The aim was to investigate clinical course of disease in patients with malignant laryngeal tumors with emphasis on various forms of disease recurrence (local recurrence, metastasis to regional lymph ...nodes, occurrence of second primary tumor). A retrospective research including 78 patients with histopathologically confirmed diagnosis of squamous cell laryngeal carcinoma was conducted. Information on cancer stage, histologic grade, type of treatment and disease recurrence was obtained from medical history. Tissue samples of the patients were submitted to immunohistochemical analysis and assessment of Ki-67 proliferation index expression. The occurrence of second primary tumor was found to be related to the significantly higher Ki-67 proliferation index. The number of patients having not undergone oncologic therapy and remained free from disease recurrence was significantly higher than expected. Treatment outcome depends on patient age, histologic grade, radiotherapy applied, and clinical course of disease. It is necessary to define the predictive factors of various forms of disease recurrence more precisely in order to identify better treatment options for patients with malignant tumors of the larynx.
We conducted an outcome analysis on surgically treated laryngeal squamous cell carcinoma (LSCC) patients.
A multicenter retrospective study with 352 patients was analyzed. A new nomogram that ...incorporates age, T- and N-classification, and treatment was created.
Recurrence was observed in 65 (18.5%) patients after a mean time of 16.5 months. After 60 months, 91 (25.9%) of patients developed secondary primary tumors (SPT), most commonly in the lungs (
= 29; 8.2%) followed by other head and neck cancers (
= 21; 6.0%). Notably, the mean time to occurrence of secondary head and neck cancers was twice that of lung cancer (101.1 vs. 47.5 months).
Recurrent disease is less common in LSCC patients and appears much earlier than SPT. Because one in every four laryngeal cancer patients develops SPTs within 5-10 years, long-term care and follow-up, including imaging studies, are highly recommended. The nomogram was useful for estimating survival.
In this review we would like to focus our attention upon very controversial reports on Erythropoietin (Epo) and Erythropoietin Receptor (EpoR) expression in cancer patients. The effects of Epo on ...cancerous tissues are poorly understood. Hypoxia results in an increase in the level of the production of both Epo and EpoR via activation of the hypoxia-inducible factor 1 (HIF-1) pathway. HIF-1α, promotes the expression of vascular endothelial growth factor (VEGF). The signaling through VEGF in both a paracrine and an autocrine manner is required for the homeostasis of adult vessels. Macrophages stimulate vessel sprouting via a soluble factor other than VEGF, rather than through direct contact with endothelial cells. The intriguing questions are set about many researches to link Epo/EpoR expression and function in order to establish one of the mechanisms of tumor growth, disease progression of cancer patient. However, it is uncertain role in tumour angiogenesis as promoter and stimulator of tumour growth which should need to be furtherly validated.
The study searched for epidermal growth factor receptor (EGFR) gene amplification in hyperplastic glottis lesions. After classical pathohistological findings of hematoxylin-eosin (HE) slides and ...quantitative immunohistochemical (IHC) analysis, fluorescent in situ hybridization (FISH) was used on tissue microarrays of laryngeal hyperplastic tissue ranging from normal mucosa to abnormal and atypical hyperplastic lesions. FISH analysis of two atypical hyperplastic lesions discovered the amplification of EGFR gene while it was not found in simple and abnormal hyperplastic lesions. The results may indicate that EGFR gene amplifications could possibly correlate with the histopathologic picture. Tissue samples burdened with specific oncogen signatures like EGFR gene amplification could be detected in precancerous lesion. This might improve follow-up and treatment protocols of glottic lesions which are an everyday problem for ENT practitioners. Further research is mandatory to confirm our findings.
Tuberculosis is an airborne disease caused by Mycobacterium tuberculosis. In 15–20% cases of active disease extrapulmonary tuberculosis may occur, most commonly in the head and neck region. ...Tuberculous otitis media accounts for 0,1% of the total number of tuberculosis patients. This paper provides insight into current state of literature of tuberculous otitis media. It also includes the case of a 53-year-old patient with tuberculous otitis media. The patient had a liver transplantation and she showed an atypical manifestation of the disease including acute otitis media and coinfection with Achromobacter xylosoxidans. The paper describes in detail the methods of diagnosis and the infection treatment. Considering the polymorphic clinical presentation of tuberculous otitis media in cases with long lasting otorrhoea differential diagnosis should include an infection with Mycobacerium tuberculosis.
Cilj je bio istražiti klinički tijek bolesti kod bolesnika sa zloćudnim tumorima grkljana s osvrtom na razne oblike povrata
bolesti (lokalni recidiv, metastaze u regionalne limfne čvorove, pojavnost ...drugog primarnog tumora). Proveli smo retrospektivno
istraživanje na 78 bolesnika s patohistološki potvrđenom dijagnozom planocelularnog karcinoma grkljana. Iz povijesti
bolesti dobili smo podatke o stadiju karcinoma, histološkom gradusu, vrsti provedenog liječenja te o povratu bolesti. Na
patohistološkim uzorcima tkiva tih bolesnika učinili smo imunohistokemijsku analizu i procjenu ekspresije proliferacijskog
čimbenika Ki-67. Pojava drugog primarnog tumora vezana je uz značajno veći proliferacijski indeks Ki-67. Značajno veći je
bio udio bolesnika kod kojih nije provedena onkološka terapija, a koji naknadno nisu razvili neki od oblika povrata bolesti.
