1/7. Candida dubliniensis in radiation-induced oropharyngeal candidiasis.Candida dubliniensis is a recently described species that has been shown to cause oropharyngeal candidiasis in patients with hiv. We present a detailed evaluation of a patient undergoing head and neck radiation for oral cancer who developed oropharyngeal candidiasis from a mixed infection of C dubliniensis and candida albicans. To our knowledge, this is the first described case of C dubliniensis contributing to oropharyngeal candidiasis in this patient population.- - - - - - - - - - ranking = 1keywords = radiation-induced (Clic here for more details about this article) |
2/7. Early radiation-induced malignant fibrous histiocytoma of the oral cavity.With an incidence of less than 0.3 per cent, post-radiation sarcomas are rare malignant neoplasms with a very poor prognosis. On average, they occur after a latency period of at least 15 years following radiation therapy with doses ranging from 24 to 80 Gy. We present the case of a post-irradiation malignant fibrous histiocytoma (MFH) on the floor of the mouth in a 79-year-old male patient arising only five and a half years after radiation therapy. The primary tumour was classified as a well differentiated squamous cell carcinoma of the right rim of the tongue. Primary therapy was surgical resection of the tumour and post-operative radiation with 50 Gy. Five and a half years later, the patient developed a rapidly progressing MFH within the field of radiation.- - - - - - - - - - ranking = 1keywords = radiation-induced (Clic here for more details about this article) |
3/7. Malignant fibrous histiocytoma of the head and neck after radiation for squamous cell carcinoma.A 60-year-old man presented with malignant fibrous histiocytoma of the oropharynx. The mass extended into the nasopharynx and larynx and caused severe upper airway obstruction that required emergency tracheotomy. Ten years earlier, he had undergone a right partial glossectomy and segmental mandibulectomy for squamous cell carcinoma of the right tongue base,followed by 50 Gy of radiation delivered over 33 sessions. The tumor was so aggressive that changes in its volume were visually distinguishable during physical examination over a 2-week hospital stay. Histologic evaluation revealed 7 mitotic figures per high-power field. Although radiation-induced malignant fibrous histiocytoma is rare in the head and neck, the recent medical literature indicates that its incidence is rising. This rise has been attributed to the increased effectiveness of head and neck cancer therapy, which results in prolonging patients' survival and, hence, their risk of subsequent disease. Because malignant fibrous histiocytoma is a late complication of radiation therapy, appearing on average 10 years following treatment, it is important that physicians who treat head and neck cancer monitor these patients over the long term and remain alert for its appearance, even despite the apparent "cure" of their original neoplasm.- - - - - - - - - - ranking = 0.25keywords = radiation-induced (Clic here for more details about this article) |
4/7. Adenosquamous carcinoma of the floor of the mouth and lower alveolus: a radiation-induced lesion?A case of adenosquamous carcinoma of the floor of the mouth and alveolus that occurred following radiation therapy is described. The possible role of radiation in the etiology of this lesion is discussed, and the complex histopathologic features of this neoplasm are emphasized.- - - - - - - - - - ranking = 1keywords = radiation-induced (Clic here for more details about this article) |
5/7. Invasive squamous cell carcinoma within verrucous carcinoma.A case of invasive squamous cell carcinoma within a verrucous carcinoma is presented in order to illustrate the potential problem of underdiagnosis of these lesions. The epidemiology, natural history and histopathology of verrucous carcinoma, and features which distinguish it from invasive squamous cell carcinoma, are reviewed. Unless rigorous attention is paid to histologic detail, a focus of invasive squamous cell carcinoma may escape detection and radiation-induced anaplastic transformation may later be suspected.- - - - - - - - - - ranking = 0.25keywords = radiation-induced (Clic here for more details about this article) |
6/7. Oral post-radiation malignant fibrous histiocytoma: a clinicopathological study.Five cases of oral malignant fibrous histiocytoma (MFH) in patients who had previously received radiotherapy in the head or neck region were included in this study. There were 3 men and 2 women. Four patients had been irradiated for nasopharyngeal carcinoma (NPC) and the other for a squamous cell carcinoma (SCC) involving the tongue and mouth floor. The MFH developed 2.5-11 years after the initial radiotherapy. Two cases of MFH occurred in the maxilla, two in the mandible, and the remaining one in the tongue, floor of mouth and mandible. Clinically, the oral post-radiation MFH presented as tender, reddish, elastic, lobulated masses with surface ulceration. Radiographic examination of the involved jaws revealed a poorly defined radiolucent lesion without any periosteal or endosteal reaction. The prognosis of these tumors was very poor. Although aggressive multimodality treatment had been applied, 3 of 5 patients eventually died of the disease, with a mean survival time of 17 months after establishing the diagnosis of MFH. In order to ensure the early diagnosis and treatment of this radiation-induced second malignancy, close oral follow-up is mandatory for patients who have received radiotherapy for head and neck malignancies.- - - - - - - - - - ranking = 0.25keywords = radiation-induced (Clic here for more details about this article) |
7/7. fibula osteoseptocutaneous flap for reconstruction of composite mandibular defects.The fibula osteoseptocutaneous flap is a versatile method for reconstruction of composite-tissue defects of the mandible. The vascularized fibula can be osteotomized to permit contouring of any mandibular defect. The skin flap is reliable and can be used to resurface intraoral, extraoral, or both intraoral and extraoral defects. Twenty-seven fibula osteoseptocutaneous flaps were used for composite mandibular reconstructions in 25 patients. All the defects were reconstructed primarily following resection of oral cancers (23), excision of radiation-induced osteonecrotic lesions (2), excision of a chronic osteomyelitic lesion (1), or postinfective mandibular hypoplasia (1). The mandibular defects were between 6 and 14 cm in length. The number of fibular osteotomy sites ranged from one to three. All patients had associated soft-tissue losses. Six of the reconstructions had only oral lining defects, and 1 had only an external facial defect, while 18 had both lining and skin defects. Five patients used the skin portion of the fibula osteoseptocutaneous flaps for both oral lining and external facial reconstruction, while 13 patients required a second simultaneous free skin or musculocutaneous flap because of the size of the defects. Four of these flaps used the distal runoff of the peroneal pedicles as the recipient vessels. There was one total flap failure (96.3 percent success). There were no instances of isolated partial or complete skin necrosis. All osteotomy sites healed primarily. The contour of the mandibles was good to excellent.- - - - - - - - - - ranking = 0.25keywords = radiation-induced (Clic here for more details about this article) |