scholarly journals Combined Techniques for Bilateral Maxillary and Nasal Reconstruction After Ablative Surgery for Adenoid Cystic Carcinoma

Author(s):  
Jan Rustemeyer ◽  
◽  
Alexander Busch ◽  

Indolent tumor growth up to large tumor masses and broad infiltration of surrounding tissue are the most typical characteristics of malignant tumors of the nasal cavity and paranasal sinuses. If surgery is a therapeutic option, extended resections and complex reconstruction modalities have to be taken into account. We present a combination of different reconstruction techniques to restore midface integrity after bilateral maxillectomy, including parts of the nasal skeleton, for adenoid cystic carcinoma. After obtaining tumor-free margins, reconstruction was performed using a microvascular double-flap technique to achieve a neo-maxilla and soft tissue lining of the oral cavity, dental implantology with prosthetic restoration and the insertion of a patient-specific implant for nasal re-shaping and stability. In cases of extended maxillary resection, a combination of different techniques can achieve sufficient functional and aesthetic rehabilitation, and restore quality of life. Further studies are warranted to evaluate the long-term stability of such complex reconstructions. However, local tumor control remains the highest priority and will be essential for years.

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Nafise Shamloo ◽  
Alireza Ghanadan ◽  
Fahimeh Sadat Hashemian ◽  
Maedeh Ghorbanpour

Background: Salivary gland tumors include a wide variety of benign and malignant tumors in the oral and maxillofacial region. Although these tumors are not common, they are not rare. The prevalence of these tumors varies with regard to age, gender, and their location in the body. Objectives: This study aimed to evaluate the frequency of benign and malignant salivary gland tumors in patients referred to three referral hospitals in Tehran, Iran. Methods: This retrospective cross-sectional study examined the demographic and pathologic records of the patients with salivary gland tumors submitted to the Department of Pathology of Amir Alam, Loghman Hakim, and Shohada Hospitals from 2005 to 2016. In this study, the histological variants of salivary gland tumors and clinical parameters such as age, gender, and the location of the tumor were examined. The clinical data were analyzed using SPSS software version 21. Results: Of 137632 patient records, 1180 cases were salivary gland tumors. Pleomorphic adenoma in 794 cases (67.3%) and adenoid cystic carcinoma in 109 cases (9.2%) were the most common tumors, respectively. Salivary gland tumors were more common in males, and the participants’ mean age was 42.86 ± 16.5 years. The most common site was parotid and minor salivary glands, with 937 (79.4%) and 137 (12%) cases, respectively. Conclusions: In this study, the most common benign tumor was pleomorphic adenoma in the parotid gland, and the most common malignant tumor was adenoid cystic carcinoma in the major salivary glands. Furthermore, benign tumors were more frequent than malignant tumors.


2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Ilias Karasmanis ◽  
John K. Goudakos ◽  
Iosif Vital ◽  
Thomas Zarampoukas ◽  
Victor Vital ◽  
...  

Introduction. The nonsquamous carcinomas of the larynx are considered rare with the majority of malignant tumors in this area, reaching the rate of 95%, to be squamous cell neoplasms.Case Report. The case refers to a 53-year-old man that presented with symptomatology of motor nerve disease. During the evaluation of the neurologic disease, a subglottic mass of the larynx was revealed accidentally in the imaging examination. Under general anesthesia, we performed direct laryngoscopy and biopsy of the mass. The histopathologic examination revealed a hybrid carcinoma coexistence of two different carcinomas, an adenoid cystic carcinoma and an adenocarcinoma, not otherwise specified with poor differentiation. Regarding the therapeutic plan, the mass was considered inoperable due to its expansion to trachea and the patient received radiotherapy.Conclusions. Both the adenocarcinoma and adenoid cystic carcinoma are extremely rare types of malignant tumors in the larynx. The special interest of the present case is the coexistence of these two rare tumors in the same region of the larynx, being a hybrid tumor of the salivary glands in the larynx, which is the second reported case, based on our systematic literature review.


2014 ◽  
Vol 2014 ◽  
pp. 1-11 ◽  
Author(s):  
Wuwei Li ◽  
Ryo Tamamura ◽  
Bo Wang ◽  
Qigui Liu ◽  
Han Liu ◽  
...  

