DETERMINATION OF DEEP SURGICAL MARGIN BASED ON ANATOMICAL ARCHITECTURE FOR LOCAL CONTROL OF SQUAMOUS CELL CARCINOMA OF THE BUCCAL MUCOSA.

Background: The objective of surgical management of oral squamous cell carcinoma (OSCC) is adequate resection with a clear margin. However, there is still a debate as to the optimal length for a mandibular resected margin. Objective: To examine the length of peri-neural spreading in T4 mandibular invaded oral cavity squamous cell carcinoma. Materials and Methods: Twenty-eight T4 pathological OSCC specimens that involved mandible and serial slices were studied and the length of tumor spreading along the inferior alveolar nerve (IAN) was determined. Tumor characteristics, risk factors, and survival were analyzed. Results: The incidence of peri-neural invasion was 11.11%, and IAN invasion was found in 14.29% of the tumor-invaded mandibular marrow. The length of tumor spreading along IAN was 3 to 12 mm. Poor prognostic factors of T4 OSCC were it being located on the tongue (HR 14.16), was pathological N2-3 (HR 31.05), and had high-risk features such as peri-neural invasion, lymphovascular invasion, and extra-nodal extension. Conclusion: A mandibular resected margin of at least 18 mm is recommended as a clear surgical margin in cases of T4 mandibular invasion OSCC. Keywords: Oral cancer, Perineural invasion, Inferior alveolar nerve, Squamous cell carcinoma, Mandibulectomy

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Pathologic Determination of Multifocality in pT1a1 Squamous Cell Carcinoma of the Cervix: A Retrospective Analysis

International Journal of Surgical Pathology ◽

10.1177/1066896921990726 ◽

2021 ◽

pp. 106689692199072

Author(s):

Jingjing Hu ◽

Kojo R. Rawish ◽

Mariah Leivo ◽

Dennis Adams ◽

Somaye Y. Zare ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Residual Disease ◽

Cervical Squamous Cell Carcinoma ◽

Tnm Staging ◽

Stromal Invasion ◽

Lateral Extent ◽

Clinicopathologic Parameters

When more than one focus of stromal invasion is present in a superficially invasive cervical squamous cell carcinoma (SCC), determination of the tumoral lateral extent/horizontal extension, and hence tumor-nodes-metastases (TNM) staging, can be problematic. In recent years, a diagnostic approach to distinguish multifocal pT1a1 from pT1b cases has gained increased attention. These criteria call for classifying SCC as multifocal when invasive foci are separated by blocks of uninvolved cervical tissues, and/or are located on separated cervical lips in a tumor that is discontinuous, and/or are situated far apart (≥2 mm) from each other. In this study, we assess our experience with multifocal stage pT1a1 cervical SCC that was retrospectively classified as such using these criteria. Slides from the loop electrosurgical excision or conization specimens, comprising 212 pT1a1, 173 pT1a2, and 206 pT1b cases, were reviewed. Twenty-four (11%) of the 212 pT1a1 cases were classified as multifocal after review. The 24 multifocal pT1a1 cases were compared with the 188 unifocal pT1a1 cases regarding a variety of clinicopathologic parameters. Notably, these 2 groups showed no significant differences regarding all parameters that were evaluated, including patient age, recurrence rate, primary tumoral features in the primary excision specimen (rate of positive margins, median depth of stromal invasion, frequency of lymphovascular invasion), and frequency of residual disease in additional excisions. In summary, we demonstrate comparably favorable patient outcomes in both unifocal and multifocal cases of pT1a1 SCC of the cervix, and, accordingly, we conclusively affirm the validity of the aforementioned criteria for establishing multifocality.

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Squamous Cell Carcinoma of the External Ear: A Review of 75 Cases

Otolaryngology ◽

10.1177/019459988709700310 ◽

1987 ◽

Vol 97 (3) ◽

pp. 308-312 ◽

Cited By ~ 30

Author(s):

William W. Shockley ◽

Fred J. Stucker

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Cancer Control ◽

Surgical Excision ◽

External Ear ◽

Common Cancer ◽

Node Metastases

Squamous cell carcinoma of the external ear can be a potentially lethal lesion. Although it is the most common cancer involving the pinna, the variables that have the greatest impact on prognosis are still in question. We reviewed 75 cases of squamous cell carcinoma of the external ear to determine patterns of occurrence and treatment failure. Forty patients had adequate follow-up for determination of cancer control rates. Local control was successful with initial treatment in 85% of the cases. The incidence of lymph node metastases was 10%, whereas distant metastasis occurred in only one patient (2.5%). This series differs from others in that most patients were unselected and most of the lesions treated were early (less than 1 cm). The significance of positive margins after surgical excision is also analyzed.

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P9. The impact of neoadjuvant chemotherapy on operable locally advanced squamous cell carcinoma of the buccal mucosa

Oral Oncology ◽

10.1016/j.oraloncology.2011.06.252 ◽

2011 ◽

Vol 47 ◽

pp. S77

Author(s):

R. Kumar ◽

S.V. Shah ◽

V.L. Choksi

Keyword(s):

Squamous Cell Carcinoma ◽

Neoadjuvant Chemotherapy ◽

Cell Carcinoma ◽

Squamous Cell ◽

Buccal Mucosa ◽

Locally Advanced ◽

Advanced Squamous Cell Carcinoma ◽

The Impact

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Occult Early Squamous Cell Carcinoma in Zenker's Diverticulum Treated With Diverticulectomy Followed by Additional Esophagectomy With Free Jejunal Reconstruction: A Case Report

International Surgery ◽

10.9738/intsurg-d-15-00268.1 ◽

2021 ◽

Vol 105 (1-3) ◽

pp. 36-41

Author(s):

Takuya Shiraishi ◽

Naoki Tomizawa ◽

Tatsumasa Andoh ◽

Hiroaki Sato ◽

Itasu Ninomiya

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Surgical Margin ◽

Zenker’S Diverticulum ◽

Resected Specimen ◽

Radical Cure ◽

Pathologic Examination ◽

Zenker's Diverticulum ◽

Additional Surgery

A 63-year-old man was evaluated for a 20-year history of dysphagia and vomiting. Barium-swallow esophagography showed a Zenker's diverticulum at the upper end of the esophagus. Esophagogastroduodenoscopy revealed the diverticulum about 20 cm from the incisors. There was no mucosal inflammation or irregularity in the diverticulum. Computed tomography showed that the diverticulum was about 8 cm in size. There was no lymphadenopathy around the esophagus. Because the patient's symptoms were worsening, we performed diverticulectomy using a linear stapling device and cricopharyngeal myotomy. The mucosa of the resected specimen had no macroscopically abnormal lesions. However, an area unstained by iodine that widely involved the surgical margin was recognized at pathologic examination. Pathologic findings revealed squamous cell carcinoma invading the lamina propria mucosa with inflammatory cell infiltration. In addition, the pathologic surgical margin was widely positive. However, a remnant tumor lesion was not detected by postoperative esophagogastroduodenoscopy. Biopsies near the staple line were negative. After obtaining informed consent, we performed resection of the cervical esophagus including the proximal stump of the diverticulum and cervical lymphadenectomy approximately 4 months after the primary operation as an additional surgery. Reconstruction was performed by free jejunal transplantation with microvascular anastomosis. The patient was discharged on postoperative day 45. Pathologic examination revealed no malignant lesion in the resected specimen, and radical cure was confirmed.

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