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The Neuroradiology Journal Jun 2017Squamous cell carcinoma is the most common head and neck cancer. This review describes the state-of-the-art computerised tomography and magnetic resonance imaging... (Review)
Review
Squamous cell carcinoma is the most common head and neck cancer. This review describes the state-of-the-art computerised tomography and magnetic resonance imaging protocols of the neck and the normal larynx anatomy, and provides a practical approach for the diagnosis and staging of laryngeal squamous cell carcinoma.
Topics: Carcinoma, Squamous Cell; Humans; Laryngeal Neoplasms; Larynx; Magnetic Resonance Imaging; Neoplasm Staging; Sensitivity and Specificity; Tomography, X-Ray Computed
PubMed: 28627987
DOI: 10.1177/1971400916689373 -
Histopathology May 2017NUT midline carcinoma (NMC) is a rare undifferentiated and aggressive carcinoma that locates characteristically to the midline of the head and neck, and mediastinum. NMC... (Review)
Review
AIMS
NUT midline carcinoma (NMC) is a rare undifferentiated and aggressive carcinoma that locates characteristically to the midline of the head and neck, and mediastinum. NMC is characterized by chromosomal rearrangements of the gene NUT, at 15q14. The BRD4 gene on 19q13 is the most common translocation partner forming a fusion oncogene, BRD4-NUT. By the end of 2014, the International NUT Midline Carcinoma Registry had 48 patients treated for NMC. Laryngeal NMC are exceedingly rare, and we report a case series of seven cases.
METHODS AND RESULTS
We searched for cases in files of different hospitals as well as a thorough search of the English language literature. The diagnosis of NMC is made by demonstration of NUT rearrangement either by immunohistochemistry, fluorescence in-situ hybridization (FISH) or reverse transcription-polymerase chain reaction (RT-PCR). We found three previously published cases, and in this series add four cases of our own.
CONCLUSIONS
NMC consists of monomorphic, often discohesive, cells with an epithelioid appearance and distinct nucleoli. The tumours typically show abrupt squamous differentiation. The mean age of the patients was 34 years, hence significantly lower than that for conventional laryngeal carcinoma. All tumours were located in the supraglottis and five patients died of the disease after 3, 7, 8, 9 and 11 months. Laryngeal NMC may be underdiagnosed, and an increased awareness among pathologists is warranted. NMC has characteristic morphological features, and positive immunostaining with the NUT antibody is diagnostic. Its aggressive behaviour demands a very intense treatment strategy and the need for its recognition is emphasized further by new promising treatment strategies.
Topics: Adolescent; Adult; Aged; Carcinoma; Child; Child, Preschool; Female; Humans; Laryngeal Neoplasms; Male; Middle Aged; Neoplasm Proteins; Nuclear Proteins; Oncogene Proteins
PubMed: 27926786
DOI: 10.1111/his.13143 -
Journal of Otolaryngology - Head & Neck... Mar 2021Supracricoid partial laryngectomy has good oncologic results in the treatment of advanced laryngeal cancer with the advantage of preserving larynx phonatory function...
BACKGROUND
Supracricoid partial laryngectomy has good oncologic results in the treatment of advanced laryngeal cancer with the advantage of preserving larynx phonatory function when compared with total laryngectomy. However the rehabilitation could be a challenge, especially regarding swallowing function. Is supracricoid partial laryngectomy associated with better quality of life than total laryngectomy?
METHODS
Survey study that included 33 patients (16 total laryngectomy and 17 supracricoid partial laryngectomy) with advanced larynx cancer surgically treated and fully rehabilitated. The quality of life were evaluated with EORTC QLQ C30 and H&N 35 instrument.
RESULTS
Patients who underwent supracricoid partial laryngectomy obtained better scores in global health status-quality of life and general activities and had lower levels of sensory and speech-related symptoms.
CONCLUSION
SPL was associated with better quality of life when compared with TL.
