Metástasis a la glándula submandibular por carcinomas escamosos de cabeza y cuello: ¿mito o realidad? / Metastasis to the submandibular gland in head and neck squamous cell carcinomas: Myth or reality?

Introducción: muy pocos estudios se han publicado respecto a la posibilidad de metástasis a la glándula submandibular por carcinomas escamosos de cabeza y cuello. Objetivo: identificar la evidencia científica más reciente respecto a la posibilidad de metástasis a la glándula submandibular por carcinomas escamosos de cabeza y cuello. Métodos: se realizó un estudio metaanalítico mediante una búsqueda retrospectiva de artículos publicados en las bases de datos electrónicas PUBMED, MEDLINE, COCHRANE, HINARI desde 2003 hasta 2013; en las revistas Acta of Otolaryngology, Journal of Otolaryngology, Journal of Laryngology and Otology, Journal of Cranio­Maxillo Surgery, International Journal of Oral and Maxillofacial Surgery, Head and Neck, Annals of Surgical Oncology con los términos: metástasis por carcinomas escamosos de cabeza y cuello, metástasis a glándulas salivales, metástasis a la glándula submandibular, tumores malignos de glándula submandibular sin restricciones idiomáticas. Además de cumplir con estos requisitos se incluyeron solo los artículos cuyo material y método reflejara: cirugía y disecciones linfonodulares cervicales como primer tratamiento oncológico específico; estudio anatomopatológico para concluir el diagnóstico y discusión del estudio donde quedara explícita la opinión de los autores. Se incluyeron artículos publicados durante los últimos 10 años. Análisis e integración de la información: el estudio metaanalítico de 12 series de pacientes con carcinomas de cabeza y cuello conformó una metapoblación de 2 483 pacientes. Solo hubo 3 casos de metástasis a la glándula submandibular, representando (0,12 por ciento del total), o sea, 1 de cada 827 presentó metástasis a esta glándula. Una metamuestra de 848 glándulas se analizó dentro de las series en que fueron reportadas y solo 0,35 por ciento presentó metástasis. Conclusión: el presente estudio sugiere que los carcinomas de cabeza y cuello metastizan a la submandibular con una frecuencia casi nula, lo que pudiera sugerir su preservación de la submandibular en las disecciones cervicales linfonodulares(AU)

Introduction: very few studies have been published about the possibility of metastasis to the submandibular gland in head and neck squamous cell carcinomas. Objective: identify the latest scientific evidence about the possibility of metastasis to the submandibular gland in head and neck squamous cell carcinomas. Methods: a meta-analytical study was conducted based on a retrospective search of papers published in the databases PUBMED, MEDLINE, COCHRANE and HINARI from 2003 to 2013, as well as in the journals Acta of Otolaryngology, Journal of Otolaryngology, Journal of Laryngology and Otology, Journal of Cranio-Maxillo Surgery, International Journal of Oral and Maxillofacial Surgery, Head and Neck, and Annals of Surgical Oncology, using the following search terms: metastasis from head and neck squamous cell carcinomas, metastasis to salivary glands, metastasis to the submandibular gland and malignant tumors of the submandibular gland, without any language restrictions. Papers were selected which met the above criteria and referred to the following contents in their materials and methods section: cervical lymph node surgery and dissection as the first onco-specific treatment, anatomopathological study to complete the diagnosis, and a clear statement of the authors opinions in the discussion of the study. The papers included had been published in the previous 10 years. Data analysis and integration: a meta-analytical study was conducted of 12 series of patients with head and neck carcinomas for a metapopulation of 2 483 patients. Only 3 cases were found of metastasis to the submandibular gland, representing 0.12 percent of the total cases, that is, 1 for every 827 cases. A meta-sample of 848 glands were analyzed within the series in which they were reported, and only 0.35 percent presented metastasis. Conclusion: the study suggests that head and neck carcinomas metastasize to the submandibular gland with an almost null frequency, which may point to the preservation of the submandibular gland in cervical lymph node dissections(AU)

Carcinoma papilar en quiste del conducto tirogloso: reporte de dos casos / Papillary carcinoma in a thyroglossal duct cyst: report of two cases

Thyroglossal duct cyst is the most common congenital anomaly of thyroid gland development. However, papillary carcinoma is described only in 1-2 percent of cases and the clinical appearance is indistinguishable from a benign thyroglossal duct cyst. We report two females aged 15 and 27years consulting for a cervical mass. In both, a solid cystic lesion was found and excised using the Sistrunk procedure. The biopsy disclosed a papillary carcinoma in both. The postoperative evolution of both patients was uneventful.

Isolated submandibular gland metastasis from an occult papillary thyroid cancer.

A case of an isolated submandibular gland metastasis from a clinically occult papillary thyroid carcinoma is described in a 46-year old lady. Initial surgery was done based on the fine needle aspiration cytology (FNAC) report of adenocarcinoma of the submandibular gland. Histopathologic examination of the specimen suggested a metastatic papillary carcinoma. Occult papillary carcinoma in the thyroid was found by multiple blind FNACs. Subsequently to near-total thyroidectomy, no other site of metastasis was found on radio-iodine scanning.