Pub Date : 2022-01-01DOI: 10.24983/scitemed.aohns.2022.00168
C. Kuo, C. Lien
{"title":"Safe Tympanic Retraction May Be Unsafe: A False Sense of Security in a Patient with Cholesteatoma","authors":"C. Kuo, C. Lien","doi":"10.24983/scitemed.aohns.2022.00168","DOIUrl":"https://doi.org/10.24983/scitemed.aohns.2022.00168","url":null,"abstract":"","PeriodicalId":8285,"journal":{"name":"Archives of otolaryngology--head & neck surgery","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88496215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.24983/scitemed.aohns.2022.00157
L. D. R. Businco, S. Pavaci, F. Tortorella
{"title":"First Report on Shockwave Tubodilation Technique for Eustachian Tube Dysfunction","authors":"L. D. R. Businco, S. Pavaci, F. Tortorella","doi":"10.24983/scitemed.aohns.2022.00157","DOIUrl":"https://doi.org/10.24983/scitemed.aohns.2022.00157","url":null,"abstract":"","PeriodicalId":8285,"journal":{"name":"Archives of otolaryngology--head & neck surgery","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75682985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Matheus Guimaraes, Tatiane Motta Cardoso, F. N. Segato, L. Colli, Liane Rapatoni, F. Peria
Introduction: Head and neck cancer (HNC) is a heterogeneous group of neoplasms that can have a poor prognosis when diagnosed in advanced stages. The optimized treatment for locally advanced and unresectable lesions is mainly based on radiotherapy associated with chemotherapy (cisplatin 100mg/m²), however, at the expense of a high toxicity index. Objective: Evaluate whether chemoradiotherapy (CRT) – the gold-standard treatment for locally advanced head and neck cancer (HNC) – is effective in the study population. Methods: This is a retrospective study aimed at determining the efficacy of definitive CRT in patients with unresectable HNC treated between the and 2018 in a single institution. The following outcomes were evaluated: objective response rate (ORR), progression-free survival (PFS), overall survival (OS), and toxicity profiles. Results: Fifty-two (52) patients diagnosed with HNC between 2012 and 2018 met the inclusion criteria. The ORR was 84.6%, with 50% showing complete response. Median PFS and OS were 35.3 and 52 months, respectively. Analysis of the toxicity profiles revealed that 69.2% of the patients presented grade 3-4 toxicity. Completion of two or more cycles of cisplatin-based therapy (HR 3.57 [95% CI 1.25–10.25]; p p<0.001), grade 3-4 toxicity (HR 0.27 [95% CI 0.09-0.8] – p<0.02), and Charlson comorbidity index (CCI) (HR 3.23 [95% CI 1.26–8.29]; p<0.001) were significantly associated with survival. Regarding toxicity, prophylactic low-level laser therapy (HR 0.48 [95% CI 0.27–0.86]; p<0.001 for those without this practice) and body mass index (BMI) (HR 0.27 [95% CI 0.09–0.76]; p<0.01) showed statistical significance. Conclusion: CRT was effective to treat HNC in the study population, with PFS and OS comparable to those reported in larger sample studies and lower toxicity grade. Some clinical characteristics have been identified as prognostic and/or predictive factors.
