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Álvarez-Calderón-Iglesias O, Pérez-Sayáns M, Hurtado-Ruzza R, Lorenzo-Pouso A, Chamorro-Petronacci C. Survival outcomes in laryngeal chondrosarcoma: a systematic review. ACTA OTORHINOLARYNGOLOGICA ITALICA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI OTORINOLARINGOLOGIA E CHIRURGIA CERVICO-FACCIALE 2022; 42:502-515. [PMID: 36654516 PMCID: PMC9853110 DOI: 10.14639/0392-100x-n1912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 09/27/2022] [Indexed: 01/18/2023]
Abstract
Laryngeal chondrosarcomas (LCS) are rare lesions that behave as locally aggressive tumours, producing symptoms such as dysphonia, dyspnoea, dysphagia and hoarseness. Different approaches for the treatment of LCS have been described in the literature. The main purpose of this investigation was to find all cases of LCS published to date and analyse management data and survival outcomes. In December 2020, a systematic review was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Provider Enrollment, Chain, and Ownership System (PECOS) method including articles published up to this date on different aspects of LCS. The search included the terms larynx, laryngeal, chondrosarcoma. A total of 148 articles were included in this systematic review describing 381 cases of LCS. Dyspnoea was the most reported symptom followed by hoarseness and neck mass sensation. Cricoid cartilage was the most usual location. Survival rate was influenced by both surgical technique (log-rank = 11.7; p = 0.008) and the degree of tumour histologic differentiation (log-rank = 18.3; p = 0.003).
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Affiliation(s)
- Oscar Álvarez-Calderón-Iglesias
- Department of Health Sciences; Faculty of Nursing and Podiatry; Research, Health and Podiatry Group - Universidade da Coruña; HM Hospitals Research Foundation, Madrid, Spain
| | - Mario Pérez-Sayáns
- Oral Medicine, Oral Surgery and Implantology Unit, MedOralRes Group, Universidade de Santiago de Compostela, Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Spain
| | - Rafael Hurtado-Ruzza
- Department of Otorhinolaryngology, Complexo Hospitalario Universitario de Ourense, Province of Ourense, Spain; Research, Health and Podiatry Group, Department of Health Sciences, Faculty of Nursing and Podiatry, Universidade da Coruña, Spain
| | - Alejandro Lorenzo-Pouso
- Oral Medicine, Oral Surgery and Implantology Unit, MedOralRes Group, Universidade de Santiago de Compostela, Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Spain
| | - Cintia Chamorro-Petronacci
- Oral Medicine, Oral Surgery and Implantology Unit, MedOralRes Group, Universidade de Santiago de Compostela, Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Spain,Correspondence Cintia Micaela Chamorro Petronacci C/ entrerrios S/N, CP: 15706, Santiago de Compostela, Spain Tel.: +34 651011815 E-mail:
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Mäkitie AA, Devaney KO, Baujat B, Almangush A, Ferlito A. Characteristics of Laryngeal Osteosarcoma: A Critical Review. Oncol Ther 2020; 8:33-44. [PMID: 32700074 PMCID: PMC7359981 DOI: 10.1007/s40487-020-00110-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Indexed: 12/14/2022] Open
Abstract
Laryngeal sarcomas constitute an extremely rare entity among head and neck malignancies. Furthermore, most of them are chondrosarcomas, and the osteogenic form remains a true rarity. In general, there is a lack of information on the characteristics of laryngeal osteosarcoma. Thus, we sought to critically review the existing world literature on laryngeal osteosarcoma in order to develop a more accurate clinicopathological profile of this malignancy. Laryngeal osteosarcoma has a predilection for elderly male patients, as 87% were male in the present series and the mean age was 62 years (range 32-80), and without a direct association with tobacco exposure. Osteosarcoma of the larynx is typically a highly malignant neoplasm that metastasizes early, has a propensity for hematogenous spread and also has a marked tendency to recur. Twelve (41%) out of the 29 cases in the present review with follow-up data had metastatic disease. The aspects that distinguish osteosarcoma from its differential diagnostic alternatives are discussed in this review.
