S K, S R. Lipoblastomatosis of the retropharyngeal space: pathogenesis, presentation, and management, with a focus on head-neck lipoblastoma(toses). B-ENT 2016; 12:33-39. [PMID: 27097392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Abstract
OBJECTIVE Lipoblastoma(toses) are benign neoplasms of embryonic white fat in a state of arrested maturation, and are seldom encountered in the head-neck region. We discuss the clinical details of lipoblastomatosis in the retropharyngeal space of a 9-year-old boy,with an emphasis on the head-neck area, the histopathological maturity of the tumor, and the practical roles of imaging, cytogenetics, and immunostaining in the diagnosis. METHODS Clinical record analysis; literature review. RESULTS A malnourished child presented with worsening respiratory distress and feeding difficulties. Imaging suggested a large, heterogeneous fibrofatty lesion in the retropharyngeal space. Surgery revealed an otherwise encapsulated mass that densely adhered to the pre-vertebral soft tissue. The findings were consistent with a diagnosis of maturing lipoblastomatosis on histopathology, which was supported by additional immunohistochemistry panel analysis. CONCLUSION This is the first report of lipoblastomatosis with the retropharyngeal space as the epicenter of involvement/ origin. Although rare and seldom diagnosed before surgery, lipoblastoma(tosis) may be more common in the head-neck area than thought previously and should be an important differential diagnosis for pediatric fibrolipomatous neoplasms in this anatomic subsite.
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Hong Y, Hu J, Liang Z. [Analysis of clinical diagnosis and treatment of 112 cases of parapharyngeal space tumors]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2015; 29:994-997. [PMID: 26536701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To explore the diagnosis, treatment and surgical approaches of parapharyngeal space tumors. METHOD This retrospective study consisted of 112 patients with parapharyngeal space tumors underwent surgeries. The data included clinical symptoms and signs, pathological types, imaging examinations, surgical approaches and postoperative complications. RESULT Computerized tomography (CT), magnetic resonance imaging (MRD and digital subtraction angiography (DSA) made clear the tumor size, localization and its relation to adjacent structures. The postoperative histopathology varied and showed benign in 98 cases consisting of salivary gland tumors (52 cases), neurogenic tumors(33 cases) and other types (13 cases). During the 3 years follow-up period, local recurrence appeared in 3 patients with salivary pleomorphic adenoma and 1 patient with neurofibromatosis. These recurrent tumor cases were cured with second surgery. In 14 patients with malignant tumors reported, 8 cases survived for 5 years, 2 cases (1 adenoid cystic carcinoma and 1 carcinoma in pleornorphic adenoma) recurred in the two and a half years cured with second surgery affiliated radiation therapy through 3 years follow-up time and the rest were followed up 1 to 3 years without recurrence. Peripheral facial paralysis was observed in 25 patients, and 3 patients experienced hypoglossal nerve palsy. Only 1 patient encountered vagus nerve injury, and 2 patients appeared Horner's syndrome, and 4 patients endured Frey syndrome. Gills leakage was discovered in 3 cases and cavity infection was noted in 1 patient. CONCLUSION CT, MRI and DSA were important in the diagnosis and differential diagnosis of parapharyngeal space tumors. The key to successful treatment is knowing the anatomy of the parapharyngeal space, preoperative assessment and appropriate surgical approach.
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Okami K. [Diagnosis and treatment on pharyngeal cancer]. Nihon Jibiinkoka Gakkai Kaiho 2015; 118:792-793. [PMID: 26567390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- Kenji Okami
- Department of Otolaryngology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan
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15
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Chiesa A, Acciarri L. Thermography of the neck. Adv Otorhinolaryngol 2015; 24:143-65. [PMID: 629161 DOI: 10.1159/000400902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Samoy K, Lerut B, Dick C, Kuhweide R, Vlaminck S, Vauterin T. Transoral robotic surgery for parapharyngeal lesions: a case series of four benign tumours. B-ENT 2015; Suppl 24:55-59. [PMID: 26891533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Abstract
OBJECTIVES The parapharyngeal space (PPS) is an anatomically complex space in the vicinity of vital structures. With the introduction of the daVinci robot in head and neck surgery, the surgical robotic system is now being used to gain direct access to the parapharyngeal space and to excise the tumors endoscopically. This study evaluates the outcomes of four patients with benign PPS tumors treated with a transoral robotic surgery approach in a single centre. MATERIAL AND METHODS All patients with benign tumors of the PPS who underwent transoral resection (between January 2012 and June 2014) using the robot were included in this retrospective study. RESULTS The study population comprised of two males and two females with a mean age of 52 (range 34-66 years). The parapharyngeal mass was successfully transorally removed in all cases. Overall, mean length of stay was 3.25 days with mean time to oral diet of one day. No intraoperative, perioperative or postoperative complications were encountered. The histological diagnosis was pleomorphic adenoma in two cases (50%). The other two cases were: schwannoma and angioma. There were no recurrences on radiological investigations during a mean follow-up of 14.5 months. MRI scan showed a stable residual fibrotic lesion in case of the angioma. The preoperative complaints of mucus in the throat, painless swelling of the soft palate or throat burden of all patients resolved after surgery. CONCLUSION With the assistance of the surgical robotic system, benign tumors within the PPS can be excised safely without neck incisions. Further long-term evaluation is needed to define patient selection and the role of TORS for PPS neoplasms.
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Luo H, Liu T. [A case report of surgical resection of giant pharyngeal pleomorphic adenoma and literature review]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2014; 28:1997-1998. [PMID: 25895329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Pleomorphic adenoma (PA) is a rare benign tumor in the pharynx. We presented a case with a huge PA in the pharynx. MRI displayed oropharyngeal mass, considering benign tumor. Preoperative fine-needle aspiration and cytology biopsy were important to confirm the diagnosis of PA preliminary. Extracapsular complete dissection for PA was performed under general anesthesia with tracheotomy subsequently. Postoperative histopathological examination confirmed the diagnosis of PA. The patient was discharged a week after operation and no recurrence was found in the following 8 months.