头颈癌(HNC)是一种异质性肿瘤，在晚期诊断时预后较差。局部晚期和不可切除病变的最佳治疗方案主要是放疗联合化疗(顺铂100mg/m²)，但其毒性指数较高。目的:评价局部晚期头颈癌(HNC)的金标准治疗——放化疗(CRT)在研究人群中的有效性。方法:这是一项回顾性研究，旨在确定在单一机构治疗的2018年至2018年期间不可切除的HNC患者的最终CRT疗效。评估了以下结果:客观缓解率(ORR)、无进展生存期(PFS)、总生存期(OS)和毒性概况。结果:2012年至2018年间，52例确诊为HNC的患者符合纳入标准。ORR为84.6%，50%显示完全缓解。中位PFS和OS分别为35.3个月和52个月。毒性分析显示69.2%的患者为3-4级毒性。完成两个或两个以上周期的顺铂类药物治疗(HR 3.57 [95% CI 1.25-10.25];p<0.001)、3-4级毒性(HR 0.27 [95% CI 0.09-0.8] - p<0.02)和Charlson共病指数(CCI) (HR 3.23 [95% CI 1.26-8.29];P <0.001)与生存率显著相关。在毒性方面，预防性低水平激光治疗(HR 0.48 [95% CI 0.27-0.86];p<0.001)和身体质量指数(BMI) (HR 0.27 [95% CI 0.09-0.76];P <0.01)，差异有统计学意义。结论:在研究人群中，CRT治疗HNC有效，PFS和OS与大样本研究报告的PFS和OS相当，毒性等级较低。一些临床特征已被确定为预后和/或预测因素。
{"title":"Outcomes, toxicity profiles, and prognostic factors of unresectable head and neck cancer treated with chemoradiotherapy","authors":"Matheus Guimaraes, Tatiane Motta Cardoso, F. N. Segato, L. Colli, Liane Rapatoni, F. Peria","doi":"10.4322/ahns.2022.0004","DOIUrl":"https://doi.org/10.4322/ahns.2022.0004","url":null,"abstract":"Introduction: Head and neck cancer (HNC) is a heterogeneous group of neoplasms that can have a poor prognosis when diagnosed in advanced stages. The optimized treatment for locally advanced and unresectable lesions is mainly based on radiotherapy associated with chemotherapy (cisplatin 100mg/m²), however, at the expense of a high toxicity index. Objective: Evaluate whether chemoradiotherapy (CRT) – the gold-standard treatment for locally advanced head and neck cancer (HNC) – is effective in the study population. Methods: This is a retrospective study aimed at determining the efficacy of definitive CRT in patients with unresectable HNC treated between the and 2018 in a single institution. The following outcomes were evaluated: objective response rate (ORR), progression-free survival (PFS), overall survival (OS), and toxicity profiles. Results: Fifty-two (52) patients diagnosed with HNC between 2012 and 2018 met the inclusion criteria. The ORR was 84.6%, with 50% showing complete response. Median PFS and OS were 35.3 and 52 months, respectively. Analysis of the toxicity profiles revealed that 69.2% of the patients presented grade 3-4 toxicity. Completion of two or more cycles of cisplatin-based therapy (HR 3.57 [95% CI 1.25–10.25]; p p<0.001), grade 3-4 toxicity (HR 0.27 [95% CI 0.09-0.8] – p<0.02), and Charlson comorbidity index (CCI) (HR 3.23 [95% CI 1.26–8.29]; p<0.001) were significantly associated with survival. Regarding toxicity, prophylactic low-level laser therapy (HR 0.48 [95% CI 0.27–0.86]; p<0.001 for those without this practice) and body mass index (BMI) (HR 0.27 [95% CI 0.09–0.76]; p<0.01) showed statistical significance. Conclusion: CRT was effective to treat HNC in the study population, with PFS and OS comparable to those reported in larger sample studies and lower toxicity grade. Some clinical characteristics have been identified as prognostic and/or predictive factors.","PeriodicalId":8285,"journal":{"name":"Archives of otolaryngology--head & neck surgery","volume":"56 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87038171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
G. Agne, H. Kohler, T. Chulam, C. Pinto, J. Vartanian, L. Kowalski
Introduction: The gold standard treatment of oral cavity squamous cell carcinoma (OCSCC) is surgical resection; however, standardization of the margins and the role of frozen section are still debatable. Microscopic tumor cut-thought (MTCT) occurs when the surgeon has an initial positive frozen section margin that is cleared with further resection to negative. Objective: This study aims to determine the impact of MTCT on local recurrence and disease-specific survival in patients with locally advanced T3-T4 OCSCC and compare it with other clinicopathological variables. Methods: A retrospective database analysis of patients diagnosed with locally advanced T3-T4 OCSCC surgically treated and submitted to intraoperative frozen section guiding the margin status. Survival was analyzed using the Kaplan-Meier estimator followed by the Cox model for multivariate analysis. Results: We analyzed 475 patients who met inclusion criteria: MTCT occurred in 29 patients (6.11%) and local recurrence was observed in 131 patients (27.6%). MTCT had an impact on univariate (HR 2.205; 95% CI 1.243 – 3.914; p =0.007) and multivariate (HR 1.851; 95% CI 1.285 – 2.666; p =0.001) analyses. Similar results were found for disease-specific survival: univariate (HZ 1.669; 95% CI 1.056 – 2.635; p =0.028) and multivariate (HZ 1.307; 95% CI 0.816 – 2.092; p =0.265) analyses. A total of 231 patients (48.6%) had died of cancer by the end of follow-up. The best predictor for compromised frozen sections was tumor depth of invasion. Conclusion: Even after negative final margins, MTCT is an important factor associated with poorer outcome, and treatment intensification should be considered in these patients.
