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BMJ Case Reports Dec 2020A 57-year-old male chronic smoker with underlying diabetes mellitus presented with dysphonia associated with cough, dysphagia and reduced effort tolerance of 3 months'...
A 57-year-old male chronic smoker with underlying diabetes mellitus presented with dysphonia associated with cough, dysphagia and reduced effort tolerance of 3 months' duration. Videoendoscope finding revealed bilateral polypoidal and erythematous true and false vocal fold with small glottic airway. The patient was initially treated as having tuberculous laryngitis and started on antituberculous drug. However, no improvement was observed. CT of the neck showed erosion of thyroid cartilage, which points to laryngeal carcinoma as a differential diagnosis. However, the erosion was more diffuse and appeared systemic in origin. The diagnosis of laryngeal perichondritis was made when the histopathological examination revealed features of inflammation, and the tracheal aspirate isolated The patient made a good recovery following treatment with oral ciprofloxacin.
Topics: Anti-Bacterial Agents; Ciprofloxacin; Cough; Deglutition Disorders; Diagnosis, Differential; Dysphonia; Humans; Laryngeal Diseases; Laryngeal Neoplasms; Laryngoscopy; Male; Middle Aged; Pseudomonas Infections; Pseudomonas aeruginosa; Thyroid Cartilage; Tomography, X-Ray Computed; Treatment Outcome; Tuberculosis, Laryngeal; Vocal Cords
PubMed: 33370978
DOI: 10.1136/bcr-2020-237129 -
Cancer Control : Journal of the Moffitt... Apr 2006Well-differentiated thyroid carcinoma (WDTC) includes three main entities: papillary thyroid carcinoma (PTC), follicular thyroid carcinoma (FTC), and Hurthle cell... (Review)
Review
BACKGROUND
Well-differentiated thyroid carcinoma (WDTC) includes three main entities: papillary thyroid carcinoma (PTC), follicular thyroid carcinoma (FTC), and Hurthle cell carcinoma (HCC). A thorough knowledge of the natural history and presentation of these carcinomas is vital to the thyroid surgeon.
METHODS
This review details the preoperative workup of patients having or suspected to have WDTC. We review the history, physical examination, laboratory, and radiographic evaluations that optimally prepare the surgeon to determine the ideal surgical thyroid and neck treatment for patients with WDTC.
RESULTS
A fiberoptic evaluation of the larynx is integral to the physical examination, and a laryngeal assessment is performed for all patients who will undergo thyroid surgery. It must be noted that vocal cord paralysis can be subtle and does not always present with clear dysphagia or voice change. Ultrasound and FNA are the primary tools of preoperative assessment. Given that patients with preoperative FNA positive for papillary cancer are expected to have clinically significant nodal disease in one third of cases, radiographic evaluation must be appropriately aggressive. The combination of US and CT allows assessment of the central and lateral neck nodes and the thyroid's relationship to central neck viscera.
CONCLUSIONS
The overriding principle in the surgical treatment of WDTC is that the surgeon recognizes and encompasses all gross disease in the thyroid and neck nodes at first surgery. The extent of thyroidectomy is tailored not only to the patient's risk group and gross operative findings but also to the progress of the specific surgery in terms of parathyroid and recurrent laryngeal nerve preservation.
Topics: Adenocarcinoma, Follicular; Biopsy, Fine-Needle; Carcinoma, Papillary; Cell Differentiation; Fluorodeoxyglucose F18; Humans; Magnetic Resonance Imaging; Preoperative Care; Thyroid Neoplasms; Thyroidectomy; Tomography, X-Ray Computed
PubMed: 16735983
DOI: 10.1177/107327480601300203 -
AJNR. American Journal of Neuroradiology Feb 2010Pediatric upper airway carcinoma is uncommon, symptoms are nonspecific, and diagnosis is often delayed. In this study, we describe the imaging, cytogenetics, and...
BACKGROUND AND PURPOSE
Pediatric upper airway carcinoma is uncommon, symptoms are nonspecific, and diagnosis is often delayed. In this study, we describe the imaging, cytogenetics, and clinical courses of 4 patients with pediatric upper airway carcinoma.
