Head and neck tumors (HNT)
ISSN / EISSN : 22221468 / 24114634
Current Publisher: Publishing House ABV Press (10.17650)
Total articles ≅ 196
Latest articles in this journal
Head and neck tumors (HNT), Volume 9; doi:10.17650/2222-1468-2019-9-3-61-71
Abstract:Modern advances in oncology can achieve significantly better results in terms of life expectancy in patients with metastatic brain disease. The combination of surgery, systemic therapy, whole brain irradiation and local methods of radiation therapy lead to good indicators for controlling the manifestations of the disease in the brain. Of course, intensification of treatment increases the risk of iatrogenic complications. The use of aggressive stereotactic radiotherapy regimens leads not only to high local control of irradiated metastases, but also to the risk of so-called radiation necrosis. The use of the most up-to-date diagnostic methods does not always allow one to unequivocally differentiate radiation necrosis from continued metastasis growth. The above example shows the need for a careful assessment of such situations and a multidisciplinary approach to interpreting the results of stereotactic radiotherapy.
Head and neck tumors (HNT), Volume 9; doi:10.17650/2222-1468-2019-9-3-24-28
Abstract:The objective is using a clinical example to demonstrate the possibilities of intra-arterial polychemotherapy (PCT) in the combined treatment of oral squamous cell carcinoma.Clinical case. A 43-year-old oral squamous cell carcinoma patient with metastases to cervical lymph nodes, left side (T3N2bM0, stage IV) underwent 2 courses of regional neoadjuvant intra-arterial PCT (docetaxel at a dose of 105 mg, cisplatin at a dose of 105 mg), accessed through a. lingualis. A total dose of 6,800 mg of 5-fluorouracil was administered as a 96-hour infusion. PCT induced oral mucositis of grade 2, no hematological side effects were observed. Clinical examination revealed that tumor volume decreased by 60 %. Ultrasound detected no changes in lymph nodes. Second step included resection of oral cavity bottom tissues, atypical tongue resection, marginal resection of the lower jaw on the left, radical neck dissection on the left. Histological study of the surgical material of primary tumor region as well as metastases of the cervical lymph nodes on the tumor side revealed pathomorphism of 4 grade. In the postoperative period, oral cavity and neck were irradiated from 2 sides. No signs of the disease were detected within 9 months after the combined treatment.Conclusion. The clinical case demonstrates the high efficiency of regional intra-arterial PCT in patients with locally invasive oral squamous cell carcinoma. It seems relevant to further study its possibilities in the combined treatment of locally invasive forms of oral squamous cell carcinoma.
Head and neck tumors (HNT), Volume 9; doi:10.17650/2222-1468-2019-9-3-72-76
Abstract:A clinical case of the malignant peripheral nerve sheath tumor is presented. It is a rare tumor in the head and neck area. The tumor arises from Schwann cells, its malignant potential is unclear. This low-growing tumor is presenting as a solitary nodule. To make a precise diagnosis immunohistochemistry assay is used. Surgical approach provides good long-term outcome.