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Stenner M, Müller KM, Koopmann M, Rudack C. Squamous cell carcinoma of the larynx arising in multifocal pharyngolaryngeal oncocytic papillary cystadenoma: a case report and review of the literature. Medicine (Baltimore) 2014; 93:e70. [PMID: 25211046 PMCID: PMC4616269 DOI: 10.1097/md.0000000000000070] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
We report on a rare case of a laryngeal carcinoma arising in a multifocal pharyngolaryngeal oncocytic papillary cystadenoma (OPC). The disease of a 63-year-old man is well documented by computed and positron emission tomography, histology, and electron microscopy. We could show that an OPC can even develop in the pharynx. The coexistence of both tumors makes this a challenging diagnosis for pathologists. Treated by surgery and radiotherapy, both lesions dissolved. Based on the literature available, we discuss the theory that the laryngeal carcinoma might be the result of a true metaplasia facilitated by chronic irritation and recommend a regular follow-up for OPC too. As in benign oncocytic lesions, we could show that the detection of numerous mitochondria is a diagnostic indicator for malignant variants as well.
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Affiliation(s)
- Markus Stenner
- Department of Otorhinolaryngology, Head and Neck Surgery (MS, MK, CR); and Institute of Pathology, University Hospital of Münster, Münster, Germany (K-MM)
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Steward SC, Chauvenet AR, O'Suoji C. Nasopharyngeal rhabdomyosarcoma mimicking a peritonsillar abscess. W V Med J 2014; 110:12-14. [PMID: 25643468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Rhabdomyosarcoma (RMS) is the most common soft tissue malignancy seen in childhood and frequently occurs in the head and neck region. Pediatric head and neck RMS is often misdiagnosed as common benign conditions. Here we describe an embryonal RMS that presented as a peritonsillar abscess (PTA). Due to an incorrect initial diagnosis and lack of imaging, the patient received unnecessary medical therapy and diagnosis of RMS was delayed.
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Hanai N, Ozawa T, Hirakawa H, Suzuki H, Fukuda Y, Hasegawa Y. The nodal response to chemoselection predicts the risk of recurrence following definitive chemoradiotherapy for pharyngeal cancer. Acta Otolaryngol 2014; 134:865-71. [PMID: 25022795 DOI: 10.3109/00016489.2014.894252] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSIONS The poor response of neck tumors to induction chemotherapy (ICT) as chemoselection is related to a significantly worse prognosis, including higher risks of local recurrence and/or distant metastasis, after definitive chemoradiotherapy (CRT). OBJECTIVES Neck dissection is frequently performed to treat residual lymph nodes after CRT for the purpose of locoregional control; however, the prognosis of patients with pathologically proven residual neck tumors is poor, and no methods for predicting unfavorable results before CRT have been established. Therefore, in the present study, we focused on the response of lymph nodes to ICT and its relationship with the prognosis among patients treated with chemoselection. METHODS We retrospectively reviewed a total of 27 oropharyngeal and 24 hypopharyngeal squamous cell carcinoma stage III/IV consecutive patients with cervical lymph node metastasis who exhibited a response of >50% in the primary tumor to ICT followed by concurrent definitive CRT. RESULTS The relapse-free survival of the patients who responded (partial response/complete response, PR/CR) to ICT was significantly superior to that of the patients who did not respond (stable disease, SD) to ICT (p = 0.008).
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Affiliation(s)
- Nobuhiro Hanai
- Department of Head and Neck Surgery, Aichi Cancer Center Hospital , Nagoya , Japan
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Sun F, Jin T, Li W, Qian Y, Wei D, Sun R, Liu D, Xie G, Lei D, Pan X. [Clinical analysis of 91 cases of primary parapharyngeal space tumors]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2014; 49:305-310. [PMID: 24931019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To summarize and analyze the clinical features, diagnosis methods, surgical approaches and treatment outcomes of patients with primary parapharyngeal space tumors. METHODS A retrospective review of 91 cases with primary parapharyngeal space tumors treated from January 1999 to December 2011 was performed. All patients underwent preoperative enhanced CT scan and postoperative histopathologic examination. Intraoperative frozen section biopsies were performed in 36 of 91 cases. The surgical approaches included trans-cervical approach in 73 cases, trans-parotid approach in 5 cases, trans-oral approach in 5 cases, and mandibulotomy in 8 cases. RESULTS The postoperative pathological diagnoses consisted of 29 variants, including 20 for benign tumors and 9 for malignant tumors. Of the 80 cases with benign tumors, 6 cases were lost to follow-up and 74 cases were followed up for 31-84 months with no recurrence. Eleven cases with malignant tumor were followed up for 8-51 months (median 29 months), of them 7 cases died and 1 case was lost to follow-up. The post-operative complications included Horner syndrome in 3 cases, hoarseness in 2 cases, hypoglossal nerve palsy in 1 case, accessory nerve palsy in 1 case, upper airway obstruction in 1 case, and internal carotid artery cavernous sinus fistula in 1 case. CONCLUSIONS Parapharyngeal space tumors are rare, with atypical clinical manifestation, and have pathological types of diversification. CT or MRI is helpful to evaluate the tumor size, location and possible sources, and to make operation scheme. Surgery is the first choice for parapharyngeal space tumors. Trans-cervical approach can be applied to most tumors. Parapharyngeal benign tumors have good prognosis, but malignant tumors have poor prognosis.
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Affiliation(s)
- Fenglin Sun
- Department of Otorhinolaryngology, Qilu Hospital of Shandong University; Key Laboratory of Otorhinolaryngology, Ministry of Health, Jinan 250012, China
| | - Tong Jin
- Department of Otorhinolaryngology, Qilu Hospital of Shandong University; Key Laboratory of Otorhinolaryngology, Ministry of Health, Jinan 250012, China
| | - Wenming Li
- Department of Otorhinolaryngology, Qilu Hospital of Shandong University; Key Laboratory of Otorhinolaryngology, Ministry of Health, Jinan 250012, China
| | - Ye Qian
- Department of Otorhinolaryngology, Qilu Hospital of Shandong University; Key Laboratory of Otorhinolaryngology, Ministry of Health, Jinan 250012, China
| | - Dongmin Wei
- Department of Otorhinolaryngology, Qilu Hospital of Shandong University; Key Laboratory of Otorhinolaryngology, Ministry of Health, Jinan 250012, China
| | - Ruijie Sun
- Department of Otorhinolaryngology, Qilu Hospital of Shandong University; Key Laboratory of Otorhinolaryngology, Ministry of Health, Jinan 250012, China
| | - Dayu Liu
- Department of Otorhinolaryngology, Qilu Hospital of Shandong University; Key Laboratory of Otorhinolaryngology, Ministry of Health, Jinan 250012, China
| | - Guang Xie
- Department of Otorhinolaryngology, Qilu Hospital of Shandong University; Key Laboratory of Otorhinolaryngology, Ministry of Health, Jinan 250012, China
| | - Dapeng Lei
- Department of Otorhinolaryngology, Qilu Hospital of Shandong University; Key Laboratory of Otorhinolaryngology, Ministry of Health, Jinan 250012, China.
