Cases reported "Carcinoma, Squamous Cell"

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11/216. Establishment of high and low metastasis cell lines derived from a human tongue squamous cell carcinoma.

    Malignant tumors are composed of cells with different phenotypic properties and only certain cell subpopulations present metastatic potential. The establishment of cell lines with high or low metastatic potential is necessary to investigate the molecular mechanisms of the metastatic process. However, human oral squamous cell carcinoma (SCC) cell lines that are suitable for the above investigation are scarce. High and low metastatic cells were obtained from a primary lesion of a patient with tongue carcinoma who had not received any therapy. Two distinct cell lines were selected, UM1 with a scattered growth pattern and loose cell-cell adhesion, and UM2 with a colony-formed growth pattern and firm cell-cell adhesion. The expression of E-cadherin in UM1 was clearly lower than that in UM2. UM1 exhibited a higher motility, invasive and metastatic activity than UM2 in vivo and in vitro. A low invasive and a metastatic oral SCC cell line, useful to investigate invasion and metastasis mechanisms, have been established.
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12/216. Prevention of tongue biting with a removable oral device: a clinical report.

    A method of preventing tongue biting with a removal device has been described in this clinical report. Restraint of the tongue may be necessary to promote healing by preventing repetitive tongue biting or as a preventive measure after a surgery or an injury. Any device that is used to restrain the tongue should be removable to avoid prolonged interference with oral hygiene, swallowing, mastication, and speech. A removable device is desirable for long-term use by comatose or semicomatose patients.
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13/216. Carcinomatous transformation of a sublingual dermoid cyst. A case report.

    Sublingual dermoid cysts are rare lesions. Typically they present as slow-growing masses that may cause elevation of the tongue, interference with speech or the appearance of a double chin. We report the first case of malignant transformation to squamous cell carcinoma of a long-standing sublingual dermoid cyst.
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14/216. A novel approach to laryngeal suspension after partial laryngectomy.

    OBJECTIVES: Supraglottic laryngectomy is a well-established surgical therapy for selected carcinomas of the larynx and hypopharynx. Most compromised by this procedure and its variations is the laryngeal mechanism that protects the lower respiratory tract from aspiration. Laryngeal suspension serves to compensate for the loss of the resected laryngeal elevator muscles by pulling the larynx upward and forward beneath the tongue base. In this study we describe a method of laryngeal suspension in supraglottic laryngectomy using a cartilage-anchored suture carrier device. STUDY DESIGN: Report of this novel approach to laryngeal suspension using seven suture anchors in two patients undergoing supraglottic laryngectomy. methods: Seven Mitek Micro anchors (Mitek, Westwood, MA) were used to perform laryngeal suspension in two patients undergoing supraglottic laryngectomy. Our technique is compared with traditional methods. Operative data as well as postoperative functional results are reviewed. RESULTS: Laryngeal suspension using suture anchors was successful, with failure of only one anchor. Oral alimentation was quickly reestablished in both patients. There were no perioperative or postoperative complications. CONCLUSIONS: We describe a novel approach to laryngeal suspension that overcomes some of the technical challenges inherent in traditional suturing techniques. This novel approach is technically easier and more efficient than traditional methods and accomplishes distribution of stress forces on the thyroid cartilage remnant.
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15/216. granular cell tumor of the hypopharynx treated by endoscopic CO(2) laser excision: report of two cases.

    BACKGROUND: granular cell tumor (GCT), or Abrikossoff's tumor, is an unusual lesion probably arising from schwann cells. It is frequently found in the head and neck region, where the tongue is the most commonly affected site. Involvement of the hypopharynx is exceedingly rare because, to the best of our knowledge, only four cases have been reported in the literature. methods: We describe hypopharyngeal GCT in two women aged 29 and 52 years, respectively. RESULTS: In the first patient, preoperative diagnostic examination, including endoscopy, CT, and MRI scan, was suggestive of a benign lesion arising from the posterior wall of the hypopharynx. In the second patient, a previous biopsy of the postcricoid area performed elsewhere suggested a diagnosis of well-differentiated squamous cell carcinoma, and CT scan staged the lesion as T1 N0. In both cases, treatment included surgical excision under microlaryngoscopy with CO(2) laser. The histopathologic study of the specimens, supported by immunohistochemical techniques, determined the lesions to be a GCT. The postoperative course was uneventful, and the patients were discharged 12 and 2 days after surgery, respectively. Both patients were asymptomatic without evidence of recurrence when last seen 2 years and 4 months after surgery, respectively. CONCLUSIONS: GCT should be included in the differential diagnosis of submucosal hypopharyngeal lesions. endoscopy and radiologic imaging do not display any typical finding suggestive of the diagnosis, which can be based only on histologic findings. Resection of the tumor, when technically feasible, should be performed under microlaryngoscopy with the CO(2) laser, which makes it possible to work in a bloodless field with minimal thermal damage and reduction of scarring and postoperative edema.
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16/216. tongue cancer in younger patients.

