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Tuberkuloz Ve Toraks Dec 2020Lymphoepithelioma-like carcinoma (LELC), is a rare type of cancer and typically occurs in pharyngeal and foregut-derivative organs, Including the salivary glands,...
Lymphoepithelioma-like carcinoma (LELC), is a rare type of cancer and typically occurs in pharyngeal and foregut-derivative organs, Including the salivary glands, thymus, stomach and liver (1). Pulmonary LELC typically affects the young and non-smoking population, and is associated with Ebstein-Barr virus (EBV) infection (1,2). We present an rare case with a pulmonary mass on CT scan of the thorax, which was subsequently proved as a LELC of the lung and a brief review of the relevant literature. The patient is a 51-year old man, presented with shorthness of breath and cough for 1 months. Chest x-ray was normal (Figure 1). Chest CT scan showed a 30-25 mm heterogeneously enhanced mass lesion with well defined margin, In the left lower lobe of the lung (Figure 2). Bronchoscopy showed no endobronchial lesion. After the PET-CT, the patient was staged as cT2aN1M0 (Stage 2B) (Figure 3). He received video-assisted thoracoscopic surgery of left lower lobe of lung and mediastinal lymph nodes dissection (Figure 4,5). His Ebv-Dna is Positive in blood tests. The pathology, immunohistochemical staining,and in situ hybridization results confirmed LELC of lung (Figure 6). Using in situ hybridization with exhibition of abundant EBV-encoded small nuclear RNA, in the majority of tumor cells is done. He received 4 cycles of induction chemotherapy with cysplatine and vinoralbine. The patient was discharged from hospital with close follow-up. No recurrence has been detected so far. Primary pulmonary LELC is a rare malignant tumor which accounts for only 0.9% of all primary lung cancer (1,2). Previous studies have demonstrated that pulmonary LELC is strongly associated with EBV infection (1,2). The majority of pulmonary LELC patients receive complete resection, as well as chemotherapy and radiotherapy based on their clinical stage (1,2). Comparing to other non-small cell cancer (NSCLC), pulmonary LELC is more sensitive to chemotherapy and radiotherapy (1,2). LELC of lung may be mistaken histopathologically for metastatic nasopharyngeal carcinoma or lymphoma. Its association with latent EBV infection have major implications for diagnosis and treatment. We present this case, because, its an unusual case with a pulmonary mass of the thorax, which was proved as a LELC of the lung.
Topics: Carcinoma; Combined Modality Therapy; Diagnosis, Differential; Humans; Lung Neoplasms; Male; Middle Aged; Positron Emission Tomography Computed Tomography; Tomography, X-Ray Computed
PubMed: 33448744
DOI: 10.5578/tt.69322 -
European Archives of... Jul 2023Minimally invasive surgery is today the main challenge of ENT surgeons who aim to achieve oncological radicality with less aesthetic and functional impact. This is the...
INTRODUCTION
Minimally invasive surgery is today the main challenge of ENT surgeons who aim to achieve oncological radicality with less aesthetic and functional impact. This is the basis for the widespread transoral surgical techniques, as the Thunderbeat.
OBJECTIVE
To date, the use of Thunderbeat in transoral surgery is still little known and widespread. So, this study analyzes, with a systematic review, current literature about the transoral use of Thunderbeat and shows our case studies.
METHODS
The research was carried out on Pubmed, Scopus, Web of Science and Cochrane databases using specific keywords. Then, a retrospective study was carried out on 10 patients who underwent transoral surgery by Thunderbeat in our ENT Clinic. Both in our cases and in the systematic review the following parameters have been evaluated: treated anatomical site and subsite, histological diagnosis, type of surgery, duration of nasogastric tube and hospitalization, post-operative complications, tracheostomy, resection margin status.
RESULTS
The review included 3 articles that described transoral use of Thunderbeat for a total of 31 patients suffering from oropharyngeal, hypopharyngeal and/or laryngeal carcinoma. Nasogastric tube was removed after 21.5 days on average, temporary tracheostomy was performed in 6 patients. The main complications were: bleeding (12.90%) and pharyngocutaneous fistula (29.03%). Thunderbeat shaft was 35 cm long and 5 mm large. Our case studies included 5 males and 5 females, mean age 64.4 ± 10.28, with oropharyngeal or supraglottic carcinoma, parapharyngeal pleomorphic adenoma and cavernous hemangioma of the tongue base. Temporary tracheostomy was performed in 8 patients. Free resection margins were achieved in all cases (100%). No peri-operative complications occurred. Nasogastric tube was removed after 5.3 ± 2 days on average. All patients were discharged without tracheal tube and NGT after 18.2 ± 4.72 days on average.
