Craniofacial surgery for nonmelanoma skin malignancy: Report of an international collaborative study

AbstractBackground.This study examined the efficacy of craniofacial surgery (CFS) in treating locally advanced nonmelanoma skin cancer (NMSC).Methods.One hundred twenty patients who underwent CFS for NMSC were identified from 17 participating institutions. Patient, tumor, and treatment information was analyzed for prognostic impact on survival.Results.Surgical margins were negative in 74%, close in 3%, and involved in 23% of patients. Complications occurred in 35% of patients, half of which were local wound problems. Operative mortality was 4%. Median follow‐up interval after CFS was 27 months. The 5‐year overall survival (OS), disease‐specific survival (DSS), and recurrence‐free survival (RFS) rates were 64%, 75%, and 60%, respectively. Squamous cell histology, brain invasion, and positive resection margins independently predicted worse OS, DSS, and RFS.Conclusion.CFS is an effective treatment for patients with NMSC invading the skull base. Histology, extent of disease, and resection margins are the most significant predictors of outcome. © 2007 Wiley Periodicals, Inc. Head Neck, 200

Cryptococcal Tongue Lesion in a Stem Cell Transplant Patient: First Reported Case

A compromised immune system places individuals at a significantly higher risk for many infectious processes. Immunosuppression also increases the risk of malignancy due to the body's decreased ability to perform its normal immunosurveilance and response. It is therefore imperative to have regular thorough evaluations of these patients, as slight abnormalities may be the early signs of infection or neoplasm. We present the first reported case of a tongue lesion in a stem cell transplant patient, highly concerning for malignancy, which was found to be a mucocutaneous presentation of disseminated Cryptococcus

Transoral Surgical Approach for Retropharyngeal Node Involvement in I-131-Negative 18-fluoro-2-deoxyglucose Positron Emission Tomography–Positive Recurrent Thyroid Cancer

Transoral pharyngotomy is a viable minimally invasive approach for resection of metastatic thyroid cancer in retropharyngeal lymph nodes in highly select patients. A few authors have already reported on its safe application with excellent outcomes. We herein describe a case where the technique is assisted with the Omniguide CO2 laser system to safely access and remove a metastatic node in the retropharyngeal space of a 24 year-old Caucasian woman. Furthermore, her disease was I-131-negative and positron emission tomography–positive, demonstrating the technique is still feasible in this dedifferentiated cancer state

Rapid development of HPV-mediated oropharyngeal squamous cell carcinoma in the setting of immune suppression following autologous stem cell transplantation for Hodgkin lymphoma

The patient is a 61-year-old male with a diagnosis of relapse classical Hodgkin lymphoma, treated with ABVD, ICE, and achieved remission. He underwent autologous stem cell transplantation and 3 months later found to have a PET-positive neck node concerning for relapsed disease of Hodgkin lymphoma. Biopsy proved the lesion was HPV-associated squamous cell carcinoma and not relapse Hodgkin disease. Iatrogenic immunosuppression such as bone marrow transplantation can cause substantial increase risk for viral-associated tumors and therefore tissue biopsies are necessary to make that distinction to avoid inappropriate treatment. Keywords: Hodgkin lymphoma, HPV, Squamous cell carcinoma, Transplantatio

Identification of Angiogenesis/Metastases Genes Predicting Chemoradiotherapy Response in Patients With Laryngopharyngeal Carcinoma

Purpose To identify genes related to angiogenesis/metastasis that predict locoregional failure in patients with laryngopharyngeal cancer (LPC) undergoing chemoradiotherapy (CRT) treatment. Methods Tumor tissue was collected and snap-frozen from 35 sequential patients with histologically confirmed LPC being treated with CRT. Gene expression analysis was performed using a novel cDNA array consisting of 277 genes functionally associated with angiogenesis (n 152) and/or metastasis (n 125). Locoregional response was correlated to the gene expression profiles to identify genes associated with outcome. These genes were internally validated by real-time reverse transcriptase polymerase chain reaction (RT-PCR) and validated externally by immunohis- tochemistry analysis on an independent set of patients. Results Locoregional failure occurred in nine of 35 patients. Seventeen genes from the cDNA microarray correlated with locoregional failure (two-sample t test, P .05). Seven genes were chosen for additional analysis based on the availability of antibodies for immunohistochemistry. Of these seven genes, real-time RT-PCR validated four genes: MDM2, VCAM-1, erbB2, and H-ras (Wilcoxon rank sum test, P .008, .02, .04, and .04, respectively). External validation by immunohistochem- istry confirmed MDM2 and erbB2 as being predictive of locoregional response. Controlling for stage of disease, positivity for MDM2 or erbB2 was an independent negative predictor of locoregional disease-free survival. Conclusion Genomic screening by cDNA microarray and validation internally by real-time RT-PCR and externally by immunohistochemistry have identified two genes (MDM2 and erbB2) as predictors of locoregional failure in LPC patients treated with CRT. The role of these genes in treatment selection and the functional basis for their activity in CRT response merit additional consideration

NCCN Guidelines Insights: Head and Neck Cancers, Version 1.2018.

The NCCN Guidelines for Head and Neck (H&N) Cancers provide treatment recommendations for cancers of the lip, oral cavity, pharynx, larynx, ethmoid and maxillary sinuses, and salivary glands. Recommendations are also provided for occult primary of the H&N, and separate algorithms have been developed by the panel for very advanced H&N cancers. These NCCN Guidelines Insights summarize the panel's discussion and most recent recommendations regarding evaluation and treatment of nasopharyngeal carcinoma

NCCN Guidelines Insights: Head and Neck Cancers, Version 1.2018.

The NCCN Guidelines for Head and Neck (H&N) Cancers provide treatment recommendations for cancers of the lip, oral cavity, pharynx, larynx, ethmoid and maxillary sinuses, and salivary glands. Recommendations are also provided for occult primary of the H&N, and separate algorithms have been developed by the panel for very advanced H&N cancers. These NCCN Guidelines Insights summarize the panel's discussion and most recent recommendations regarding evaluation and treatment of nasopharyngeal carcinoma