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1.
Oncol Ther ; 8(1): 33-44, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32700074

RESUMO

Laryngeal sarcomas constitute an extremely rare entity among head and neck malignancies. Furthermore, most of them are chondrosarcomas, and the osteogenic form remains a true rarity. In general, there is a lack of information on the characteristics of laryngeal osteosarcoma. Thus, we sought to critically review the existing world literature on laryngeal osteosarcoma in order to develop a more accurate clinicopathological profile of this malignancy. Laryngeal osteosarcoma has a predilection for elderly male patients, as 87% were male in the present series and the mean age was 62 years (range 32-80), and without a direct association with tobacco exposure. Osteosarcoma of the larynx is typically a highly malignant neoplasm that metastasizes early, has a propensity for hematogenous spread and also has a marked tendency to recur. Twelve (41%) out of the 29 cases in the present review with follow-up data had metastatic disease. The aspects that distinguish osteosarcoma from its differential diagnostic alternatives are discussed in this review.

2.
Laryngoscope Investig Otolaryngol ; 5(1): 74-81, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32128433

RESUMO

BACKGROUND: The current treatment results of laryngeal squamous cell carcinoma still remain modest. Various prognostic factors have been investigated and need to be included in the management decision making. METHODS: We reviewed the pertinent literature regarding host, tumor, and treatment factors as prognostic indicators that influence outcome in patients diagnosed with laryngeal squamous cell carcinoma. RESULTS: Host, tumor, and treatment factors all have an important impact upon an individual patient's prognosis with laryngeal squamous cell carcinoma, whereas staging systems only take into account tumor factors. There is much work yet to be done to establish reliable, independent biomarkers that predict survival and response to treatment. CONCLUSIONS: Optimal outcomes for an individual patient can be achieved when taking into account tumor, host, and treatment factors.

3.
Eur Arch Otorhinolaryngol ; 276(10): 2635-2647, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31338576

RESUMO

INTRODUCTION: The tissues of the laryngeal region only rarely harbor primary cartilaginous lesions, and squamous cell carcinoma remains the most frequently encountered malignant tumor in this area. MATERIALS AND METHODS: We reviewed the salient histological features of cartilaginous laryngeal lesions to provide differential diagnostics and guidelines for distinguishing the benign from the malignant ones. RESULTS: Cartilaginous neoplasms of the larynx include chondroma and chondrosarcoma. Among the overarching group of all forms of laryngeal sarcoma, chondrosarcoma forms the most common entity in the larynx, followed by rhabdomyosarcoma. Cartilaginous tumors comprise about 0.1%-1% of all laryngeal neoplasms with chondrosarcomas being more frequently encountered than chondromas. Several neoplasms earlier reported as giant-cell tumors of the larynx would most likely, using current terminology, be classified as cases of undifferentiated pleomorphic sarcoma (previously known as malignant fibrous histiocytoma, giant-cell variant) or aneurysmal bone cyst. CONCLUSION: When true laryngeal sarcomas do exist, they may prove to be challenging lesions both for the pathologist and the treating clinician. The diagnostic problems are mainly a result of the infrequent exposure of clinicians and diagnosticians to these lesions.


Assuntos
Carcinoma de Células Escamosas/diagnóstico , Condroma , Condrossarcoma , Cartilagens Laríngeas/patologia , Neoplasias Laríngeas , Neoplasias de Tecidos Moles , Biópsia/métodos , Neoplasias Ósseas/diagnóstico , Condroma/diagnóstico , Condroma/patologia , Condroma/terapia , Condrossarcoma/diagnóstico , Condrossarcoma/patologia , Diagnóstico Diferencial , Feminino , Humanos , Neoplasias Laríngeas/classificação , Neoplasias Laríngeas/diagnóstico , Neoplasias Laríngeas/patologia , Neoplasias Laríngeas/terapia , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Prognóstico , Neoplasias de Tecidos Moles/diagnóstico , Neoplasias de Tecidos Moles/patologia , Neoplasias de Tecidos Moles/terapia
4.
Adv Ther ; 36(7): 1511-1517, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31119694

RESUMO

A new edition of the World Health Organization (WHO) Histological classification of tumours of the hypopharynx, larynx, trachea and parapharyngeal space was published in 2017. We have considered this classification regarding laryngeal neoplasms and discuss the grounds for said revision. Many of the laryngeal neoplasms described in the literature and in the previous WHO edition from 2005 have been omitted from this current revision. Many are described elsewhere in the book but it may give the new generation of pathologists/surgeons/oncologists the false impression that these tumour entities do not exist in the larynx.


