Sigmoid Squamous Cell Carcinoma presenting as a bladder mass: A case report

@#Primary squamous cell carcinoma (SCC) of the colon and rectum is a rare malignancy, with an incidence of less than 1 in 1,000 diagnosed colorectal cancers. This is a case of a 59-year-old male who presented with a three-month history of urinary symptoms. Work-up, however, revealed a locally-advanced, partially-obstructing primary sigmoid squamous cell carcinoma with extension to the urinary bladder. He subsequently underwent a proximal bowel diversion after extensive carcinomatosis was discovered on diagnostic laparoscopy. Colon SCC represents less than 0.5% of all colorectal tumors, and its incidence is estimated to be 0.1%. Clinically, it presents with similar signs and symptoms as colorectal adenocarcinoma. No standardized management approach has been established yet. A multidisciplinary team approach is essential in dealing with such cases. Keen attention and further investigation are warranted to clearly define the management approach to achieve better outcomes.

Platelet-rich plasma injection of skin graft in a patient with squamous cell carcinoma and psoriasis on prolonged methotrexate therapy: A case report

Introduction@#Psoriasis and some of its treatments such as methotrexate have been linked to the development of non-melanoma skin cancers including cutaneous squamous cell carcinoma (SCC). Chronic maque psoriasis, Koebnerization, and prolonged methotrexate therapy are some of the concerns that may impact wound healing and graft uptake when treating these patients. @*Case Report@#We report a case of a 64-year-old male with a 32-year history of moderate to severe psoriasis continuously self-medicating with methotrexate for 30 years who presented with a solitary indurated tumor with ulceration on the right anterior leg. Histopathology result revealed acantholytic cSCC. The patient concomitantly has generalized psoriatic plaques that complicated the selection of donor site for the skin graft, and raised concerns on wound healing and graft uptake. He underwent wide excision surgery with gastrocnemius (medial head) flap and split thickness skin graft. Platelet-rich plasma (PRP) injections were utilized post-operatively to increase graft survival and donor site regeneration. @*Discussion@#The main risk factors for the development of cSCC for this patient are the history of chronic plaque psoriasis and chronic methotrexate therapy. These two can also complicate the success of grafting and wound healing for this patient. PRP was utilized to for better graft survival, faster wound healing, and prevention of Koebnerization.

Erythroderma as first manifestation of squamous cell lung cancer: rare case report

Abstract Erythroderma as the first manifestation of a solid organ malignancy is rare. The underlying cancer is a challenging condition to diagnose. There are a few cases of erythroderma in cancer patients reported in the literature. We here describe the case of a 70-year-old man who presented with asthenia, weight loss, dry cough and total body erythema with desquamation over the past month. A chest computed tomography scan showed a nodular lesion, which was finally diagnosed as a squamous cell lung carcinoma. To our knowledge, as an erythroderma presentation, only 13 cases have been reported in the literature. This case report demonstrates the need to search for a neoplasm in patients presenting with erythroderma, particularly in the presence of accompanying debilitating symptoms.

Retalho de peitoral maior estendido e pediculado para reconstrução de região orbito-fronto-parietal direita após exérese de carcinoma espinocelular invasivo / Extended and pedicled pectoralis major flap for right orbitofrontal-parietal reconstruction following invasive squamous cell carcinoma resection

Introdução: O retalho miocutâneo de peitoral maior é um dos mais usados na reconstrução de defeitos da cabeça e pescoço, porém com restrição ao terço médio da face. Com técnicas de dissecção de perfurantes, consegue-se alongar mais o pedículo, obtendo coberturas da região orbito-fronto-parietal. Relato de Caso: Paciente masculino de 63 anos apresentando carcinoma espinocelular invasivo pouco diferenciado, que após sua ressecção cirúrgica apresentou defeito final de 12,0 x 18,0cm na região órbito-fronto-parietal direita com exposição de dura-máter, seio frontal e órbita superior direita. Foi desenhado retalho de peitoral maior com ilha cutânea de dimensões iguais ao defeito na região paraesternal direita, desde o quarto espaço intercostal até a região subcostal (estendido). O pedículo foi seccionado após 4 semanas. A cobertura foi efetiva, sem complicações maiores e resultado estético satisfatório. Conclusão: Este retalho mostrou ser uma excelente opção para reconstrução do terço superior da cabeça quando existam limitações para a realização de microcirurgia.

