scholarly journals Synovial Sarcoma of the Head and Neck: A Single Institution Review

Sarcoma ◽  
2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Vancheswaran Gopalakrishnan ◽  
Behrang Amini ◽  
Michael J. Wagner ◽  
Erica N. Nowell ◽  
Alexander J. Lazar ◽  
...  
Keyword(s):  
Head And Neck ◽  
Tumor Size ◽  
Soft Tissues ◽  
Local Therapy ◽  
Retrospective Chart Review ◽  
Progression Free Survival ◽  
Surgical Excision ◽  
Distant Recurrence ◽  
Anatomical Location ◽  
Synovial Sarcomas

Background. The prognosis and clinical characteristics of head and neck synovial sarcomas (HNSS) are unclear. Herein, we present an update using a cohort of patients treated at our institution. Methods. We performed a retrospective chart review of 44 patients diagnosed with primary HNSS between March 1990 and June 2012. Overall survival (OS) and progression-free survival (PFS) curves were estimated and hazard ratios (HRs) were calculated. Results. The entire cohort’s median PFS was 4.6 years, and 20 of the 44 (45%) patients developed either local or distant recurrence. Tumor size ≥ 5 cm (p=0.008, HR = 4.69; 95% CI = 1.34–16.38) and a primary presentation in the soft tissues of the neck (p=0.04, HR = 2.41; 95% CI = 1.003–5.82) were associated with significantly worse PFS. The OS and PFS of patients who received definitive local therapy versus those who received additional adjuvant systemic therapy did not differ significantly. Conclusion. Despite the treatment challenges associated with HNSS, our cohort of patients had a better prognosis than one might expect in this unfavorable anatomical location. Our findings suggest that tumor size and site are predictive of PFS and that wide surgical excision is of vital importance, since traditional cytotoxic chemotherapy has limited efficacy at this site.

Osteosarcoma of the Pelvis: Experience of the Cooperative Osteosarcoma Study Group

2003 ◽  
Vol 21 (2) ◽  
pp. 334-341 ◽  
Author(s):  
Toshifumi Ozaki ◽  
Silke Flege ◽  
Matthias Kevric ◽  
Norbert Lindner ◽  
Rainer Maas ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Survival Rates ◽  
Surgical Margin ◽  
Local Therapy ◽  
Progression Free Survival ◽  
Surgical Excision ◽  
Study Group ◽  
Large Tumor ◽  
Primary Tumor Site ◽  
Definitive Surgery

Purpose: To define patients and tumor characteristics as well as therapy results, patients with pelvic osteosarcoma who were registered in the Cooperative Osteosarcoma Study Group (COSS) were analyzed. Patients and Methods: Sixty-seven patients with a high-grade pelvic osteosarcoma were eligible for this analysis. Fifteen patients had primary metastases. All patients received chemotherapy according to COSS protocols. Thirty-eight patients underwent limb-sparing surgery, 12 patients underwent hemipelvectomy, and 17 patients did not undergo definitive surgery. Eleven patients received irradiation to the primary tumor site: four postoperatively and seven as the only form of local therapy. Results: Local failure occurred in 47 of all 67 patients (70%) and in 31 of 50 patients (62%) who underwent definitive surgery. Five-year overall survival (OS) and progression-free survival rates were 27% and 19%, respectively. Large tumor size (P = .0137), primary metastases (P = .0001), and no or intralesional surgery (P < .0001) were poor prognostic factors. In 30 patients with no or intralesional surgery, 11 patients with radiotherapy had better OS than 19 patients without radiotherapy (P = .0033). Among the variables, primary metastasis, large tumor, no or intralesional surgery, no radiotherapy, existence of primary metastasis (relative risk [RR] = 3.456; P = .0009), surgical margin (intralesional or no surgical excision; RR = 5.619; P < .0001), and no radiotherapy (RR = 4.196; P = .0059) were independent poor prognostic factors. Conclusion: An operative approach with wide or marginal margins improves local control and OS. If the surgical margin is intralesional or excision is impossible, additional radiotherapy has a positive influence on prognosis.

scholarly journals Clinical Profile of Patients with Head and Neck Amyloidosis: A Single-Institution Retrospective Chart Review