口腔鳞状细胞癌(OCSCC)的金标准治疗是手术切除;然而，边缘的标准化和冷冻切片的作用仍有争议。显微肿瘤切割(MTCT)发生在外科医生有一个最初的阳性冷冻切片边缘，通过进一步切除清除到阴性。目的:本研究旨在确定MTCT对局部晚期T3-T4 OCSCC患者局部复发和疾病特异性生存的影响，并与其他临床病理指标进行比较。方法:回顾性分析经手术诊断为局部晚期T3-T4 OCSCC的患者，并进行术中冷冻切片指导切缘状态。生存率分析采用Kaplan-Meier估计，Cox模型进行多变量分析。结果:我们分析了475例符合纳入标准的患者，其中29例(6.11%)发生MTCT, 131例(27.6%)局部复发。MTCT对单因素有影响(HR 2.205;95% ci 1.243 - 3.914;p =0.007)和多因素(HR 1.851;95% ci 1.285 - 2.666;P =0.001)分析。在疾病特异性生存率方面也发现了类似的结果:单变量(HZ为1.669;95% ci 1.056 - 2.635;p =0.028)和多因素(HZ 1.307;95% ci 0.816 - 2.092;P =0.265)分析。随访结束时，共有231例患者(48.6%)死于癌症。冰冻切片受损的最佳预测指标是肿瘤浸润深度。结论:即使最终切缘阴性，MTCT仍是预后较差的重要因素，应考虑加强治疗。
{"title":"Oncologic outcomes of microscopic tumor cut-through in locally advanced oral squamous cell carcinoma","authors":"G. Agne, H. Kohler, T. Chulam, C. Pinto, J. Vartanian, L. Kowalski","doi":"10.4322/ahns.2022.0013","DOIUrl":"https://doi.org/10.4322/ahns.2022.0013","url":null,"abstract":"Introduction: The gold standard treatment of oral cavity squamous cell carcinoma (OCSCC) is surgical resection; however, standardization of the margins and the role of frozen section are still debatable. Microscopic tumor cut-thought (MTCT) occurs when the surgeon has an initial positive frozen section margin that is cleared with further resection to negative. Objective: This study aims to determine the impact of MTCT on local recurrence and disease-specific survival in patients with locally advanced T3-T4 OCSCC and compare it with other clinicopathological variables. Methods: A retrospective database analysis of patients diagnosed with locally advanced T3-T4 OCSCC surgically treated and submitted to intraoperative frozen section guiding the margin status. Survival was analyzed using the Kaplan-Meier estimator followed by the Cox model for multivariate analysis. Results: We analyzed 475 patients who met inclusion criteria: MTCT occurred in 29 patients (6.11%) and local recurrence was observed in 131 patients (27.6%). MTCT had an impact on univariate (HR 2.205; 95% CI 1.243 – 3.914; p =0.007) and multivariate (HR 1.851; 95% CI 1.285 – 2.666; p =0.001) analyses. Similar results were found for disease-specific survival: univariate (HZ 1.669; 95% CI 1.056 – 2.635; p =0.028) and multivariate (HZ 1.307; 95% CI 0.816 – 2.092; p =0.265) analyses. A total of 231 patients (48.6%) had died of cancer by the end of follow-up. The best predictor for compromised frozen sections was tumor depth of invasion. Conclusion: Even after negative final margins, MTCT is an important factor associated with poorer outcome, and treatment intensification should be considered in these patients.","PeriodicalId":8285,"journal":{"name":"Archives of otolaryngology--head & neck surgery","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78355308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
F. Hojaij, Lesley Mirian de Paula Santos, R. Moyses, Bruna Dos Santos Souza, F. Akamatsu, Bruna Brasil Carneiro Costa, L. Chinelatto, A. Jacomo
Introduction: Human anatomy is essential for both clinical and surgical practice. Although the anterior jugular veins (AJVs) are of great importance in many surgeries, there are few studies addressing the anatomic variations of these vessels. This study highlights the venous drainage of the head and neck and the importance of anatomical variations in the AJVs. Objective: To observe and describe the anatomy of the jugular veins and evaluate whether there are patterns influenced by anthropometric factors or comorbidities. Methods: Neck dissections were performed on 30 cadavers. The anatomical characteristics of the AJVs were described considering diameter, midline distance, anastomosis, and presence of the jugular venous arch. Results: Cadavers of 14 women and 16 men were dissected. Ninety percent (90%) of the jugular veins had a rectilinear path and 37% presented anastomosis: H-shaped (63.7%),N-shaped (27.3% ), and Y-shaped (9%). In relation to the number of veins, 20% of the cadavers had only one AJV, 63.3% had two, 10% had three, and 6.7% presented a total of four. Mean distance between jugular veins was 12 mm, and most veins (60%) had a diameter <5 mm. There was no statistically significant correlation between anatomical variations and anthropometric factors. Conclusion: AJVs were always present in the dissected cadavers, and the configuration most commonly found was two veins, each <5 mm in diameter. They were less than 10 mm away from the cervical midline and, when they presented anastomosis, it was H-shaped in most cases.