Topics: Female; Humans; Laryngeal Neoplasms; Laryngectomy; Male; Middle Aged; Neoplasm Staging; Quality of Life
PubMed: 33766134
DOI: 10.1186/s40463-021-00499-w -
Head & Neck Oncology May 2009The principles of management of the laryngeal cancer have evolved over the recent past with emphasis on organ preservation. These developments have paralleled... (Review)
Review
The principles of management of the laryngeal cancer have evolved over the recent past with emphasis on organ preservation. These developments have paralleled technological advancements as well as refinement in the surgical technique. The surgeons are able to maintain physiological functions of larynx namely speech, respiration and swallowing without compromising the loco-regional control of cancer in comparison to the more radical treatment modalities. A large number of organ preservation surgeries are available to the surgeon; however, careful assessment of the stage of the cancer and selection of the patient is paramount to a successful outcome. A comprehensive review of various organ preservation techniques in vogue for the management of laryngeal cancer is presented.
Topics: Catheter Ablation; Combined Modality Therapy; Humans; Laryngeal Neoplasms; Laryngectomy; Laryngoscopy; Organ Preservation; Plastic Surgery Procedures; Robotics
PubMed: 19442314
DOI: 10.1186/1758-3284-1-12 -
Head & Neck Oncology Jul 2009Neurogenic tumors of the larynx are extremely rare. The goal of this report is to advert to this rare disease, to review and discuss diagnostics, differential diagnoses...
OBJECTIVES
Neurogenic tumors of the larynx are extremely rare. The goal of this report is to advert to this rare disease, to review and discuss diagnostics, differential diagnoses and treatment options.
STUDY DESIGN
Retrospective case report and review of the literature.
METHODS
Case report of a schwannoma of the supraglottic larynx and review of the English- and German-language literature regarding neurogenic tumors of the larynx.
RESULTS
Neurogenic laryngeal tumors typically involve the supraglottic larynx, rarely the glottis. They can course globus sensation, dysphagia, dysphonia and upper airway obstruction. Imaging does not yield a definite diagnosis. The only curative treatment option is complete surgical resection.
CONCLUSIONS
A definite diagnosis can only be made histologically. Endoscopic (laser-) resection for smaller lesions and external approaches for larger lesions are recommended treatment options.
Topics: Adult; Female; Humans; Laryngeal Neoplasms; Magnetic Resonance Imaging; Neurilemmoma; Tomography, X-Ray Computed
PubMed: 19586539
DOI: 10.1186/1758-3284-1-24 -
Head & Neck Dec 2009Neuroendocrine neoplasms of the larynx are rare but are the most common nonsquamous tumors of this organ. In the past, there has been considerable confusion about the... (Review)
Review
Neuroendocrine neoplasms of the larynx are rare but are the most common nonsquamous tumors of this organ. In the past, there has been considerable confusion about the nature and classification of these neoplasms, but the current consensus is that there are 4 different types of laryngeal neuroendocrine tumors composed of paraganglioma, typical carcinoid, atypical carcinoid tumor, and small cell neuroendocrine carcinoma. Carcinoids and small cell neuroendocrine carcinomas are epithelial neoplasms, whereas paragangliomas are of neural origin. Diagnosis is based primarily on light microscopy and confirmed by immunohistochemistry and electron microscopy. Precise diagnosis is essential because the natural history, treatment, and prognosis vary widely for the different neoplastic categories. Typical carcinoids are very rare and are treated by wide local excision, usually partial laryngectomy, without elective neck dissection. Atypical carcinoid tumors are more common and more aggressive. They are treated by partial or total laryngectomy with elective or therapeutic neck dissection. Adjuvant chemo/radiotherapy may be of benefit in some cases. Small cell neuroendocrine carcinomas are highly aggressive and should be considered disseminated at initial diagnosis. The treatment is by irradiation and chemotherapy as surgery has proven to be of a little benefit. Paragangliomas are treated by local excision or partial laryngectomy. It is difficult to determine the valid survival statistics for typical carcinoids because of their rarity and confusion in the literature with their atypical counterparts. They have a greater tendency to metastasize, and thus a worse prognosis than was previously believed. Atypical carcinoid tumors have a 5-year survival rate of approximately 50%, which decreases with time. The prognosis of small cell neuroendocrine carcinoma of the larynx is dismal, with 5-year survival rates of 5%. The biological behavior of laryngeal paraganglioma is generally benign and the prognosis is excellent.