MATERIALS AND METHODS
Four patients with upper airway carcinoma were identified during a 2.5-year period. CT (n = 4) and MR imaging (n = 3) studies, tumor histopathologic features and cytogenetics, patient treatment, and clinical course were reviewed.
RESULTS
Patients were aged 12 to 15 years. One tumor involved the larynx with poorly defined margins and heterogeneous enhancement; 1 heterogeneously enhancing tumor involved the epiglottis with necrotic cervical lymphadenopathy. There were 2 enhancing sinonasal tumors with bony destruction in 1 tumor. Tumors had a relatively short relaxation time on FSEIR MR imaging. Histopathologic examination revealed poorly differentiated squamous cell carcinoma (n = 3) and well-differentiated squamous cell carcinoma (n = 1). Cytogenetic analysis revealed chromosomal abnormalities in 3 tumors: 2 showed a chromosomal translocation t(15;19), and 1 showed a chromosomal translocation t(1;5) and loss of a portion of chromosome 22q. Results of in situ hybridization for EBV were negative (n = 3). Treatment included tumor resection (n = 2), chemotherapy (n = 4), and radiation therapy (n = 3). Patients with t(15;19) died months after diagnosis. Two patients were alive at 8-year follow-up.
CONCLUSIONS
Childhood carcinoma of the upper airway is uncommon but should be considered in the diagnosis of upper airway tumors that display aggressive imaging characteristics. Carcinoma with t(15;19) is rare but has been reported, usually in young patients with midline carcinoma of the neck or mediastinum, with a rapidly fatal course.
Topics: Adolescent; Carcinoma, Squamous Cell; Child; Chromosomes, Human, Pair 15; Chromosomes, Human, Pair 19; Epiglottis; Female; Glottis; Humans; In Situ Hybridization, Fluorescence; Laryngeal Neoplasms; Magnetic Resonance Imaging; Male; Nose Neoplasms; Retrospective Studies; Tomography, X-Ray Computed; Translocation, Genetic
PubMed: 19779003
DOI: 10.3174/ajnr.A1800 -
BMJ Case Reports Jul 2021Lymphoepithelial carcinoma (LEC) is an entity mostly frequent in the nasopharynx, which represents 40% of all neoplasms. The incidence's not exclusive of a geographic...
Lymphoepithelial carcinoma (LEC) is an entity mostly frequent in the nasopharynx, which represents 40% of all neoplasms. The incidence's not exclusive of a geographic area; however, it has an endemic distribution in Southeast Asia and Eskimos. LEC is not exclusive of the nasopharynx, has also been reported in other anatomical areas, such as the sinonasal tract, nasolacrimal duct, oral cavity, oropharynx, salivary glands, thymus, hypopharynx, oesophagus, stomach, trachea, lung and others. Non-nasopharyngeal and nasopharyngeal LEC have the same microscopic features, but the nasopharyngeal is more likely associated with Epstein-Barr virus. LEC has been approved by the WHO. LEC located in the larynx is quite rare and worthy of attention for its implication in the treatment and prognosis. We present a case of LEC treated in our ENT department in a middle-aged man.
Topics: Carcinoma, Squamous Cell; Epstein-Barr Virus Infections; Herpesvirus 4, Human; Humans; Laryngeal Neoplasms; Larynx; Male; Middle Aged
PubMed: 34285018
DOI: 10.1136/bcr-2020-241460 -
European Archives of... Jan 2022Non-squamous cell carcinoma (non-SCC) accounts for about 5% of laryngeal malignancies. Survival data are limited, and consensus on management principles is lacking. The...
PURPOSE
Non-squamous cell carcinoma (non-SCC) accounts for about 5% of laryngeal malignancies. Survival data are limited, and consensus on management principles is lacking. The present study reviews our experience in the surgical treatment of non-metastatic non-SCC of the larynx and compares oncological and functional outcomes in a cohort of patients affected by traditional SCC.
METHODS
We collected data on 592 patients affected by laryngeal neoplasms. Univariate and multivariable survival analyses were performed using Cox proportional-hazards models; survival estimates were reported by hazard ratios (HR) with 95% confidence intervals (CI), and survival curves were established with the Kaplan-Meier method.
