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Bini A, Derka S, Stavrianos S. Management of head & neck sarcomas in adults: A retrospective study. J Craniomaxillofac Surg 2024; 52:877-883. [PMID: 38443189 DOI: 10.1016/j.jcms.2024.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/05/2024] [Accepted: 01/06/2024] [Indexed: 03/07/2024] Open
Abstract
The research purpose is to review the surgical approach and evaluate the results in adult patients with head and neck sarcomas. The histopathology varied, including two leiomyosarcomas, six malignant fibrous histiocytomas, two malignant peripheral nerve sheath tumors, four dermatofibrosarcomas protuberans, three osteosarcomas, two angiosarcomas, one liposarcoma, one Ewing sarcoma, one synovial sarcoma, two unclassified/non-differentiated sarcomas and one solitary fibrous tumor. Surgical resection included maxillectomy, mandibulectomy, craniectomy, parotidectomy, scalp resection, face skin resection and laminectomy. The reconstruction was performed with one rectus abdominis flap, four radial forearm flaps, two latissimus dorsi flaps, two vascularized fibula flaps, two pectoralis major myocutaneous flaps, two trapezius flaps, two temporalis flaps, seven scalp flaps and two nasolabial flaps. The total patient number was 24. The hospitalization was uncomplicated, followed by postoperative radiotherapy in the majority of cases. In a mean 15-year follow-up period, 11 patients are still alive and disease-free. There were four recurrences treated with palliative radiotherapy. The surgical approach for head and neck sarcomas, including the achievement of a functionally acceptable result by organ sparing techniques, remains challenging. Wide resection combined with the appropriate reconstruction, particularly with microsurgical techniques, and followed by adjuvant radiotherapy or chemotherapy offer improved prognosis and quality of life.
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Affiliation(s)
- Aikaterini Bini
- Plastic and Reconstructive Surgery Department, Athens General Anticancer - Oncology Hospital "Aghios Savvas", 171 Alexandras Ave, 11522, Athens, Greece.
| | - Spyridoula Derka
- Plastic and Reconstructive Surgery Department, Athens General Anticancer - Oncology Hospital "Aghios Savvas", 171 Alexandras Ave, 11522, Athens, Greece.
| | - Spyridon Stavrianos
- Plastic and Reconstructive Surgery Department, Athens General Anticancer - Oncology Hospital "Aghios Savvas", 171 Alexandras Ave, 11522, Athens, Greece.
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2
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Franchi A, Agaimy A. Granulation tissue-like spindle cell (sarcomatoid) carcinoma of the head and neck: a deceptively bland-looking underdiagnosed malignancy. Virchows Arch 2024; 484:799-806. [PMID: 38403668 PMCID: PMC11106124 DOI: 10.1007/s00428-024-03770-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 02/16/2024] [Accepted: 02/20/2024] [Indexed: 02/27/2024]
Abstract
The diagnosis of head and neck spindle cell squamous carcinoma (SC-SCC) is often challenging. Lesions with a prominent inflammatory infiltrate and reactive vessels may have a granulation tissue-like appearance, therefore being difficult to distinguish from reactive lesions, like contact ulcers, post-intubation granulomas, inflammatory pseudotumors, or benign vascular lesions. In this study, we analyzed the clinicopathological features of a series of 17 head and neck SC-SCC with granulation tissue-like appearance. All patients, but two, were males, ranging in age between 57 and 80 years. The larynx was the most frequently affected site (n = 12), followed by the tongue (n = 4). One tumor was hypopharyngeal. Most consult cases were submitted with benign suggestion or because of unexpected recurrences of granulation tissue polyps. Histologically, all lesions consisted of an ulcerated polypoid proliferation of moderately to markedly atypical spindle cells, with a minor component of conventional invasive or in situ squamous carcinoma. At least one cytokeratin cocktail was positive in 13 cases. The staining was limited to a few neoplastic cells in most cases. Positivity for p63, p40, and cytokeratins 5/6 was detected only in the conventional squamous cell carcinoma component, when present. ALK1 was negative in all cases. Sixteen cases were tested for p53 and all showed aberrant expression (12 diffusely positive and 4 of null-phenotype). The diagnosis of granulation tissue-like SC-SCC is challenging due to the close clinical and histological overlap with several benign conditions. Since the expression of epithelial markers is limited, the use of an immunohistochemical panel including p53 is recommended.
