Active pulmonary Koch’s in a locally advanced recurrent head and neck malignancy: a case report

Even though the global incidence of tuberculosis (TB) has been showing a declining trend every year, it is still a significant public health problem in India. On the other hand, cancer has also been the reason for considerable mortality and morbidity across this population. The incidence of TB has been reportedly increasing in patients with both pulmonary and non-pulmonary cancers. Incidence of pulmonary TB in head and neck malignancy is around 3.1% to 6.6%. We present a case history of 50 years old with locally advanced recurrent head and neck malignancy with active pulmonary Koch’s. The decision was to provide him supportive care and treating the infection was pragmatic in spite of expected delay in anti-cancer treatment. It is extremely important to come up with a proper protocol for the need of prophylactic treatment, detection and the concurrent treatment of both cancer and TB.

Mimics of perineural tumor spread in the head and neck

Perineural spread (PNS) is an important potential complication of head and neck malignancy, as it is associated with decreased survival and a higher risk of local recurrence and metastasis. There are many review articles focused on the imaging findings of PNS. However, a false-positive diagnosis of PNS can be just as harmful to the patient as an overlooked case. In this manuscript, we delineate and classify various imaging mimics of PNS. Mimics can be divided into the following categories: normal variants (including vascular structures and failed fat suppression), infections, inflammatory disease (including granulomatous disease and demyelination), neoplasms, and post-traumatic/surgical changes. Knowledge of potential mimics of PNS will prevent false-positive imaging interpretation, and enable appropriate oncologic management.

Neutrophilic Dermatosis of Hands as Oncological Finding: Importance of Follow-Up

Neutrophilic febrile dermatosis (NFD) is a rare paraneoplastic syndrome that may be found in patients with head and neck cancer. NFD may appear before the neoplasia and may only concern the dorsal faces of the hands. This article reports the NFD findings of a patient with pharyngeal cancer, which was developed 2 years after the occurrence of NFD. The development of NFD in patient with alcohol and tobacco consumption should lead otolaryngologists and dermatologists to suspect head and neck malignancy. In cases of normal otolaryngological examination, patients have to be followed.

Het traject van een patiënt met een hoofd- en halsmaligniteit in België

The pathway of a patient with a head and neck malignancy in Belgium This article describes the pathway of a patient with a head and neck malignancy from diagnosis to treatment. As this is the sixth most frequent malignancy, every physician has patient contacts in this population. Consecutively, the history taking, clinical examination and red flags are described, as well as the treatment which may consist of surgery, radiotherapy or systemic therapy or a combination of these. The indications, goal and complications of each of these therapies are discussed. The side effects and contra indications are highlighted. The innovative treatment and the recent addition of immunotherapy for head and neck tumors are discussed. Finally, the importance of support by a nurse specialized in oncological care is emphasized and the quality criteria implemented by the Belgian Health Care Knowledge Centre (KCE) are described.