Endodermal sinus tumors in the head and neck region

Extragonadal germ cell tumors of the head and neck region account for only 5% of all benign and malignant germ cell tumors. Endodermal sinus tumors (EST) of the head and neck region are rare. We report three patients with EST of head and neck region over a period of 10 years; the primary sites of tumor were orbit, maxillofacial region and retroauricular region. Histopathological examination revealed malignant teratoma with predominant endodermal sinus pattern in two, and pure EST in one patient. Serum alpha fetoprotein (AFP) was elevated in all three patients. Two patients had initial surgery but did not receive adjuvant chemotherapy, as the parents refused it. Partial remission was achieved in the other patient who received chemotherapy (cisplatin, bleomycin and vinblastin) and the patient died of infection after four courses of chemotherapy. Med. Pediatr. Oncol. 29:303–307, 1997. © 1997 Wiley-Liss, Inc.     

Congenital ichthyosis and endodermal sinus tumor of the ovary in a ten-year-old child

Acquired ichthyosis is very likely to be associated with a malignancy, especially with Hodgkins disease. The association of congenital ichthyosis with malignant tumors has been so far reported only in two instances. Herein we report on a third case. Due to the small number of cases, no conclusion can be drawn about the correlations between the two diseases.     

Pyriform sinus fistula appearing as a neck tumor in the neonatal period: a case report

: Pyriform sinus cyst and fistula is a relatively rare tumor of the neck, even less is the neonatal period. We experienced a case of this one, and preoperative diagnosis was made by using endoscopy and cine-esophagography. A dyeing method that confirmed the fistula tract of cyst lead us to successful resection. Accepted: 1 October 1998     

Phase II evaluation of galactitol in head and neck cancer: A southwest oncology group study

A phase II evaluation of DAG in head and neck cancer patients produced one partial response and one patient with prolonged stable disease from nine fully evaluable patients with squamous carcinomas. One partial response was produced in a patient with anaplastic thyroid carcinoma. No drug deaths or life-threatening toxicity were reported. Further evaluation of DAG in thyroid tumors is warranted.     

Thirty-six-hour preoperative high-dose methotrexate infusion in patients with squamous carcinoma of the head and neck

Twenty 36-hour infusions of high-dose methotrexate were given preoperatively to 10 patients with head and neck cancer. Plasma methotrexate levels of greater than 1 × 10^?5 M were maintained for 36 hours and declined with primary and secondary plasma half-lives of 1.7 and 9.2 hours following the end of the infusion. Toxicity of this infusion regimen was minimal (10% incidence of significant (WBC <2000/mm³) myelosuppression; no renal toxicity) and all patients underwent surgical resection within 3 weeks of therapy without obvious increase in operative complications. Four of ten patients responded to chemotherapy. Further comparison of the therapeutic efficacy of this prolonged preoperative infusion regimen with surgery alone or schedules employing conventional doses or 6-hour infusions of high-dose methotrexate appears warranted.     

小儿性腺外内胚窦瘤3例诊断与治疗分析

目的总结小儿原发性腺外内胚窦瘤的诊断与治疗经验。方法回顾性分析我院2003年10月-2011年9月收治的3例性腺外内胚窦瘤患儿的病历资料。结果术前均行PEB或JEB方案新辅助化疗,根治性手术切除,术后病理均为完全缓解,术后继续化疗。随访3个月～8年,2例无病存活,1例原位复发,经术前化疗、再次手术切除及术后化疗后,现随访25个月,无病存活。结论甲胎蛋白水平对小儿性腺外内胚窦瘤诊断及术后复发监测灵敏度较高,化疗与手术结合治疗效果良好。     

Delayed resection in the management of non-orbital rhabdomyosarcoma of the head and neck in childhood