2020 ◽  
Vol 24 (04) ◽  
pp. e450-e456
Author(s):  
Anup Singh ◽  
Mubashshirul Haq ◽  
Poonam Gautam ◽  
Dheeraj Gautam ◽  
Aru C. Handa ◽  
...  
Keyword(s):  
Head And Neck ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Surgical Excision ◽  
Clinicopathological Characteristics ◽  
Systemic Amyloidosis ◽  
Sinus Surgery ◽  
Amyloid Deposits ◽  
Systemic Spread ◽  
Localized Disease

Abstract Introduction Isolated amyloidosis involving the head and neck is a rare entity. The pathophysiology of the localized disease appears to be distinct from that of the systemic counterpart. Systemic progression of the localized disease is unusual, and the prognosis of the localized form is excellent. Objective To describe the demographic and clinicopathological characteristics of patients presenting with localized head and neck subsite amyloidosis. Methods A retrospective chart review of the patients with head and neck amyloidosis identified by the electronic search of the electronic database of the Departments of Pathology and Otorhinolaryngology was performed. The various demographic and clinical data were tabulated. Results In total, seven patients (four females, three males) with localized head and neck amyloidosis (three supraglottic, three lingual and one sinonasal) were identified. Six patients had AL-amyloid deposits, and one patient had AA-amyloid deposits. Supraglottic involvement and that of the base of the tongue were treated surgically using CO2 laser, and these patients were disease-free at the last follow-up. The patient with sinonasal amyloidosis experienced symptom recurrence after six months of the functional endoscopic sinus surgery. All of the patients were screened for systemic amyloidosis with abdominal fat pad biopsy, and were found to be free of systemic spread. Conclusion Isolated head and neck amyloidosis, as opposed to systemic amyloidosis, has an excellent prognosis in terms of survival. Therefore, systemic amyloidosis should be excluded in all cases. The treatment of choice remains surgical excision; however, watchful waiting may be a suitable strategy for mild symptoms or for cases in which the disease was discovered incidentally.

scholarly journals An Ambiguous Growth in Floor of the Mouth

2013 ◽  
Vol 4 (1) ◽  
pp. 51-54
Author(s):  
Sonal Vahanwala ◽  
Sukhjinder Kaur Khosa ◽  
Sandeep S Pagare ◽  
Chaitanya D Nayak
Keyword(s):  
Differential Diagnosis ◽  
Oral Cavity ◽  
Head And Neck ◽  
Salivary Glands ◽  
Soft Tissues ◽  
Surgical Excision ◽  
Diverse Group ◽  
Floor Of The Mouth ◽  
Physiological Alterations ◽  
Rare Lesion

ABSTRACT Pathologic growths of the oral soft tissues are fairly common and include a diverse group of reactive and neoplastic conditions. Enlargement of or in relation to salivary glands have many causes, chief among them being inflammatory, neoplastic or physiological alterations. Nonspecific enlargement without any detectable cause has been classified as idiopathic and has been rarely reported. We describe a case of a 23-year-old female patient with a growth in floor of the mouth that was treated with conservative surgical excision. The histopathological features and differential diagnosis of this rare lesion are described and discussed. The awareness of this lesion is important to highlight the variations in the hyperplasias found in oral cavity for avoiding diagnosis and treatment pitfalls. How to cite this article Khosa SK, Nayak CD, Vahanwala S, Pagare SS. An Ambiguous Growth in Floor of the Mouth. Int J Head and Neck Surg 2013;4(1):51-54.

Cosmetic Results of Cryosurgery Versus Surgical Excision for Primary Uncomplicated Basal Cell Carcinomas of the Head and Neck

2000 ◽  
Vol 26 (8) ◽  
pp. 759-764 ◽  
Author(s):  
M. R. T. M. Thissen ◽  
F. H. M. Nieman ◽  
A. H. L. B. Ideler ◽  
P. J. M. Berretty ◽  
H. A. M. Neumann
Keyword(s):  
Head And Neck ◽  
Basal Cell ◽  
Surgical Excision ◽  
Cosmetic Results ◽  
Basal Cell Carcinomas

scholarly journals Effectiveness of nivolumab affected by prior cetuximab use and neck dissection in Japanese patients with recurrent or metastatic head and neck cancer: results from a retrospective observational study in a real-world setting

2021 ◽  
Author(s):  
Shin Kariya ◽  
Yasushi Shimizu ◽  
Nobuhiro Hanai ◽  
Ryuji Yasumatsu ◽  
Tomoya Yokota ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Dissection ◽  
Neck Cancer ◽  
Median Overall Survival ◽  
Response Rate ◽  
Objective Response ◽  
Progression Free Survival ◽  
Japanese Patients ◽  
Free Survival

