Thyroid gland involvement in advanced laryngeal squamous cell carcinoma

@#<p style="text-align: justify;"><strong>OBJECTIVE:</strong> This study aims to determine the prevalence and pattern of thyroid gland involvement in advanced laryngeal squamous cell carcinoma and to identify factors associated with its development.<br /><strong>METHOD:</strong> Records of 118 patients who underwent laryngectomy with thyroidectomy for advanced laryngeal squamous cell carcinoma in a tertiary government hospital from January 2010 to August 2015 were reviewed. Demographic, clinical and histopathology data were obtained. The relationship of the laterality of primary tumor bulk and lobe involvement was analyzed using Fischer's exact test. The association between thyroid gland invasion and other factors was analyzed using logistic regression.<br /><strong>RESULTS:</strong> Thyroid gland involvement was found in 11% of the patients via direct spread in 92.3%. Single lobe involvement accounted for 61.5% of cases. There is a tendency for laryngeal squamous cell carcinoma to invade the thyroid lobe ipsilateral to the primary tumor bulk. Extralaryngeal spread, tracheostomal involvement, and tracheal extension were associated with thyroid gland involvement.<br /><strong>CONCLUSION:</strong> Thyroid gland involvement in advanced laryngeal squamous cell carcinoma is rare; hence, indications for performing thyroidectomy in relation to the presence of thyroid gland involvement should be established to avoid unnecessary surgeries.</p>

Risk factors for recurrent papillary thyroid carcinoma

@#<p style="text-align: justify;"><strong>OBJECTIVE:</strong> To identify risk factors associated with disease recurrence among Filipinos with papillary thyroid carcinoma (PTC).<br /><strong>METHODS:</strong><br /><strong>Design:</strong> Retrospective Cohort Study<br /><strong>Setting:</strong> Tertiary National University Hospital<br /><strong>Participants:</strong> 76 patients diagnosed with papillary thyroid carcinoma, classified as low and low-to-intermediate risk (2015 ATA classification) that underwent total thyroidectomy with or without neck dissection from 2010-2014 and were followed up from 10 months to 5 years. Log rank and Cox regression analyses were used to determine significant risk factors for recurrence.<br /><strong>RESULTS:</strong> 29 (38.15%) had recurrence. On univariate analysis, age, tumor size, multifocality, extrathyroidal extension, presence of lateral neck nodes and RAI therapy were statistically associated with recurrence. However, on multivariate analysis, no clinicopathologic factor was statistically associated with recurrence.<br /><strong>CONCLUSION:</strong> Age of >45 years, female sex, tumor size of >2 cm, multifocality, presence of microscopic extrathyroidal extension and lymph node metastasis might contribute to the recurrence of papillary thyroid cancer while post-operative radioactive ablation may have some protective effect. However, this study suggests that other factors must be included in the model to better understand the relationship between these factors and recurrence.</p>

Extragnathic sinonasal ameloblastoma: A rare benign intranasal tumor with malignant features

@#<p><strong>OBJECTIVE:</strong> To report a case of extragnathic sinonasal ameloblastoma and discuss its clinical features, approach to diagnosis, pathology and management.<br /><br /><strong>METHODS:<br /></strong><strong>Design:</strong> Case Report<br /><strong>Setting:</strong> Tertiary Government University Hospital<br /><strong>Patient:</strong> One<br /><br /><strong>RESULTS:</strong> A 40-year-old female consulted for a rapidly enlarging right intranasal mass of four months duration associated with recurrent profuse epistaxis and nasal obstruction. Previous specimens of the mass were histopathologically interpreted as ameloblastoma versus craniopharyngioma. Examination revealed a pink, fleshy, smooth right intranasal mass with associated nasomaxillary bulge and supero-Iateral displacement of the right eye. Computed tomography (CT) scan and magnetic resonance imaging (MRI) of the nasal cavity and paranasal sinuses demonstrated a soft-tissue density occupying the entire nasal cavity with erosion but no invasion of the maxillary sinus and no intracranial extension despite erosion of the skull base. The mass was completely excised via lateral rhinotomy and the final histopathologic diagnosis was ameloblastoma.<br /><br /><strong>CONCLUSION:</strong> Extragnathic sinonasal ameloblastoma is a benign but locally aggressive variant of ameloblastoma involving the nasal cavity and/or paranasal sinuses often mimicking malignant tumors. Diagnosis is primarily based on histopathology but radiologic and intraoperative findings help distinguish it from differentials. Complete surgical excision remains the treatment of choice, and coupled with good follow up, may improve the prognosis of patients.</p>