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Affiliation(s)
- Alessandro Franchi
- Section of Anatomic Pathology, Department of Translational Research, University of Pisa, 56124, Pisa, Italy.
| | - Abbas Agaimy
- Institute of Pathology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Comprehensive Cancer Center (CCC) Erlangen-EMN, 91054, Erlangen, Germany
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3
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Reis CSM, Reis JGC, Conceição-Silva F, Valete CM. Oral and oropharyngeal mucosal lesions: clinical-epidemiological study of patients attended at a reference center for infectious diseases. Braz J Otorhinolaryngol 2024; 90:101396. [PMID: 38359743 PMCID: PMC10877199 DOI: 10.1016/j.bjorl.2024.101396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 12/05/2023] [Accepted: 12/26/2023] [Indexed: 02/17/2024] Open
Abstract
OBJECTIVE To determine the prevalence, epidemiological profile, and clinical characteristics of Oral or Oropharyngeal Mucosal Lesions (OOPML) in patients attended at the Otorhinolaryngology Service of the Evandro Chagas National Institute of Infectious Diseases (INI-FIOCRUZ) from 2005 to 2017. METHODS Statistical analysis of descriptive data from medical records (gender, age, education level, skin color, origin, smoking, alcoholism, HIV co-infection, time of disease evolution, first symptom, and OOPML location) was performed. RESULTS Of 7551 patients attended at the service, 620 (8.2%) were included in the study. OOPML were classified into developmental anomalies (n = 3), infectious diseases (non-granulomatous n = 220; granulomatous n = 155), autoimmune diseases (n = 24), neoplasms (benign n = 13; malignant, n = 103), and unclassified epithelial/soft tissue diseases (n = 102). OOPML of infectious diseases (60.5%) and neoplasms (18.7%) were the most frequent. The predominant demographics of patients with OOPML were: males (63.5%), white (53.5%), and those in the fifth to sixth decades of life (43.3%). Local pain (18.1%) and odynophagia (15%) were the most reported first symptoms, and the most frequent OOPML sites were the palatine tonsil (28.5%), hard palate (22.7%), and tongue (20.3%). The median evolution time was three months. CONCLUSIONS Infectious OOPML were the most frequent, as expected in a reference center for infectious diseases, and thus, they are likely to be less frequent in general care and/or dental services. Underreporting of OOPML is possible, as oral/oropharyngeal examination is often not included in the routine medical examination. Oral cavity/oropharynx examination should be performed by specialists, such as dentists and otorhinolaryngologists, who have the expertise in identifying OOPML, even in incipient/asymptomatic cases. Given the numerous diseases in which OOPML can present, diagnosis could be facilitated by multidisciplinary teams, potentially enabling the early treatment of diseases, and thus, reduce morbidity and improve prognosis. The use of standardized medical records for oral/oropharyngeal systematic examination could provide relevant tools for differential diagnoses and information for new clinical-epidemiological studies. LEVEL OF EVIDENCE Level 3.
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Affiliation(s)
- Clarissa Souza Mota Reis
- Fundação Oswaldo Cruz (FIOCRUZ), Instituto Nacional de Infectologia Evandro Chagas (INI), Rio de Janeiro, RJ, Brazil; Fundação Oswaldo Cruz (FIOCRUZ), Instituto Oswaldo Cruz (IOC), Laboratório de Imunoparasitologia, Rio de Janeiro, RJ, Brazil
| | - João Gustavo Corrêa Reis
- Fundação Oswaldo Cruz (FIOCRUZ), Instituto Nacional de Infectologia Evandro Chagas (INI), Rio de Janeiro, RJ, Brazil; Fundação Oswaldo Cruz (FIOCRUZ), Instituto Oswaldo Cruz (IOC), Laboratório de Imunoparasitologia, Rio de Janeiro, RJ, Brazil; Hospital Federal de Bonsucesso, Departamento de Broncoesofagolaringologia e Cirurgia de Cabeça e Pescoço, Rio de Janeiro, RJ, Brazil.
