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Watanabe K, Okumura Y, Hashimoto K, Suzuki T. Clear Cell Carcinoma of the Base of the Tongue. Ann Otol Rhinol Laryngol 2014; 124:55-61. [DOI: 10.1177/0003489414542094] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: Clear cell carcinoma (CCC) is a rare, low-grade malignant neoplasm of minor salivary glands. Clear cell carcinoma is composed of monomorphic clear cells that contain glycogen within a hyalinized stroma. The microscopic diagnosis can be challenging, and the treatment strategy has not been established. Methods: We report a case of a 56-year-old woman with CCC in the base of the tongue. A literature review, including 22 published cases and our case, was performed to clarify the clinical characteristics of CCC in the base of the tongue. Results: The exophytic tumor showed no infiltration to the neighboring tissues. She underwent a local excision en bloc transorally and is free of the disease 15 months after surgery. In our review of 23 cases of CCC in the base of the tongue, 21 cases received surgical excision for the purpose of the primary treatment modality. The fact that the distinctive features of restricted site-related symptoms and the rare presentation of pain emerged was similar to previously reported cases of CCC. A relatively good prognosis was still indicated. Conclusion: We reveal the features of the unusual occurrence of CCC in the base of the tongue and consider the appropriate surgical approach for primary treatment.
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Affiliation(s)
- Kenichi Watanabe
- Department of Otolaryngology, Sendai Social Insurance Hospital, Sendai, Japan
- Department of Otorhinolaryngology–Head and Neck Surgery, Tohoku University School of Medicine, Sendai, Japan
| | - Yuri Okumura
- Department of Otolaryngology, Sendai Social Insurance Hospital, Sendai, Japan
| | - Ken Hashimoto
- Department of Otolaryngology, Sendai Social Insurance Hospital, Sendai, Japan
| | - Takashi Suzuki
- Department of Pathology and Histotechnology, Tohoku University School of Medicine, Sendai, Japan
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Chen EY, Lim J, Boss EF, Inglis AF, Ou H, Sie KC, Manning SC, Perkins JA. Transoral approach for direct and complete excision of vallecular cysts in children. Int J Pediatr Otorhinolaryngol 2011; 75:1147-51. [PMID: 21752477 PMCID: PMC4038648 DOI: 10.1016/j.ijporl.2011.06.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2011] [Revised: 06/10/2011] [Accepted: 06/11/2011] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To review the presentation, evaluation, and treatment of children with vallecular cysts and introduce a new technique of transoral excision for this entity. METHODS Retrospective case series of children diagnosed with vallecular cyst between 2001 and 2008 at a single tertiary care children's hospital. Data collected, including age at diagnosis, presenting symptoms, additional diagnoses, diagnostic modality, prior and subsequent surgical therapy, length of hospital stay, length of follow-up, and recurrence were analyzed with descriptive statistics. RESULTS Seven children (mean age 198 days, range 2 days to 2.9 years) were included in this series. Five children presented with respiratory distress and/or swallowing difficulties. Vallecular cyst was diagnosed by initial flexible fiberoptic laryngoscopy (5/7), MRI (1/7), and intubating laryngoscopy (1/7). All children underwent complete cyst excision via transoral surgical approach. Two children underwent additional supraglottoplasty for concomitant laryngomalacia, one of whom underwent tracheotomy for persistent respiratory distress and vocal cord immobility. The average length of hospital stay postoperatively was 9.5 days, and four patients stayed less than 2 days. No patients experienced recurrence of the vallecular cyst at last follow-up (range 4-755 days, mean 233 days). CONCLUSIONS Vallecular cysts are rare but should be considered in children with respiratory distress and dysphagia. Awake, flexible fiberoptic laryngoscopy with particular attention to the vallecular region should be performed on any child presenting with these symptoms. Direct, transoral approach for excision of the vallecular cyst is our preferred method of treatment with no recurrences to date.
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Affiliation(s)
- Eunice Y. Chen
- Division of Pediatric Otolaryngology, Section of Otolaryngology, Department of Surgery, Children’s Hospital at Dartmouth, Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States
| | - Jae Lim
- Division of Pediatric Otolaryngology, Seattle Children’s Hospital, Department of Otolaryngology – Head and Neck Surgery, University of Washington, 4800 Sand Point Way NE, M/S W-7729, Seattle, WA 98105-0371, United States
| | - Emily F. Boss
- Division of Pediatric Otolaryngology, Department of Otolaryngology – Head and Neck Surgery, Johns Hopkins Medicine, Baltimore, MD, United States
| | - Andrew F. Inglis
- Division of Pediatric Otolaryngology, Seattle Children’s Hospital, Department of Otolaryngology – Head and Neck Surgery, University of Washington, 4800 Sand Point Way NE, M/S W-7729, Seattle, WA 98105-0371, United States
| | - Henry Ou
- Division of Pediatric Otolaryngology, Seattle Children’s Hospital, Department of Otolaryngology – Head and Neck Surgery, University of Washington, 4800 Sand Point Way NE, M/S W-7729, Seattle, WA 98105-0371, United States
| | - Kathleen C.Y. Sie
- Division of Pediatric Otolaryngology, Seattle Children’s Hospital, Department of Otolaryngology – Head and Neck Surgery, University of Washington, 4800 Sand Point Way NE, M/S W-7729, Seattle, WA 98105-0371, United States
| | - Scott C. Manning
- Division of Pediatric Otolaryngology, Seattle Children’s Hospital, Department of Otolaryngology – Head and Neck Surgery, University of Washington, 4800 Sand Point Way NE, M/S W-7729, Seattle, WA 98105-0371, United States
| | - Jonathan A. Perkins
- Division of Pediatric Otolaryngology, Seattle Children’s Hospital, Department of Otolaryngology – Head and Neck Surgery, University of Washington, 4800 Sand Point Way NE, M/S W-7729, Seattle, WA 98105-0371, United States
,Corresponding author. Tel.: +1 206 987 3468; fax: +1 206 987 3925. (J.A. Perkins)
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Leu YS, Ho GM. A Means of Achieving More Surgical Exposure during Transoral Surgery on the Tongue Base and Vallecula. EAR, NOSE & THROAT JOURNAL 2005. [DOI: 10.1177/014556130508400510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Yi-Shing Leu
- Department of Otolaryngology–Head and Neck Surgery, Mackay Memorial Hospital, Taipei, Taiwan
| | - Guan-Min Ho
- Department of Otolaryngology–Head and Neck Surgery, Mackay Memorial Hospital, Taipei, Taiwan
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