RESULTS
We identified 326 patients affected by untreated SCC, while 21 had non-SCC histotypes. The non-SCC cohort was composed of 5 soft tissue sarcomas, 8 chondrosarcomas, 2 adenoid cystic carcinomas, 2 neuroendocrine carcinomas, 2 solitary fibrous tumors, 1 Kaposi's sarcoma, and 1 malignant peripheral nerve sheath tumor. Overall survival and disease-specific survival were not significantly different according to histology (p = 0.6 and p = 0.349, respectively). The non-SCC group showed an increased risk of recurrence (HR 5.87; CI 2.15-16.06; p < 0.001). Nonetheless, no significant difference (p = 0.31) was found at multivariable analysis between the two groups in total laryngectomy-free survival with an organ preservation rate over 5 years of 81% for the non-SCC histologies.
CONCLUSION
Non-SCC is a broad spectrum pathology, but generalized laryngeal surgical management principles are still feasible and it is possible to identify patients amenable to conservative surgical treatment without affecting survival.
Topics: Humans; Laryngeal Neoplasms; Laryngectomy; Larynx; Neoplasm Staging; Retrospective Studies
PubMed: 34557960
DOI: 10.1007/s00405-021-07076-x -
Journal of Osteopathic Medicine Jul 2021
Topics: Carcinoma, Squamous Cell; Epiglottis; Humans
PubMed: 34261201
DOI: 10.1515/jom-2021-0071 -
Head and Neck Pathology Sep 2020Basaloid squamous cell carcinoma (BSCC) with a spindle cell component of the head and neck is an uncommon entity. In this case, we present a radiology-pathology...
Basaloid squamous cell carcinoma (BSCC) with a spindle cell component of the head and neck is an uncommon entity. In this case, we present a radiology-pathology correlation of a rare laryngeal BSCC with sarcomatous transformation and osteosarcomatous differentiation involving the laryngeal cartilage, which thus mimicked clinically and radiographically osteosarcoma or chondrosarcoma with calcification. Microscopic examination revealed predominantly BSCC with extensive osseous metaplasia among sheets and nests of basaloid tumor cells. There were also small foci of osteosarcoma, undifferentiated pleomorphic sarcoma, and spindle cell carcinoma. The presence of squamous cell carcinoma (SCC) in-situ, small areas of conventional SCC and diffuse positivity of p40 in conventional and basaloid squamous components confirmed that this tumor was indeed derived from surface squamous epithelium. Awareness of the broad differentiation potentials of SCC can avoid misdiagnosis of SCCs as sarcoma. This case emphasizes the importance of radiologic-pathologic correlation in definitive diagnosis and clinical management of laryngeal malignancies.
Topics: Alcohol Drinking; Cell Differentiation; Diagnosis, Differential; Humans; Laryngeal Neoplasms; Male; Middle Aged; Sarcoma; Smoking; Squamous Cell Carcinoma of Head and Neck; Thyroid Cartilage; Tobacco, Smokeless
PubMed: 31873935
DOI: 10.1007/s12105-019-01119-w -
Head & Neck Dec 2020Our purpose is to review the role radiotherapy (RT) in the treatment of glottic squamous cell carcinoma (SCC). (Review)
Review
INTRODUCTION
Our purpose is to review the role radiotherapy (RT) in the treatment of glottic squamous cell carcinoma (SCC).
METHODS
A concise review of the pertinent literature.
RESULTS
RT cure rates are Tis- T1N0, 90% to 95%; T2N0, 70% to 80%; low-volume T3-T4a, 65% to 70%. Concomitant cisplatin is given for T3-T4a SCCs. Severe complications occur in 1% to 2% for Tis-T2N0 and 10% for T3-T4a SCCs. Patients with high-volume T3-T4 SCCs undergo total laryngectomy, neck dissection, and postoperative RT. Those with positive margins and/or extranodal extension receive concomitant cisplatin. The likelihood of local-regional control at 5 years is 85% to 90%. Severe complications occur in 5% to 10%.
CONCLUSIONS
RT is a good treatment option for patients with Tis-T2N0 and low-volume T3-T4a glottic SCCs. Patients with higher volume T3-T4 cancers are best treated with surgery and postoperative RT.
