ABSTRACT
We report a 57-year-old male case of adenocarcinoma of the parotid gland with metastases to the cervical lymph nodes (T3N2bM0, Stage IV A). S-1 was administered at the conventional dose of 120mg/day for 4 weeks followed by a 2-week rest. After 4 courses of S-1, PET findings showed a remarkable regression of the tumor resulting in a partial response (PR) for the primary lesion. After this treatment, partial parotidectomy and upper neck dissection were performed. The histological effect was Grade 3.
Subject(s)
Oxonic Acid/therapeutic use , Parotid Neoplasms/drug therapy , Parotid Neoplasms/pathology , Tegafur/therapeutic use , Biopsy , Combined Modality Therapy , Drug Combinations , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Neoplasm Staging , Parotid Neoplasms/diagnostic imaging , Parotid Neoplasms/surgery , Positron-Emission Tomography , Remission InductionABSTRACT
Therapy-related myelodysplastic syndrome (t-MDS) and therapy-related leukemia (TRL) are reported increasingly often, and we report two cases of T-MDS after concurrent chemoradiotherapy (CCRT) with oral cancer. Patients underwent CCRT with cisplatin (CDDP) or carboplatin (CBDCA). The interval between primary CCRT and t-MDS was 11 months in 1 case and 14 years in the other. Chromosomal analysis indicated abnormal karyotypes. Platinum has a relatively lower t-MDS risk than alkylating agents or topoisomerase II inhibitors, but our experience supports concurrent use of radiotherapy with platinum affects the risk of t-MDS. If pancytopenia is detected after CCRT, bone marrow and cytogenetic examinations should be conducted to rule out T-MDS.
Subject(s)
Mouth Neoplasms/therapy , Myelodysplastic Syndromes/etiology , Aged , Carcinoma, Squamous Cell/therapy , Combined Modality Therapy/adverse effects , Humans , Male , Middle Aged , Tongue Neoplasms/therapyABSTRACT
The term "malignant mixed tumor" is usually synonymous with "carcinoma in pleomorphic adenoma," a secondary carcinoma developing in pre-existing pleomorphic adenoma. However, it sometimes indicates a group of tumors consisting of carcinoma in pleomorphic adenoma, carcinosarcoma (true malignant mixed tumor) and metastasizing benign mixed tumor, the latter 2 being the most infrequent. According to the data of the Japanese committee on TNM classification for salivary gland carcinomas, carcinoma in pleomorphic adenoma accounted for about 10% of all salivary gland carcinomas, both in the parotid and submandibular glands. The main type of carcinomas arising in pleomorphic adenoma were undifferentiated carcinoma, adenocarcinoma and squamous cell carcinoma. Crude 5- and 10-year survival rates were 54.7% and 42.7%, respectively. Invasive carcinomas and carcinomas of high grade malignancy carried worse prognoses. The treatment of choice for carcinoma in pleomorphic adenoma has consisted of en-bloc excision with wide margin. Invasive growth, facial nerve involvement, lymph node metastasis or high-grade malignant tumor are grounds for postoperative radiation therapy. The role of chemotherapy has not yet been well established.
