Merkel cell carcinoma of the auricle

Merkel cell carcinoma is a rare malignant tumor of the skin. The face and extremities are the most common locations. We present a case of Merkel cell carcinoma of the auricle in a 93-year-old man subsequently treated with surgery and radiotherapy. The clinical features, prognosis, and treatment of the Merkel cell carcinoma are discussed.     

Synchronous bilateral epithelial–myoepithelial carcinoma of the parotid gland: case report and review of the literature

Synchronous bilateral malignancy in the parotid glands is extremely rare. The English literature reveals nine case reports. The most common synchronous bilateral malignancies are acinic cell carcinoma. Epithelial–myoepithelial carcinoma is an uncommon neoplasm comprising 1% of all salivary gland tumours. In this case report, we describe, to our best of knowledge, the first case of a patient with a synchronous bilateral epithelial–myoepithelial carcinoma of the parotid gland. The clinical histopathological and immunohistochemical peculiarities are elucidated. Imaging studies like ultrasonography are mandatory for both parotid glands and upper necks in the clinical presence of a unilateral parotid gland tumour.     

Concurrent nonfunctioning parathyroid carcinoma and parathyroid adenoma

Parathyroid carcinoma is a rare etiology of primary hyperparathyroidism characterized by severe clinical symptoms of hypercalcemia and markedly elevated serum parathormone levels. Nonfunctioning parathyroid carcinoma is an inactive form of the disease. There are less than 30 reports of nonfunctioning parathyroid carcinoma in the English literature and the association with parathyroid adenoma has not been described. This report describes a patient with concurrent nonfunctioning parathyroid carcinoma and a functioning parathyroid adenoma.     

鼻咽部肌上皮癌1例报告并文献复习

目的 探讨鼻咽部肌上皮癌的临床特征和治疗方法。方法 回顾性分析1例鼻咽肌上皮癌患者病历资料,结合复习相关文献,讨论肌上皮癌的临床特征和治疗方法。结果 肌上皮癌为是好发于涎腺的上皮源性恶性肿瘤,极其罕见,来源于鼻咽部者更罕见,治疗以手术为主,辅以放化疗治疗。结论 早期手术效果较好,必要时可联合放化疗治疗。     

妊娠期鼻咽恶性肿瘤临床分析

目的 总结妊娠期合并鼻咽恶性肿瘤患者的临床资料,探讨妊娠期合并鼻咽恶性肿瘤的临床特点,以达到早期诊断、早期治疗的目的。方法 以2007年9月至2012年7月收治的妊娠期合并鼻咽恶性肿瘤5例作为研究对象。其中鼻咽鳞状细胞癌4例,鼻咽恶性肌上皮瘤1例。回顾分析患者的临床表现、诊断结果及治疗情况,并对患者及其子代进行随访。结果 5例患者均为单胎妊娠,3例(60.00%)在妊娠过程中活检确诊后终止妊娠行引产术,2例(40.00%)为妊娠中发病,分别于产后1周和产后1个月活检确诊。新生儿健康存活。鼻咽鳞状细胞癌患者均采用同期放化疗,鼻咽恶性肌上皮瘤患者采用经鼻内镜及软腭联合径路手术治疗,术后1周辅助放疗。结论 妊娠期合并鼻咽恶性肿瘤较为少见,合并鼻咽恶性肌上皮瘤更为罕见。妊娠期由于检查及用药的局限性,容易出现漏诊及误诊。治疗应根据肿瘤性质、分期、患者意愿等因素综合考虑,并对患者及子代做长期随访。     

雄激素受体和雌激素受体在喉癌中的表达

目的：探讨雄激素受体（AR）和雌激素受体（ER）在喉癌发生、发展中的作用。方法：应用原位杂交法对63例喉癌组织、20例癌旁正常组织和20例喉良性病变组织进行AR和ER的测定。结果：AR和ER在癌旁正常组织和喉良性病变组织中的表达均为阴性;在喉癌组织中AR的阳性表达率为68．3％,ER为69．8％,AR和、ER在喉癌组织中的表达与患者性别、临床分型无关（均P〉0．05）。AR的表达率随喉癌的病理分级和临床分期的升高而增高,ER则相反（P〈O．01或P〈O．05）。有淋巴结转移者AR表达增强,ER表达降低,分别与无淋巴结转移者比较,差异均有统计学意义（P〈0．05或P〈0．01）。结论：性激素受体的表达与喉癌的发病有关,AR和ER可作为了解肿瘤的恶性程度和预后的标志;但AR及ER的表达与患者性别无关,因此,尚不能用AR及ER的表达来解释喉癌发病率在性别上的差异,说明男女喉癌在发病率上的明显差异可能还有其他因素参与。     

