Gingival squamous cell carcinoma mimicking periodontal disease.

Gingival squamous cell carcinoma (GSCC) is relatively rare, representing less than 10% of oral cavity squamous cell carcinomas. Because of its proximity to the teeth and periodontium, the tumor can mimic tooth-related benign inflammatory conditions. In this article, a case of GSCC with clinical features very similar to those of periodontal disease in an 86-year-old nonsmoking woman is presented.

Total glossectomy in the organ preservation era.

Purpose Of Review: Total or subtotal glossectomy is considered a highly morbid procedure. However, in some institutions and in selected cases of unsuccessful chemoradiation regimens, it is performed with acceptable oncological and functional outcomes.

Recent Findings: Chemoradiation for advanced oral and oropharyngeal cancers is also highly morbid and some authors reported reasonable functional results after major glossectomies.

Validation of the Washington University Head and Neck Comorbidity Index in a cohort of older patients.

Objectives: To validate the prognostic ability of the Washington University Head and Neck Comorbidity Index (WUHNCI) relative to 5-year survival in a cohort of older patients with head and neck cancer and to compare it with that of the Adult Comorbidity Evaluation 27 (ACE-27).

Design: Validation study.

Setting: Academic research.

Giant pleomorphic adenoma of the parotid gland.

Pleomorphic adenoma is the most common type of all benign and malignant salivary gland tumors, involving more frequently the parotid gland. It is a benign tumor with a slow and continuous growth that without treatment can reach an enormous size. We present a case of a giant pleomorphic adenoma in a 78-year-old man with a history of more than 30 years of a growing lesion in the parotid gland.

Preservation of the internal jugular vein in the radical treatment of node-positive neck--is it safe?

Background: The aim of this study was to evaluate risk factors of neck recurrence in patients with pN+ necks submitted to a modified or a classic radical neck dissection and the safety of preserving the internal jugular vein in the treatment of a subgroup of these patients.

Methods: The medical records of 311 untreated patients with squamous cell carcinoma of the oral cavity (106 cases), oropharynx (95 cases), larynx (49 cases), and hypopharynx (61 cases) were reviewed. Their clinical stages (CS) were CS II in 1%, CS III in 19.

Internal jugular vein preservation in neck dissection for pN1-N2c oral and oropharyngeal carcinoma.

Purpose: The aim of this study is to evaluate risk factors of neck recurrence in patients with pN1-N2 neck stage, submitted to a modified radical neck dissection with preservation of the internal jugular vein.

Materials And Methods: We reviewed the medical records of 72 patients with squamous cell carcinoma of the oral cavity (43 cases) and oropharynx (29 cases). The clinical stage of the neck was N1 in 23 cases and N2a-c in 49.

Predictive factors for complications in elderly patients who underwent head and neck oncologic surgery.

Background: Postoperative complications are relevant outcomes in patients with head and neck tumor who have undergone surgery. Few trials have assessed predictive factors in older patients. We assessed the predictive effect of preoperative clinical factors on postoperative complications.

Multiple cutaneous metastases from a parotid adenoid cystic carcinoma.

Cutaneous metastasis from salivary gland adenoid cystic carcinoma is extremely rare. We report a case of a 39-year-old man that presented multiple cutaneous metastases from a parotid salivary gland adenoid cystic carcinoma. The clinical, histopathological and immunohistochemical features are described and discussed.

Is galectin-3 a good method for the detection of malignancy in patients with thyroid nodules and a cytologic diagnosis of "follicular neoplasm"? A critical appraisal of the evidence.

Background: Thyroid nodules are the most common surgical disease of the thyroid. Fine-needle aspiration biopsy (FNAB) is the most commonly employed tool for establishing a diagnosis. However, 15% to 25% of FNAB reports yield inconclusive results.

Factors that influence treatment decision in older patients with resectable head and neck cancer.

Objectives: To find clinical factors related to administration of substandard treatment in older patients with head and neck cancer.

Study Design: Historic cohort.

Methods: Patients of 70 years of age of older with diagnosis of resectable head and neck cancer were included.

Shorter CAG repeat length in the AR gene is associated with poor outcome in head and neck cancer.

Objective: Alterations in the size of the [CAG](n) repeats of the AR gene have been described in several types tumors. The purpose of this study was to evaluate if there is an association between the AR [CAG](n) repeat alleles and the relative risk for head and neck cancer and to analyse microsatellite instability (MSI) and loss of heterozygosity (LOH) in these tumors.

Design: Matched samples of blood and head and neck tumors were evaluated using two methodologies, silver-stained gels to perform the analyses of MSI and LOH, and automated analysis to confirm these results and for genotyping of the AR [CAG](n) repeat length.

