scholarly journals A case series of metastatic lateral cervical lymphadenopathy

2017 ◽  
Vol 4 (3) ◽  
pp. 988
Author(s):  
Amit Narayan Pothare ◽  
Karuna Ilamkar
Keyword(s):  
Head And Neck ◽  
Neck Dissection ◽  
Primary Tumor ◽  
Radical Neck Dissection ◽  
Case Series ◽  
Cervical Lymphadenopathy ◽  
Neck Region ◽  
Signs And Symptoms ◽  
Selective Neck Dissection ◽  
Occult Metastasis

Background: Metastasis is a common cause of lymphadenopathy, seen mainly in patients above 40 years of age. Regional nodes entrap the tumor cells and setup complex immunological reactions within the nodes. The histological appearance of the nodes often suggests the primary tumor. The head and neck cancers spread to regional nodes via embolism and permeation. Primary site is evident most of times. The nodes are initially mobile but later may becomes fixed. The aim was to study the lateral cervical metastasis secondary to either lymphatic spread from distant primary or occult metastasis, their signs and symptoms, diagnostic procedure and treatment modalities.Methods: The study was conducted from July 2012 to June 2015. All patients having cervical lymphadenopathy secondary to metastasis diagnosed by FNAC, are included in study. Patients are evaluated as a whole, starting with clinical history and examinations as per proforma. In cases of lympahdenopathy where the diagnosis was not established with FNAC, biopsy was performed and efficacy of FNAC has been calculated. Results: Total 37 patients are studied. Most cases occurred in 5th decade of life, followed by 4th decade. More common in male 83.70% as compared to female 16.30% due to tobacco and smoking addiction more common in males. Change in voice is most common presentation in 46% of cases, followed by dysphagia in 35.13% of patients. Primary tumor was evident in 83.78% of cases and occult in 16.22%. Fixed nodes present in 54.05%, reduced mobility in 21.62% and mobile in 24.32%. FNAC was done in all the cases and positive results obtained in 91.8% with sensitivity of 90% and specificity of 98%. In patients treated by neoadjuvant chemotherapy followed by modified neck dissection, no recurrence occurred. Out of 10 patients treated by radical neck dissection only 2 patients had recurrence in follow up period and managed by radiotherapy. In 15 patients treated by radical radiotherapy, 5 patients had local recurrence and required selective neck dissection in follow up.Conclusions: Cervical lymph node metastasis was major presentation of malignancies of head and neck region and also from distant site. Whenever presents, it should raise suspicion of metastatic origin. Early diagnosis of primary tumor followed by aggressive treatment via multimodal approach prolongs survival.

Surgical management of lymphangiomas in adults

1996 ◽  
Vol 110 (6) ◽  
pp. 586-589 ◽  
Author(s):  
A. J. Curran ◽  
N. Malik ◽  
D. McShane ◽  
C. V. I. Timon
Keyword(s):  
Parotid Gland ◽  
Facial Nerve ◽  
Head And Neck ◽  
Neck Dissection ◽  
Surgical Management ◽  
Neck Region ◽  
Selective Neck Dissection ◽  
Older Population ◽  
Head And Neck Region ◽  
Congenital Tumours

AbstractLymphangiomas are uncommon benign congenital tumours. Most occur in the head and neck region and the vast majority present before the age of two. This paper describes the presentation and management of four cases presenting after puberty and involving the parotid gland. The cases are unusual in that all were intimately associated with the facial nerve and in an older population. The value of selective neck dissection and facial nerve exposure as an approach to these lesions is discussed.

S174 – Therapeutic Selective Neck Dissection Outcomes

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P134-P134
Author(s):  
Peter M Shepard ◽  
Olson Jordan ◽  
Glen E Leverson ◽  
Paul M Harari ◽  
Gregory K Hartig
Keyword(s):  
Neck Dissection ◽  
Primary Tumor ◽  
Postoperative Radiotherapy ◽  
Radical Neck Dissection ◽  
Retrospective Chart Review ◽  
Regional Recurrence ◽  
Selective Neck Dissection ◽  
Nodal Metastases ◽  
Neck Node ◽  
Primary Tumor Site

