Hepatocellular carcinoma metastatic to the mandible.

We describe the case of a 55-year-old man with known multifocal hepatocellular carcinoma (HCC) who presented with a painful mandibular mass. Fine-needle aspiration cytology of the mass revealed the presence of bile canaliculi and bile formation, an extremely rare finding. Findings on immunoperoxidase staining of the aspirate were consistent with an HCC.

Temporal bone verrucous carcinoma: outcomes and treatment controversy.

Objectives: Verrucous carcinoma is a rare tumor that presents in the head and neck with the most common sites in the larynx and oral cavity. Fourteen cases of verrucous carcinoma of the temporal bone have been described in the literature; this study aims to examine treatment outcomes and discuss the controversy surrounding postoperative radiation.

Study Design: A literature review along with individual case report in the setting of a tertiary care medical center.

Temporal bone verrucous carcinoma: outcomes and treatment controversy.

Verrucous carcinoma is a rare tumor that presents in the head and neck with the most common sites being the oral cavity and larynx. Fourteen cases of verrucous carcinoma of the temporal bone have been described in literature; this study aims to examine treatment outcomes and discuss the controversy surrounding postoperative radiation. The study design included a literature review along with individual case report in the setting of a tertiary care medical center.

Adjuvant external-beam radiotherapy in patients with high-risk well-differentiated thyroid cancer.

The role of adjuvant external-beam radiation therapy (EBRT) in well-differentiated thyroid cancer is not well delineated. Many clinicians rely solely on iodine 131 (131I) to destroy thyroid remnants following thyroidectomy. However, the lesser uptake of isotope in tumor cells suggests that 131I alone may not be sufficient to eradicate microscopic residual disease when no gross thyroid tissue remains.

Reirradiation after salvage surgery and microvascular free flap reconstruction for recurrent head and neck carcinoma.

Objective: To evaluate the outcome and complications of reirradiation of recurrent head and neck cancer after salvage surgery and microvascular reconstruction.

Study Design: Retrospective.

Subjects And Methods: Twelve patients underwent salvage surgery with microvascular reconstruction for recurrent or second primary head and neck cancer in a previously irradiated field.

Comparison of quality of life outcomes in laryngeal cancer patients following chemoradiation vs. total laryngectomy.

Objective: To evaluate quality of life issues in patients with laryngeal cancer after treatment with either chemoradiation or total laryngectomy and radiation therapy.

Methods: Forty-nine patients with a history of stage II-IV laryngeal squamous cell carcinoma treated primarily with either chemoradiation or by total laryngectomy with postoperative radiation completed the University of Washington Quality of Life instrument, version 4. Patients were identified on a volunteer basis in an academic university head and neck clinic setting.

Early nodal response as a predictor for necessity of functional neck dissection after chemoradiation.

Purpose: Chemoradiation is increasingly becoming the standard of care for node-positive squamous cell cancer of the head and neck. Response to chemoradiation for clinically node-positive disease in the neck is often difficult to ascertain because clinical response may or may not be predictive of pathological response. This often leads to uncertainty about the necessity of a functional neck dissection after chemoradiation.

Sinonasal undifferentiated carcinoma: case series and literature review.

Purpose: The purpose of this study was to understand the natural history and progression of sinonasal undifferentiated carcinoma (SNUC) to establish optimal management guidelines. Methods and materials We analyzed 8 consecutively treated patients diagnosed with SNUC between 1995 and 2002 at UCLA Medical Center. Staging was classified by the Kadish System with 7 patients presenting at stage C and 1 patient with stage B disease.

Efficacy of radiation therapy in the local control of desmoplastic malignant melanoma.

Background: Desmoplastic malignant melanoma (DMM) is a rare variant of malignant melanoma with high local recurrence rate after surgical excision. We performed a retrospective review to address the role of radiation therapy in local control of this tumor.

Methods: Between 1976 and 1997, 44 patients with the pathologic diagnosis of DMM were registered at our tumor registry.

The role of radiation in the treatment of advanced juvenile angiofibroma.

Objectives/hypothesis: To demonstrate the efficacy of external beam radiation therapy as a primary treatment modality for the management of patients with advanced juvenile nasopharyngeal angiofibroma (JNA).

Study Design: Retrospective chart review.

Methods: The medical records of 130 patients with the diagnosis of JNA seen at UCLA Medical Center over a 41-year period (1960-2000) were retrospectively reviewed.

Positron emission tomography: an independent indicator of radiocurability in head and neck carcinomas.

Positron emission tomography (PET) is a biochemical-imaging tool that uses the uptake of the glucose analog 2-deoxy-2-[F-18] fluoro-D-glucose (FDG) to detect head and neck tumor proliferation. The aim of this study is to determine if quantitation of either primary tumor metabolic activity or tumor response using PET scans could predict local control and overall survival in patients with head and neck cancer undergoing primary radiotherapy. Twelve patients with squamous cell carcinomas of the head and neck underwent PET scans before and 6 weeks after completion of radiation therapy.

Outcomes and factors impacting local recurrence of ductal carcinoma in situ.

Background: The optimal management of ductal carcinoma in situ (DCIS) remains controversial. Investigators have focused on identifying patients who are eligible for treatment by excision alone. A retrospective analysis of patients with DCIS treated by various modalities was conducted to compare outcomes and determine factors significant for local recurrence (LR).

Accuracy and clinical impact of mediastinal lymph node staging with FDG-PET imaging in potentially resectable lung cancer.

To determine the sensitivity, specificity, and accuracy of staging mediastinal nodal disease in potentially resectable lung cancer using fluorodeoxyglucose-positron emission tomography (FDG-PET), computed tomography (CT), or both and compare these results to surgical staging. We also assessed whether PET scanning results changed clinical management. From 1992 to 1997, 50 patients underwent CT, and PET scanning before or close to the time of surgical staging.