Laryngeal blastomycosis: a commonly missed diagnosis. Report of two cases and review of the literature

Blastomycosis is a relatively uncommon fungal disease that most commonly affects the lungs. Other organs may be involved, usually secondary to dissemination of the organism. Laryngeal blastomycosis may occur in isolation from active pulmonary disease. The signs, symptoms, clinical features, and pathological findings of laryngeal blastomycosis mimic those of squamous cell carcinoma. Misdiagnosis may result in inappropriate treatment with potential morbidity. Proper understanding of the clinical presentation and familiarity with the histopathologic features of this disease are therefore imperative. In this paper, we report 2 cases of laryngeal blastomycosis, 1 of which was misdiagnosed as squamous cell carcinoma, clinically and microscopically, with consequent radiotherapy and laryngectomy. In the other case, a clinical diagnosis of glottic squamous cell carcinoma was rendered. However, blastomycosis was identified in a biopsy specimen. We also review cases of isolated laryngeal blastomycosis that have been reported in the English-language literature during the last 80 years. A number of those cases were misdiagnosed clinically and microscopically as squamous cell carcinoma.     

Spindle cell carcinoma of the larynx with a verrucous carcinoma component: combined carcinoma of larynx

Squamous cell carcinoma (SCC) is the most common neoplasm of the larynx. There are three variants of SCC. Each variant presents distinctive biologic behaviors and clinical courses. Therefore reaching the exact diagnosis and distinguishing the variants is fateful. We describe a case of spindle cell carcinoma of the larynx with a verrucous carcinoma component. To our knowledge, this entity has never been documented before.     

鳞状细胞癌抗原在鼻腔鼻窦鳞癌患者血清中的表达及临床意义

目的 探讨鼻腔鼻窦鳞癌患者血清中鳞状细胞癌抗原(SCC Ag)的表达及其临床意义。方法 对35例鼻腔鼻窦鳞癌、20例鼻内翻性乳头状瘤和30例鼻息肉患者采用微粒子酶免疫法检测血清SCC值,结合临床资料分析该抗原改变的临床意义。结果 鼻腔鼻窦鳞癌、鼻内翻性乳头状瘤、鼻息肉患者SCC阳性率分别为54.29%、35.0%和6.67%,差异有统计学意义(P<0.05); 鼻腔鼻窦鳞癌患者的病理分级及临床分期均与SCC有相关关系(P<0.05)。结论 检测鼻腔鼻窦鳞癌患者血清SCC表达水平对判断病情、临床分期等有一定的临床意义。     

Paraneoplastic syndromes in patients with laryngeal neuroendocrine carcinomas: clinical manifestations and prognostic significance

Paraneoplastic syndromes are associated with a variety of malignant neoplasms and are systemic and non-metastatic manifestations that develop in a minority of cancer patients. This review examines all published cases of paraneoplastic syndromes associated with neuroendocrine carcinomas of the larynx. There are a total of ten patients reported with paraneoplastic syndromes associated with laryngeal neuroendocrine carcinomas in the literature. Of these, nine died and the tenth is alive with liver metastases. There were five cases of small-cell neuroendocrine carcinoma, four cases of moderately differentiated neuroendocrine carcinoma, and one case of well-differentiated neuroendocrine carcinoma associated with paraneoplastic syndromes. As these syndromes have significant clinical relevance, physicians should be aware of the possible presence of paraneoplastic syndromes in the diagnostic process of patients with neuroendocrine carcinoma of the larynx.     

