Lipoma of the Deep Neck Space

Lipoma is a common tumor throughout the body, but occurrence in the deep neck space is very rare, and only some cases have been reported by otolaryngologist and pathologist for the last century. In head and neck area, as elsewhere, the lipoma is mainly originated from the subcutaneum. But in deeper tissues, its characteristics are different from those of other sites of lipoma. Submucosal lipoma in the head and neck area usually occur in oral cavity and hypopharynx. Recently we hae experienced 3 cases of deep neck space lipoma, so we report our clinical experiences with brief review of literature.ope

A Case of Transoral Robotic Radical Lateral Oropharyngectomy in Tonsilar Cancer

Transoral robotic system (TORS) is performed by positioning at least 3 robotic arms through the oral cavity that are operated by the surgeon bimanually. The elaborate movements of the operating tools and high resolution endoscopic images provided by the robot can overcome the shortcomings of transoral radical lateral oropharyngectomy, thus enabling wide and effective surgery. Also, it preserves postoperative functions and improves the quality of life, thereby decreasing postoperative morbidity. In this study, the possibility of TORS as a novel surgical method in managing tonsillar carcinoma has been identified. However, a long term observation regardingpostoperative swallowing, phonation, quality of life and oncologic safety in using TORS is further requiredope

Expression of HGF/c-Met in Hypopharyngeal Squamous Cell Carcinoma

Hepatocyte growth factor (HGF), a potent stimulator of hepatocyte growth, stimulates motility, invasiveness, proliferation, and morphogenesis of epithelium, and may be involved in physiologic and pathologic processes such as embryogenesis, wound healing, organ regeneration, inflammation, and tumor invasion. So we examined the role of the HGF/c-Met on invasion and metastasis of hypopharyngeal squamous cell carcinoma (SCC). We performed immunohistochemical stains on 40 normal mucosas and 40 SCCs of hypopharynx with HGF antibody and c-Met antibody. For RT-PCR and Western blot, fresh normal tissues and cancer tissues in hypopharynx obtained from five patients were used. The positive rates of HGF and c-Met expression in hypopharyngeal SCC were 77.5% and 70%, respectively. HGF staining was significantly correlated with lymph node metastasis and pathologic stage (p<0.05). c-Met staining was only significantly correlated with lymph node metastasis (p<0.05). The increased expresssion of c-Met mRNA (RT-PCR) and protein (Western Blot) were detected in hypopharyngeal cancer tissue. These results suggest that HGF may play an important role in the progression of hypopharyngeal cancer.ope

Effect of HGF in Invasion of Hypopharyngeal Squamous Cell Carcinoma Cell Line

Background and Objectives：Recent reports revealed that hepatocyte growth factor (HGF) is related to tumor invasion and metastasis. Activation of the urokinase-type plasminogen activator (u-PA)/plasmin proteolytic network and matrix metalloproteinase has been shown to play a key role in tumor invasion and dissemination of various malignancies. So we examined the effect of HGF/c-Met on MMP-2, 9 and u-PA in FaDu cell, a hypopharyngeal squamous cell carcinoma cell line. Materials and Method：We performed RT-PCR and Western blot in FaDu. Tumor cell invasiveness was assessed by the membrane invasion assay (using Transwell chamber). To examine the role of MMP-2, 9 and the relation between HGF and MMP in the invasion of hypopharyngeal cancer, RT-PCR and zymography were performed in FaDu cells. We tested to confirm the HGF-mediated plasmin activation. Results：The expressions of c-Met mRNA and protein were detected in the hypopharyngeal cell line while that of HGF was not. HGF markedly enhanced the invasion of cancer cells in a Transwell invasion chamber in a dose-dependent manner (p<0.05). The expression of MMP was detected in hypopharyngeal cancer cells and exogenous HGF slightly enhanced the induction of MMP-2 activity in zymogram analysis. The activity of u-PA was detected in FaDu and HGF (above 10 units/mL) enhanced the activity of u-PA (p<0.05). Conclusion：These results suggest that HGF may play an important role in hypopharyngeal cancer through the activation of u-PA and matrix metalloproteinase.ope

Retroauricular Endoscope-Assisted Approach to the Neck: Early Experience in Latin America

Introduction?There has been a significant increase in concern towards improving aesthetic and functional outcomes without compromising the oncologic effectiveness in head and neck surgery. In this subset, endoscope-assisted and robotic procedures allowed the development of new approaches to the neck, including the retroauricular access, which is now routinely used, especially in Korea. Objectives?This study aims to provide a descriptive analysis of our initial experience with retroauricular endoscope-assisted approach assessing feasibility, safety, and aesthetic results. Methods?Prospective analysis of the first 11 eligible patients submitted to retroauricular endoscope-assisted approach for neck procedures in the Head and Neck Surgery Department at AC Camargo Cancer Center. Results?A total of 18 patients were included in this study, comprising 7 supraomohyoid neck dissections, 8 submandibular gland excisions, 3 thyroid lobectomies, and one paraganglioma excision. There was no significant local complications, surgical accident, or need for conversion into conventional open procedure in this series. Conclusion?Our initial experience has shown us that this approach is feasible, safe, oncologically efficient, and applicable to selected cases, with a clear cosmetic benefit.ope