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Affiliation(s)
- Antti A Mäkitie
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. .,Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland. .,Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet and Karolinska Hospital, Stockholm, Sweden. .,Sorbonne université, Service d'oto-rhino-laryngologie et de chirurgie cervicofaciale, DMU CHIR, Hôpital Tenon, Assistance-Publique-Hôpitaux de Paris, 4, rue de la Chine, 75020, Paris, France.
| | | | - Bertrand Baujat
- Sorbonne université, Service d'oto-rhino-laryngologie et de chirurgie cervicofaciale, DMU CHIR, Hôpital Tenon, Assistance-Publique-Hôpitaux de Paris, 4, rue de la Chine, 75020, Paris, France.,EURACAN (European Rare Cancer Network) Group 7 Head and Neck rare tumours, Paris, France.,REFCOR (Réseau d'Expertise Français sur les cancers ORL Rares), Paris, France
| | - Alhadi Almangush
- Department of Pathology, University of Helsinki, Helsinki, Finland.,Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland.,Institute of Dentistry, University of Misurata, Misurata, Libya
| | - Alfio Ferlito
- Coordinator of the International Head and Neck Scientific Group, Padua, Italy
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3
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Bennion NR, Baine MJ, Malouff T, Zhen W. Osteosarcoma of the Larynx: Treatment Outcomes and Patterns of Failure Analysis. Rare Tumors 2017; 9:6955. [PMID: 28458793 PMCID: PMC5379232 DOI: 10.4081/rt.2017.6955] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 01/11/2017] [Accepted: 02/14/2017] [Indexed: 11/23/2022] Open
Abstract
The incidence of laryngeal sarcoma is exceedingly low with osteosarcomas of the larynx being rarer still, comprising less than 1% of all associated malignancies. To date, only 32 cases have been reported since this pathologic entity was first described in 1942. In this article, we discuss the most recent case of laryngeal osteosarcoma in a patient presenting with respiratory distress found to be due to a tumor mass arising from her cricoid cartilage. We further summarize current knowledge regarding the epidemiology, presentation, and diagnosis of this uncommon disease. Lastly, we synthesize all available information regarding treatment and outcomes of the 32 previously described cases of osteosarcoma of the larynx as well as the presently described case in an attempt to offer some insight regarding optimal treatment in future cases.
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Affiliation(s)
- Nathan R Bennion
- Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, NE
| | - Michael J Baine
- Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, NE
| | | | - Weining Zhen
- Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, NE
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4
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Zhu W, Hu F, Zhao T, Wang C, Tao Q. Clinical Characteristics of Radiation-Induced Sarcoma of the Head and Neck: Review of 15 Cases and 323 Cases in the Literature. J Oral Maxillofac Surg 2015; 74:283-91. [PMID: 26275593 DOI: 10.1016/j.joms.2015.07.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Revised: 07/21/2015] [Accepted: 07/21/2015] [Indexed: 01/28/2023]
Abstract
PURPOSE This retrospective study aimed to identify the clinical characteristics of radiation-induced sarcoma of the head and neck (RISHN) that could help in the early diagnosis of this rare disease. MATERIALS AND METHODS From August 1995 through October 2014, 15 cases of RISHN presenting at the authors' department and 323 cases in the literature were reviewed. RESULTS The incidence of RISHN was higher in men than in women (male-to-female ratio, 2.4:1). The mean latency was long (9.3 yr), and the tumor often occurred in middle age (50.0 yr old). Osteosarcoma was the predominant pathologic diagnosis (34.1%). The prognosis of RISHN was poor. CONCLUSION RISHN is a serious long-term complication of radiotherapy and its incidence has been increasing in recent years. Owing to the long latency period, its early diagnosis is difficult to make. RISHN should be considered when a patient who has undergone radiotherapy presents with a mass, pain, or trismus in the irradiated field.
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Affiliation(s)
- Wangyong Zhu
- Resident, Department of Oral Maxillofacial-Head and Neck Oncology, Affiliated Hospital of Stomatology and Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Fengchun Hu
- Resident, Department of Oral Maxillofacial-Head and Neck Oncology, Affiliated Hospital of Stomatology and Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Tengda Zhao
- Resident, Department of Oral Maxillofacial-Head and Neck Oncology, Affiliated Hospital of Stomatology and Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Cheng Wang
- Attending Physician and Associate Professor, Department of Oral Maxillofacial-Head and Neck Oncology, Affiliated Hospital of Stomatology and Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Qian Tao
- Attending Physician and Professor, Department of Oral Maxillofacial-Head and Neck Oncology, Affiliated Hospital of Stomatology and Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China.