| | - Fátima Conceição-Silva
- Fundação Oswaldo Cruz (FIOCRUZ), Instituto Oswaldo Cruz (IOC), Laboratório de Imunoparasitologia, Rio de Janeiro, RJ, Brazil
| | - Cláudia Maria Valete
- Fundação Oswaldo Cruz (FIOCRUZ), Instituto Nacional de Infectologia Evandro Chagas (INI), Rio de Janeiro, RJ, Brazil; Universidade Federal do Rio de Janeiro, Faculdade de Medicina, Departamento de Otorrinolaringologia e Oftalmologia, Rio de Janeiro, RJ, Brazil
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Allen DZ, Gorelik D, Butler EB, Zhang J, Kain JJ. Single-port transoral robotic surgery for a rare tonsil mass. J Surg Case Rep 2023; 2023:rjad197. [PMID: 37090905 PMCID: PMC10115462 DOI: 10.1093/jscr/rjad197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 03/13/2023] [Indexed: 04/25/2023] Open
Abstract
Squamous cell carcinoma predominates as the most common malignant lesion of the oropharynx with human papilloma virus-associated disease now predominant over tobacco-related oropharynx cancer. Other rare malignant pathologies can manifest as visible neoplasms in these anatomic sites with varying degrees of symptoms such as dysphagia, odynophagia, otalgia, aspiration, hemorrhage, weight loss and dyspnea. We present a case of a rarely encountered primary oropharyngeal sarcoma managed by single-port transoral robotic resection and a selective cervical lymph node dissection followed by adjuvant radiotherapy.
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Affiliation(s)
- David Z Allen
- Department of Otorhinolaryngology—Head and Neck Surgery, McGovern Medical School at the University of Texas Health Science Center, Houston, TX, USA
| | - Daniel Gorelik
- Department of Otolaryngology —Head and Neck Surgery, Houston Methodist Hospital, Houston, TX, USA
| | - Edward B Butler
- Department of Radiation Oncology, Houston Methodist Hospital, Houston, TX, USA
| | - Jun Zhang
- Department of Hematology and Medical Oncology, Houston Methodist Hospital, Houston, Texas USA
| | - Joshua J Kain
- Correspondence address. Department of Otolaryngology-Head & Neck Surgery, Houston Methodist Hospital, Houston, Texas, 77030, USA. Tel: 713-441-1368; Fax: 713-796-2349; E-mail:
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Barron K, Omiunu A, Celidonio J, Cruz-Mullane A, Din-Lovinescu C, Chemas-Velez MM, Baredes S, Eloy JA, Fang CH. Kaposi Sarcoma of the Larynx: A Systematic Review. Otolaryngol Head Neck Surg 2023; 168:269-281. [PMID: 35671149 DOI: 10.1177/01945998221105059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 05/13/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Kaposi sarcoma (KS) of the larynx is a rare disease with few cases reported in the literature. This study aims to provide a comprehensive review of laryngeal KS, including patient characteristics, treatment, and clinical outcomes. DATA SOURCES PubMed, CINAHL, SCOPUS, and Cochrane Library. REVIEW METHODS A systematic review of the published English literature was conducted. An electronic search and bibliographic examination of articles pertaining to laryngeal KS were performed. Demographic data, tumor site, treatment strategies, follow-up, and outcome were analyzed. RESULTS A total 77 cases from 50 articles were included in the review. The mean age was 47.6 years (range, 8-81). There was an 8.6:1 male:female ratio. The most common presenting symptoms were dyspnea (n = 35) and hoarseness (n = 25). Laryngeal KS arose most frequently in the supraglottic region (n = 16). Chemotherapy alone (n = 27) was the most common treatment modality in patients with AIDS-associated KS, and surgical excision alone (n = 7) was most common in patients with other subtypes of KS (eg, classic, transplant associated). Average follow-up was 20.4 months (range, 0.75-120). Most patients with AIDS-associated KS died of other causes (n = 25), but most patients with other subtypes of KS were alive with no evidence of disease at follow-up (n = 13). CONCLUSION This review contains the largest pool of laryngeal KS cases to date. Long-term outcomes were generally unfavorable, often due to advanced HIV disease at the time of diagnosis.