Objectives To examine the efficacy of selective neck dissection in patients with nodal metastases from head and neck squamous cell carcinoma. Methods A retrospective chart review was performed on a cohort of 156 subjects with clinically positive regional nodal metastases, whose initial management included neck dissection by a single surgeon from 1994–2007. 69 subjects underwent selective neck dissection (SND), while 87 underwent radical or modified radical neck dissection (R/MRND). The majority of subjects (81%) received postoperative radiotherapy. Primary outcomes included 3-year regional recurrence and 5-year overall survival, using Kaplan-Meier analysis. Results Following exclusion of subjects with local recurrence before or concurrent with regional recurrence, there were 4 (8.6%) regional recurrences in the SND group and 15 (22%) in the R/MRND group. 2 and 6 of these recurrences involved the contralateral neck in each group, respectively. Using multivariate analysis we adjusted for differences in nodal and primary tumor stage, primary tumor site, year of surgery, extracapsular spread, and postoperative radiotherapy rates. The lower regional recurrence rate in the SND group remained statistically significant (p=0.02). Overall 5-year survival was 46% in the SND group vs. 34% in the R/MRND group (p=0.23). Conclusions These results demonstrate excellent regional disease control following SND in patients with neck node metastases. SND with adjunctive radiotherapy remains our preferred approach for most patients undergoing therapeutic neck dissection.

scholarly journals P2: CONSIDERATIONS IN SURGICAL VERSUS NONSURGICAL MANAGEMENT OF HEAD AND NECK MERKEL CELL CARCINOMA

2021 ◽  
Vol 108 (Supplement_1) ◽  
Author(s):  
T Crotty ◽  
A McHugh ◽  
P Griffith ◽  
T Moran
Keyword(s):  
Cell Carcinoma ◽  
Neck Dissection ◽  
Merkel Cell Carcinoma ◽  
Multidisciplinary Approach ◽  
Neuroendocrine Tumour ◽  
Radical Neck Dissection ◽  
Case Series ◽  
Selective Neck Dissection ◽  
Merkel Cell ◽  
Nonsurgical Management

Abstract Introduction MCC is a rare cutaneous neuroendocrine tumour with a high risk of regional and distant metastasis. Management of this highly aggressive tumour is complex and mandates a multidisciplinary approach for optimal outcomes. Method Over 12 months, three cases of MCC in the cervicofacial region were identified and described. A critical review of the literature is included. Result Tumour staging confirmed 2/3 cases had regional spread. One patient underwent unilateral parotidectomy with modified radical neck dissection and adjuvant radiotherapy. The other case is awaiting radiotherapy following a selective neck dissection. The final case had no further surgery and is currently under surveillance. Conclusion This case series illustrates the diversity in managing cervicofacial MCC's at various stages of their development. Take-home message Merkel cell carcinoma must be managed aggressively with a multidisciplinary approach, regardless of how localised it may appear.

scholarly journals The effectiveness of oral propranolol for infantile hemangioma on the head and neck region: A case series

2021 ◽  
pp. 106120
Author(s):  
Prasetyanugraheni Kreshanti ◽  
Nandya Titania Putri ◽  
Valencia Jane Martin ◽  
Chaula Luthfia Sukasah
Keyword(s):  
Head And Neck ◽  
Case Series ◽  
Neck Region ◽  
Infantile Hemangioma ◽  
Head And Neck Region ◽  
Oral Propranolol

scholarly journals Automatic segmentation of head and neck primary tumors on MRI using a multi-view CNN

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Jens P.E. Schouten ◽  
Samantha Noteboom ◽  
Roland M. Martens ◽  
Steven W. Mes ◽  
C. René Leemans ◽  
...  
Keyword(s):  
Head And Neck ◽  
Treatment Planning ◽  
Primary Tumor ◽  
Tumor Volume ◽  
Automatic Segmentation ◽  
Neck Region ◽  
Primary Tumors ◽  
Head And Neck Region ◽  
Primary Tumor Volume ◽  
Mri Sequences

Abstract Background  Accurate segmentation of head and neck squamous cell cancer (HNSCC) is important for radiotherapy treatment planning. Manual segmentation of these tumors is time-consuming and vulnerable to inconsistencies between experts, especially in the complex head and neck region. The aim of this study is to introduce and evaluate an automatic segmentation pipeline for HNSCC using a multi-view CNN (MV-CNN). Methods The dataset included 220 patients with primary HNSCC and availability of T1-weighted, STIR and optionally contrast-enhanced T1-weighted MR images together with a manual reference segmentation of the primary tumor by an expert. A T1-weighted standard space of the head and neck region was created to register all MRI sequences to. An MV-CNN was trained with these three MRI sequences and evaluated in terms of volumetric and spatial performance in a cross-validation by measuring intra-class correlation (ICC) and dice similarity score (DSC), respectively. Results The average manual segmented primary tumor volume was 11.8±6.70 cm3 with a median [IQR] of 13.9 [3.22-15.9] cm3. The tumor volume measured by MV-CNN was 22.8±21.1 cm3 with a median [IQR] of 16.0 [8.24-31.1] cm3. Compared to the manual segmentations, the MV-CNN scored an average ICC of 0.64±0.06 and a DSC of 0.49±0.19. Improved segmentation performance was observed with increasing primary tumor volume: the smallest tumor volume group (<3 cm3) scored a DSC of 0.26±0.16 and the largest group (>15 cm3) a DSC of 0.63±0.11 (p<0.001). The automated segmentation tended to overestimate compared to the manual reference, both around the actual primary tumor and in false positively classified healthy structures and pathologically enlarged lymph nodes. Conclusion An automatic segmentation pipeline was evaluated for primary HNSCC on MRI. The MV-CNN produced reasonable segmentation results, especially on large tumors, but overestimation decreased overall performance. In further research, the focus should be on decreasing false positives and make it valuable in treatment planning.