{"title":"Anatomy of the anterior jugular veins: anatomical study of 30 cadavers","authors":"F. Hojaij, Lesley Mirian de Paula Santos, R. Moyses, Bruna Dos Santos Souza, F. Akamatsu, Bruna Brasil Carneiro Costa, L. Chinelatto, A. Jacomo","doi":"10.4322/ahns.2022.0005","DOIUrl":"https://doi.org/10.4322/ahns.2022.0005","url":null,"abstract":"Introduction: Human anatomy is essential for both clinical and surgical practice. Although the anterior jugular veins (AJVs) are of great importance in many surgeries, there are few studies addressing the anatomic variations of these vessels. This study highlights the venous drainage of the head and neck and the importance of anatomical variations in the AJVs. Objective: To observe and describe the anatomy of the jugular veins and evaluate whether there are patterns influenced by anthropometric factors or comorbidities. Methods: Neck dissections were performed on 30 cadavers. The anatomical characteristics of the AJVs were described considering diameter, midline distance, anastomosis, and presence of the jugular venous arch. Results: Cadavers of 14 women and 16 men were dissected. Ninety percent (90%) of the jugular veins had a rectilinear path and 37% presented anastomosis: H-shaped (63.7%),N-shaped (27.3% ), and Y-shaped (9%). In relation to the number of veins, 20% of the cadavers had only one AJV, 63.3% had two, 10% had three, and 6.7% presented a total of four. Mean distance between jugular veins was 12 mm, and most veins (60%) had a diameter <5 mm. There was no statistically significant correlation between anatomical variations and anthropometric factors. Conclusion: AJVs were always present in the dissected cadavers, and the configuration most commonly found was two veins, each <5 mm in diameter. They were less than 10 mm away from the cervical midline and, when they presented anastomosis, it was H-shaped in most cases.","PeriodicalId":8285,"journal":{"name":"Archives of otolaryngology--head & neck surgery","volume":"57 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75397243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
of nerves head neck surgery intraoperative facial nerve monitoring. branches of the facial nerve during parotid gland surgery
头颈外科术中面神经监测。腮腺手术中面神经的分支
{"title":"SBCCP course - Qualification for mapping of cranial nerves in head and neck surgery - intraoperative facial nerve monitoring","authors":"Fátima C. Mendes de Matos, V. M. Vasconcellos","doi":"10.4322/ahns.2022.0001","DOIUrl":"https://doi.org/10.4322/ahns.2022.0001","url":null,"abstract":"of nerves head neck surgery intraoperative facial nerve monitoring. branches of the facial nerve during parotid gland surgery","PeriodicalId":8285,"journal":{"name":"Archives of otolaryngology--head & neck surgery","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74916335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Angélica Lopes Frade, Beatriz Santos Borges, Fátima C. Mendes de Matos, A. K. D. L. Vidal
Introduction : In Brazil, cancer is a public health problem because of its epidemiological, social, and economic amplitude. Objective : This study aimed to identify and analyze the difficulties experienced by head and neck (H&N) cancer patients, who are users of the Brazilian public health system (SUS), from their perspective of diagnosis to post-treatment. Methods : Qualitative case series carried out using individual semi-structured interviews. Data were collected from October 2019 to March 2020 and interpreted by content analysis. Results : Three categories emerged from the analysis: “difficulties in the diagnosis phase”, “conflicts experienced during treatment” and “post-treatment difficulties/sequelae”. Corroborating the literature, it was found that the difficulties faced by cancer patients are present in all stages of the disease: from access to prevention health services and diagnosis to post-treatment, influenced by late diagnosis, treatment side effects, and disease comorbidities. Conclusion : It is essential to carry out studies addressing changes in the family, professional and personal scope of cancer patients, aiming to provide them with comprehensive care and health professionals with understanding about what this disease represents in the life of these individuals.
