Carcinoma linfoepitelial de cuello uterino con recurrencia a distancia / Lymphoepithelioma-like carcinoma of the cervix with distant recurrence

Resumen El carcinoma similar al linfoepitelioma (LELC) del cuello uterino es una variante infrecuente del carcinoma de células escamosas. Se presenta el caso de una mujer con un tumor exofítico en el cuello uterino de consistencia aumentada, sangrado al tacto y parametrios libres de tumor clasificándose como etapa clínica IBI; el estudio histopatológico reportó LELC con recurrencia a distancia al año de seguimiento. Debido a su buen pronóstico existen pocos casos reportados de recurrencia posterior al tratamiento inicial.

Abstract Lymphoepithelioma-like carcinoma (LELC) of the cervix is an uncommon variant of squamous cell carcinoma. We present the case of a woman with an exophytic tumor on the cervix of increased consistency, bleeding to the touch and tumor-free parametriums classified as clinical stage IBI; the histopathological study reported LELC with distant recurrence at one year of follow-up. Due to its good prognosis, there are few reported cases of recurrence after initial treatment.

[Transverse glossectomy for tongue cancer treatment]. / Glosectomía transversa para el tratamiento del cáncer de lengua.

INTRODUCTION: Standard care of patients with oral tongue-invasive squamous cell carcinoma in early stages is local resection and neck dissection. Traditionally, tumor resection was performed with hemiglossectomy (tongue resection in lingual long axis), which implied morbidity for deglutition and speech. Although surgical margins are sufficient, they are usually larger than necessary. OBJECTIVE: To know functional results and surgical margins in patients with T1-T2 oral tongue cancer submitted to transverse glossectomy (TG). MATERIAL AND METHODS: We analyzed charts of patients with T1-T2 oral tongue squamous cell carcinoma treated by TG during a 2-year period. We studied surgical margins, deglutition, speech intangibility, performance status and patient satisfaction. RESULTS: We included 20 patients: 12 women and eight men, with mean age of 45 years. Tumor-thickness mean was 8 mm; 19 patients showed free tumor margins in definitive histology study with mean of 1.8 cm three-dimensionally. In one patient, frozen sections were free-of-tumor, but definitive study showed a microscopic area of squamous cell carcinoma in surgical margin. All patients preserved > 50% of oral tongue and all showed lingual tip deviation and short tongue. None required nasogastric tube for feeding and speech was intelligible in all patients. CONCLUSIONS: TG provided sufficient surgical margin in all patients in this series without important morbidity and with good functional result; thus, TG is an alternative to classic vertical hemiglossectomy for patients in early stages of tongue mobile cancer.

[Prognostic factors in oropharyngeal cancer]. / Factores pronóstico en cáncer de orofaringe.

INTRODUCTION: Oropharyngeal carcinoma (OFC) is rare in Mexico, it only represents 0.6% of all carcinomas. Treatment alternatives are radiotherapy (RT) or radiotherapy-surgery association and prognosis depends on stage and tumor location. OBJECTIVE: Our objective was to know prognostic factors in patients with OFC treated with RT. MATERIAL AND METHODS: We conducted a retrospective analysis of patients with OFC. Analyzed variables were tumor location, RT technique (with or without field reduction; TRC and TSRC), tumor stage, histologic grade, and macroscopic tumor type. Survival was estimated with Kaplan-Meier method. RESULTS: A total of 70 patients, median age of 62 years, 19 women and 51 men. Locations included 24 tonsil, 35 tongue base, eight soft palate, and three posterior lateral wall. A total of 32 tumors were excrescent and 38, ulcer infiltrating, 81% T3-T4 and 18% T1-T2. RT median dose was 5,625 rads; 51 were treated with TSRC and 19 with TRC. Local-regional control was achieved in 35 patients (50%), mortality secondary to treatment was 12.9% whit there were 5-year overall survival. Loco-regional recurrence was 44%. Most frequent morbility for treatment was dysphagia (66%). Variables with statistical survival significance were TRC (18% vs. 53% p = 0.0012), stage (T1-2 vs. T3-4; 58% vs. 21% p = 0.0025, and tonsil location (43% vs. 24% p < 0.005). OFC diagnosis is usually made in advanced stages. Survival prognostic factors are tumor location, tumor stage, and RT technique.