CONCLUSION
This study demonstrated that Thunderbeat has several advantages over other transoral surgical approaches, such as CO2 laser and robotic surgery, in terms of best combination of oncological and functional success, less post-operative complications and costs. So, it could represent a step forward in transoral surgery.
Topics: Male; Female; Humans; Middle Aged; Aged; Carcinoma, Squamous Cell; Retrospective Studies; Laryngeal Neoplasms; Hypopharynx; Larynx; Robotic Surgical Procedures; Postoperative Complications; Treatment Outcome
PubMed: 37014427
DOI: 10.1007/s00405-023-07944-8 -
Cancer Immunology, Immunotherapy : CII Feb 2024Hypopharyngeal and laryngeal squamous cell carcinoma (SCC) account for 25-30% of head and neck SCC. Total laryngectomy, while effective, compromises the quality of life....
Retrospective assessment of neoadjuvant camrelizumab combined with induction chemotherapy: efficacy in laryngeal preservation for advanced hypopharyngeal and laryngeal squamous cell carcinoma.
BACKGROUND
Hypopharyngeal and laryngeal squamous cell carcinoma (SCC) account for 25-30% of head and neck SCC. Total laryngectomy, while effective, compromises the quality of life. Immune checkpoint inhibitors such as Camrelizumab offer potential in laryngeal preservation. The study investigated Camrelizumab combined with TP regimen as a neoadjuvant therapy for laryngeal preservation in advanced hypopharyngeal and laryngeal SCC.
METHODS
A retrospective study was conducted at Sun Yat-sen University Cancer Center on patients diagnosed with locally advanced SCC of the hypopharynx and larynx from October 1, 2019, to October 25, 2022. The efficacy of a first-line treatment combining Camrelizumab (200 mg) and TP regimen (Albumin-bound paclitaxel at 260 mg/m and Cisplatin at 60 mg/m) was evaluated using RECIST 1.1 criteria. Outcomes included overall survival (OS), progression-free survival (PFS), laryngectomy-free survival (LFS), and response rates.
RESULTS
Of the 71 included patients, the median age was 60.7 years. Post the first-line treatment, 90.1% demonstrated an overall response. The one-year and two-year OS rates were 91.5% and 84.3%, respectively. One-year and two-year PFS rates were 92.9% and 83.9%, respectively, with LFS at 85.6% and 73.2%. The initial T4 stage as significantly associated with reduced OS and LFS. Skin reaction was the predominant adverse event.
CONCLUSION
The Camrelizumab-TP regimen demonstrated promising results for advanced hypopharyngeal/laryngeal SCC patients, exhibiting high response rates, OS, and LFS, positioning it as a potential primary option for laryngeal preservation. Further comprehensive, randomized controlled studies are imperative to validate these initial observations and elucidate the regimen's full clinical efficacy in optimizing laryngeal outcomes.
Topics: Humans; Middle Aged; Neoadjuvant Therapy; Retrospective Studies; Hypopharynx; Quality of Life; Squamous Cell Carcinoma of Head and Neck; Larynx; Head and Neck Neoplasms; Antibodies, Monoclonal, Humanized
PubMed: 38358522
DOI: 10.1007/s00262-023-03579-0 -
Bioengineered Mar 2022This study explored the function and mechanisms of HOX transcript antisense RNA (HOTAIR) in the drug resistance of nasopharyngeal carcinoma (NPC). Quantitative PCR,...
