Head & neck cancer. Its impact on the history of mankind.

Squamous cell carcinoma is the most common head & neck malignancy, and its first descriptions date from the pharaonic era. It has impacted humanity by affecting labor, scientific and cultural productivity and, sometimes, it has influenced the course of history. Head & neck cancer is more common in economically impoverished countries and individuals; however, it can affect any socioeconomic stratum; it has been suffered by known, famous, economically powerful celebrities, intellectuals and artists.

Aspectos fundamentales del nódulo tiroideo y el cáncer bien diferenciado de tiroides para los médicos general y familiar.

The physician that has the first contact with the patient is the general or family doctor, on whose initial assessment patient treatment success often depends. National and international treatment guidelines are designed for specialists in the area, and the primary care physician often finds them difficult to interpret. The purpose of this document is to offer primary care physicians the fundamentals for the diagnostic and reference process of patients with thyroid nodules and possibly with well-differentiated thyroid cancer, from an objective and pragmatic point of view.

[Evaluación funcional de deglución-aspiración en pacientes sometidos a laringectomía subtotal supracricoidea con cricohioidoepiglotopexia].

Introduction: Cardiovascular disease is the main cause of mortality worldwide. In women, its incidence increases at the sixth decade of life, coinciding with postmenopause. Whether this effect is due to menopause-related hormonal changes is not known.

[Melanoma cutáneo. Etapificación ganglionar con base en la evidencia actual].

Most patients with cutaneous melanoma present with clinical stage 1 at diagnosis, i.e., with no evidence of lymph node or systemic metastases.

[Incisión cervical transversa en disección radical de cuello].

Antecedentes: La disección radical de cuello es la única forma de estadificar a pacientes con neoplasias con riesgo de metástasis ganglionares. Se han efectuado diversos tipos de incisiones a lo largo de la historia, con el objetivo de obtener una exposición suficiente que permita la resección completa de los grupos ganglionares en riesgo. Es importante combinar la seguridad oncológica con unas adecuadas estética, funcionalidad y calidad de vida.

[Mandibular osteoradionecrosis (ORN) as a side effect of head and neck cancer treatment: Factors that induce it].

Introduction: Osteoradionecrosis of the mandible is a relatively common complication in patients with head and neck cancer undergoing radiotherapy or concomitant chemoradiotherapy, characterized by exposure of the mandibular bone either in the mouth or in the facial skin, with no improvement with conservative treatment for six months. The risk factors are radiotherapy in head and neck region, lack of dental prophylaxis before treatment and dental extraction.

Material And Methods: Retrospective observational study analyzing incidence and etiologic factors of osteoradionecrosis in 250 patients undergoing radiotherapy or combined treatment of cervicofacial area between 2002 and 2010.

[Laryngeal conservative surgery in patients candidates for combined treatment with chemo-radiotherapy].

Background: The standard of care for advanced-stage laryngeal cancer is combined treatment (chemo-radiotherapy). However, the complications with this treatment are not few, mainly in swallowing. Conservative laryngeal surgery remains an effective alternative for cancer control without the complications of chemo-radiotherapy.

[Clinical characteristics of malignant tumours originating in the external ear].

Background: Skin tumours that originate in the external ear are common in individuals with type 1 skin and phenotype 1 and 2. The skin cancer is associated with chronic or intermittent, but intense sunlight. The most common malignant tumour is basal cell carcinoma, followed by squamous cell carcinoma and melanoma.

[Histopathological evaluation of the subtotal laryngectomy specimen].

Introduction: The goal of conservative surgical treatment of laryngeal cancer is to obtain oncological control with preservation of laryngeal function. The concept of laryngeal function preservation should be understood as the preservation of the patient's ability to breathe normally with neither tracheostomy nor aspiration, and maintaining intelligible speech. This can be achieved by a balance between two fundamental aspects, proper patient selection (based on tumour extension and preoperative laryngeal function), and an adequate histopathological analysis of the surgical specimen.

[Dermoscopy in cutaneous melanoma].

Background: The mortality of cutaneous melanoma has not declined over the past 50 years. The only interventions that can reduce mortality are primary prevention and early diagnosis, and the dermoscopic evaluation is essential to achieve this. Dermoscopy identifies characteristics of melanoma that would go unnoticed to the naked eye.

