Acute hepatitis in patients on chemotherapy has always been challenging. Demystifying the truth becomes essential to continue chemotherapy. Wepresent a case of carcinoma buccal mucosa who developed acute hepatitis following a single dose of cisplatin and radiotherapy. In the background of a history of chronic alcoholism, and alcohol abstinence of more than 3 months, acute alcoholic hepatitis was unlikely. Though he had occult hepatitis B with HBsAg negative and positive IgG anti-HBc antibody status, however, with undetectable HBV DNA PCR quantitative, hepatitis B was unlikely to be the cause of acute hepatitis. With all viral markers including atypical viruses and autoimmune work-up being negative, it was a real-time challenge to find the exact cause.
UNASSIGNED: Gupta T. Acute Hepatitis in an Immunosuppressed Patient: A Dilemma. Euroasian J Hepato-Gastroenterol 2023;13(1):26-27.

The thyroid cartilage metastatic involvement is an extremely rare entity. It can be asymptomatic at the earlier stage and can become symptomatic later on. Involvement of thyroid cartilage is frequent in melanoma and renal and rarely reported in an advanced stage of carcinoma prostate, breast, and lung. These cases were usually reported on positron emission tomography/computed tomography (PET/CT) as can often easily be missed on computed tomography scan alone. We present a case report of metastatic involvement of thyroid cartilage in squamous cell carcinoma of buccal mucosa detected on the whole-body 18F-fluorodeoxyglucose PET/CT.

OBJECTIVE: To analyze the long-term local control, overall survival and toxicity in Carcinoma Buccal Mucosa patients treated with interstitial brachytherapy.
METHODS: This analysis included patients diagnosed as Carcinoma Buccal Mucosa on biopsy and treated with radical brachytherapy or External Beam Radiotherapy (EBRT) followed by brachytherapy boost. All patients received High dose rate (HDR) interstitial brachytherapy. The total dose was 35 Gy in ten fractions for brachytherapy alone. Patients who received EBRT (50-54 Gy) were boosted by brachytherapy to a dose of 18-24 Gy in 6-8 fractions. All patients were treated using CT based planning.
RESULTS: Between 2007 to 2017, a total of 24 patients of Carcinoma Buccal Mucosa received HDR interstitial brachytherapy either alone or as a boost. Majority of the patients were tobacco chewers (80%). 17(71%) patients were clinical stage T2N0M0 and 7(29%) were clinically T1N0M0. At a median follow up of 7 years (3-12 years), the local control rate was 100% in stage I and 88% in stage II. The 5 year overall survival rate was 80%. Two patients developed nodal recurrence and one patient developed distant metastasis within two years of treatment. Tumor size and brachytherapy technique (radical vs. boost) did not impact local control or overall survival (p > 0.05). Majority of the acute toxicities were Grade 1 and 2. One patient developed osteoradionecrosis of the mandible.
CONCLUSIONS: Interstitial brachytherapy in early-stage Buccal Mucosa cancer either alone or as a boost provides excellent long term local control and overall survival. The acute and late toxicities are acceptable with majority of the patients presenting with Grade 1 or 2 toxicity.

Patients with carcinoma buccal mucosa requiring marginal mandibulectomy pose various key challenges with regard to reconstruction. To study the role and feasibility of the PMMC flap reconstruction in patients of carcinoma buccal mucosa with intact mandible. Study design: retrospective analysis of prospectively maintained data at a tertiary cancer institute in India. Inclusion criteria: all patients of carcinoma buccal mucosa undergoing marginal mandibulectomy at our institute from 1st Jan 2015 to 31st March 2018 with reconstruction done by the PMMC flap. The retrospective analysis showed 82 patients satisfied the inclusion criteria. Median age of the patients was 46 years. Seventy-seven (93.90%) patients were male while 5 (6.09%) patients were female. Median Ryle\'s tube dependency was 13 days. Median follow-up period was 28 months. All the patients had acceptable cosmesis and mouth opening with minimal morbidity. PMMC flap reconstruction after marginal mandibulectomy in patients with carcinoma buccal mucosa is a robust, cosmetically, and functionally acceptable option.

暂无摘要。

The objective of this study was to examine the clinical and pathological features of squamous cell carcinoma of the Tongue and Buccal Mucosa and understand their differences. This is a retrospective analysis of prospectively collected data of 735 patients with squamous cell carcinoma of the tongue and 665 cases of carcinoma of the buccal mucosa treated by surgery at our hospital. Statistical analysis was done to examine clinical and pathological differences between carcinoma of the tongue and the buccal mucosa with regards to age, gender, clinical T stage/N stage, pathological T stage/N stage, overall stage, grade, thickness, perinodal extension (PNE), lymphovascular emboli (LVE) and perineural invasion (PNI). Statistically significant differences were found for factors like age (p < 0.001), gender (p < 0.001), clinical T staging (p < 0.001) and pathological stage (p < 0.001), grade of tumor (p < 0.001) and perineural invasion (p < 0.001) between carcinoma of the tongue and the buccal mucosa. Forty-eight percent patients in either subsite had pathologically proven node negative necks (pN0, p = 0.88). Multivariate analysis for occult nodal metastases revealed that predictive factors were different for the two subsites. There are significant differences between cancers of the tongue and buccal mucosa for various clinical and pathological factors. This may be a reflection of the underlying differences in their causation and pathophysiology. Squamous cell carcinoma in these two subsites should therefore be regarded as clinico-pathologically distinct entities.

BACKGROUND: The technique of anterograde over a retrograde guide is considered to be more reliable and preferable in comparison to only retrograde one, for improving the success rate of retrograde intubation. As the prior technique requires a lengthy guidewire to negotiate the whole channel of a tube guide, we designed a side eye at one end of tube guide, which obviated the above requirement while maintaining the integrity of the whole channel assembly. The efficacy of this modified technique was compared with the conventional one for retrograde intubation procedure.
METHODS: In a prospective, randomised fashion, 98 cases posted for surgery of carcinoma buccal mucosa were included in this trial. These cases were randomised to the conventional (Group I) or the modified technique (Group II) for retrograde intubation. Intubation time (first attempt), total number of successful intubations, cause of failures and any associated side effects were recorded and compared between the groups.
RESULTS: The total number of successful intubations were significantly higher in group II (95.83%, 46/48 cases) as compared to group I (66.66%, 31/48 cases) (P<0.001). Mean intubation time was 118±22 second in group I versus 124±26 second in group II (P=0.39). The side effects did not differ significantly between the groups.
CONCLUSIONS: Improvising the tube guide resulted in a significant rise in the number of successful intubations through a modified retrograde intubation technique, with no side effects. This should encourage the use of retrograde intubation technique as a first option for difficult airway management.