Cases reported "Carcinoma, Squamous Cell"

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1/216. Squamous cell metastasis from the tongue to the myocardium presenting as pericardial effusion.

    Cardiac metastasis from head and neck cancer is rarely encountered. We present a base-of-tongue squamous cell carcinoma with metastasis to the heart that was diagnosed antemortem. autopsy series indicate that tongue cancer may metastasize more frequently to the heart than from other head and neck sites. However, none of these studies was controlled. Most importantly, cardiac metastasis should be suspected in any patient with cancer in whom new cardiac symptoms develop. The diagnosis is best confirmed with two-dimensional echocardiography or cardiac MRI. A myocardial or endocardial biopsy specimen can be obtained with angiographic guidance. Despite the improvement in diagnostic capability, available treatments are only palliative. All patients eventually die of their metastatic disease.
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2/216. Squamous cell carcinoma of the tongue in a patient with rothmund-thomson syndrome.

    rothmund-thomson syndrome is a rare autosomal recessive genodermatosis characterised by poikilodermatous skin changes that appear in childhood. patients exhibit variable additional features including juvenile cataracts, skeletal abnormalities and a higher than expected incidence of malignancies. We report a case of squamous cell carcinoma of the tongue in a 37-year-old rothmund-thomson syndrome patient and review the natural history of this rare disease, given that the patient was diagnosed with rothmund-thomson syndrome at the age of 8 years and was first reported in 1975.
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3/216. Vascular transformation of sinuses in bilateral cervical lymph nodes.

    BACKGROUND: Vascular transformation of sinuses (VTS) in lymph node has been infrequently reported. We present a case of incidental VTS in bilateral cervical nodes discovered at the time of operation for tongue cancer. methods: Standard histopathologic review was undertaken. RESULTS: In this case, a spectrum of varied vasoformative patterns involving lymph nodes in either a pan-nodal or localized fashion were identified. The hilum was occupied by smooth muscle proliferation and adipose tissue. Two nodes also displayed similar features of angiolipomatous hamartoma. No metastatic carcinoma was found in lymph nodes with VTS. CONCLUSIONS: This case suggests that lymphovenous congestion and distention represented the major cause through which VTS developed.
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4/216. The lateral tongue flap: a salvage option for reconstruction of buccal recurrences.

    BACKGROUND: Surgery in an irradiated, previously operated field is fraught with danger. Though microvascular tissue transfers are being gone, they may not be feasible in all circumstances. methods: A lateral tongue flap was executed in 11 cases of intraoral buccal recurrence. The aims of this study were to evaluate the procedure, the function of the remaining tongue and the speed of rehabilitation with respect to preoperative functional status. RESULTS: Out of 11 such reconstructions in a period of 12 months, only 1 flap had tip necrosis while a haematoma developed in 2 cases. Swallowing, speech, and tongue protrusion were not significantly hampered by the procedure. patients were rehabilitated very quickly (within 2 weeks), to preoperative functional status. CONCLUSIONS: The Lateral tongue Flap is a simple, robust vascular transfer and an effective salvage reconstructive option in a post-excisional defect caused by a recurrent intraoral cancer.
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5/216. The role of positron emission tomography in occult primary head and neck cancers.

    PURPOSE: To evaluate the utility of positron emission tomography (PET) fluorodeoxyglucose (FDG) imaging in the workup of unknown primary head and neck tumors. methods: Fourteen patients with squamous cell carcinoma of cervical lymph node metastasis of unknown primary origin (clinical stage N2-N3) were studied prospectively. The patients underwent conventional workup, including physical examination, computed tomography, and random biopsies of the potentially suspected sites. If no primary site was found, 8 to 13 mCi of FDG was given intravenously, and whole-body scans with standardized uptake values were obtained. The results of FDG-PET imaging were compared with clinical, CT, and histopathologic findings. To eliminate bias, PET scans were reviewed by nuclear medicine physicians who had no previous knowledge of the other findings. RESULTS: PET identified the location of primary tumor in three patients: lung hilum, base of tongue, and pyriform sinus. These lesions were pathologically confirmed. All these primary sites were not visualized on CT or physical examination, except for a pyriform sinus lesion, which was seen on CT, but initial biopsy result was negative. In one patient, the initial PET did not identify a primary tumor, but a nasopharyngeal carcinoma was identified in post-radiation therapy follow-up PET. In the remaining nine patients, a primary lesion was never found. All cervical lymph nodes detected by CT were identified by PET. DISCUSSION: A previously unknown primary tumor can be identified with FDG-PET in about 21% of the patients in our prospective series. PET can be of value in guiding endoscopic biopsies for histologic diagnosis and treatment options.
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6/216. Local tumor recurrence or emergence of a new primary lesion? A molecular analysis.

