Cervical Vertebral Metastasis from Tongue Carcinoma: A Rare Case Report and Review.

Head and neck cancers are emerging as major health problems in India. In 2010, head and neck cancer was ranked as the sixth leading cause of cancer death worldwide. Approximately 481,100 new cases developed, and 320,000 persons died of this disease, resulting in an average mortality rate of 7.3 and 3.2 per 100,000 males and females, respectively. Oral squamous cell carcinoma is the most common head and neck malignancy having a propensity for the locoregional spread. Vascular invasion is very rare when compared to lymphatic spread. Most frequent sites of distant metastasis are lung, bone, liver, adrenals, heart, and kidney. We report a rare case of 39-year-old male with cervical vertebral metastasis from tongue carcinoma which is 9th case reported according to literature.

Comparative study of catheter drainage and needle aspiration in management of large liver abscesses.

Objective To compare the effectiveness of percutaneous catheter drainage (PCD) and percutaneous needle aspiration (PNA) in the management of large (>10 cm diameter) liver abscesses. Methods Seventy-two patients with liver abscess (amebic 48, pyogenic 24) were randomly allocated to PCD or PNA (36 each), which were done within 24 hours of admission. Both groups received parenteral antibiotics for at least 10 days. PNA was repeated every third day if the cavity size had not declined to 50% of the original for up to three times. Persistence of cavity or of clinical symptoms was considered failure of treatment. Duration to attain clinical relief, duration of hospital stay, complications, treatment failure, and deaths were recorded. Results PNA was successful in 31 of 36 (86%) patients (one aspiration in 10, two in 18, and three in 3 patients), whereas PCD was successful in 35 (97%) patients (p=ns). Duration to attain clinical relief (10.2 [2.0] vs. 8.1 [2.7] days; p=0.02) and parenteral antibiotics needed (15.5 [1.1] vs. 10.9 [2.7] days; p=0.04) were significantly lower in PCD group. Duration of hospital stay was similar in the two groups. One patient with PNA had a subcapsular hematoma and one with PCD had continuous bile leakage which stopped spontaneously. One patient in PCD group died. Conclusion PCD is a better treatment option than PNA for the management of large liver abscesses of size >10 cm, in terms of duration to attain clinical relief and duration for which parenteral antibiotics are needed.