scholarly journals The importance of flaps in reconstruction of locoregionally advanced lateral skull-base cancer defects: a tertiary otorhinolaryngology referral centre experience

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Domen Vozel ◽  
Peter Pukl ◽  
Ales Groselj ◽  
Aleksandar Anicin ◽  
Primoz Strojan ◽  
...  
Keyword(s):  
Skull Base ◽  
Neck Dissection ◽  
Temporal Bone ◽  
Free Flap ◽  
Radical Neck Dissection ◽  
Selective Neck Dissection ◽  
Flap Reconstruction ◽  
Referral Centre ◽  
Regional Flap ◽  
Lateral Skull Base

Abstract Background The aim of the study was to identify the value of extensive resection and reconstruction with flaps in the treatment of locoregionally advanced lateral skull-base cancer. Patients and methods The retrospective case review of patients with lateral skull-base cancer treated surgically with curative intent between 2011 and 2019 at a tertiary otorhinolaryngology referral centre was made. Results Twelve patients with locoregionally advanced cancer were analysed. Lateral temporal bone resection was performed in nine (75.0%), partial parotidectomy in six (50.0%), total parotidectomy in one (8.3%), ipsilateral selective neck dissection in eight (66.7%) and ipsilateral modified radical neck dissection in one patient (8.3%). The defect was reconstructed with anterolateral thigh free flap, radial forearm free flap or pectoralis major myocutaneous flap in two patients (17.0%) each. Mean overall survival was 3.1 years (SD = 2.5) and cancer-free survival rate 100%. At the data collection cut-off, 83% of analysed patients and 100% of patients with flap reconstruction were alive. Conclusions Favourable local control in lateral skull-base cancer, which mainly involves temporal bone is achieved with an extensive locoregional resection followed by free or regional flap reconstruction. Universal cancer registry should be considered in centres treating this rare disease to alleviate analysis and multicentric research.

Endoscopic Cervical Lymph Node Dissection Using the Extra-cervical Anterior Chest Wall Approach: A New Technique

2021 ◽  
pp. 155335062110576
Author(s):  
Islam A. Elzahaby ◽  
Mosab Shetiwy ◽  
Amr Hossam ◽  
Amr Elafy
Keyword(s):  
Head And Neck ◽  
Neck Dissection ◽  
Chest Wall ◽  
Anterior Chest Wall ◽  
Selective Neck Dissection ◽  
Open Approach ◽  
Primary Tumors ◽  
Estimated Blood Loss ◽  
The Mean ◽  
Neurovascular Structures

Introduction This study aims to demonstrate the safety, surgical feasibility, and esthetic features of total endoscopic neck dissection (END) through anterior chest wall approach (ACWA) without creation of any neck incisions. Resection of their primary tumors followed by selective total END through ACWA using 3 ports (one 10-mm port for the camera and two 5-mm ports for the working instruments). Methods From January 2020 to August 2020, 6 patients with a biopsy proven head and neck carcinoma underwent resection of their primary tumors followed by selective total END through ACWA using 3 ports (one 10-mm port for the camera and two 5-mm ports for the working instruments). Results The selective neck dissection was successfully performed endoscopically in all cases with no conversion to open approach and with good visualization of the major neurovascular structures. The operative time for the END ranged from 120 to 170 minutes, with 10–50 mL estimated blood loss. No significant perioperative complications were encountered. The mean total number of cervical LN retrieved was 13.67 + 2.42, and the mean LNR was .01 + .13. All patients were discharged in the third postoperative day, and they were satisfied with the cosmetic outcome. Conclusion Selective total END through ACWA is technically feasible and safe with satisfactory cosmetic results. The absence of neck scars and magnification of the important neurovascular structures are the most obvious advantages of this innovative technique. It may be a valid alternative to conventional surgery when performed in selected patients. However, further research with longer follow up is needed to clarify the oncological safety and the real benefits of END in head and neck cancer patients.

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