Assuntos
Classificação/métodos , Neoplasias Laríngeas , Humanos , Imuno-Histoquímica , Neoplasias Laríngeas/classificação , Neoplasias Laríngeas/diagnóstico , Organização Mundial da Saúde
5.
Adv Anat Pathol ; 26(4): 246-250, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31033507

RESUMO

Well-differentiated neuroendocrine carcinoma (also known as "carcinoid") of the larynx is an exceedingly rare tumor that has an epithelial origin. These tumors are malignant and have a low, but definite, risk of metastasis. Although it can be challenging, this tumor should be differentiated from moderately differentiated neuroendocrine carcinoma (also known as "atypical carcinoid"). The clinical and pathologic features of this tumor, as well as treatment and prognosis, are reviewed in detail.


Assuntos
Tumor Carcinoide/patologia , Carcinoma Neuroendócrino/patologia , Neoplasias Laríngeas/patologia , Laringe/patologia , Tumores Neuroendócrinos/patologia , Tumor Carcinoide/diagnóstico , Carcinoma Neuroendócrino/diagnóstico , Humanos , Neoplasias Laríngeas/diagnóstico , Tumores Neuroendócrinos/diagnóstico , Incerteza
6.
Pathol Res Pract ; 215(1): 1-4, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30396757

RESUMO

Current knowledge of laryngeal neuroendocrine cells in man and other vertebrates is reviewed. Particular attention is paid to differences in the distribution of neuroendocrine cells between squamous and respiratory laryngeal mucosa, foetal versus post-natal spatial arrangements, relation to the laryngeal cavity and nerve fibres, and immunoreactivities of these cells. Methodological deficiencies and gaps in knowledge are outlined. Comparisons with neuroendocrine cells in lung and gut are drawn, caution with regard to existing histogenetic models of laryngeal neuroendocrine neoplasia is advised and lines of future research are suggested.


Assuntos
Neoplasias Laríngeas/patologia , Laringe/patologia , Células Neuroendócrinas/patologia , Tumores Neuroendócrinos/patologia , Animais , Humanos , Mucosa Laríngea/patologia , Fibras Nervosas/patologia
7.
Ultrastruct Pathol ; 42(6): 465-476, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30526219

RESUMO

Salivary myoepithelial cells bear particular appendages and are involved in processes that have received incomplete attention in previous reviews. Here, cilia on myoepithelial cells are reviewed as regards substructure, occurrence, detection (electron microscopy, double immunofluorescence together with confocal microscopy), and roles (sensory reception, evolutionary homology, paracrine interaction). Attention is drawn to regressive changes affecting those cells (e.g. accumulation of lipofuscin), possible alterations of their cytoskeleton, internalization of apoptotic bodies and haemosiderin, and role in salivary microcalcification. The ability of differentiated salivary myoepithelial cells to divide is re-examined, particularly its increase in chronic inflammation and under experimental conditions. Caution with regard to histogenetic models of salivary neoplasia is re-emphasized; methodological deficiencies and areas of controversy are outlined; and lines of future research are suggested.


Assuntos
Citoesqueleto/ultraestrutura , Células Epiteliais/citologia , Epitélio/ultraestrutura , Neoplasias das Glândulas Salivares/patologia , Imunofluorescência/métodos , Humanos , Músculo Liso/patologia
8.
Eur Arch Otorhinolaryngol ; 275(11): 2609-2613, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30238310

RESUMO

A preoperative cytologic or histologic diagnosis of parotid gland neoplasms is mandatory to decide which surgical procedure would be appropriate. Open biopsies are contraindicated because of the risk of recurrence secondary to tumour cell seeding; furthermore a subsequent curative parotid surgery can be complicated by a previous open biopsy. While fine-needle aspiration cytology (FNAC) was the only preoperative diagnostic procedure to distinguish benign versus malignant neoplasms over the past decades, core needle biopsy (CNB) has been increasingly used over the last few years. This created a debate as to whether FNAC or CNB should be the preoperative procedure of choice. The focus of this editorial is to analyse the advantages and disadvantages of FNAC and CNB, and to discuss which procedure is more appropriate in the preoperative work-up of parotid neoplasms.


