1/97. Gastric adenocarcinoma with tonsil and submaxillary gland metastases: case report.Local invasion, hematogenous and lymphatic metastases are the major modes of spreading gastric cancer. The most common sites of metastases in patients with gastric cancer are liver, peritoneum, omentum, lungs and mesentery. Of the two pathological types of gastric cancer, intestinal-type gastric cancer showed preferential metastasis to the liver, whereas the diffuse-type showed a preference for peritoneal involvement and lymph node metastasis. However, metastases of gastric cancer to the head and neck regions are not common. The hematogenous route appears to account for a great majority of metastases to the head and neck regions. Malignant neoplasm metastases to major salivary glands or tonsils are not common. Several patients with cancers from the infraclavicular area have been reported with parotid gland or tonsil metastases. However, metastasis of gastric adenocarcinoma to the tonsils or submandibular glands is rare. We present a patient with recurrent gastric adenocarcinoma with both tonsil and submandibular gland metastases which is even rarer.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |
2/97. Late onset of tonsillar metastasis from breast cancer.A 71-year-old woman non-smoker referred for repeated haemoptysis showed a tumoral lesion of the left tonsil. Pathological analysis of the biopsy showed characteristics compatible with a breast carcinoma metastasis, in which oestrogen and progesterone receptors were present. The patient had undergone mastectomy and had received adjuvant radiotherapy 24 years previously for a breast cancer with no complaints or signs of recurrence since. Investigations showed disseminated bone metastases but no other soft-tissue deposits. Anti-oestrogen therapy was applied. Only seven similar cases of tonsillar metastasis from breast cancer have been reported.- - - - - - - - - - ranking = 0.16666666666667keywords = carcinoma (Clic here for more details about this article) |
3/97. Bilateral synchronous tonsillar carcinoma.Synchronous cancers occur in four per cent of patients with head and neck malignancies but no bilateral synchronous tonsillar carcinomas have been described in the English literature. We describe the first such case and discuss the prognostic aspect of this carcinoma. In the presence of contralateral neck nodes in patients with head and neck malignancies, a careful search should be made for a second head and neck primary.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |
4/97. Multilobated large B-cell lymphoma diagnosed cytologically. A case report.BACKGROUND: Fine needle aspiration (FNA) biopsy can be used to reliably classify most conditions involving lymph nodes or, at least, significantly reduce the differential diagnosis. CASE: A 70-year-old male presented with an ulcerated mass arising from the left tonsillar fossa and involving the anterior and posterior pillars. A biopsy of the tonsillar mass performed at an outside hospital was interpreted as a large cell undifferentiated carcinoma. Subsequently the patient developed systemic lymphadenopathy. A bone scan showed intense uptake within the medial tibial plateau of the left knee. FNA biopsy of the right axillary mass was interpreted at University of Cincinnati Medical College as a large cell lymphoma, multilobated type. Histologic and immunohistochemical studies of the lymph node confirmed the presence of multilobated B-cell lymphoma. lymphoma chemotherapy was initially successful but was discontinued due to toxicity. The patient died two months after the initial cytologic diagnosis of lymphoma. CONCLUSION: Multilobated lymphomas are an unusual variant of non-Hodgkin's lymphomas (mostly B-cell type). Cytology and immunocytochemistry are useful diagnostic procedures that can help to diagnose this relatively uncommon type of lymphoma and significantly reduce the possibility of misdiagnosis.- - - - - - - - - - ranking = 0.16666666666667keywords = carcinoma (Clic here for more details about this article) |
5/97. Acute leukemia following prolonged cytotoxic agent therapy.1. Nine patients in whom acute non-lymphoblastic leukemia (ANLL) developed following prolonged alkylating agent therapy are described. Five of the patients received no radiotherapy. The conditions treated were: Hodgkin's disease (four patients), primary amyloidosis, primary macroglobulinemia, malignant lymphoma, multiple myeloma, and carcinoma of the tonsil. 2. Prior to the advent of chemotherapy, this complication was not observed in large series of patients with lymphoproliferative disorders and multiple myeloma. However, the medical literature now contains at least 125 other detailed reports of ANLL developing after prolonged cytotoxic agent therapy. 3. multiple myeloma and Hodgkin's disease, both of which commonly have good responses to chemotherapy, predominate as the underlying diseases. However, 35% of the case reports involve patients with other illnesses, including 12 patients who did not have neoplasms. 4. More than half of the patients developing ANLL have received chemotherapy alone without radiotherapy. 5. At least half of the patients developing ANLL experienced long periods of significant cytopenia during therapy, often with documentation of bone marrow dysplasia. 