Laryngeal Schwannoma: A Case Presentation and Review of the Mayo Clinic Experience.

OBJECTIVES: The aim of this study was to clarify the nature of laryngeal schwannomas through review of the experience of a single institution during a 104-year period. STUDY DESIGN: This is a retrospective case series. METHODS: The Mayo Clinic, Rochester, Minnesota clinical and surgical pathology database was reviewed for the years 1985-2011. Four cases of laryngeal schwannoma were identified. These cases were pooled with a previously published series of laryngeal schwannomas treated at our institution between 1907 and 1986. The characteristics of all 11 cases were studied, and relevant literature was reviewed. RESULTS: A total of 11 cases of schwannoma of the larynx were identified. The mean age at presentation was 48 years (range 12-73 years). The most common presenting symptoms were dysphonia and dysphagia. The most frequently involved primary site was the false vocal fold (six patients), followed by the aryepiglottic fold (three), epiglottis (two), subglottis (two), ventricle (one), true vocal fold (one) and postcricoid region (one). The mean maximal tumor diameter was 2.5 cm. In all but one case, surgical excision was curative with no recurrence during recorded follow up ranging from 1 to 17 years. CONCLUSIONS: Laryngeal schwannomas, although rare, should be considered in the differential diagnosis of laryngeal tumors. They occur most frequently in the false vocal fold and present most commonly with dysphonia and/or dysphagia. Surgical excision is the treatment of choice.

Identification of NY-ESO-1, MAGE-1, and MAGE-3 in head and neck squamous cell carcinoma.

BACKGROUND: Certain tumor antigens have been identified that stimulate an immune response, thus making them targets for immunotherapy. NY-ESO-1, MAGE-1, and MAGE-3 are such antigens. This study was undertaken to determine their presence or absence in head and neck squamous cell cancers and to correlate this with patient characteristics. METHODS: Reverse transcriptase polymerase chain reaction (RT-PCR) and immunohistochemistry (IH) were used to identify NY-ESO-1, MAGE-1, and MAGE-3 in surgical specimens. Patient data (previous treatment, gender, age, primary site, metastasis, tumor grade, tumor stage, smoking history, and alcohol history) were collected by chart review and examined for correlation with presence or absence of antigen. RESULTS: Three tumors were found to be positive for NY-ESO-1 by RT-PCR. All of these tumors were also positive for MAGE-1 and MAGE-3. IH was only positive for NY-ESO-1 in one patient. Eighteen of the 45 tumors (40%) were positive for MAGE-1 by RT-PCR. By IH, only six tumors were positive for MAGE-1. Five (83.3%) of those that were positive by IH were positive by RT-PCR. Twenty of the 45 tumors (44.4%) were positive for MAGE-3 by RT-PCR. By IH, 12 tumors were positive for MAGE-3. Nine (75%) of those positive by IH were also positive by RT-PCR. Overall, of the 45 tumors, 27 (60%) were positive by RT-PCR for at least one of the antigens. None of the patient characteristics correlated with the presence or absence of antigen. CONCLUSIONS: There is high expression of MAGE-1 and MAGE-3 antigens in head and neck squamous cell carcinomas, whereas NY-ESO-1 is not significantly expressed. IH correlates but is not as sensitive as RT-PCR for detection of these antigens. There is no correlation between antigen expression and patient data. On the basis of the high levels of MAGE-1 and MAGE-3 expression, use of these antigens may serve as a potential approach to immunotherapy for squamous cell carcinoma from head and neck sources.