| | - Xinliang Pan
- Department of Otorhinolaryngology, Qilu Hospital of Shandong University; Key Laboratory of Otorhinolaryngology, Ministry of Health, Jinan 250012, China
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Clark NP, Marks JG, Sandow PR, Seleski CE, Logan HL. Comparative effectiveness of instructional methods: oral and pharyngeal cancer examination. J Dent Educ 2014; 78:622-629. [PMID: 24706693 PMCID: PMC4075323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This study compared the effectiveness of different methods of instruction for the oral and pharyngeal cancer examination. A group of thirty sophomore students at the University of Florida College of Dentistry were randomly assigned to three training groups: video instruction, a faculty-led hands-on instruction, or both video and hands-on instruction. The training intervention involved attending two sessions spaced two weeks apart. The first session used a pretest to assess students' baseline didactic knowledge and clinical examination technique. The second session utilized two posttests to assess the comparative effectiveness of the training methods on didactic knowledge and clinical technique. The key findings were that students performed the clinical examination significantly better with the combination of video and faculty-led hands-on instruction (p<0.01). All students improved their clinical exam skills, knowledge, and confidence in performing the oral and pharyngeal cancer examination independent of which training group they were assigned. Utilizing both video and interactive practice promoted greater performance of the clinical technique on the oral and pharyngeal cancer examination.
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Affiliation(s)
- Nereyda P Clark
- College of Dentistry, University of Florida, 1395 Center Drive, Room D9-34, PO Box 100415, Gainesville, FL 32610-0415;
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Lee DH, Yoon TM, Lim SC, Lee JK. Immature teratoma of the parapharyngeal space presenting with airway obstruction in an infant. B-ENT 2014; 10:71-73. [PMID: 24765832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
Teratoma is the most common germ cell tumour in childhood. Teratoma typically arises in the sacrococcygeal region, gonads and mediastinum. The head and neck region is seldom involved. Teratomas of the neck region represent one of the most unusual causes of respiratory distress during the neonatal period. We present a case of an immature teratoma in the parapharyngeal space presenting with airway obstruction in an infant. Surgeons should consider the possibility of immature teratoma in the head and neck region in the differential diagnosis of respiratory distress in an infant, even if the patient does not have an external deformity.
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Torretta S, Gaffuri M, Recalcati S, Marzano AV, Cantarella G, Iofrida E, Pignataro L. Pharyngolaryngeal location of Kaposi's sarcoma with airway obstruction in an HIV-negative patient. Tumori 2013. [PMID: 24362871 DOI: 10.1700/1377.15316] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Kaposi's sarcoma (KS) is a human herpes virus-8 (HHV-8)-associated angioproliferative disorder, and its occurrence may be favored by human immunodeficiency virus (HIV) infection and iatrogenic immunosuppression. It has also been postulated that a chronic inflammatory disease of the skin can pave the way to its development. KS generally involves mucosal and cutaneous sites, including the head and neck. An oropharyngeal location is quite common, but laryngeal involvement with possible upper airway obstruction and respiratory distress requiring tracheotomy is rare, and no hypopharyngeal locations have yet been reported. We describe the case of a 68-year-old male patient who developed KS after immunosuppressive treatment for pemphigus vulgaris, an autoimmune bullous disease presenting with blisters and erosions on the skin and the oral mucosa. KS was initially localized to the oral cavity and oropharynx, but subsequent involvement of the laryngeal and hypopharyngeal tract led to acute airway obstruction and the need for tracheotomy. This unique case of pharyngolaryngeal KS suggests that clinicians faced with purple nodular lesions should consider a differential diagnosis of KS in immunocompromised patients, even if they are HIV negative, and should carefully manage the patency of the upper airways.
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25
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Dolan RW, Anderson TD. Practical applications of in-office fiberoptic transnasal esophagoscopy in the initial evaluation of patients with squamous cell cancer of the head and neck. Ear Nose Throat J 2013; 92:450-455. [PMID: 24057905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
We conducted a study to analyze the effectiveness of transnasal esophagoscopy (TNE) as an alternative to operative endoscopy (OE) for the evaluation of primary head and neck cancers and for the surveillance of synchronous esophageal cancers. Our study population was made up of 96 consecutively presenting patients-75 men and 21 women, aged 45 to 88 years (mean: 64)-who were treated at our institution for squamous cell cancer of the head and neck. Of this group, 42 patients had been evaluated with TNE and 54 with OE. More OEs were performed in patients with an unknown primary (26 vs. 3). Incidental findings on TNE included 3 cases of gastritis, 2 cases each of hiatal hernia and esophagitis, 1 case of Barrett esophagus, and 1 inlet patch. No incidental findings were reported during OE. Primary cancers were biopsied by TNE through a port on the endoscope in 4 patients; 2 of these cancers were in the tongue base, 1 in the hypopharynx, and 1 in the aryepiglottic fold. After the initial visit, patients in the TNE group waited significantly fewer days for their endoscopy than did those in the OE group (median: 6.5 vs. 16; p < 0.05). Conversely, patients in the OE group waited significantly fewer days for treatment following endoscopy (median: 12 vs. 20; p < 0.05). However, there was no significant difference between the TNE patients and the OE patients in the total number of days comprising their entire course of management, from the initial visit to definite treatment (median: 27.5 and 33 days, respectively; p = 0.7). We conclude that TNE is a reasonable alternative to OE for the initial screening for synchronous esophageal cancers in patients with squamous cancers of the head and neck. OE is preferred for the initial workup of unknown primary cancers and for large tongue base cancers. The rate of detection of clinically relevant incidental findings is higher with TNE. Biopsy is possible during TNE for all subsites within the upper aerodigestive tract.