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Affiliation(s)
- Kendyl Barron
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Ariel Omiunu
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Joseph Celidonio
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Alexandra Cruz-Mullane
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Corina Din-Lovinescu
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Maria Manuela Chemas-Velez
- Department of Otolaryngology and Maxillofacial Surgery, Pontificia Universidad Javeriana, Bogota, Colombia
| | - Soly Baredes
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
- Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Jean Anderson Eloy
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
- Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey, USA
- Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
- Department of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, New Jersey, USA
- Department of Otolaryngology and Facial Plastic Surgery, Saint Barnabas Medical Center-RWJBarnabas Health, Livingston, New Jersey, USA
| | - Christina H Fang
- Department of Otorhinolaryngology-Head and Neck Surgery, Montefiore Medical Center, The University Hospital of Albert Einstein College of Medicine, Bronx, New York, USA
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Shabaan A, Alkashash A, Hou T, Saeed O, Yesensky J, Roshal A, Mesa H. Isolated Kaposi sarcoma of the upper aerodigestive tract in immunocompetent individuals, an underrecognized entity with favorable prognosis. EAR, NOSE & THROAT JOURNAL 2022:1455613221128112. [PMID: 38124324 DOI: 10.1177/01455613221128112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Abstract
Kaposi sarcoma (KS) is a rare vascular neoplasm that most commonly arises in the setting of immunosuppression, in areas with high prevalence of Human Herpesvirus-8 infection, and when both situations coexist. Most cases affect the skin, isolated involvement of the upper respiratory tract without skin involvement is extremely rare with only a few cases reported in the literature. We present a case of isolated nasopharyngeal KS in an immunocompetent patient who achieved remission after multimodality therapy. Recent advances in KS-therapy are discussed.
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Affiliation(s)
- Abdelrahman Shabaan
- Departments of Pathology and Laboratory Medicine, School of Medicine, Indiana University, Indianapolis, IN, USA
| | - Ahmad Alkashash
- Departments of Pathology and Laboratory Medicine, School of Medicine, Indiana University, Indianapolis, IN, USA
| | - Tieying Hou
- Departments of Pathology and Laboratory Medicine, School of Medicine, Indiana University, Indianapolis, IN, USA
| | - Omer Saeed
- Departments of Pathology and Laboratory Medicine, School of Medicine, Indiana University, Indianapolis, IN, USA
| | - Jessica Yesensky
- Departments of Otolaryngology & Head and Neck Surgery, School of Medicine, Indiana University, Indianapolis, IN, USA
| | - Anna Roshal
- Departments of Hematology Oncology, School of Medicine, Indiana University, Indianapolis, IN, USA
| | - Hector Mesa
- Departments of Pathology and Laboratory Medicine, School of Medicine, Indiana University, Indianapolis, IN, USA
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Oral Manifestations Associated with HIV/AIDS Patients. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58091214. [PMID: 36143891 PMCID: PMC9504409 DOI: 10.3390/medicina58091214] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 08/01/2022] [Accepted: 08/30/2022] [Indexed: 11/17/2022]
Abstract
Oral manifestations are early and important clinical indicators of Human Immunodeficiency Virus (HIV) infection since they can occur in up to 50% of HIV-infected patients and in up to 80% of patients at the AIDS stage (<200 CD4+ T lymphocytes). Oral health is related to physical and mental well-being because the presence of some lesions can compromise dental aesthetics, and alter speech, chewing, and swallowing, thus impacting the quality of life of patients. For this reason, it is necessary to integrate, as part of the medical treatment of HIV-positive patients, the prevention, diagnosis, and control of oral health. It is essential that health professionals have the power to identify, diagnose, and treat oral pathologies through clinical characteristics, etiological agents, and risk factors, both local and systemic. A diagnosis at an early stage of injury allows optimizing and prioritizing oral treatments, especially in acute pathologies, such as gingivitis and necrotizing periodontitis. In this group of patients, the development of strategies for the prevention, control, and reduction of these pathologies must be prioritized in order to reduce morbidity and mortality in this group of patients.
