Conjunctival Squamous Cell Carcinoma With Perineural Invasion Resulting in Death

2005 ◽  
Vol 36 (3) ◽  
pp. 249-251 ◽  
Author(s):  
Andrew Kaines ◽  
Garry Davis ◽  
Dinesh Selva ◽  
Igal Leibovitch ◽  
Thomas Dodd ◽  
...  

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


Author(s):  
Roberto Milazzotto ◽  
Rocco Luca Emanuele Liardo ◽  
Giuseppe Privitera ◽  
Luigi Raffaele ◽  
Vincenzo Salamone ◽  
...  

Abstract Aim: Conjunctival squamous cell carcinoma (SCC) is a rare tumour of the ocular region and microscopic radical surgical is difficult. There are no single guidelines for therapeutic management and the role of radiation therapy is not clearly defined although conventionally photon or electron beams are used. Proton beam radiotherapy (PBRT) is a new option for a conservative approach and allows good sparing of the organs at risk. Materials and methods: After surgical resection, we collected 15 cases treated at our institution with PBRT. The dose delivered was between 48 and 60 Gy relative biological effectiveness (RBE), with fractions of 12–15 Gy RBE. Results: After an average period of 48 months, the patients achieved excellent disease control (overall survival and disease-free survival: 86·6%), with minimal acute and late toxicity. Findings: In this work, we present our experience on the use of PBRT technique in SCC treatment. A larger sample of patients is needed to draw conclusions about the impact of this treatment on disease recurrence and overall survival.


2002 ◽  
Vol 87 (3) ◽  
pp. 301-308 ◽  
Author(s):  
R Newton ◽  
◽  
J Ziegler ◽  
C Ateenyi-Agaba ◽  
L Bousarghin ◽  
...  

2003 ◽  
Vol 34 (5) ◽  
pp. 406-408
Author(s):  
Jerry A Shields ◽  
Carol L Shields ◽  
Steven Luminais ◽  
Ralph C Eagle

2005 ◽  
Vol 129 (3) ◽  
pp. 354-359 ◽  
Author(s):  
Kevin A. Kurtz ◽  
Henry T. Hoffman ◽  
M. Bridget Zimmerman ◽  
Robert A. Robinson

Abstract Context.—Perineural invasion and vascular invasion may be adverse prognostic factors in patients with oral cavity squamous cell carcinoma. However, the incidence of perineural and vascular invasion varies in the literature, and the use of immunohistochemistry to enhance their detection has not been evaluated in oral cavity squamous cell carcinomas. Objective.—To determine if the previously assessed incidence of perineural and vascular invasion in cases of oral cavity squamous cell carcinoma would be increased by re-review of the original routinely hematoxylin-eosin–stained sections as well as review of slides stained immunohistochemically with S100 and CD31 to enhance visualization of nerves and vessels. Design.—Forty cases of oral cavity squamous cell carcinoma in which the status of perineural and vascular invasion had been part of the original pathology report were reviewed. All original routinely stained slides were reviewed as well as S100- and CD31-stained sections of each case's tissue blocks that contained tumor. Results.—Perineural invasion was identified in 30% (12/ 40) of tumors in the original reports, 62% (25/40) of the authors' re-review of the same slides, and 82% (33/40) when cases were stained with S100. Vascular invasion was identified in 30% (12/40) of tumors in the original reports, 35% (14/40) of the authors' re-review of the same slides, and 42% (17/40) when cases were stained with CD31. False-positive and false-negative results were common in the original reports. The number of foci of both types of invasion was related to its discovery in the original reports. Vascular invasion, but not perineural invasion, was significantly associated with death at 5-year follow-up. Conclusions.—Although careful re-review of routinely stained slides will detect a significant number of cases of perineural and vascular invasion, immunohistochemical enhancement further improves the accuracy of the determination.


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