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Affiliation(s)
- Robert W Dolan
- Department of Otolaryngology-Head and Neck Surgery, Lahey Clinic, 41 Mall Rd., Burlington, MA 01805, USA.
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Fishero BA, Guido KM, McGuff HS, Heim-Hall JM, Miller FR. Hemangiopericytoma of the parapharyngeal space. Ear Nose Throat J 2013; 92:436-440. [PMID: 24057903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
Hemangiopericytomas of the head and neck are rarely found in the parapharyngeal space. We report the case of a 53-year-old woman who presented with a globus sensation in her throat. Imaging detected a left submucosal oropharyngeal mass that extended into the prestyloid parapharyngeal space. The tumor was surgically excised en bloc. Histopathologic examination identified it as a hemangiopericytoma. We discuss the diagnosis and management of this rare entity.
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Affiliation(s)
- Brian A Fishero
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Health Science Center, San Antonio, TX, USA
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Emura F, Baron TH, Gralnek IM. The pharynx: examination of an area too often ignored during upper endoscopy. Gastrointest Endosc 2013; 78:143-9. [PMID: 23582474 DOI: 10.1016/j.gie.2013.02.021] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2012] [Accepted: 02/14/2013] [Indexed: 12/11/2022]
Affiliation(s)
- Fabian Emura
- Advanced Gastrointestinal Endoscopy, EmuraCenter LatinoAmerica, Emura Foundation for the Promotion of Cancer Research Medical School, Universidad de La Sabana, Bogota, Colombia
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Shiga Kiyoto. [Diagnosis and treatment of pharynx necrosis]. Nihon Jibiinkoka Gakkai Kaiho 2013; 116:640-1. [PMID: 24024278 DOI: 10.3950/jibiinkoka.116.640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Walsh MM, Rankin KV, Silverman S. Influence of continuing education on dental hygienists' knowledge and behavior related to oral cancer screening and tobacco cessation. J Dent Hyg 2013; 87:95-105. [PMID: 23986143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
PURPOSE There are more than 35,000 new cases of oral and pharyngeal cancers (OPC) diagnosed each year. Most OPCs are diagnosed in advanced stages, requiring aggressive treatment and resulting in higher morbidity and mortality than when diagnosed early. The overall 5 year survival rate of OPC is about 60%. Early detection of OPC lesions are the key to survival. A major risk factor for OPC is chronic tobacco use. The purpose of this paper is to report changes in dental hygienists' knowledge, attitudes and behaviors 6 months after attending a standardized lecture format continuing education (CE) course on early OPC detection and tobacco cessation counseling compared to baseline values. METHODS A total of 64 CE courses were given for dental professionals throughout the 10 U.S. public health districts to determine if OPC screenings and tobacco cessation counseling behaviors could be modified at 6 months post-training. Questionnaires were obtained at baseline and 6 months later using a pre-/post-test design. RESULTS A total of 1,463 dental hygienists participated at baseline and 543 at a 6 month follow-up. Data showed a significant difference in knowledge and behavior compared to baseline values. CONCLUSION CE appeared to have a significant influence on participants' OPC and tobacco cessation knowledge and behavior, and could potentially make a difference on prevention, early detection and ultimately on OPC control.
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Meier PS, Meng Y, Holmes J, Baumberg B, Purshouse R, Hill-McManus D, Brennan A. Adjusting for unrecorded consumption in survey and per capita sales data: quantification of impact on gender- and age-specific alcohol-attributable fractions for oral and pharyngeal cancers in Great Britain. Alcohol Alcohol 2013; 48:241-9. [PMID: 23345391 DOI: 10.1093/alcalc/agt001] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
AIMS Large discrepancies are typically found between per capita alcohol consumption estimated via survey data compared with sales, excise or production figures. This may lead to significant inaccuracies when calculating levels of alcohol-attributable harms. Using British data, we demonstrate an approach to adjusting survey data to give more accurate estimates of per capita alcohol consumption. METHODS First, sales and survey data are adjusted to account for potential biases (e.g. self-pouring, under-sampled populations) using evidence from external data sources. Secondly, survey and sales data are aligned using different implementations of Rehm et al.'s method [in (2010) Statistical modeling of volume of alcohol exposure for epidemiological studies of population health: the US example. Pop Health Metrics 8, 1-12]. Thirdly, the impact of our approaches is tested by using our revised survey dataset to calculate alcohol-attributable fractions (AAFs) for oral and pharyngeal cancers. RESULTS British sales data under-estimate per capita consumption by 8%, primarily due to illicit alcohol. Adjustments to survey data increase per capita consumption estimates by 35%, primarily due to under-sampling of dependent drinkers and under-estimation of home-poured spirits volumes. Before aligning sales and survey data, the revised survey estimate remains 22% lower than the revised sales estimate. Revised AAFs for oral and pharyngeal cancers are substantially larger with our preferred method for aligning data sources, yielding increases in an AAF from the original survey dataset of 0.47-0.60 (males) and 0.28-0.35 (females). CONCLUSION It is possible to use external data sources to adjust survey data to reduce the under-estimation of alcohol consumption and then account for residual under-estimation using a statistical calibration technique. These revisions lead to markedly higher estimated levels of alcohol-attributable harm.
