ABSTRACT
A series of 106 patients with malignant melanoma of the head and neck and clinically negative local lymph-node status were included in a multimodal therapy programme and underwent sentinel lymph-node extirpation in 1999-2003. Out of 246 preoperatively marked lymph nodes, only 172 (70%) were identified intraoperatively and removed. In 89% of all patients at least one sentinel lymph node was removed. Histological examination revealed metastases in the sentinel lymph nodes of 17 patients. In the mean follow-up period of 47 months (range 4-76 months), regional lymph-node metastases were found in another eight patients. The non-marked lymph nodes that were often removed at the same time, in an elective cervical lymph-node dissection, did not reveal any metastasis in any of the cases where the sentinel lymph nodes were negative. The sensitivity of sentinel lymph-node extirpation was influenced by the length of the follow-up period and the detection rate, and was 68% (17/17+8), a result superior to that of any other diagnostic tool. Sentinel lymph-node extirpation is a valuable method in addition to elective lymph-node dissection.
Subject(s)
Head and Neck Neoplasms/surgery , Lymph Node Excision/methods , Lymph Nodes/diagnostic imaging , Melanoma/surgery , Sentinel Lymph Node Biopsy/methods , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , False Negative Reactions , Female , Head and Neck Neoplasms/diagnostic imaging , Head and Neck Neoplasms/pathology , Humans , Lymph Nodes/surgery , Lymphatic Metastasis , Male , Melanoma/diagnostic imaging , Melanoma/pathology , Middle Aged , Neck/diagnostic imaging , Neck/surgery , Neoplasm Staging , Radionuclide Imaging , Reproducibility of Results , Sensitivity and SpecificityABSTRACT
An 84-year-old gentleman developed an angiosarcoma in the lateral temporal fossa 60 years after a World War II injury. The tumour resection confirmed the close spatial relationship of the tumour and a shell splinter. Analysis of the metallic composition showed no clear carcinogenic potential of the ingredients; an inflammation-related carcinogenesis seems more probable. A review of the literature revealed two similar cases.
Subject(s)
Blast Injuries/pathology , Foreign Bodies/pathology , Foreign-Body Reaction/pathology , Hemangiosarcoma/pathology , Maxillary Sinus Neoplasms/pathology , Maxillary Sinus/injuries , Metals , Aged, 80 and over , Blast Injuries/diagnostic imaging , Blast Injuries/surgery , Cicatrix/pathology , Fibrosis , Foreign Bodies/diagnostic imaging , Foreign Bodies/surgery , Foreign-Body Reaction/diagnostic imaging , Foreign-Body Reaction/surgery , Hemangiosarcoma/diagnostic imaging , Hemangiosarcoma/surgery , Humans , Male , Maxillary Sinus/diagnostic imaging , Maxillary Sinus/pathology , Maxillary Sinus/surgery , RadiographyABSTRACT
Oral and maxillofacial tumors occur rarely in the pediatric population compared with the adult population. We report a case of a 6-months old female infant suffering from a melanotic neuroectodermal tumor of infancy involving the mandible. Tumor resection was performed using a submandibular approach; the mandibular defect was reconstructed primarily with autogenous costochondral grafts. During a 7-year follow-up period, there has been no tumor recurrence. The costochondral graft healed well; tracing of panoramic radiographs at 2, 3, and 6 years documented some vertical overgrowth and growth retardation in the transversal dimension. The authors conclude that the use of costochondral grafts despite its controversial role for mandibular reconstruction can be recommended in particular after continuity resections in newborn infants. However, long-term follow-up is necessary as well as secondary corrective surgery at early skeletal maturity.
