Surgical treatment of mucoepidermoid carcinoma of the salivary glands

Cilj ovog rada je bio utvrditi broj kirurški liječenih bolesnika s mukoepidermoidnim karcinomom žlijezda slinovnica u razdoblju od 25 godina, odrediti njihovu raspodjelu prema spolu, dobi bolesnika i lokalizaciji, te procijeniti uspješnost terapije. Retrospektivnom analizom podataka utvrđeno je da je u Klinici za kirurgiju lica, čeljusti i usta KB Dubrava u razdoblju od 1990. do 2014. godine primarno kirurški liječeno 65 bolesnika s mukoepidermoidnim karcinomom žlijezda slinovnica, koji je bio nešto učestaliji kod muškaraca (52,3%) nego kod žena (47,7%). Srednja dob bolesnika je bila 46 godina, a 10,8% bolesnika bilo je dječje dobi. Najčešća lokalizacija mukoepidermoidnog karcinoma bila je u parotidnoj žlijezdi (56,9%), a od malih žlijezda slinovnica najčešće su bile zahvaćene one na nepcu. Bolesnici su najčešće bili liječeni isključivo kirurškom ekscizijom odnosno parotidektomijom, a kod uznapredovale bolesti i dodatnom disekcijom regionalnih limfnih čvorova na vratu. Ukupno preživljenje je bilo 87,7%, što odgovara statističkim podacima iz recentne literature o preživljenju za mukoepidermoidne karcinome niskog i srednjeg stupnja malignosti. Ovi podaci potvrđuju da je kirurška metoda optimalan izbor liječenja bolesnika s mukoepidermoidnim karcinomom žlijezda slinovnica.The aim of this study was to determine the number of surgically treated patients with mucoepidermoid carcinoma of the salivary glands during a 25-year period, to analyze its distribution according to the patients’ gender, age and the localization of the tumor, and to evaluate the success of treatment. A retrospective analysis of medical records showed that from 1990 to 2014 at the Department of Maxillofacial Surgery, University Hospital Dubrava 65 patients with mucoepidermoid carcinoma of the salivary glands were treated surgically, men (52,3%) slightly more often than woman (47,7%). The patients’ average age was 46 years, with 10.8% of patients of childhood age. The most frequent localization of mucoepidermoid carcinoma was the parotid gland, with the palate being the most frequent localization of carcinoma of the minor salivary glands. Patients were most frequently treated by surgical excision or parotidectomy, and additional dissection of the cervical lymph nodes was performed on cases with advanced disease. The overall survival rate was 87,7%, which corresponds with statistical information obtained from literature concerning the survival rate for low- and intermediate-grade mucoepidermoid carcinoma. These findings confirm that surgical treatment is the optimal choice in treating patients with mucoepidermoid carcinoma of the salivary glands