    tongue cancer involving the anterior tongue often presents at an early stage. The aetiology is strongly associated with smoking and alcohol abuse similar to other squamous cell carcinomas (SCC) of the head and neck (HN). Surgery and radiotherapy, either alone or together, offer the prospect of cure in the majority of patients. However, there remains a group of younger patients less than 40 years old for whom outcome is often poor. Presented here is the case of a 24-year-old woman who developed SCC of the anterior tongue. Despite treatment, loco-regional relapse occurred resulting in death. The literature identifies a distinct subgroup of younger patients who develop HN SCC, particularly of the oral cavity. The aetiology remains unclear. Recent studies have looked at the prognostic significance of various new non-clinico-pathological markers in HN SCC (including p53 tumour suppressor gene, cyclin d1 protein, Ki 67 antigen and tumour angiogenesis). The majority of these studies, as expected, have involved the typical HN patient (male, aged > 60 years old). However, the relevance of these studies is of likely importance to all patients diagnosed with HN SCC. The recent use of these non-clinical-pathological markers in HN SCC, including reference to such studies in younger patients, is discussed. The English literature during the past 30 years is reviewed with reference to the diagnosis of tongue SCC in younger patients.
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17/216. Squamous cell carcinoma of the tongue as a second malignancy in a patient previously treated for osteosarcoma.

    A 15-year-old girl was diagnosed with osteosarcoma; limb salvage surgery was performed after preoperative chemotherapy. Postoperatively, adjuvant chemotherapy was given for 2 years. One year after completion of chemotherapy, the patient was readmitted for systemic recurrence. amputation of the lower extremity and wedge resection of lung metastasis were performed followed by combination chemotherapy. Two years after cessation of chemotherapy, ulcer of the tongue was noted and cervical lymph nodes were detected by palpation. biopsy of the lesion showed squamous cell carcinoma. The patient underwent a radical partial tongue resection and postoperative irradiation, followed by chemotherapy. Six years after treatment for the second malignancy, the patient remains well without evidence of disease. Squamous cell carcinoma of the tongue as a second malignancy after treatment of osteosarcoma is quite rare. Long-term follow-up, with particular attention to the head and neck, may be warranted in children treated for osteosarcoma.
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18/216. Total tongue reconstruction with free functional gracilis muscle transplantation: a technical note and review of the literature.

    The tongue is one of the most difficult structures of the body to reconstruct if more than 85% to 90% of it has been resected. A functional neotongue requires both soft-tissue bulk and restoration of muscle function. The innervated gracilis muscle flap folded on itself was used to reconstruct a total glossectomy defect. The genioglossus muscle, which makes the greatest contribution to swallowing, and the mylohyoid muscle, which elevates the larynx to prevent aspiration, were simulated with the design and placement of the gracilis muscle. The muscle was placed and secured longitudinally from the remnant of the tongue base and pharynx to the mandible, and then folded on itself and attached to the hyoid bone. The obturator nerve to the gracilis was coapted with the hypoglossal nerve. The patient was able to resume oral feeding without aspiration. Electromyographic results demonstrated reinnervation of the flap with active elevation of the mouth base. The patient died 1 year postoperatively because of recurrence of her disease. This type of design and placement of gracilis muscle transplantation is recommended.
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19/216. New multilobe "accordion" flaps for three-dimensional reconstruction of wide, full-thickness defects in the oral floor.

    When reconstructing a wide, full-thickness intraoral defect, the following principles are necessary for active food transport and improved swallowing and speech. First, the flap should touch the palate and obliterate the oral cavity. Second, jaw or flap excursion should not be hindered by tethering of the flap in the neck. And third, all surfaces of the tongue and oral floor, and the dead space of the floor should be reconstructed. To accomplish these goals, two new designs, similar to an accordion, using an anterolateral thigh flap and a deep inferior epigastric perforator flap have been developed. The outlines of multilobe flaps create an accordion-type structure of the tongue and oral floor complex. The advantages of the new designs using anterior thigh or deep inferior epigastric perforator flaps are follows: First, three-dimensional intraoral reconstitution allows maximal movement postoperatively of the reconstructed tongue. Second, the donor sites are so far from the tongue that simultaneous flap elevation is possible for tumor resectioning. Third, even in obese patients, totally or partially thin flaps are available. And fourth, in most patients the donor defects can be closed directly.
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20/216. pemphigus with pemphigoid-like presentation, associated with squamous cell carcinoma of the tongue.

    A 53-year-old woman presented with an inoperable squamous cell carcinoma of the tongue associated with tense large bullae consistent with bullous pemphigoid, preceded by a prodrome of urticarial plaques. The histological findings showed a regenerating subepidermal blister with eosinophils and no acantholysis. Direct immunofluorescence study, however, showed positive staining for IgG and C3 throughout the epidermis consistent with pemphigus. The blistering eruption had no mucosal involvement and responded to low dose corticosteroids. Our patient may represent another presentation of a 'paraneoplastic pemphigus spectrum'.
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