Diagnosis of HPV-driven head and neck cancer with a single test in routine clinical practice.

Accurate screening of HPV-driven head and neck squamous cell carcinoma is a critical issue. Although there are commercial direct and indirect assays for HPV-related head and neck squamous cell carcinoma, none are ideal. Recently, a novel RNA in situ hybridization test (the RNAscope HPV-test) has been developed for the detection of high-risk HPV E6/E7 mRNA in formalin-fixed paraffin-embedded tissue.

PABPN1 (GCN)11 as a Dominant Allele in Oculopharyngeal Muscular Dystrophy -Consequences in Clinical Diagnosis and Genetic Counselling.

Oculopharyngeal muscular dystrophy (OPMD) is mainly characterized by ptosis and dysphagia. The genetic cause is a short expansion of a (GCN)10 repeat encoding for polyalanine in the poly(A) binding protein nuclear 1 (PABPN1) gene to (GCN)12-17 repeats. The (GCN)11/Ala11 allele has so far been described to be either a polymorphism or a recessive allele with no effect on the phenotype in the heterozygous state.

[Basaloid squamous cell carcinomas of the head and neck].

Basaloid squamous cell carcinomas (SCC) are a rare variant of SCC of the head and neck. Their histological characteristics have been described by Wain in 1986 and are reported in the 2005 WHO classification. A poorer prognosis of BSCC has been reported.

[Locally advanced head and neck cancers: recommendations of an expert panel and perspectives for the use of TPF regimen (docetaxel, cisplatin and fluoro-uracil) as induction therapy].

Purpose: The purpose of the present article was to evaluate indications, regimens, treatment modalities, and predictive factors of response to treatment in locally advanced squamous cell carcinoma of the head and neck (SCCHN).

Methods: An expert panel including otolaryngology and head and neck surgery specialists, oncologists, radiotherapists and biologists analyzed the literature providing a synthesis and giving some recommendations.

Synthesis: Findings from the main randomized phase III trials highlight that the TPF regimen (docetaxel, cisplatin, fluorouracil) represent a preferential option when induction chemotherapy is indicated in either operable or non-operable patients.

[PET in thyroid cancers].

FDG PET can detect thyroid cancer in patients referred for exploration of a different cancer. Because of its lack of specificity, however, this modality is not indicated for examination of thyroid nodules: ultrasonography and fine needle biopsy with cytology allow histological diagnosis, which can be completed by iodine-123 scintigraphy when an autonomous nodule is suspected. No information is currently available about the utility of FDG PET in preoperative staging.

[FDG-PET in localization of cancers of unknown primary origin].

FDG-PET can be successful in localizing the primary cancer when a metastasis is discovered but no primary tumor can be identified (cancer of unknown primary, or CUP) by physical examination, laboratory testing (for tumor markers, for example) or conventional imaging. The greatest number of PET studies in CUP concern secondary lesions in cervical lymph nodes, and PET is an established clinical use (highest ranking, 1A) according to the 3rd German Consensus Conference and an "option" in the French Standards, Options, and Recommendations. Success rates range from 30% to 50% in most studies using PET; a higher rate was reported recently with PET/CT.

[PET in head and neck cancers].

FDG PET is useful when cancer in the head or neck (except for tumors of the salivary glands, which cannot be characterized accurately) is diagnosed or suspected but not confirmed by biopsy. It can, for example, find evidence of suspicious lymph nodes in clinically N0 necks, detect foci suggestive of distant metastases or second cancers, and provide useful prognostic information. Because it can be very difficult to identify anatomical structures and landmarks on PET images in the head and neck region, PET/CT fusion is very helpful in this area.

Human papillomavirus infection in the malignant and premalignant head and neck epithelium.

A prospective study was undertaken to determine the prevalence and histological correlates of human papillomavirus infection in the head and neck epithelium. Oral, pharyngeal, and laryngeal paraffin-embedded samples were analyzed by polymerase chain reaction with use of human papillomavirus E6 consensus sequence primers. Human papillomavirus infection was detected in 20 of 126 (15.