Adenoid cystic carcinoma (ACC) is one of the most common salivary gland malignant tumors with a high risk of recurrence and metastasis. Current studies on cancer stem cells (CSCs) have verified that CSCs are the driving force behind tumor initiation and progression, suggesting that new cancer therapies may be established by effectively targeting and killing the CSCs. The primary goal of this study is to investigate the expression patterns of ABCG2, CD133, and podoplanin in ACC of minor salivary glands by immunohistochemistry analysis. We found that ABCG2 was weakly expressed in normal looking salivary gland tissues. A significant upregulation of ABCG2 expression in ACC was observed with a similar expression pattern of Ki-67. CD133 was detected in apical membrane of epithelial cells and podoplanin was expressed positively in myoepithelial cells of both normal looking tissue and ACC. However, no significant difference was found of the expression pattern of CD133 and podoplanin between normal looking tissues and ACC. Our observations suggest that CSCs may exist in quiescent cells with ABCG2 positive staining, which are surrounded by cells with positive expression of ABCG2 and Ki-67 in ACC, and costaining with ABCG2 and Ki-67 may help predict the location of CSCs.


2007 ◽  
Vol 125 (5) ◽  
pp. 295-296 ◽  
Author(s):  
André Del Negro ◽  
Edson Ichihara ◽  
Alfio José Tincani ◽  
Albina Altemani ◽  
Antônio Santos Martins

CONTEXT: Adenoid cystic carcinomas are malignant tumors that occur in both the major and the minor salivary glands. A laryngeal location is rare because of the paucity of accessory salivary glands in this area. Adenoid cystic carcinomas account for less than 1% of all malignant tumors in the larynx, and only about 120 cases have been reported in the literature. These tumors have a slight female predisposition, and their peak incidence is in the fifth and sixth decades of life. In this article, we describe a case of laryngeal adenoid cystic carcinoma and discuss its clinical characteristics and treatment. CASE REPORT: We report on a case of laryngeal adenoid cystic carcinoma in a 55 year-old female patient who presented with dyspnea and hoarseness. Features of the diagnostic and therapeutic evaluation are described and the clinical management of such cases is outlined. The clinical course, definitive treatment strategy and surgical procedure, and also adjuvant treatment with irradiation are discussed. Although the tumor is radiosensitive, it is not radiocurable.


2021 ◽  
pp. 2-2
Author(s):  
Nikola Zivkovic ◽  
Milos Kostic ◽  
Ana Cvetanovic ◽  
Maja Jovicic-Milentijevic ◽  
Milan Spasic ◽  
...  

Salivary gland tumors are neoplasms characterized by a high level of pleomorphism and histological overlap. One tumor may contain several cell types; therefore, it is necessary to include immunohistochemical staining, as well as morphometric analysis of tumor cells as prerequisites for an appropriate diagnosis. Our research included 120 tumors, such as pleomorphic adenoma, Warthin tumor, basal cell adenoma, myoepithelioma, adenoid cystic carcinoma, mucoepidermoid carcinoma, salivary duct carcinoma, polymorphous low-grade carcinoma and myoepithelial carcinoma. The aim of the study was to differentiate benign and malignant tumors based on the characteristics of nuclei. The expression of Ki67 and the morphometric nuclear parameters - area, perimeter, Feret diameter, integrated optical density, circularity, and roundness, were analyzed. It was observed that the Ki67 proliferative index was statistically significantly higher in malignant tumors (P<0.001). Adenoid cystic carcinoma exhibited the highest value, whereas the lowest value was exhibited in basal cell adenoma. Morphometric analysis showed statistically significantly increased values of integrated optical density (P<0.001) and nuclear size parameters (P<0.05) in malignant tumors. The determination of the Ki67 proliferative index and morphometric analysis of the integrated optical density and area can differentiate benign from malignant tumors with high precision. The presented values suggest the obtained results as cut-off values.