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8
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Xiang P, Liu M, Lu X, Tang W, Liu J. Primary Kaposi's Sarcoma of the Nasal Cavity: Clinical Experience and Review of the Literature. EAR, NOSE & THROAT JOURNAL 2022:1455613221111734. [PMID: 35758033 DOI: 10.1177/01455613221111734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Kaposi's sarcoma (KS) is a vascular sarcoma derived from vascular endothelial cells and presents with multiple lesions. It mainly appears on the skin and oral mucosa, usually in the face, oral mucosa, and genitals. Very few cases of primary lesions in the nasal cavity have been reported. It is often difficult to diagnose only by imaging examination. Here, we describe a case of KS in a patient who was human immunodeficiency virus (HIV)-negative, in which the primary sites were the nasal mucosa and nasal septum. A diagnosis was made according to the patient's clinical presentation, physical examination, laboratory examination, imaging examination, and histopathological results. We used surgical resection combined with chemotherapy, with 6 months' postoperative follow-up without recurrence. We reviewed the relevant literature to identify similar cases and summarize the findings reported on this rare manifestation of KS. We recommend that, where possible, antiviral therapy such as interferon, and regular review should continue, to improve the survival rate and patients' quality of life.
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Affiliation(s)
- Peng Xiang
- Graduate School, Youjiang Medical University for Nationalities, Baise, China
| | - Mengya Liu
- Graduate School, Youjiang Medical University for Nationalities, Baise, China
| | - Xueyan Lu
- Graduate School, Youjiang Medical University for Nationalities, Baise, China
| | - Wei Tang
- Graduate School, Youjiang Medical University for Nationalities, Baise, China
| | - Jin Liu
- Department of Otorhinolaryngology, Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China
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Sousa RH, Souza LL, Guedes PT, Prado-Ribeiro AC, Rodrigues-Oliveira L, Brandão TB, Alves BW, Lopes MA, Santos-Silva AR, Monteiro JC, Gonçalves TT, Almeida OP. Oral Kaposi sarcoma development is associated with HIV viral load, CD4+ count and CD4+/CD8+ ratio. Med Oral Patol Oral Cir Bucal 2021; 26:e748-e753. [PMID: 34704977 PMCID: PMC8601642 DOI: 10.4317/medoral.24708] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 09/27/2021] [Indexed: 11/09/2022] Open
Abstract
Background Kaposi’s sarcoma (KS) is an uncommon, multifocal and angioproliferative lesion, which demonstrates a poor prognosis. The aim of the present research was to explore the association of HIV viral load, CD4+ and CD8+ counts and the CD4+/CD8+ ratio on the risk of oral Kaposi’s sarcoma (KS) development. Material and Methods A total of 62 patients were retrieved from March 2008 to October 2020 from the files of two oral pathology centres. Clinical, laboratory and follow-up data were retrieved from their medical files. Poisson regression was used to explore the role of history of immunosuppression and its association with oral KS development. A P-value <0.05 was considered significant. Results Sixty-two patients were included in the present study (32 with oral KS and 30 with no presentation of lesions anywhere on the body). Patients with oral KS presented a mean age of 32.6 years, and male patients were more affected. The hard palate (15 cases; 46.8%) was the main anatomical site affected. The lesions were mostly presented as swellings (13 cases; 40.6%) and nodules (12 cases; 37.5%). Systemic manifestations were also observed, including candidiasis (4 cases; 12.5%), bacterial infection (3 cases; 9.3%), tuberculosis (3 cases; 9.3%), herpes simplex (3 cases; 9.3%) and pneumonia (3 cases; 9.3%). A significant correlation was observed between HIV viral load, CD4+ count and the CD4+/CD8+ ratio with oral KS development. Conclusions HIV viral load, CD4+ count and the CD4+/CD8+ ratio are associated with oral KS development. Key words:Cancer, oral, Kaposi’s sarcoma, diagnostic.
