scholarly journals Facial Nerve Preservation In Treatment Of Primary Parotid Squamous Cell Carcinoma: A Case Report

2021 ◽  
Author(s):  
Chunming Huang ◽  
Mingliang Cheng ◽  
Xiaojuan Luo ◽  
Xiaoping Zhao
Keyword(s):  
Squamous Cell Carcinoma ◽  
Lymph Node ◽  
Parotid Gland ◽  
Facial Nerve ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Radical Resection ◽  
Nerve Preservation ◽  
Facial Nerve Preservation ◽  
Total Parotidectomy

Abstract BackgroundPrimary squamous cell carcinoma rarely occurs in parotid gland. Partial, superficial or total parotidectomy as well as radical resection is performed based on patients’ conditions. For patients with symptoms of facial nerve weakness or dysfunction, facial nerve preservation is considered justifiably, whereas groundlessly if the malignancy is asymptomatic. We hereby reported a case of symptomatic primary parotid squamous cell carcinoma performed with total parotidectomy and facial nerve preservation.Case summaryWith the complaint of an asymptomatic mass in right parotid gland for five years and it grew aggressively and pricked recent months, a 46-year-old man visited the local hospital two week ago. A biopsy was performed and squamous cell carcinoma in right parotid gland was diagnosed. He was subsequently referred to Tongji hospital in Wuhan, China. Physical exam revealed a scar in the right parotid gland and impaired function of right facial nerves. An immoveable mass was touched in lower and posterior pole of right parotid gland. The mass was about 2.1*3.1 cm without clear boundary, and moderate pain was observed. No obvious enlarged lymph node was touched in right submandibular region and neck. Magnetic resonance imaging revealed a 1.6*2.4 cm nodular located in a diffuse suspicious mass in right parotid gland. Radical resection of the malignancy was rejected due to the inevitable facioplegia. Considering the short history of tumor aggressive behaviors, unique anatomical structure of parotid gland and absent sign of lymph node metastasis, total parotidectomy with facial nerve preservation and elective right neck dissection were performed. Finial pathological examination confirmed squamous cell carcinoma of right parotid gland. Post-operation radiotherapy was scheduled in the following month. Restoration of facial nerve function was observed in two months later, absent local recurrence and distant metastasis was observed in the three years’ follow-up.Conclusion Primary parotid squamous cell carcinoma is rarely observed in clinical and facial nerve sacrifice requires great attention in treatment. Based on carefully evaluation of patients’ conditions before treatment, individualized treatment is crucial for improvement of patients’ quality of life while completely dissection of the malignancy.

P178 SYNCHRONOUS TRIPLE CANCER OF THE ESOPHAGUS, GASTRIC CARDIA AND GIST OF THE STOMACH: A CASE REPORT AND REVIEW OF THE LITERATURE

2019 ◽  
Vol 32 (Supplement_2) ◽  
Author(s):  
M Czubba ◽  
R L Riepl ◽  
J Theisen
Keyword(s):  
Squamous Cell Carcinoma ◽  
Lymph Node ◽  
Ct Scan ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Epigastric Pain ◽  
Early Stage ◽  
Radical Resection ◽  
Gastric Cardia ◽  
Gastric Gist

Abstract Background A 82-year old man was admitted to our hospital in February 2019 for a thorough investigation to determine an incidential finding of a tumor of the stomach in a CT-Scan. He had no history of previous abdominal surgery or of serious illness. The initial symptoms were slight dysphagia, deterioriation in general condition and weight loss in the last months. Endoscopy of the stomach confirmed a poorly differentiated adenocarcinoma of the gastric cardia (intestinal type, Siewert Type II AEG) with the suspicion of paragastric lymph node metastasis. The consensus of our Comprehensive Cancer Center was a neoadjuvant FLOT-chemotherapy followed by radical resection. The Patient presented again during chemotherapy in April 2019 complaining of discomfort and epigastric pain. Endoscopy showed a partial regress of the primary tumor and on CT scan a progress of the potential lymph node metastases. Due to the symptoms and findings early resection was recommended. On surgery extensive tumor masses were found around the lesser curve and around the peritoneal cavity not like lymph node metastases. An radical resection with intrathoracic anastomoses with gastric pull up was performed. The patient was discharged 4 weeks postoperatively. The histopathological findings showed 2 other synchronous cancers besides the adenocarcinoma of the gastric cardia (ypT1b, L0;V1,G3,R0, HER2-negative, no microsatellite instability). It showed an early stage of squamous cell carcinoma of the esophagus (pT1a (m3-Type), Gn0 (0/21), L0, V0, G1, R0) and the potential paragastric lymphnode metastasis revealed to be a rare high-risk wild-type GIST of the stomach which showed a high mitotic index (> 120 mitoses/15 high-power fields). The patient was readmitted to our hospital because of severe epigastric pain. A CT-Scan showed a massive progress and local recurrence of the GIST with a diameter of 7cm and infiltration into the portal vein and ascites with suspicion on peritoneal carcinomatosis. Despite the attempt of a sunitinib therapy the patient died in the beginning of May 2019 in a palliative setting . Conclusion There have only been few reports in the literature of synchronous triple cancer of gastric GIST, esophageal squamous cell carcinoma, and gastric adenocarcinoma. In our case we considered the gastric adenocarcinoma to be a middle stage cancer and the squamous cell carcinoma an early stage esophageal cancer. The incidental finding of the high-grade gastric GIST with a high mitotic index and unfavorable histopathological features as the wild-type confirmation was probably the cause of death of the patient.

scholarly journals Salvage treatment for lymph node recurrence after radical resection of esophageal squamous cell carcinoma

