October 26, 2011 J. Madana, MS, DNB, Deeke Yolmo, MS, S. Gopalakrishnan, MS, and Sunil Kumar Saxena, MS
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Abstract
Paranasal sinus carcinoma is rare, with an estimated annual incidence of less than 1 per 100,000 population. Primary frontal sinus involvement is extremely rare, accounting for only 0.3% of all paranasal sinus malignancies. A frontal sinus cancer may be mistaken for a mucocele, pyocele, or osteomyelitis. We report the case of a 48-year-old woman with a carcinoma that originated in the frontal sinus. Computed tomography and magnetic resonance imaging demonstrated bony destruction with intracranial extension but no involvement of the bulbus. The patient underwent a frontal craniotomy, tumor excision, and postoperative radiotherapy. One year later, she remained symptom-free.
October 26, 2011 Bevinahalli N. Nandeesh, MD, DNB, Anuradha Ananthamurthy, MD, Yeliur K. Inchara, MD, DNB, Marjorie M.A. Correa, MD, and Isha Garg, MD
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Abstract
Papillary thyroid carcinoma (PTC) is the most frequently occurring malignant neoplasm of the thyroid gland and is known to have several morphologic variants. PTC with nodular fasciitis-like stroma (PTC-NFS) is one of the unusual variants of PTC, with only a few cases being reported in the literature. This neoplasm is characterized by extensive reactive stromal proliferation, which may occupy 60 to 80% of the tumor along with areas of a typical papillary carcinoma. We report a case of PTC-NFS and address the diagnostic difficulties posed by the condition's extensive reactive stromal proliferation. We also emphasize that when one encounters a fibroproliferative lesion of the thyroid, a diligent search should also be made for PTC to avoid diagnostic errors.
September 20, 2011 Woong Na, MD, Si-Hyong Jang, MD, Kyueng-Whan Min, MD, Seok Hyun Cho, MD, PhD, and Seung Sam Paik, MD, PhD
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Abstract
Cervical thymic cysts are rare embryonic remnants that develop along the course of thymic migration in the neck. They usually occur during infancy and childhood, and they are extremely rare in adults. We report a case of cervical thymic cyst in a 53-year-old man. The patient presented with a small mass of the thyroid gland and a cystic mass at the left level II area of the neck. On histopathology, the thyroid mass was identified as a papillary carcinoma and the left-sided neck mass was diagnosed as a cervical thymic cyst lined with nonkeratinizing, flattened squamous epithelium. The cyst wall contained atrophic thymic tissue composed of lymphoid cells, epithelial cords, and Hassall corpuscles. Although it is rare, cervical thymic cyst should be considered in the differential diagnosis of a lateral cystic neck mass in an adult.
August 15, 2011 Bruce Watkins, MD, Andrew C. Urquhart, MD, and James J. Holt, MD
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Abstract
Eccrine porocarcinoma (EP) is believed to arise from the intraepithelial portion of the eccrine sweat glands. The incidence rate of EP is reported to be 18 per 450,000 biopsies. Most of the diagnosed cases involve the lower extremities; a case of EP involving the ear is rare. We describe the clinical, radiologic, and histopathologic features of EP in an 11-year-old boy.
August 15, 2011 Candice Colby, MD and Adam M. Klein, MD
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Abstract
Papillary squamous cell carcinoma is a rare variant of squamous cell carcinoma of the aerodigestive tract that has been correlated with a more favorable prognosis than conventional squamous cell carcinoma of the head and neck. In this report, the authors present a case of papillary squamous cell carcinoma and a review of the literature on this topic.
April 30, 2011 Wael A. Ahmed, MD, MSc, Kenji Suzuki, MD, PhD, Yoshimune Horibe, MD, PhD, Ichiro Kato, MD, Toshiyuki Fujisawa, MD, and Yoichi Nishimura, MD
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Abstract
Laryngeal anterior commissure (AC) cancer has been the subject of much controversy. Our study was aimed at pathologically evaluating the tendency of AC cancer to invade the thyroid cartilage and analyzing the role of thyroid cartilage invasion by tumor cells at the AC as an anatomic cause for irradiation failure. Our study included 36 patients with glottic cancer involving AC. Patients with recurrent or persistent disease after radiotherapy underwent salvage surgery. Surgical specimens from 22 patients who had open surgery, either as primary or salvage surgery, were available for pathologic examination to identify the presence of cartilage invasion. We found microscopic invasion of the thyroid cartilage in 40.9% of the studied tumors. Only 21.4% of patients who had open salvage surgery showed evidence of cartilage invasion at the AC. We concluded that laryngeal AC cancers are more likely to invade the cartilage, and that anatomic risk factors are not the main cause of irradiation failure.