Topics: Carcinoid Tumor; Carcinoma, Small Cell; Chemotherapy, Adjuvant; Combined Modality Therapy; Female; Humans; Laryngeal Neoplasms; Laryngectomy; Male; Neck Dissection; Neoplasm Staging; Neuroendocrine Tumors; Paraganglioma; Prognosis; Radiotherapy, Adjuvant; Risk Assessment; Survival Analysis
PubMed: 19536850
DOI: 10.1002/hed.21162 -
Advances in Clinical and Experimental... 2017Human papillomavirus (HPV) belongs to the Papillomaviridae family and infects squamous cells and mucous membranes of humans. Various studies conducted over the last... (Review)
Review
Human papillomavirus (HPV) belongs to the Papillomaviridae family and infects squamous cells and mucous membranes of humans. Various studies conducted over the last years have shown a correlation between HPV infection and carcinogenesis process. The DNA of the virus is detected in approximately 20% of cancers of the upper respiratory tract. The presence of HPV in cancerous lesion of the larynx varies depending on the procedure applied for sample collection and the viral DNA detection method. The high variance in the frequency of HPV detection is observed even among results obtained with the use of PCR reaction. It varies between 3 and 85%. HPV is also the etiological factor of laryngeal papillomas in both children and adults. However, a considerable amount of research demonstrates that 1-7% of the larynx papillomas in adults undergo transformation into squamous cell carcinoma. The aim of the study was to summarize the current state of knowledge regarding the presence of the HPV virus in the larynx as well as its participation in malignant transformation.
Topics: Cell Transformation, Neoplastic; DNA, Viral; Humans; Laryngeal Neoplasms; Papillomaviridae; Papillomavirus Infections; Precancerous Conditions
PubMed: 28791831
DOI: 10.17219/acem/67461 -
Head & Neck Nov 2011Evidence-based medicine integrates the best available data in decision making, with the goal of minimizing physicians' and patients' subjectivity. In 2006, the American... (Comparative Study)
Comparative Study Review
Evidence-based medicine integrates the best available data in decision making, with the goal of minimizing physicians' and patients' subjectivity. In 2006, the American Society of Clinical Oncology edited clinical practice guidelines for the use of larynx preservation strategies. The objective of this review was to evaluate the current levels of evidence for glottic squamous cell carcinoma. Current guidelines for early stage glottic cancer are based on low-level evidence. Conservation surgery (open or transoral) and radiation therapy are all valid options for T1 and selected T2 lesions. For advanced lesions, surgery and combined chemotherapy and radiation are options. High-level evidence favors combined chemotherapy and radiation therapy or altered fractionation radiation therapy as nonsurgical strategies for organ preservation, compared with radiation therapy alone. The optimal combination of chemotherapy, targeted therapy, and radiation therapy remains to be demonstrated, however, and for high-volume tumors, total laryngectomy may still be warranted.