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Affiliation(s)
- R-H Sousa
- João de Barros Barreto University Hospital Department of Surgery and Oral Pathology Mundurucus Street, nº 4487 Zip Code 66073-000, Belém, Pará, Brazil
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Emerging Oncogenic Viruses in Head and Neck Cancers from Romanian Patients. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11199356] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
(1) Background: Head and neck squamous cell carcinomas (HNSCCs) are some of the most frequent malignancies globally. Oncogenic viruses MCPyV, EBV and HPVs are recognized to be related to HNSCCs and skin cancers. There are no data from Romania regarding the involvement of herpes viruses and polyomaviruses in these types of cancer. We aim to evaluate the association of oncogenic viruses from Papillomaviridae, Herpesviridae, and Polyomaviridae families in HNSCCs and skin cancers. (2) Methods: A total of 26 fresh tumors (6/26 women) were tested for 67 viral agents using a multiplex PCR genotyping assay. (3) Results: A total of 23/26 (88.5%) samples were positive for one or more viruses. All the tested tumors were negative for any HPV (alpha or beta types). In total, we detected as positive samples: 16 (61.63%) EBV1, 12 (46.15%) HHV7, 8 (30.76%) MCV, 6 (23.07%) CMV and HHV6, 2 (7.69%) HHV8, 1 (3.8%) HPyV6 and EBV2. (4) Conclusions: We detected HPV-negative cases that are HPyV and HHV positive. In these fractions of HPV-negative HNSCCs cases, other oncogenic viruses may be involved, such as EBV1, MCV or CMV. Additional research is required for clarifying the natural history of these viruses in HNSCCs, as virus detection would have a decisive impact on diagnostic and decisional algorithms.
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11
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Etesami I, Kalantari Y, Ghanadan A, Rezayat A. Recurrent Kaposi sarcoma of the ear in an HIV-negative patient: A case report with review of the literature. Is ear a predilection site for Kaposi sarcoma in HIV-negatives? Clin Case Rep 2021; 9:e04516. [PMID: 34257991 PMCID: PMC8259920 DOI: 10.1002/ccr3.4516] [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: 04/19/2021] [Accepted: 05/31/2021] [Indexed: 12/12/2022] Open
Abstract
While Kaposi sarcoma (KS) of the head and neck is common in HIV-positives, it is a rare presentation in HIV-negatives. It is important to consider KS in the differential diagnosis of ear lesions in HIV-negative patients.
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Affiliation(s)
- Ifa Etesami
- Department of DermatologyRazi HospitalTehran University of Medical SciencesTehranIran
| | - Yasamin Kalantari
- Department of DermatologyRazi HospitalTehran University of Medical SciencesTehranIran
| | - Alireza Ghanadan
- Department of PathologyRazi HospitalTehran University of Medical SciencesTehranIran
| | - Azadeh Rezayat
- Department of DermatologyRazi HospitalTehran University of Medical SciencesTehranIran
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Oral lymphangioma-like Kaposi sarcoma: a Brazilian case report in a scenario of a still high number of HIV infections. Oral Maxillofac Surg 2021; 26:171-176. [PMID: 34089420 DOI: 10.1007/s10006-021-00974-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 05/17/2021] [Indexed: 10/21/2022]
Abstract
We present a challenging case of HIV-related lymphangioma-like Kaposi sarcoma (LLKS) affecting the oral cavity. A 54-year-old Brazilian male patient was referred to our center complaining of bleeding lesions affecting the oral cavity for 2 months. Interestingly, these oral lesions were the first clinical manifestation of HIV infection. Clinically, multiple erythematous nodular and patch lesions were observed. An incisional biopsy was performed, revealing numerous microscopic angled and irregular vascular channels lined with flattened endothelial cells. More cellularized and solid areas consisting of more fusiform cells with little pleomorphism and with slit-like vascular channels were noted. Based on immunoreactivity for CD31, CD34, D2-40, and HHV-8, the final diagnosis was oral LLKS. Highly active antiretroviral therapy (HAART) was initiated with dolutegravir, tenofovir, and lamivudine. During follow-up, the patient showed KS metastases to other sites and a chemotherapeutic protocol was initiated. Regression of the oral lesion was clearly noted by the clinicians 1 year after the KS diagnosis. Dentists should be able to recognize systemic diseases that affect the oral cavity such as KS in order to make an early diagnosis of its oral manifestations and to implement effective therapeutic measures to ensure a better prognosis.
