April 30, 2009 Eleftheria Kiverniti, MRCSEd, DO-HNS, Ulkem Cilasun, DDS, PhD, Arvind Singh, BSc, MRCS, DLO, Rehan Kazi, MS, Peter M. Clarke, BSc, FRCS, and Daniel J. Archer, FDSRCS, FRCS
We present the case of a 23-year-old woman with aggressive fibromatosis of the oropharynx that was initially treated elsewhere as a peritonsillar abscess. We discuss the characteristics of this rare tumor and review the literature, stressing the importance of postoperative follow-up for peritonsillar abscesses to avoid missing other important diagnoses, such as the one described here.
July 31, 2007 Samer Rajjoub, BA; Suzanne R. Basha, MD; Eugene Einhorn, MD; Marc C. Cohen, MD; Doug M. Marvel, BA; Duane A. Sewell, MD
Abstract The presence of tumor-infiltrating lymphocytes has been shown to significantly improve clinical outcomes in many types of cancer. However, their effects on outcomes in patients with oropharyngeal cancer specifically have yet to be elucidated. We conducted a retrospective study in an effort to shed light on this issue. We reviewed the records of 48 consecutively presenting patients with oropharyngeal cancer, and we performed immunohistochemistry to analyze their archived paraffin-embedded tissue samples for the presence of CD3-positive tumor-infiltrating lymphocytes. We also used real-time polymerase chain reaction testing to look for human papillomavirus type 16 (HPV-16) in the tumors. We found that patients with large numbers of tumor-infiltrating lymphocytes (CD3high) had a significantly lower incidence of metastasis at presentation than did those with low numbers of tumor-infiltrating lymphocytes (CD3low) (40.0 vs. 88.5%; p = 0.001), regardless of HPV status. When HPV status was taken into account, the correlation between a high CD3 count and a lower rate of metastasis was maintained in the HPV-positive patients but not in the HPV-negative patients. We also found that the CD3high patients had higher rates of overall survival and disease-free survival at 3 and 5 years than did the CD3low patients; however, these differences only approached but did not reach statistical significance.
Abstract Spindle-cell hemangioendothelioma is an uncommon vascular lesion that exhibits a predilection for the extremities. Very few reports have been published describing this lesion in the head and neck, and to the best of our knowledge, its occurrence in the oropharynx has not been previously reported. In addition to reporting an unusual site of this lesion, our rationale for publishing this case is to comment on the diagnostic dilemma that arose in view of an unclear clinicohistopathologic pattern and to discuss this lesion's similarity to other aggressive tumors.
April 1, 2005 Neena Chaudhary, MS; Sanjay Agrawal, MS; Anil K. Rai, MS
Abstract Descending necrotizing mediastinitis is believed to be a rare and serious complication of odontogenic and oropharyngeal infections. It is associated with a high (up to 40%) mortality rate, which can be attributed to delays in diagnosis and inadequate surgical drainage. Between May 1999 and September 2002, we treated 7 cases at our institution in New Delhi, indicating that such fulminating infections are not so rare in developing countries. In our 7 cases, a high index of suspicion and early computed tomography helped us make a rapid diagnosis and initiate prompt treatment, which resulted in a favorable outcome in 6 cases (mortality rate: 14.3%).