    The distinction between a new primary oral tumor and recurrence may bear significant prognostic implications. Currently, this differentiation relies mainly on tumor location: when both lesions are at or near the same site, the new one is regarded as a recurrence; when the two are at different sites, the second lesion is regarded as a new primary. Recent investigations using molecular analysis have demonstrated that some oral squamous cell carcinomas (SCC) arising from different sites show the same clonogenical changes. In this case report, we studied the clonality of three SCC (one primary, two apparent recurrences) from the right lateral tongue of a young, non-smoking woman by using microsatellite analysis for loss of heterozygosity. The results showed that while the first two tumors were clonogenically similar, the third tumor was clonogenically different and was consistent with the development of a new primary. This result indicates that location of tumors alone is not always reliable in determining whether a new tumor is a recurrence or a new primary lesion.
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7/216. Various extrahepatic manifestations caused by hepatitis c virus infection.

    It has been reported that hepatitis c virus (HCV) causes not only liver disease but also disorders of other organs and tissues. Previously, many HCV-related extrahepatic manifestations have been reported. In this study, we report 2 patients in whom tongue cancer was detected during the treatment of HCV-related liver disease. In one patient, tongue cancer was detected during the treatment of HCV-related liver cirrhosis, and articular rheumatism developed thereafter. The duration of HCV-related liver disease was 10 years. In the other patient, tongue cancer was detected during the treatment of HCV-related hepatocellular carcinoma. This patient had a past history of thyroid disease. The duration of HCV-related liver disease was 6 years. In these patients, the possibility that several conditions incidentally and concurrently developed cannot be denied. However, the conditions described above may be regarded as HCV-related extra-hepatic manifestations. In patients with HCV infection, it is important to examine conditions in organs other than the liver. Careful follow-up is needed.
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8/216. Ultrasonographic monitoring of high dose rate interstitial implant using template technique for oral tongue cancer.

    192Ir high dose rate (HDR) fractionated interstitial brachytherapy was performed on two patients with tongue cancer with the aid of real-time intraoral ultrasonographic (US) guidance and the template technique. Blind-ended catheters with metallic rods (Obturator, Nucletron, the netherlands) were inserted into the tongue from the submandibular region. This US monitoring allows for detection of the accurate location of both tumor and catheters in real-time motion. After implantation, we reconfirmed the position of the catheters by CT examination. Intraoral US monitoring was thus found to be a useful procedure for accurate implantation of brachytherapy for tongue cancer.
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9/216. High dose rate microselectron mould ratiotherapy of a widespread superficial oral cancer.

    Treatment of a case of widespread superficial oral squamous cell carcinoma with external beam irradiation, followed by high dose rate Microselectron mould radiotherapy, is reported. The tumor disappeared macroscopically after treatment, but there was infield recurrence in the buccogingival sulcus where the radiation dose might have been inadequate. Apart from some radiation mucositis within the treated area, edema and a superficial ulcer were observed in the tongue. These were considered to be due to radiation overdose. Although there is room for improvement, this mode of treatment has something to offer patients with hard-to-cure cancer.
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10/216. tongue reconstruction with a combined brachioradialis-radial forearm flap.

    Total glossectomy adversely affects speech and swallowing, and subsequent reconstruction results in limited functional return. The radial forearm flap has been reliably used to resurface glossectomy defects, but has limited bulk with which to aid in palatoglossal contact for speech. The authors have modified the forearm flap by incorporating a segment of brachioradialis muscle, to increase bulk posteriorly and to aid in speech. Sufficient muscle perforators arise from the proximal brachial artery and enter the brachioradialis to permit transfer of the muscle with the fasciocutaneous forearm flap as a single free-flap unit. The muscle is folded onto itself and enclosed within the forearm flap skin to create a neotongue. Coaptation of the antebrachial cutaneous nerves can provide a senate flap. Successful transfer of the combined brachioradialis/forearm flap in a patient who had undergone total glossectomy resulted in a neotongue good shape. speech was rated good by a speech pathologist, and palatoglossal contact was observed on cineoradiograph. No functional loss at the donor site occurred. Inclusion of the brachioradialis muscle with the radial forearm flap as a combined unit results in a neotongue with good form and increased bulk posteriorly at the base, compared to a standard fasciocutaneous flap alone. This is a useful variation of the forearm flap. Sensory return is possible if the medial and/or lateral antebrachial cutaneous nerves of the flap are coapted to the lingual nerve.
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