{"title":"Cancer in the head and neck region and its face under the perspective of users of a public reference hospital in Recife, state of Pernambuco, Brazil","authors":"Angélica Lopes Frade, Beatriz Santos Borges, Fátima C. Mendes de Matos, A. K. D. L. Vidal","doi":"10.4322/ahns.2022.0012","DOIUrl":"https://doi.org/10.4322/ahns.2022.0012","url":null,"abstract":"Introduction : In Brazil, cancer is a public health problem because of its epidemiological, social, and economic amplitude. Objective : This study aimed to identify and analyze the difficulties experienced by head and neck (H&N) cancer patients, who are users of the Brazilian public health system (SUS), from their perspective of diagnosis to post-treatment. Methods : Qualitative case series carried out using individual semi-structured interviews. Data were collected from October 2019 to March 2020 and interpreted by content analysis. Results : Three categories emerged from the analysis: “difficulties in the diagnosis phase”, “conflicts experienced during treatment” and “post-treatment difficulties/sequelae”. Corroborating the literature, it was found that the difficulties faced by cancer patients are present in all stages of the disease: from access to prevention health services and diagnosis to post-treatment, influenced by late diagnosis, treatment side effects, and disease comorbidities. Conclusion : It is essential to carry out studies addressing changes in the family, professional and personal scope of cancer patients, aiming to provide them with comprehensive care and health professionals with understanding about what this disease represents in the life of these individuals.","PeriodicalId":8285,"journal":{"name":"Archives of otolaryngology--head & neck surgery","volume":"55 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82104917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Emerson Kennedy Ribeiro de Andrade, Thiago Câmara de Souza Barbalho, Sheila Ramos de Miranda Henriques, Marina Mayara Batista do Rêgo
{"title":"Asymptomatic foreign body spontaneously discharged from Wharton s duct: a case report","authors":"Emerson Kennedy Ribeiro de Andrade, Thiago Câmara de Souza Barbalho, Sheila Ramos de Miranda Henriques, Marina Mayara Batista do Rêgo","doi":"10.4322/ahns.2022.0011","DOIUrl":"https://doi.org/10.4322/ahns.2022.0011","url":null,"abstract":"","PeriodicalId":8285,"journal":{"name":"Archives of otolaryngology--head & neck surgery","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86845873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.24983/scitemed.aohns.2022.00165
Vanessa Gehrke, B. Beraldin, J. L. Lubianca Neto, M. Barra, Jéssica De Castro Viga, Marina Zottis De Deus Vieira, Iazmim Samih Hamed Moh´D Houdali, Marcelo Assis Moro da Rocha Filho
The sinonasal region is frequently associated with malignancies, but adenocarcinomas are extremely rare, especially the non-intestinal type. The symptoms of a disease are usually non-specific, making a diagnosis difficult until the disease has reached a late stage. Radiographic studies are essential for determining the stage of the disease and planning the surgical procedure. The endonasal surgical approach has gained popu-larity in recent years. This case report describes the case of a 49-year-old male who suffered from left nasal obstruction, headaches, recurrent epistaxis, low visual acuity, and proptosis. A magnetic resonance image revealed a contrast-enhancing bulky lesion that occupied the left sinona sal cavity up to the level of the choana. The patient was subjected to an endoscopic procedure employing a centripetal technique, which allowed the medial wall of the orbit and the anterior base of the skull to be preserved while the tumor was completely removed. Upon review of the pathology report, the tumor was identified as a high grade non-intestinal adenocarcinoma. Tumors of this type are more common in men and can affect anyone from teenagers to older adults. A nasal obstruction is the most common symptom, but swelling and facial deformity may also be present. This tumor is characterized by a solid pattern and is an invasive cancer that has an aggressive nature. The level of pleomorphism is moderate to severe, with a high mitotic index and atypical mitoses as well as necrosis. There is CK7 positivity in the immunohistochemistry pattern, while CK20 and CDX-2 are negative. The diagnosis poses a number of challenges. An immunohistochemical study and a histological examination are essential in order to confirm these findings. An accurate classification of the disease is critical for determining its prognosis.