Introdução: O retalho miocutâneo de peitoral maior é um dos mais usados na reconstrução de defeitos da cabeça e pescoço, porém com restrição ao terço médio da face. Com técnicas de dissecção de perfurantes, consegue-se alongar mais o pedículo, obtendo coberturas da região orbito-fronto-parietal. Relato de Caso: Paciente masculino de 63 anos apresentando carcinoma espinocelular invasivo pouco diferenciado, que após sua ressecção cirúrgica apresentou defeito final de 12,0 x 18,0cm na região órbito-fronto-parietal direita com exposição de dura-máter, seio frontal e órbita superior direita. Foi desenhado retalho de peitoral maior com ilha cutânea de dimensões iguais ao defeito na região paraesternal direita, desde o quarto espaço intercostal até a região subcostal (estendido). O pedículo foi seccionado após 4 semanas. A cobertura foi efetiva, sem complicações maiores e resultado estético satisfatório. Conclusão: Este retalho mostrou ser uma excelente opção para reconstrução do terço superior da cabeça quando existam limitações para a realização de microcirurgia.

Oral squamous papilloma: a view under clinical, fluorescence and histopathological aspects / Papiloma escamoso oral: uma visão sob aspectos clínicos, de fluorescência e histopatológicos

ABSTRACT Oral squamous papilloma is a benign tumor whose pathogenesis has been associated with human papillomavirus infection. Thus, it is noteworthy that human papillomavirus infection is one of the risk factors associated with the development of cervical, anogenital, pharynx, larynx and oral cavity carcinomas. Oral squamous papilloma can affect any region of the oral cavity, and transmission of human papillomavirus can occur by direct contact, sexual intercourse or from mother to child during delivery. The diagnosis is clinical and histopathological, with surgical removal representing the treatment of choice. Recently, widefield optical fluorescence has been used as a complementary examination to the conventional clinical examination in the screening of oral pathological lesions and for the delimitation of surgical margins. We report a case of oral squamous papilloma with its clinical, histopathological features and, in addition, from the perspective of wide field optical fluorescence.

RESUMO O papiloma escamoso oral é um tumor benigno, cuja patogênese tem sido associada à infecção pelo papilomavírus humano. A infecção pelo papilomavírus humano é um dos fatores de risco associado ao desenvolvimento dos carcinomas cervicais, anogenitais, faríngeos, laríngeos e da cavidade oral. O papiloma escamoso oral pode acometer qualquer região da cavidade oral, e a transmissão do papilomavírus humano ocorre por contato direto, relação sexual ou de mãe para filho durante o parto. O diagnóstico é clínico e histopatológico, e a remoção cirúrgica representa o tratamento de escolha. Recentemente, a fluorescência óptica de campo amplo tem sido empregada como exame complementar ao exame clínico convencional, no rastreio de lesões patológicas orais e para delimitação de margens cirúrgicas. Relatamos um caso de papiloma escamoso oral com suas características clínicas e histopatológicas, sob a perspectiva da fluorescência óptica de campo amplo.

Chemoradiotherapy for Esophageal Cancer

Esophageal cancer is a highly lethal malignancy. Squamous cell cancer (SCC) and adenocarcinoma are two major histologic types of esophageal cancer. The therapeutic approaches for both histologic types tend to be similar. Endoscopic therapy is considered in patients with Tis and T1a, and surgery alone is recommended in patients with T1N0 esophageal SCC or adenocarcinoma. Definitive chemoradiotherapy is a reasonable option for patients unable to withstand surgery. Esophagectomy is considered as the initial treatment for patients with clinical T2N0 esophageal SCC and those with adenocarcinoma with low lymph node metastasis risk. Combined modality therapy is recommended for patients with T3N0, T4aN0, and clinically node-positive thoracic esophageal cancer, regardless of histology. Definitive concurrent chemoradiotherapy is the most appropriate treatment approach for patients with esophageal SCC who are not surgical candidates. Definitive concurrent chemoradiotherapy is also considered for esophageal SCC patients who are potential surgical candidates with an endoscopically documented complete response after neoadjuvant chemoradiotherapy. For chemoradiotherapy non-responders, surgery is recommended for those who remain operable after chemoradiotherapy. Esophagectomy is also recommended for patients with esophageal adenocarcinoma after neoadjuvant chemoradiotherapy. Definitive concurrent chemoradiotherapy is preferred over surgery in patients with cervical esophageal cancer because its survival rate is similar to that of surgery and major morbidity can be avoided. Concurrent chemoradiotherapy rather than radiation therapy alone is recommended for patients who can tolerate this approach for non-metastatic, inoperable, or unresectable esophageal SCC or adenocarcinoma.

