1/113. Dysphagia secondary to invasive candidiasis of a jejunal free flap.The presence of a mass in a jejunal free flap that causes dysphagia less than two years after a pharyngolaryngectomy for carcinoma usually indicates tumour recurrence. We present a case of invasive candidiasis of a jejunal free flap presenting with dysphagia and a mass. To our knowledge this is previously unreported. Such a cause should always be considered in the differential diagnosis, as early recognition and treatment are likely to result in a favourable outcome.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |
2/113. The answer is blowing in the wind: a pedunculated tumour with saw tooth flow-volume loop.Obstructing tumours of the upper airways have been demonstrated to alter the flow volume loop of pulmonary function testing. These alterations could be clues to the nature and location of the obstruction. This report describes a case of a pedunculated squamous cell carcinoma arising in the pharynx whose flow volume loop showed a saw tooth pattern which reflected the location and structure of the tumour.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |
3/113. Successful surgical treatment of a solitary parapharyngeal metastasis from thyroid cancer, using the mandibular swing-transcervical approach: report of a case.A 72-year-old man presented with a right parapharyngeal mass, 4 cm in diameter, which was subsequently diagnosed as a metastasis originating from papillary carcinoma of the thyroid gland. The parapharyngeal tumor was successfully removed by the mandibular swing-transcervical approach with pharyngeal reconstruction, performed using a buccal mucosal island flap based on the facial artery. His postoperative course was uneventful, and the preoperative clinical symptoms such as dysphagia and headaches completely resolved after surgery.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |
4/113. head and neck cancers associated with Madelung's disease.BACKGROUND: Madelung's disease is a rare lipodystrophy that presents with multiple fatty masses in the neck, trunk, and upper extremities. The fatty accumulation is considered a benign disease, but compression of the aerodigestive tract may occur in long-standing disease. methods: Eight Chinese patients with Madelung's disease were reviewed. All were male, aged 48 to 67 years, with a history of disease ranging from 4 to 20 years. Two of the eight patients developed aerodigestive symptoms and were subsequently found to have head and neck cancers. These two patients are described. RESULTS: The possible mechanism that may account for an increase in malignant tumors of the airway in this group of patients is the synergistic effect of smoking and alcohol abuse as risk factors for both Madelung's disease and malignant tumors of the airway. Currently it is recommended that these patients should have their fatty lesions removed surgically. The removal of fat facilitates examination of the neck for signs of cervical lymphadenopathy in malignant disease. CONCLUSIONS: patients with Madelung's disease should be followed regularly. The development of aerodigestive symptoms should be fully investigated with endoscopy and imaging. The cause of symptoms should not be attributed to fatty compression until a carcinoma of the upper airway has been excluded.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |
5/113. dental caries after radiotherapy of the oral regions.Five cases of dental caries after radiation therapy of the oral regions for treatment of carcinomas are presented. The differences in clinical appearance and behavior between radiation caries and ordinary smooth-surface dental caries are described. The role of salivary gland irradiation and the resultant xerostomia in the development of these lesions is discussed. Some explanations are offered as to how these lesions develop in the light of current knowledge concerning plaque and the development of dental caries. Several measures that may be taken to reduce the incidence and severity of these lesions are suggested.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |
6/113. Vallecular acinic cell carcinoma in a 9-year-old girl: report of an unusual case.An unusual case of acinic cell tumour of the vallecula is presented. Acinic cell carcinoma occurs usually in the major salivary glands. Minor salivary gland location is unusual and vallecular origin exceptional. This peculiar histologic tumour should now be classified as an low grade carcinoma and adequate treatment has to be initiated. The patient, a 9-year-old girl, had undergone a suprahyoid access for total tumor removal with a bilateral neck exploration. Postsurgical radiotherapy has to be done in case with perineural invasion, invaded margins, node invasion or high grade tumor. The clinical and histopathological findings are discussed in the light of the literature.- - - - - - - - - - ranking = 6keywords = carcinoma (Clic here for more details about this article) |
7/113. Extended esophagolaryngeal resection with parathyroid autotransplantation.Esopharyngolaryngeal resection for carcinoma of the cervical esophagus must be accompanied by resection of the thyroid gland, parathyroid bodies, and regional lymph nodes. In order to reduce long-term morbidity associated with the procedure, we performed parathyroid autotransplantation in two patients who underwent esophagolaryngeal resections. Grafting of the upper two parathyroid glands into the sternocleidomastoid muscle was carried out successfully in both cases. Graft function was rapidly restored. During the third postoperative week, blood levels of intact parathormone (PTH) reached 20 pg ml(-1) in the first case and 15 pg ml(-1) in the second, and the patients were successfully weaned off calcium and vitamin d supplementation. Parathyroid autotransplantation should be attempted in all cases of esophagolaryngeal resections provided that parathyroid glands are free of malignancy.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |
8/113. radiation-induced rhombencephalopathy.We report the case of a patient who underwent radiotherapy of the neck because of an epidermoid carcinoma in Rosenmuller's fossa. Eleven months later, T1-weighted brain magnetic resonance imaging (MRI) revealed a bulbo-pontine lesion, and the clinical course and sequential MRI results led to a diagnosis of radionecrosis-induced rhombencephalopathy. At a distance of more than three years, the lesion is no longer visible on MRI images but the severe neurological deficits remain. The clinical picture has not been improved by treatment with prednisone, hyperbaric oxygen, symptomatic therapies or anticoagulants.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |
9/113. Metastasis to a percutaneous gastrostomy site from head and neck cancer: radiobiologic considerations.BACKGROUND: The use of percutaneously placed feeding tubes has increased in recent years in an effort to maintain adequate caloric balance in patients receiving combined therapy for head and neck cancers, particularly concurrent radiotherapy and chemotherapy. methods: We report a case of a metastasis to a percutaneous endoscopic gastrostomy site occurring in a patient with an advanced tonsillar squamous cell carcinoma and review the published literature regarding this subject. Radiobiologic principles were examined to explain the most likely cause of such metastases. RESULTS: Six cases of percutaneous endoscopic site metastases occurring in patients with head and neck primary tumors have been reported in the literature. The interval from performance of the procedure to development of the metastases ranged from 3 to 16 months. Tumor kinetics suggest that a significant tumor burden (10(5)-10(6) cells) would need to be present at the site to manifest a metastatic lesion in such a short time interval. CONCLUSIONS: The development of metastases at percutaneous endoscopic gastrostomy sites is a relatively uncommon occurrence. Direct tumor implantation by means of instrumentation at the time of the procedure is most likely explanation for such metastases, although hematogenous seeding cannot be completely discounted. Techniques should be used so as not to disrupt the tumor bed, particularly when gross residual disease is present.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |
10/113. gangrene of the fingertips after bleomycin and methotrexate.The increased use of cytostatic drugs, which are sometimes used in combination chemotherapy, may result in new and unusual cutaneous side effects. We describe a 57-year-old man with acral erythrocyanosis progressing to acute digital ischemia and gangrene that developed after combined chemotherapy (bleomycin and methotrexate) used to treat a metastatic squamous cell carcinoma of the hypopharynx. A leukocytoclastic vasculitis was found in both the acute phase and in the amputated fingertips. This supports the well-reported potential of bleomycin to trigger acral vascular toxicity.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |
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