{"title":"A Rare Case of High-Grade Non-intestinal Sinonasal Adenocarcinoma","authors":"Vanessa Gehrke, B. Beraldin, J. L. Lubianca Neto, M. Barra, Jéssica De Castro Viga, Marina Zottis De Deus Vieira, Iazmim Samih Hamed Moh´D Houdali, Marcelo Assis Moro da Rocha Filho","doi":"10.24983/scitemed.aohns.2022.00165","DOIUrl":"https://doi.org/10.24983/scitemed.aohns.2022.00165","url":null,"abstract":"The sinonasal region is frequently associated with malignancies, but adenocarcinomas are extremely rare, especially the non-intestinal type. The symptoms of a disease are usually non-specific, making a diagnosis difficult until the disease has reached a late stage. Radiographic studies are essential for determining the stage of the disease and planning the surgical procedure. The endonasal surgical approach has gained popu-larity in recent years. This case report describes the case of a 49-year-old male who suffered from left nasal obstruction, headaches, recurrent epistaxis, low visual acuity, and proptosis. A magnetic resonance image revealed a contrast-enhancing bulky lesion that occupied the left sinona sal cavity up to the level of the choana. The patient was subjected to an endoscopic procedure employing a centripetal technique, which allowed the medial wall of the orbit and the anterior base of the skull to be preserved while the tumor was completely removed. Upon review of the pathology report, the tumor was identified as a high grade non-intestinal adenocarcinoma. Tumors of this type are more common in men and can affect anyone from teenagers to older adults. A nasal obstruction is the most common symptom, but swelling and facial deformity may also be present. This tumor is characterized by a solid pattern and is an invasive cancer that has an aggressive nature. The level of pleomorphism is moderate to severe, with a high mitotic index and atypical mitoses as well as necrosis. There is CK7 positivity in the immunohistochemistry pattern, while CK20 and CDX-2 are negative. The diagnosis poses a number of challenges. An immunohistochemical study and a histological examination are essential in order to confirm these findings. An accurate classification of the disease is critical for determining its prognosis.","PeriodicalId":8285,"journal":{"name":"Archives of otolaryngology--head & neck surgery","volume":"49 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84961381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
José Gabriel Miranda da Paixão, I. Martins, Vinicius Fialho Teixeira
Financial support: None Conflicts of interest: No conflicts of interest declared concerning the publication of this article. Submitted: August 25, 2020. Accepted: October 21, 2020. The study was carried out at Hospital Ophir Loyola, Belém, PA, Brasil. abstract Introduction: Leiomyosarcoma (LMS) is rare, although commonly described in oral cavity. It can appear anywhere smooth muscle is present and there are reports of this type of neoplasm in many subsites in head and neck. Case Report: 44-year-old male patient with 2-year-history of cervical nodule, progressively growing, causing pain and neck movement limitation. Patient underwent en bloc resection of the tumor along with right ECM muscle, cervical levels II, III, IV and V. Discussion: Primary resection with wide margins is the treatment of choice for localized lesions. The present case originating in ECM may be unique until now, but it was handled based on the available literature and presented a satisfactory outcome.
{"title":"Leiomyosarcoma in sternocleidomastoid muscle: a case report","authors":"José Gabriel Miranda da Paixão, I. Martins, Vinicius Fialho Teixeira","doi":"10.4322/ahns.2020.0021","DOIUrl":"https://doi.org/10.4322/ahns.2020.0021","url":null,"abstract":"Financial support: None Conflicts of interest: No conflicts of interest declared concerning the publication of this article. Submitted: August 25, 2020. Accepted: October 21, 2020. The study was carried out at Hospital Ophir Loyola, Belém, PA, Brasil. abstract Introduction: Leiomyosarcoma (LMS) is rare, although commonly described in oral cavity. It can appear anywhere smooth muscle is present and there are reports of this type of neoplasm in many subsites in head and neck. Case Report: 44-year-old male patient with 2-year-history of cervical nodule, progressively growing, causing pain and neck movement limitation. Patient underwent en bloc resection of the tumor along with right ECM muscle, cervical levels II, III, IV and V. Discussion: Primary resection with wide margins is the treatment of choice for localized lesions. The present case originating in ECM may be unique until now, but it was handled based on the available literature and presented a satisfactory outcome.","PeriodicalId":8285,"journal":{"name":"Archives of otolaryngology--head & neck surgery","volume":"162 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78074385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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