[Cutaneous malignant melanoma and the new drugs].

The treatment of cutaneous melanoma has historically been essentially surgical. Much progress has been made in this area, and the resection margins have been established based on tumour depth. Candidates are also identified for lymphadenectomy, avoiding the morbidity of the procedure in patients who do not require it.

[Subtotal-supracrioid laryngectomy (SCSL): the importance of the histopathological analysis].

The purpose of conservative surgical treatment of laryngeal cancer is to obtain cancer control with preservation of laryngeal function, and in turn, the preservation of laryngeal function should be understood as the preservation of the patient's ability to ventilate in the normal way without tracheostomy and without aspiration and maintaining intelligible speech. This objective is achieved by maintaining a balance between two fundamental aspects: proper patient selection (based on tumor extension and preoperative laryngeal function) and an adequate histopathological analysis of the surgical specimen. Supracricoid subtotal laryngectomy (SCSL) is the voice conservative surgical technique which offers the best possibility of control in patients with locally advanced laryngeal cancer, and the proper histopathological analysis allows staging and selecting patients eligible for adjuvant therapy, avoiding unnecessary therapies, and allows design of a monitoring and surveillance program based on risk factors.

[Adnexal neoplasms in the context of skin cancer: trichilemmal carcinoma. Apropos of a case].

Background: The trichilemmal carcinoma is a rare malignant neoplasm, whose origin lies in the annexes of the skin, because of its low prevalence often confused with other dermal tumors, the differential diagnosis is not easy and is usually made by exclusion; in theory, its behavior is slow with little tendency to send both regional lymph node metastasis and systemic. Due to the limited number of cases there is no consensus on the prognosis, although it is generally considered good. The aim of this report is to show a case that, contrary to previous reports, the clinical presentation is aggressive with large soft tissue tumor infiltration around the site of origin in a patient without risk factors for skin cancer.

[Drainage time in patients submitted to radical neck dissection. Influence of peri-operative intravenous liquid perfusion].

Introduction: Drainage after radical neck dissection (RND) is routine and several factors impact the postoperative drainage number of days (PODND).

Objective: to determine the impact of trans-operative intravenous fluid management (TOFM) in in PODND.

Methods: Retrospective analysis of patients subjected to some type of radical neck dissection.

Partial surgery of the larynx: techniques and outcomes.

Background: in recent years preservation of the larynx has been one of the most studied subjects in the field of cervicofacial oncology and is the secondary target in the treatment of laryngeal cancer after locoregional control.

Discussion: Treatment of cancers originating generally in the mucosa of the head and neck and in particular of the larynx has evolved greatly during the past 10 years. Inclusion of induction chemotherapy and the association of concomitant chemotherapy/radiotherapy in the medical armamentarium has totally changed the therapeutic strategy for this neoplasm.

Partial laryngectomy in supraglottic pharyngeal tumors.

Background: The upper third of the larynx shares a wall with the pharynx, the laryngopharyngeal wall. This anatomic structure is common to both organs and is often the source of epidermoid carcinomas. These carcinomas are more frequent in subjects who ingest large amounts of alcohol.

Cranial vault reconstruction using computer-designed polyetheretherketone (PEEK) implant: case report.

Background: Reconstruction of the bones of the skull is a complex procedure and represents a challenge for the surgical team. It is generally performed in patients who have loss of the cranial vault secondary to chronic infection or uncontrolled osteoradionecrosis, indicating a greater chance of failure or rejection of the materials used for repair of the defect. Selection of material to replace the cranial vault is complex due to the diversity of existing products.

[Unsual clinical signs of primary hyperparathroidism].

Background: A growing number of patients with primary hyperparathyroidism (PHPT) are diagnosed in the absence of symptoms following routine biochemical screening. However, in some countries, overt manifestations and osteitis fibrosa cystica (OFC) still dominate the clinical profile of PHPT patients.

Methods: We retrospectively studied clinical and biochemical manifestations of 47 consecutive patients with primary hyperparathyroidism who were treated with parathyroidectomy from October 1993 to June 2005.