A Case of Nivolumab-induced Cutaneous Toxicity / 대한피부과학회지

Nivolumab is anti-programmed death 1 (PD1) receptor antibody, which can be used in the treatment of metastatic squamous cell cancer. By blocking the PD1 receptors on T cells, it enhances T-cell response against cancer cells. A 69-year-old man, who works as a farmer, presented with erythematous lichenified plaques on sun-exposed areas, such as the face, the chest, and both the forearms. Before the hospital visit, he was receiving lung cancer treatment with paclitaxel and cisplatin, but there was no improvement. Subsequently, the regimen was changed into nivolumab, and PET-CT showed decreased in cancer size. However, skin rashes developed simultaneously. It is consistent with the results of a previous study in which cutaneous side effects developed in 42% of responders compared to 7% of non-responders. Herein, we report a case of nivolumab-induced cutaneous toxicity on sun-exposed areas based on the clinical findings, including the distribution of rashes, which were improved after decreasing the nivolumab dose with literature review.

New Diagnostic Approach for Esophageal Squamous Cell Neoplasms Using Linked Color Imaging and Blue Laser Imaging Combined with Iodine Staining

A 62-year-old man with a flat early esophageal cancer was referred for endoscopic treatment. White light imaging revealed a pale red lesion, whereas linked color imaging (LCI) and blue laser imaging (BLI) yielded purple and brown images, respectively. Iodine staining demonstrated a large unstained area with a homogenous but very weak pink-color sign. This area appeared more clearly as purple and green on LCI and BLI, respectively; however, a different colored portion was observed at the 4 o'clock position inside the iodine-unstained area. Histopathology findings of the resected specimen revealed squamous intraepithelial neoplasia at the 4 o'clock position and an esophageal squamous cell carcinoma in the remaining iodine-unstained area. LCI and BLI combined with iodine staining produce characteristic images that overcomes the pink-color sign, reflecting the histological features of a flat esophageal neoplasm. This new method is useful for detailed evaluation of early flat squamous cell neoplasms.

Usefulness of Probe-Based Confocal Laser Endomicroscopy for Esophageal Squamous Cell Neoplasm

No abstract available.

Bimodal Chromoendoscopy with Confocal Laser Endomicroscopy for the Detection of Early Esophageal Squamous Cell Neoplasms

BACKGROUND/AIMS: This study aimed to evaluate the diagnostic accuracy of dual-focus narrow-band imaging (dNBI) and Lugol'schromoendoscopy (LCE) combined with probe-based confocal laser endomicroscopy (pCLE) to screen for esophageal squamous cell neoplasms (ESCNs) in patients with a history of head and neck cancer. METHODS: From March to August 2016, dNBI was performed. Next, LCE was performed, followed by pCLE and biopsy. Histology has historically been the gold standard to diagnose ESCN. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of dNBI and LCE adjunct with pCLE were determined. RESULTS: Twenty-four patients were included. Ten ESCNs were found in 8 patients (33%). Forty percent of high-graded intraepithelial neoplasias and all low-grade intraepithelial neoplasias were overlooked by dNBI. The sensitivity, specificity, PPV, NPV, and accuracy of dNBI vs. LCE combined with pCLE were 50% vs. 80%, 62% vs. 67%, 36% vs. 44%, 75% vs. 91%, and 83% vs. 70%, respectively. CONCLUSIONS: The use of dNBI to detect ESCN was suboptimal. LCE with pCLE following dNBI had additional value for detecting esophageal dysplasia not detected by dNBI. The use of pCLE to detect dNBI-missed lesions yielded a high NPV, while pCLE-guided biopsy could reduce the number of unnecessary biopsies.

Pilomatrixoma proliferante una rara variante histopatológica simulando un carcinoma de células escamosas / Pilomatrixoma proliferating a rare variant histopathological simulating a cell carcinoma scaly

El Pilomatrixoma es un tumor anexial benigno. Presenta una variante histopatológica infrecuente denominada pilomatrixoma proliferante reportada en 1997 por Kaddu et al. Corresponde a una lesión compuesta predominantemente por una proliferación lobular de células basaloides, con atipia nuclear variable y figuras mitóticas, áreas focales que contienen material cornificado eosinófilo, junto con células sombra. Se propuso al pilomatrixoma proliferante como un subconjunto histopatológico distintivo del pilomatrixoma y se consideró como una variante proliferativa con un perfil histopatológico benigno. La dermatoscopía en este tumor, sobre todo en pacientes de edad avanzada, puede llegar a constituir una trampa dermatoscópica, que es difícil de diferenciar de otras lesiones, como el melanoma o el carcinoma de células basales. Existen múltiples reportes de casos en la literatura donde se informa de pilomatrixomas clásicos o proliferantes simulando otras neoplasias. Presentamos el caso de una paciente de 88 años con pilomatrixoma proliferante facial que simuló clínicamente un carcinoma de células escamosas y llevó a confusión diagnóstica inicial, se destacan las características histopatológicas y clínicas de los pilomatrixomas proliferantes.

