bluuebunny/crossref_metadata_2025 huggingface dataset:
Fluorescence in situ hybridisation studies to characterise complete and partial monosomy 7 in myeloid disorders
Authors: Gibbons Barbara , Lillington Debra M. , Monard Simon , Young Bryan D. , Cheung Kan Luk , Lister T. Andrew , Kearney Lyndal
Published: February 2007

Eight patients with myeloid disorders characterised by a karyotype including apparent monosomy or partial monosomy 7, in the presence of a ring or marker chromosome, were investigated by fluorescence in situ hybridisation (FISH) with a chromosome 7 centromere‐specific probe and an Alu‐PCR derived chromosome 7 paint. In 4 of 5 cases a ring chromosome was shown to be of chromosome 7 origin; in one of these the apparent ring was shown to consist solely of chromosome 7 centromeric material, and in the fifth case the ring was derived from chromosome 18. In three cases monosomy 7 had arisen during the course of karyotype evolution and was clearly not the primary cytogenetic abnormality. One further case demonstrated fragmentation and cryptic translocation of chromosome 7 material. In the last case a chromosome described as der(I)t(I;7)(p II;pII) was redefined as dic(I;7)(pII;qII). The application of FISH has enabled a more accurate characterisation of chromosome abnormalities, and extended studies of this type may eventually lead to more precise prognostic groups defined by karyotype. Genes Chromosom Cancer 10:244–249 (1994). © 1994 Wiley‐Liss, Inc.
Analysis of androgen receptor DNA reveals the independent clonal origins of uterine leiomyomata and the secondary nature of cytogenetic aberrations in the development of leiomyomata
Authors: Mashal Robert D. , Fejzo Marlena L. Schoenberg , Friedman Andrew J. , Mitchner Natasha , Nowak Romana A. , Rein Mitchell S. , Morton Cynthia C. , Sklar Jeffrey
Published: February 2007

Uterine leiomyomata are thought to be monoclonal neoplasms. Accordingly, investigations of clonality with G6PD isoforms used as a marker for X chromosome inactivation have suggested independent origins for multiple tumors within individual uteri. However, results from a recent study assessing methylation differences between DNA of active and inactive X chromosomes have been interpreted to suggest that multiple tumors may arise from a common precursor. We have examined the clonality of 36 leiomyomata from 16 patients by analyzing X chromosome inactivation as indicated by the methylation status of the X‐linked androgen receptor gene. As shown by this assay, all informative leiomyomata were monoclonal in origin. In patients with multiple leiomyomata, a random distribution of inactivation between the X homologs was noted, consistent with an independent origin of each tumor. Cytogenetic analysis was also performed on short‐term cell cultures of 27 of the 36 tumors. In each of two tumors that had both cells with a clonal karyotypic abnormality and karyotypically normal cells, DNA prepared from short‐term cultures showed a monoclonal pattern of X inactivation identical to that of the leiomyoma from which they were derived. These data suggest that karyotypically normal cells present in short‐term cultures of uterine leiomyomata are part of the tumor clone, and that clonal expansion of tumor cells precedes the development of cytogenetic aberrations.
Loss of heterozygosity on the short arm of chromosome 3 in mesothelioma cell lines and solid tumors
Authors: Zeiger Martha A. , Gnarra James R. , Zbar Berton , Linehan W. Marston , Pass Harvey I.
Published: February 2007

Cytogenetic analysis of mesothelioma cell lines and solid tumors has documented non‐random chromosomal abnormalities on the short arm of chromosome 3 from 3p 14 to 3p25. We therefore examined nine mesothelioma cell lines, their corresponding tumors, and 15 additional mesothelioma tumors for loss of heterozygosity on 3p from 3p 13 to 3p25.5 by polymerase chain reaction and restriction fragment length polymorphism analysis at 8 loci: D3S3, D3S30, D3S6, D3S2, D3S32, D3FI5S2, THRB, and VHL Loss of heterozygosity was documented by loss of one of two alleles in the tumor DNA whose corresponding normal DNA was heterozygous and was documented in four of nine mesothelioma cell lines and six of 15 mesothelioma tumors or a total of 42% of the mesotheliomas evaluated. This study suggests the involvement of a gene on the short arm of chromosome 3 in the development of mesotheliomas.
The insulin‐like growth factor I receptor gene is the target for the 15q26 amplicon in breast cancer
Authors: Almeida Anna , Muleris Martine , Dutrillaux Bernard , Malfoy Bernard
Published: February 2007

We report the amplification and overexpression of the IGFIR (insulin‐like growth factor I receptor) gene in primary breast cancers with an amplification of band 15q26. The involvement of IGFIR, which may vary in frequency from 2‐3% in unselected tumor series to more than 10% in breast cancers with hsr, may represent an important event in tumor progression.
Origin and biology of a testicular wilms' tumor
Authors: Gillis Ad J. M. , Oosterhuis J. Wolter , Schipper Magriet E. I. , Barten E. J. , Van Berlo Romy , Van Gurp Ruud J. H. L. M. , Abraham Mary , Saunders Grady F. , Looijenga Leendert H. J.
Published: February 2007

