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Digestive Endoscopy : Official Journal... Nov 2013Giant hemangioma in the neck and head is an uncommon vascular neoplasm and has an unpredictable clinical behavior. We report a hemangioma that extended from the pharynx...
Giant hemangioma in the neck and head is an uncommon vascular neoplasm and has an unpredictable clinical behavior. We report a hemangioma that extended from the pharynx to the esophagus that could have been misdiagnosed as an esophageal varix. A 42-year-old man with dilated varices-like vessels on his esophagus that were incidentally detected by endoscopy was referred to our hospital for further evaluation. On re-examined endoscopy, multiple vascular dilatations were noted in the pharynx, expanding into the esophagogastric junction. These dilatations looked like esophageal varices that are found in patients with liver cirrhosis. There was no significant abnormality, including liver cirrhosis, on the abdomino-pelvic computed tomography scan. On the endoscopic esophageal biopsy, dilatedsubmucosal blood vessels were diagnosed as hemangioma. In consultation with an otorhinolaryngologist for evaluation of the risk of hemangioma, it was determined that the hemangioma was not dangerous to the patient as long as it did not cause hoarseness, dyspnea or dysphagia. We planned regular 6-month follow ups. We report a case of extended hemangioma that could possibly have been misdiagnosed as an esophageal varix on endoscopy. Even if head and neck hemangioma is uncommon, careful consideration during endoscopy is required to avoid the misdiagnosis of varices or hemangioma.
Topics: Adult; Biopsy; Bromhexine; Diagnosis, Differential; Diagnostic Errors; Endoscopy; Esophageal Neoplasms; Esophageal and Gastric Varices; Hemangioma; Humans; Incidental Findings; Male; Pharyngeal Neoplasms
PubMed: 24164602
DOI: 10.1111/j.1443-1661.2012.01405.x -
Clinical Oncology (Royal College of... Jul 2017Dysphagia after primary chemoradiotherapy or radiation alone in pharyngeal cancers can have a devastating impact on a patient's physical, social and emotional state.... (Review)
Review
Dysphagia after primary chemoradiotherapy or radiation alone in pharyngeal cancers can have a devastating impact on a patient's physical, social and emotional state. Establishing and validating efficient dysphagia-optimised radiotherapy techniques is, therefore, of paramount importance in an era where health-related quality of life measures are increasingly influential determinants of curative management strategies, particularly as the incidence of good prognosis, human papillomavirus-driven pharyngeal cancer in younger patients continues to rise. The preferential sparing achievable with intensity-modulated radiotherapy (IMRT) of key swallowing structures implicated in post-radiation dysfunction, such as the pharyngeal constrictor muscles (PCM), has generated significant research into toxicity-mitigating strategies. The lack of randomised evidence, however, means that there remains uncertainty about the true clinical benefits of the dosimetric gains offered by technological advances in radiotherapy. As a result, we feel that IMRT techniques that spare PCM cannot be incorporated into routine practice. In this review, we discuss the swallowing structures responsible for functional impairment, analyse the studies that have explored the dose-response relationship between these critical structures and late dysphagia, and consider the merits of reported dysphagia-optimised IMRT (Do-IMRT) approaches, thus far. Finally, we discuss the dysphagia/aspiration-related structures (DARS) study (ISRCTN 25458988), which is the first phase III randomised controlled trial designed to investigate the impact of swallow-sparing strategies on improving long-term function. To maximise patient benefits, improvements in radiation delivery will need to integrate with novel treatment paradigms and comprehensive rehabilitation strategies to eventually provide a patient-centric, personalised treatment plan.
Topics: Aged; Deglutition Disorders; Humans; Middle Aged; Pharyngeal Neoplasms; Radiotherapy, Intensity-Modulated
PubMed: 28242166
DOI: 10.1016/j.clon.2017.02.002 -
Head & Neck Sep 2014Carcinoma is a rare complication of pharyngeal diverticula. There is a paucity of information about its incidence, presentation, management, and treatment outcomes. A... (Review)
Review
BACKGROUND
Carcinoma is a rare complication of pharyngeal diverticula. There is a paucity of information about its incidence, presentation, management, and treatment outcomes. A systematic review and analysis of all reported cases has been carried out.