Assuntos
Biópsia por Agulha Fina , Biópsia com Agulha de Grande Calibre , Glândula Parótida/patologia , Neoplasias Parotídeas/diagnóstico , Biópsia por Agulha Fina/efeitos adversos , Biópsia com Agulha de Grande Calibre/efeitos adversos , Humanos , Sensibilidade e Especificidade
9.
Adv Ther ; 35(7): 887-898, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29923043

RESUMO

An endolymphatic sac tumor (ELST) is a rare, indolent but locally aggressive tumor arising in the posterior petrous ridge. Patients present with sensorineural hearing loss and tinnitus. As the tumor progresses, patients may experience vertigo, ataxia, facial nerve paresis, pain and otorrhea. Most patients present in their 4th or 5th decade with a wide age range. Patients with von Hippel-Lindau disease have an increased likelihood of developing ELST. Histologically, ELST is a low-grade adenocarcinoma. As it progresses, it destroys bone and extends into adjacent tissues. The likelihood of regional or distant metastases is remote. The optimal treatment is resection with negative margins. Patients with positive margins, gross residual disease, or unresectable tumor are treated with radiotherapy or radiosurgery. Late recurrences are common, so long follow-up is necessary to assess efficacy. The likelihood of cure depends on tumor extent and is probably in the range of 50-75%.


Assuntos
Adenocarcinoma , Neoplasias da Orelha , Saco Endolinfático/patologia , Osso Temporal/patologia , Doença de von Hippel-Lindau , Adenocarcinoma/patologia , Adenocarcinoma/terapia , Gerenciamento Clínico , Progressão da Doença , Neoplasias da Orelha/patologia , Neoplasias da Orelha/terapia , Humanos , Fatores de Risco , Doença de von Hippel-Lindau/diagnóstico , Doença de von Hippel-Lindau/epidemiologia
10.
Am J Surg Pathol ; 42(2): e11-e27, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29076877

RESUMO

Salivary gland neoplasms are a morphologically heterogenous group of lesions that are often diagnostically challenging. In recent years, considerable progress in salivary gland taxonomy has been reached by the discovery of tumor type-specific fusion oncogenes generated by chromosome translocations. This review describes the clinicopathologic features of a selected group of salivary gland carcinomas with a focus on their distinctive genomic characteristics. Mammary analog secretory carcinoma is a recently described entity characterized by a t(12;15)(p13;q25) translocation resulting in an ETV6-NTRK3 fusion. Hyalinizing clear cell carcinoma is a low-grade tumor with infrequent nodal and distant metastasis, recently shown to harbor an EWSR1-ATF1 gene fusion. The CRTC1-MAML2 fusion gene resulting from a t(11;19)(q21;p13) translocation, is now known to be a feature of both low-grade and high-grade mucoepidermoid carcinomas associated with improved survival. A t(6;9)(q22-23;p23-34) translocation resulting in a MYB-NFIB gene fusion has been identified in the majority of adenoid cystic carcinomas. Polymorphous (low-grade) adenocarcinoma and cribriform adenocarcinoma of (minor) salivary gland origin are related entities with partly differing clinicopathologic and genomic profiles; they are the subject of an ongoing taxonomic debate. Polymorphous (low-grade) adenocarcinomas are characterized by hot spot point E710D mutations in the PRKD1 gene, whereas cribriform adenocarcinoma of (minor) salivary glands origin are characterized by translocations involving the PRKD1-3 genes. Salivary duct carcinoma (SDC) is a high-grade adenocarcinoma with morphologic and molecular features akin to invasive ductal carcinoma of the breast, including HER2 gene amplification, mutations of TP53, PIK3CA, and HRAS and loss or mutation of PTEN. Notably, a recurrent NCOA4-RET fusion has also been found in SDC. A subset of SDC with apocrine morphology is associated with overexpression of androgen receptors. As these genetic aberrations are recurrent they serve as powerful diagnostic tools in salivary gland tumor diagnosis, and therefore also in refinement of salivary gland cancer classification. Moreover, they are promising as prognostic biomarkers and targets of therapy.