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Affiliation(s)
- Petra Sylvia Meier
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
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Blanchard D, Louis MY, Rame JP, de Raucourt D. [Tumours of the buccal cavity and the upper respiratory-digestive tracts]. Rev Prat 2013; 63:411-422. [PMID: 23687777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Affiliation(s)
- David Blanchard
- Service d'ORL et de chirurgie cervico-faciale, CLCC François-Baclesse, 14000 Caen, France
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Chen HH, Wang HM, Fan KH, Lin CY, Yen TC, Liao CT, Chen IH, Kang CJ, Huang SF. Pre-treatment levels of C-reactive protein and squamous cell carcinoma antigen for predicting the aggressiveness of pharyngolaryngeal carcinoma. PLoS One 2013; 8:e55327. [PMID: 23383155 PMCID: PMC3561298 DOI: 10.1371/journal.pone.0055327] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Accepted: 12/21/2012] [Indexed: 11/18/2022] Open
Abstract
The levels of squamous cell carcinoma antigen (SCC-Ag) and C-reactive protein (CRP) can be used to predict tumor invasion, lymph node metastasis, staging and survival in patients with oral cavity cancer. The present study analyzed the relationship between pre-treatment levels of SCC-Ag and CRP in relation to clinicopathological factors in patients with pharyngolaryngeal cancer (PLC) and determined whether elevated levels of CRP and SCC-Ag were associated with tumor metabolic activity via [18F] fluorodeoxyglucose positron emission tomography (FDG-PET). We retrospectively recruited one hundred and six PLC patients between June 2008 and December 2011. All patients received computed tomography (CT)/magnetic resonance imaging (MRI) and FDG-PET staging analyses, and the serum levels of SCC-Ag and CRP in these patients were measured prior to treatment. A SCC-Ag level ≥2.0 ng/ml and a CRP level ≥5.0 mg/L were significantly associated with clinical stage (P<0.001), clinical tumor status (P<0.001), and clinical nodal status (P<0.001). The elevation of both SCC-Ag and CRP levels was correlated with the standardized uptake value (SUV) max of the tumor (≥8.6 mg/L) and lymph nodes (≥5.7 ng/ml) (P = 0.019). The present study demonstrated that the presence of high levels of both pre-treatment SCC-Ag and CRP acts as a predictor of clinical stage, clinical tumor status, and clinical nodal status in patients with PLC. Moreover, elevated levels of SCC-Ag and CRP were associated with a high metabolic rate as well as the proliferative activity measured according to the SUVmax of the tumor and lymph nodes. Therefore, elevated levels of these two factors have the potential to serve as biomarkers for the prediction of tumor aggressiveness in cases of PLC.
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Affiliation(s)
- Hsuan-Ho Chen
- Departments of Otolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan, Republic of China
- Head and Neck Oncology Group, Chang Gung Memorial Hospital, Linkou, Taiwan, Republic of China
- Chang Gung University, Linkou, Taiwan, Republic of China
| | - Hung-Ming Wang
- Internal Medicine, Division of Hematology/Oncology, Chang Gung Memorial Hospital, Linkou, Taiwan, Republic of China
- Head and Neck Oncology Group, Chang Gung Memorial Hospital, Linkou, Taiwan, Republic of China
- Chang Gung University, Linkou, Taiwan, Republic of China
| | - Kang-Hsing Fan
- Radiation Oncology, Chang Gung Memorial Hospital, Linkou, Taiwan, Republic of China
- Head and Neck Oncology Group, Chang Gung Memorial Hospital, Linkou, Taiwan, Republic of China
- Chang Gung University, Linkou, Taiwan, Republic of China
| | - Chien-Yu Lin
- Radiation Oncology, Chang Gung Memorial Hospital, Linkou, Taiwan, Republic of China
- Head and Neck Oncology Group, Chang Gung Memorial Hospital, Linkou, Taiwan, Republic of China
- Chang Gung University, Linkou, Taiwan, Republic of China
| | - Tzu-Chen Yen
- Nuclear Medicine and Molecular Imaging Center, Chang Gung Memorial Hospital, Linkou, Taiwan, Republic of China
- Head and Neck Oncology Group, Chang Gung Memorial Hospital, Linkou, Taiwan, Republic of China
- Chang Gung University, Linkou, Taiwan, Republic of China
| | - Chun-Ta Liao
- Departments of Otolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan, Republic of China
- Head and Neck Oncology Group, Chang Gung Memorial Hospital, Linkou, Taiwan, Republic of China
- Chang Gung University, Linkou, Taiwan, Republic of China
| | - I-How Chen
- Departments of Otolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan, Republic of China
- Head and Neck Oncology Group, Chang Gung Memorial Hospital, Linkou, Taiwan, Republic of China
- Chang Gung University, Linkou, Taiwan, Republic of China
| | - Chung-Jan Kang
- Departments of Otolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan, Republic of China
- Head and Neck Oncology Group, Chang Gung Memorial Hospital, Linkou, Taiwan, Republic of China
- Chang Gung University, Linkou, Taiwan, Republic of China
| | - Shiang-Fu Huang
- Departments of Otolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan, Republic of China
- Head and Neck Oncology Group, Chang Gung Memorial Hospital, Linkou, Taiwan, Republic of China
- Chang Gung University, Linkou, Taiwan, Republic of China
- * E-mail:
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Tanna N, Chadha N, Sharma RR, Goodman JF, Sadeghi N. Malignant ossifying fibromyxoid tumor of the parapharyngeal space. Ear Nose Throat J 2012; 91:E15-E17. [PMID: 23076857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
Ossifying fibromyxoid tumor (OFMT) is a rare, recently described entity. As such, there is a paucity of information in the literature regarding this neoplasm. According to most reports, the tumor usually develops subcutaneously in the soft tissues of the extremities. Malignant forms of the tumor are far more rare than their benign counterparts. We present a new case of a malignant OFMT of the parapharyngeal space in a 33-year-old Pakistani man. The tumor was excised, and the patient did well with no complications. This case represents a rare occurrence of OFMT of the parapharyngeal space.
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Affiliation(s)
- Neil Tanna
- Division of Plastic and Reconstructive Surgery, Department of Surgery, North Shore-Long Island Jewish Health System, Lake Success, NY 10142, USA.