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5
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Bhatt NR, Kakked GA, Merchant R, Bhatt R. Extraskeletal osteosarcoma of the larynx: an extremely unusual tumour. BMJ Case Rep 2014; 2014:bcr-2014-206759. [PMID: 25323286 DOI: 10.1136/bcr-2014-206759] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Osteosarcoma of the larynx is probably the rarest mesenchymal tumour of the larynx, with only 16 cases reported so far. The majority of them occur in males between the sixth and eighth decades of life. Patients usually present with non-specific symptoms such as dysphonia and upper airway compromise. The most common site of distant metastasis is the lung. Clinically, the tumour follows an aggressive course and is associated with high mortality. The case we present is unusual as it occurred at a young age (38 years) as compared with the norm and it did not arise from the endolarynx, unlike many of the other cases. This was the only known case where a Pearson near-total laryngectomy was performed whereby the patient's natural speech mechanism was preserved. This surgery was possible because the contralateral half of the larynx was clearly disease free and the interarytenoid region was uninvolved. The patient underwent postoperative adjuvant external beam radiotherapy beginning 4 weeks after surgery. The patient is doing well after 15 months of follow-up and shows no signs of recurrence.
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Affiliation(s)
- Nikita R Bhatt
- Department of Surgery, SSG Hospital, Baroda, Gujarat, India
| | | | - Rajiv Merchant
- Department of Orthopedics, Vincent's University Hospital, Dublin, Ireland
| | - Rajiv Bhatt
- Department of Oncosurgery, Shubhechha Multispecialty Hospital, Vadodara, Gujarat, India
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6
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Kuba K, Inoue H, Hayashi T, Matsumura S, Minami K, Takajo H, Morita K, Nakahira M, Sugasawa M. Laryngeal osteosarcoma: case report and literature review. Head Neck 2014; 37:E26-9. [PMID: 24824784 DOI: 10.1002/hed.23767] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2014] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Sarcomas of the larynx are uncommon tumors, and osteosarcoma is the rarest. Only 24 cases of osteosarcoma of the larynx have been reported. The only case reported in Asia was from Thailand in 1981. METHODS A 55-year-old male patient was referred to our hospital because of an 8-month history of odynophagia and a gradually enlarging left neck mass. A neck CT scan was performed. A literature review was also performed for this report. RESULTS The CT scan revealed extensive calcification with enlargement of the thyroid cartilage. The patient was diagnosed with osteosarcoma and was successfully treated by surgery alone. CONCLUSION Adequate surgical resection is required for successful treatment of laryngeal sarcomas. Adjuvant therapy is not contraindicated, but chemotherapy may improve the prognosis in patients with high-grade tumors or metastatic disease.
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Affiliation(s)
- Kiyomi Kuba
- Department of Head and Neck Surgery and Otolaryngology, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
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7
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A review of primary osteosarcoma of the larynx and case report. Head Neck Pathol 2014; 9:158-64. [PMID: 24947052 PMCID: PMC4382484 DOI: 10.1007/s12105-014-0550-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Accepted: 06/07/2014] [Indexed: 10/25/2022]
Abstract
Sarcomas of the larynx are exceedingly uncommon, of which primary laryngeal osteosarcomas are the rarest. To date, 25 cases of primary laryngeal osteosarcomas have been reported in the literature. Laryngeal osteosarcomas may closely simulate sarcomatoid carcinomas, since both entities share clinical, histological and immunohistochemical features. Herein, we report a case of primary laryngeal osteosarcoma in a 55 year old male, focusing on the importance of light microscopic, immunohistochemical and ultrastructural features in accurately establishing the diagnosis. In addition, the current paper provides a review of the English language literature on the subject. Laryngeal osteosarcomas usually carry a dismal prognosis with no general consensus on the most effective mode of therapy. Similarly, the current patient developed bilateral lung metastases 8 months after the initial surgery.
