Head and neck cancer

In this review, the authors outline the epidemiology, genetic factors, treatment and outcomes of head and neck cancer.     

Head and neck dermoids

The clinical picture, associated anomalies and distribution in 95 cases of head and neck dermoids is described. Orbital and ocular dermoids formed the commonest site of head and neck dermoids. Mandibulofacial and external ear anomalies were frequently associated with dermoids due to failure of embryonic blood supply. Injection of radiopaque material into the dermoid can help in locating its pouches, and sinuses which can be responsible for the recurrences after their excision.     

Head and neck cancer

Tumors of the head and neck comprise an important neoplasia group, the incidence of which is increasing in many parts of the world. Recent advances in diagnostic and therapeutic techniques for these lesions have yielded novel molecular targets, uncovered signal pathway dominance, and advanced early cancer detection. Proteomics is a powerful tool for investigating the distribution of proteins and small molecules within biological systems through the analysis of different types of samples. The proteomic profiles of different types of cancer have been studied, and this has provided remarkable advances in cancer understanding. This review covers recent advances for head and neck cancer; it encompasses the risk factors, pathogenesis, proteomic tools that can help in understanding cancer, and new proteomic findings in this type of cancer. Cancer 2010. © 2010 American Cancer Society.     

Head and neck melanoma.

BACKGROUND: Melanoma of the head and neck and its treatment are complex issues. The behavior of head and neck melanoma is aggressive, and it has an overall poorer prognosis than that of other skin sites. METHODS: The authors review current data on the treatment of head and neck melanoma, including both cutaneous and mucosal melanoma. RESULTS: Current understanding of the behavior of head and neck melanoma is reviewed and treatment stratagems are presented. Controversies in treatment include lymphoscintigraphy with sentinel node biopsy, nodal dissection, margin size, role of radiation therapy, and reconstruction. The management goal is to treat melanoma aggressively while minimizing the effects of treatment on patient quality of life. CONCLUSIONS: Due to its aggressiveness, head and neck melanoma should be treated aggressively when morbidity is not significantly increased. Patient specific treatment is imperative.     

Head and neck squamous cancers

Head and neck squamous cancers are a heterogeneous group of neoplasms with varying etiologic factors, presenting symptoms, staging, treatment, and expected outcome. In this monograph, we discuss principles of management common to all sites as well as individual differences. The presenting symptoms of disease are reviewed, stressing the importance of early diagnosis. Accurate pathologic diagnosis can be improved on in difficult cases by newer immunohistochemical techniques. Following diagnosis, accurate clinical staging must be performed, and the evaluation of an unknown primary in the neck is described. We review general considerations for planning the treatment of head and neck cancer, and then discuss specific guidelines for individual sites, stressing the optimal integration of surgery and radiation therapy, particularly brachytherapy. Controversial management issues and new, innovative approaches are discussed. The conventional use of chemotherapy in head and neck cancer is for palliation of recurrent disease. In recent years, chemotherapy has been added to the primary treatment program in an induction role, as a radiosensitizer, as an adjunct following standard therapy, and for organ preservation. The current status of these roles is reviewed. This is a cancer for which there are known etiologic agents. Future efforts in this disease should be directed toward early detection and prevention.     

Head and neck synovial sarcomas

Eleven cases of synovial sarcoma of the head and neck are analyzed. Patients presented with a mass either in the parapharynx, pharyngeal wall, or nape of the neck. The tumors ranged in size from 3 to 8 cm. Microscopically, the classic biphasic pattern was seen in 10 tumors. Immunohistochemistry and electron microscopy were useful in the diagnosis of the single monophasic variant of synovial sarcoma. Radical surgery was the mainstay of treatment with post-operative radiotherapy for residual disease. Five patients were dead of disease while 6 were alive for periods varying from 9 months to 15 years. The purpose of this presentation is to accrue data on this sarcoma at a rare site, and to highlight the histopathological differential diagnosis, which includes both carcinomas and sarcomas. Treatment decisions would be affected by the histology report. © 1993 Wiley-Liss, Inc.     

Head and neck cancer surgery.

This review presents several areas of current interest in head and neck oncology including endoscopic and conservation management of early laryngeal cancer, intraoperative radiotherapy, and microvascular reconstruction techniques. Endoscopic treatment of early laryngeal cancer using the CO2 laser has been shown to be effective in several recent studies, and improved laryngeal reconstruction techniques following conservation laryngeal surgery have resulted in improved functional results. Intraoperative radiotherapy for head and neck carcinoma has received more attention recently, with encouraging results for the treatment of advanced and recurrent skull base and head and neck tumors. New techniques of free flap reconstruction following surgery for head and neck cancer continue to result in improved rehabilitation.