Head and neck tumors (HNT), Volume 9; doi:10.17650/2222-1468-2019-9-3-12-23
Abstract:The study objective is to assess the capabilities of ultrasonography in the diagnosis of oropharyngeal squamous cell carcinomas and in the evaluation of treatment efficacy (changes in tumor volume).Materials and methods. This study included 98 patients (27 (27.5 %) females and 71 (72.5 %) males aged between 20 and 78 years with oropharyngeal tumors; of them, 12 (12.2 %) patients had recurrent tumors. Sixty-seven (68.4 %) participants had their tumors located in the tonsils; 31 (31.6 %) patients had tumors of the root of the tongue; 47 (48.0 %) patients presented with tumors invading adjacent tissues; 57 (58.2 %) patients had their lymph nodes involved. Thirty-two patients were operated at the first stage of treatment, whereas 66 (67.3 %) individuals received induction chemotherapy followed by sequential chemoradiotherapy. Treatment efficacy was evaluated 2 weeks following the completion of the second course of induction chemotherapy. We assessed tumor volume, its structure, type and intensity of vascularization, and the number and size of lymph nodes affected by metastasis. Ultrasonography findings were compared with the results of fibroscopy, X-ray computed tomography (CT) and magnetic resonance imaging (MRI) performed 2 weeks following the completion of the second course of induction chemotherapy (no later than 7–10 days).Results. The disagreement between histology and ultrasonography findings reflecting tumor volume (of either newly diagnosed or recurrent tumor) was statistically insignificant. The results of X-ray CT were more likely to be in agreement with histology than the ultrasonography results (85.0 % vs 70.0 %); however, this difference was not statistically significant. Data of X-ray CT and ultrasonography on the tumor volume demonstrated no significant difference between them. MRI and ultrasonography findings on the tumor volume were consistent in 50 % of cases. We identified the most common changes in the structure of the oropharyngeal tumors typical of positive and negative dynamics after 2 courses of induction chemotherapy. Patients with positive dynamics demonstrated a significant decrease in tumor volume detected by all diagnostic methods used (ultrasonography, X-ray CT, and MRI). There was a significant negative correlation between the efficacy of treatment assessed by ultrasonography and the grade of therapeutic pathomorphosis assessed by histology (r = –0.69; р = 0.0014).Conclusion. The accuracy of ultrasonography for the estimation of oropharyngeal tumor volume and its spread is comparable with that of X-ray CT and MRI. The disagreement between these methods was statistically insignificant. Ultrasonography is a more sensitive method for the evaluation of patient response to treatment than clinical data.
Head and neck tumors (HNT), Volume 9; doi:10.17650/2222-1468-2019-9-3-29-37
Abstract:One of the earliest and most common adverse events of radiotherapy in patients with oropharyngeal cancers is mucositis. Radiation-induced mucositis significantly impairs the quality of life, patient compliance, and sometimes even long-term treatment outcomes. Currently, there is a wide range of drugs and techniques for the prevention and treatment of this complication. Nevertheless, these methods are not always highly effective and often have their own adverse events; therefore, the search for a universal method still continues. The present review aims to analyze the efficacy of hyaluronic acid in the prevention and treatment of oropharyngeal mucositis.
Head and neck tumors (HNT), Volume 9; doi:10.17650/2222-1468-2019-9-3-97-101
Abstract:The objective is to demonstrate possibilities of a harpoon biopsy under ultrasound guidance for malignant neoplasms early detection using a clinical example.Clinical case. A 65-year-old patient with morphologically verified laryngeal cancer (stage II, T2N0M0) underwent radiation therapy, which resulted in a complete tumor resorption. Subsequent ultrasound detected a neoplasm in the projection of the folding section. Percutaneous harpoon biopsy was performed under ultrasound guidance because standard clinical and instrumental studies were unable to confirm the diagnosis. Histological study of the biopsy material confirmed the “relapse of larynx squamous cell carcinoma”.Conclusion. A transdermal harpoon biopsy under ultrasound guidance followed by morphological biopsy study makes it possible to diagnose the disease and determine therapeutic approach as soon as possible.
