1/13. Transmucosal fine-needle aspiration diagnosis of intraoral and intrapharyngeal lesions.OBJECTIVES: The effectiveness of fine-needle aspiration biopsy (FNAB) for the diagnosis of neck, thyroid, and salivary gland masses is well documented. Very few reports explore the potential of an intraoral FNAB approach for the diagnosis of submucosal lesions. We describe our technique and present case examples of pertinent differential diagnostic entities. We recommend an expanded role for FNAB of the oral cavity and oropharynx. STUDY DESIGN: Retrospective review. methods: A uniform technique was employed for transmucosal FNAB of 76 patients with intraoral masses. In applicable cases, cytology results were compared with traditional biopsy methods and permanent histopathologic specimens for accuracy. RESULTS: Our experience demonstrates the high sensitivity (93%) and specificity (86%) of intraoral FNAB when compared with biopsy by conventional means. FNAB provides distinct advantages for the cytologic diagnosis of submucosal lesions, which may be difficult to reach and adequately sample through conventional biopsy. FNAB of the tonsil and tonsillar fossa provides a safe and effective means of diagnosing both lymphoma and squamous cell cancer. Transmucosal FNAB via the mouth led to rapid diagnosis of a number of benign and malignant lesions. Applying this uniform FNAB technique, we had no significant complications. CONCLUSION: We recommend transmucosal FNAB as an effective means for highly accurate diagnosis of submucosal lesions of the oral cavity and oropharynx. CLINICAL RELEVANCE: Traditional biopsy techniques in the oral cavity may require anesthesia and may have diagnostic difficulties, particularly for submucosal lesions. Transmucosal FNAB overcomes these shortcomings by providing a minimally invasive means to rapid diagnosis of intraoral lesions.- - - - - - - - - - ranking = 1keywords = oral cavity, cavity (Clic here for more details about this article) |
2/13. Autoamputation of the tongue.Autoamputation is an uncommon phenomenon that has been reported for the fingers, toes, appendix, ovary, spleen, etc. Autoamputation of the tongue has never been reported. An elderly man with carcinoma of lateral pharyngeal wall and tonsil presented with an autoamputated tongue that was attached to the oral cavity with a thin band. The patient required detachment of the tongue and tracheostomy followed by radiotherapy for the primary tumour.- - - - - - - - - - ranking = 0.33333333333333keywords = oral cavity, cavity (Clic here for more details about this article) |
3/13. Metastatic melanoma to the palatine tonsil with a favourable prognosis.Metastasis to the oral cavity from cutaneous melanoma is rare: fewer than 30 cases of metastatic melanoma to the palatine tonsil have been reported. Tonsil metastasis is haematogenously disseminated and therefore usually has a poor prognosis. We present a case of metastatic melanoma to the palatine tonsil occurring 6(1/2) years after removal of the primary cutaneous lesion. The patient has remained disease-free for 18 months since the removal of skin and tonsil metastases. Immunohistopathologically, HLA class II and costimulatory factor B7-2 molecules were concomitantly expressed on melanoma cells: we suggest that the patient was therefore able to develop antimelanoma T-cell activation resulting in prevention of further metastasis, and thus a favourable prognosis.- - - - - - - - - - ranking = 0.33333333333333keywords = oral cavity, cavity (Clic here for more details about this article) |
4/13. Polymorphous low-grade adenocarcinoma of the tonsil: report of a case and review of the literature.Polymorphous low-grade adenocarcinoma (PLGA) is a relatively common malignancy of the oral cavity, representing 7% to 11% of all intraoral minor salivary gland tumors, and 19% to 26% of those that are malignant. However, it is a rare finding in the oropharynx, with only 6 cases reported in the medical literature. The clinical features of a case of PLGA of the tonsillar fossa in a 64-year-old gentleman are presented, only the second such case reported in the medical literature. A review and discussion of the literature pertaining to PLGA of the oral cavity and the oropharynx is provided. (Am J Otolaryngol 2002;23:297-299.- - - - - - - - - - ranking = 0.66666666666667keywords = oral cavity, cavity (Clic here for more details about this article) |
5/13. Follicular dendritic cell sarcoma of the tonsil: report of a rare case.Follicular dendritic cell tumors are extremely rare. Only 17 cases have been previously described in the literature, and only three of them involved primary tumours of the oral cavity. We describe a new case of the latter, which occurred in a 51-year-old man who sought evaluation for a painless enlargement of his left palatine tonsil. The tonsil was excised, and histologic examination revealed that the tumor was a primary sarcoma that had arisen from the dendritic reticulum cells of the palatine tonsil. Postoperatively, the tumor site was treated with percutaneous irradiation (total dose: 70 Gy). After more than 5 years of follow-up, the patient showed no evidence of recurrence. We also discuss the salient features of the immunohistochemical examination.- - - - - - - - - - ranking = 0.33333333333333keywords = oral cavity, cavity (Clic here for more details about this article) |