Topics: Carcinoma, Squamous Cell; Chemoradiotherapy; Disease-Free Survival; Evidence-Based Medicine; Female; Glottis; Humans; Immunohistochemistry; Laryngeal Neoplasms; Laryngectomy; Laser Therapy; Male; Neoplasm Recurrence, Local; Neoplasm Staging; Prognosis; Randomized Controlled Trials as Topic; Risk Assessment; Survival Analysis; Treatment Outcome
PubMed: 21990228
DOI: 10.1002/hed.21528 -
Acta Otorhinolaryngologica Italica :... Dec 2016Residual or recurrent laryngeal cancer after irradiation is a difficult clinical problem with a rate that ranges from 13% to 36% of cases. Supracricoid laryngectomy... (Meta-Analysis)
Meta-Analysis Review
Residual or recurrent laryngeal cancer after irradiation is a difficult clinical problem with a rate that ranges from 13% to 36% of cases. Supracricoid laryngectomy (SCL) with cricohyoidopexy (CHP) or cricohyoidoepiglottopexy (CHEP) provide reliable oncological and functional results for selected primary and recurrent patients with glottic and supraglottic carcinomas. We conducted a systematic review and meta-analysis to assess the oncological and functional outcomes of patients treated with open partial horizontal laryngectomy types IIa and IIb (CHEP, CHP) in terms of the recurrence of squamocellular cancer of the larynx after radiotherapy failure. The databases searched included MEDLINE, PubMed and EMBASE (from January 1990 to December 2015, English language). The meta-analysis was performed with a mixed random effects model using the DerSimonian and Laird method. The heterogeneity was measured with the I statistic. Fourteen papers out of 276 were included and comprised a total of 291 patients. The five-year overall survival was 80.2% (CI 0.719-0.885; I = 62%; p = 0.003), and the 5-year disease-free survival was 89.5% (CI 0.838-0.952; I = 52%; p = 0.022). The indications for SCL after the failure of radiation therapy (RT) were similar to those specified for previously untreated patients. We therefore hypothesised that careful assessment of tumour extension might be responsible for the high 5-year OS and 5-year DFS. The early postoperative recovery outcomes indicated that the mean time until decannulation was 35.6 days (CI 24.3-46.9; I = 95%; p < 0.001), and the mean time until nasogastric tube (NGT) or percutaneous endoscopic gastrostomy (PEG) removal was 28.3 days (CI 22.7-33.8; I = 86%; p< = 0.001). These data are according to authors who prefer the initial removal of the NGT and the initiation of oral alimentation with a tracheostomy tube to protect and clean the airways and permit the suction of any residual food that might be present.
Topics: Carcinoma, Squamous Cell; Chemoradiotherapy; Cricoid Cartilage; Humans; Laryngeal Neoplasms; Laryngectomy; Neoplasm Recurrence, Local
PubMed: 28177326
DOI: 10.14639/0392-100X-1063 -
Head & Neck Dec 2021High-grade neuroendocrine carcinoma of the larynx (HG-NECL) is rare and aggressive with limited data regarding response to systemic therapy. We evaluated...
BACKGROUND
High-grade neuroendocrine carcinoma of the larynx (HG-NECL) is rare and aggressive with limited data regarding response to systemic therapy. We evaluated clinicopathological features, therapeutic approaches, and outcomes in patients with laryngeal or hypopharyngeal HG-NECL.
METHODS
Data were retrospectively collected through 1997-2020. Median disease-free (mDFS), progression-free (mPFS), and overall survival (mOS) were estimated using the Kaplan-Meier method.
RESULTS
Fifteen patients were identified; most had locoregional (N = 7) or metastatic disease (N = 5). The main curative-intent treatment was chemoradiation concurrent with platinum-based chemotherapy; the rate of complete response was 78%. Most patients (80%) developed recurrence; the mDFS was 13.1 months. For the first-line palliative therapy, the ORR and mPFS were 50% and 3.1 months, respectively. For all patients, the mOS was 17.8 months, and 8.6 months for metastatic disease.
CONCLUSION
Laryngeal HG-NEC is associated with high relapse rates and dismal prognosis for those with recurrent/metastatic disease. Novel therapeutic strategies are needed.
Topics: Carcinoma, Neuroendocrine; Humans; Hypopharynx; Laryngeal Neoplasms; Larynx; Neoplasm Recurrence, Local; Retrospective Studies; Survival Rate
PubMed: 34524729
DOI: 10.1002/hed.26865