喉癌术后复发及颈部转移临床治疗的远期疗效观察

目的：探讨治疗喉癌术后复发及颈部转移的有效方法。方法：回顾性分析我院1990年4月～1998年4月收治的喉癌术后复发及颈部转移患者70例，其中局部复发癌3i例，气管造口复发癌15例，颈淋巴结转移24例。结果：31例局部复发癌中，19例二次手术者术后15例生存，4例死亡；未行手术治疗的12例分别在1～3年内死亡。15例气管造口复发癌中，9例二次手术者术后5例生存，4例死亡；未行手术治疗的6例均在18个月内死亡。24例颈淋巴结转移者中，15例二次手术者术后8例生存，7例死亡；9例未行Ⅱ期手术者2年内死亡。结论：喉癌术后定期复查及系统的临床随访，有利于喉癌术后复发及颈部转移的早期发现和早期治疗；二次手术是喉癌术后复发及颈部转移临床治疗的重要措施；放射治疗或化学治疗作为综合治疗手段有一定疗效，但其疗效有限。     

Metastasis of renal cell carcinoma to the thyroid gland 19 years after nephrectomy: a case report

Although metastases to the thyroid are never uncommon at autopsy in patients who died of malignancy, metastatic thyroid carcinomas are rarely detected in clinical practice in most cases and cases of secondary thyroid cancer which require thyroid surgery clinically are few. A clinical case of thyroid metastasis from renal cell carcinoma with thyroidectomy is described herein. An 87-year-old Japanese woman was referred to us for a slow-growing palpable neck tumor with dysphagia. She had undergone a nephrectomy for renal clear cell carcinoma 19 years earlier at another hospital. Preoperative imaging examinations suspected an adenomatous goiter and a fine needle aspiration (FNA) cytology was suggestive of an atypical follicular tumor. Hemithyroidectomy was performed as a follicular tumor of thyroid for restriction of subjective symptom. A pathological examination of the thyroid tumor revealed clear cell carcinoma, postoperatively. The negative result of immunohistochemical staining for thyroglobulin also suggested metastatic renal cell carcinoma to the thyroid. Clinically significant metastases to the thyroid gland are relatively infrequent. However, if patient who bears a thyroid tumor has a history of malignancy, the possibility of metastatic disease should be taken under consideration.     

Primary subglottic carcinoma masquerading clinically as T1 glottic carcinoma--a report of nine cases

In a clinical and pathological study of patients who had failed radiotherapy for T1 glottic carcinoma, nine patients were encountered who presented with hoarseness, and were considered clinically to have glottic carcinoma at an early stage. Whole organ sections of the laryngectomy specimens showed them to be tumors arising in the subglottic region with involvement of the vocal cord as a late manifestation of their disease. The clinical and pathological features of these nine patients and their tumors are discussed with emphasis on how the diagnosis may be made prior to embarking upon therapy.     

Population-based outcomes for pediatric thyroid carcinoma

OBJECTIVES/HYPOTHESIS: The objective was to determine clinical features and clinical outcomes for pediatric thyroid carcinoma. STUDY DESIGN: Cross-sectional analysis of national cancer database. METHODS: The Surveillance, Epidemiology, and End Results database (1988-2000) was surveyed, extracting all cases of pediatric thyroid carcinoma. Clinical features including age, gender, tumor type, tumor size, nodal disease, treatment modality, and survival variables were retrieved. Kaplan-Meier survival analysis was conducted to determine actuarial survival according to histological type. Cox regression analysis was conducted to determine prognostic factors affecting survival in pediatric carcinoma. RESULTS: In all, 566 cases of thyroid carcinoma were extracted for the time period. Mean patient age at presentation was 16.0 years, with a female predominance (84.8%). There were 378 cases of papillary carcinoma, 137 cases of follicular variant of papillary carcinoma, and 51 cases of follicular carcinoma. The average tumor size was 2.6 cm, and 37.1% of patients presented with positive nodal disease. Overall survival was excellent with mean survivals greater than 145 months for each histological type. Follicular carcinoma exhibited a slightly poorer survival that was statistically significant (P = .017) CONCLUSION: Pediatric thyroid carcinoma primarily affects girls. Clinical features of tumor presentation are similar to those of adults with thyroid carcinoma. However, overall survival for pediatric thyroid carcinoma is excellent, with few patients dying of disease.     