Surgical treatment of mucoepidermoid carcinoma of the salivary glands

Cilj ovog rada je bio utvrditi broj kirurški liječenih bolesnika s mukoepidermoidnim karcinomom žlijezda slinovnica u razdoblju od 25 godina, odrediti njihovu raspodjelu prema spolu, dobi bolesnika i lokalizaciji, te procijeniti uspješnost terapije. Retrospektivnom analizom podataka utvrđeno je da je u Klinici za kirurgiju lica, čeljusti i usta KB Dubrava u razdoblju od 1990. do 2014. godine primarno kirurški liječeno 65 bolesnika s mukoepidermoidnim karcinomom žlijezda slinovnica, koji je bio nešto učestaliji kod muškaraca (52,3%) nego kod žena (47,7%). Srednja dob bolesnika je bila 46 godina, a 10,8% bolesnika bilo je dječje dobi. Najčešća lokalizacija mukoepidermoidnog karcinoma bila je u parotidnoj žlijezdi (56,9%), a od malih žlijezda slinovnica najčešće su bile zahvaćene one na nepcu. Bolesnici su najčešće bili liječeni isključivo kirurškom ekscizijom odnosno parotidektomijom, a kod uznapredovale bolesti i dodatnom disekcijom regionalnih limfnih čvorova na vratu. Ukupno preživljenje je bilo 87,7%, što odgovara statističkim podacima iz recentne literature o preživljenju za mukoepidermoidne karcinome niskog i srednjeg stupnja malignosti. Ovi podaci potvrđuju da je kirurška metoda optimalan izbor liječenja bolesnika s mukoepidermoidnim karcinomom žlijezda slinovnica.The aim of this study was to determine the number of surgically treated patients with mucoepidermoid carcinoma of the salivary glands during a 25-year period, to analyze its distribution according to the patients’ gender, age and the localization of the tumor, and to evaluate the success of treatment. A retrospective analysis of medical records showed that from 1990 to 2014 at the Department of Maxillofacial Surgery, University Hospital Dubrava 65 patients with mucoepidermoid carcinoma of the salivary glands were treated surgically, men (52,3%) slightly more often than woman (47,7%). The patients’ average age was 46 years, with 10.8% of patients of childhood age. The most frequent localization of mucoepidermoid carcinoma was the parotid gland, with the palate being the most frequent localization of carcinoma of the minor salivary glands. Patients were most frequently treated by surgical excision or parotidectomy, and additional dissection of the cervical lymph nodes was performed on cases with advanced disease. The overall survival rate was 87,7%, which corresponds with statistical information obtained from literature concerning the survival rate for low- and intermediate-grade mucoepidermoid carcinoma. These findings confirm that surgical treatment is the optimal choice in treating patients with mucoepidermoid carcinoma of the salivary glands

Indistinctly Synchronous Lung and Base of the Tongue Adenocarcinoma: Case Report and Discussion of Possi- ble Patterns of Disease Development

Adenokarcinom pluća čini oko 40% svih karcinoma pluća i karakteriziraju ga različite stanične i molekularne značajke. Česte su udaljene metastaze iz primarnog karcinoma pluća, međutim metastaze u jeziku prilično su rijetke i neočekivane. Ako postoje dokazi o metastazama u jeziku, primarni tumor je najvjerojatnije širen, a prognoza loša. Takvi pacijenti zahtijevaju cjelovitu obradu kako bi se procijenio opseg bolesti, jer stadij tumora igra glavnu ulogu u određivanju izbora liječenja. U ovom slučaju želimo predstaviti neobičan slučaj istodobnog adenokarcinoma pluća i baze jezika i razgovarati o mogućim obrascima razvoja bolesti.Lung adenocarcinoma accounts for about 40% of all lung cancers and is characterized by distinct cellular and molecular features. Distant metastases from primary lung cancer are frequent, howev- er metastasis of the tongue is quite rare and unexpected. If there is existing evidence of metastasis in tongue, primary tumor is most probably generally disseminated and prognosis is poor. Such patients require a complete staging workup to evaluate the extent of disease, because tumor stage plays a major role in determining the choice of treatment. In this case report we want to present an unusual case of simultaneous lung and base of the tongue adenocarcinoma and discuss the possible patterns of disease development

Potencijal virtualnog prikaza u razumijevanju normalne i promijenjene građe kljova divljih svinja (Sus scrofa L.)