A pure triphasic testicular Wilms' tumor, without teratomatous elements, was studied using multiple techniques. Carcinoma in situ (CIS), the characteristic precursor of testicular germ cell tumors of adults (TGCTs), was found in the adjacent parenchyma. Flow cytometric analysis showed a single hypotriploid tumor stem line. Karyotyping of the tumor revealed some numerical and structural abnormalities, including an i(12p), the chromosomal marker of TGCTs. In situ hybridization supported the karyotypic findings, and showed a similar numerical distribution in CIS and the tumor. Molecular analysis of the tumor illustrated that all short arms of chromosome 12, including i(12p), were of maternal origin. No 12q deletions were detected. In spite of complete loss of the paternal 11p13 band, the zinc finger regions and exons 2 and 6 of the WTI gene contained no aberrations. Therefore, this tumor suppressor gene is not inactivated due to aberrations in the studied regions. In addition, all four WTI alternative transcripts were expressed in the tumor. No aberrations were found in chromosomal bands 11p15.5, 16q22.1, and 16q24. Both parental alleles of the human imprinted genes H19 and IGF2 were expressed in the tumor. This is the first report on the chromosomal and molecular characterization of an extrarenal Wilms' tumor. Its germ cell origin was unequivocally demonstrated.
Telomere length variation in normal and malignant human tissues
Authors: Schmitt Holger , Blin Nikolaus , Zankl Heinrich , Scherthan Harry
Published: February 2007

Tissue and tumor specific length variation of telomere (TTAGGG)n repeats was studied in DNAs from various normal and malignant tissues. DNA was isolated from bone marrow and blood cells, malignant tissues, and established tumor cell lines. Nonisotopic Southern hybridization revealed a reduction of telomere repeat arrays in 14 of the 35 tumors analyzed. However, other cases (60%) showed no reduction, or even an increase, in telomeric length. Our finding of elongated telomere stretches in several tumors of different origin compared with normal tissue is in contrast to previous reports describing a general shortening of terminal repeat length in colorectal cancer and neuroblastoma. We tentatively conclude that there is no general tendency to telomere reduction in malignant tissues.
Loss of heterozygosity in 8p is associated with microinvasion in colorectal carcinoma
Authors: Kelemen Pond R. , Yaremko M. Lisa , Kim Anne H. , Montag Anthony , Michelassi Fabrizio , Westbrook Carol A.
Published: February 2007

Loss of heterozygosity (LOH) from the short arm of chromosome 8 is frequent in a variety of malignancies, suggesting the presence of a tumor suppressor gene in this region. Previous studies suggested that this deletion may correlate with higher clinicopathologic stages in colorectal cancer, but others did not support this finding; in part, this difficulty is due to the low heterozygosity of the RFLP markers that were used. Here we report on a preliminary investigation in which we used highly informative microsatellite markers to determine whether deletions of 8p are correlated with poor prognostic features. Paraffin‐embedded tumor tissue from 15 patients was analyzed with a panel of three microsatellite markers that are known to be sites of frequent LOH. Fourteen of the 15 cases were informative with at least one marker, and 7 showed LOH. Analysis of clinical features showed that there was no relation of 8p LOH with patient age or tumor stage, grade, location, or pattern of growth. However, a statistically significant correlation was seen between LOH and lymphatic, vascular, or perineural microinvasion (Fisher exact test, P = 0.01). This histologic feature is known to be a stage‐independent indicator of prognosis. Our data suggest that 8p LOH may be associated with poor outcome and demonstrate the utility of these microsatellite markers for its detection.
Chromosome analysis of brain tumors in childhood
Authors: Fujii Yuji , Hongo Teruaki , Hayashi Yasuhide
Published: February 2007

We performed a chromosome analysis of 26 pediatric brain tumors, including 20 primitive neuroectodermal tumors (PNETs), 5 astrocytomas, and I immature teratoma. Specimens were treated with collagenase, placed in overnight or short‐term cultures, and harvested for chromosome analysis. Numerical and/or structural abnormalities were noted in 14 of the 20 PNETs and 4 of the 5 astrocytomas. In 13 PNETs, so‐called medulloblastoma in the cerebellum, an i(17q) was the most frequent structural abnormality, accounting for 30% (4/13). Double minute chromosomes (dmin) were observed in one tumor. Near‐diploidy was demonstrated in three of these PNETs, hyperdiploidy in three, and near‐tetraploidy in three. We could not find any correlation of these cytogenetic findings with the prognosis. In the remaining seven PNETs other than medulloblastoma, the karyotypes of five PNETs demonstrated a variety of numerical and structural abnormalities. As to the astrocytomas, losses of chromosomes 7 and 9 with dmin were observed in two, and structural abnormalities of chromosomes 1 and 17 were also observed in two tumors. In our limited cases, however, we could not find the same chromosome abnormalities that are well known in adult astrocytomas. A congenital immature teratoma showed hyperdiploidy with increased numbers of chromosomes 3, 6, and 12. We conclude that i(17q) is an important chromosome abnormality in medulloblastomas, and that the oncogenesis of pediatric astrocytomas might be different cytogenetically from that of adult astrocytomas.
Physical mapping of the uterine leiomyoma t(12;14)(q13‐15;q24.1) breakpoint on chromosome 14 between SPTB and D14S77
Authors: Hug Katherine , Doney Michael K. , Tyler Mary J. , Grundy David A. , Soukup Shirley , Houseal Timothy W. , Menon Anil G.
Published: February 2007

