scholarly journals Selectively Sparing the Submandibular Gland When Level IB Lymph Nodes Are Included in the Radiation Target Volume: A Safety and Toxicity Analysis in Cancers of the Oropharynx and Oral Cavity

2016 ◽  
Vol 94 (4) ◽  
pp. 887
Author(s):  
J.F. Greskovich ◽  
N.P. Joshi ◽  
A. Juloori ◽  
M.C. Ward ◽  
H. Qu ◽  
...  
Keyword(s):  
Oral Cavity ◽  
Lymph Nodes ◽  
Submandibular Gland ◽  
Target Volume ◽  
Toxicity Analysis ◽  
Safety And Toxicity

Submandibular Gland Invasion by Oral Cavity Cancers: A Systematic Review

2019 ◽  
Vol 161 (2) ◽  
pp. 227-234 ◽  
Author(s):  
Yusuf Dundar ◽  
Quinton Mandle ◽  
Syed N. Raza ◽  
Ho-Sheng Lin ◽  
John Cramer ◽  
...  
Keyword(s):  
Systematic Review ◽  
Oral Cavity ◽  
Lymph Nodes ◽  
Submandibular Gland ◽  
Primary Treatment ◽  
Treatment Modalities ◽  
Adjuvant Radiation ◽  
Primary Tumors ◽  
Tumor Involvement ◽  
Oral Cavity Cancers

ObjectiveThe submandibular gland (SMG) is typically included in level I neck dissection specimens despite limited data demonstrating SMG invasion. The main objective of this article is to determine the rate and pathways of SMG invasion by squamous cell carcinoma of the oral cavity and oropharynx.Data SourcesA systematic review of relevant studies was performed, evaluating articles identified via the PubMed, Cochrane, and Medline databases.Review MethodsDescriptive features of primary tumors, primary treatment modalities, the rate and pathway of SMG invasion, and survival outcomes, if present, were reported following the PRISMA guidelines.ResultsThe initial literature search yielded 273 articles, of which 17 met inclusion criteria. A total of 2306 patients with 2792 SMG resections were analyzed. Fifty-eight resections (2.0%) were revealed to have tumor involvement. Among patients with SMG tumor involvement, the most common invasion pathway was direct SMG invasion by primary tumor (43 of 58, 74.1%). The second-most common mode of SMG invasion was from involved adjacent lymph nodes (10 of 58, 17.2%). Only 3 SMG resections out of 2792 (0.1%) had isolated metastatic parenchyma without evidence of direct tumor invasion or invasion by involved lymph nodes.ConclusionGiven this rarity of SMG involvement, preservation of SMG might be feasible in selected patient population. However, additional studies need to examine the functionality of preserved SMGs among patients who receive postoperative adjuvant radiation therapy.

scholarly journals Level I Nodal Positivity as a Factor for Involvement of the Submandibular Gland in Oral Cavity Carcinoma: A Case Series Report

2020 ◽  
Author(s):  
Hamdan Ahmed Pasha ◽  
Rahim Dhanani ◽  
Shayan Khalid Ghaloo ◽  
Kulsoom Ghias ◽  
Mumtaz Jamshed Khan
Keyword(s):  
Oral Cavity ◽  
Lymph Nodes ◽  
Neck Dissection ◽  
Submandibular Gland ◽  
Primary Tumor ◽  
Oral Carcinoma ◽  
Care Hospital ◽  
Direct Extension ◽  
Oral Cavity Carcinoma ◽  
Level I

Abstract Introduction The routine practice of neck dissection in the surgical management of oral carcinoma has evolved into a more functionally conservative approach. Over time, the rationale for removal of the submandibular gland has been questioned. Routine extirpation of the submandibular gland can aggravate the xerostomia experienced by many patients, significantly affecting their quality of life. Objective The objective of the present study was to determine the incidence of submandibular gland metastases in oral cavity carcinoma and to identify possible factors that may affect their involvement. Methods A total of 149 cases of oral carcinoma presenting at a private tertiary care hospital in Karachi, Pakistan, over the course of 1 year were reviewed retrospectively. Results Histopathological data showed that the submandibular gland was involved in 7 (4.7%) cases. Involvement of level I lymph nodes was found in all of the cases. Direct extension of primary tumor was noted in two cases when the primary tumor was in the floor of the mouth. Conclusion The results suggest that preservation of the submandibular gland during neck dissection for oral carcinoma can be practiced safely when there is no evidence of direct extension of the primary tumor toward the submandibular gland or when there is no clinical or radiological evidence of neck disease in level I. Presence of pathological lymph nodes in level I requires caution when contemplating preservation of the submandibular gland.

Possible translocation of periodontal pathogens into the lymph nodes draining the oral cavity

2012 ◽  
Vol 50 (5) ◽  
pp. 827-836 ◽  
Author(s):  
G. Amodini Rajakaruna ◽  
Makoto Umeda ◽  
Keisuke Uchida ◽  
Asuka Furukawa ◽  
Bae Yuan ◽  
...  
Keyword(s):  
Oral Cavity ◽  
Lymph Nodes ◽  
Periodontal Pathogens

scholarly journals Failure patterns of cervical lymph nodes in metastases of unknown origin according to target volume

