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Sanchez Teran AI, Martínez Zamorano M, Trujillo Ortíz JA, Cerna Arriaga J. Renal cell carcinoma (RCC) spreading to the larynx: an unusual condition. BMJ Case Rep 2024; 17:e255459. [PMID: 38272511 PMCID: PMC10826486 DOI: 10.1136/bcr-2023-255459] [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] [Indexed: 01/27/2024] Open
Abstract
A man in his mid-70s, heavy smoker with chronic alcohol consumption and a chronic exposure to insecticides and burning of crop residues was referred to the surgical oncology department because of a 4-month onset of hoarseness, dyspnoea and laryngeal stridor. He had a history of left nephrectomy due to Fuhrman IV clear cell renal cancer 2 years ago. The patient underwent a bronchoscopy which identified a deforming tumour of the left vallecula, occlusion of 90% of the lumen and did not allow a safe biopsy. Following discussion between the oncological team, total laryngectomy and bilateral neck dissection of levels II, III, IV and V were performed, finding a transglottic tumour of approximately 4×3 cm with extension to the right anterolateral thyroid cartilage. The pathology report described metastatic RCC. The patient recovered well postoperatively and started systemic therapy with a vascular endothelial growth factor receptors inhibitor.
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Bandoh N, Kubota A, Takeda R, Sakaue S, Goto T, Baba S, Hashiba N, Kato Y, Nishihara H. Renal Cell Carcinoma Metastasizing to the Cricoid Cartilage Presenting With Subglottic Stenosis: A Case Report and Literature Review. EAR, NOSE & THROAT JOURNAL 2023:1455613231177188. [PMID: 37231666 DOI: 10.1177/01455613231177188] [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: 05/27/2023] Open
Abstract
A 72-year-old Japanese man with a 4-month history of hoarseness and 1-week history of difficulty breathing was admitted to our department. He underwent right total nephrectomy for primary clear cell-type renal cell carcinoma (RCC) 6 years ago and left partial nephrectomy for the metastasis 4 years ago. Flexible laryngeal fiberscope examination revealed bilateral subglottic stenosis without obvious mucosal lesions. Enhanced computerized tomography (CT) scan of the neck revealed that the cricoid cartilage had become bilaterally expansive and tumorous lesion exhibiting enhancement. We performed tracheostomy on the appointed day and biopsied the tumor in the cricoid cartilage via the skin incision. Results of histologic and immunohistologic examinations for AE1/AE3, CD10, and vimentin positivity were consistent with clear cell-type RCC. Chest and abdomen CT scans revealed a few tiny metastases in the upper lobe of the left lung but no recurrence in the abdomen. At 2 weeks from the day of tracheostomy, total laryngectomy was performed. Postoperatively, the patient was treated transorally with axitinib (10 mg/day) and as of 12 months he remains alive with unchanging lung metastasis. Next-generation sequencing of targeted regions using a surgical specimen from the tumor revealed a frameshift mutation in the von Hippel-Lindau gene (p.T124Hfs*35) and a missense mutation in the TP53 gene (p.H193R).