6. The wide variety of drugs associated with this complication suggests that any cytotoxic agent may be leukemogenic. However, alkylating agents overwhelmingly predominate as the class of compounds which are most often associated with terminal ANLL. 7. The vast majority of patients reported in the literature with ANLL complicating underlying malignancies have received cytotoxic drugs for prolonged periods (median 3 1/2 years) and leukemia developed most commonly 3 to 5 years after the diagnosis of the underlying disease. Most of these patients benefited from therapy and survived longer (median 5 years) than historical control of untreated patients. 8. The leukemogenic potential in man of prolonged cytotoxic agents therapy, especially with alkylating agents, seems to be well established. This evidence admonishes against the prolonged use of these drugs in non-fatal disorders. 9. More accurate assessment of risk: benefit ratios awaits the results of prospective controlled studies. The results of these studies could also lead to significant modifications in recommendations for long-term maintenance therapy with cytotoxic agents.- - - - - - - - - - ranking = 0.16666666666667keywords = carcinoma (Clic here for more details about this article) |
6/97. 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 = 0.16666666666667keywords = carcinoma (Clic here for more details about this article) |
7/97. Metastatic melanoma of the tonsil.Metastasis to the tonsils from malignant melanoma is rare. This paper describes one such case in a woman with synchronous breast adenocarcinoma and cutaneous malignant melanoma who had a most unusual clinical course.- - - - - - - - - - ranking = 0.16666666666667keywords = carcinoma (Clic here for more details about this article) |
8/97. Waldeyer's ring lymphoma presenting as massive oropharyngeal hemorrhage.A case report of a patient presenting with massive oropharyngeal hemorrhage originating from lymphoma of the tonsil and it's management is discussed. Locally advanced or recurrent squamous cell carcinoma may manifest with massive oropharyngeal hemorrhage, however, it is unusual for Waldeyer's ring lymphoma to present in this fashion. Management of oropharyngeal malignancies presenting in this manner includes airway control, control of hemorrhage, and biopsy of the tumor. hemorrhage control is provided by surgical exploration or intraarterial embolization. Extranodal lymphoma of the head and neck is not uncommon and is thoroughly discussed in the medical literature. hemorrhage into the upper aerodigestive tract is occasionally observed in the patient with head and neck cancer. It usually occurs, however, in patients with squamous cell carcinoma that have been previously treated or in patients with locally advanced cancers. A comprehensive review of the literature has revealed no other reports of head and neck lymphoma presenting with massive oropharyngeal hemorrhage.- - - - - - - - - - ranking = 0.33333333333333keywords = carcinoma (Clic here for more details about this article) |
9/97. Distinctive distribution of human papillomavirus type 16 and type 20 dna in the tonsillar and the skin carcinomas of a patient with epidermodysplasia verruciformis.BACKGROUND: epidermodysplasia verruciformis (EV) is a rare skin disease characterized by disseminated pityriasis versicolor-like or flat wart-like lesions and by the development of skin carcinomas. It is well established that specific cutaneous human papillomaviruses (EV-HPVs) are associated with both benign and malignant skin lesions in EV patients. However, little is known of the relationship between HPV and the mucosal lesions of EV patients. OBJECTIVES: To detect and identify HPV types associated with skin and mucosal lesions of an EV patient. PATIENT/methods: We investigated the skin carcinoma and the coexisting tonsillar carcinoma of a 41-year-old man with EV. Histopathologically, both lesions were squamous cell carcinomas. We analysed these two lesions by immunohistochemistry, in situ hybridization, and by molecular virology. RESULTS: Neither skin nor tonsillar lesions exhibited positivity for HPV capsid antigen by immunohistochemistry. By Southern blot hybridization, however, the skin carcinoma harboured 'EV-specific' HPV20 dna, while the tonsillar carcinoma harboured 'genital' HPV16 dna. In addition, in situ hybridization localized the respective viral dna in the corresponding lesion. CONCLUSIONS: The results indicate that EV-HPV could be responsible for the development of the skin carcinoma, but not the mucosal carcinoma in this patient.- - - - - - - - - - ranking = 2keywords = carcinoma (Clic here for more details about this article) |
10/97. Early thyrotoxic thyroiditis after radiotherapy for tonsillar carcinoma.thyroiditis with hyperthyroidism is a recognized early complication of intrathyroidal irridiation by orally ingested radiolabeled iodine I 131, but has seldom been described following external delivery of radiotherapy to the thyroid bed. We treated a man who was initially seen with a clinical picture suggestive of hyperthyroidism after receiving a course of radiotherapy for tonsillar carcinoma. Laboratory studies and thyroidal radioiodine uptake confirmed the diagnosis of thyrotoxic thyroiditis, having onset within 2 weeks of completion of the course of radiotherapy. The literature concerning thyroiditis and thyroid function following external beam radiotherapy is reviewed. Because several of the clinical features of thyrotoxic thyroiditis may resemble those resulting from the cancer under treatment or complications of its therapy, we recommend evaluation of thyroid function at the conclusion of the course of radiotherapy and 2 weeks thereafter to exclude this self-limited and treatable cause of weight loss.- - - - - - - - - - ranking = 0.83333333333333keywords = carcinoma (Clic here for more details about this article) |
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