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Sato Y. [Diagnosis and treatment of laryngopharynx cancer]. Nihon Jibiinkoka Gakkai Kaiho 2012; 115:926-929. [PMID: 24163855 DOI: 10.3950/jibiinkoka.115.926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Langevin SM, Michaud DS, Eliot M, Peters ES, McClean MD, Kelsey KT. Regular dental visits are associated with earlier stage at diagnosis for oral and pharyngeal cancer. Cancer Causes Control 2012; 23:1821-9. [PMID: 22961100 DOI: 10.1007/s10552-012-0061-4] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2012] [Accepted: 08/28/2012] [Indexed: 11/25/2022]
Abstract
PURPOSE Oral and pharyngeal cancer patients diagnosed at an advanced stage experience increased morbidity and mortality relative to those with localized disease. The aim of this study was to assess the impact of dental insurance status and regularity of dental visits on early detection of oral and pharyngeal cancer. METHODS We examined the relationship of dental insurance and frequency of dental visits with stage at diagnosis among 441 oral and pharyngeal cancer cases from a population-based study of head and neck cancer. Ordinal logistic regression models were used to assess the association with stage, and tumor (T) and nodal (N) classification. RESULTS Never or rarely going to the dentist was associated with being diagnosed at higher stage for oral and pharyngeal cancer (cumulative OR = 2.28, 95 % CI: 1.02-5.10) and oral cancer (cumulative OR = 9.17, 95 % CI: 2.70-31.15) compared to those going to the dentist at least annually. Oral and pharyngeal cancer patients who went to the dentist infrequently (cumulative OR = 1.82, 95 % CI: 1.09-3.05) or rarely/never (cumulative OR = 3.24, 95 % CI: 1.59-6.57) were diagnosed with a higher T classification compared with those who went at least annually. CONCLUSIONS Receipt of regular dental examinations at least annually may reduce the public health burden of oral and pharyngeal cancer by facilitating earlier detection of the disease.
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Affiliation(s)
- Scott M Langevin
- Department of Epidemiology, Brown University, 70 Ship Street, Box G-E5, Providence, RI 02912, USA
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Parida PK, Bakshi J, Bhagat S, Virk RS. Case report: leiomyosarcoma of the parapharyngeal space. Ear Nose Throat J 2012; 91:E20-E22. [PMID: 22829041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
Leiomyosarcoma is usually found in the female genital tract, the retroperitoneum, the wall of the gastrointestinal tract, and subcutaneous tissues. An appearance of this malignant tumor in the parapharyngeal space is extremely rare and may be difficult to diagnose. Because of its rarity, little information exists on management and prognosis. We report the case of a 50-year-old man with a parapharyngeal space leiomyosarcoma who was treated with total excision of the tumor and postoperative radiotherapy. At follow-up 6 months postoperatively, he was well and free of disease. To the best of our knowledge, this is only the third case of a leiomyosarcoma in the parapharyngeal area to be reported in the literature. We discuss the diagnosis and treatment of leiomyosarcoma in this aspect.
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Affiliation(s)
- Pradipta Kumar Parida
- Department of Ear, Nose & Throat, JIPMER, Dhanvantri Nagar, Gorimedu, Pondicherry, Pin-605006, India.
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Janjatov B, Erić M, Sojić D. An unusual bilateral fibroepithelial pharyngeal polyps: report of a case. Eur Rev Med Pharmacol Sci 2012; 16:701-703. [PMID: 22774416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Fibroepithelial polyps are benign polypoid lesions arising from the mesodermal tissue and composed of varying amounts of stroma covered by squamous epithelium. We report the unusual case of a 57 years old man who visited our Hospital with complains of airway obstruction and uneasy feeling like a foreign body deep in his throat. After medical examination we find a large mass on the right side of his hypopharinx and we resected tumour as an emergency procedure. Postoperative recovery was good. After two years patient came again in our Hospital with the same feeling and we found another lesion on the left side of his hypopharynx. We repeated the same surgical procedure like the first time. In medical review that is a rare lesion with small number of references. In this case, fibroepithelial polyps arose from the hypopharynx and these potentially fatal lesions may have resulted in complete airway obstruction.
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Affiliation(s)
- B Janjatov
- Department of ENT and Maxillofacial Surgery, General Hospital, Sremska Mitrovica, Serbia
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Garas G, Madani G, Tolley N. Radiology quiz case 2. Retropharyngeal prevertebral lipoma. Arch Otolaryngol Head Neck Surg 2012; 138:424-425. [PMID: 22508630 DOI: 10.1001/archoto.2012.193a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- George Garas
- St Mary’s Hospital, Imperial College Healthcare NHS Trust, London, England
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Zhang I, Husein M, Dworschak-Stokan A, Jung J, Matic DB, Siu V, Prasad C, Doyle PC. Neurofibromatosis and velopharyngeal insufficiency: is there an association? J Otolaryngol Head Neck Surg 2012; 41:58-64. [PMID: 22498270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
OBJECTIVE Velopharyngeal insufficiency (VPI) is an often underrecognized disorder of palatal and nasopharyngeal closure that leads to the production of hypernasal speech. However, the potential clinical association between VPI and neurofibromatosis type 1 (NF1) remains undefined in the literature. The purpose of this study sought to identify and describe the potential clinical association of VPI in NF1 patients. DESIGN A combined retrospective and prospective study. SETTING Tertiary referral centre. METHODS The NF1 database from 1998 to 2007 from the Medical Genetics Unit of our institution was used for this project. All NF1 patients seen during this period were sent a letter soliciting their participation in the study, which was designed to screen for the presence of VPI. MAIN OUTCOME MEASURES Perceptual testing was undertaken using the American Cleft Palate-Craniofacial Association (ACPA) clinical database form and acoustic measurement of nasal flow, including standard nasometry and nasalance scores. A comprehensive chart review was also performed. RESULTS One hundred forty-nine NF1 patients were identified from the database; 18 patients responded to our request for participation, with 3 additional participants recruited from recent clinical visits. Eleven of these 21 patients exhibited VPI based on perceptual evaluation and nasometry screening. CONCLUSIONS This preliminary study attempted to identify a potential association between NF1 and VPI. Although this sample of NF1 patients was small, the finding of 11 of 21 patients being positively identified with some degree of VPI is of clinical interest, and further research is warranted.