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Affiliation(s)
- Nobuyuki Bandoh
- Department of Otolaryngology-Head and Neck Surgery, Hokuto Hospital, Obihiro, Hokkaido, Japan
| | - Akinobu Kubota
- Department of Otolaryngology-Head and Neck Surgery, Hokuto Hospital, Obihiro, Hokkaido, Japan
- Department of Otolaryngology-Head and Neck Surgery, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Ryuhei Takeda
- Department of Otolaryngology-Head and Neck Surgery, Hokuto Hospital, Obihiro, Hokkaido, Japan
- Department of Otolaryngology-Head and Neck Surgery, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Shota Sakaue
- Department of Otolaryngology-Head and Neck Surgery, Hokuto Hospital, Obihiro, Hokkaido, Japan
- Department of Otolaryngology-Head and Neck Surgery, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Takashi Goto
- Department of Otolaryngology-Head and Neck Surgery, Hokuto Hospital, Obihiro, Hokkaido, Japan
| | - Shogo Baba
- Department of Pathology, Hokuto Hospital, Obihiro, Hokkaido, Japan
| | - Natsumi Hashiba
- Department of Pathology, Hokuto Hospital, Obihiro, Hokkaido, Japan
| | - Yasutaka Kato
- Department of Pathology, Hokuto Hospital, Obihiro, Hokkaido, Japan
| | - Hiroshi Nishihara
- Keio Cancer Center, Keio University School of Medicine, Tokyo, Japan
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Haddad G, Sataloff RT, Hamdan AL. Laryngeal Metastatic Lesions: A Literature Review. J Voice 2022:S0892-1997(22)00170-9. [PMID: 35918235 DOI: 10.1016/j.jvoice.2022.06.016] [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: 05/06/2022] [Accepted: 06/10/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Cancer ravages all aspects of a patient's life. In recent decades, there has been a substantial paradigm shift in the treatment of cancer with an emphasis on quality of life and patient comfort. Patients are treated holistically, a complex task given how multifaceted cancers are. Voice, a subtle indicator of patients' well-being is affected commonly by malignancies. One of the various ways by which voice is disturbed by non-laryngeal cancers is through metastasis to the larynx and adjacent areas. Metastasis to the larynx is rare but well-documented. If not diagnosed in a timely fashion, it can have devastating consequences on patients from life-threatening airway obstruction to progressive dysphonia that erodes their quality of life. Metastatic lesions of the larynx usually appear submucosal with intact overlying mucosa and are located most commonly in the supraglottis. Deep biopsies usually are needed for diagnosis, and management may entail endoscopic resection or other treatments. OBJECTIVES This paper reviews the literature to identify typical features of laryngeal metastatic lesions of the ten cancers that are among the most common worldwide, ie, skin, renal, breast, colorectal, lung, prostate, thyroid and liver. By summarizing their most prevalent locations in the larynx, type and appearance, the authors hope to aid physicians in their diagnostic process, particularly in cases in which laryngeal involvement is the first presenting sign of a malignancy.
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Affiliation(s)
- Ghassan Haddad
- Department of Otolaryngology and Head & Neck Surgery, American University of Beirut-Medical Center, Beirut, Lebanon
| | - Robert Thayer Sataloff
- Department of Otolaryngology-Head and Neck Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania
| | - Abdul-Latif Hamdan
- Department of Otolaryngology and Head & Neck Surgery, American University of Beirut-Medical Center, Beirut, Lebanon.
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Lee TH, Rangan V, Khallafi H. A Case of Sphenoid Sinus Metastasis in Hepatocellular Carcinoma. Hepatology 2016; 63:2050-3. [PMID: 26928869 DOI: 10.1002/hep.28516] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Revised: 02/02/2016] [Accepted: 02/18/2016] [Indexed: 12/07/2022]
Abstract
Sphenoid sinus metastasis from hepatocellular carcinoma (HCC) has been reported only rarely. We present a case of solitary sphenoid sinus metastasis of a 2.7 × 2.3 cm single HCC lesion. (Hepatology 2016;63:2050-2053).
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Affiliation(s)
- Tae Hoon Lee
- Division of Gastroenterology and Hepatology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH
| | - Vikram Rangan
- Division of Gastroenterology and Hepatology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH
| | - Hicham Khallafi
- Division of Gastroenterology and Hepatology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH
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5
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López F, Devaney KO, Hanna EY, Rinaldo A, Ferlito A. Metastases to nasal cavity and paranasal sinuses. Head Neck 2016; 38:1847-1854. [PMID: 27218239 DOI: 10.1002/hed.24502] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2016] [Indexed: 12/19/2022] Open
Abstract
The sinonasal cavities are rare locations for metastases. Metastases to these locations are usually solitary and produce similar symptoms to those of a primary sinonasal tumor. Nasal obstruction and epistaxis are the most frequent symptoms. The maxillary sinus is most frequently involved. The most common primary tumor sites to spread to this region originate in the kidney, breast, thyroid, and prostate, although any malignancy could potentially lead to a metastasis to the paranasal sinuses. The patient's prognosis is usually poor because of the fact that the sinonasal metastasis is usually associated with widespread disseminated disease. In the majority of patients, palliative therapy is the only possible treatment option. Nevertheless, whenever possible, surgical excision either alone or combined with radiotherapy may be useful for palliation of symptoms and, rarely, to achieve prolonged survival. This review considers the most interesting cases reported in the literature that presents metastases to the sinonasal cavities. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1847-1854, 2016.