Ishod liječenja ovisi o dobi bolesnika, histološkom gradusu, primijenjenoj radioterapiji i kliničkom tijeku bolesti. Potrebno
je preciznije definirati prediktivne čimbenike rizika za razne oblike povrata bolesti kako bismo bolje i kvalitetnije liječili
bolesnike s malignim tumorima grkljana.
Cilj: Cilj rada je prikazati slučaj s višestrukim rijetkim komplikacijama laringokele. Prikaz slučaja: Prikazujemo slučaj 71-godišnje pacijentice s višestrukim komplikacijama laringokele. Pacijentica ...se prvi put javlja u kliniku za otorinolaringologiju i kirurgiju glave i vrata KBC-a Rijeka u veljači 2008. te biva podvrgnuta traheotomiji zbog epizode akutnog epiglotitisa. Godinu dana kasnije pacijentica se vraća na kliniku zbog odinofagije i disfagije. Postavlja se dijagnoza parafaringealnog apscesa te se on incidira i drenira. Godine 2010. pacijentica biva ponovno hospitalizirana zbog mase na vratu te se započinje s dijagnostikom. Nekoliko dana kasnije pacijentica se otpušta, ali se ubrzo samoinicijativno vraća na kliniku dispnoična. Učini se magnetska rezonancija vrata i postavi se dijagnoza laringokele koju se liječi kirurškom ekstirpacijom. Zaključak: Naša pacijentica prezentira se nizom zanimljivih i vrlo rijetkih komplikacija koje čine ovaj slučaj vrijednim prikazivanja. Pretpostavljamo da je pacijentica u ovom slučaju laringokelu razvila zbog traheotomije 2008. godine. Pretražujući literaturu, pronašli smo samo jedan slučaj koji povezuje traheotomiju s nastajanjem laringokele. Nadalje, laringokela je pacijentici uzrokovala po život opasnu opstrukciju dišnog puta, što je samo po sebi vrlo rijetka komplikacija. Možemo pretpostaviti da bi ranija dijagnoza i adekvatno liječenje omogućilo ovoj pacijentici da izbjegne sve komplikacije te se nadamo kako će ovaj slučaj podići svijest o laringokeli i smanjiti incidenciju komplikacija u budućnosti.
Objective: The aim of this case report is to present a case with multiple rare laryngocele complications. Case review: This case report follows a 71-year-old female patient with multiple complications following the formation of a laryngocele. The patient first arrives at the Otorhinolaryngology, head and neck surgery clinic in February 2008 and undergoes a tracheotomy for acute epiglottitis. A year later, the patient returns to the clinic complaining about odynophagia and dysphagia. A diagnosis of parapharyngeal abscess is made and the patient is treated with incision and drainage. In 2010 the patient is re-hospitalized for a neck formation and a diagnostic procedure is initiated. A few days later, the patient is discharged, but soon returns to the hospital dyspnoeic. Magnetic resonance imaging of the neck is performed, and a diagnosis of laryngocele is made. The patient undergoes surgical extirpation of the laryngocele. Conclusion: The patient in this case has an interesting combination of rare complications which makes this case worth representing. Firstly, we assume that this patient has developed a laryngocele following a tracheostomy. We were able to find only one case of post-tracheostomy laryngocele formation in the literature. Secondly, the laryngocele caused this patient a life threating airway obstruction which is in itself a very rare complication. We can speculate that an earlier diagnosis and treatment could have saved the patient of all the complication she had, and we hope this case can contribute to lower the incidence of laryngocele complications in the future.
Renal clear cell metastatic carcinoma of the larynx is an extremely rare diagnosis with poor survival. The objective of this short review is to provide insight into current state of literature on ...this rare neoplasm. Additionally we include the case of a patient with metastatic process of the thyroid cartilage that was treated with novel targeted therapies which enabled prolonged survival and good quality of life. These findings support their inclusion in treatment protocols of patients with metastatic renal clear cell carcinoma of the larynx, especially in those refusing surgery which is the main treatment option in literature so far.
Metastaza svjetlostaničnog karcinoma bubrežnih stanica u grkljan izuzetno je rijetka dijagnoza s lošim preživljavanjem. Cilj je ovog kratkog preglednog članka pružiti uvid u trenutno stanje literature o ovoj rijetkoj novotvorini. Uz to uključujemo i slučaj pacijenta s metastatskim procesom tiroidne hrskavice koji je liječen novim ciljanim terapijama koje su omogućile produljeno preživljavanje i dobru kvalitetu
života. Ova otkrića potkrepljuju njihovo uključivanje u protokole liječenja pacijenata sa svjetlostaničnim metastatskim karcinomom grkljana, posebno kod pacijenata koji odbijaju kirurško liječenje, što je dosad glavni modalitet liječenja prema dostupnoj literaturi.
Metastaza svjetlostaničnog karcinoma bubrežnih stanica u grkljan izuzetno je rijetka dijagnoza s lošim preživljavanjem. Cilj je ovog kratkog preglednog članka pružiti uvid u trenutno stanje ...literature o ovoj rijetkoj novotvorini. Uz to uključujemo i slučaj pacijenta s metastatskim procesom tiroidne hrskavice koji je liječen novim ciljanim terapijama koje su omogućile produljeno preživljavanje i dobru kvalitetu života. Ova otkrića potkrepljuju njihovo uključivanje u protokole liječenja pacijenata sa svjetlostaničnim metastatskim karcinomom grkljana, posebno kod pacijenata koji odbijaju kirurško liječenje, što je dosad glavni modalitet liječenja prema dostupnoj literaturi.
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