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Affiliation(s)
- Irene Zhang
- Department of Otolaryngology-Head and Neck Surgery, London Health Sciences Centre–Victoria Hospital, London, ON N6A 5W9
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Liu LF, Huang DL, Wang JL, Wu WM, Liu MB, Zhao JD, Ma YY. [Diagnosis and treatment of the primary parapharyngeal space tumors]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2012; 47:48-52. [PMID: 22455775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVE To study the clinical characteristics, diagnosis and surgical managements of the parapharyngeal space tumors. METHODS A retrospective study of 40 patients with primary parapharyngeal space tumors treated from January 2006 to December 2008 in Chinese PLA General Hospital was performed. Among the 40 patients, there were male 22 patients, female 18 (45%), age ranged from 1 - 77, median 42 years old. CT scan combined with MRI was helpful to diagnose the parapharyngeal space tumor and make surgical plan. The surgical approaches include: trans-oral in 1 patient, trans-cervical approach in 22, transcervical-parotid approach in 8, vertical ramus osteotomy approach in 1, transcervical-partial bone resection in the angle of mandible in 4, transparotid approach in 2, and transcervical in combination with post auricle craniotomy approach in 2. RESULTS All 40 patients had undergone surgical treatment. Postoperative histopathology showed benign in 28 patients and malignant in 12 patients. The tumors originating from salivary glands were in 15 patients, neurogenic tumors in 12 patients and tumors originating from other tissues were in 13 patients.Among 28 patients with benign tumors, 23 had been cured with one operation, without recurrence during following-up of 13 - 47 months, with a median of 39 months. Among 12 patients with malignant tumors, 6 patients alive (with following-up of 24 - 50 months and a median of 36 months), 3 patients died in half year after operation and 3 patients lost. The post-operative complication included Cerebrospinal fluid leak in one patient, operative field infection in 2 patients, and vagus nerve injury in 3 patients. CONCLUSIONS Surgery is the first choice for parapharyngeal space tumors. Transcervical approach alone can apply to most tumors and a broader approach is indicated for malignant or large benign tumors. The prognosis is good for the benign lesions, but poor for the malignant tumors.
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Affiliation(s)
- Liang-fa Liu
- Department of Otorhinolaryngology Head and Neck Surgery, Chinese People Liberation Army General Hospital, Beijing 100853, China.
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MESH Headings
- Adenocarcinoma/diagnosis
- Adenocarcinoma/secondary
- Adenocarcinoma/therapy
- Carcinoma, Squamous Cell/diagnosis
- Carcinoma, Squamous Cell/therapy
- Diagnosis
- Diagnosis, Differential
- Diagnostic Errors
- Female
- History, 18th Century
- History, 19th Century
- History, 20th Century
- History, Medieval
- Humans
- Lung Neoplasms/diagnosis
- Lung Neoplasms/pathology
- Lung Neoplasms/therapy
- Lymphatic Diseases/diagnosis
- Lymphatic Diseases/pathology
- Lymphatic Metastasis
- Male
- Middle Aged
- Neck
- Neoplasms, Multiple Primary/diagnosis
- Neoplasms, Multiple Primary/therapy
- Pharyngeal Neoplasms/diagnosis
- Pharyngeal Neoplasms/secondary
- Philosophy, Medical/history
- Probability
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Affiliation(s)
- Navin Mani
- Department of Head and Neck Surgical Oncology, Christie Hospital, Manchester M20 4BX, UK.
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Sang J, Lou W, Zhang Y. [Diagnosis and surgical approach of parapharyngeal space neoplasms]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2011; 25:961-965. [PMID: 22260072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVE To explore the diagnosis and reasonable surgical approach for parapharyngeal space neoplasms. METHOD From July 2004 to July 2009, a retrospective review of 45 patients with neoplasms of parapharyngeal space was performed. Fourty-five cases were examined by CT, some of them were examined by MRI or DSA. Several surgical approaches were selected. The transcervical approach was used in 35 cases, the transparotid approach was used in 5 cases, the transmandible approach was used in 2 cases, and the transparotid and temporal approach was used in 3 cases. RESULT Among 45 patients, 37 cases (82.22%) were benign and 8 cases (17.78%) were malignant. Neurogenic neoplasms and salivary glands neoplasms were the most common tumors. Using CT, MRI or DSA could obtain useful information about the location, size, shape, density and degree of enhancement of the parapharyngeal space neoplasms, acquire their relationship with styloid and carotid, and make preoperative diagnosis. The diagnostic coincidence rate between preoperative diagnosis and pathological diagnosis was 80% (origin of tissue). All benign tumors were completely resected. A lymphangiomas had recurrence after 1 year,and the second operation had no recurrence. In the 45 cases, 8 cases were malignant tumors. Of 2 patients with malignant mixed tumors, 1 survived disease free after a follow-up of 4 years,and another was still alive with disease after a follow-up of 3 years; Of 2 patients with synovial sarcomas, 1 survived disease free for a follow-up of 3 years, the other one survived disease free after a follow-up of 2 years; 1 patient of nasopharyngeal carcinoma with metastasis in the parapharyngeal space had post-operative radical radiotherapy and survived disease free after a follow-up of 5 years. One patient with chordoma was still alive with disease after a follow-up of 3 years; 1 patient with poorly differentiated squamous cell carcinoma, died of pulmonary metastasis after a 4 year follow-up; 1 case with follicular dendritic cell sarcoma survived disease free after a follow-up of 2 years. CONCLUSION CT, MRI and DSA are essential for the diagnosis and differentiation of parapharyngeal space neoplasm. The transcervical approach is a simple, safe and minimal invasive procedure for resecting parapharyngeal space neoplasms. It is the best approach for treatment of parapharyngeal space neoplasms.
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Affiliation(s)
- Jianzhong Sang
- Department of Otorhinolaryngology-Head and Neck Surgery, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
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Li J, Guo H, Sun J. [Diagnosis and treatment of the parapharyngeal space tumors]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2011; 25:676-678. [PMID: 22010334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVE To study the diagnosis and treatment of the parapharyngeal space tumors. METHOD The clinical data of 22 patients with parapharyngeal space tumors treated in our hospital were retrospectively studied. All the patients underwent surgery. The tumors located in the left parapharyngeal space in 14 cases and in the right parapharyngeal space in 8 cases. RESULT Different surgical approaches were used: transcervical in 19 cases, transcervical-transmandibular in 2 cases, transoral in one case. The tumors were neurogenic origin in 15 cases, salivary gland origin in 4 cases, and others in 3 cases proved by postoperative pathology. Of these, 18 (81.8%) were benign and 4 (18.2%) malignant. Two patients with malignant tumors died 2 and 3 years respectively after operation due to recurrences, and others showed no evidence of recurrence after follow up for over one year. The fine-needle aspiration biopsy guided by ultrasonography provided the correct results of benign or malignant tumors in 4 cases. CONCLUSION The image examination of the neck can identify the tumors in the parapharyngeal space. The fine-needle aspiration biopsy guided by ultrasonography can differentiate the tumor between benign and malignancy. Surgery is the mainstay treatment for tumors in the parapharyngeal space.