Assuntos
Biomarcadores Tumorais/genética , Carcinoma/genética , Técnicas de Diagnóstico Molecular , Neoplasias das Glândulas Salivares/genética , Biópsia , Carcinoma/patologia , Carcinoma/terapia , Diagnóstico Diferencial , Fusão Gênica , Predisposição Genética para Doença , Humanos , Mutação , Gradação de Tumores , Fenótipo , Valor Preditivo dos Testes , Neoplasias das Glândulas Salivares/patologia , Neoplasias das Glândulas Salivares/terapia , Translocação Genética
11.
Head Neck ; 39(5): 1033-1045, 2017 05.
Artigo em Inglês | MEDLINE | ID: mdl-28199045

RESUMO

Juvenile angiofibroma is an uncommon, benign, locally aggressive vascular tumor. It is found almost exclusively in young men. Common presenting symptoms include nasal obstruction and epistaxis. More advanced tumors may present with facial swelling and visual or neurological disturbances. The evaluation of patients with juvenile angiofibroma relies on diagnostic imaging. Preoperative biopsy is not recommended. The mainstay of treatment is resection combined with preoperative embolization. Endoscopic surgery is the approach of choice in early stages, whereas, in advanced stages, open or endoscopic approaches are feasible in expert hands. Postoperative radiotherapy (RT) or stereotactic radiosurgery seem valuable in long-term control of juvenile angiofibroma, particularly those that extend to anatomically critical areas unsuitable for complete resection. Chemotherapy and hormone therapy are ineffective. The purpose of the present review was to update current aspects of knowledge related to this rare and challenging disease. © 2017 Wiley Periodicals, Inc. Head Neck 39: 1033-1045, 2017.


Assuntos
Angiofibroma/diagnóstico , Angiofibroma/terapia , Neoplasias Nasofaríngeas/diagnóstico , Neoplasias Nasofaríngeas/terapia , Angiofibroma/epidemiologia , Criança , Humanos , Neoplasias Nasofaríngeas/epidemiologia
12.
Head Neck ; 38(12): 1847-1854, 2016 12.
Artigo em Inglês | MEDLINE | ID: mdl-27218239

RESUMO

The sinonasal cavities are rare locations for metastases. Metastases to these locations are usually solitary and produce similar symptoms to those of a primary sinonasal tumor. Nasal obstruction and epistaxis are the most frequent symptoms. The maxillary sinus is most frequently involved. The most common primary tumor sites to spread to this region originate in the kidney, breast, thyroid, and prostate, although any malignancy could potentially lead to a metastasis to the paranasal sinuses. The patient's prognosis is usually poor because of the fact that the sinonasal metastasis is usually associated with widespread disseminated disease. In the majority of patients, palliative therapy is the only possible treatment option. Nevertheless, whenever possible, surgical excision either alone or combined with radiotherapy may be useful for palliation of symptoms and, rarely, to achieve prolonged survival. This review considers the most interesting cases reported in the literature that presents metastases to the sinonasal cavities. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1847-1854, 2016.


Assuntos
Cavidade Nasal/patologia , Neoplasias dos Seios Paranasais/mortalidade , Neoplasias dos Seios Paranasais/secundário , Neoplasias Ósseas/mortalidade , Neoplasias Ósseas/patologia , Neoplasias Ósseas/terapia , Neoplasias da Mama/mortalidade , Neoplasias da Mama/patologia , Neoplasias da Mama/terapia , Carcinoma de Células Renais/mortalidade , Carcinoma de Células Renais/patologia , Carcinoma de Células Renais/terapia , Feminino , Humanos , Neoplasias Renais/mortalidade , Neoplasias Renais/patologia , Neoplasias Renais/terapia , Neoplasias Hepáticas/mortalidade , Neoplasias Hepáticas/patologia , Neoplasias Hepáticas/terapia , Neoplasias Pulmonares/mortalidade , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/terapia , Masculino , Neoplasias do Seio Maxilar/mortalidade , Neoplasias do Seio Maxilar/secundário , Neoplasias do Seio Maxilar/terapia , Neoplasias dos Seios Paranasais/terapia , Prognóstico , Neoplasias da Próstata/mortalidade , Neoplasias da Próstata/patologia , Neoplasias da Próstata/terapia , Medição de Risco , Análise de Sobrevida , Neoplasias da Glândula Tireoide/mortalidade , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/terapia
13.
Am J Otolaryngol ; 37(4): 365-8, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27105979

