ABSTRACT
Malignant mixed tumors of salivary glands are classified as three types:carcinoma arising in a pleomorphic adenoma, the most common; benign metastasizing pleomorphic adenoma; and carcinosarcoma (true malignant mixed tumor), which is very rare [Ann. Otol. Rhinol. Laryngol. (1982) 91 342]. In carcinoma, both epithelial and soft tissue elements are malignant. In the context of previous reports, we discuss a case of carcinosarcoma of the submandibular gland including the results of postmortem examination.
Subject(s)
Carcinosarcoma/pathology , Submandibular Gland Neoplasms/pathology , Aged , Autopsy , Carcinosarcoma/classification , Carcinosarcoma/secondary , Carcinosarcoma/therapy , Combined Modality Therapy , Fatal Outcome , Humans , Lung/pathology , Lung Neoplasms/secondary , Male , Neoplasm Recurrence, Local/pathology , Submandibular Gland/pathology , Submandibular Gland Neoplasms/classification , Submandibular Gland Neoplasms/therapyABSTRACT
Although regions of the sensorimotor cortex, insula, and anterior cingulate gyrus are reported to be activated during swallowing, findings concerning contributions of the cerebellum and basal ganglia have been contradictory. We investigated cerebellar and basal ganglionic activation using functional magnetic resonance imaging (fMRI). In 11 subjects, single-shot gradient-echo echoplanar image volumes sensitive to BOLD contrast were acquired in block design fashion using an oblique orientation covering both cerebrum and cerebellum. Using statistical parametric mapping, regional activation upon swallowing was observed in the sensorimotor cortex, insula, cerebellum, putamen, globus pallidus, thalamus, anterior cingulate gyrus, supplementary motor area, superior temporal gyrus, and substancia nigra. The cerebellum was activated bilaterally, especially on the left; activation of the putamen and globus pallidus was also found bilaterally. Thus, volitional swallowing involves the cerebellum and basal ganglia as well as cortical structures. The method used was well tolerated by normal subjects and should also be applicable to patients with dysphagia.
Subject(s)
Basal Ganglia/pathology , Basal Ganglia/physiology , Cerebellum/pathology , Cerebellum/physiology , Deglutition/physiology , Magnetic Resonance Imaging , Volition/physiology , Adult , Female , Humans , Male , Reference ValuesABSTRACT
Cine-magnetic resonance imaging (cine-MRI) creates moving pictures by a video system and turbo-flash method that allow for high-speed MRI. This report describes our experience using this new technique for dynamic imaging using the fast spoiled GRASS (SPGR) sequence to study swallowing in patients with dysphagia following radical surgery for oral cancer. We defined two new parameters, laryngeal elevation and the angle of the epiglottis, to quantify swallowing ability by cine-MRI. These variables were markedly different in patients with dysphagia than they were in healthy controls. Cine-MRI not only provides dynamic images of swallowing but can generate objective measures of swallowing ability as well.