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8
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Chung J, Lee V, Tsang R, Chan J, Kwong DLW, Lam KO, Sze HCK, Leung TW. Treatment outcomes of postradiation second head and neck malignancies managed by a multidisciplinary approach. Head Neck 2014; 37:815-22. [PMID: 24623597 DOI: 10.1002/hed.23674] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Revised: 01/01/2014] [Accepted: 03/06/2014] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The purpose of this study was to report on the treatment outcomes of patients with postradiation second head and neck malignancies. METHODS Fifty-seven consecutive patients with postradiation second malignancy were reviewed. Progression-free survival (PFS), overall survival (OS), and prognostic factors were analyzed. RESULTS Mean time interval between first course of radiation therapy to the development of postradiation second malignancy was 13.2 years. Median PFS and OS for the whole group were 12.0 and 67.0 months, respectively. Postradiation sarcoma conferred a worse PFS (p = .003) and OS (p = .001) as compared to postradiation carcinoma. Multivariate analysis revealed that Eastern Cooperative Oncology Group (ECOG) performance status ≥3 (p = .034), postradiation sarcoma (p = .007), and lack of radical surgery (p = .044) are prognostic of PFS, whereas postradiation sarcoma (p = .002), lack of postprogression surgery (p < .001), and lack of postprogression systemic therapy (p = .011) were prognostic factors of OS. CONCLUSION Treatment outcomes of postradiation second malignancy seemed promising under a multidisciplinary management.
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Affiliation(s)
- Joseph Chung
- Division of Otorhinolaryngology, Department of Surgery, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong
| | - Victor Lee
- Department of Clinical Oncology, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong
| | - Raymond Tsang
- Division of Otorhinolaryngology, Department of Surgery, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong
| | - Jimmy Chan
- Department of Surgery, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong
| | - Dora L W Kwong
- Department of Clinical Oncology, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong
| | - Ka-On Lam
- Department of Clinical Oncology, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong
| | - Henry C K Sze
- Department of Clinical Oncology, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong
| | - To-Wai Leung
- Department of Clinical Oncology, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong
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Surkin MI, Schwartz SA, Markiewicz DA. Late-onset complications after chemoradiation for head and neck carcinomas. EAR, NOSE & THROAT JOURNAL 2014; 92:E18. [PMID: 23975497 DOI: 10.1177/014556131309200822] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Acute complications from chemoradiation for head and neck cancers are relatively common. These can be minor or severe and can have a significant impact on the patient's quality of life. The incidence of late-onset (>5 years after cancer cure) complications is unknown, but the effect on quality of life is just as severe as with acute problems. What makes matters worse is that many of these patients lived years without dysphagia or other issues and were able to resume a normal lifestyle before developing complications. We present 4 cases involving patients with late-onset complications and discuss the need to remain vigilant in follow-up and caring for patients with head and neck cancer.
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Affiliation(s)
- Marc I Surkin
- Department of Otolaryngology, Drexel University College of Medicine, 301 West Chester Pike, Havertown, PA 19083, USA.
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10
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Malone JP, Levin RJ. Second malignant tumors after treatment of nasopharyngeal carcinoma: four case reports and literature review. Skull Base 2011; 12:87-91. [PMID: 17167655 PMCID: PMC1656915 DOI: 10.1055/s-2002-31576-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
The purpose of this study was to identify the histopathology, location, and latency interval for the development of second malignant tumors (SMT) after successful treatment for nasopharyngeal carcinoma (NPC). Of 55 patients, four developed SMT after successful treatment of NPC in a single institutional series for an incidence of 7%. An additional 31 patients with SMT after treatment for NPC were identified from the literature. At minimum, all patients were treated with radiotherapy to the primary site. The histopathology of SMT included sarcoma (69%), squamous cell carcinoma (17%), adenocarcinoma (6%), meningioma (6%), and lymphoma (3%). SMT occurred at various sites in the head and neck, but most (51%) arose in the sinonasal cavity. For the entire group, the mean latency interval between treatment for NPC and the development of SMT was 11.8 years. These findings indicate that the development of SMT in patients achieving long-term survival after treatment for NPC may be radiation induced. Long-term follow-up for these patients is important to assess for this potentially late complication.