RESUMO

Problems related to definition of collision tumors are briefly examined in conjunction with etiology and natural history. Examples of genuine collision tumors in larynx are rare in the literature and are herein identified and tabulated. Aspects related to diagnosis and therapeutic strategies are also explored.


Assuntos
Adenoma/diagnóstico , Carcinoma/diagnóstico , Neoplasias Laríngeas/diagnóstico , Neoplasias Primárias Múltiplas/diagnóstico , Adenoma/mortalidade , Adenoma/terapia , Carcinoma/mortalidade , Carcinoma/terapia , Humanos , Neoplasias Laríngeas/mortalidade , Neoplasias Laríngeas/terapia , Neoplasias Primárias Múltiplas/mortalidade , Neoplasias Primárias Múltiplas/terapia
14.
Adv Ther ; 33(4): 553-79, 2016 04.
Artigo em Inglês | MEDLINE | ID: mdl-27084720

RESUMO

Adenoid cystic carcinoma (AdCC) of the head and neck is a well-recognized pathologic entity that rarely occurs in the larynx. Although the 5-year locoregional control rates are high, distant metastasis has a tendency to appear more than 5 years post treatment. Because AdCC of the larynx is uncommon, it is difficult to standardize a treatment protocol. One of the controversial points is the decision whether or not to perform an elective neck dissection on these patients. Because there is contradictory information about this issue, we have critically reviewed the literature from 1912 to 2015 on all reported cases of AdCC of the larynx in order to clarify this issue. During the most recent period of our review (1991-2015) with a more exact diagnosis of the tumor histology, 142 cases were observed of AdCC of the larynx, of which 91 patients had data pertaining to lymph node status. Eleven of the 91 patients (12.1%) had nodal metastasis and, based on this low proportion of patients, routine elective neck dissection is therefore not recommended.


Assuntos
Carcinoma Adenoide Cístico , Neoplasias Laríngeas , Linfonodos , Esvaziamento Cervical/métodos , Carcinoma Adenoide Cístico/patologia , Carcinoma Adenoide Cístico/cirurgia , Procedimentos Cirúrgicos Eletivos/métodos , Humanos , Neoplasias Laríngeas/patologia , Neoplasias Laríngeas/cirurgia , Linfonodos/patologia , Linfonodos/cirurgia , Metástase Linfática , Seleção de Pacientes
15.
Auris Nasus Larynx ; 43(5): 477-84, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27017314

RESUMO

The purpose of this study was to suggest general guidelines in the management of the N0 neck of oral cavity and oropharyngeal adenoid cystic carcinoma (AdCC) in order to improve the survival of these patients and/or reduce the risk of neck recurrences. The incidence of cervical node metastasis at diagnosis of head and neck AdCC is variable, and ranges between 3% and 16%. Metastasis to the cervical lymph nodes of intraoral and oropharyngeal AdCC varies from 2% to 43%, with the lower rates pertaining to palatal AdCC and the higher rates to base of the tongue. Neck node recurrence may happen after treatment in 0-14% of AdCC, is highly dependent on the extent of the treatment and is very rare in patients who have been treated with therapeutic or elective neck dissections, or elective neck irradiation. Lymph node involvement with or without extracapsular extension in AdCC has been shown in most reports to be independently associated with decreased overall and cause-specific survival, probably because lymph node involvement is a risk factor for subsequent distant metastasis. The overall rate of occult neck metastasis in patients with head and neck AdCC ranges from 15% to 44%, but occult neck metastasis from oral cavity and/or oropharynx seems to occur more frequently than from other locations, such as the sinonasal tract and major salivary glands. Nevertheless, the benefit of elective neck dissection (END) in AdCC is not comparable to that of squamous cell carcinoma, because the main cause of failure is not related to neck or local recurrence, but rather, to distant failure. Therefore, END should be considered in patients with a cN0 neck with AdCC in some high risk oral and oropharyngeal locations when postoperative RT is not planned, or the rare AdCC-high grade transformation.