This study explored the function and mechanisms of HOX transcript antisense RNA (HOTAIR) in the drug resistance of nasopharyngeal carcinoma (NPC). Quantitative PCR, Western blotting, MTT assay, flow cytometry, Transwell assay, and luciferase assay were performed. HOTAIR expression levels were upregulated in cisplatin (DDP)-resistant NPC tissues and cells. Knockdown of HOTAIR in DDP-resistant NPC cells increased cell sensitivity of DDP, as well as decreased cell viability, expression of chemoresistance-related proteins, migration and invasion, increased cell apoptosis. In addition, downregulation of microRNA 106a-5p (miR-106a-5p) expression and upregulation of SRY-box transcription factor 4 (SOX4) expression were observed in DDP-resistant NPC tissues and cells. MiR-106a-5p targets HOTAIR and SOX4; thus, silencing of HOTAIR significantly increased miR-106a-5p expression. The overexpression of miR-106a-5p significantly reversed the increase in SOX4 expression induced by HOTAIR lentivirus (Lv-HOTAIR). Knockdown of SOX4 reduced the drug resistance of DDP caused by the silencing of miR-106a-5p expression. In summary, HOTAIR enhanced DDP resistance in NPC cells by regulating the miR-106a-5p/SOX4 axis.
Topics: Animals; Cell Line, Tumor; Cisplatin; Drug Resistance, Neoplasm; Humans; Mice; Mice, Nude; MicroRNAs; Nasopharyngeal Carcinoma; Nasopharyngeal Neoplasms; Nasopharynx; RNA, Long Noncoding; SOXC Transcription Factors
PubMed: 35227173
DOI: 10.1080/21655979.2022.2038429 -
Cancer Control : Journal of the Moffitt... 2022Nasopharyngeal small cell carcinoma (SmCC) is a rare histological type of nasopharyngeal cancer, and its prognosis remains poor. This study aimed to determine the...
BACKGROUND
Nasopharyngeal small cell carcinoma (SmCC) is a rare histological type of nasopharyngeal cancer, and its prognosis remains poor. This study aimed to determine the clinical characteristics and survival prognostic factors of nasopharyngeal SmCC.
METHODS
Detailed clinicopathologic and therapeutic characteristics of a patient diagnosed with nasopharyngeal SmCC were determined. Nasopharyngeal SmCC cases reported previously were reviewed and summarized. Furthermore, a retrospective analysis was performed on data from the Surveillance, Epidemiology, and End Results (SEER) Program database. Kaplan-Meier analysis was conducted to compare survival within groups. Univariate and multivariate analyses were performed to investigate prognostic factors.
RESULTS
A nasopharyngeal SmCC patient treated with chemoradiotherapy who achieved 46 months long-term survival was reported. In reviewing 16 reported cases with epidemiologic and therapeutic details, we found most of nasopharyngeal SmCC patients were diagnosed with advanced grades and received chemoradiotherapy. In total, 13,993 cases of nasopharyngeal cancer were extracted from the SEER database, from which 57 nasopharyngeal SmCC cases were eventually screened out. The mean age of the patients was 55.70 years, and 64.9% of these cases were either grade III or IV; the median overall survival (OS) was 18 months. Statistically significant differences were observed in the OS values of groups categorized by age (P = .025) or radiotherapy (P = .037). Age (<70 years) and radiotherapy were identified as independent survival and prognostic factors.
CONCLUSION
Patients with nasopharyngeal SmCC are usually diagnosed with advanced grades and have poor prognoses; nevertheless, they can benefit from radiotherapy with prolonged overall survival.
Topics: Aged; Carcinoma, Small Cell; Humans; Lung Neoplasms; Middle Aged; Nasopharyngeal Neoplasms; Nasopharynx; Prognosis; Retrospective Studies; SEER Program
PubMed: 35341342
DOI: 10.1177/10732748221087075 -
The Laryngoscope Dec 2017Different reconstructive options are available for defects following total laryngectomy (TL) and circumferential (CH) or partial hypopharyngectomy (PH). We evaluated the... (Comparative Study)
Comparative Study
OBJECTIVES/HYPOTHESIS
Different reconstructive options are available for defects following total laryngectomy (TL) and circumferential (CH) or partial hypopharyngectomy (PH). We evaluated the flap success, pharyngocutaneous fistula, and pharyngoesophageal stenosis rates in two groups of patients treated by different policies.
STUDY DESIGN
Comparison between two cohorts of patients treated by TL with PH/CH ± cervical esophagectomy and reconstructed according to different strategies.