Uterine leiomyoma is the most common tumor of smooth muscle cell origin and is often associated with the recurrent balanced translocation t(12;14)(q13‐15;q24). As an initial step toward finding the gene or genes that are interrupted by the translocation breakpoint, a somatic cell hybrid carrying the derivative 14 as the single t(12;14) translocated chromosome was constructed from a leiomyoma cell line with this translocation. Sequence tagged sites (STS) whose locations on the genetic map of chromosome 14 were known were used to map the breakpoint in the translocated chromosomes. The results of this analysis place the translocation breakpoint on the long arm of chromosome 14 between the proximal marker SPTB and the distal marker D14S77, narrowing the chromosomal translocation breakpoint to a region of approximately 7 cM. The identification of flanking markers on chromosome 14 lays the foundation for efforts to clone the breakpoint and to identify the genes involved in the formation of leiomyoma.
Galectins as modulators of tumor progression in head and neck squamous cell carcinomas
Authors: Saussez Sven , Camby Isabelle , Toubeau Gerard , Kiss Robert
Published: February 2007

Head and neck squamous cell carcinomas (HNSCCs) remain a significant cause of morbidity worldwide. Biological therapies able to induce and/or upregulate antitumor immune responses could represent a complementary approach to conventional treatments for patients with HNSCC because, despite advances in surgery, radiotherapy, and chemotherapy, the overall survival rates for these patients have not changed over recent decades. Galectins are involved in the control of cell proliferation, cell death, and cell migration and in the modulation of various functions of the immune system. In this context, galectin‐1 is known to protect HNSCCs from the immune system. The present review details the involvement of galectins in HNSCC biology and suggests a number of approaches to reduce the levels of expression of galectin‐1 in HNSCCs, with the aim of improving the efficiency of HNSCC immunotherapy. © 2007 Wiley Periodicals, Inc. Head Neck, 2007
The myth regarding bone or cartilage involvement by cancer and the likelihood of cure by radiotherapy
Authors: Million Rodney R.
Published: February 2007

A myth persists that tumor involvement of bone and/or cartilage represents a clinical situation in which cure by radiotherapy would be considered unusual. There are sufficient data to the contrary. This essay reviews the radiotherapy results for (1) primary tumors of bone (benign and malignant), (2) primary malignant tumors of cartilage, and (3) benign and malignant tumors that secondarily involve bone and/or cartilage. It is hoped that the myth concerning radiocurability and bone and/or cartilage involvement will be replaced by an appreciation of the relative rates of cure depending on the clinical situation.
Needle aspiration biopsy of the pre‐epiglottic space
Authors: Cusumano Robert J. , Kaufman David , Weiss Michael , Gallo Leza , Reede Deborah , Myssiorek David
Published: February 2007

Clinical staging of supraglottic carcinoma requires evaluation of the pre‐epiglottic space (PES). To explore the role of fine needle aspiration biopsy of the PES in the staging of epiglottic carcinoma, endoscopic transvallecular fine needle aspiration biopsies of the PES were performed in 16 patients with epiglottic carcinoma. The results of aspiration cytology were compared with CT scanning and postoperative histopathologic sections of the PES after total or supraglottic laryngectomy. This preliminary report shows that needle aspiration biopsy of the PES is a safe and sensitive technique, having a high correlation with histopathologic follow‐up. Needle biopsy, along with CT scan, is clinically useful in staging the PES, which cannot be examined directly.
Bulbar amyotrophic lateral sclerosis: Patterns of progression and clinical management
Authors: Hillel Allen D. , Miller Robert
Published: February 2007

Patients with bulbar amyotrophic lateral sclerosis (ALS) are often referred to the otolaryngologist/head and neck surgeon and speech pathologist for evaluation and management of dysphagia and dysarthria. These patients comprise an unusual group because of the progressive and multi‐system nature of their illness. The neuromuscular disabilities associated with bulbar ALS cause a myriad of related symptoms associated with swallowing, speech, and respiration. Although the rate of progression cannot be predicted, a general pattern of progression is noted. Bulbar disease accounts for the majority of the worst symptoms of ALS. The loss of the ability to swallow changes eating from a pleasurable task to a burden of survival. Loss of communication effectively imprisons the patient in a state of isolation. The progressive weakness of respiration, predominantly a spinal rather than bulbar manifestation, is the cause of death for nearly all ALS patients and is also discussed. The general patterns of progression of bulbar ALS are outlined in this paper. The development of symptoms are correlated with specific treatment recommendations to aid the clinician in devising an orderly plan of management for this progressive disease.
Retinoic acid inhibition of a head and neck multicellular tumor spheroid model
Authors: Sacks Peter G. , Oke Victor , Vasey Tracey , Lotan Reuben
Published: February 2007

The effects of retinoic acid (RA) on multicellular tumor spheroids (MTS) derived from a head and neck squamous carcinoma cell line, MDA 886Ln, were studied. Growth of MTSs was shown to be inhibited by 10−5 to 10−7 M RA; dose response studies demonstrated that by 10−10 M RA, MTS growth was inhibited by less than 20%. MTSs treated with RA for 10 days had a decreased labeling index (15% compared with 23% for controls). Histologic studies at 10 days showed both an alteration in tissue‐like architecture and an inhibition of squamous differentiation in RA‐treated spheroids. Morphologic inhibition of differentiation was confirmed by immunohistochemical staining for involucrin. Histologic sections were also probed with a series of biotinylated lectins to search for RA‐induced changes in glycosylation. Changes in staining occurred with two lectins, soybean agglutinin and peanut agglutinin. This study showed that RA induced perturbations in biological processes such as growth and differentiation in a new model system for squamous carcinomas of the head and neck, MDA 886Ln MTS.
Metastatic papillary carcinoma of the thyroid: The significance of extranodal extension
Authors: Spires James R. , Robbins K. Thomas , Luna Mario A. , Byers Robert M.
Published: February 2007