Results of non invasive virtual imaging of normal and altered wild boar tusks are presented. Pathologically altered tusk structure is presented for two pairs of mandibular canines that experienced different traumatic impacts and in one lower mandible with a complete loss of the right lower canine. Wild boar tusks represent a valuable material for dental pathologists due to their characteristic position and consequent predisposition to injury, their enormous reparative potential and the fact that they are collected and kept as trophies over extended periods of time. However, their value as trophy often limits the possibility of analysis of internal structural changes by destructive methods. In this situation, the use of non invasive methods can provide insights into the nature of pathological and reparation processes related to traumatic impacts on wild boar tusks.U radu je dan virtualan prikaz normalne i promijenjene građe kljova divljih svinja, kao neinvazivna metoda vizualizacije strukturalnih promjena. Normalna građa kljova predstavljena je kompjuterskom tomografijom donjih očnjaka, dok su patološki promijenjene kljove zastupljene sa dva para donjih očnjaka nakon ozljede te jednom donjom čeljusti sa potpunim gubitkom desnoga očnjaka. Kljove divljih svinja predstavljaju vrijedan materijal za proučavanje zubne patologije zahvaljujući karakterističnom položaju i posljedičnoj sklonosti ozljedama, izrazitom reparacijskom potencijalu te ponajviše dugotrajnom čuvanju u svojstvu trofeja. Međutim, njihova vrijednost kao trofej često umanjuje mogućnosti proučavanja. S druge pak strane virtualan prikaz zuba osigurava neinvazivnu vizualizaciju promjena u građi, razumijevanje patoloških i reparacijskih procesa, mjerenje dijelova zuba, kao i odvajanje i detaljan pregled pojedinih dijelova

Case of Unrecognised of Maxillary Adenoid Cystic Carcinoma

Adenoidni cistični karcinom rjeđe je dijagnosticirani tumor koji može zahvatiti velike i male žlijezde slinovnice. Prikazan je slučaj 70-godišnjeg bolesnika koji je upućen u Zavod za oralnu medicinu Stomatološkog fakulteta u Zagrebu zbog boli u desnoj strani gornje čeljusti. U ovom slučaju opisujemo kako jednostrana oštra bol u gornjoj čeljusti i oku može ukazivati na dijagnozu adenoidnog cističnog karcinoma, iako bolesnik nema u usnoj šupljini vidljivih promjena.Adenoid cystic carcinoma is a less commonly diagnosed cancer that may affect the major or minor salivary glands. We present a 70 year old male patient who was admitted to the Department of Oral Medicine, School of Dental Medicine in Zagreb, Croatia due to pain in the right maxilla. In this case we report a case of the patient with unilateral pain in the maxilla & eye which lead to the diagnosis of adenoid cystic cancer without any visible oral lesions

Human DLG1 and SCRIB are distinctly regulated independently of HPV-16 during the progression of oropharyngeal squamous cell carcinomas: a preliminary analysis

The major causative agents of head and neck squamous cell carcinomas (HNSCCs) are either environmental factors, such as tobacco and alcohol consumption, or infection with oncogenic human papillomaviruses (HPVs). An important aspect of HPV-induced oncogenesis is the targeting by the E6 oncoprotein of PDZ domain-containing substrates for proteasomal destruction. Tumor suppressors DLG1 and SCRIB are two of the principal PDZ domain-containing E6 targets. Both have been shown to play critical roles in the regulation of cell growth and polarity and in maintaining the structural integrity of the epithelia. We investigated how modifications in the cellular localization and protein expression of DLG1 and SCRIB in HPV16- positive and HPV-negative histologic oropharyngeal squamous cell carcinomas (OPSCC) might reflect disease progression. HPV presence was determined by p16 staining and HPV genotyping. Whilst DLG1 expression levels did not differ markedly between HPV-negative and HPV16-positive OPSCCs, it appeared to be relocated from cell–cell contacts to the cytoplasm in most samples, regardless of HPV16 positivity. This indicates that alterations in DLG1 distribution could contribute to malignant progression in OPSCCs. Interestingly, SCRIB was also relocated from cell–cell contacts to the cytoplasm in the tumor samples in comparison with normal tissue, regardless of HPV16 status, but in addition there was an obvious reduction in SCRIB expression in higher grade tumors. Strikingly, loss of SCRIB was even more pronounced in HPV16-positive OPSCCs. These alterations in SCRIB levels may contribute to transformation and loss of tissue architecture in the process of carcinogenesis and could potentially serve as markers in the development of OPSCCs

Some Morphological Characteristics of Wild Boar Tusks and Evaluation of Aging Methods

