ABSTRACT
PURPOSE: To evaluate the effectiveness of sentinel lymph node biopsy (SLNB) as an optimal staging method in oral and oropharyngeal squamous cell carcinoma (OOSCC) and the impact of the extent of SLN involvement on the decision for neck dissection (ND). MATERIALS AND METHODS: A prospective cohort study was performed in 96 consecutive patients with stage T1 to T4N0M0 OOSCC (mean follow-up, 62.9 months). SLN localization was determined using cervical lymphoscintigraphy and single-photon emission computed tomography. Patients underwent SLNB examination and ND. The ND specimen was investigated by hematoxylin and eosin (H&E) staining and the SLNs were investigated using H&E staining and step-serial sectioning and cytokeratin antibodies AE1 and AE3. The statistical study calculated the sensitivity and negative predictive value (NPV). The sample size of 96 patients was calculated for a 95% confidence interval with an accuracy of ±2% and an estimated a priori sensitivity of 99% compared with the benchmark. The impact of extent of SLN involvement on the decision for ND was analyzed by χ(2) test. A logistic regression model was used to assess the association of predictor variables with SLN involvement and neck disease. RESULTS: The diagnostic accuracy, sensitivity, NPV, and negative likelihood ratio were 95%, 88%, 94%, and 0.06. The statistical comparison between the extent of metastatic involvement of the SLN and neck disease was important for SLN macrometastasis (odds ratio = 11.9), but not for SLN micrometastasis (odds ratio = 0.93). CONCLUSIONS: SLNB examination is an excellent staging method in OOSCC. The present data indicate a very small risk of additional lymph node metastasis with SLN micrometastasis.
Subject(s)
Carcinoma, Squamous Cell/surgery , Decision Making , Mouth Neoplasms/surgery , Neck Dissection/methods , Oropharyngeal Neoplasms/surgery , Sentinel Lymph Node Biopsy/statistics & numerical data , Adult , Aged , Aged, 80 and over , Carcinoma, Squamous Cell/diagnostic imaging , Carcinoma, Squamous Cell/secondary , Cohort Studies , Female , Follow-Up Studies , Humans , Keratins/analysis , Lymph Nodes/pathology , Lymphatic Metastasis/diagnostic imaging , Lymphoscintigraphy/methods , Male , Middle Aged , Mouth Neoplasms/pathology , Neoplasm Staging , Oropharyngeal Neoplasms/pathology , Predictive Value of Tests , Prospective Studies , Radiopharmaceuticals , Sensitivity and Specificity , Technetium , Tomography, Emission-Computed, Single-Photon/methodsABSTRACT
The parotid gland is the most usual location of benign neoplasms affecting major salivary glands and quite oftenthe recurrence of these tumours is noticed, specially in the case of pleomorphic adenoma. The occurrence of multipletumours in the parotid glands is rare and the majority of these are multifocal Warthin`s tumors (papillary cystadenomalymphomatosum). The simultaneous development of tumours with different histological types is unusualand when it occurs, the most common combination is a pleomorphic adenoma and a Warthin`s tumor. There aremany articles about Multiple Parotid Tumors (MPT) but only a few of them are focused on unilateral synchronousbenings tumors, being pleomorphic adenoma and Warthin´s these tumors.The report describes a 55 year old female with a pleomorphic adenoma occurring synchronously with a Warthin`stumor within the superficial lobe of her left parotid gland (AU)
Subject(s)
Humans , Female , Middle Aged , Adenolymphoma , Adenoma, Pleomorphic , Neoplasms, Multiple Primary , Parotid Neoplasms , Adenolymphoma/diagnosis , Adenolymphoma/surgery , Adenoma, Pleomorphic/diagnosis , Adenoma, Pleomorphic/surgery , Neoplasms, Multiple Primary/diagnosis , Neoplasms, Multiple Primary/surgery , Parotid Neoplasms/diagnosis , Parotid Neoplasms/surgeryABSTRACT
The parotid gland is the most usual location of benign neoplasms affecting major salivary glands and quite often the recurrence of these tumours is noticed, specially in the case of pleomorphic adenoma. The occurrence of multiple tumours in the parotid glands is rare and the majority of these are multifocal Warthin's tumors (papillary cystadenoma lymphomatosum). The simultaneous development of tumours with different histological types is unusual and when it occurs, the most common combination is a pleomorphic adenoma and a Warthin's tumor. There are many articles about Multiple Parotid Tumors (MPT) but only a few of them are focused on unilateral synchronous benings tumors, being pleomorphic adenoma and Warthin's these tumors. The report describes a 55 year old female with a pleomorphic adenoma occurring synchronously with a Warthin's tumor within the superficial lobe of her left parotid gland.