A retrospective study of patients with papillary carcinoma of the thyroid was conducted at The University of Texas M. D. Anderson Cancer Center to determine the significance of cervical nodal metastases in which the cancer has extended beyond the capsule of the node. The survival of 25 patients with extracapsular invasion was compared to 63 controls. There was no statistically significant difference in regional recurrence, distant metastases, death from cancer, or recurrence‐free survival between the two groups. Surgically resectable extrathyroid extension of tumor at the primary site and the clinical stage of cervical metastases also had no prognostic significance. The most important prognostic factors for differentiated thyroid carcinoma remain the age and sex of the patient, the histology of the cancer, and the presence of distant metastatic disease.
T‐cell markers in tumor‐infiltrating lymphocytes of head and neck cancer
Authors: Snyderman Carl H. , Heo D. S. , Chen K. , Whiteside Theresa L. , Johnson Jonas T.
Published: February 2007

Fresh suspensions of tumor‐infiltrating lymphocytes (TIL) from 16 patients with squamous cell carcinoma of the head and neck (SCCHN) were examined for T‐cell markers including CD4 (helper‐inducer), CDS (cytotoxic‐suppressor), natural killer (NK) cell, and activation surface markers using monoclonal antibodies and two‐color flow cytometry. Two of 8 (25%) patients with a CD4/CD8 ratio of less than 1 developed cervical lymph node metastases; none had extracapsular spread. Six of 8 (75%) patients with a CD4/CD8 ratio of greater than 1 developed cervical metastases; 5 of 6 (83%) exhibited extracapsular spread. An increased CD4/CD8 ratio was attributable to a decrease in CD8+cells. A CD4/CD8 ratio of greater than 1 may be a useful prognostic indicator of the development of cervical metastases.
Mutagen‐induced chromosome fragility within peripheral blood lymphocytes of head and neck cancer patients
Authors: Schantz Stimson P. , Hsu T. C.
Published: February 2007

The expression of chromosome breakage as a response to mu‐tagen exposure may contribute to the development of head and neck cancer. Lymphocytes from 46 previously untreated head and neck cancer patients were cultured in vitro and exposed to the radiomimetic clastogen, bleomycin. The lymphocytes were then arrested in metaphase and analyzed for bleomycin‐induced chromosome breaks. Mean bleomycin‐induced chromosome breaks per cell (b/c) in head and neck cancer patients (0.94 ± 0.3 b/c) were significantly higher than in either controls (0.70 ± 0.3 b/c; p < 0.001) or a concurrently examined patient population with central nervous system tumors (0.55 ± 0.3 b/c; p < 0.001). The expression of mutagen‐induced chromosome fragility in the head and neck cancer population was site‐specific, being most evident in patients with laryngeal or pharyngeal cancer but not oral cavity disease. The differential responses to muta‐gen effects may be a reflection of DNA repair deficiency. Head and neck cancer patients express a higher degree of chromosomal mutagen sensitivity, which may contribute to neoplastic development.
Intraoral and oropharyngeal reconstruction using a de‐epithelialized forearm flap
Authors: Kawashima Takao , Harii Kiyonori , Ono Isamu , Ebihara Satoshi , Yoshizumi Takashi
Published: February 2007

We have used free forearm flaps for closure of various intraoral and oropharyngeal defects after radical ablation of tumors. A problem remained, however, in that split‐thickness skin grafts required to close the forearm defect had to be obtained from other areas. To avoid this disadvantage, we de‐epithelialized forearm flaps and the donor defects were closed with the split‐thickness skin obtained from flap de‐epithelialization. As a result of this procedure, unnecessary scarring has been avoided and postoperative management has been simplified. Such complications as flap loss, fistulae, or scar contracture have not occurred with greater frequency than is seen in normal circumstances. The de‐epithelialized forearm flap procedure is explained. Histological findings concerning the de‐epithelialized forearm flap are described, and the advantages of this method stated.
Evaluation of some prognostic factors in small squamous cell carcinoma of the mobile tongue: A multicenter study in Sweden
Authors: Nathanson Arthur , Ågren Karin , Biörklund Anders , Lind Magnus G. , Andréason Lars , Anniko Matti , Freijd Anders , Lejdeborn Lars , Kinman Staffan , Kumlien Anders , Köling Anders , Lindström Jörgen , Novik Anders , Olofsson Jan , Pettersson Kari‐Lvar
Published: February 2007

In a retrospective study of 58 patients from all over Sweden, treated for small squamous cell carcinoma of the mobile tongue (T1N0M0), different prognostic factors were evaluated. A partial glossectomy was performed as primary treatment in all patients. The cancer recurred in 28 (38%) of 58 patients. One of 7 patients with only local recurrence, and 9 of 14 with recurrence in the neck died of their disease. The relative survival rate was 77%. Of the prognostic factors tested, tumor thickness was found to be the most significant. In patients with tumor thickness exceeding 10 mm, recurrences occurred in 58% (P < 0.0048), and 87% (P < 0.0164) died of their cancer. This represents a statistically significant higher degree when compared with tumor thickness of less than 10 mm. Elective treatment of the neck nodes is recommended in epidermoid cancer of the mobile tongue when tumor thickness exceeds 10 mm, even in stage I tumors (i.e., the surface extension diameter is smaller than 20 mm at most).
Nutritional concepts and considerations in head and neck surgery
Authors: Williams Edwin F. , Meguid Michael M.
Published: February 2007

