FDG-PET in the Pretherapeutic Evaluation of Primary Squamous Cell Carcinoma of the Oral Cavity and the Involvement of Cervical Lymph Nodes

Background: Metastasis of aerodigestive tract cancers to cervical lymph nodes is one of the otolaryngologists’ concerns that relies on a variety of factors such as the size of the primary tumor and its spread. We aimed to study the prevalence of occult cervical metastases in patients with clinical N0 neck in oral cavity squamous cell carcinoma. Methods: In this cross-sectional analytic study, the researchers referred to the archive of Emam Reza Hospital and studied medical files of patients with a definite diagnosis of oral cavity squamous cell carcinoma admitted from April 2011 to April 2016 while collecting relevant data such as age, gender, size of the primary mass, place of the lesion, clinical and pathological nodal involvement. The data was analyzed employing SPSS 19 whereas the statistical significance level in all exams was set at 0.05. Results: Average age of participants was 61.67 ± 14.02, and they were mostly male. Forty-five percent of participants had a clinical N0 neck and the majority of them didn’t have metastasis in the pathological study. The prevalence of metastatic lymph nodes in patients with clinical N0 was 30%. No significant relationship was observed between the number of lymph nodes containing occult metastasis and T of the tumor (P = .578). Conclusion: In squamous cell carcinoma of oral cavity, the prevalence of metastatic lymph nodes in the neck is 30% and is significantly related to the location of the lesion while no significant relationship to T of the tumor is observed.

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A Report on Synchronous Polymorphous Low-grade Adenocarcinoma and Unknown Primary Squamous Cell Carcinoma

International Journal of Head and Neck Surgery ◽

10.5005/jp-journals-10001-1251 ◽

2015 ◽

Vol 6 (4) ◽

pp. 181-186

Author(s):

Adam D Fisher ◽

Shawn A McClure ◽

Johnny Franco

Keyword(s):

Squamous Cell Carcinoma ◽

Lymph Nodes ◽

Cell Carcinoma ◽

Head And Neck ◽

Squamous Cell ◽

Unknown Primary ◽

Low Grade ◽

Primary Squamous Cell Carcinoma ◽

Cervical Lymph Nodes ◽

The Right

ABSTRACT Background This is a case report of synchronous, noncollision head and neck malignancies, consisting of a large polymorphous low-grade adenocarcinoma (PLGA) and an unknown primary squamous cell carcinoma (SCC) that was diagnosed on final pathology. Materials and methods Positron emission tomography– computed tomography (CT) scan with and without contrast was obtained, which showed a large destructive soft tissue mass emanating from the right maxilla into the right maxillary sinus with invasion into the surrounding tissue and bone, compatible with an underlying primary maxillary malignancy. Increased D-18 fluorodeoxyglucose activity was also seen in the neck corresponding to numerous bilateral cervical lymph nodes. Magnetic resonance imaging showed the extent of the soft tissue mass, which expanded to the inferior aspect of the right orbital floor, with no evidence of gross invasion into the orbit. Results The patient underwent a subtotal maxillectomy, bilateral modified radial neck dissection, and reconstruction. Pathology revealed metastatic PLGA present in the right cervical lymph nodes. Left cervical lymph nodes, however, revealed metastatic SSC. The patient was taken back to the operating room and a panendoscopy was performed. Physical examination was benign and multiple biopsies were negative for SSC. The patient underwent radiation therapy for PLGA and unknown primary SSC antigen. Conclusion Synchronous tumors of the head and neck are seldom reported and they present unique treatment challenges. This case report discusses the diagnosis, management, and unique nature of two malignant synchronous noncollision tumors in the head and neck. How to cite this article Fisher AD, McClure SA, Franco J. A Report on Synchronous Polymorphous Low-grade Adenocarcinoma and Unknown Primary Squamous Cell Carcinoma. Int J Head Neck Surg 2015;6(4):181-186.

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Regional intra-arterial polychemotherapy to increase the effectiveness of conservative treatment of locally invasive oral squamous cell carcinoma

Head and neck tumors (HNT) ◽

10.17650/2222-1468-2019-9-3-24-28 ◽

2019 ◽

Vol 9 (3) ◽

pp. 24-28

Author(s):