Subject(s)
Adenolymphoma , Adenoma, Pleomorphic , Neoplasms, Multiple Primary , Parotid Neoplasms , Adenolymphoma/diagnosis , Adenolymphoma/surgery , Adenoma, Pleomorphic/diagnosis , Adenoma, Pleomorphic/surgery , Female , Humans , Middle Aged , Neoplasms, Multiple Primary/diagnosis , Neoplasms, Multiple Primary/surgery , Parotid Neoplasms/diagnosis , Parotid Neoplasms/surgeryABSTRACT
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Subject(s)
Humans , Female , Middle Aged , Tongue Neoplasms/diagnosis , Vascular Neoplasms/diagnosis , Tongue Neoplasms/surgery , Diagnosis, DifferentialABSTRACT
Se presenta un caso de quiste odontogénico calcificante asociadocon odontoma (QOCaO) y con un canino permanente incluidoen maxilar superior, en un paciente varón de 19 años.El Quiste Odontogénico Calcificante (QOC) fue descrito porprimera vez cómo una entidad patológica por Gorlin y col. en1962.Se trata de un tumor benigno odontogénico mixto,y aunquela mayoria de estas lesiones presentan características quísticasen algunos casos se presenta como una masa sólida (15 %), ysu transformación maligna está bien documentada. El QOC sepresenta en ocasiones asociado a otros tumores odontogénicos,el más común es el odontoma al que aparece relacionado en el24% de los casos. Para esta asociación se ha sugerido el términode Quiste Odontogénico Odontocalcificante.Radiológicamente es una lesión mixta, bien definida y quehistológicamente consiste en un gran quiste en cuya parte centralexiste un área sólida con acúmulos de esmalte y dentinadistribuidos irregularmente en algunas zonas y en otros lugaresadopta un aspecto organoide bien definido.Se efectúa una revisión de la literatura y se discute su patogénesis
We report a calcifying odontogenic cyst associated with odontoma(COCaO) and an included permanent canine in the superiormaxilla, in a 19 year-old-man.The calcifying odontogenic cyst (COC) was first described asa distinct entity by Gorlin et al in 1962.The lesion is a mixed odontogenic benign tumor, and althoughmost of the cases present cystic characteristics, a few are of thesolid type (15%), and its rare malignant transformation is welldocumented.The COC may occur in association with other odontogenictumors, the most common is the odontoma, occurring in about24% of the cases. For this association the term Odontocalcifyingodontogenic cyst has been suggested.Radiographically is a well defined mixed lesion and histologicallyconsists of a large cyst. In the central area of the cyst enameland dentin deposits can be found, irregularly distributed in areasand in other parts it takes on a well defined organoid aspect.A thorough review of literature takes place and the pathogenesisis discussed
Subject(s)
Male , Humans , Odontogenic Cyst, Calcifying/pathology , Odontogenic Tumors/pathology , Odontoma/etiology , Anesthesia, LocalABSTRACT
We report a calcifying odontogenic cyst associated with odontoma (COCaO) and an included permanent canine in the superior maxilla, in a 19 year-old-man. The calcifying odontogenic cyst (COC) was first described as a distinct entity by Gorlin et al in 1962. The lesion is a mixed odontogenic benign tumor, and although most of the cases present cystic characteristics, a few are of the solid type (15%), and its rare malignant transformation is well documented. The COC may occur in association with other odontogenic tumors, the most common is the odontoma, occurring in about 24% of the cases. For this association the term Odontocalcifying odontogenic cyst has been suggested. Radiographically is a well defined mixed lesion and histologically consists of a large cyst. In the central area of the cyst enamel and dentin deposits can be found, irregularly distributed in areas and in other parts it takes on a well defined organoid aspect. A thorough review of literature takes place and the pathogenesis is discussed.