Association between mobile phone use and pleomorphic adenoma of parotid gland

OBJECTIVES : When a person talks on a mobile telephone, the salivary glands, and the parotid gland in particular, are among the areas of the body with most exposure to the phone, as they are located in front of the ear. We examined the association of parotid gland tumors with mobile phone use. This study included patients who had undergone surgical parotid gland tumor removal and whose pathology was designated as pleomorphic adenoma. The objective of this case-case study was to assess whether the use of wireless phones is associated with an increased risk or growth rate of tumors at this site. METHODS : 220 patients with parotid gland pleomorphic adenoma were included. The location and volume of the tumors were determined by enhanced neck CT scan. Patients were divided according to the amount of mobile phone use in terms of duration, daily amount, and cumulative hours. We compared the volume of tumors to the above mobile phone use parameters. Associations between the laterality of phone use and tumor location were analyzed. RESULTS : In the case-case study of all included patients, no significant difference in volume between heavy mobile phone users and light mobile phone users was observed. However, there was a strong correlation between the side of the head on which tumors were located and the side of mobile phone use (which was limited to ipsilateral users). Tumor volume and estimated cumulative hours were also strongly correlated, while tumor volume was notably larger in heavy phone users than light users (p=0.012). CONCLUSION : We found that tumor incidence might coincide with the more frequently used ear of mobile phone users and also found that tumor volume was strongly correlated with the amount of mobile phone use. Ther efore, it is possible that mobile phone use may affect tumor growth.ope

Growth inhibition and apoptosis by (−)-epicatechin gallate are mediated by cyclin D1 suppression in head and neck squamous carcinoma cells

In recent studies, green tea components have been shown to induce cell growth arrest and apoptosis in head and neck squamous cell carcinoma (HNSCC) cells. In this report, we have investigated the effects of epicatechin gallate (ECG), one of the catechins in green tea, on anti-cancer activity in vitro. We found that cyclin D1 was highly expressed in HNSCC cells, and ECG suppressed 90% of cyclin D1 expression in SCC7 cells. We have also evaluated the effect of ECG on cell growth and apoptosis, showing that ECG (50 μM) exhibited a significant inhibition (50%) on the growth of SCC7 cells via G1 cell cycle arrest. ECG suppressed cyclin D1 in SCC7 cells in a dose- and time-dependent manner, and the suppression of the β-catenin pathway by ECG is one of the mechanism to facilitate ECG-induced cell growth arrest. These results suggest that ECG has a potential usage as a chemopreventive agent in HNSCC.ope

Expression of matrix metalloproteinases and their inhibitors in squamous cell carcinoma of the tonsil and their clinical significance

OBJECTIVES: To investigate expressions of matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) in squamous cell carcinoma of the tonsil and to correlate expression profiles with clinicopathological characteristics. METHODS: Paraffin blocks were obtained from 45 tonsil squamous cell carcinoma (SCC) patients, who underwent surgery as an initial treatment between 1994 and 2004, and from 20 normal controls. Expressions of MMP-2, MMP-9, MMP-13, TIMP-1, and TIMP-2 were investigated immunohistochemically. RESULTS: The expressions of MMPs (except MMP-2) and TIMPs were found to be significantly different in tonsil SCC and normal control tissues. Furthermore, MMP-13 expression was found to be correlated with tumor invasion (P=0.05), and the expressions of MMP-9 and TIMP-1 with nodal metastasis (P=0.048, 0.031). No relation was found between MMP or TIMP expression and recurrence. However, MMP-9 expression was found to be significantly associated with 5-year survival in tonsil SCC patients by multivariate analysis (hazard ratio, 3.853; P=0.013). CONCLUSION: Significant overexpressions of multiple MMPs and TIMPs were found in tonsil SCC tissues. Furthermore, our findings suggest that MMP-9 expression might be a useful prognostic factor.ope

Multicenter, Open-Labeled, Observational Clinical Trial to Investigate the Efficacy and Safety of Oral Administration of Megace Suspension in Patients with Head and Neck Cancer During Radiotherapy

Background and Purpose：Nausea, vomiting and weight loss are common problems that are encountered in the course of cancer patient treatment who are receiving radiotherapy. In this study, we are aiming to analyze the effect of megestrol acetate on quality of life of head and neck cancer patients receiving radiotherapy, resulting from improvement of weight loss, appetite and nutritional status via multicenter, open-labeled, observational clinical trial. Material and Methods：A total of 270 patients from 10 medical institutes who are receiving radiotherapy or who have completed radiotherapy within 3 months, between February 2007 and February 2008, were selected as candidates for the study. Megestrol acetate suspension(megace) was given to the subjectives once a week for 4 weeks with the amount of 20ml(megestrol 800mg). Measurement of weight and questionnaire surveys were carried out three times: at the start of the study, 4 weeks after the start of the medication, and 4 weeks after the end of the medication, respectively. Results：The group who has received megace had a total number of 199, and control group was 70. The group who have received megace showed mean weight loss of 1kg in 8 weeks, compared with the weight loss of 5.5kg in control group, which showed that the medication was effective in reducing the amount of weight loss(P=0.027). The group who received megace had a tendency to report a reduced rate of decrease in the score of appetite, nausea and vomiting, and QOL score, but it did not have statistical significance(P>0.05). Conclusion：Megestrol acetate have reduced the degree of weight loss significantly, and it has a tendency to reduce the rate of decrease in appetite, aggravation of nausea and vomiting, and quality of lifeope

Colon Interposition after Radical Total Pharyngolaryngoesophagectomy in a Patient with Subtotal Gastrectomy

The principle treatment for cervical esophageal cancer and hypopharyngeal cancer with esophageal invasion is radical total pharyngolaryngoesophagectomy (PLE), and it is necessary to totally reconstruct the defect of the resected organ. Stomach, small bowel, colon, a laryngotracheal flap and a pectoralis major musculocutaneous flap can all be used. We commonly use stomach because stomach has a rich blood supply and a low incidence of leakage. But in this present reported case, because previous radical subtotal gastrectomy with gastrojejunostomy had been done, we had to use colon for reconstruction. We use the left colon and left colic artery, and there were no complications. We report here on using the left colon and left colic artery to reconstruct a PLE defect for the first time in Korea.ope