U radu je načinjena analiza ovisnosti 14 elemenata kljova vepra. Uzorak se sastojao od 26 parova sjekača i brusača (ukupno 52 sjekača i 52 brusača), iz državnog lovišta broj VII/4 “Garjevica” i VII/15 “Zapadna Garjevica”. Elementi ocjene kljova pokazival su statistički visoke pozitivne i značajne ovisnosti sa starošću grla dobivenoj po Brandtovoj i Biegerovoj me­todi, i negativne, puno niže i uglavnom nesignifikantne ovisnosti sa starošću procijenjenoj po metodi tetive. Navedeni rezultati upućuju na potrebu preispiti­vanja odnosa duljine tetive i visine luka sjekača ovisno o dobi vepra (validira­nje ove metode za pojedine populacije divljih svinja), ili bi visinu i duljinu luka sjekača kao kriterij procjene dobi veprova u potpunosti trebalo odbaciti. Para­metri određivanja dobi putem Biegerove i Brandtove metode pokazival sui puno višu ovisnost o dobi kod zakrivljenijih kljova nego kod izduženijih. Tije­kom povećanja dobi primijećuje se relativno kontinuiran rast ostalih eleme­nata izmjere trofeja. Pri tomu je ovisnost srednje duljine sjekača o dobi vepra puno viša od ovisnosti širine sjekača (R2=0,799; p<0,0001; respektivno R2=0,62; p<0,0001). Najveći prirast, izraženo u trofejnoj vrijednosti (CIC točke) ima srednja širina sjekača, dok najmanji prirast vrijednosti ima opseg brusača. Najveću ovisnost s trofejnom vrijednošću pokazuju širina (r=0,98; p<0,01) i duljina sjekača (r=0,98; p<0,01). Opseg brusača i ukupna zakrivlje­nost kljova (sjekača i brusača zajedno) pokazuju razmjerno visoku, ali daleko manju ovisnost (r=0,87; p<0,01; respektivno r=0,77; p<0,01). Općenito gle­dano, između svih elemenata izmjere trofeja nađene su relativno visoke i stati­stički značajne ovisnosti (p<0,01), koje su se kretale od r=0,62 (između opsega i zakrivljenosti kljova), do r=0,98 (između duljine i širine sjekača).In this paper 14 parameters of wild boar tusks were analyzed. The analyzed sample contained 26 pairs of lower and upper canines (52 lower and 52 upper canines in total), originating from state hunting grounds No. VII/4 “Garjevica” and VII/15 “Zapadna Garjevica”. Measured parameters showed statistically high positive and significant relations with age according to Brandt and Bieger methods of estimation, but lower and even negative, non-significant relations with age assessed by tendon method. Obtained re­sults indicate necessity of re-evaluation of tendon method of age estimation (validation for specific wild boar population), or even to drop this method from further use. The parameters used to estimate age by Bieger and Brandt methods showed higher correlation to age in more curved tusks. By increasing age a relatively continuous growth of other parameters was observed. Within that, correlation of average length of lower canine with age is much higher than the correlation of canine width and age (R2=0.799; p<0.0001; respecti­vely R2=0.62; p<0.0001). Highest increase, expressed in trophy value (CIC points) is in average width of lower canine, while lowest increase shows upper canine girth. The lower canine width (r=0.98; p<0.01) and length (r=0.98; p<0.01) showed highest correlation with trophy value. Upper canine girth and total tusk curves (of both upper and lower canines) expressed relatively high, but still much lower correlation (r=0.87; p<0.01; respectively r=0.77; p<0.01). In general, relatively high and statistically significant correlation between all trophy evaluation parameters were found (p<0.01), ranging from r=0.62 (between girth and tusk curves) to r=0.98 (between lower canine length and width)

Head and Neck Cancer Patients’ Survival According to HPV Status, miRNA Profiling, and Tumour Features—A Cohort Study

