Establishment of carcinoma cell lines from larynx and submandibular gland

For many techniques in the oncology of head and neck tumors large amounts of pure tumor cells are required. Although larynx and salivary gland tumors are common in man, no report exists on isolation and purification of tumor cells of which malignancy was proved. The present paper describes in vitro cultivation of living human malignant tumor cells from a larynx and a submandibular gland carcinoma. Carcinoma cells were freed from all non-tumor cells and cloned thus indicating that cultures contained only a single cell type. Transplantation of grown cells s.c. into athymic (nu/nu) mice induced rapidly growing tumors of which malignancy was demonstrated by histology.     

咽喉部鳞状细胞癌细胞系

咽喉部鳞状细胞癌是头颈外科常见恶性肿瘤,头颈部解剖结构复杂,原发部位不同的鳞状细胞癌发病率、诊疗方案不同,其发生的分子机制也可能存在差异。因此,选择适合的咽喉部鳞状细胞癌细胞系对于研究者选择适合的临床前研究模型,以及更好地理解肿瘤发生发展机制具有重要意义。总结了鼻咽、口咽、喉咽、喉四个解剖部位的鳞状细胞癌细胞系,以望对研究者选择适当的细胞系作为研究对象提供参考。     

Verrucous carcinoma of the larynx

Summary Verrucous carcinoma of the larynx in a middle-aged male patient is reported. The related diagnostic problems are described in detail and clinical and morphological differentiating features from other variants of squamous cell carcinoma are outlined on the basis of literary data and our own experience.     

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.     

Metastasis of adenoid cystic carcinoma from a submandibular gland to the larynx

The present article discusses the first reported case of adenoid cystic carcinoma (ACC) metastasis from a submandibular gland to the larynx. Both treatments of distant metastasis of ACC and secondary laryngeal tumor are challenging. Despite its slow progression, ACC is associated with high rates of local recurrence, distant metastasis, and poor prognosis. Patients with secondary laryngeal cancer often have other concurrent metastatic lesions. Therefore, treatment selection should consider the biological behavior of the tumor and characteristics of the laryngeal lesion, along with the general condition and quality of life of the patient. The patient (55-year-old female) had a history of ACC of the right submandibular gland, removed surgically 9 years prior to the present consultation. Follow-up showed multiple pulmonary metastases. The patient complained of dysphonia lasting 3 months. Following the diagnosis of ACC metastasis to the larynx (supraglottic) and a neck lymph node via biopsy, we performed partial laryngectomy, left neck dissection, and tracheotomy. Histopathological examination showed an increase in the tumor grade over time. Two months after discharge, there was no obvious local recurrence or increase in lung metastasis.     

Small cell carcinoma of the larynx: imaging findings

Small cell carcinoma of the larynx is an uncommon epithelial tumor, which is the most aggressive subtype of neuroendocrine carcinomas. Because of its nonspecific clinical and radiological manifestations, the diagnosis of small cell carcinoma of the larynx is essentially based on the light microscopic examination aided by electron microscopy or immunohistochemical staining. We report a case of supraglottic small cell carcinoma accompanied by large bilateral cervical lymph node metastasis ocurring in a 70-year-old man. On CT scans, no area of low attenuation indicating necrosis was demonstrated within such large metastatic lymph nodes. We suggest that small cell carcinoma of the larynx should be included in the diagnostic considerations when a laryngeal mass is accompanied by large cervical lymph nodes without necrosis shown by CT.     

Basaloid squamous cell carcinoma of the larynx

Basaloid squamous cell carcinoma is a variant of squamous cell carcinoma that was first described in 1986. In the English-language literature, only 26 cases of this infrequent histopathological entity have been reported in the larynx. Tumors have an aggressive biological behavior, justifying combined surgical treatment with radiotherapy. Two new cases are presented and the literature reviewed.     