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Affiliation(s)
- Jinrang Li
- Department of Otorhinolaryngology Head and Neck Surgery, Navy General Hospital, Beijing, 100048, China
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Macoveanu G, Costinescu VN, Hamarsheh AK. [Parapharyngeal space--history and surgical study]. Rev Med Chir Soc Med Nat Iasi 2011; 115:820-825. [PMID: 22046793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
UNLABELLED One area of anatomy, which is a true passage of secrecy, is the anatomy of the potential anatomical spaces. The study of the fascial layers of the head and neck and the potential spaces they make-up is both fascinating and confusing. Much of the confusion is a function of the multiple synonymous terms and classifications that various authors use, and not the basic anatomical description. Their anatomy and communications, to the base of skull and downward to diaphragm, acts like a route through which infection from mouth and throat can reach the superior mediastinum. CONCLUSIONS Understanding the anatomy of the parapharyngeal space is important in making a correct diagnosis and surgical plan for removing tumors in this region.
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Calda P, Novotná M, Cutka D, Břešt'ák M, Hašlík L, Goldová B, Vítková I, Vaněčková M, Seidl Z. A case of an epignathus with intracranial extension appearing as a persistently open mouth at 16 weeks and subsequently diagnosed at 20 weeks of gestation. J Clin Ultrasound 2011; 39:164-168. [PMID: 21387329 DOI: 10.1002/jcu.20762] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2010] [Accepted: 09/20/2010] [Indexed: 05/30/2023]
Abstract
We report a rare case of oral mass (epignathus) with intracranial extension originally suspected antenatally at 16 weeks' gestation because of a persistent open mouth. Postmortem MRI and pathologic examination of the fetus confirmed an oral teratoma with bilateral ventricular dilatation, corpus callosum agenesis, and a neuroepithelial intracranial cyst. The relevant literature regarding this anomaly is reviewed.
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Affiliation(s)
- Pavel Calda
- Charles University in Prague, First Faculty of Medicine, Department of Obstetrics and Gynecology of the First Faculty of Medicine and General University Hospital, Apolinářská 18, 128 51, Prague 2, Czech Republic
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Geriboni-Shehan ML. Fibromyxoma during labor. A rare tumor in an unusual location in a woman about to deliver. Adv NPs PAs 2011; 2:31-34. [PMID: 25693272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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47
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Ho MP, Cheung WK, Tsang YM. Forestier's disease presenting as a retropharyngeal mass in an elderly with dysphagia. Ann Acad Med Singap 2010; 39:943-2. [PMID: 21274495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Tian W, Li X, Li D, Liu X, Lin S, Liang Y. [Imageology features and transoral approach of benign parapharyngeal space tumors]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2010; 24:983-986. [PMID: 21261019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVE To analyze the imageology features of benign parapharyngeal space (PPS) tumors, and also to summarize our experience in removing PPS benign tumors through transoral approach. METHOD A retrospective review was conducted to 48 patients with benign tumors in PPS during a 10-year period. CT were performed in all patients, and only a few required MRI. Transoral approach (33.3%) and transcervical (39.6%) were the most commonly performed surgical procedures followed by the transcervical-transparotid approach (27.1%). RESULT CT scan and MRI often provided complementary information to help the surgeons delineate the size, precise location and likely cause of these tumors. After a follow-up of three years, only 2 of 48 patients had disease recurrence. The transoral approach described herein safely allowed for en bloc resection of most benign neoplasms. No significant complications attributed to the approach itself. CONCLUSION CT or MRI scan can distinguish prestyloid from poststyloid lesions, and to assess the extension of the tumor as well as its relationship with adjacent structures. The transoral approach safely provides access to some benign PPS tumors with a low rate of complications and recurrence as well as traditional transcervical approaches.
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Affiliation(s)
- Wendong Tian
- Department of Otorhinolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
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Abstract
Sixty-four standardized continuing education courses were given for dentists throughout the ten public health districts of the USA to determine if certain behaviors regarding oral and pharyngeal cancer (OPC) control could be modified. Questionnaires were obtained at baseline and at 6 months along with matched control groups. One thousand eight hundred two general dentists participated at baseline and 988 at a 6-month questionnaire follow-up. Analysis of the data indicated that continuing education courses had a positive influence on participants' oral cancer attitudes, knowledge, and behavior that potentially could make a difference on prevention, early detection, and ultimately OPC control.
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Affiliation(s)
- Sol Silverman
- Department Orofacial Sciences, School of Dentistry Box 0422, University of California, 513 Parnassus Avenue, San Francisco, CA 94143 USA
| | - A. Ross Kerr
- Department of Oral & Maxillofacial Pathology, Radiology & Medicine, New York University College of Dentistry, 345 E. 24th Street, New York, NY 10010 USA
| | - Joel B. Epstein
- Department of Oral Medicine, University of Illinois College of Dentistry, 801 S. Paulina Street, Chicago, IL 60612 USA
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Abstract
Sore throat is a common medical complaint seen by the emergency practitioner, internist, pediatrician, and otolaryngologist. The differential for sore throat is vast. However, with a directed history this can often be narrowed down to 2 to 3 possible diagnoses. By paying particular attention to the associated symptoms and duration of symptoms, common self-limited etiologies like viral pharyngitis and nonstreptococcal tonsillitis can be distinguished from those that require more investigation, such as supraglottitis and tonsillar cancer. A sore throat is most commonly caused by an infectious, inflammatory, or neoplastic etiologic factor.
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Affiliation(s)
- Teresa V Chan
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center at Dallas, 5323 Harry Hines Boulevard, Dallas, TX 75390-9035, USA.
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