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Xi M, Liu MZ, Wang HX, Cai L, Zhang L, Xie CF, Li QQ. Radiation-induced sarcoma in patients with nasopharyngeal carcinoma. Cancer 2010; 116:5479-86. [DOI: 10.1002/cncr.25329] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2009] [Revised: 01/01/2010] [Accepted: 02/17/2010] [Indexed: 11/10/2022]
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12
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Lo WC, Ting LL, Ko JY, Lou PJ, Yang TL, Chang YL, Wang CP. Malignancies of the ear in irradiated patients of nasopharyngeal carcinoma. Laryngoscope 2008; 118:2151-5. [PMID: 18948828 DOI: 10.1097/mlg.0b013e3181839b8c] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES/HYPOTHESIS To report on the clinical profiles and treatment experiences of patients with second primary ear malignancy after treatment of nasopharyngeal carcinoma (NPC). STUDY DESIGN Retrospective case series. METHODS A retrospective review of the clinical outcomes and pathology of 11 irradiated NPC patients who subsequently had second primary malignancies of the ear at a single institution. RESULTS Ten tumors were squamous cell carcinoma and one tumor was chondrosarcoma occurring within the radiation field of previous treatment for NPC. The interval between previous radiotherapy and diagnosis of ear malignancy was 3 to 27 years with a median time of 17 years. Six tumors were located in the external auditory canal, two in the middle ear cavity, two in the periauricular region and one in the mastoid cavity. Four patients underwent surgery, and the other seven patients underwent surgery plus adjuvant radiotherapy. The 3-year disease-free and overall survival rates were 30.3% and 20%, respectively. CONCLUSIONS Postirradiated malignancy of the ear is extremely rare, but is one of the causes of death for NPC long-term survivors despite curative-intended treatment with surgery plus adjuvant radiotherapy is instituted.
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Affiliation(s)
- Wu-Chia Lo
- Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
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13
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Sergi C, Zwerschke W. Osteogenic sarcoma (osteosarcoma) in the elderly: tumor delineation and predisposing conditions. Exp Gerontol 2008; 43:1039-43. [PMID: 18845233 DOI: 10.1016/j.exger.2008.09.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2008] [Revised: 09/02/2008] [Accepted: 09/11/2008] [Indexed: 10/21/2022]
Abstract
Osteogenic sarcoma (OS), the most common primary bone cancer, is conventionally a primary intramedullary (conventional OS) high-grade malignant tumor characterized by malignant cells forming immature bone or osteoid. The age distribution data for primary bone sarcomas are bimodal. OS is largely a disease of the young but about one-third of OS occurs in patients over 40 years of age. Thus, though considered as rare occurrences, bone tumors occur also in the geriatric population. In this report, tumor delineation and the significance of predisposing conditions to the occurrence of OS are reviewed.
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Affiliation(s)
- Consolato Sergi
- Institute of Pathology, Medical University of Innsbruck, Muellerstrasse 44, AT-6020 Innsbruck, Austria.
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14
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Boussen H, Kochbati L, Oueslati Z, Gritli S, Daoud J, Gammoudi A, Besbes M, Bouaouina N, Benna F, Ladgham A, Maalej M. [Metachronous cancers after treatment for undifferentiated nasopharyngeal carcinoma]. ACTA ACUST UNITED AC 2005; 121:282-5. [PMID: 15711481 DOI: 10.1016/s0003-438x(04)95521-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To collect second cancers occurring in the head and neck area after treatment by chemotherapy and/or radiotherapy for undifferentiated nasopharyngeal carcinoma in Tunisia. PATIENTS AND METHODS This is a retrospective study of patients developing second cancers after treatment for nasopharyngeal UCNT by radiotherapy and/or chemotherapy. To be retained in this study, second tumour had to be histologically different from the initial UCNT, localised in the irradiated area and occurring after a minimal delay of 3 years. RESULTS We collect 11 cases of second cancers occurring among 2346 patients treated from 1984 to 2001 in Tunisia (0.46%). Patients have been treated for nasopharyngeal UCNT mainly advanced T3-T4 (72%) or N2-N3 (63%). Median age was 20 years (11 to 48) with a sex-ratio of 0.3 (3 M/8 F). Treatment protocol included primary chemotherapy in 4 cases (adriamycin-cisplatin) or adjuvant (in 4) associated to the loco-regional irradiation at a mean dose of 72 Gy (70 to 75). Median delay of second cancer occurrence was 9 years (3 to 17). Tumors were epidermoid carcinomas in 4 cases, fibrosarcomas (2), osteosarcomas (2), glioblastoma (1) and basocellular carcinomas in 2. Second tumors have been treated by surgery alone in 4 cases and chemotherapy alone in 7 patients. No patient have been reirradiated. Median survival was 17 months, 4 patients died and 7 are still alive including 4 in complete remission (24+, 36, 36 and 48+ months) and 3 with progressing disease (8, 16 and 18 months). CONCLUSION Even very rare, second cancers after treatment for UCNT need to be detected and have a poor prognosis.