Comorbidity is a prognostic factor in elderly patients with head and neck cancer.

Background: The number of aged patients with head and neck cancer is increasing. Comorbidities are common in this population. It is necessary to evaluate the effect of comorbidities as measured with the ACE-27 index on recurrence and survival of elderly patients with head and neck cancer, adjusting by other prognostic factors as age, clinical stage and functional status index.

H19-DMR allele-specific methylation analysis reveals epigenetic heterogeneity of CTCF binding site 6 but not of site 5 in head-and-neck carcinomas: a pilot case-control analysis.

Aberrant methylation of seven potential binding sites of the CTCF factor in the differentially methylated region upstream of the H19 gene (H19-DMR) has been suggested as critical for the regulation of IGF2 and H19 imprinted genes. In this study, we analyzed the allele-specific methylation pattern of CTCF binding sites 5 and 6 using methylation-sensitive restriction enzyme PCR followed by RFLP analysis in matched tumoral and lymphocyte DNA from head-and-neck squamous cell carcinoma (HNSCC) patients, as well as in lymphocyte DNA from control individuals who were cancer-free. The monoallelic methylation pattern was maintained in CTCF binding site 5 in 22 heterozygous out of 91 samples analyzed.

Prognostic factors in salvage surgery for recurrent oral and oropharyngeal cancer.

Background: Therapeutic decisions in recurrent oral and oropharyngeal squamous carcinoma (SCC) remain controversial.

Methods: Two hundred forty-six consecutive patients who underwent salvage surgery for recurrent squamous cell carcinoma (SCC) of the oral cavity and oropharynx were studied. The tumor sites were lip, 33 cases; oral cavity, 143; oropharynx, 70.

DNA methylation in the CTCF-binding site I and the expression pattern of the H19 gene: does positive expression predict poor prognosis in early stage head and neck carcinomas?

Loss of allele-specific expression by the imprinted genes IGF2 and H19 has been correlated with a differentially methylated region (DMR) upstream to the H19 gene. The H19-DMR contains seven potential CCCTC-binding factor (CTCF) binding sites. CTCF is a chromatin insulator and a multifunctional transcription factor whose binding to the H19-DMR is suppressed by DNA methylation.

Predictive factors for distant metastasis from oral and oropharyngeal squamous cell carcinoma.

The presence of distant metastasis after the initial treatment of head and neck squamous cell carcinoma is not considered a common event and is associated with a poor outcome. The objective of this study was to investigate the prevalence and risk factors associated with the diagnosis of distant metastasis in oral and oropharyngeal carcinoma patients. The medical charts of 2327 patients treated from 1954 to 1997 were reviewed.

Pectoralis major and other myofascial/myocutaneous flaps in head and neck cancer reconstruction: experience with 437 cases at a single institution.

Background: Pectoralis major and other myofascial/myocutaneous flaps have been recognized as important reconstructive methods in head and neck cancer surgery. Even with the worldwide use of free flaps, they are still the mainstay reconstructive procedures in many centers.

Methods: We retrospectively analyzed the records of patients with head and neck cancer who underwent an immediate reconstruction with pectoralis major or other myofascial/myocutaneous flaps at a tertiary cancer center from 1982 to 1998.

Endodermal sinus tumor of the parotid gland in a child.

We report a case of a 16-month-old girl with a primary endodermal sinus tumor (EST) of the parotid gland. The girl was admitted to the hospital with a left side cervical tumor with a quick growth (within 3 wk). The tumor was surgically resected.

Predictive factors and distribution of lymph node metastasis in lip cancer patients and their implications on the treatment of the neck.

The frequency of neck metastasis in lip cancer patients is low, however if present, it decreases survival rates, which reinforce the neck treatment as an important step in the management of these patients. This study evaluates the predictive factors, the distribution of lymph node metastasis and their implications on the neck treatment. A retrospective analysis of lip cancer patients treated in our institution from 1969 to 1999 was performed.

Postoperative complications after en bloc salvage surgery for head and neck cancer.

Objective: To analyze the frequency of and risk factors for postoperative complications after en bloc salvage surgery for head and neck cancer.

Design: Retrospective cohort study.

Setting: Patients were evaluated from February 7, 1990, to November 17, 1999, in a tertiary cancer center hospital.

Trends of oral and oropharyngeal cancer survival over five decades in 3267 patients treated in a single institution.

The objective of this study was to analyze the influence of changes in the treatment on the prognosis of patients treated over 44 years in a single institution. The 5-decade trends in treatment approach and 5-year survival of 3267 patients treated between 1953 and 1997 were analyzed. An increase was observed in primary surgical treatment and its association with radiotherapy.