2020 ◽  
Vol 38 (1) ◽  
pp. 18-25
Author(s):  
Dong-Yun Kim ◽  
Dae Seog Heo ◽  
Bhumsuk Keam ◽  
Chan Young Ock ◽  
Soon Hyun Ahn ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Unknown Origin ◽  
Target Volume ◽  
Cervical Lymph Nodes ◽  
Failure Patterns

scholarly journals Submandibular gland in early stage oral cavity cancer

2015 ◽  
Author(s):  
Suphi Bulgurcu ◽  
İlker Burak Arslan ◽  
Erhan Demirhan ◽  
Melek Uncel ◽  
İbrahim Çukurova
Keyword(s):  
Oral Cavity ◽  
Submandibular Gland ◽  
Oral Cavity Cancer ◽  
Early Stage

scholarly journals Ossifying fibrous epulis as an IgG4-related disease of the oral cavity: a case report and literature review

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Yoshiko Ike ◽  
Takahiro Shimizu ◽  
Masaru Ogawa ◽  
Takahiro Yamaguchi ◽  
Keisuke Suzuki ◽  
...  
Keyword(s):  
Oral Cavity ◽  
Lymph Nodes ◽  
Plasma Cells ◽  
Maxillofacial Surgery ◽  
The Body ◽  
Pathological Diagnosis ◽  
Cervical Lymph Nodes ◽  
Related Disease ◽  
Igg4 Related Disease ◽  
Organ Manifestations

Abstract Background Fibrous sclerosing tumours and hypertrophic lesions in IgG4-related disease (IgG4-RD) are formed in various organs throughout the body, but disease in the oral region is not included among individual organ manifestations. We report a case of ossifying fibrous epulis that developed from the gingiva, as an instance of IgG4-RD. Case presentation A 60-year-old Japanese man visited the Department of Oral and Maxillofacial Surgery, Gunma University Hospital, with a chief complaint of swelling of the left mandibular gingiva. A 65 mm × 45 mm pedunculated tumour was observed. The bilateral submandibular lymph nodes were enlarged. The intraoperative pathological diagnosis of the enlarged cervical lymph nodes was inflammation. Based on this diagnosis, surgical excision was limited to the intraoral tumour, which was subsequently pathologically diagnosed as ossifying fibrous epulis. Histopathologically, the ossifying fibrous epulis exhibited increased levels of fibroblasts and collagen fibres, as well as infiltration by numerous plasma cells. The IgG4/IgG cell ratio was > 40%. Serologic analysis revealed hyper-IgG4-emia (> 135 mg/dL). The patient met the comprehensive clinical diagnosis criteria and the American College of Rheumatology and European League Against Rheumatism classification criteria for IgG4-RD. Based on these criteria, we diagnosed the ossifying fibrous epulis in our patient as an IgG4-related disease. A pathological diagnosis of IgG4-related lymphadenopathy was established for the cervical lymph nodes. Concomitant clinical findings were consistent with type II IgG4-related lymphadenopathy. Conclusions A routine serological test may be needed in cases with marked fibrous changes (such as epulis) in the oral cavity and plasma cells, accompanied by tumour formation, to determine the possibility of individual-organ manifestations of IgG4-related disease.

scholarly journals FDG-PET/CT in the Radiotherapy Treatment Planning of Locally Advanced Anal Cancer: A Monoinstitutional Experience

2021 ◽  
Vol 11 ◽  
Author(s):  
Clelia Di Carlo ◽  
Maika di Benedetto ◽  
Lisa Vicenzi ◽  
Sara Costantini ◽  
Francesca Cucciarelli ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Anal Cancer ◽  
Dose Escalation ◽  
Locally Advanced ◽  
Target Volume ◽  
Target Volume Delineation ◽  
18Fdg Pet ◽  
Volume Delineation ◽  
Pet Ct ◽  
The Impact

AimsRadiotherapy with concurrent 5-fluorouracil/mitomycin-C based chemotherapy has been established as definitive standard therapy approach for anal cancer. Intensity Modulated Radiotherapy (IMRT) leads to a precise treatment of the tumor, allowing dose escalation on Gross Tumor Volume (GTV), with a surrounding healthy tissues sparing. Our study assessed the impact of 18-Fluorodeoxyglucose positron emission tomography (18FDG-PET/CT) on the radiotherapy contouring process and its contribution to lymphatic spread detection, resulting to a personalization of Clinical Target Volume (CTV) and dose prescription.MethodsThirty-seven patients, with histologically proven squamous cell carcinoma of the anal canal (SCCAC) were analyzed. All patients were evaluated with history and physical examination, trans-anal endoscopic ultrasound, pelvis magnetic resonance imaging (MRI), computed tomography (CT) scans of the chest, abdomen and pelvis and planning 18FDG-PET/CT. The GTV and CTV were drawn on CT, MRI and 18FDG-PET/CT fused images.ResultsThirty-four (91%) out of 37 patients presented lymph nodes involvement, in one or more areas, detected on 18FDG-PET/CT and/or MRI. The 18FDG-PET/CT showed positive lymph nodes not detected on MRI imaging (PET+, MRI−) in 14/37 patients (38%). In 14 cases, 18FDG-PET/CT allowed to a dose escalation in the involved nodes. The 18FDG-PET/CT fused images led to change the stage in 5/37(14%) cases: four cases from N0 to N1 (inguinal lymph nodes) and in one case from M0 to M1 (common iliac lymph nodes).ConclusionsThe 18FDG-PET/CT has a potentially relevant impact in staging and target volume delineation/definition in patients affected by anal cancer. In our experience, clinical stage variation occurred in 14% of cases. More investigations are needed to define the role of 18FDG-PET/CT in the target volume delineation of anal cancer.

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