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Affiliation(s)
- H Boussen
- Institut Salah Azaïz de Tunis, Boulevard du 9 avril, Bab Saadoun, Tunis, Tunisie.
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Miura K, Kum Y, Han G, Tsutsui Y. Radiation-induced laryngeal angiosarcoma after cervical tuberculosis and squamous cell carcinoma: Case report and review of the literature. Pathol Int 2003; 53:710-5. [PMID: 14516323 DOI: 10.1046/j.1440-1827.2003.01540.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Primary laryngeal angiosarcoma (LA) is quite rare with only 13 cases reported in English literature to date. A case of LA after radiation therapy for tuberculosis and squamous cell carcinoma is reported. A 70-year-old woman had a history of radiation therapy for left cervical tuberculosis at the age of 28. At 60 years of age a squamous cell carcinoma of the larynx was found and chemotherapy and radiotherapy, consisting of a total dose of 68.4 Gy, were administered. At the age of 68, recurrent squamous cell carcinoma was suspected from several biopsies, and a total laryngectomy with right thyroidectomy was performed. The tumor cells formed vascular spaces and expressed some endothelial markers, such as CD34, CD31, and Ulex europaeus agglutinin I, but no epithelial markers, such as cytokeratins or epithelial membrane antigen. No residual squamous cell carcinoma was found. In the present case, it was suspected that irradiation to the larynx for cervical tuberculosis and squamous cell carcinoma induced angiosarcoma. The patient was still alive despite multiple skin and soft tissue metastasis 3 years and 6 months after the radical operation. Distinction of postirradiation angiosarcoma from pseudoangiosarcomatous carcinoma seems difficult but is important because irradiation is not effective and an initial radical surgery is the only effective treatment. Although irradiation is a common treatment for laryngeal squamous cell carcinoma, this is only the second case of radiation-induced LA in English literature.
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MESH Headings
- Aged
- Antineoplastic Agents/therapeutic use
- Biomarkers, Tumor/analysis
- Carcinoma, Squamous Cell/etiology
- Carcinoma, Squamous Cell/secondary
- Carcinoma, Squamous Cell/therapy
- Female
- Hemangiosarcoma/etiology
- Hemangiosarcoma/secondary
- Hemangiosarcoma/therapy
- Humans
- Immunohistochemistry
- Laryngeal Neoplasms/etiology
- Laryngeal Neoplasms/pathology
- Laryngeal Neoplasms/therapy
- Laryngectomy
- Neoplasm Recurrence, Local
- Neoplasms, Multiple Primary/etiology
- Neoplasms, Multiple Primary/pathology
- Neoplasms, Multiple Primary/therapy
- Neoplasms, Radiation-Induced/etiology
- Neoplasms, Radiation-Induced/pathology
- Neoplasms, Radiation-Induced/therapy
- Radiotherapy, Adjuvant
- Treatment Outcome
- Tuberculosis, Lymph Node/pathology
- Tuberculosis, Lymph Node/radiotherapy
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Affiliation(s)
- Katsutoshi Miura
- Division of Pathology, Hamamatsu University School of Medicine, Handa-yama, Hamamatsu, Japan.