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Affiliation(s)
- Fernando López
- Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain.,University of Oviedo. Instituto Universitario de Oncología del Principado de Asturias, Oviedo, Spain
| | | | - Ehab Y Hanna
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | - Alfio Ferlito
- Coordinator of the International Head and Neck Scientific Group
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6
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Zenga J, Mehrad M, Bradley JP. Metastatic Cancer to the Larynx: A Case Report and Update. J Voice 2015; 30:774.e9-774.e12. [PMID: 26743607 DOI: 10.1016/j.jvoice.2015.11.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 11/20/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The aim of this study was to describe a case of colorectal carcinoma metastatic to the larynx and provide a review of the current literature. METHODS A case report with chart review was performed. A review of the current literature was performed by systematically searching PubMed, OVID, CINAHL Plus, and EMBASE. RESULTS In 1988, a comprehensive literature review identified melanoma as the most common neoplasm to exhibit laryngeal involvement. Since that study, 41 subsequent cases have been reported, and among these, colorectal adenocarcinoma was the most frequent distant primary (24%). In 25 (58%) cases, curative surgery was attempted, but only 4 patients remained disease-free at last follow up. We report the history of a 52-year-old man who presented with rectal adenocarcinoma metastatic to his larynx 4 years after definitive treatment of the primary site. CONCLUSIONS In patients with a laryngeal mass and a history of colorectal cancer, or those at high risk of having an occult colorectal primary, metastatic spread to the larynx must always be considered. Although secondary laryngeal metastasis portends a poor prognosis, for the select patient, surgical intervention can provide long-term disease control.
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Affiliation(s)
- Joseph Zenga
- Department of Otolaryngology, Washington University, 660 S. Euclid Ave, Saint Louis, Missouri, 63110
| | - Mitra Mehrad
- Department of Pathology, University of Pittsburgh Medical Center, UPMC Presbyterian, 200 Lothrop Street, Pittsburgh, PA 15213
| | - Joseph P Bradley
- Department of Otolaryngology, Washington University, 660 S. Euclid Ave, Saint Louis, Missouri, 63110.
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7
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Namad T, Benbrahim Z, Najib R, Mohammed A, Baggar S, Bouyahia N, Arifi S, Mellas N. Maxillofacial metastasis from breast cancer. Pan Afr Med J 2014; 19:156. [PMID: 25767674 PMCID: PMC4345222 DOI: 10.11604/pamj.2014.19.156.4948] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 08/26/2014] [Indexed: 11/23/2022] Open
Abstract
Metastatic tumors to paranasal sinuses are exclusively rare. In this paper, we report acase of breast carcinoma metastasizing to the right maxilla. The metastasis occurred 5 years after radical mastectomy and presented as a primary sinonasalmass. The diagnosis was confirmed with histopathologic andimmunohistochemical examination however the patient died before starting any specific treatment because of tumor bleeding.
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Affiliation(s)
- Tariq Namad
- Department of Medical Oncology, Hassan II University Hospital, Fez, Morocco
| | - Zineb Benbrahim
- Department of Medical Oncology, Hassan II University Hospital, Fez, Morocco
| | - Rajae Najib
- Department of Medical Oncology, Hassan II University Hospital, Fez, Morocco
| | - Afif Mohammed
- Department of Radiation Therapy, National Institut of Oncology, Rabat, Morocco
| | - Soufiane Baggar
- Department of Medical Oncology, Hassan II University Hospital, Fez, Morocco
| | - Nezar Bouyahia
- Department of Medical Oncology, Hassan II University Hospital, Fez, Morocco
| | - Samia Arifi
- Department of Medical Oncology, Hassan II University Hospital, Fez, Morocco
| | - Nawfel Mellas
- Department of Medical Oncology, Hassan II University Hospital, Fez, Morocco
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8
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Laforga JB, Gasent JM. Mammary invasive duct carcinoma metastatic to parotid gland: report of a case diagnosed by fine-needle aspiration. Diagn Cytopathol 2008; 37:154-8. [PMID: 19030187 DOI: 10.1002/dc.21010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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9
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Chang CW, Wang TE, Chen LT, Chang WH, Leu YS, Fan YK, Chan YJ. Unusual presentation of metastatic hepatocellular carcinoma in the nasal septum: a case report and review of the literature. Med Oncol 2007; 25:264-8. [PMID: 18040899 DOI: 10.1007/s12032-007-9028-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2007] [Accepted: 10/22/2007] [Indexed: 10/22/2022]
Abstract
Hepatocellular carcinoma with sinonasal metastasis is extremely rare. We report a case of a 49-year-old man who had a history of synchronous hepatocellular carcinoma and verrucous carcinoma of tongue. A painless and non-bleeding mass was found in the left nasal septum 16 months after hepatocellular carcinoma was diagnosed. On computed tomography, the mass was enhanced with contrast. It was resected and proved to be metastatic hepatocellular carcinoma. The patient was treated with radiotherapy to the nasal area and then with chemotherapy. He was still alive, 15 months after the appearance of the nasal metastasis.