Head and neck cancers (HNC) are a heterogeneous group of tumours mainly associated with tobacco and alcohol use and human papillomavirus (HPV). Over 90% of all HNC are squamous cell carcinomas (HNSCC). Sample material from patients diagnosed with primary HNSCC (n = 76) treated with surgery as primary treatment at a single centre were assessed for HPV genotype, miR-9-5p, miR-21-3p, miR-29a-3p and miR-100-5p expression levels. Clinical and pathological data were collected from medical records. Patients were enrolled between 2015 and 2019 and followed-up until November 2022. Overall survival, disease-specific survival and disease-free survival were assessed and correlated with clinical, pathological, and molecular data. Kaplan-Meier and Cox proportional hazard regression was used to assess different risk factors. In the study, male gender, HPV-negative HNSCC (76.3%) mostly located in the oral region (78.9%) predominated. Most patients had stage IV cancer (47.4%), and the overall survival rate was 50%. HPV was found not to affect survival, indicating that in this population, classic risk factors predominate. The presence of both perineural and angioinvasion was strongly associated with survival in all analyses. Of all miRNAs assessed, only upregulation of miR-21 was consistently shown to be an independent predictor of poor prognosis and may thus serve as a prognostic biomarker in HNSCC

Surgical treatment of mucoepidermoid carcinoma of the salivary glands

Cilj ovog rada je bio utvrditi broj kirurški liječenih bolesnika s mukoepidermoidnim karcinomom žlijezda slinovnica u razdoblju od 25 godina, odrediti njihovu raspodjelu prema spolu, dobi bolesnika i lokalizaciji, te procijeniti uspješnost terapije. Retrospektivnom analizom podataka utvrđeno je da je u Klinici za kirurgiju lica, čeljusti i usta KB Dubrava u razdoblju od 1990. do 2014. godine primarno kirurški liječeno 65 bolesnika s mukoepidermoidnim karcinomom žlijezda slinovnica, koji je bio nešto učestaliji kod muškaraca (52,3%) nego kod žena (47,7%). Srednja dob bolesnika je bila 46 godina, a 10,8% bolesnika bilo je dječje dobi. Najčešća lokalizacija mukoepidermoidnog karcinoma bila je u parotidnoj žlijezdi (56,9%), a od malih žlijezda slinovnica najčešće su bile zahvaćene one na nepcu. Bolesnici su najčešće bili liječeni isključivo kirurškom ekscizijom odnosno parotidektomijom, a kod uznapredovale bolesti i dodatnom disekcijom regionalnih limfnih čvorova na vratu. Ukupno preživljenje je bilo 87,7%, što odgovara statističkim podacima iz recentne literature o preživljenju za mukoepidermoidne karcinome niskog i srednjeg stupnja malignosti. Ovi podaci potvrđuju da je kirurška metoda optimalan izbor liječenja bolesnika s mukoepidermoidnim karcinomom žlijezda slinovnica.The aim of this study was to determine the number of surgically treated patients with mucoepidermoid carcinoma of the salivary glands during a 25-year period, to analyze its distribution according to the patients’ gender, age and the localization of the tumor, and to evaluate the success of treatment. A retrospective analysis of medical records showed that from 1990 to 2014 at the Department of Maxillofacial Surgery, University Hospital Dubrava 65 patients with mucoepidermoid carcinoma of the salivary glands were treated surgically, men (52,3%) slightly more often than woman (47,7%). The patients’ average age was 46 years, with 10.8% of patients of childhood age. The most frequent localization of mucoepidermoid carcinoma was the parotid gland, with the palate being the most frequent localization of carcinoma of the minor salivary glands. Patients were most frequently treated by surgical excision or parotidectomy, and additional dissection of the cervical lymph nodes was performed on cases with advanced disease. The overall survival rate was 87,7%, which corresponds with statistical information obtained from literature concerning the survival rate for low- and intermediate-grade mucoepidermoid carcinoma. These findings confirm that surgical treatment is the optimal choice in treating patients with mucoepidermoid carcinoma of the salivary glands