METHODS
Group A (historical) was composed of 89 patients reconstructed by pectoralis major myocutaneous (PMMC), radial forearm (RF), and anterolateral thigh (ALT) flaps. A salivary bypass stent (SBPS) was not routinely applied and left in place for a maximum of 14 days. Forty-four (49%) patients received preoperative radiotherapy/chemoradiotherapy (RT/CRT). Group B (prospective) included 105 patients reconstructed by RF or ALT with long-lasting SBPS left in place for a maximum of 45 days. Sixty-one (59%) received preoperative RT/CRT.
RESULTS
In group A, flap failure occurred in four (4%) cases, and all were managed by PMMC. We encountered 22 (26%) fistulas and 14 (16%) stenoses. In group B, flap failure occurred in six (6%) cases and was managed by PMMC. We encountered seven (7%) fistulas and three (3%) stenoses. Comparing complications among the two groups, we encountered a statistically significant difference in favor of group B for both fistula (P < .001) and stenosis (P = .001). We did not evidence any significant difference in terms of flap success rate.
CONCLUSIONS
First-line application of RF and ALT free flaps with long-lasting SBPS in reconstruction after PH/CH allows obtaining reduced incidences of both fistula and stenosis.
LEVEL OF EVIDENCE
4. Laryngoscope, 127:2731-2737, 2017.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Carcinoma, Squamous Cell; Fascia; Female; Free Tissue Flaps; Humans; Hypopharyngeal Neoplasms; Hypopharynx; Laryngectomy; Male; Middle Aged; Pharyngectomy; Postoperative Complications; Prospective Studies; Retrospective Studies; Skin; Young Adult
PubMed: 28573675
DOI: 10.1002/lary.26705 -
BMJ Case Reports Apr 2021
Topics: Carcinoma, Neuroendocrine; Humans; Neck; Nose; Otolaryngology; Pharynx; Thyroid Neoplasms; Trachea
PubMed: 33893135
DOI: 10.1136/bcr-2021-242352 -
The British Journal of Radiology May 2020To study if pre-treatment CT texture features in locally advanced squamous cell carcinoma of laryngo-pharynx can predict long-term local control and laryngectomy free...
Tumor radiomic features complement clinico-radiological factors in predicting long-term local control and laryngectomy free survival in locally advanced laryngo-pharyngeal cancers.
OBJECTIVE
To study if pre-treatment CT texture features in locally advanced squamous cell carcinoma of laryngo-pharynx can predict long-term local control and laryngectomy free survival (LFS).
METHODS
Image texture features of 60 patients treated with chemoradiation (CTRT) within an ethically approved study were studied on contrast-enhanced images using a texture analysis research software (TexRad, UK). A filtration-histogram technique was used where the filtration step extracted and enhanced features of different sizes and intensity variations corresponding to a particular spatial scale filter (SSF): SSF = 0 (without filtration), SSF = 2 mm (fine texture), SSF = 3-5 mm (medium texture) and SSF = 6 mm (coarse texture). Quantification by statistical and histogram technique comprised mean intensity, standard-deviation, entropy, mean positive pixels, skewness and kurtosis. The ability of texture analysis to predict LFS or local control was determined using Kaplan-Meier analysis and multivariate cox model.
RESULTS
Median follow-up of patients was 24 months (95% CI:20-28). 39 (65%) patients were locally controlled at last follow-up. 10 (16%) had undergone salvage laryngectomy after CTRT. For both local control & LFS, threshold optimal cut-off values of texture features were analyzed. Medium filtered-texture feature that were associated with poorer laryngectomy free survival were entropy ≥4.54, ( = 0.006), kurtosis ≥4.18; = 0.019, skewness ≤-0.59, = 0.001, and standard deviation ≥43.18; = 0.009). Inferior local control was associated with medium filtered features entropy ≥4.54; p 0.01 and skewness ≤ - 0.12; = 0.02. Using fine filters, entropy ≥4.29 and kurtosis ≥-0.27 were also associated with inferior local control ( = 0.01 for both parameters). Multivariate analysis showed medium filter entropy as an independent predictor for LFS and local control ( < 0.001 & = 0.001).
CONCLUSION
Medium texture entropy is a predictor for inferior local control and laryngectomy free survival in locally advanced laryngo-pharyngeal cancer and this can complement clinico-radiological factors in predicting prognosticating these tumors.
