ABSTRACT
Neuroendocrine carcinomas (NECs) of the head and neck (HN) account for <1% of HN cancers (HNCs), with a 5-year overall survival (OS) <20%. This is a retrospective study of HN NECs diagnosed at our institution between 2005 and 2022. Immunohistochemistry and next-generation sequencing (NGS) were used to evaluate neuroendocrine markers, tumor mutational burden (TMB), mutational profiles and T-cell receptor repertoires. Eleven patients with high-grade HN NECs were identified (male:female ratio 6:5; median age 61 (Min-Max: 31-86)): nasoethmoidal (3), parotid gland (3), submaxillary gland (1), larynx (3) and base of tongue (1). Among n = 8 stage II/IVA/B, all received (chemo)radiotherapy with/without prior surgery or induction chemotherapy, with complete response in 7/8 (87.5%). Among n = 6 recurrent/metastatic patients, three received anti-PD1 (nivolumab (2), pembrolizumab (1)): two achieved partial responses lasting 24 and 10 months. After a median follow-up of 30 and 23.5 months since diagnosis and since recurrent/metastatic, median OS was not reached. Median TMB (n = 7) was 6.72 Mut/Mb. The most common pathogenic variants were TP53, HNF1A, SMARCB1, CDKN2A, PIK3CA, RB1 and MYC. There were 224 median TCR clones (n = 5 pts). In one patient, TCR clones increased from 59 to 1446 after nivolumab. HN NECs may achieve long-lasting survival with multimodality treatment. They harbor moderate-high TMBs and large TCR repertoires, which may explain responses to anti-PD1 agents in two patients and justify the study of immunotherapy in this disease.
ABSTRACT
Resumen Introducción La rehabilitación oral con implantes es en la actualidad la mejor opción para el tratamiento de pacientes parcial o totalmente edéntulos. Sin embargo, no es un procedimiento exento de complicaciones. La aparición de carcinoma epidermoide en la encía circundante de los implantes, aunque infrecuente puede ser una de ellas y aunque no hay muchos casos descritos en la literatura, sería conveniente establecer qué relación, si es que existiera, pueden tener los implantes en el desarrollo de esta enfermedad. Caso clínico Presentamos el caso de una mujer de 85 años de edad con antecedentes personales de liquen plano oral, exfumadora y portadora de implantes osteointegrados colocados en las áreas correspondientes a 34, 45 y 46, que desarrolló un carcinoma epidermoide en la encía periimplantaria.
Introduction Currently, dental implants is considered as the best choice for edentulism partial or complete treatment. However, this treatment has some associated medical complications such as surrounding gum squamous cell carcinoma. Even though there are not that many cases described in medical literature, it could be appropriated to determine whether there is any relation between this neoplasic disease and the dental implants. Clinical case Presenting a 85-year-old women with PMH of lichen planus, ex-smoker and osseointegrated dental implant in areas 34, 45 and 46, with surrounding implant gum area Squamous cell carcinoma.
Subject(s)
Humans , Female , Aged, 80 and over , Mouth Neoplasms/diagnosis , Carcinoma, Squamous Cell/diagnosis , Dental Implantation/adverse effects , Mouth Neoplasms/surgery , Mouth Neoplasms/etiology , Carcinoma, Squamous Cell/surgery , Carcinoma, Squamous Cell/etiologyABSTRACT
El carcinoma mioepitelial es de aparición rara en la glándula submaxilar. Presentamos un caso clínico y una revisión de la literatura que nos permiten establecer un diagnóstico diferencial y un tratamiento óptimo de este tumor. La histología y la inmunohistoquímica desempeñan un papel importante en el diagnóstico definitivo (AU)
Myoepithelial carcinomas or malignant myoepitheliomas are considered an uncommon salivary gland tumour with a predilection for the parotid gland. A case report is presented, along with a literature review in order to investigate the biological behaviour and proper management of myoepithelial carcinomas. Clinicopathological and immunohistochemical features are shown to achieve a better understanding this entity and to prevent their easy confusion with many other tumours (AU)
Subject(s)
Aged, 80 and over , Female , Humans , Myoepithelioma/surgery , Myoepithelioma , Carcinoma/surgery , Carcinoma , Submandibular Gland/surgery , Submandibular Gland , Diagnosis, Differential , Immunohistochemistry/methods , Immunohistochemistry , Mouth Floor/pathology , Mouth Floor/surgery , Mouth Floor , PrognosisABSTRACT
No disponible
Subject(s)
Female , Humans , Middle Aged , Solitary Fibrous Tumors/diagnosis , Solitary Fibrous Tumors/surgery , Temporal Lobe/surgery , Temporal Lobe , Surgical Flaps/surgery , Surgical Flaps , Facial Paralysis/complications , Antigens, CD34 , Solitary Fibrous Tumors , Temporal Lobe/pathology , Postoperative Complications , Facial Nerve/pathology , Immunohistochemistry/methodsABSTRACT
No disponible