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Affiliation(s)
- Ching-Wei Chang
- Division of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital, Mackay Medicine, Nursing and Management College, No. 92, Sec. 2, Chung Shan North Road, Taipei, Taiwan
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10
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Huang HH, Chang PH, Fang TJ. Sinonasal metastatic hepatocellular carcinoma. Am J Otolaryngol 2007; 28:238-41. [PMID: 17606038 DOI: 10.1016/j.amjoto.2006.08.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2006] [Revised: 08/17/2006] [Accepted: 08/26/2006] [Indexed: 12/16/2022]
Affiliation(s)
- Hsueh-Hsin Huang
- Department of Otolaryngology, Chang Gung Memorial Hospital, Keelung, Taiwan
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12
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Daly SF, Sciubba J, Tufano RP. Lower-Extremity Liposarcoma Metastatic to the Larynx: Case Report. EAR, NOSE & THROAT JOURNAL 2006. [DOI: 10.1177/014556130608500316] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Distant metastases to the larynx are rare. We describe the case of a 46-year-old man who was referred to our head and neck surgery clinic with a 6-week history of sore throat and otalgia. He was found to have a laryngeal lesion that was consistent with a primary myxoid liposarcoma that had been extirpated from a lower extremity earlier. To the best of our knowledge, no case of myxoid liposarcoma metastatic to the larynx has been previously reported in the English-language literature.
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Affiliation(s)
- Scott F. Daly
- From the Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins University, Baltimore
| | - James Sciubba
- From the Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins University, Baltimore
| | - Ralph P. Tufano
- From the Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins University, Baltimore
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13
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Matsuda H, Tanigaki Y, Yoshida T, Matsuda R, Tsukuda M. A case of metastatic hepatocellular carcinoma in the nasal cavity. Eur Arch Otorhinolaryngol 2005; 263:305-7. [PMID: 16177918 DOI: 10.1007/s00405-005-1000-8] [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] [Received: 04/06/2005] [Accepted: 05/13/2005] [Indexed: 11/26/2022]
Abstract
Metastatic hepatocellular carcinoma in the nasal cavity and paranasal sinuses is rare. We report the case of a 71-year-old male afflicted with hepatocellular carcinoma with metastasis in the maxillary sinus and nasal cavity. He underwent radiation therapy with a total dose of 36 Gy, but he died of terminal liver failure. The possible metastatic route and prognosis of metastatic hepatocellular carcinoma in the sinonasal tract are discussed.
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Affiliation(s)
- Hideki Matsuda
- Department of Otorhinolaryngology, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, 236-004, Yokohama, Japan.