Assuntos
Carcinoma Adenoide Cístico/terapia , Linfonodos/patologia , Neoplasias Bucais/terapia , Esvaziamento Cervical , Recidiva Local de Neoplasia , Neoplasias Orofaríngeas/terapia , Radioterapia , Carcinoma Adenoide Cístico/patologia , Gerenciamento Clínico , Humanos , Metástase Linfática , Neoplasias Bucais/patologia , Pescoço , Neoplasias Orofaríngeas/patologia
16.
Adv Ther ; 33(3): 357-68, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26895332

RESUMO

Adenoid cystic carcinoma (AdCC) is among the most common malignant tumors of the salivary glands. It is characterized by a prolonged clinical course, with frequent local recurrences, late onset of metastases and fatal outcome. High-grade transformation (HGT) is an uncommon phenomenon among salivary carcinomas and is associated with increased tumor aggressiveness. In AdCC with high-grade transformation (AdCC-HGT), the clinical course deviates from the natural history of AdCC. It tends to be accelerated, with a high propensity for lymph node metastasis. In order to shed light on this rare event and, in particular, on treatment implications, we undertook this review: searching for all published cases of AdCC-HGT. We conclude that it is mandatory to perform elective neck dissection in patients with AdCC-HGT, due to the high risk of lymph node metastases associated with transformation.


Assuntos
Carcinoma Adenoide Cístico/patologia , Metástase Linfática/patologia , Neoplasias das Glândulas Salivares/patologia , Adulto , Carcinoma Adenoide Cístico/mortalidade , Carcinoma Adenoide Cístico/cirurgia , Feminino , Humanos , Linfonodos/patologia , Masculino , Pessoa de Meia-Idade , Neoplasias das Glândulas Salivares/mortalidade , Neoplasias das Glândulas Salivares/cirurgia
17.
Eur Arch Otorhinolaryngol ; 273(10): 2867-75, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26459007

RESUMO

The clinical significance of papillary or follicular thyroid tissue incidentally discovered in cervical lymph nodes during pathological assessment of neck dissections for non-thyroid cancers of the upper aero-digestive tract is critically reviewed. Special emphasis is given to controversies over normal-looking, nodal, thyroid follicles. Arguments for and against the benign nature of these follicles are considered together with processes that could be involved in their formation. The admittedly limited evidence suggests that benign, thyroid follicular inclusions rarely occur in cervical lymph nodes. Histological criteria that could be helpful in recognizing the inclusions, which include assessing their extent in conjunction with the size of the node, are discussed. Finally, an algorithm based on collaboration between specialists, correlating histological findings with imaging and loco-regional control of the upper aero-digestive tract cancer, is suggested for the management of patients with incidentally discovered, nodal thyroid tissue.


Assuntos
Coristoma/patologia , Achados Incidentais , Linfonodos/patologia , Linfadenopatia/patologia , Glândula Tireoide , Adulto , Algoritmos , Carcinoma Papilar/secundário , Feminino , Humanos , Excisão de Linfonodo , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Pescoço , Esvaziamento Cervical , Neoplasias da Glândula Tireoide/patologia , Tireoidectomia
18.
Eur Arch Otorhinolaryngol ; 273(10): 2925-30, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26530293