Verrucous squamous cell carcinoma of the larynx: diagnostic and therapeutic considerations

The clinical findings, histopathology, management and outcome of 31 patients with verrucous squamous cell carcinoma of the larynx (VSCC) are discussed. Laryngeal VSCC is a rare, highly differentiated variant of SCC and has specific morphological features and clinical behavior. A close liaison between the laryngologist and pathologist is needed to formulate a correct diagnosis, because this tumor appears to be malignant clinically and histologically benign. A low-power magnification of multiple large specimens, including the deep margins of the lesion, is required in order to differentiate VSCC from keratosis, verruca vulgaris or SCC with verrucous appearance, and to detect underlying microscopic foci of invasive SCC within or adjacent to a verrucous carcinoma. Long-lasting hoarseness was the most common symptom as the glottic region was the most common site of VSCC. Presumed clinically positive N1 lymph nodes were observed in the necks of 7 patients, but none had metastatic disease on histopathological study. Surgery alone was the most effective form of treatment, as it allowed a good outcome of all treated patients. Surgery plus radiotherapy was associated with an early recurrence and a poor outcome in 2 of 7 patients treated. The generally benign behavior of VSCC allows for conservative surgery, with complete endoscopic resection using the carbon dioxide laser representing a more conservative surgical approach. Neck dissection is not indicated due to the non-metastatic behavior of this tumor.     

Neuroendocrine carcinoma of the larynx presenting as a primary unknown carcinoma

Objective

The case of an 80-year-old man showing a metastatic cervical small cell neuroendocrine carcinoma is presented.

Results

The primary site could not be found at first; it took 8–10 months to detect the primary lesion in the larynx.

Conclusion

¹⁸F-deoxyglucose positron emission tomography (FDG-PET) was useful to find the submucosal lesion. Despite surgical treatments and chemotherapy, the patient survived for only 21 months.     

Clinical and histopathological considerations for the diagnosis and treatment of verrucous carcinoma of the larynx

Summary Verrucous carcinoma of the larynx is quite distinct from well-differentiated squamous cell carcinoma and has a characteristic morphology and specific clinical behavior. It accounts for approximately l%–2% of all laryngeal carcinomas. However, difficulties are encountered clinically in separating verrucous carcinomas from keratoses, verruca vulgaris and squamous cell carcinomas with a verrucous appearance. Between 1962 and 1982, 1504 patients with squamous cell carcinomas of the larynx were diagnosed and treated by staff physicians in the Department of Otolaryngology — Head and Neck Surgery, Washington University in St. Louis. Fifteen of these patients (1%) had verrucous carcinomas. These cases were studied in order to clarify any diagnostic problems, trace the biologic behavior of the tumors and report the results of the treatment used. Of these 15 patients, we were able to follow up 8. The latter had been treated only with surgery and none of them had received radiotherapy. One death occurred, but the patient died of other causes and remained free of cancer. Reports in the literature describe a high rate of recurrence of verrucous carcinomas following radiotherapy with occasional anaplastic transformation of tumors. No patients in our series developed a metastasis in the neck, indicating that neck dissection is not justified for patients with these neoplasms even though clinically enlarged neck nodes may be present.On leave from the Department of Otorhinolaryngology, University of Kosovo, Prishtina, Yugoslavia     

原发性腮腺鳞状细胞癌的诊治

目的探讨原发性腮腺鳞状细胞癌（简称鳞癌）的临床特点、治疗和预后因素。方法回顾性分析中国医学科学院肿瘤医院头颈外科1990年1月～2008年8月24例原发性腮腺鳞癌,总结其临床资料、病理结果、生存情况和预后因素。结果Kaplan-Meier法计算全组5年生存率达35.9%,手术肉眼切净肿瘤的患者（n=18）5年生存率达47.9%。初治（n=15）和复发挽救（n=9）患者的5年生产率分别为44.2%和22.2%（P=0.132）,治疗失败的原因主要是局部区域复发。多因素分析提示二次治疗和肿瘤肉眼残存是预后不良的因素。结论原发性腮腺鳞癌恶性程度较高,首次治疗是关键,切除的肿瘤可获得较好的效果,肿瘤肉眼残存或二次治疗的患者预后较差。     

Unusual features of metastatic atypical carcinoid of the larynx

This report describes a case of atypical carcinoid of the larynx with metastatic tumor to cervical lymph nodes showing features similar to paraganglioma. Immunohistochemically, both the primary and metastatic tumor were positive for epithelial membrane antigen, cytokeratin, neuron-specific enolase, chromogranin, synaptophysin, calcitonin and carcinoembryonic antigen. The sustentacular cells in pseudo-cell ball (“Zellballen”) formations were shown by a positive S-100 marker. Electron microscopic analysis revealed numerous neuroendocrine granules measuring 150–250 nm in diameter. Clinical features, histological appearance, histochemical, immunohistochemical and ultrastructural findings, as well as differential diagnosis are discussed. Received: 30 August 1996 / Accepted: 4 December 1997     