METHODS
A comprehensive literature search for pharyngeal diverticula carcinoma was performed from 1896 to 2008. Descriptive analyses were carried out by analyzing the absolute and relative frequencies. Comparison of groups was illustrated with Kaplan-Meier curves and tested statistically using the log-rank test. A cohort of 56 patients with benign pharyngeal diverticula was selected for comparison with the accumulated cohort of pharyngeal diverticula carcinoma, and a Fisher's exact test was carried out on the extracted clinical characteristics of this cohort to evaluate for differences between benign and malignant pharyngeal diverticula.
RESULTS
Forty-three articles reporting 60 cases satisfied the inclusion criteria. The mean age at presentation was 68.8 years (SD = 9.8 years). Five-year cancer-specific survival (CSS) rates for patients who underwent excision alone, excision + postoperative radiotherapy (PORT), and radiotherapy alone were 0.74 versus 0.63 versus 0.0, respectively (p = .39). Five-year CSS rates of patients <65 versus ≥65 years were 0.43 versus 0.78, respectively (p = .046).
CONCLUSION
Irregular symptoms in benign diverticula should raise suspicion of malignancy. Management consists of surgical excision ± PORT. © 2014 Wiley Periodicals, Inc. Head Neck 36: 1368-1375, 2014.
Topics: Carcinoma; Humans; Pharyngeal Neoplasms; Zenker Diverticulum
PubMed: 23996210
DOI: 10.1002/hed.23491 -
Acta Medica Okayama Apr 2019The efficacy and safety of endoscopic submucosal dissection (ESD) for superficial cancer of the pharynx are still unclear. To identify clinicopathological features of...
The efficacy and safety of endoscopic submucosal dissection (ESD) for superficial cancer of the pharynx are still unclear. To identify clinicopathological features of superficial pharyngeal cancer, and the efficacy and safety of ESD, we retrospectively assessed 70 pharyngeal cancers in 59 patients who underwent ESD. Of these patients, 61.0% and 50.8% had a history of esophageal cancer and head and neck cancer, respectively. The median tumor size was 15 mm, and 75.7% of the lesions were located at the piriform sinus. The en bloc resection rate was 94.9%. Treatment-related adverse events occurred in 8 cases, but there was no treatment-related death. The lateral margin was positive for neoplasm in 3 lesions (4.3%) and inconclusive in 27 lesions (38.6%), but no local recurrence was observed. Cervical lymph node metastasis was observed in 6 patients, and was successfully treated by cervical lymph node dissection. The three-year overall survival rate was 91.5% (95%CI: 76.6-97.3%) and the cause-specific survival rate was 97.6% (95%CI: 84.9-99.7%). In conclusion, ESD for superficial pharyngeal cancer was safe and effective. "Resect and watch" is probably a feasible and rational strategy for treatment of patients with superficial pharyngeal cancer.
Topics: Adult; Aged; Aged, 80 and over; Carcinoma, Squamous Cell; Endoscopic Mucosal Resection; Female; Humans; Male; Margins of Excision; Middle Aged; Pharyngeal Neoplasms; Retrospective Studies; Survival Rate
PubMed: 31015745
DOI: 10.18926/AMO/56646 -
Acta Medica (Hradec Kralove) 2018The most common benign neoplasm of the pharynx is papilloma. It is characterized by bulging brittle lesions, which are pedicled or sessile, whitish-grey or pinkish...
The most common benign neoplasm of the pharynx is papilloma. It is characterized by bulging brittle lesions, which are pedicled or sessile, whitish-grey or pinkish colour. Progressive hoarseness is the main clinical feature. When the papillomata spread throughout the tracheobronchial tree symptoms such as chronic cough, stridor, dyspnea or acute respiratory distress are mostly present. Hemoptysis as a presenting symptom is exceptionally rare in patients with pharyngeal papillomatosis. Herein, we report a case of pharyngeal papillomatosis in which hemoptysis was the primary clinical manifestation. The clinical and therapeutic aspects of the disease are briefly discussed.
Topics: Adult; Biopsy; Bronchoscopy; Diagnosis, Differential; Hemoptysis; Humans; Male; Papilloma; Pharyngeal Neoplasms; Polymerase Chain Reaction; Tomography, X-Ray Computed
PubMed: 30664450
DOI: 10.14712/18059694.2018.136 -
Annals of the Royal College of Surgeons... Nov 1984Twenty-two patients undergoing pharyngolaryngectomy and pharyngeal reconstruction are presented. Four patients died before leaving hospital swallowing. Fistulae and...
