Laryngeal cancer neck node metastases: Patterns of spread

OBJECTIVE: To determine the patterns of neck node metastases of patients with laryngeal carcinoma in our institution.METHODS:Design: Chart ReviewSetting: Tertiary Public HospitalParticipants: Records of thirty-eight (38) laryngeal cancer patients who underwent laryngectomy with neck dissection from January 2010 to January 2017 were considered.RESULTS: Records of 34 laryngeal cancer patients with ages ranging from 45-72 years old were included. The most common subsite was the glottis with 19 (55.88%) patients. The distribution of neck node metastases for all subsites were 0/64 (0%) for level I, 22/64 (34.37%) for level II, 12/64 (18.75%) for level III, 7/64 (10.93%) for level IV, 0/64 (0%) for level V, and 1/64 (1.56%) for level VI. Distributions of lymph nodes per subsite for supraglottic SCCA were 0 (0%) for level I, 3/22 (13.63%) for level II, 2/12 (16.66%) for level III, 1/7 (14.28%) for level IV, 0 (0%) for level V, and 0/1 (0%) for level VI. For glottic SCCA, they were 0 (0%) for level I, 12/22 (54.54%) for level II, 8/12 (66.66%) for level III, 3/7 (42.85%) for level IV, 0 (0%) for level V, and 1/1 (100%) for level VI; and for transglottic SCCA, they were 0 (0%) for level I, 7/22 (31.81%) for level II, 5/12 (41.66%) for level III, 3/7 (42.85%) for level IV, 0 (0%) for level V, and 0/1 (0%) for level VI.CONCLUSION: Our findings show that neck node levels II, III and IV are most frequently affected in laryngeal carcinoma patients in our sample and may guide recommendations for neck dissection in our institution.

Accuracy of fine needle aspiration biopsy in diagnosing parotid gland malignancy

@#<p style="text-align: justify;"><strong>OBJECTIVE:</strong> To determine the sensitivity, specificity, positive predictive value, negative predictive value and overall accuracy of FNAB in detecting parotid malignancies in our institution.<br /><strong>METHODS:</strong><br /><strong>Design:</strong> Restrospective Chart Review<br /><strong>Setting:</strong> Tertiary Government Hospital<br /><strong>Participants:</strong> Postoperative records of seventy six (76) patients with tumors of the parotid gland preoperatively diagnosed by FNAB. <br /><strong>RESULTS:</strong> The sensitivity of FNAB was 46%. The specificity and positive predictive value were both 100% and negative predictive value was 90%. Overall accuracy in diagnosing malignant parotid tumor was 91%.<br /><strong>CONCLUSION:</strong> FNAB in this institution is a poor predictor of malignancy, having a sensitivity rate of only 46%. While this may serve as a basis for not recommending pre-operative FNAB for patients with parotid tumors in the interim, other factors should also be considered, including concerns with the actual performance and interpretation of FNAB in our institution.<br /><br /> </p>

Chemodectoma and tetralogy of fallot

@#<p style="text-align: justify;"><strong>OBJECTIVES:</strong> To describe a rare case of chemodectoma, its clinical features and management, and to discuss its relationship chronic hypoxia from Tetralogy of Fallot.<br /><br /><strong>METHODS:</strong><br /><strong>Design:</strong> Case Report<br /><br /><strong>Setting:</strong> Tertiary Government Hospital<br /><br /><strong>Patient:</strong> One<br /><br /><strong>RESULTS:</strong> A 23-year-old woman presented with a painless, slow growing, movable right submandibular mass, initially diagnosed as a lipoma by fine needle aspiration biopsy.  Computed tomography scan showed a solid nodule with ill-defined margins from the angle of the mandible to the level of the hyoid bone along the carotid sheath. There was also an incidental finding of patent ductus arteriosus and Tetralogy of Fallot on pre-operative clearance. Excision of the mass under general anesthesia revealed adherence to the posterior portion of the carotid trunk enveloping both the internal & external carotid artery. Final histopathological diagnosis was chemodectoma.<br /><br /><strong>CONCLUSION:</strong> Although rare, chemodectoma should be considered as one of the differentials in a patient with a submandibular mass. Hyperplastic chemodectoma may result from chronic hypoxia due to Tetralogy of Fallot.  Surgical excision is the treatment of choice.</p>