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14
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Imamura SI, Suzuki H. Head and neck metastases from occult abdominal primary site: a case report and literature review. Acta Otolaryngol 2004; 124:107-12. [PMID: 14977087 DOI: 10.1080/00016480310002177] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVES A very rare case of cervical lymph node metastasis from the liver is reported. The clinical findings and the diagnosis of a metastasis to the head and neck from the isolated silent abdominal cancer are discussed. MATERIAL AND METHODS The clinical and histopathological findings of a 56-year-old woman with a metastatic cervical lymph node of unknown origin are presented, together with a literature review of metastases from an occult abdominal primary. RESULTS The primary site was identified as an undifferentiated cholangiolocellular carcinoma using immunostaining for anti-cytokeratin subclasses after autopsy. Fifty-two cases of head and neck metastases from an abdominal primary cancer were found and separately summarized according to the metastatic routes. CONCLUSIONS When a metastatic neck cancer of unknown origin is diagnosed, it is very important to consider the possibility of a metastasis from an abdominal organ. Recognition of metastatic routes and their characteristics is helpful in the search for the occult abdominal primary site. Immunohistochemistry of the metastatic cancer may provide important information for identifying the primary site in cases of metastasis of an undifferentiated carcinoma.
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Affiliation(s)
- Shun-Ichi Imamura
- Department of Otolaryngology, School of Medicine, Shinshu University, Matsumoto City, Japan.
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15
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Prescher A, Schick B, Stütz A, Brors D. Laryngeal prostatic cancer metastases: an underestimated route of metastases? Laryngoscope 2002; 112:1467-73. [PMID: 12172264 DOI: 10.1097/00005537-200208000-00026] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Despite the high rate of metastases in advanced prostatic cancer, only 12 reports with 13 cases of laryngeal metastases in prostatic cancer have been given in the literature since the first description by Schmorl in 1908. A histopathological study was undertaken to clarify the obvious controversial clinical experience of multiple metastases in prostatic cancer but rare observations of laryngeal involvement. STUDY DESIGN Postmortem laryngeal examination in advanced prostatic cancer. METHODS Six patients with prostatic cancer and tumor spread to different organs but without clinical symptoms of laryngeal involvement were available for postmortem analysis. Gross anatomical inspection of the inner and outer surfaces of the removed larynx, horizontal slices of the larynx, and subsequent histological investigations including immunohistochemical analysis were used to search for metastases. RESULTS Macroscopic evaluation of the whole-larynx specimens did not lead to suspicion of laryngeal metastases. Interestingly, in all six larynx specimens of patients with metastatic prostatic cancer, laryngeal tumor infiltration was detected by macroscopic inspection of horizontal slices and proven histologically. Tumor infiltration ranged from focal micrometastases in the hematopoietic tissue of the ossified laryngeal skeleton to partial destruction of the external and/or internal osseous or cartilaginous lamina of the laryngeal skeleton. CONCLUSIONS The larynx is more often affected in metastatic prostatic cancer disease than is suggested by clinical experience. Because prostatic cancer metastasis starts in the hematopoietic areas of the ossified laryngeal skeleton, macroscopic evaluation of the whole larynx fails to detect metastases. Detecting laryngeal involvement requires horizontal slices and histological analysis.
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Affiliation(s)
- Andreas Prescher
- Institute of Anatomy, University Hospital and School of Medicine (RWTH) Aachen, Aachen, Germany
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16
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Hepatocellular Cancer Metastatic to the Zygoma: Primary Resection and Immediate Reconstruction. EAR, NOSE & THROAT JOURNAL 2002. [DOI: 10.1177/014556130208100118] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Hepatocellular carcinoma is common worldwide but relatively rare in the United States, where only 13,000 new cases are diagnosed each year. Metastasis to osseous structures in the head and neck are extremely rare; when they do occur, most appear as oral cavity masses secondary to mandibular and maxillary involvement. We report the case of an isolated zygomatic metastasis in a patient who had been previously treated for hepatocellular carcinoma with orthotopic liver transplantation. The patient underwent a complete excision of the mass followed by immediate reconstruction of the zygomaxillary buttress and the orbital rim and floor. To our knowledge, only one other case similar to ours has been previously reported; in that instance, the metastatic tumor was not resectable.