А. М. Mudunov ◽

B. I. Dolgushin ◽

А. А. Аkhundov ◽

М. N. Narimanov ◽

D. А. Safarov ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Oral Squamous Cell Carcinoma ◽

Oral Cavity ◽

Lymph Nodes ◽

Cell Carcinoma ◽

Squamous Cell ◽

Clinical Case ◽

Combined Treatment ◽

Radical Neck Dissection ◽

Cervical Lymph Nodes

The objective is using a clinical example to demonstrate the possibilities of intra-arterial polychemotherapy (PCT) in the combined treatment of oral squamous cell carcinoma.Clinical case. A 43-year-old oral squamous cell carcinoma patient with metastases to cervical lymph nodes, left side (T3N2bM0, stage IV) underwent 2 courses of regional neoadjuvant intra-arterial PCT (docetaxel at a dose of 105 mg, cisplatin at a dose of 105 mg), accessed through a. lingualis. A total dose of 6,800 mg of 5-fluorouracil was administered as a 96-hour infusion. PCT induced oral mucositis of grade 2, no hematological side effects were observed. Clinical examination revealed that tumor volume decreased by 60 %. Ultrasound detected no changes in lymph nodes. Second step included resection of oral cavity bottom tissues, atypical tongue resection, marginal resection of the lower jaw on the left, radical neck dissection on the left. Histological study of the surgical material of primary tumor region as well as metastases of the cervical lymph nodes on the tumor side revealed pathomorphism of 4 grade. In the postoperative period, oral cavity and neck were irradiated from 2 sides. No signs of the disease were detected within 9 months after the combined treatment.Conclusion. The clinical case demonstrates the high efficiency of regional intra-arterial PCT in patients with locally invasive oral squamous cell carcinoma. It seems relevant to further study its possibilities in the combined treatment of locally invasive forms of oral squamous cell carcinoma.

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Detection of Cervical Lymph Node Micrometastases in Patients with Squamous Cell Carcinoma of the Oral Cavity, Pharynx and Larynx

Acta Medica (Hradec Kralove Czech Republic) ◽

10.14712/18059694.2015.95 ◽

2015 ◽

Vol 58 (2) ◽

pp. 62-65 ◽

Cited By ~ 1

Author(s):

Petr Čelakovský ◽

David Kalfeřt ◽

Katarína Smatanová ◽

Viktor Chrobok ◽

Jan Laco

Keyword(s):

Squamous Cell Carcinoma ◽

Oral Cavity ◽

Lymph Nodes ◽

Cell Carcinoma ◽

Neck Dissection ◽

Tumor Cells ◽

Squamous Cell ◽

Elective Neck Dissection ◽

Cervical Lymph Nodes ◽

Level I

Background: The goal of this prospective study was to determine the frequency of micrometastases in patients with squamous cell carcinoma (SCC) of the oral cavity, pharynx and larynx in whom elective neck dissection was indicated (cN0). Patients and Methods: A total of 12 patients (10 males and 2 females) were enrolled in the study. The age ranged 42–73 years (median 62 years). Elective neck dissection was performed in all patients (8 ipsilateral, 4 bilateral) and a total of 256 lymph nodes were removed and sent for microscopic examination. Results: The presence of tumor cells in cervical lymph nodes was found in 5/12 (42%) patients. Micrometastases of SCC were found in two patients and isolated tumor cells (ITC) in two other patients. In the remaining one patient with oropharyngeal SCC, a micrometastasis of papillary thyroid carcinoma (PTC) was detected. Positive lymph nodes were localized in level II in three patients with SCC of larynx, hypopharynx and tongue base, respectively, in level I in one patient with SCC of oral tongue and in level III in one patient with PTC. Conclusion: Our results indicate that SCC of head and neck has a high potential for creating micrometastases which frequency is higher compared to clinically detected macrometastases. Therefore, elective neck dissection or radiotherapy of the neck should be considered in patients with high risk of occult metastases or micrometastases.

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Role of Clinical Palpation in Evaluation of Cervical Lymph Node in Oral Squamous Cell Carcinoma

Update Dental College Journal ◽

10.3329/updcj.v1i2.13978 ◽

2013 ◽

Vol 1 (2) ◽

pp. 02-06

Author(s):

SM Anwar Sadat ◽

Sufia Nasrin Rita ◽

Shoma Banik ◽

Md Nazmul Hasan Khandker ◽

Md Mahfuz Hossain ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Lymph Node ◽

Oral Squamous Cell Carcinoma ◽

Lymph Nodes ◽

Cell Carcinoma ◽

Squamous Cell ◽

Predictive Value ◽

Cervical Lymph Node ◽

Betel Quid ◽

Cervical Lymph Nodes

A cross sectional study of 29 cases of oral squamous cell carcinoma with or without cervical lymph node metastasis was done among Bangladeshi patients from January 2006 to December 2007. Majority of the study subjects (34.5%) belonged to the age group of 40-49 years. 58.6% of the study subjects were male, while remaining 41.4% of them were female. 51.7% of the lesions were located in the alveolar ridge where the other common sites were buccal mucosa (27.6%) and retro molar area (13.8%). Half of the study subjects (51.7%) were habituated to betel quid chewing followed by 37.9% and 10.3% were habituated to smoking and betel quid-smoking respectively. Grade I lesions was most prevalent (75.9%) in the study subjects. Majority of cases presented with Stage IV lesions (55.2%). The sensitivity, specificity, positive predictive value, negative predictive value & accuracy of clinical palpation method for determining metastatic cervical lymph nodes were 93.33%, 64.29%, 73.68%, 90% and 79.3% respectively. Careful and repeated clinical palpation plays important role in evaluation of cervical lymph nodes though several modern techniques may help additionally in the management of oral cancer.DOI: http://dx.doi.org/10.3329/updcj.v1i2.13978 Update Dent. Coll. j. 2011: 1(2): 02-06

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