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de Souza LL, Morais TMDL, Pontes HAR, de Almeida OP, de Carvalho MGF, Soares CD. Rapidly ulcerated swelling in the hard palate of a HIV-positive pregnant woman. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 131:e59-e64. [PMID: 32063512 DOI: 10.1016/j.oooo.2019.12.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 12/15/2019] [Accepted: 12/31/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Lucas Lacerda de Souza
- Department of Oral Pathology, João de Barros Barreto University Hospital, Federal University of Pará, Belém, Pará, Brazil
| | - Thayná Melo de Lima Morais
- Oral Diagnosis Department, Oral Pathology Area, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Hélder Antônio Rebelo Pontes
- Department of Oral Pathology, João de Barros Barreto University Hospital, Federal University of Pará, Belém, Pará, Brazil; Oral Diagnosis Department, Oral Pathology Area, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Oslei Paes de Almeida
- Oral Diagnosis Department, Oral Pathology Area, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Maria Goretti Freire de Carvalho
- Oral Diagnosis Department, Oral Pathology Area, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Ciro Dantas Soares
- Oral Diagnosis Department, Oral Pathology Area, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil.
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Brahmbhatt AN, Skalski KA, Bhatt AA. Vascular lesions of the head and neck: an update on classification and imaging review. Insights Imaging 2020; 11:19. [PMID: 32034537 PMCID: PMC7007481 DOI: 10.1186/s13244-019-0818-3] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 11/13/2019] [Indexed: 02/07/2023] Open
Abstract
Vascular lesions have a varied appearance and can commonly occur in the head and neck. A majority of these lesions are cutaneous and congenital; however, some may be acquired and malignant. The presentation and clinical history of patients presenting with head and neck lesions can be used to guide further imaging, which can provide important diagnostic and therapeutic considerations. This review discusses the revised International Society for the Study of Vascular Anomalies (ISSVA) classification system for vascular tumors and malformations, as well as explores the most common vascular anomalies including their clinical presentations and imaging findings.
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Affiliation(s)
- Akshaar N Brahmbhatt
- Department of Imaging Sciences, University of Rochester - Strong Memorial hospital, 601 Elmwood Avenue, Rochester, NY, 14642, USA.
| | - Kamila A Skalski
- Department of Imaging Sciences, University of Rochester - Strong Memorial hospital, 601 Elmwood Avenue, Rochester, NY, 14642, USA
| | - Alok A Bhatt
- Department of Radiology, Division of Neuroradiology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
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Peduto T, Cillo F, Nappa P, Delfino M, Fabbrocini G, Ferrillo M. Atypical Manifestations in Classic Kaposi Sarcoma: Case Series of Two Patients HIV - Negative. Open Access Maced J Med Sci 2019; 7:1021-1024. [PMID: 30976353 PMCID: PMC6454158 DOI: 10.3889/oamjms.2019.162] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 03/20/2019] [Accepted: 03/21/2019] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND: Kaposi’s sarcoma (KS) is a tumour of endothelial, blood and lymphatic cells, caused by an infection with human herpesvirus-8 (HHV-8). The skin lesions of KS, especially of the classical or Mediterranean variant (CKS), are represented by red-purple macules, plaques and nodules, localised mainly on the extremities. CASE REPORT: This case series intend to describe multifocal atypical kaposian manifestations in two HIV negative subjects, affected by CKS, treated with successful chemotherapy. CONCLUSIONS: Although atypical manifestations are extremely rare events, we suggest an accurate, objective examination because a prompt diagnosis can lead to a vital intervention in the patient’s health and sometimes to the identification of the disease itself.
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Affiliation(s)
- Tiziana Peduto
- Department of Dermatology, University of Naples Federico II, Via Pansini 5, 80131 Napoli, Italy
| | - Francesco Cillo
- Department of Dermatology, University of Naples Federico II, Via Pansini 5, 80131 Napoli, Italy
| | - Paola Nappa
- Department of Dermatology, University of Naples Federico II, Via Pansini 5, 80131 Napoli, Italy
| | - Mario Delfino
- Department of Dermatology, University of Naples Federico II, Via Pansini 5, 80131 Napoli, Italy
| | - Gabriella Fabbrocini
- Department of Dermatology, University of Naples Federico II, Via Pansini 5, 80131 Napoli, Italy
| | - Maria Ferrillo
- Department of Dermatology, University of Naples Federico II, Via Pansini 5, 80131 Napoli, Italy
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McNamara KK, Kalmar JR. Erythematous and Vascular Oral Mucosal Lesions: A Clinicopathologic Review of Red Entities. Head Neck Pathol 2019; 13:4-15. [PMID: 30693460 PMCID: PMC6405795 DOI: 10.1007/s12105-019-01002-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 01/02/2019] [Indexed: 02/07/2023]
Abstract
Erythematous lesions of the oral mucosa are common and can reflect a variety of conditions, ranging from benign reactive or immunologically-mediated disorders to malignant disease. Together with vascular abnormalities, which can vary from reddish to bluish-purple in color, the differential diagnosis for erythematous oral mucosal change is quite diverse. This review focuses on salient clinical features and histopathologic findings of selected conditions which clinically present as red or vascular-like oral mucosal alterations, including oral vascular malformations and neoplasms, pyogenic granuloma, localized juvenile spongiotic gingival hyperplasia, denture stomatitis, benign migratory glossitis (geographic tongue), orofacial granulomatosis, granulomatosis with polyangiitis (Wegener granulomatosis), megaloblastic anemia, and erythroplakia. Recognition of the characteristic clinical features of these conditions, in conjunction with thorough patient history, will allow clinicians to narrow the differential diagnosis and guide appropriate clinical decision making, including the need for tissue biopsy, in order to complete the diagnostic process and initiate optimal patient care.