This retrospective study was undertaken to evaluate the effect of delayed resection on outcome of head and neck rms in a single institution which has experience in cranial base surgery. Since 1988, patients with primary non-orbital rms of the head and neck following treatment at the Children's Hospital of Pittsburgh, were evaluated by the Department of Otolaryngology, Eye and Ear Hospital at the University of Pittsburgh Medical Center either at the time of presentation or when response to chemotherapy and/or radiation therapy was thought to have been optimized for the possibility of definitive surgery. Medical records of patients who did or did not have delayed surgery were reviewed and compared with respect to demographics, tumor stage, response to therapy, survival, and cosmetic results. Of 16 children diagnosed with non-orbital head and neck rms from 1988–1994 and treated with chemotherapy according to IRS II–IV, 3 had group I or II disease following extensive surgery at diagnosis. Thirteen had group III or IV disease. Of these, 6 patients had delayed resection and 7 did not. Delayed resection was undertaken 3–12 months (median, 4 months) from diagnosis in 4 children who had a partial response (PR) and 2 children who had stable disease (SD) with chemotherapy and/or radiation. Delayed resection converted all children to complete responses (CR), including one child with clinical SD and one with PR who were found to have no viable tumor at surgery. The overall percentages of CRs for patients with group II or IV disease (documented any time post-diagnosis) were at least as good for patients who had undergone delayed surgery as for those who had not (100% vs. 71%, p = .465). Median survivals for patients with advanced disease were 3 ½ years and 2 years, respectively (p = .2801). Cosmetic and functional problems attributable to surgery were not severe but included facial asymmetry (n = 4), trismus (n = 1), cranial nerve deficits (n = 1), and abnormal dentition (n = 1). In locally extensive head and neck rms, cranial base surgery should be considered after initial cytoreductive therapy, since it may contribute to achievement of CR and to survival with acceptable morbidity. Med. Pediatr. Oncol. 28:294–298. © 1997 Wiley-Liss, Inc.     

Sentinel lymph node biopsy in head and neck rhabdomyosarcoma

Head and neck rhabdomyosarcoma lymph node staging is challenging due to varied patterns of lymphatic drainage and the suboptimal predictive value of available imaging modalities. Furthermore, regional relapse rates are unacceptably high, and the toxicity of empiric radiation is undesirable in the pediatric and young adult population. In an attempt to improve locoregional control without excess morbidity, we have adopted routine sentinel lymph node biopsy in head and neck rhabdomyosarcoma, which is safe and feasible in pediatric patients. Of six procedures reported here, pathologic findings led to intensification of regional and/or systemic therapy in two patients.     

Methotrexate content in squamous cell carcinoma of the head and neck after low-dose methotrexate

Eleven patients with squamous carcinoma of the head and neck who were scheduled for surgical resection or endoscopic biopsy of tumor received 15 mg/m² of methotrexate (MTX). Samples of tumor, normal mucosa, and plasma were obtained at surgery or endoscopy, 18-24 hours after the last MTX dose. Tissue content and plasma concentration of MTX and folate were measured using sequential radioligand-binding assays. Median MTX content was 50.0 pmol/g wet weight in tumor, 19.0 in normal mucosa, and <0.5 nM (pmol/ml) in plasma. Since dihydrofolate reductase (DHFR) content of human tumors has previously been shown to be less than 5 pmol enzyme/g wet weight, tumor MTX content exceeded expected DHFR content in all but one patient. These data support the concept that low doses of MTX saturate tumor DHFR and that, in this regard, dose escalation may have limited value. © 1994 Wiley-Liss, Inc.     

Chemotherapy of head and neck cancer: Combination treatment with cyclophosphamide,adriamycin, methotrexate,and bleomycin

A combination of cyclophosphamide, adriamycin, methotrexate, and bleomycin (CAMB) was explored in patients with advanced, nonresectable epidermoid carcinoma from primary sites in the head and neck, recurrent or persistent after radiation or surgery. Objective regression (greater than 50%) of measurable tumor was present in 35% of the patients. The median duration of response was 2.5 months. Median survival of responders was slightly less than the nonresponders, but the difference was not significant. Drug-related morbidity was substantial; leukopenia, mucositis, and weight loss were the most frequent major side effects. Three deaths were attributable to the regimen. The results seem comparable to those one might expect from methotrexate alone.