April 30, 2011 Lester D.R. Thompson, MD
April 30, 2011 Nadia Mohyuddin, MD and Mike Yao, MD
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Abstract
Primary intraosseous carcinoma of the head and neck is rare, and lesions isolated to the anterior maxilla are obviously even more rare. The diagnosis of intraosseous carcinoma can be difficult, and it must be based on strict criteria. We report the case of a 40-year-old man who was referred for definitive treatment of a cancerous lesion of the anterior maxilla. The patient's mass had initially been thought to be a benign odontogenic cyst. The patient was treated with surgery and prosthetic rehabilitation. We describe the clinical presentation, pertinent workup including imaging, and the treatment of this case, and we review the literature.
March 31, 2011 Amy L. Rutt, DO, Mary J. Hawkshaw, BSN, RN, CORLN, Deborah Lurie, PhD, and Robert T. Sataloff, MD, DMA, FACS
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Abstract
Previous research has shown that salivary gland tumors are rare in the young population. A clinical diagnosis has to be made very carefully because the proportion of malignancies is higher in children than in adults. We present a review of cases of malignant salivary gland carcinoma (SGC) in patients younger than 30 years of age. Data were extracted from the Surveillance, Epidemiology, and End Results (SEER) 17 Registry. A total of 763 patients younger than 30 years with carcinoma of a major salivary gland from 1973 to 2004 were identified within the SEER database. The most common salivary gland cancer was mucoepidermoid parotid gland carcinoma. The incidence of all major salivary gland carcinomas increased with increasing patient age. The 5-year relative survival rate for salivary gland carcinomas in our population was calculated according to the Kaplan-Meier analysis in each age group. Relative 5-year survival was 100% in the 1 patient younger than 1 year, 50.0% in the 1- to 4-year-old group; 87.2% among the 5- to 9-year-olds; 97.0% among the 10- to 14-year-olds; 95.0% among the 15- to 19-year-olds; 95.1% among the 20- to 24-year-olds; and 93.6% in the 25- to 29-year-old group. We found that SGC affects patients of all ages, even children in the first year of life. It is essential for physicians to detect salivary gland neoplasms promptly and to evaluate them thoroughly when they are found in children.
February 1, 2011 J. Clinton Lasiter, MD, Benjamin D. Liess, MD, Robert P. Zitsch III, MD, and Jessica Wieberg, MD
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Abstract
Hepatocellular carcinoma (HCC) is one of the most frequently encountered malignancies. Distant metastasis is a common sequela, occurring in approximately 50% of cases. Metastasis to the oral cavity is very rare. Careful immunohistochemical evaluation is critical in differentiating HCC from other metastatic malignancies. An understanding of the possibility that HCC may initially present as a mandibular metastasis is crucial to guide management. We describe the case of a 76-year-old man with a 3- to 4-month history of a painless, slowly enlarging, left-sided jaw mass. Biopsy findings were consistent with HCC. While the patient was a known hepatitis C carrier, the presence of HCC had been previously unknown. Additional workup revealed a large hepatic lesion. In view of his poor health, the patient elected to forgo chemotherapy, and he entered a hospice facility. This case provides an illustration that an isolated mandibular mass may represent the initial presentation of HCC. Subsequent identification of the primary tumor via radiographic and pathologic evaluations is important for the guidance of further management.
December 17, 2010 Asher A. Mendelson, MDCM; Khalil al-Macki, MD, FRCS(C); Peter Chauvin, DDS, MSc, FRCD(C); Karen M. Kost, MD, FRCS(C)
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Abstract
Sclerosing mucoepidermoid carcinoma (SMEC) is an extremely rare variant of mucoepidermoid carcinoma with unique histologic features. To the best of our knowledge, only 14 cases of salivary gland SMEC have been previously reported in the English-language literature since it was discovered in 1987. We report a new case of salivary gland SMEC, and we review the literature. Because of SMEC's distinctive histologic features and rarity, its diagnosis can be difficult. Moreover, no clear treatment strategy has emerged with regard to adjuvant postoperative radiotherapy. We attempt to elucidate a natural course of this disease, and we propose a conservative approach to postoperative management.
December 17, 2010 Sampan S. Bist, MS, Saurabh Varshney, MS, Rakesh Kumar, MS, Sanjeev Bhagat, MS, and Nitin Gupta, MS