Assessment and correction of malnutrition is a major contribution to the improvements in the pre‐ and postoperative management of patients with head and neck cancer over the past 20 years. These patients are often in a poor nutritional status and thereby are at a higher operative risk secondary to the local and systemic effects of the tumor and its treatment. This article reviews current data emphasizing preoperative nutritional assessment, modalities available for nutritional therapy in head and neck cancer patients, and indications for perioperative use of these modalities.
Epidermal growth factor receptor gene amplification and expression in head and neck cancer cell lines
Authors: Weichselbaum Ralph R. , Dunphy Edward J. , Beckett Michael A. , Tybor Allen G. , Moran William J. , Goldman Michael E. , Vokes Everett E. , Panje William R.
Published: February 2007

We studied epidermal growth factor receptor (EGFR) gene am plification and expression in 11 early passage human head and neck carcinoma cell lines. Three cell lines demonstrated EGFR gene amplification and 10 lines showed an increase in EGFR mRNA when compared with normal keratinocytes, placenta, and a human skin carcinoma cell line. The effects of EGF on growth in 6 head and neck carcinoma cell lines was also studied. Growth inhibition at a concentration of 20 ng/mL was observed in one cell line but had no effect on growth in 5 cell lines. An increase in EGFR may be important in the etiology of, or progression of, head and neck carcinoma although the mecha nisms need to be elucidated by further study.
Patterns of spread of squamous cell carcinoma within the mandible
Authors: McGregor A. D. , Macdonald D. G.
Published: February 2007

The patterns of spread of squamous cell carcinoma within the mandible were investigated in 43 nonirradiated (33 edentulous and 10 partially dentate) and 16 irradiated mandibles. Two modes of spread were identified: (1) spread in relation to the inferior alveolar nerve, and (2) spread in spaces between cancellous bony trabeculae. Although nerve‐related spread was significantly more frequent in the edentulous than in the partially dentate nonirradiated mandible, the difference in incidence between all nonirradiated mandibles and irradiated mandibles was not significant. The patterns of spread in cancellous bone in irradiated and nonirradiated mandibles differed little. Spread of tumor within the medulla, deep to an intact cortex beyond the extent of extraosseous soft tissue tumor, was seen infrequently.
Tracheogastric puncture for vocal rehabilitation following total pharyngolaryngoesophagectomy
Authors: Maniglia Anthony J. , Leder Steven B. , Goodwin W. Jarrard , Sawyer Robert , Sasaki Clarence T.
Published: February 2007

Speech rehabilitation postpharyngolaryngoesophagectomy has not received significant emphasis. We describe our experience with five patients who underwent a delayed tracheogastric puncture (TGP) after pharyngogastric anastomosis. When compared to patients who had undergone tracheoesophageal puncture (TEP) after laryngectomy, speech intelligibility and fluency were adequate for conversational speech, but voice quality was characterized by lower pitch, reduced intensity, slower rate, and a “wet” quality. There were no complications related to the TGP. TGP is a safe and often useful procedure for voice and speech restoration in patients who have undergone total pharyngolaryngoesophagectomy and pharyngogastric anastomosis.
Iatrogenic cholesteatoma of the neck
Authors: Fliss Dan M. , Puterman Marco , Tovi Ferit
Published: February 2007

Epidermal cysts of the upper neck may appear years after ipsilateral radical mastoidectomy for cholesteatoma. Three patients are presented, and the etiological factors operating in the development of such tumors in these patients and others cited in the literature are discussed.
Significance and therapeutic implications of tumor regression following radiotherapy in patients treated for squamous cell carcinoma of the oropharynx and pharyngolarynx
Authors: Bataini Jean P. , Jaulerry Christian , Brunin Francoise , Ponvert Dominic , Ghossein Nemetallah A.
Published: February 2007

The prognostic significance of tumor regression following radiotherapy was evaluated in 1,897 patients with oro‐ and pharyngo‐laryngeal cancer. Complete tumor regression occurred in 62% and 80% at the end of treatment and 2 months later, respectively. Complete regression was significantly higher for early tumors than for advanced stages and for exophytic lesions compared to deeply infiltrative cancers. Depending on tumor location, 75% to 90% of T1, T2 stages and 50% to 80% of more advanced tumors were locally controlled in patients who experienced complete tumor regression at 2 months. The local failure rate was at least 80% for those who did not have complete regression. The local failure rate for the incomplete responder was the same for early and advanced tumors. Complete tumor clearance following radiotherapy is a reliable indicator of permanent local control. Tumor regression after a dose of 5,000 to 5,500 cGy should be used as a guide to select patients who could be treated by either radical irradiation or surgery.
Integration of chemotherapy in an MFD‐radiotherapy plan for advanced inoperable squamous cell carcinoma of the head and neck
Authors: Corvo Renzo , Merlano Marco , Looney William B. , Benasso Marco , Bacigalupo Almalina , Margarino Giovanni
Published: February 2007