Pilomatrixoma is a benign adnexal tumor. It has an infrequent histopathological variant called proliferating pilomatrixoma reported in 1997 by Kaddu et al. It corresponds to a lesion composed predominantly by a lobular proliferation of basaloid cells, with variable nuclear atypia and mitotic figures, focal areas containing eosinophilic cornified material, together with shadow cells. The proliferating pilomatrixoma was proposed as a distinctive histopathological subset of the pilomatrixoma and was considered as a proliferative variant with a benign histopathological profile. Dermatoscopy in this tumor, especially in elderly patients, can result in a dermatoscopic trap, which makes it difficult to differentiate from other lesions, such as melanoma or basal cell carcinoma. There are multiple reports of cases in the literature where classic or proliferating pilomatrixomas were reported simulating other neoplasms. We present the case of an 88-year-old patient with a proliferating facial pilomatrixoma that clinically simulated a squamous cell carcinoma and led to an initial diagnostic confusion, highlighting the histopathological and clinical characteristics of the proliferating pilomatrixoma.

Malignant and pre-malignant oesophageal pathology in a South African teaching hospital

Background: South Africa (SA) has one of the highest global incidences of squamous cell carcinoma of the oesophagus (SCC). A decreasing incidence of oesophageal SCC in SA has been suggested. The study aimed to assess whether the incidence of these malignant histopathological subtypes has changed in this setting. Methods: A retrospective review of histopathological reports on pre-malignant and malignant oesophageal lesions over three time periods (TP), namely: 2003­4 (TP1), 2008­9 (TP2) and 2013­14 (TP3) was carried out at Inkosi Albert Luthuli Central Hospital, Durban, South Africa.Results: A total of 1341 specimen reports were retrieved. TP1-3 consisted of 514 (39.3%), 320 (24.5%) and 474 (36.2%) patients respectively. Six hundred and forty-nine patients were male (48.3%), 642 were female (47.8%) and 50 were not specified. i.e. a sex ratio of 1.01:1. The mean age was 60.8 (± 11.8). There were 1197 Black patients (91.5%), 66 Asian (5.1%), 25 White (1.9%), 9 mixed ancestry (0.7%), and 11 of unknown race (0.8%). SCC was the most common cancer 1098 (89.1%) followed by adenocarcinoma (AC) 69 (5.6%). The ratio of SCC to AC remained fairly consistent over the total time period. Seventy-four oesophageal resections were performed with a yearly average resection rate of only 5.6%.Conclusions: SCC is still the most prevalent oesophageal cancer (OC) without an increase in the ratio of AC to SCC. The diagnosis of squamous cell dysplasia is concordant with previously cited rates. Barrett's oesophagitis remains uncommon. Resection rates for OC are low but similar to other South African referring centers

Immunotherapy in Head and Neck Squamous Cell Cancer

Prognosis in relapsed metastatic head and neck squamous cell cancer (RM-HNSCC) is dismal. Platinum based chemotherapy in combination with Cetuximab is used in first-line setting, while no further validated options are available at progression. Immunotherapy has produced durable clinical benefit in some patients with RM-HNSCC although the premises are several patients are nonresponders. Studies are ongoing to determine predictive factors and the ideal setting/combination of novel immunotherapies. In this paper, we discuss the past and present of immunotherapy in head and neck cancer and provide an up-to-date information regarding the potential ways to improve immunotherapy outcomes in HNSCC.

