Oral cavity carcinoma

  • 文章类型: Case Reports
    口腔转移性食管癌的报道很少,大多数病例是转移到下颌骨的腺癌。由于食管鳞状细胞癌的罕见性以及诊断和治疗这种疾病的困难,因此首次报道了将食管鳞状细胞癌转移到口腔底部的病例至关重要。
    一名53岁的男性在口腔底部左侧有一个疼痛的粘膜下肿块,持续了2个月。活检提示中分化鳞状细胞癌。口腔内肿块出现前六个月,患者患有胸段食管中分化鳞状细胞癌,并接受同步放化疗治疗。结合以前的病史和病理回顾,诊断为口底转移性食管鳞状细胞癌。内窥镜检查和18F-氟代脱氧葡萄糖正电子发射断层扫描-计算机断层扫描显示没有其他异常或其他远处转移。患者接受了手术切除和术后放化疗。他能够有规律的饮食,并且有很好的言语功能。治疗完成后10个月,他的口底疾病反复发作,并伴有肺转移。
    食管鳞状细胞癌的口腔转移非常罕见,应根据临床和病理特征与原发性口腔癌区分开。18F-氟代脱氧葡萄糖正电子发射断层扫描-计算机断层扫描是排除原发性肿瘤持续性和其他转移的首选成像方法。治疗通常是姑息性的;然而,对于口腔疾病有限的患者,保留功能手术可能是一种选择。
    UNASSIGNED: Metastatic esophageal carcinoma to the oral cavity has been rarely reported, and most cases were adenocarcinoma metastasizing to the mandible. This first report of a case of metastatic esophageal squamous cell carcinoma to the floor of the mouth is crucial due to its rarity and difficulties in diagnosing and managing this condition.
    UNASSIGNED: A 53-year-old male had a painful submucosal mass on the left side of the floor of the mouth for 2 months. A biopsy indicated a moderately differentiated squamous cell carcinoma. Six months before the intraoral mass appeared, the patient had a moderately differentiated squamous cell carcinoma of the thoracic esophagus and was treated with concurrent chemoradiotherapy. With the previous history and pathological review, the diagnosis of metastatic esophageal squamous cell carcinoma to the floor of the mouth was made. Panendoscopy and an 18F-fluorodeoxyglucose positron emission tomography-computed tomography scan revealed no other abnormality or other distant metastasis. The patient underwent surgical resection with postoperative chemoradiotherapy. He was able to take a regular diet and had good speech function. Ten months after treatment completion, he has had recurrent disease at the floor of the mouth with lung metastasis.
    UNASSIGNED: Oral metastasis from esophageal squamous cell carcinoma is very rare and should be differentiated from primary oral cancer using clinical and pathological features. 18F-fluorodeoxyglucose positron emission tomography-computed tomography scanning is the preferred imaging method to exclude primary tumor persistence and other metastases. Treatment is usually palliative; however, function-preserving surgery may be an option for a patient with limited disease in the oral cavity.
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  • 文章类型: Journal Article
    Adequate treatment of lymph node metastases is essential for patients with head and neck squamous cell carcinoma (HNSCC). However, there is still no consensus on the optimal surgical treatment of the neck for patients with a clinically positive (cN+) neck. In this review, we analyzed current literature about the feasibility of selective neck dissection (SND) in surgically treated HNSCC patients with cN + neck using the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. From the reviewed literature, it seems that SND is a valid option in patients with cN1 and selected cN2 neck disease (non-fixed nodes, absence of palpable metastases at level IV or V, or large volume ->3 cm-multiple lymph nodes at multiple levels). Adjuvant (chemo) radiotherapy is fundamental to achieve good control rates in pN2 cases. The use of SND instead a comprehensive neck dissection (CND) could result in reduced morbidity and better functional results. We conclude that SND could replace a CND without compromising oncologic efficacy in cN1 and cN2 cases with the above-mentioned characteristics.
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