The incidence of thyroid gland invasion in advanced laryngeal squamous cell carcinoma

IntroductionInvasion of the thyroid gland is not a general feature of advanced laryngeal carcinoma. There is no need for performing thyroidectomy in all total laryngectomy cases.ObjectivesTo evaluate the frequency of the thyroid gland invasion in patients with advanced laryngeal squamous cell carcinoma submitted to total laryngectomy and thyroidectomy and to determine whether clinical and pathological characteristics of laryngeal carcinoma can predict glandular involvement.MethodsA retrospective case series with chart review, from March 2009 to January 2018, was undertaken in the the Princess Norah Oncology Center, King Abdul-Aziz Medical City, Jeddah/KSA. An inception cohort of 56 patients with laryngeal squamous cell carcinoma was considered. Nine cases were excluded. All patients had advanced stage cancer of the larynx (clinically T3‒T4) and underwent total laryngectomy in association with thyroidectomy. Total thyroidectomy was performed in all bilateral lesions or if there was suspicion of contralateral lobe involvement. Hemithyroidectomy was performed in all lateralized lesions. Retrospective histopathologic analysis of thyroid specimens was subsequently performed. The frequency of thyroid gland invasion was calculated and analysis of demographic, clinical and pathological characteristics associated with thyroid gland invasion was performed.ResultsIn all, 47 patients underwent total laryngectomy (40 treated with primary laryngectomy and seven treated with salvage laryngectomy following radiation failure or chemoradiation failure). Hemithyroidectomy was performed in 42 patients and the total thyroidectomy was performed in five patients. The overall frequency of invasion of the thyroid gland was 4.3%. Glandular involvement was seen in one advanced transglottic squamous cell carcinoma and one subglottic. In spite of thyroid cartilage invasion in 25.5% of cases detected in the preoperative radiological imaging, only one case demonstrated microscopic thyroid gland invasion.ConclusionsThyroidectomy may only be required during total laryngectomy for selected cases of advanced transglottic tumors and tumors with subglottic extension more than 10 mm.     

Salivary gland carcinomas of the larynx: a national study in Denmark

Objective

Salivary gland carcinomas of the larynx are rare. The purpose of this study is to present a national series of laryngeal salivary gland carcinoma patients and to bring a review of recent literature.

Methods

By merging The Danish Cancer Registry, The National Pathology Registry and The National Patient Registry all registered patients with laryngeal salivary carcinomas diagnosed from 1990 to 2007 were identified. The histological slides were reviewed and data concerning age, sex, symptoms, topography, histology, treatment and outcome were registered. Based on a supplemented PubMed search a review of literature from 1991 to 2010 was performed.

Results

Six Danish patients with a malignant salivary gland tumor in the larynx were identified resulting in an incidence of 0.001/100,000 inhabitants/year. Four had adenoid cystic carcinoma and two a mucoepidermoid carcinoma. All patients were male. The patients were treated with surgery and/or radiotherapy. Three patients had recurrent disease. One died of the primary disease and one died of other causes. Four are alive with no evidence of disease. Merging of actual study group with patients from recent literature resulted in 83 cases. The male vs. female ratio was 2:1, the most common location was the supraglottic region (52%) and the most predominant histological subtypes were adenoid cystic carcinoma (46%), mucoepidermoid carcinoma (35%) and adenocarcinoma NOS (12%).

Conclusion

Laryngeal salivary gland carcinoma is a rare disease with a male predominance and most often localized in the supraglottic region. Data concerning treatment and outcome are scarce, but primary surgery with utmost focus on free surgical margins is the treatment of choice. Recurrences are observed later than ten years after primary treatment and a long follow up time is advocated.     