ADVANCES IN KNOWLEDGE
Texture features play an important role as a surrogate imaging biomarker for predicting local control and laryngectomy free survival in locally advanced laryngo-pharyngeal tumors treated with definitive chemoradiation.
Topics: Carcinoma, Squamous Cell; Disease-Free Survival; Female; Humans; Kaplan-Meier Estimate; Laryngeal Neoplasms; Laryngectomy; Male; Middle Aged; Pharyngeal Neoplasms; Prospective Studies; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 32101463
DOI: 10.1259/bjr.20190857 -
European Annals of Otorhinolaryngology,... Feb 2016To describe the clinical, histological and therapeutic characteristics of a prospective multicenter series of 95 head and neck adenoid cystic carcinoma patients, and to...
OBJECTIVES
To describe the clinical, histological and therapeutic characteristics of a prospective multicenter series of 95 head and neck adenoid cystic carcinoma patients, and to determine any prognostic factors for disease-free survival.
PATIENTS AND METHODS
Ninety-five patients with adenoid cystic carcinoma were included in the Réseau d'Expertise Français Des Cancers ORL Rares (REFCOR, French Rare Head and Neck Cancer Expert Network) database between 2009 and 2012. The primary site was the salivary glands in 39 cases, sinus cavities (including hard palate) in 36 cases, pharynx-larynx-trachea in 14 cases, and lips and oral cavity in 4 cases. The tumor was stage I in 15% of cases, stage II in 23%, stage III in 26% and stage IV in 36%. Nine patients had cervical lymph node involvement and 5 had metastases at diagnosis. Fifty-six percent of patients were managed by surgery with postoperative radiation therapy. During follow-up, 3 patients died, 9 developed metastases and 12 showed recurrence or local progression.
RESULTS
Mean follow-up was 18 months. On univariate analysis, disease-free survival correlated with T stage (P=0.05), N stage (P=0.003), resection margins (P=0.04), lymph node involvement on histology (P=0.01), and absence of chemotherapy (P=0.03). On multivariate analysis, disease-free survival correlated with T stage (P=0.01), N stage (P=0.09) and surgery (P=0.005).
CONCLUSION
The essential issue in adenoid cystic carcinoma is long-term control. The present results confirm that the reference attitude is radical surgical resection for optimal local control. Adjuvant radiation therapy did not emerge as a prognostic factor. This study also provides a starting-point for translational studies in pathology and genetics.
Topics: Adult; Aged; Aged, 80 and over; Carcinoma, Adenoid Cystic; Disease-Free Survival; Female; France; Head and Neck Neoplasms; Humans; Lymphatic Metastasis; Male; Middle Aged; Prognosis; Prospective Studies; Radiotherapy, Adjuvant; Young Adult
PubMed: 26493113
DOI: 10.1016/j.anorl.2015.09.009 -
Revista Do Colegio Brasileiro de... 2014To analyze the genetic polymorphisms of the cytochrome P450 family and their relationship with squamous cell carcinoma of the oral cavity, pharynx and larynx. (Review)
Review
OBJECTIVE
To analyze the genetic polymorphisms of the cytochrome P450 family and their relationship with squamous cell carcinoma of the oral cavity, pharynx and larynx.
METHODS
We present a narrative literature review, conducted in PubMed, Lilacs and Cochrane Databases of articles published in the last five years correlating genetic polymorphisms of the cytochrome P450 family and cancer risk in different populations worldwide.
RESULTS
We initially found 65 articles and, after selection criteria, 20 case-control studies with various populations worldwide were eligible. The most studied polymorphisms were those of CYP2E1 and CYP1A1 subfamilies. There is little about the other subfamilies. The association found between polymorphisms and cancer risk amounted to a countless number of variables, amongst them: population, selection methods, racial factors and different modes of exposure to carcinogens, genotyping methods, and nomenclature of the polymorphisms.
CONCLUSION
so far, there is no proven link between genetic polymorphisms of cytochrome P450 family and squamous cell carcinoma of the oral cavity, pharynx and larynx relationship.
Topics: Carcinoma, Squamous Cell; Cytochrome P-450 Enzyme System; Humans; Laryngeal Neoplasms; Mouth Neoplasms; Pharyngeal Neoplasms; Polymorphism, Genetic
PubMed: 25467103
DOI: 10.1590/0100-69912014005012