Clinical target volume [CTV] in postoperation radiotherapy of esophageal squamous cell carcinoma could benefit from the detection of telomere length in lymph node

Background: This study evaluated the relation between telomere length in lymph node [LN] and prognosis of esophageal squamous cell carcinoma [ESCC]

Materials and Methods: LNs collected from 50 patients were assessed by pathological examination and quantitative reverse transcription polymerase chain reaction [qRT-PCR], which was used for detecting telomere length. The relation between clinical factors and the number of lymph node metastasis [LNM] identified were analyzed by the x2 test. The comparison of the pattern of LNM identified by pathological examination and detection of telomere length was assessed by Wilcoxon signed-rank test. Overall survival was assessed using the Kaplan-Meier method, and Cox proportional hazard regression analysis was used to evaluate the relationship between survival and the number of LNM

Results: The best threshold values, which could define the positive metastasis by detecting the telomere length, were 1.50, using the critical value method of statistic. Length of tumor, depth of tumor invasion and differentiation of tumor correlated closely with LNM were identified by detecting telomere length. The rates of LNM identified by detecting telomere length were 34.4%, 22.4%, 22.9%, 5.0% in 108,107, 7, and 3 LN station, respectively. The number of LNM identified by detecting telomere length was more closely related to the prognosis of ESCC than that of pathological examination [HR: 1.23 VERSUS 1.04]

Conclusion: The change of telomere length in LN was closely related to the prognosis of ESCC. Delineation of clinical target volume [CTV] may benefit from the detection of telomere length in regional LN

Profile of apoptotic proteins in oral squamous cell carcinoma: A cluster analysis of 171 cases

Oral squamous cell carcinoma (OSCC) is the eighth most prevalent cancer worldwide. In recent large-scale studies, by immunohistochemistry and cluster analysis, several markers were associated with patient survival in various tumors. The aim of this study was to analyze the expression profiles of 23 proteins that have been linked to the inhibition (Bcl-2, Bcl-x, Bcl-xL, Bcl-2-related protein A1, BAG-1, and survivin) and promotion (Bak, Bax, Bim/Bod, Bim-Long, Bad, Bid, PUMA, Apaf-1, caspase-2, caspase-3, caspase-6, caspase-7, caspase-8, caspase-9, caspase-10, Smac/DIABLO, and cytochrome c) of apoptosis in OSCC. METHODS: Two-hundred and twenty nine cases of OSCC, arranged in a tissue microarray, were immunohistochemically analyzed, and the results were quantified on an automated imaging system. The data were analyzed using a random forest clustering method. RESULTS: Overall protein expression patterns defined two chief clusters: an anti-apoptotic cluster (142 cases) and a pro-apoptotic cluster (29 cases). These groups could not be explained by any clinical or pathological characteristic, and overall and disease-free survival did not differ between them. CONCLUSIONS: Although there was no association with survival, the cluster analysis demonstrated specific protein profiles that could be of interest for using targeted therapies: in one of the clusters, the expression of pro-apoptotic proteins was more prominent, demonstrating a pro-apoptotic profile and highlighting the importance of apoptosis during OSCC development.

Comparative Effects of Non-Thermal Atmospheric Pressure Plasma on Migration and Invasion in Oral Squamous Cell Cancer, by Gas Type

PURPOSE: The fourth state of matter, plasma is known as an ionized gas with electrons, radicals and ions. The use of non-thermal plasma (NTP) in cancer research became possible because of the progresses in plasma medicine. Previous studies on the potential NTP-mediated cancer therapy have mainly concentrated on cancer cell apoptosis. In the present study, we compared the inhibitory effect of NTP on cell migration and invasion in the oral squamous cancer cell lines. MATERIALS AND METHODS: We used oral squamous cancer cell lines (SCC1483, MSKQLL1) and different gases (N₂, He, and Ar). To investigate the mechanism of plasma treatment, using different gases (N₂, He, and Ar) which induces anti-migration and anti-invasion properties, we performed wound healing assay, invasion assay and gelatin zymography. RESULTS: The results showed that NTP inhibits cancer cell migration and invasion of oral squamous cancer cell. In addition, focal adhesion kinase expression and matrix metalloproteinase-2/9 activity were also inhibited. CONCLUSION: The suppression of cancer cell invasion by NTP varied depending on the type of gas. Comparison of the three gases revealed that N₂ NTP inhibited cell migration and invasion most potently via decreased expression of focal adhesion kinase and matrix metalloproteinase activity.