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16
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Osipov V, Ho KC, Krouwer HG, Meyer G, Shidham VB. Post-radiation dedifferentiation of meningioma into osteosarcoma. BMC Cancer 2002; 2:34. [PMID: 12464160 PMCID: PMC138810 DOI: 10.1186/1471-2407-2-34] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2002] [Accepted: 12/03/2002] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A number of osteoblastic meningiomas, primary osteosarcomas of the meninges, and post-radiation osteosarcomas of the head have been reported. However, postradiation dedifferentiation of meningioma into osteosarcoma has not been reported previously. CASE PRESENTATION In 1987 a caucasian man, then 38 years old, presented with a pituitary macroadenoma. He underwent a subtotal resection of the tumor and did well until 1990 when a recurrent tumor was diagnosed. This was treated with subtotal resection of the tumor, followed by radiation therapy for six weeks to a total of 54 Gy. He was considered "disease-free" for nearly ten years. However, most recently in July 2000, he presented with a visual field deficit due to a second recurrence of his pituitary macroadenoma, now with suprasellar extension. At this time, as an incidental finding, a mass attached to the dura was noted in the left parietal hemisphere. This dura-based mass had grown rapidly by January 2001 and was excised. It showed histological, immunohistochemical, and electron microscopic features of malignant meningioma and osteosarcoma with a sharp demarcation between the two components. CONCLUSIONS We report a rare case of a radiation induced dedifferentiation of meningioma into osteosarcoma, which has not been reported previously.
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Affiliation(s)
- Vladimir Osipov
- Department of Pathology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Khang-Che Ho
- Department of Pathology, Medical College of Wisconsin, Milwaukee, WI, USA
| | | | - Glenn Meyer
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Vinod B Shidham
- Department of Pathology, Medical College of Wisconsin, Milwaukee, WI, USA
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Guney E, Yigitbasi OG, Balkanli S, Canoz OM. Postirradiation malignant fibrous histiocytoma of the larynx: a case report. Am J Otolaryngol 2002; 23:293-6. [PMID: 12239696 DOI: 10.1053/ajot.2002.124554] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A 63-year-old man presented with malignant fibrous histiocytoma of the larynx occurring 16 years after radiation treatment for squamous cell carcinoma of the larynx. Postirradiation sarcoma of the larynx is an unusual tumor. The location, the histopathologic and immunohistochemical appearance of the tumor, and the time elapsed since the initial treatment make it probable that this tumor is associated with prior radiation treatment. The possibility of postirradiation sarcomas after radiation therapy should not be a major factor influencing treatment decisions in the patients with head and neck cancer. Wide surgical resection of the tumor seems to be an efficient means in the management of this tumor.
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Affiliation(s)
- Ercihan Guney
- Otorhinolaryngology-Head and Neck Surgery Department and the Pathology Department, Faculty of Medicine, Erciyes University, Kayseri, Turkey
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18
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19
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Nicolai P, Caruso G, Redaelli de Zinis LO, Devaney KO, Rinaldo A, Berlucchi M, Ferlito A. Regional and distant metastases in laryngeal and hypopharyngeal sarcomas. Ann Otol Rhinol Laryngol 1998; 107:540-6. [PMID: 9635467 DOI: 10.1177/000348949810700615] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Cervical node and distant metastases are the most important prognostic factors in malignant laryngeal neoplasms. Owing to the unusual occurrence of laryngeal sarcomas, the prevalence of their metastases has never been analyzed in detail. We reviewed the laryngeal sarcomas reported in the literature and noticed that both regional and distant metastases are rare events and variable for different histotypes. These observations have obvious therapeutic and prognostic implications.
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Affiliation(s)
- P Nicolai
- Department of Otolaryngology, University of Brescia, Italy
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20
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Abstract
About 11,600 cases of laryngeal cancer were reported in the United States in 1995, accounting for 1% of all reported cancers. Fewer than 1% of laryngeal cancers are sarcomas, osteosarcoma being the rarest type. Twelve cases of laryngeal osteosarcoma have been cited in the literature. A 47-year-old man presented with hoarseness following a benign vocal polypectomy. The entire larynx appeared swollen, although both vocal folds moved well. Biopsies did not reveal pathologic tissue. Computed tomographic imaging revealed a destructive, expansile lesion of the thyroid cartilage. A computed tomography-guided biopsy of this cartilage revealed a high-grade sarcoma. Laryngeal osteosarcoma was diagnosed following total laryngectomy. Laryngeal osteosarcoma is a highly malignant neoplasm with early hematogenous spread. Survival statistics for peripheral osteosarcoma are poor. Limited experience reveals that a combination of surgery and radiotherapy with adjuvant chemotherapy can offer some palliation. The literature and published cases of laryngeal osteosarcoma are reviewed.
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Affiliation(s)
- D Myssiorek
- Department of Otolaryngology, Long Island Jewish Medical Center, New Hyde Park, New York, USA
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