ABSTRACT
Objective The after-effects of coronavirus disease 2019 (COVID-19) infection are still unknown; therefore, we investigate the possibility that COVID-19 may interrupt cancer treatment and impact prognosis. Methods We examined the characteristics, prognosis, and changes in treatment options before and after COVID-19 in 11 head and neck cancer patients who were infected with COVID-19 after admission for cancer treatment at Gifu University Hospital. These patients were compared to 110 patients unaffected by COVID-19 during the same period. To identify the effects of COVID-19 on the cancer treatment sequence, we examined the rates of overall survival, progression-free survival, and completion, as well as radiation dosage in radiotherapy and cisplatin dosage in chemoradiotherapy. Results All 11 patients with COVID-19 had their planned cancer treatment postponed or interrupted. There was no significant difference in overall or progression-free survival compared to patients without COVID-19. Notably, only 3/6 of the COVID-19-affected patients completed radiotherapy compared to 42/46 unaffected patients. The ratio of actual radiation dose to planned dose was significantly impaired in COVID-19 affected patients group (98.3% vs. 88.6%). Cisplatin dosage in chemoradiation was not significantly different in either the radical (100 mg/m2, every three weeks) or adjuvant (40 mg/m2, every one week) treatment groups. Conclusion COVID-19 infection in head and neck cancer patients had no apparent impact on cancer prognosis. However, when restricted to irradiation, the treatment completion rate and the ratio of planned to actual dose decreased significantly, underscoring the impact of COVID-19 infection on cancer treatment. The difference in irradiation may affect the success of patients' treatment going forward, and it should be explored whether irradiation can be continued without delay.
ABSTRACT
The cases of coronavirus disease 2019 (COVID-19) typically present with pulmonary and upper respiratory tract symptoms, but may also present with neurologic complications. Because severe cases are often intubated or ventilated, there are some reports of vocal cord palsy associated with intubation; however, there are few reports of recurrent nerve palsy without intubation management. We experienced a case of left vocal cord palsy following COVID-19 in a healthy young male patient with no previous medical history. The patient became aware of hoarseness symptoms three days after he was found to be COVID-19 positive, and an endoscopic examination of the larynx revealed left vocal cord palsy. Since the patient had no previous medical history and there were no lesions that could cause recurrent nerve palsy on neck-thorax imaging, it was considered likely that the patient had unilateral recurrent nerve palsy due to acute inflammation caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Medication was started and his hoarseness became relieved. In vocal cord palsy occurring after COVID-19 illness, it is necessary to consider the presence of both vocal cord palsy related to tracheal intubation and recurrent nerve palsy associated with SARS-CoV-2 infection.
ABSTRACT
Extranodal NK/T cell lymphoma, nasal type (ENKL) primarily involves the nasal cavity. Although patients might visit an otorhinolaryngologist with nasal symptoms, such as nasal obstruction and epistaxis, it would be difficult to make a diagnosis correctly. We present a case of ENKL in which the patient had been in remission after initial treatment and relapsed 14 years after treatment. The patient had a worsening of nasal symptoms before the recurrence, but on this occasion, treatment such as sinusitis was successful in alleviating the symptoms. Although recurrence of lymphoma 10 years after treatment is rare, the possibility of recurrence should always be considered in post-malignant lymphoma cases as with any malignant tumor.
ABSTRACT
The cases of coronavirus disease 2019 (COVID-19) mainly present with symptoms such as persistent fever, cough, and general malaise, which may become severe or fatal; while young people do not show these typical symptoms and are asymptomatic, some cases are infected with minor symptoms or none. Herein, we report a case of a 20-year-old woman who was hospitalized for infectious mononucleosis (IM). Initially, fever and sore throat were observed without typical COVID-19 symptoms, but polymerase chain reaction (PCR) tests performed before admission confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positivity. Fortunately, she was discharged without any serious symptoms as IM and COVID-19. Virological examination suggested a primary infection with the Epstein-Barr virus. In the COVID-19 pandemic, we should also pay attention to the possibility of SARS-CoV-2 coinfection in mild and asymptomatic young cases, even if the symptoms suggesting IM are preceded.
ABSTRACT
Hypoglossal nerve palsy is usually associated with glossopharyngeal nerve, vagus nerve, and accessory nerve palsy, and the occurrence of hypoglossal nerve palsy alone is rare. We report a case of a 41-year-old man with unilateral isolated hypoglossal nerve palsy. The patient was aware of a leftward deviation of the tongue along with pharyngeal pain. The pharyngeal pain was quickly relieved by antibiotic treatment, but the deviation of the tongue did not improve, and the patient was referred to our hospital. As a result of the medical examination, a single paralysis of the left hypoglossal nerve and mild swelling of the left lingual tonsil up to the left palatine tonsil were observed. Various tests were performed, but there were no significant abnormal findings other than a suggestion of mild tonsillitis. We diagnosed the patient as idiopathic or tonsillitis-induced unilateral hypoglossal nerve palsy and started medical treatment with corticosteroids and methylcobalamin. The hypoglossal nerve palsy showed a tendency to improve after one month of onset and was almost cured by two months of onset.
