ABSTRACT
INTRODUCTION: Lesions mimicking malignancies in the nasopharynx are frequently seen in adult patients. These include inflammatory, metaplastic, and cystic lesions. We aimed to draw attention to rare tumor-like lesions that can be confused with malignancies and cause diagnostic difficulties clinically and radiologically. METHODS: A total of 538 patients who underwent nasopharyngeal biopsy in our center between January 2010 and June 2020 were evaluated. Patient information was obtained from patient files and evaluated retrospectively. RESULTS: A total of 19 of the 538 patients had tumor-like lesions that were included in the study. Granulomatous inflammation was present in seven cases, oncocytic metaplasia in four cases, benign cyst in five cases, fungal infection in two cases, and immunoglobulin G4-related disease in one case. CONCLUSIONS: The nasopharynx is a region where various lesions can be seen. Some lesions form tumor-mimicking mass effect, cause increased thickness, and lead to increased metabolic activity in positron emission tomography-computed tomography that create the illusion of a malignant tumor and histopathologic verification is crucial. We aimed to present these rare tumor-like lesions that should be kept in mind in the differential diagnosis.
Subject(s)
Neoplasms , Adult , Biopsy , Diagnosis, Differential , Humans , Metaplasia/pathology , Nasopharynx/pathology , Neoplasms/pathology , Retrospective StudiesABSTRACT
COVID-19 is highly transmissible and spreads rapidly in the population. This increases the occupational risk for health care workers. In otolaryngology clinic practice, patients with upper respiratory tract infection symptoms are common. Also, routine head and neck examinations such as oral cavity examination, nasal/nasopharyngeal examination, or video laryngostroboscopic evaluation are highly risky because of the aerosol formation. To emphasize this issue, two leading otolaryngology organizations in Turkey; 'Voice Speech and Swallowing Disorders Society', and 'Professional Voice Society' gathered a task force. This task force aimed to prepare a consensus report that would provide practical recommendations of the safety measurements during routine clinical care of laryngology patients. To fulfill this, universal aim, on the 2nd and 9th of May 2020, two web-based meetings were conducted by 20 expert physicians. This eighteen items list was prepared as an output.
ABSTRACT
Neck dissection is an important treatment for metastases from upper aerodigestive carcinoma; an event that markedly reduces survival. Since its inception, the philosophy of the procedure has undergone significant change from one of radicalism to the current conservative approach. Furthermore, nonsurgical modalities have been introduced, and, in many situations, have supplanted neck surgery. The refinements of imaging the neck based on the concept of neck level involvement has encouraged new philosophies to evolve that seem to benefit patient outcomes particularly as this relates to diminished morbidity. The purpose of this review was to highlight the new paradigms for surgical removal of neck metastases using an evidence-based approach.
Subject(s)
Carcinoma, Squamous Cell/secondary , Carcinoma, Squamous Cell/surgery , Head and Neck Neoplasms/surgery , Lymph Nodes/surgery , Neck Dissection/methods , Carcinoma, Squamous Cell/mortality , Disease-Free Survival , Evidence-Based Medicine , Female , Head and Neck Neoplasms/mortality , Head and Neck Neoplasms/pathology , Humans , Lymph Node Excision/methods , Lymph Nodes/pathology , Lymphatic Metastasis , Male , Neck Dissection/mortality , Prognosis , Risk Assessment , Survival Analysis , Treatment OutcomeABSTRACT
Retropharyngeal lymph node (RPLN) metastasis of primary head and neck cancer often receives less consideration than lymph node metastasis in the neck. With improvements in imaging techniques and reports of surgical pathology, there is an improved understanding of the risk and subsequently the need for treatment of RPLNs. The rates of RPLN metastasis from carcinomas of the nasopharynx, oropharynx, hypopharynx, postcricoid region, maxillary sinus, and cervical esophagus are sufficiently high to warrant routine treatment, either electively or therapeutically, of this region. Through improved diagnostic techniques and heightened awareness of RPLN metastasis, patients at risk of having these metastases can be treated more effectively.
Subject(s)
Head and Neck Neoplasms/pathology , Lymphatic Metastasis/diagnosis , Diagnostic Imaging , Humans , Incidence , Lymph Node Excision , Lymph Nodes/pathology , Lymph Nodes/surgery , Lymphatic Metastasis/radiotherapy , PharynxABSTRACT
The most common morbidity associated with selective neck dissection (SND; II-IV) is spinal accessory nerve dysfunction and related shoulder disability. Nerve dysfunction is usually attributed to stretching of the nerve during clearance of lymph nodes lying posterior and superior to the spinal accessory nerve (level IIb). If these lymph nodes were left in place and not removed, stretching of the spinal accessory nerve during neck dissection and postoperative shoulder disability could be avoided. 113 SNDs (II-IV) performed on clinically N0 necks of patients with laryngeal carcinoma were enrolled in this prospective study. During SND, level IIb was separately removed and processed. Mean number of lymph nodes in level IIb was 6.26 (range, 0-19). In none of the 113 SND (II-IV) specimens did level IIb contain metastases, thus providing an oncological basis that leaving these lymph nodes in place is an oncologically safe approach, probably avoiding postoperative shoulder disability.