Head and neck tumors (HNT), Volume 9; doi:10.17650/2222-1468-2019-9-3-89-96
Abstract:The objective of the work is to demonstrate the signs of mucoepidermoid carcinoma of the minor salivary glands in pediatric patients on a clinical example.Clinical case. In August 2017, a girl of 9 years old appeared in the area of the right half of the hard palate. The dentist at the place of residence diagnosed an abscess in the area of the hard palate, performed the lancing and drainage of the “abscess”, prescribed antibiotic therapy. After 3.5 months (in December 2017), hyperemia and an increase in the volume of the mucous membrane reappeared in the same zone. Reapplied to the dentist. The girl was sent to the Oral and Maxillofacial Surgery Department, where the hard palate formation was removed on 23.01.2018; according to histological examination a highly differentiated tumor of the hard palate was diagnosed. The girl was sent for a consultation to the N. N. Blokhin National Medical Research Center of Oncology, where histological preparations were reviewed: a fragment of the mucous membrane of the hard palate covered with squamous epithelium, with the growth of low-grade mucoepidermoid cancer (from the minor salivary glands of the hard palate). A biopsy of the postoperative scar 3 mm long and of the formation of a hard palate 1 mm in diameter was performed; during histological examination of the biopsy material tumor cells were not detected (the material was represented by fibrous tissue). Despite the biopsy results, taking into account the medical history, the results of a review of histological preparations, the rarity and high aggressiveness of the tumor, poor prognosis for relapse, lack of data for regional and distant metastases, at the concilium it was accepted the decision to conduct repeated surgery. In the Surgical Department No. 1 of the Research Institute of Pediatric Oncology and Hematology, N. N. Blokhin National Medical Research Center of Oncology on 13.03.2018 a resection of the hard palate was performed with plastic surgery of the defect with a mixed skin-muscle flap on the vascular pedicle.Conclusion. Mucoepidermoid cancer of the minor salivary glands of the hard palate in children and adolescents can be manifested by the presence of a slowly growing, painless, pale blue tumor. For a correct clinical and morphological diagnosis, a biopsy of the tumor is necessary, further the removal of the tumor is recommended with resection of the hard palate, in view of the high risk of tumor spreading in the thickness of the bone.
Head and neck tumors (HNT), Volume 9; doi:10.17650/2222-1468-2019-9-3-38-48
Abstract:Medullary thyroid cancer (MTC) is a rare disorder that accounts for approximately 1.7 % of all thyroid malignancies. MTC is usually detected at early stages; however, approximately 10–15 % of patients are diagnosed with locally advanced MTC and distant metastases. Treatment of such patients is challenging due to biological characteristics of the disease and very few effective treatment approaches available. The investigation of mechanisms of carcinogenesis, as well as advances in pharmacology, allowed the development of a new group of targeted drugs, namely tyrosine kinases, which efficacy against progressive unresectable locally advanced or metastatic MTC has been demonstrated in multiple clinical trials. Vandetanib has been registered for MTC treatment in the Russian Federation. MTC is very rare, thus, each case of vandetanib use for its treatment is particularly interesting. Moreover, since the approval of this drug in 2011 by the U. S. Food and Drug Administration (FDA), new data on the clinical use of vandetanib have been accumulated. Importantly, clinical trials are usually well designed and conducted in near-ideal conditions, whereas the real conditions can be different and patients may have individual characteristics. Therefore, the aim of this study was to update the information on the efficacy and safety of vandetanib by retrospective analysis of available publications and to report a case of MTC treated with vandetanib.
Head and neck tumors (HNT), Volume 9; doi:10.17650/2222-1468-2019-9-3-49-60
Abstract:Most of the malignant neoplasms of the head and neck are represented by squamous cell carcinoma. 18F-fluorodeoxyglucose positron emission tomography combined with computed tomography in squamous cell carcinoma of the head and neck is applied for primary staging, treatment planning, treatment response assessment evaluation and progression detection. The article presents a literature review on the use of 18F-fluorodeoxyglucose positron emission tomography combined with computed tomography in head and neck squamous cell carcinoma patients, and major trends of other radiopharmaceuticals usage in this nosology.
Head and neck tumors (HNT), Volume 9; doi:10.17650/2222-1468-2019-9-3-77-82
Abstract:Clinical case of solitary metastasis of the clear cell variant of renal cell carcinoma into the thyroid gland was analyzed. The thyroid mass was initially considered to be benign. The diagnostic showed signs similar to thyroid follicular neoplasia. The patient was operated on. The thyroid tumor was finally diagnosed as metastasis from clear cell variant of renal cell carcinoma.