2020 ◽  
Vol 12 (4) ◽  
pp. 129-133
Author(s):  
Ivo Bedini ◽  
Lautaro Acosta ◽  
Luciano Cavalieri ◽  
Carlos Santiago Ruggeri

bjectives: To determine the result of reconstruction with local or regional flaps of skin defects in the temporo-parotid region, after resection of malignant parotid gland and ear tumors, and to establish a reconstruction algorithm according to the size of the defect. Methods: The electronic medical records of the patients who underwent surgery for malignant tumors of the parotid gland and ear with invasion of the skin of the region, and who had reconstructions of the skin defect with local and regional flaps, were selected. The surgeries were performed by the surgical team of the Otorhinolaryngology service of the Italian hospital in Buenos Aires between 2005 and 2018. Results: Five patients were included.There were two malignant parotid gland tumors with histology of adenoid cystic carcinoma and squamous cell carcinoma, and three temporal bone tumors: squamous cell carcinoma, basal cell carcinoma in another and adenoid cystic carcinoma. The reconstructions were made with local or regional flaps. In skin defects smaller than 8cm the reconstructions were made with cervical and scalp flaps. In skin defects larger than 8cm the pectoralis major musculoctaneous flap were used. No patient had partial or total necrosis of the flaps. Conclusions: The results of the reconstructions with local and regional flaps of the skin defects caused by the resection of malignant tumors of the ear and the parotid gland were very good, since they allowed the repair of the defect with a good aesthetic result, without the need to perform grafts in the donor area and with few minor complications. In patients with advanced malignant tumors of the ear and parotid gland with infiltration of the surrounding skin, it is better to do the reconstruction with local or regional flaps due to the greater simplicity and speed of the surgical technique, similar aesthetic results and few complications.


2022 ◽  
Vol 11 ◽  
Author(s):  
Mónica García-Sevilla ◽  
Rafael Moreta-Martinez ◽  
David García-Mato ◽  
Gema Arenas de Frutos ◽  
Santiago Ochandiano ◽  
...  

Adenoid Cystic Carcinoma is a rare and aggressive tumor representing less than 1% of head and neck cancers. This malignancy often arises from the minor salivary glands, being the palate its most common location. Surgical en-bloc resection with clear margins is the primary treatment. However, this location presents a limited line of sight and a high risk of injuries, making the surgical procedure challenging. In this context, technologies such as intraoperative navigation can become an effective tool, reducing morbidity and improving the safety and accuracy of the procedure. Although their use is extended in fields such as neurosurgery, their application in maxillofacial surgery has not been widely evidenced. One reason is the need to rigidly fixate a navigation reference to the patient, which often entails an invasive setup. In this work, we studied three alternative and less invasive setups using optical tracking, 3D printing and augmented reality. We evaluated their precision in a patient-specific phantom, obtaining errors below 1 mm. The optimum setup was finally applied in a clinical case, where the navigation software was used to guide the tumor resection. Points were collected along the surgical margins after resection and compared with the real ones identified in the postoperative CT. Distances of less than 2 mm were obtained in 90% of the samples. Moreover, the navigation provided confidence to the surgeons, who could then undertake a less invasive and more conservative approach. The postoperative CT scans showed adequate resection margins and confirmed that the patient is free of disease after two years of follow-up.


Author(s):  
H. J. Finol ◽  
M. E. Correa ◽  
L.A. Sosa ◽  
A. Márquez ◽  
N.L. Díaz

In classical oncological literature two mechanisms for tissue aggression in patients with cancer have been described. The first is the progressive invasion, infiltration and destruction of tissues surrounding primary malignant tumor or their metastases; the other includes alterations produced in remote sites that are not directly affected by any focus of disease, the so called paraneoplastic phenomenon. The non-invaded tissue which surrounds a primary malignant tumor or its metastases has been usually considered a normal tissue . In this work we describe the ultrastructural changes observed in hepatocytes located next to metastases from diverse malignant tumors.Hepatic biopsies were obtained surgically in patients with different malignant tumors which metatastized in liver. Biopsies included tumor mass, the zone of macroscopic contact between the tumor and the surrounding tissue, and the tissue adjacent to the tumor but outside the macroscopic area of infiltration. The patients (n = 5), 36–75 years old, presented different tumors including rhabdomyosarcoma, leiomyosarcoma, pancreas carcinoma, biliar duct carcinoma and colon carcinoma. Tissue samples were processed with routine techniques for transmission electron microscopy and observed in a Hitachi H-500 electron microscope.


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