RESUMO

While small cell neuroendocrine carcinomas (SCNCs) most often arise in the lung, extrapulmonary SCNCs arise in a variety of locations-including the head and neck region. In particular, laryngeal SCNCs-while rare tumors-are nevertheless recognized as distinct lesions. The rarity of laryngeal SCNC gives rise to two distinct difficulties: first (particularly with small biopsy specimens), laryngeal SCNC can be difficult to diagnose by routine light microscopy; second, limited experience with these tumors can make the crafting of a treatment plan for individual patients difficult. As regards the first problem, pathologic diagnosis is greatly enhanced by the application of immunohistochemistry. The second problem-crafting a successful treatment strategy-presents a much larger difficulty. It is tempting to extrapolate from experience with the (more common) pulmonary SCNC in search of a strategy applicable to laryngeal SCNC; such an extrapolation, however, may not be uniformly successful. In particular, while a combination of radiation therapy and chemotherapy appears to be as valuable in the treatment of extrapulmonary as it is in the treatment of pulmonary SCNC, prophylactic cranial irradiation (PCI)-which has enjoyed some success in the treatment of some patients with pulmonary SCNC-does not appear to have similar utility in patients with laryngeal SCNC. Accordingly, the use of PCI does not appear to have a role to play at this point in time in the treatment of patients with laryngeal SCNC.


Assuntos
Neoplasias Encefálicas/prevenção & controle , Carcinoma Neuroendócrino/prevenção & controle , Carcinoma de Células Pequenas/prevenção & controle , Irradiação Craniana , Neoplasias Laríngeas/patologia , Neoplasias Encefálicas/secundário , Carcinoma Neuroendócrino/patologia , Carcinoma Neuroendócrino/secundário , Carcinoma de Células Pequenas/patologia , Carcinoma de Células Pequenas/secundário , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade
19.
Head Neck ; 38 Suppl 1: E2259-66, 2016 04.
Artigo em Inglês | MEDLINE | ID: mdl-26041714

RESUMO

Neuroendocrine neoplasms of the sinonasal region, which are relatively uncommon but clinically very important, are reviewed here in the light of current knowledge. Using a definition for neuroendocrine based on phenotypic, histologic, immunohistochemical, and electron microscopic features rather than histogenetic criteria, sinonasal neuroendocrine carcinomas are examined with a particular emphasis on the small-cell and large-cell subtypes. This is followed by revisiting olfactory neuroblastoma because it is also a tumor that shows a neuroendocrine phenotype. Kadish clinical and Hyams histologic grading systems as prognosticators of olfactory neuroblastoma are also considered in detail. Finally, controversies regarding sinonasal undifferentiated carcinoma as a neuroendocrine tumor are discussed and a possible relationship with high-grade olfactory neuroblastoma is explored. Genetic events and current management of these tumors are also outlined. © 2015 Wiley Periodicals, Inc. Head Neck 38: E2259-E2266, 2016.


Assuntos
Carcinoma Neuroendócrino/diagnóstico , Estesioneuroblastoma Olfatório/diagnóstico , Neoplasias Nasais/diagnóstico , Humanos , Cavidade Nasal/patologia
20.
Head Neck ; 38(1): 147-55, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25242350

RESUMO

Primary mucosal melanomas (PMMs) of the head and neck are uncommon malignancies that arise mainly in the nasal cavity and paranasal sinuses, followed by the oral cavity. The mainstay of treatment is radical surgical resection followed by adjuvant radiotherapy in selected patients with high-risk features. Multimodality therapy has not been well studied and is not standardized. Adjuvant radiotherapy seems to improve locoregional control but does not improve overall survival (OS). Elective neck dissection is advocated in patients with oral PMM. Systemic therapy should be considered only for patients with metastatic or unresectable locoregional disease. Despite improvements in the field of surgery, radiotherapy, and systemic therapy, patients with PMM still face a very unfavorable prognosis (5-year disease-free survival [DFS] <20%) with high rates of locoregional recurrence and distant metastasis. The present review aims to summarize the current state of knowledge on the molecular biology, pathological diagnosis, and management of this disease.


Assuntos
Neoplasias de Cabeça e Pescoço/terapia , Melanoma/terapia , Terapia Combinada , Neoplasias de Cabeça e Pescoço/mortalidade , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Melanoma/mortalidade , Melanoma/patologia , Neoplasias Bucais/terapia , Recidiva Local de Neoplasia/prevenção & controle , Estadiamento de Neoplasias , Neoplasias Nasais/terapia , Neoplasias dos Seios Paranasais/terapia , Prognóstico , Fatores de Risco , Resultado do Tratamento
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