From January 1987 to May 1988, 16 patients with advanced squamous cell carcinoma of the head and neck received combined treatment, based on an alternating schedule of chemotherapy and multiple fractions per day (MFD)‐radiotherapy. The chemotherapy regimen consisted of cisplatin, 20 mg/m2, followed by 5‐fluorouracil (5‐FU), 200 mg/m2 i.v. push, from days 1 to 5 during weeks 1, 5, and 9. Radiotherapy was administered in two courses of 32 Gy each (total dose, 64 Gy) during weeks 2 and 3 and 6 and 7. Each course was given in two fractions per day, 5 days per week. The 16 patients were evaluated for toxicity and response. We observed 7 complete responders, 6 partial responders, and 3 nonresponders. The overall response rate was 81%. Toxicity was heavy: 44% of the patients developed grade III‐IV mucositis. Our results suggest that cisplatin and 5‐fluorouracil alternating with MFD‐radiotherapy is effective; however, a new less toxic scheduling must be determinated.
Computed tomography of the clinically negative neck
Authors: Stern Wendy B. R. , Silver Carl E. , Zeifer Barbara A. , Persky Mark S. , Heller Keith S.
Published: February 2007

Members of the New York Head and Neck Society conducted a multi‐institutional review correlating preoperative computed tomography (CT) of the neck with postoperative pathology in 59 patients with squamous cell carcinoma of the oral cavity, pharynx, and larynx, without palpable lymphadenopathy. All underwent CT followed by surgery that included partial or complete cervical lymphadenectomy. Sixteen (28%) patients had occult cervical metastases including 6 (17%) of 36 patients with “early stage” (T1 and T2) primary tumors and 10 (44%) of 23 patients with “advanced” (T3 or T4) lesions. There was agreement of CT scan findings with presence or absence of metastatic disease in 41 (69%) of 59 studies, with sensitivity 38%, and with specificity 81%. Findings of central lucency and nodal confluence were highly reliable indicators of malignancy, whereas nodal size bore a less direct relationship. Intravenous contrast medium was useful for anatomical delineation, but not for identification of malignancy. Review of films by a single radiologist did not produce greater diagnostic accuracy than the original interpretations. The authors conclude that while it is not possible to identify all instances of cervical node involvement, employment of CT in addition to physical examination and prognostication.
Spontaneous and nonspontaneous internal jugular vein thrombosis
Authors: Chowdhury Khalid , Bloom Joseph , Black Martin J. , Al‐Noury Khaled
Published: February 2007

Nonspontaneous internal jugular vein thrombosis (IJVT) is an uncommon condition historically associated with deep neck infections during the pre‐antibiotic era. Today, trauma to the internal jugular vein from catheterization and repeated intravenous injections by drug users are the leading causes of thrombosis, with direct extension of tumor being a rare cause. Spontaneous IJVT occurs when there are no apparent predisposing causes, although many of these patients may harbor an occult malignant neoplasm. Therefore, careful investigation and follow‐up are imperative in these patients. The diagnosis of IJVT is readily confirmed by contrast‐enhanced computed tomography or magnetic resonance imaging. Management of IJVT involves anticoagulation, antibiotics, and with few indications for surgical intervention.
Unexpected lymph node pathology in neck dissection for head and neck cancer
Authors: Ratcliffe Robert J. , Soutar David S.
Published: February 2007

The pathological findings in 62 patients with head and neck cancers who underwent neck dissection during a 12‐month period are presented. Histological confirmation of metastatic disease was obtained in 46 cases (74%). In the remaining 16 cases (26%), there was no evidence of metastasis from the primary tumor. In 7 cases (11%), there was unexpected pathology in the cervical lymph nodes which was not related to the primary tumor. Accurate clinical staging of head and neck tumors is made increasingly more difficult in such cases where unrelated or dual lymph node pathology exists.
Investigation of urinary transforming growth factor alpha levels as tumor markers in patients with advanced squamous cell carcinoma of the head and neck
Authors: Fazekas‐May Mary , Suen James Y. , Yeh Yun Chi , Yeh Hsing Wu , Milligan Lynda Beth
Published: February 2007

The objective of this study was to determine whether transforming growth factor alpha (TGF alpha) levels could be used as nonspecific tumor markers in patients with advanced squamous cell carcinoma (SCC) of the head and neck. Fourteen patients with epidermoid carcinoma of the head and neck were followed with serial urine TGF alpha levels, and the results were compared with the extent of cancer and the course of the disease. Based on the findings of this study further research is necessary before urine TGF levels can be recommended as a routine screening test for SCC of the head and neck.
Familial occurrence of carotid body tumors
Authors: Shedd Donald P. , Arias Joanna D. , Glunk Richard P.
Published: February 2007

Four new cases of carotid body tumors are reported, all familial, including 2 patients with bilateral tumors. The embryology, physiology, pathology, natural history, and treatment of these rare tumors are reviewed. It is recommended that all carotid body tumors be excised unless there are contraindicating medical or technical reasons.
Arteriovenous malformation of the maxilla
Authors: Kennedy Kevin S.
Published: February 2007