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17
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Reino AJ. Factors in the pathogenesis of tumors of the sphenoid and maxillary sinuses: a comparative study. Laryngoscope 2000; 110:1-38. [PMID: 11037807 DOI: 10.1097/00005537-200010001-00001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES/HYPOTHESIS To explain the processes that lead to the development of tumors in the maxillary and sphenoid sinuses. STUDY DESIGN A 32-year review of the world's literature on neoplasms of these two sinuses and a randomized case-controlled study comparing the normal mucosal architecture of the maxillary to the sphenoid sinus. METHODS Analysis of a 32-year world literature review reporting series of cases of maxillary and sphenoid sinus tumors. Tumors were classified by histological type and separated into subgroups if an individual incidence rate was reported. Histomorphometry of normal maxillary and sphenoid sinus mucosa was performed in 14 randomly selected patients (10 sphenoid and 4 maxillary specimens). Specimens were fixed in 10% formalin, embedded in paraffin, and stained with periodic acid-Schiff (PAS) and hematoxylin. Histomorphometric analysis was performed with a Zeiss Axioscope light microscope (Carl Zeiss Inc., Thornwood, NY) mounted with a Hamamatsu (Hamamatsu Photonics, Tokyo, Japan) color-chilled 3 charge coupled device digital camera. The images were captured on a 17-inch Sony (Sony Corp., Tokyo, Japan) multiscan monitor and analyzed with a Samba 4000 Image Analysis Program (Samba Corp., Los Angeles, CA). Five random areas were selected from strips of epithelium removed from each sinus, and goblet and basal cell measurements were made at magnifications x 100 and x 400. RESULTS The literature review revealed that the number and variety of tumors in the maxillary sinus are much greater than those in the sphenoid. The incidence of metastatic lesions to each sinus is approximately equal. No recognized pattern of spread from any particular organ system could be determined. On histomorphometric study there were no statistically significant differences between the sinuses in the concentration of goblet cells, basal cells, or seromucinous glands. CONCLUSIONS Factors involved in the pathogenesis of tumors of the maxillary and sphenoid sinuses include differences in nasal physiology, embryology, morphology, and topography. There are no significant histological differences in the epithelium and submucous glands between the two sinuses to explain the dissimilar formation of neoplasms.
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Affiliation(s)
- A J Reino
- Manhattan Ear, Nose and Throat Associates, New York, New York 10128, USA
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18
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Zhang C, Cohen JM, Cangiarella JF, Waisman J, McKenna BJ, Chhieng DC. Fine-needle aspiration of secondary neoplasms involving the salivary glands. A report of 36 cases. Am J Clin Pathol 2000; 113:21-8. [PMID: 10631854 DOI: 10.1309/urkm-u33a-jv0y-qawl] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Metastases or secondary deposits account for 16% of the malignant neoplasms involving the major salivary glands. A correct diagnosis of a secondary neoplasm is important to avoid unnecessary radical surgery and to guide further therapy. Fine-needle aspiration biopsy (FNAB) is an excellent noninvasive diagnostic tool for evaluating salivary gland lesions. We reviewed 36 secondary malignant salivary gland neoplasms evaluated by FNAB. Ancillary studies were performed in selected cases. Follow-up included clinical correlation and review of histologic material. For 4 adenocarcinomas, 4 squamous cell carcinomas, 1 undifferentiated carcinoma, 1 cutaneous basal cell carcinoma, 10 cutaneous melanomas including 1 desmoplastic variant, 3 osteosarcomas, 11 non-Hodgkin lymphomas, and 2 multiple myelomas, there was 1 false-negative FNAB result. The desmoplastic melanoma was interpreted as reactive lymphoid hyperplasia. A malignant diagnosis was given in all remaining cases except the secondary basal cell carcinoma, which was diagnosed as a neoplasm with basal cell features. FNAB is a reliable tool to differentiate hematologic malignant neoplasms and melanomas from other salivary gland neoplasms. A complete knowledge of the clinical history, review of previous pathologic materials, and, in some instances, the use of ancillary studies are crucial for recognizing solid malignant neoplasms secondarily involving the salivary glands.
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Affiliation(s)
- C Zhang
- Department of Pathology, Wintrop University Hospital, Mineola, NY, USA
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19
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Abstract
OBJECTIVES To present cases of renal cell carcinoma presenting with only head and neck metastases, to review theories of physiology and anatomy describing this phenomenon, and to discuss the role of the otolaryngologist in the treatment of these lesions. STUDY DESIGN Retrospective review of the records of three patients who presented with renal cell carcinoma with head and neck metastases over the 3-year period from 1992 to 1995. METHODS Retrospective review of the records of three patients who presented with renal cell carcinoma with head and neck metastases. In addition, English-language literature was reviewed with special focus on the anatomic and physiologic pathways possible to allow for such a phenomenon. CONCLUSIONS Renal cell carcinoma has an occasional presentation as a head and neck mass without evidence of disease elsewhere. Various routes of spread have been postulated. Batson's venous plexus, as postulated by Nahum and Bailey, is an anatomic route through which emboli could navigate to the head and neck and avoid pulmonary vascular filtration. Interactions on the cellular level may also be responsible for the seemingly paradoxical spread. We recommend local excision of head and neck metastases of renal cell carcinoma without sacrifice of vital structures as a sound treatment regimen.