6/13. New modification of the mandibulotomy approach without lip splitting.BACKGROUND: A lower lip-splitting incision has traditionally been performed with different types of mandibulotomy approaches for obtaining wide access to oral and oropharyngeal cancers. However, lip splitting can be associated with unfavorable aesthetic results. We describe our new modification of a traditional mandibulotomy approach without lip splitting to avoid these morbidities. This is a case series in a tertiary referral center. methods: The primary tumor site was the oropharynx in four cases, the oral cavity in two cases, and the parapharynx in one case. Each case was assessed for TNM staging, perioperative complications, status of the resection margins, tumor recurrence, and the aesthetic and functional results of the lower lip. RESULTS: All the tumors were safely removed by means of our modified non-lip-splitting mandibulotomy approach through the combined intraoral and transcervical routes with adequate resection margins. There were no troublesome difficulties in reconstruction of the surgical defects with various major flaps. The cosmetic results were excellent with intact lip function. CONCLUSION: We believe this new modified non-lip-splitting mandibulotomy approach could replace the conventional mandibulotomy approach for some selected malignant lesions, with excellent cosmetic and functional results of the lower lip.- - - - - - - - - - ranking = 0.33333333333333keywords = oral cavity, cavity (Clic here for more details about this article) |
7/13. Tonsillar leiomyoma.Tumors of smooth muscle origin are rare in the oral cavity. To date, only eighty-three cases of oral leiomyomas have been reported. A first case of tonsillar leiomyoma in a 73-year-old male is presented. The theories of origin and the various histologic types of oral leiomyomas are discussed. leiomyoma can easily be confused with other spindle-cell tumours. Special stains are necessary to reach a correct diagnosis. It is sometimes difficult to differentiate benign leiomyoma from malignant leiomyosarcoma. The use of mitotic figure count to indicate malignant behaviour is not always reliable. The need for wide surgical excision of the tumour, complete sectioning and examination of the specimen and meticulous follow-up of the patient for evidence of recurrence are emphasized.- - - - - - - - - - ranking = 0.33333333333333keywords = oral cavity, cavity (Clic here for more details about this article) |
8/13. lipoma in the peri-tonsillar space.Lipomas in the head and neck region usually occur in the immediate subcutaneous tissue, and only rarely in the upper aerodigestive tract. We report here a case of a 58-year-old female with a lipoma in the peri-tonsillar space. The tumour originated from the left peri-tonsillar space over the palate tonsil and partly protruded into the oral cavity. MRI (magnetic resonance imaging) showed not only the accurate location of the tumour but also suggested its pathology. To our knowledge, a lipoma in the peri-tonsillar space is quite rare and MRI is useful in its diagnosis.- - - - - - - - - - ranking = 0.33333333333333keywords = oral cavity, cavity (Clic here for more details about this article) |
9/13. Multiple primary carcinomas of the upper aerodigestive tract.Multiple primary squamous cell carcinomas in the upper aerodigestive tract are well described but rare. To be recognised as distinct primary tumours, such malignancies must fulfil a number of anatomical and histological criteria as defined by Warren and Gates. classification is based on the temporal sequence of tumour diagnosis into three groups; simultaneous, synchronous and metachronous. Second and subsequent primary tumours may escape early detection if not actively searched for. We present a very unusual case of three synchronous tumours in the oral cavity and oropharynx. The literature is reviewed emphasising the importance of thorough investigation of the entire upper aerodigestive tract in patients with a squamous cell carcinoma in this region. Recommendations regarding follow up are also discussed.- - - - - - - - - - ranking = 0.33333333333333keywords = oral cavity, cavity (Clic here for more details about this article) |
10/13. Follicular dendritic cell tumors of the oral cavity.Follicular dendritic cell tumors are uncommon, and all the reported cases have occurred as primary lymph node tumors. We report two cases in the oral cavity, one in the soft palate and one in the tonsil. The tumors were characterized by sheets, whorls, and storiform arrays of spindly and syncytial-appearing cells with oval nuclei, fine chromatin, distinct nucleoli, and occasional nuclear pseudoinclusions. Multinucleated forms were present and were prominent in one case. An unusual feature was the presence of irregular pseudovascular spaces, which could raise a concern for vascular neoplasm. Because the tumors showed cohesive growth and a sharp interface with the fibrous stroma, they could also be mistaken for carcinoma, sarcoma, or melanoma. After radiation therapy, the palatal tumor showed a greater degree of nuclear pleomorphism, numerous nuclear pseudoinclusions, and striking nuclear grooving and foldings, mimicking interdigitating reticulum cell tumors. The diagnosis in both cases was confirmed by immunoreactivity with CD21 and CD35 and by ultrastructural demonstration of interdigitating cell processes with desmosomes. Both tumors also showed unexpected immunoreactivity with muscle-specific actin. Follicular dendritic cell tumor merits wider recognition of its possible extranodal occurrence as well as its full morphological spectrum in order to better define its behavior.- - - - - - - - - - ranking = 1.6666666666667keywords = oral cavity, cavity (Clic here for more details about this article) |
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