Topics: Carcinoma, Squamous Cell; Glottis; Head and Neck Neoplasms; Humans; Laryngeal Neoplasms; Laryngectomy; Neoplasm Staging; Retrospective Studies
PubMed: 32896071
DOI: 10.1002/hed.26419 -
Brazilian Journal of Otorhinolaryngology 2020Squamous cell carcinoma is the most common laryngeal neoplasm and accounts for approximately 95% of all malignant neoplams of the larynx. However, various benign and...
INTRODUCTION
Squamous cell carcinoma is the most common laryngeal neoplasm and accounts for approximately 95% of all malignant neoplams of the larynx. However, various benign and malignant tumors and inflammatory diseases may affect the larynx.
OBJECTIVE
The purpose of this study is to analyze the clinical and imaging findings of non-squamous cell neoplasms and inflammatory diseases of the larynx.
METHODS
This retrospective study was conducted in 18 patients who were diagnosed with non-squamous cell carcinoma lesions of larynx at our institution between 2007-2017. Clinical symptoms, examination findings, imaging characteristics, histopathologic diagnosis and treatment modalities were analyzed.
RESULTS
There were 9 malignant lesions (2 chondrosarcoma, 1 neuroendocrine tumor-atipical carcinoid, 1 Natural Killer/T-cell lymphoma, 1 diffuse large B-cell lymphoma, 3 plasmocytoma-multiple myeloma involvement, 1 adenocarcinoma metastasis), 3 benign neoplasms (chondroma, paraganglioma, lipoma), 2 tumor-like lesions (Brown tumor and inflammatory myofibroblastic tumor), 3 inflammatory lesions (Wegener granulomatosis, Behçet's disease and tuberculosis involvements), and 1 vascular malformation. The most common presenting symptom was hoarseness (66.6%). Paraganglioma was seen as hypervascular lesion on computed tomography and magnetic resonance imaging and showed intense tracer uptake on 68Gallium-DOTA-peptide PET/CT. Chondroid matrix calcifications were detected in chondroma and chondrosarcoma-grade 1. In patients with vascular malformation and lipoma, the typical imaging findings made it possible to diagnose.
CONCLUSION
Imaging studies may provide clues for diagnosis of non-squamous cell laryngeal lesions. Clinical and imaging findings and previous clinical history should be evaluated together in clinical management of laryngeal lesions.
Topics: Bone Neoplasms; Carcinoma, Squamous Cell; Humans; Laryngeal Neoplasms; Larynx; Positron Emission Tomography Computed Tomography; Retrospective Studies
PubMed: 30956151
DOI: 10.1016/j.bjorl.2019.02.003 -
Scientific Reports Aug 2016This study aimed to compare the accuracy of CT and MRI in determining the invasion of thyroid cartilage by and the T staging of laryngeal carcinoma with anterior vocal... (Comparative Study)
Comparative Study
This study aimed to compare the accuracy of CT and MRI in determining the invasion of thyroid cartilage by and the T staging of laryngeal carcinoma with anterior vocal commissure (AVC) involvement. A total of 26 cases of laryngeal carcinomas with AVC involvement from May 2012 to January 2014 underwent enhanced CT and MRI scan, out of whom 6 patients also underwent diffusion-weighted magnetic resonance imaging(DWI). T staging and thyroid cartilage involvement were evaluated. All the surgical specimens underwent serial section and were reviewed by two senior pathologists independently. When compared with pathologic staging, the accuracy was 88.46% (23/26) of MRI scan (with a 95% confidence interval 37~77%) and 57.69% (15/26) of CT scan (with a 95% confidence interval 70~98%), respectively (P < 0.01). We also reported three cases who were misdiagnosed on CT or MRI about either the thyroid cartilage was involved or not, and one case of preliminary study of DWI. Compared to CT, MRI exhibited a higher accuracy rate on T staging of laryngeal carcinomas with AVC involvement. Combined utility of CT and MRI could help improve the accuracy of assessment of thyroid cartilage involvement and T staging of laryngeal carcinomas with AVC involvement.
Topics: Aged; Aged, 80 and over; Carcinoma; Diffusion Magnetic Resonance Imaging; Humans; Image Processing, Computer-Assisted; Laryngeal Neoplasms; Male; Middle Aged; Reproducibility of Results; Thyroid Cartilage; Tomography, X-Ray Computed; Vocal Cords
PubMed: 27480073
DOI: 10.1038/srep30353