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Jie Chen ◽  
Wenming Yin ◽  
Hui Yao ◽  
Wendong Gu
Keyword(s):  
Overall Survival ◽  
Squamous Cell Carcinoma ◽  
Lymph Node ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Regional Lymph Node ◽  
Radical Resection ◽  
Salvage Treatment ◽  
Lymph Node Recurrence

Abstract Background Patients with regional lymph node recurrence after radical resection of esophageal cancer have poor therapeutic outcomes. Currently, there is no standard treatment for regional lymph node recurrence, and its prognostic risk factors are not well-understood. This study retrospectively analyzed 83 patients with postoperative regional lymph node recurrence after radical resection of esophageal squamous cell carcinoma. The aim was to evaluate the clinical efficacy and prognostic factors of salvage radiotherapy with or without chemotherapy in these patients. Methods The survival and prognostic factors of 83 patients with esophageal squamous cell carcinoma with regional lymph node recurrence after radical surgery were retrospectively analyzed. All patients underwent radiotherapy, of which 74 patients received volumetric modulated arc therapy (VMAT), 9 patients received three-dimensional conformal radiation therapy (3DCRT), administered using a conventional segmentation protocol with a dose distribution range of 50.4–66.2Gy (median dose of 60Gy). In total, 41 patients received radiotherapy alone, 42 received radiotherapy combined with chemotherapy, and the concurrent chemotherapy regimen was mainly composed of either platinum or fluorouracil monotherapy, except for 4 patients who were given 5-fluorouracil plus platinum (FP) or paclitaxel plus platinum (TP). Results The median follow-up time was 24 (range, 9–75) months. The overall survival (OS) rates at 1 year, 2 years, 3 years, and 5 years were 83.0, 57.1, 40.1, and 35.1%, respectively. The median overall survival (OS) time was 18 (range, 5–75) months. The 3-year survival rate was 47.5% in patients with radiation alone and 41.9% in patients receiving concurrent chemoradiotherapy(p = 0.570), while the response rate (CR + PR) in those two groups was 73.2 and 91.4%, respectively. By multivariate analysis of OS, age (worse in younger patients, p = 0.034) was found to be significantly associated with disease prognosis. The commonly toxicities were esophagitis, neutropenia and anemia. 18% patients experienced grade 3 toxicity and no treatment-related death occurred. Conclusions These results of this retrospective analysis suggest that radiotherapy with or without chemotherapy is an effective and feasible salvage treatment for lymph node recurrence after radical resection of esophageal squamous cell carcinoma.

Multifocal extraparotid Warthin's tumours mimicking metastatic squamous cell carcinoma of the upper neck

2015 ◽  
Vol 129 (5) ◽  
pp. 513-516 ◽  
Author(s):  
S G Mistry ◽  
D Gouldesbrough ◽  
C Bem
Keyword(s):  
Squamous Cell Carcinoma ◽  
Parotid Gland ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Frozen Section ◽  
Radical Neck Dissection ◽  
Radical Resection ◽  
Unknown Primary ◽  
Male Smoker ◽  
Metastatic Squamous Cell Carcinoma

AbstractBackground:Warthin's tumours can show features of pseudo-neoplasia. They do not usually cause problems for diagnosis and management when present within the parotid gland. However, extraparotid Warthin's tumours that are associated with pseudo-neoplasia upon cytological analysis can mimic metastatic malignant disease. The case of a patient presenting with multifocal extraparotid Warthin's tumours is described.Case report:A 57-year-old male smoker presented with rapidly growing upper neck lumps. Fine needle aspiration cytology, magnetic resonance imaging and positron emission tomography findings were compatible with metastatic squamous cell carcinoma secondary to either an unknown primary upper aerodigestive or a parotid malignancy. The patient subsequently underwent total conservative parotidectomy and modified radical neck dissection. Final histology findings revealed multifocal benign Warthin's tumours with four extraparotid components.Conclusion:Warthin's tumours may present outside the parotid gland, present with multifocal lesions and mimic metastatic disease. Frozen section examination prior to radical resection should be considered to guide management.

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

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

scholarly journals A nomogram to predict lymph node metastasis risk for early esophageal squamous cell carcinoma

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiaofeng Duan ◽  
Xiaobin Shang ◽  
Jie Yue ◽  
Zhao Ma ◽  
Chuangui Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Squamous Cell Carcinoma ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Early Stage ◽  
Derivation Cohort ◽  
Node Metastasis

Abstract Background A nomogram was developed to predict lymph node metastasis (LNM) for patients with early-stage esophageal squamous cell carcinoma (ESCC). Methods We used the clinical data of ESCC patients with pathological T1 stage disease who underwent surgery from January 2011 to June 2018 to develop a nomogram model. Multivariable logistic regression was used to confirm the risk factors for variable selection. The risk of LNM was stratified based on the nomogram model. The nomogram was validated by an independent cohort which included early ESCC patients underwent esophagectomy between July 2018 and December 2019. Results Of the 223 patients, 36 (16.1%) patients had LNM. The following three variables were confirmed as LNM risk factors and were included in the nomogram model: tumor differentiation (odds ratio [OR] = 3.776, 95% confidence interval [CI] 1.515–9.360, p = 0.004), depth of tumor invasion (OR = 3.124, 95% CI 1.146–8.511, p = 0.026), and tumor size (OR = 2.420, 95% CI 1.070–5.473, p = 0.034). The C-index was 0.810 (95% CI 0.742–0.895) in the derivation cohort (223 patients) and 0.830 (95% CI 0.763–0.902) in the validation cohort (80 patients). Conclusions A validated nomogram can predict the risk of LNM via risk stratification. It could be used to assist in the decision-making process to determine which patients should undergo esophagectomy and for which patients with a low risk of LNM, curative endoscopic resection would be sufficient.

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