Expression of p53 protein related to the presence of human papillomavirus infection in precancer lesions of the larynx.

The aim of this study was to gain some insight into the relationship of human papillomavirus (HPV) infection to p53 expression and to some pathological parameters in precancerous lesions of the larynx. Formalin-fixed paraffin-embedded tissue sections containing human laryngeal precancerous lesions were screened for p53 protein by immunohistochemistry with the monoclonal antibody DO7 and for the presence of HPV infection by polymerase chain reaction with consensus primers directed against the E6 gene. The presence of p53 protein was detected in 31 of 57 specimens (54.

Expression of Bcl-2 protein in human laryngeal keratoses.

Strong Bcl-2 immunostaining was detected in 2 of 21 samples of human laryngeal keratoses, one of which contained neither p53 gene mutation nor human papillomavirus sequences nor significant levels of p53 protein. The other 19 samples including 6 cases with moderate or strong p53 staining were Bcl-2-unreactive or had minimal Bcl-2 reactivity similar to that observed in normal samples. Minimal Bcl-2 staining in 5 samples with moderate or severe dysplasia was only seen in the adjacent nondysplastic area.

Safety of preoperative enoxaparin in head and neck cancer surgery.

Background: Thromboembolism is a risk in major head and neck cancer surgery patients predisposed to thrombosis. This study was designed to determine whether enoxaparin (a low molecular weight heparin) administered prior to surgery induces perioperative bleeding.

Methods: Forty patients scheduled for major cervicofacial cancer surgery were randomized in a double-blind study to receive either 20 mg enoxaparin or placebo, 12 hours before surgery.

[Primary adenoid cystic carcinoma of the skin. Histologic and ultrastructural study of two cases localized in the external auditory canal].

Primary cutaneous adenoid cystic carcinoma is a rare tumor, even if its frequency has often be underestimated, its localization in the external auditory meatus being generally considered separately. The results of the histological and ultrastructural study of two cases of adenoid cystic carcinoma, arising in the external auditory meatus, are presented, confirming the essential morphological similarity of adenoid cystic carcinoma of the skin and salivary glands. In these two cases, the ultrastructural study revealed two types of unique intra luminal inclusions, composed respectively of parallel straight tubular arrays and paracrystalline quadrangular structures, probably corresponding to a peculiar organization of secretion products or cellular debris.

[Partial pharyngo-laryngectomy with subtotal esophagectomy and 1-stage coloplasty].

A patient with cancer of both the hypopharynx and esophagus was treated by partial pharyngolaryngectomy, subtotal esophagectomy and a reconstructive one-stage coloplasty. Surgical and carcinologic problems raised by this technique are discussed.

[Undifferentiated carcinoma and lymphoma of the thyroid gland. Apropos of a series of 38 cases].

Twenty-seven patients with undifferentiated carcinoma and eleven with lymphoma of the thyroid are reviewed. Histologic sections of all tumors were re-examined critically. Most tumors were extensive forms spreading beyond the thyroid.

[Laryngeal immobility after intubation].

Based on findings in 14 cases of post-intubation laryngeal immobility simulating a paralysis, it is demonstrated that a mechanical cause bringing into play the arytenoids exists in every case. The origin may be from a synechia between the vocal cords, crico-arytenoid ankylosis, inter-arytenoid and plate of the cricoid fibrosis, or a combination of these lesions. Conclusive evidence of the type of lesion involved is rarely apparent from clinical or paraclinical examinations, an exact diagnosis requiring a median thyrotomy.

[Cellulitis of the neck due to anaerobic germs: report of 10 cases (author's transl)].

Cellulitis of the neck in 10 patients was found to be due to anaerobic germ infections of either dental or tonsillar origins or following surgery. The lesion was diffuse in 8 cases, unilateral in two, and associated with signs of severe toxic infection in 9 cases. Early clinical crepitation was detected in 4 patients.