Filgrastim (r-metHuG-CSF) and its potential use in the reduction of radiation-induced oropharyngeal mucositis: an interim look at a randomized, double-blind, placebo-controlled trial.

We wished to determine if filgrastim administration to chemotherapy/radiation therapy-naive patients receiving external-beam irradiation for head-and-neck malignancies would reduce the incidence and severity of oral/oropharyngeal mucositis. Patients were randomized to receive subcutaneous injections of either filgrastim or placebo beginning on day 1 of radiation and continuing daily throughout treatment. Study medication was titrated to keep the neutrophil count between 10 x 10(9) and 30 x 10(9)/l.

The role of positron emission tomography in occult primary head and neck cancers.

Purpose: To evaluate the utility of positron emission tomography (PET) fluorodeoxyglucose (FDG) imaging in the workup of unknown primary head and neck tumors.

Methods: Fourteen patients with squamous cell carcinoma of cervical lymph node metastasis of unknown primary origin (clinical stage N2-N3) were studied prospectively. The patients underwent conventional workup, including physical examination, computed tomography, and random biopsies of the potentially suspected sites.

Radiation tolerance of transverse rectus abdominis myocutaneous-free flaps used in immediate breast reconstruction.

The authors determine the effects of postoperative radiation therapy on flap and local control outcomes in patients who have undergone immediate transverse rectus abdominis myocutaneous (TRAM)-free flap reconstruction after modified radical mastectomy for locally advanced breast cancer. Details of surgery, chemotherapy, and radiation therapy for 21 patients who had undergone immediate TRAM-free flap reconstruction after modified radical mastectomy were gathered retrospectively. The outcomes examined were flap complications, overall cosmesis, and local recurrence rate.

The role of adjuvant radiotherapy in the treatment of resectable desmoid tumors.

Purpose: Desmoid tumors have a high propensity for local recurrence with surgical resection. There are many reports describing good responses of desmoid tumors to irradiation, but none have clearly established the indications for adjuvant radiotherapy in treating resectable desmoid tumors.

Methods And Materials: A retrospective analysis was performed on 61 patients with resectable desmoid tumor(s) who were treated at our institution from 1965 to February of 1992.

Concomitant pilocarpine during head and neck irradiation is associated with decreased posttreatment xerostomia.

Purpose: To retrospectively compare subjective postirradiation xerostomia scores of patients who received concomitant oral pilocarpine during radiotherapy for head and neck cancer and 3 months thereafter with those of similar cohorts who did not receive pilocarpine.

Methods And Materials: Subjective xerostomia was assessed using a visual analog scale xerostomia questionnaire that measured oral dryness, oral comfort, difficulty with sleep, speech, and eating. The concomitant pilocarpine group had both parotid glands in the initial field treated to at least 45 Gy and received 5 mg pilocarpine hydrochloride four times per day (q.

Angiosarcoma. A report of 67 patients and a review of the literature.

Background: Angiosarcomas (AS) are rare, aggressive tumors. Optimal treatment has not been well defined. The authors undertook a retrospective review of patients seen at their institution with the intent of identifying prognostic factors and optimal treatment strategies.

Radiation recall dermatitis and pneumonitis in a patient treated with paclitaxel.

Background: Radiation recall refers to a tissue reaction produced by a chemotherapeutic agent in a previously irradiated field that would not occur in a nonirradiated field. A number of agents have been reported to cause radiation recall. Recently, there have been case reports of recall dermatitis from paclitaxel treatment.

Resistance to common viruses during intralymphatic injections of tumor cell vaccines. Correlation with circulating cytokines.

Patients with advanced malignancies who received intralymphatic injections of irradiated tumor cell suspensions ("vaccines") were unexpectedly found to be resistant to common viral diseases; 17 patients with a documented past history of viral infections who have been observed for 48 to 148 months (median 108 months), were analyzed. The resistance to viruses was found to correlate closely with the presence, in the serum, of certain cytokines. Specifically, the interleukins, -2, -6, -8 and interferon-gamma, at low but sustained levels appeared to be possibly responsible for the nonspecific protection against viral infections obtained by intralymphatic injections of cellular material.

Margin status and local recurrence after breast-conserving surgery.

Objective: To examine the effect of microscopic tumor at the margins on local recurrence after breast-conserving surgery for invasive carcinoma.

Design: Retrospective review of patients treated with surgical resection followed by radiation therapy.

Setting: A university-based radiation department and a community-based cancer referral center.

Use of positron emission tomography with fluorodeoxyglucose in patients with extracranial head and neck cancers.

Background: The purpose of this study was to evaluate the utility of positron emission tomography- (PET) 2-[18F]-fluoro-2-deoxy-D-glucose (FDG) imaging in extracranial head and neck cancers.

Methods: Sixty patients with biopsy-proven cancers were studied using PET-FDG. Thirty-four patients were studied before therapy (staging), of which 15 patients received primary radiotherapy and serial PET-FDG imaging (monitoring).

Mucosal melanoma of the head and neck: the impact of local control on survival.

The management for mucosal melanoma of the head and neck is controversial in view of the poor prognosis. Thirty-five patients seen from 1955 to 1991 were analyzed retrospectively. Almost all (34/35) presented with localized disease.

Application of stereotactic radiosurgery to the head and neck region.

Nasopharyngeal carcinoma recurrent following primary radiation therapy has been treated with surgery and reirradiation. Reirradiation is often limited by the tolerance of structures previously treated. Radiosurgery was used to boost the recurrent site while avoiding critical structures.