Twenty-two patients undergoing pharyngolaryngectomy and pharyngeal reconstruction are presented. Four patients died before leaving hospital swallowing. Fistulae and stricture formation were fairly common in patients who had been previously irradiated. The 2-year survival was 37%.
Topics: Esophagus; Female; Humans; Laryngectomy; Male; Methods; Middle Aged; Neck Dissection; Neoplasm Recurrence, Local; Pharyngeal Neoplasms; Pharyngectomy; Pharynx; Postoperative Complications; Surgical Flaps
PubMed: 6508156
DOI: No ID Found -
The Laryngoscope Dec 2021To analyze the clinical features, classification, and treatment of adult nasopharyngolaryngeal hemangioma (ANPLH).
OBJECTIVES/HYPOTHESIS
To analyze the clinical features, classification, and treatment of adult nasopharyngolaryngeal hemangioma (ANPLH).
STUDY DESIGN
Retrospective study.
METHODS
From February 2009 to May 2020, 101 patients with ANPLH were reviewed and analyzed.
RESULTS
Symptoms of ANPLH were frequently displayed as abnormal pharyngeal sensation and functional defection. According to lesion location, ANPLH was divided into five categories including nasopharyngeal, oropharyngeal, hypopharyngeal, laryngeal, and mixed types. The mixed type constitutes the highest portion, and the nasopharyngeal type is the least in our cohort. Most lesions could resect through natural cavity under endoscopy. Patients with mixed lesions had a higher rate of postoperative recurrence and planned multiple surgeries. Acceptable but not severe intraoperative and postoperative complications occurred in our patient cohort.
CONCLUSIONS
Patients with ANPLH are always symptomatic and even functional defective, which can be classified into five categories based on lesion location. For these patients, endoscopic surgery through natural cavity is recommended to remove lesions with fewer complications and favorable clinical outcomes.
LEVEL OF EVIDENCE
4 Laryngoscope, 131:2724-2728, 2021.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Female; Follow-Up Studies; Hemangioma; Humans; Laryngeal Neoplasms; Male; Middle Aged; Natural Orifice Endoscopic Surgery; Neoplasm Recurrence, Local; Nose Neoplasms; Pharyngeal Neoplasms; Retrospective Studies; Young Adult
PubMed: 34160868
DOI: 10.1002/lary.29703 -
Digestive Endoscopy : Official Journal... Nov 2017
Topics: Endoscopy; Humans; Pharyngeal Neoplasms
PubMed: 28816382
DOI: 10.1111/den.12948 -
Head & Neck Jun 2010Oncocytoma is a rare, benign salivary neoplasm composed of mitochondria-rich cells called oncocytes. Although oncocytoma usually occurs in the parotid glands, it has... (Review)
Review
Oncocytoma is a rare, benign salivary neoplasm composed of mitochondria-rich cells called oncocytes. Although oncocytoma usually occurs in the parotid glands, it has much less commonly been reported to occur in minor salivary gland tissues. Although there have been a few reported cases of oncocytomas being found in the parapharyngeal space, most if not all cases seem to be extensions of deep lobe parotid tumors. We present a case of a 73-year-old man with a previous history of prostate cancer that had the incidental finding of an (18)F-fluorodeoxyglucose (FDG) image of a highly avid parapharyngeal space lesion noted on a follow-up positron emission tomography-computed tomography (PET/CT) scan. Excision of the mass, through a transcervical approach, demonstrated it to be an isolated oncocytoma of the parapharyngeal space, noncontiguous with the parotid gland. Based on our literature search, this may be the first such reported case. A brief review of the available literature examining the known body of knowledge regarding these neoplasms is presented.
Topics: Adenoma, Oxyphilic; Aged; Biopsy, Fine-Needle; Humans; Male; Oxyphil Cells; Pharyngeal Neoplasms; Positron-Emission Tomography
PubMed: 19787785
DOI: 10.1002/hed.21237 -
Acta Oto-laryngologica Jul 2002
Review
Topics: Head and Neck Neoplasms; Humans; Lymphatic Metastasis; Pharyngeal Neoplasms
PubMed: 12206269
DOI: 10.1080/00016480260092408