Immunohistochemical and fine structural characterization of primary carcinoid tumors of the larynx

Carcinoid tumors belong to the group of neuroendocrine tumors of epithelial origin, i.e., neuroendocrine carcinomas. These neoplasms usually occur in the gastrointestinal tract or bronchial system but are very rare neoplasms in the larynx. Since carcinoid tumors in this latter site may appear to be undifferentiated by light microscopy, they may possibly be misinterpreted and their neuroendocrine characteristics may remain unrecognized. Using immunohistochemical methods, three carcinoid tumors were studied and showed positive immunostaining for markers of epithelial origin (cytokeratins, epithelial membrane antigen, carcino-embryonic antigen) and, in particular, for markers of neuroendocrine differentiation (chromogranin, synaptophysin, neuron-specific enolase). All tumors expressed calcitonin-, serotonin- and adrenocorticotropic-hormone-like immunoreactivity. In contrast, three poorly differentiated squamous cell carcinomas showed positive immunostaining for epithelial markers but did not show any immunoreactivity with markers of endocrine characteristics. Fine structurally, carcinoid tumor cells contained neurosecretory-type granules scattered throughout the cytoplasm. The present study demonstrated that (1) carcinoid tumors of the larynx possess distinct immunohistochemical characteristics that allow a clear classification, (2) it is advisable to use a battery of primary antibodies rather than rely on specificity and sensitivity of a single marker to establish diagnosis and (3) the fine structural demonstration of neurosecretory-type granules serves as a reliable adjunct to diagnosis.The results were presented in part at the 65th annual meeting of the German Society for Otorhinolaryngology-Head and Neck Surgery (Deutsche Gesellschaft für Hals-Nasen-Ohrenheilkunde, Kopf- and Halschirurgie), Chemnitz, 14–18 May 1994     

Large-cell undifferentiated carcinoma of the submandibular gland

Large-cell undifferentiated carcinoma (LCUC) arising in the submandibular gland is so rare that there have been only a few reported cases. We encountered a 65-year-old Japanese male, whose left submandibular gland was enlarged due to LCUC. Exenteration of the left submandibular gland together with selective neck dissection was performed, followed by postoperative radiotherapy. Current literature concerning the histopathological and clinical features of this neoplasm was reviewed.     

Mucoepidermoid carcinoma of the larynx

Summary Two cases of mucoepidermoid carcinoma (MEC) of the larynx are reported. The peculiarities of both cases are emphasized, in particular the site of involvement and the young age of the former and the histological subtype (clear cell variant) of the latter. The microscopic differential diagnosis of MEC and its biological behavior according to the grade of differentiation is discussed. The available literature is reviewed.     

Predictors of thyroid gland invasion in glottic squamous cell carcinoma

OBJECTIVE: This study examines preoperative clinical and intraoperative histopathologic characteristics that can be used to predict thyroid gland invasion in the setting of squamous cell carcinoma (SCC) of the glottis. STUDY DESIGN: The study was retrospectively performed using 30 serially sectioned whole-organ total laryngectomy with thyroidectomy specimens with associated preoperative clinical data. METHODS: Histopathologic and clinical variables including true vocal cord (TVC) fixation, cricoarytenoid joint invasion, subglottic extension (SGE) of tumor, patterns of laryngeal spread, and prior radiation were examined as univariate and multivariate correlates of thyroid gland invasion. RESULTS: Twenty-three percent of thyroid gland specimens demonstrated SCC invasion. Five were T4 stage, two were T3 stage, and all demonstrated direct extension to the thyroid gland. Of these, all had a fixed ipsilateral TVC (P = .003) and SGE of tumor greater than 15 mm (P = .003). Using multivariate analysis, SGE of tumor and TVC fixation contribute independently as correlates of thyroid gland invasion. Prior radiation of the larynx did not correlate with thyroid gland invasion and did not significantly influence the predictive capacity of these variables. Tumors invading the thyroid gland also invaded the cricothyroid membrane (100%), anterior commissure (100%), laryngeal ventricle (100%), and thyroid cartilage (86%). CONCLUSION: Preoperative assessment of TVC mobility and extent of SGE are significant correlates of thyroid gland invasion by SCC of the glottis. Distinct patterns of laryngeal spread are associated with thyroid gland invasion. Prophylactic hemithyroidectomy with isthmusectomy is indicated for glottic SCC in the preoperative setting of a fixed TVC and SGE greater than 15 mm. Additional study correlating patterns of laryngeal spread with thyroid gland invasion will add to these data in determining when to selectively perform thyroidectomy in this setting.