Parathyroid carcinoma: two new cases--diagnosis, therapy, and treatment

Carcinoma of the parathyroid gland is a disease only rarely encountered in clinical practice. As most of these tumors retain the ability to manufacture active parathyroid hormone, most patients with the disease present with hypercalcemia, many times symptomatic. Since the tumor accounts for only 0.5% to 4.0% of cases of primary hyperparathyroidism, the diagnosis of parathyroid carcinoma may be unsuspected and delayed. The clinical index of suspicion should be elevated if there is a palpable neck mass, an exceptionally high serum calcium level, and/or recurrence of hypercalcemia following surgery. We review two patients with parathyroid carcinoma who presented with hypercalcemia. In both, the diagnosis of malignancy was made only after microscopic examination of the operative specimen. Surgery consisted of wide local excision in both cases; radiation therapy was administered in one. Postoperative disease-free status is now 23 and 37 months. One of the patients had a history of radiation therapy to the larynx 20 years prior to the development of parathyroid carcinoma. Also reviewed in this paper are the clinical and histopathologic criteria for making the diagnosis of parathyroid carcinoma and the therapeutic approaches and prognosis of this unusual tumor.     

Insular carcinoma of the thyroid

Thyroid surgeons are becoming increasingly more aware of a histologically distinct subset of thyroid carcinoma whose classification falls between well-differentiated and anaplastic carcinomas with respect to both cell differentiation and clinical behavior. This subtype of tumors has been categorized as poorly differentiated or insular carcinoma, based on its characteristic cell groupings. Although the differentiation of insular carcinoma from other thyroid carcinomas has important prognostic and therapeutic significance, relatively little about insular carcinoma has been published in the otolaryngology literature. In this article, we describe a new case of insular carcinoma and we discuss the findings of our review of the literature. We conclude that insular thyroid carcinoma warrants aggressive management with total thyroidectomy followed by radioactive iodine ablation of any remaining thyroid tissue.     

Thyroid cancer in patients 70 years of age or older. Retrospective study of 50 patients

This report presents our experience with 50 thyroid cancer patients 70 years of age or older, out of 606 patients of all ages. Comparing this series to those describing thyroid cancer patients of all ages, we found that thyroid carcinoma in the 70+ age group presents at a more advanced clinical stage, behaves more aggressively, and has a higher death rate. These findings are attributed mainly to the higher incidence of undifferentiated carcinoma and the more aggressive course of the differentiated types of carcinoma in the older age group. If suspected thyroid nodules are managed by initial radical treatment, carcinoma can be diagnosed earlier and patients will survive longer.     

Non-surgical therapy of basal cell carcinoma of the head-neck region

Basal cell carcinoma is a semi-malignant epithelial skin tumour with a locally destructive growth pattern but a very low tendency to metastases. Basal cell carcinoma represent the most frequent malignant cutaneous tumour worldwide in white population with a lifetime risk of 30 % and still increasing incidence. Lifetime cumulative UV-exposure, as well as frequent sunburns are the most common exogeneous risk factors, others are ionising radiation, exposure to chemical carcinogens, genetic predisposition, and chronic immunosuppression. Basal cell carcinoma are predominantly located in the central region of the face. The characteristic clinical feature is a single nodule with multiple teleangiectasia, as well as an irregular shaped ulceration with and elevated border. The very rarely observed occurrence of metastases seems to be a result of insufficient therapy or a metatypic basal cell carcinoma type. Therapy of first choice of basal cell carcinoma is the complete, micrographically controlled excision. In addition, radiotherapy, topical immunotherapy with Imiquimod or photodynamic therapy may be considered as therapeutic alternatives in selected cases.     

Verrucous carcinoma of the maxillary antrum

Verrucous carcinoma is a well-differentiated variant of squumous cell carcinoma. In this article, we present a patient of verrucous carcinoma of the maxillary annum. There are only 6 reported cases of verrucous carcinoma of the maxillary antrum. Ours is the 7th case. We, here, would like to highlight that our case had a different clinical presentation from the previously reported cases.