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Affiliation(s)
- Kristin K. McNamara
- 0000 0001 2285 7943grid.261331.4The Ohio State University, 305 W. 12 Ave, Columbus, OH 43210 USA
| | - John R. Kalmar
- 0000 0001 2285 7943grid.261331.4The Ohio State University, 305 W. 12 Ave, Columbus, OH 43210 USA
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Soon GST, Petersson F, Thong MKT, Tan CL. Primary Nasopharyngeal Kaposi Sarcoma as Index Diagnosis of AIDS in a Previously Healthy Man. Head Neck Pathol 2018; 13:664-667. [PMID: 30039355 PMCID: PMC6854163 DOI: 10.1007/s12105-018-0954-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 07/18/2018] [Indexed: 12/28/2022]
Abstract
A 38-year-old, previously healthy man presented with blood-stained saliva and epistaxis. A 3 mm nasopharyngeal lesion was found. A biopsy was performed and microscopic examination revealed a Kaposi sarcoma. The patient was subsequently found to be positive for human immunodeficiency virus (HIV). The diagnosis of Kaposi sarcoma in the presence of HIV infection advanced his disease to Acquired Immunodeficiency Syndrome (AIDS). Primary manifestation of Kaposi sarcoma in the nasopharynx is extremely rare. The histologic differential diagnosis of Kaposi sarcoma in this unusual site, especially without the clinical history of immunosuppression, is broad. Awareness that nasopharynx can be a primary involvement site of Kaposi sarcoma and serves as index diagnosis of AIDS is important given its serious clinical implication.
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Affiliation(s)
- Gwyneth S T Soon
- Department of Pathology, National University Health System, Singapore, Singapore
| | - Fredrik Petersson
- Department of Pathology, National University Health System, Singapore, Singapore
| | - Mark K T Thong
- Department of Otolaryngology, National University Health System, Singapore, Singapore
| | - Char Loo Tan
- Department of Pathology, National University Health System, Singapore, Singapore.
- Department of Pathology, National University Hospital, 5 Lower Kent Ridge Road, Singapore, 119074, Singapore.
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Rupp NJ, Bode B, Broglie MA, Morand GB. Kaposi Sarcoma of the Ear in HIV-Negative Patients. Head Neck Pathol 2018; 13:255-256. [PMID: 29671213 PMCID: PMC6513922 DOI: 10.1007/s12105-018-0919-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 04/13/2018] [Indexed: 10/17/2022]
Affiliation(s)
- Niels J. Rupp
- 0000 0004 1937 0650grid.7400.3Department of Pathology and Molecular Pathology, University Hospital and University of Zurich, Schmelzbergstrasse 12, 8091 Zurich, Switzerland
| | - Beata Bode
- 0000 0004 1937 0650grid.7400.3Department of Pathology and Molecular Pathology, University Hospital and University of Zurich, Schmelzbergstrasse 12, 8091 Zurich, Switzerland
| | - Martina A. Broglie
- 0000 0004 1937 0650grid.7400.3Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital and University of Zurich, Zurich, Switzerland
| | - Grégoire B. Morand
- 0000 0004 1937 0650grid.7400.3Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital and University of Zurich, Zurich, Switzerland
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