The highly vascular nature of the head and neck area provides a particularly enhanced challenge to the head and neck surgeon when a vascular lesion is encountered. Vascular malformations in this area are classified according to the microanatomical architecture and clinical appearance of the lesion. Although bleeding is a common presentation with vascular malformations, other local and systemic problems may be associated with this problem. An unusual case of an arteriovenous malformation of the ethmoid and maxillary sinuses which caused persistent and recurrent epistaxis is presented. A review of the current literature concerning vascular lesions of the head and neck area is included. Adequate treatment of this lesion presently includes angiographically controlled vascular embolization followed by complete surgical excision.
Preliminary trial of nonrecombinant interferon alpha in recurrent squamous cell carcinoma of the head and neck
Authors: Vlock Daniel R. , Johnson Jonas , Myers Eugene , Day Roger , Gooding William E. , Whiteside Theresa , Pelch Karen , Sigler Barbara , Wagner Robin , Colao Denise , Rust Deborah
Published: February 2007

Fourteen patients with recurrent squamous cell carcinoma of the head and neck (SCCHN) were treated with 10 × 106 U of nonrecombinant interferon alpha (IFN) intramuscularly (IM) daily for 3 days every 28 days. There were 11 men and 3 women, with ages ranging from 48 to 74 years. Patients had previously been treated with surgery (9 patients), radiotherapy (13 patients), or chemotherapy (8 patients). All patient had measurable disease by physical exam and radiologic evaluation and a performance status of ⩽2 (ECOG). Patients were treated for a minimum of 3 months and continued on therapy until disease progression. The dose and treatment schedule of IFN was well‐tolerated. Toxicities included low‐grade fever, mild anorexia, and malaise. Treatment was stopped in 1 patient due to the development of atrial fibrillation. One death occurred as a complication of aspiration pneumonia 2 weeks following the onset of therapy and was not felt to be related to IFN therapy. Of the 14 patients treated, there was 1 complete response (30+ months) of a base of tongue primary. Two patients had stabilization of disease (SD, 8 and 12 months). One patient had a mixed response with resolution of subcutaneous nodules. The remaining 10 patients died of progressive disease. Immunoogical assessment was performed on 8 patients. The 1 patient who has a complete response was noted to have markedly low pretreatment natural killer (NK) cell activity and subsequent sharp rise in activity after intial treatment. We conclude that low‐dose cyclic IFN is well‐tolerated in patients with recurrent SCCHN and has potential antitumor activity.
Mucosal melanoma of the head and neck
Authors: Stern Scott J. , Guillamondegui Oscar M.
Published: February 2007

Forty‐two patients with mucosal melanoma of the head and neck were treated at the M. D. Anderson Cancer Center from 1944‐1989. Their records were evaluated regarding: location of the primary, stage of the disease at presentation, type of treatment, location of recurrences, and overall survival. These patients received the majority of their therapy at M. D. Anderson Cancer Center. The treatment consisted of surgery, radiotherapy, chemotherapy, immunotherapy, or a combination of these. The 5‐year survival rate was 40%. Twenty‐four of 27 patients who died with metastatic melanoma had local or regional disease concomitantly. Forty percent of patients were free of disease at 5 years; however, only 26% had long‐term survival. Although the majority of patients eventually succumbed to their disease, local and regional control was obtained initially in 92% of the group. These data indicate that prolonged survival is possible with mucosal melanoma of the head and neck; however, recurrence or metastasis remain possible many years after the initial diagnosis.
Neurofibroma of the vagus nerve in the head and neck: A case report
Authors: Peetermans Johan F. E. , Van de Heyning Paul H. , Parizel Paul M. , Martin Jean J. , Forton Glen E. J. , Vanmaele Rudolphe G. M. , Valcke Hélène H. D. , Marquet Jean F. E. , De Schepper Arthur M. A.
Published: February 2007

A case of a tumor of the vagus nerve, showing typical features of a neurofibroma, is presented. The natural history is reviewed, and several technical investigations, with particular reference to the contributions of magnetic resonance imaging and immuno‐histochemical techniques in the differential diagnosis, are discussed.
Congenital middle ear encephalocele initially seen with facial paresis
Authors: Uri Nechama , Shupak Avi , Greenberg Elhanan , Kelner Judith
Published: February 2007

Congenital middle ear encephalocele (CMEE) is a rare entity, previously reported in only 29 patients. It might originate from dehiscence of the tegmen tympani or antri or the bony plate of the posterior fossa. The common presenting symptoms are spontaneous cerebrospinal fluid (CSF) otorrhea and/or rhinor‐rhea, persistent “serous otitis media,” conductive hearing loss, and, occasionally, recurrent meningitis. We report a case of CMEE initially seen with progressive facial paresis, review the previously reported cases of CMEE, and discuss the pathogenesis and surgical management.
Outpatient and short‐stay thyroid surgery
Authors: Gerfo Paul Lo , Gates Richard , Gazetas Polyxene
Published: February 2007

