摘要:

AbstractBetween 1978 and 1991, 54 patients with metastatic squamous cell or undifferentiated carcinoma to the cervical lymph nodes, with unknown primary mucosal sites, were treated with curative intent at McGill University teaching hospitals. The median age at diagnosis was 58 years with a male:female ratio of 6:1. All patients presented with a painless neck mass. Five patients (9%) presented with N1 disease, 28 (52%) with N2a disease, four (7%) with N2b disease, three (6%) with N2c disease, and 14 (26%) with N3 disease. Twenty‐four patients (44%) underwent neck dissection, and 30 (56%) had only excisional lymph node biopsy. Fifty‐three patients (98%) were treated with radiotherapy to a median dose of 60 Gy (range 38 to 66 Gy) in 30 fractions. With a median follow‐up time of 49 months, the overall actuarial survival was 63% and 59% at 5 and 10 years, respectively. Three patients were found to have a subsequent primary head and neck tumor. The single most important prognostic factor was the N stage, which influences both neck control and long‐term survival. There was no statistically significance difference in survival or local neck control rates between patients who had neck dissection or excisional lymph node biopsy (p>0.05). © 1994 John Wiley&S

ISSN:1043-3074    

DOI:10.1002/hed.2880160112

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1994

数据来源: WILEY

摘要:

AbstractA 69‐year‐old man presented with recurrent Hürthle cell carcinoma of the thyroid. Successful surgical resection of the recurrent tumor included the larynx and trachea; skin, soft tissues, and lymph nodes of the neck; and the tissues of the anterior mediastinum, including upper sternum and clavicular heads. Coverage of the wound was accomplished with an inferiorly based parasternal fasciocutaneous flap and a long pectoralis myocutaneous flap. This represents the first reported case of Hürthle cell carcinoma treated with mediastinal dissection for extensive local disease. Radical surgical resection should be considered for any patient with Hürthle cell carcinoma of the thyroid in view of the ineffectiveness of nonsurgical modalities. © 1994 John Wiley&So

ISSN:1043-3074    

DOI:10.1002/hed.2880160113

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1994

数据来源: WILEY

摘要:

AbstractTracheal obstruction and superior vena cava (SVC) syndrome are rare complications of retrosternal goiter. These two conditions present a difficult diagnostic and therapeutic challenge. Malignancy is the most common cause of SVC syndrome. Determining whether SVC syndrome is due to a benign or malignant process is imperative before instituting treatment, but this determination may be difficult. We present a case of a patient presenting with upper airway obstruction and SVC syndrome with a large mediastinal mass. The mass was determined to be a multinodular goiter. The patient was managed by surgical removal of the goiter with complete resolution of symptoms. This case illustrates the need for careful preoperative evaluation and the importance of establishing a histologic diagnosis prior to initiating treatment for SVC syndrome. © 1994 John Wiley&Sons, Inc

ISSN:1043-3074    

DOI:10.1002/hed.2880160114

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1994

数据来源: WILEY

摘要:

AbstractThis is the first reported case of congenital extraskeletal Ewing's sarcoma (EES) in the head and neck region. The tumor arose from the medial aspect of the right lower eyelid and rapidly increased in size despite surgery and chemotherapy. Accurate histologic diagnosis is emphasized, and the differential diagnosis, pathology, and treatment are discussed. © 1994 John Wiley&Sons, Inc

ISSN:1043-3074    

DOI:10.1002/hed.2880160115

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1994

数据来源: WILEY

摘要:

AbstractA case of oral cancer that had derived from a 19‐year skin graft on the left buccal mucosa is reported. The patient had had three previous operations due to squamous cell carcinoma, erosion, and squamous cell carcinoma of the left buccal mucosa, respectively. In the last two operations, skin was transplanted, and the present cancer is believed to have derived from the latter one. The tumor was resected, and a new skin was grafted. In situ hybridization of human papilloma virus (HPV) was carried out; the HPV 16 DNA could not be detected in the specimen. Eight months later, a cervical lymph node metastasis was detected; thus, a radical neck dissection was performed. © 1994 John Wiley&Sons, I

ISSN:1043-3074    

DOI:10.1002/hed.2880160116

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1994

数据来源: WILEY

摘要:

AbstractAxillary metastases from squamous cell carcinomas of the head and neck are usually considered signs of incurability. A case is presented in which the patient developed well‐differentiated squamous cell carcinoma in bilateral axillary nodes following total laryngectomy and radical neck dissection for advanced recurrent squamous cell carcinoma of the larynx. Bilateral axillary dissection was performed on this patient followed by a second neck dissection for metastasis. The patient remained well for 25 years free of disease, dying of a massive heart attack. One report of this phenomenon has been found in the literature. The authors conclude that radical axillary dissection should be considered in selective cases of well‐differentiated carcinoma in axillary nodes from a controlled primary in the head and neck mucosa when no other signs of dissemination have been found. A brief review of cervical and axillary lymphatic anatomy is included. © 1994 John Wiley&Sons,

ISSN:1043-3074    

DOI:10.1002/hed.2880160117

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1994

数据来源: WILEY

摘要:

AbstractInterleukin‐1 (IL‐1) has a number of fundamental immunoregulatory, hematologic, metabolic, and physiologic effects and thus is instrumental in the coordination of tissue interactions, such as wound healing, inflammation, and host tumor response. IL‐1 stimulates the activation and differentiation of pre‐B cells and T cells, chemotaxis of neutrophils, recruitment of bone marrow stem cells, stimulation of arachidonic acid metabolism, degradation of proteoglycans, and increase in basal body temperature. Altered production of IL‐1 or IL‐1 regulatory factors may have profound clinical consequences, such as seen in AIDS, other viral and malignant diseases, and in uncontrolled inflammatory processes. A variety of positive and negative feedback mechanisms for regulation of IL‐1 production have been found; therapeutic interventions are aimed at these regulatory pathways. Through approaches interfering with the signal transduction or processing of IL‐1, especially by interleukin‐1‐receptor antagonists (IL‐1RA), future treatment modalities are on the horizon. © 199

ISSN:1043-3074    

DOI:10.1002/hed.2880160118

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1994

数据来源: WILEY

ISSN:1043-3074    

DOI:10.1002/hed.2880160119

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1994

数据来源: WILEY

ISSN:1043-3074    

DOI:10.1002/hed.2880160120

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1994

数据来源: WILEY

ISSN:1043-3074    

DOI:10.1002/hed.2880160122

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1994

数据来源: WILEY