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Affiliation(s)
- M D Gottlieb
- Department of Otolaryngology, New York University School of Medicine, New York 10016, USA
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20
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Koutnouyan HA, Rumore GJ, Kahn JM. Skull metastasis from renal cell carcinoma. Case report and literature review. Ann Otol Rhinol Laryngol 1998; 107:598-602. [PMID: 9682856 DOI: 10.1177/000348949810700710] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Metastatic tumors to the head and neck are uncommon. We report a case of renal cell carcinoma that presented as an epidermal inclusion cyst on the forehead. The forehead is an exceedingly uncommon site for renal cell metastases. We review the biology of tumor metastases and explore the pathways by which infraclavicular tumors spread to the head and neck. We then discuss the clinical appearance and management of metastatic renal cell carcinoma.
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Affiliation(s)
- H A Koutnouyan
- Department of Head and Neck Surgery, Kaiser Permanente Medical Center, Oakland, California 94553-4696, USA
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21
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Scott A, Raine M, Stansbie JM. Ethmoid metastasis of endometrial carcinoma causing mucocoele of maxillary antrum. J Laryngol Otol 1998; 112:283-5. [PMID: 9624381 DOI: 10.1017/s0022215100158360] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
We report a case of an antral mucocoele secondary to the obstruction of its ostium by metastatic endometrial carcinoma. This is the first report of such a cause for a mucocoele, and for a metastasis from such a tumour in the head and neck.
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Affiliation(s)
- A Scott
- Department of Otolaryngology, Walsgrave Hospital NHS Trust, Coventry, UK
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22
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Llanes F, Sanz-Ortega J, Suarez B, Sanz-Esponera J. Hepatocellular carcinomas diagnosed following metastasis to the oral cavity. Report of 2 cases. J Periodontol 1996; 67:717-9. [PMID: 8832483 DOI: 10.1902/jop.1996.67.7.717] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Oral metastases from hepatocellular carcinomas are rare. Case 1 was a 66-year-old male without previous history of liver disease who presented with metastasis to the gingival jaw mucosae on the lingual side. Case 2 was a 71-year-old male, with a previous history of diabetes, hepatitis, and cirrhosis who presented with metastasis to the right palatine tonsil. Oral metastases were the first manifestation of the hepatocellular carcinoma in both cases. A review of the literature disclosed 20 cases of hepatocellular carcinoma metastasizing to the oral cavity, 7 affecting the gingival mucosae and none of them affecting the palatine tonsil.
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Affiliation(s)
- F Llanes
- Departamento Anatomia Patologica, Hospital Universitario San Carlos, Madrid, Spain
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23
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Nicolai P, Puxeddu R, Cappiello J, Peretti G, Battocchio S, Facchetti F, Antonelli AR. Metastatic neoplasms to the larynx: report of three cases. Laryngoscope 1996; 106:851-5. [PMID: 8667982 DOI: 10.1097/00005537-199607000-00013] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Metastatic involvement of the larynx by distant malignancies is a rare event that can occur by hematogenous or lymphogenous spread through a retrograde or anterograde route. Only 143 cases of secondary laryngeal tumors have been reported in the literature. Metastases from cutaneous melanoma and renal carcinoma are the most common, whereas only sporadic cases stemming from lung and colon adenocarcinoma have been documented. The authors report a case of lung adenocarcinoma and two cases of colonic adenocarcinoma metastatic to the larynx and discuss the problems related to the pathogenesis, diagnosis, and management of secondary laryngeal neoplasms.
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Affiliation(s)
- P Nicolai
- Department of Otolaryngology, University of Brescia, Italy
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