With the realization that simple thyroid procedures had a very low rate of complication and that patients often seemed well enough to go home from the recovery room, we began performing them in an ambulatory surgery setting. We review here 134 consecutive thyroid procedures performed at Columbia Presbyterian Medical Center between July 1987 and July 1989. Patients undergoing reoperation, neck dissection, sternal splits, or other concomitant procedures were excluded. There were 105 women and 29 men with an average age of 47 years. Fifty percent of the operations were performed for benign disease, although the most common diagnosis was papillary cancer (44%). Twenty‐one operations (16%) were performed under local anesthesia. Most patients underwent surgery in our ambulatory surgery unit and 76 were discharged the day of surgery. Of these patients, 21 underwent total thyroidectomy, 13 subtotal thyroidectomy, and 42 simple thyroid lobectomy. Of the 58 patients who were admitted, 53 were discharged on the day following surgery. The average length of stay was 0.49 days. Extensive pre‐ and postoperative teaching was given regarding the signs and symptoms associated with the complications of thyroid surgery. All patients were felt to be reliable and capable of understanding the procedure and of complying with the postoperative plans. Postoperative complications included 8 patients (6%) with transient hypocalcemia and 1 patient (0.75%) with permanent unilateral recurrent laryngeal nerve paralysis. All complications occurred in patients who underwent total thyroidectomies. No patient had a postoperative complication requiring reoperation or readmission. We conclude that by using specific selection criteria, thyroid lobectomies and subtotal thyroidectomies can be performed safely in an ambulatory surgery setting without increase in morbidity or mortality.
Maxillary swing approach to the orbit
Authors: Lam Kam H. , Lau Wai F. , Yue Chung P. , Wei William I.
Published: February 2007

A new surgical approach to the inferior half of the orbit is described and 2 cases are presented. The approach involves releasing the roof and the anterior wall of the maxillary antrum by osteotomies, keeping their blood supply via the attached masseter muscle, and swinging the osteoplastic flap away from the orbit. With the wide exposure gained, the retrobulbar tumor or large orbital floor tumor is dealt with, and the mobilized bone is replaced and wired into position. There is no postoperative disturbance of cosmetic appearance.
Interleukin‐2 injected around tumor‐draining lymph nodes in head and neck cancer
Authors: Cortesina Giorgio , De Stefani Antonella , Galeazzi Emanuela , Cavallo Giovanni P. , Jemma Cristina , Giovarelli Mirella , Vai Stefania , Forni Guido
Published: February 2007

Twenty patients with recurrent, inoperable head and neck squamous cell carcinoma received perilymphatic injections of natural interleukin‐2 (nlL‐2) for 10 days. Ten patients received 200 units (U) of nlL‐2; five 1,000 U; and five 5,000 U. Irrespective of the location of the recurrence, the injections were always performed 1.5 cm below the insertion of the sternocleidomastoid muscle on the mastoid. When the ipsilateral lymphatic chain was still present, they were performed on the same side as the tumor site, whereas when it had been stripped as a result of previous surgery, they were contralateral. Patients who had undergone bilateral neck dissection were injected on the tumor side. Whenever possible, the treatment was repeated after 45 day intervals. In 13 patients (65%) with bilateral or contralateral lymph nodes, complete or partial disappearance of the lesion was observed. Despite these marked responses, the tumor always relapsed, and subsequent IL‐2 courses were poorly effective. There were no systemic disturbances during or after treatment, but only moderate local swelling and pain.
Laryngotracheal stenosis: A 5‐year review
Authors: Smith Richard J. H. , Catlin Francis L.
Published: February 2007

Twenty‐seven children with varying degrees of laryngotracheal stenosis were treated at Texas Children's Hospital (TCH) from January 1984 to January 1989. Nineteen children had a residual airway demonstrable preoperatively, and following laryngotra‐cheoplasty, 18 (95%) were successfully decannulated; all but 1 had a normal voice. Eight children had complete stenosis. Of these children, 6 could be decannulated, but 3 required a second laryngotracheoplasty. Four children now have voice abnormalities.
Bone contouring and fixation in functional, primary microvascular mandibular reconstruction
Authors: Buchbinder Daniel , Urken Mark L. , Vickery Carlin , Weinberg Hubert , Biller Hugh F.
Published: February 2007

Experience in over 65 cases of microvascular mandibular reconstruction has resulted in the development of reliable techniques for bone fixation and contouring to achieve the best functional results. Methods of graft contouring and the application of rigid internal fixation are described in detail. Unusual situations in which the tumor extends through the buccal cortex of the mandible, and when condylar replacement is necessary, are presented. The options for managing these situations are discussed.
Ancient neurilemmoma of the infratemporal fossa: A case report
Authors: Ogren Frederic P. , Wisecarver James L. , Lydiatt Daniel D. , Linder James
Published: February 2007

Ancient neurilemmoma (schwannoma) is a rare variant of the neurilemmoma. It is a slow‐growing, benign neoplasm with a favorable clinical course. Histologically, it can be confused with a sarcoma. A case of an ancient neurilemmoma of the infratemporal fossa is reported. The clinical, histologic, radiologic, and surgical aspects of this tumor are discussed with an emphasis on diagnosis and treatment.
Toxic shock syndrome following functional endonasal sinus surgery: A case report
Authors: Younis Ramzi T. , Gross Charles W. , Lazar Rande H.
Published: February 2007

Toxic shock syndrome (TSS) is a serious multisystem disease that was first described in 1978 by Todd. It occurs most often in menstruating women using superabsorbent tampons. The exact pathogenesis is not well understood, but it is felt to be due to the effects of an enterotoxin produced by certain strains of Staphyloccus aureus. The reported incidence of TSS following nasal surgery is 16/100,000. We report a case of TSS following endo‐nasal sinus surgery in which minimal packing was used. The nasal surgeon should be aware of this rare and possibly fatal entity, as TSS may occur following any nasal/sinus surgery, even where packing is minimal and of short duration and when the patient is receiving antibiotic therapy.