Abstract Background To examine the effect of prior use of cetuximab and neck dissection on the effectiveness of nivolumab, we conducted a large-scale subgroup analysis in Japanese patients with recurrent/metastatic head and neck cancer. Methods Data on the effectiveness of nivolumab were extracted from patient medical records. All patients were analyzed for effectiveness by prior cetuximab use. In the analyses for prior neck dissection, only patients with locally advanced disease were included. Results Of 256 patients analyzed, 155 had received prior cetuximab. Nineteen of 50 patients with local recurrence underwent neck dissection. The objective response rate was 14.7 vs 17.2% (p = 0.6116), median progression-free survival was 2.0 vs 3.1 months (p = 0.0261), and median overall survival was 8.4 vs 12 months (p = 0.0548) with vs without prior cetuximab use, respectively. The objective response rate was 23.1 vs 25.9% (p = 0.8455), median progression-free survival was 1.8 vs 3.0 months (p = 0.6650), and median overall survival was 9.1 vs 9.9 months (p = 0.5289) with vs without neck dissection, respectively. Conclusions These findings support the use of nivolumab for patients with recurrent/metastatic head and neck cancer regardless of prior cetuximab use or neck dissection history. Trial registration number UMIN-CTR (UMIN000032600), Clinicaltrials.gov (NCT03569436)

scholarly journals Tumor morphology and location associate with immune cell composition in pleomorphic sarcoma

2021 ◽  
Author(s):  
Rosanna L. Wustrack ◽  
Evans Shao ◽  
Joey Sheridan ◽  
Melissa Zimel ◽  
Soo-Jin Cho ◽  
...  
Keyword(s):  
T Cells ◽  
Tumor Microenvironment ◽  
Cd8 T Cells ◽  
Tumor Size ◽  
Immune Cell ◽  
Human Cancer ◽  
Soft Tissue Sarcomas ◽  
Inverse Correlation ◽  
Anatomical Location ◽  
Pleomorphic Sarcoma

Abstract Background Soft-tissue sarcomas (STS) are a rare group of mesenchymal malignancies that account for approximately 1% of adult human cancer. Undifferentiated pleomorphic sarcoma (UPS) is one of the most common subtypes of adult STS. Clinical stratification of UPS patients has not evolved for decades and continues to rely on tumor-centric metrics including tumor size and depth. Our understanding of how the tumor microenvironment correlates to these clinicopathologic parameters remains limited. Methods Here, we performed single-cell flow cytometric immune-based profiling of 15 freshly resected UPS tumors and integrated this analysis with clinical, histopathologic, and outcomes data using both a prospective and retrospective cohort of UPS patients. Results We uncovered a correlation between physiologic and anatomic properties of UPS tumors and the composition of immune cells in the tumor microenvironment. Specifically, we identified an inverse correlation between tumor-infiltrating CD8 + T cells and UPS tumor size; and a positive correlation between tumor-infiltrating CD8 + T cells and overall survival. Moreover, we demonstrate an association between anatomical location (deep or superficial) and frequency of CD4 + PD1hi infiltrating T cells in UPS tumors. Conclusions Our study provides an immune-based analysis of the tumor microenvironment in UPS patients and describes the different composition of tumor infiltrating lymphocytes based on size and tumor depth.

scholarly journals Resolution of Metastatic Subungal Eccrine Porocarcinoma Treated with Intralesional Interleukin-2

2020 ◽  
Vol 28 (1) ◽  
pp. 220-225
Author(s):  
Ashley Drohan ◽  
Jennifer Melvin ◽  
Joanne Murphy ◽  
Carman Giacomantonio ◽  
Lucy Helyer
Keyword(s):  
Interleukin 2 ◽  
Standard Of Care ◽  
Surgical Excision ◽  
Distant Recurrence ◽  
Unique Case ◽  
Cutaneous Malignancy ◽  
Complete Surgical Excision ◽  
Locally Recurrent ◽  
Eccrine Porocarcinoma

Eccrine porocarcinoma is a rare aggressive cutaneous malignancy. Complete surgical excision is the standard of care, although there are high rates of local and distant recurrence. We present a unique case of locally recurrent and metastatic subungal porocarcinoma successfully treated with intralesional interleukin-2.