GAB2 Amplification in Squamous Cell Lung Cancer of Non-Smokers

Lung squamous cell cancer (SCC) is typically found in smokers and has a very low incidence in non-smokers, indicating differences in the tumor biology of lung SCC in smokers and non-smokers. However, the specific mutations that drive tumor growth in non-smokers have not been identified. To identify mutations in lung SCC of non-smokers, we performed a genetic analysis using arrays comparative genomic hybridization (ArrayCGH). We analyzed 19 patients with lung SCC who underwent surgical treatment between April 2005 and April 2015. Clinical characteristics were reviewed, and DNA was extracted from fresh frozen lung cancer specimens. All of copy number alterations from ArrayCGH were validated using The Cancer Genome Atlas (TCGA) copy number variation (CNV) data of lung SCC. We examined the frequency of copy number changes according to the smoking status (non-smoker [n = 8] or smoker [n = 11]). We identified 16 significantly altered regions from ArrayCGH data, three gain and four loss regions overlapped with the TCGA lung squamous cell carcinoma (LUSC) patients. Within these overlapped significant regions, we detected 15 genes that have been reported in the Cancer Gene census. We also found that the proto-oncogene GAB2 (11q14.1) was significantly amplified in non-smokers patients and vice versa in both ArrayCGH and TCGA data. Immunohistochemical analyses showed that GAB2 protein was relatively upregulated in non-smoker than smoker tissues (37.5% vs. 9.0%, P = 0.007). GAB2 amplification may have an important role in the development of lung SCC in non-smokers. GAB2 may represent a potential biomarker for lung SCC in non-smokers.

Trending Speculations of Tumor-Initiating Cells in Squamous Cell Cancers of Head and Neck

Tumor-initiating cells are a diminutive subpopulation of stem cells that have ability of long term self-renewal and generation of varied traits of tumor cell population. Understanding the concept of tumor-initiating cells may have a great implicative intimation for our comprehension of cancer pathobiology and for the delineation of new therapies directed towards these stem cells. The present review is an endeavor to conceptualize the role of tumor-initiating cells in the Squamous Cell Cancers (SCC) of head and neck, their role in tumorigenesis and the possible supplementary approach in the latest treatment modalities.

Transoral CO2 Laser Microsurgery Outcomes for Early Glottic Carcinomas T1-T2

Abstract Introduction Transoral laser microsurgery (TLM) has won territory in larynx oncology, establishing itself as an effective option in treatment of glottic, supraglottic, and hypopharynx tumors. Its advantages include limited resections, a reduction in number of tracheostomies, and the use of nasogastric tubes. Moreover, its oncological benefits are similar to those from open surgery in patients with early or advanced stages, when correctly selected. Objective The objective of this study is to review oncologic outcomes obtained with the treatment of a series of glottic tumors, treated by TLM. Methods Retrospective analysis of patients previously untreated, diagnosed with squamous cell carcinoma of the glottis (T1a, T1b, T2) in a tertiary university hospital. Endpoints for analysis were local control, overall and disease-specific survival, and larynx preservation rate. Results The study group included 58 patients that met the inclusion criteria: 57 (98.3%) men and 1 (1.7%) woman. Mean age was 65.5 10.7 years (Min: 46/Max: 88). The tumor stages of the patients included were 30 T1a, 11 (19%) T1b, and 17 (29.3%) T2. Three-year overall survival rate was 89.7% (Fig. 1), and three-year disease-specific survival rate was 96.5%, three-year local control rate was 98.3%, and three-year organ preservation rate was 98.3%. Conclusion TLM is a safe and effective option in the treatment of glottis carcinomas, associated with less morbidity and a high percentage of local control, overall survival, specific survival, and organ preservation.

Complications in CO2 Laser Transoral Microsurgery for Larynx Carcinomas

Abstract Introduction Transoral laser microsurgery (TLM) has established itself as an effective option in the management of malignant tumors of the glottis, supraglottis, and hypopharynx. Nonetheless, TLM is not a harmless technique. Complications such as bleeding, dyspnea, or ignition of the air may appear in this type of surgery. Objective The aim of this study is to describe the complications that occurred in a group of patients treated for glottic and supraglottic carcinomas in all stages by TLM. Methods This study is a retrospective analysis of patients diagnosed with squamous cell carcinoma of the glottis and supraglottis for all stages (T1, T2, T3, T4), N -/ + , M -/+ treated with TLM between January 2009 and March 2012 in a tertiary hospital. Results Ninety-eight patients met the inclusion criteria, which had undergone a total of 131 interventions. Ninety-four (95.9%) patients were male and 4 (4.1%) were female. The mean age was 64.2 years ( 10.7 years =min 45; max 88). The presence of intraoperative complications was low, affecting only 2% of patients. Immediate postoperative complications occurred in 6.1%, whereas delayed complications affected 13.2% of patients, without any of them being fatal. Conclusion TLM has shown good oncologic results and low complication rate compared with traditional open surgery during intervention, in the immediate and delayed postoperative period and in the long-term with respect to radiotherapy.