Epithelioid haemangioendothelioma in the parapharyngeal space

2006 ◽  
Vol 120 (6) ◽  
pp. 505-507 ◽  
Author(s):  
J-C Lee ◽  
B-J Lee ◽  
S-G Wang ◽  
H-W Kim
Keyword(s):  
Endothelial Cells ◽  
Facial Nerve ◽  
Head And Neck ◽  
Soft Tissues ◽  
Parapharyngeal Space ◽  
Malignant Potential ◽  
Vascular Neoplasm ◽  
Cytoplasmic Vacuolation ◽  
Upper And Lower Extremities ◽  
Epithelioid Haemangioendothelioma

Epithelioid haemangioendothelioma (EHE) is an uncommon vascular neoplasm which occurs rarely in the head and neck and has an unpredictable clinical behaviour. It is characterized by round or spindle-shaped endothelial cells with cytoplasmic vacuolation. Most often, EHE arises from the soft tissues of the upper and lower extremities, and it has borderline malignant potential. We describe the first reported case of EHE in the parapharyngeal space, which was treated successfully via a transcervical–transparotid approach (following angiography with embolization), without massive intra-operative bleeding or facial nerve damage.

scholarly journals An open-label, single-arm, phase II trial of buparlisib in patients with melanoma brain metastases not eligible for surgery or radiosurgery—the BUMPER study

2020 ◽  
Vol 2 (1) ◽  
Author(s):  
Teresa Amaral ◽  
Heike Niessner ◽  
Tobias Sinnberg ◽  
Ioannis Thomas ◽  
Andreas Meiwes ◽  
...  
Keyword(s):  
Phase Ii ◽  
Phase Ii Trial ◽  
Local Therapy ◽  
Progression Free Survival ◽  
Pi3k Inhibitor ◽  
Open Label ◽  
Preclinical Data ◽  
Overall Response ◽  
Intracranial Disease ◽  
Dismal Prognosis

Abstract Background Patients with melanoma brain metastasis (MBM) still carry a dismal prognosis. Preclinical data originated in xenograft models showed that buparlisib therapy was highly effective in therapy-naïve MBM. Patients and Methods In this open-label, phase II trial, we investigate the safety and efficacy of monotherapy with buparlisib, a PI3K inhibitor, in patients with asymptomatic MBM who were not candidates for local therapy. These patients had also progressed under immunotherapy if BRAF wild-type or under targeted therapy with BRAF/MEK inhibitors if carrying a BRAFV600E/K mutation. The primary endpoint was the intracranial disease control rate assessed by the investigators. The secondary endpoints were overall response rate, duration of response (DOR) of intracranial disease, overall response, progression-free survival (PFS), overall survival (OS), safety, and tolerability of buparlisib. Results A total of 20 patients were screened and 17 patients were treated with buparlisib. Twelve patients had progressed under more than 2 systemic therapy lines and 17 had received at least 1 previous local therapy. There were no intracranial responses. Three patients achieved intracranial stable disease; the median DOR was 117 days. The median PFS was 42 days (95% confidence interval [CI]: 23–61 days) and the median OS was 5.0 months (95% CI: 2.24–7.76 months). No new safety signs were observed. Conclusions Buparlisib was well tolerated but no intracranial responses were observed. These results might be explained in part by the inclusion of only heavily pretreated patients. However, preclinical data strongly support the rationale to explore PI3K inhibitor-based combinations in patients with MBM displaying hyperactivation of the PI3K–AKT pathway.

Bowel Perforation Presenting as Head and Neck Subcutaneous Emphysema

2021 ◽  
pp. 000313482199508
Author(s):  
Dezarae R. Leto ◽  
Derek T. Clar ◽  
David A. Goodman
Keyword(s):  
Head And Neck ◽  
Chest Wall ◽  
Clinical Evaluation ◽  
Subcutaneous Emphysema ◽  
Balloon Dilatation ◽  
Soft Tissues ◽  
Bowel Resection ◽  
Bowel Perforation ◽  
Endoscopic Balloon Dilatation ◽  
Endoscopic Balloon

This patient with Crohn's disease underwent endoscopic balloon dilatation of an ileocolic stricture, and shortly thereafter developed subcutaneous emphysema in the soft tissues of her face, neck, and chest wall. Clinical evaluation and imaging revealed peritonitis from perforated bowel. She underwent laparotomy and bowel resection and recovered well. Subcutaneous emphysema in the head and neck from perforated bowel is a rare but recognized presentation of viscus perforation.

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