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Tsavdaridou I, Pink D, Aristeidou A. Head and neck soft tissue sarcomas fighting for their own identity: A case report of a retropharyngeal liposarcoma and a literature review of case reports of retropharyngeal liposarcomas. OTOLARYNGOLOGY CASE REPORTS 2023. [DOI: 10.1016/j.xocr.2023.100532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Moore P, Cardemil F, Hayward NJ, Flatman S. Scoping review of head and neck neoplasms presenting with obstructive sleep apnoea: the importance of flexible nasendoscopy. ANZ J Surg 2020; 91:55-61. [PMID: 32580251 DOI: 10.1111/ans.16090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 05/19/2020] [Accepted: 05/27/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND Obstructive sleep apnoea (OSA) can be caused by neoplasms involving the upper aerodigestive tract. Currently, many of these patients have this diagnosis missed, as most adults diagnosed with OSA do not undergo adequate head and neck examination including flexible nasendoscopy. We performed a review of the literature to shed light on this phenomenon and outline the pathologies and issues surrounding this sub-population of patients diagnosed with OSA. METHODS A scoping review of the literature was conducted on head and neck neoplasms presenting with OSA. Data were extracted on demographics, clinical presentation, histopathology, treatment and patient outcomes. RESULTS Sixty-seven articles were included, describing 79 patients. Mean age was 45.8 years, and 77.2% were male. Symptoms of OSA were present for an average of 29.2 months before a diagnosis of causative neoplasm was made. Forty-two different benign and malignant histopathological entities were reported. At diagnosis, the causative pathology of 100% of patients was visible on head and neck examination including flexible nasendoscopy, while only 53.2% were visible on trans-oral examination. One-third of patients had commenced inappropriate treatment for OSA, including three who had undergone sleep surgical procedures. The majority of patients were treated with surgery alone (72.2%). CONCLUSION Although rare, neoplasms of the upper aerodigestive tract should be considered as a cause of OSA, especially in patients experiencing other symptoms in addition to the typical symptoms of OSA. They should particularly be considered in patients with comparatively lower body mass index or those with worsening OSA without an apparent cause identified.
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Affiliation(s)
- Phillip Moore
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Felipe Cardemil
- Department of Otolaryngology, University of Chile, Santiago, Chile.,Department of Otolaryngology, Clinica Las Condes, Santiago, Chile
| | - Nathan J Hayward
- Department of Otolaryngology, Monash Health, Melbourne, Victoria, Australia
| | - Samuel Flatman
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
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Kodiyan J, Rudman JR, Rosow DE, Thomas GR. Lipoma and liposarcoma of the larynx: case reports and literature review. Am J Otolaryngol 2015; 36:611-5. [PMID: 25841535 DOI: 10.1016/j.amjoto.2014.07.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 07/02/2014] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Two cases of laryngeal lipomatous tumors are presented. Their diagnoses and management are discussed and contrasted. METHODS Case report and literature review. RESULTS Patient 1 is a 58 year old male presenting with five years of progressive shortness of breath, dysphagia, and globus sensation. Clinical exam and imaging study showed a 3.5 cm hypodense laryngeal mass, and he underwent transoral robotic-assisted surgery for complete excision. Final pathology revealed a well-differentiated liposarcoma. Patient 2 is a 79 year old female presenting with one year of non-progressive hoarseness and globus sensation. Clinical examination and imaging study revealed a 1.8 cm hypodense laryngeal mass. Transoral endoscopic complete excision of the submucosal mass was performed. Final pathology revealed benign spindle-cell lipoma. CONCLUSION Liposarcoma and lipoma may present with similar symptomatology, clinical, and imaging findings. Pathology evaluation is of utmost importance for definitive diagnosis. Therefore, diagnosis and treatment of laryngeal lipomatous lesions are best accomplished with complete excision of the mass.
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Affiliation(s)
- Joyson Kodiyan
- Department of Otolaryngology-Head & Neck Surgery, University of Miami-Miller School of Medicine, 1475 NW 12th Avenue, Miami, FL, USA.
| | - Jason R Rudman
- Department of Otolaryngology-Head & Neck Surgery, University of Miami-Miller School of Medicine, 1475 NW 12th Avenue, Miami, FL, USA
| | - David E Rosow
- Department of Otolaryngology-Head & Neck Surgery, University of Miami-Miller School of Medicine, 1475 NW 12th Avenue, Miami, FL, USA
| | - Giovana R Thomas
- Department of Otolaryngology-Head & Neck Surgery, University of Miami-Miller School of Medicine, 1475 NW 12th Avenue, Miami, FL, USA
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Faiz SA, Balachandran D, Hessel AC, Lei X, Beadle BM, William WN, Bashoura L. Sleep-related breathing disorders in patients with tumors in the head and neck region. Oncologist 2014; 19:1200-6. [PMID: 25273079 DOI: 10.1634/theoncologist.2014-0176] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Sleep disturbance is a prominent complaint of cancer patients. Most studies have focused on insomnia and cancer-related fatigue. Obstructive sleep apnea (OSA) has been reported in small studies and case reports. METHODS In a retrospective review of patients who underwent formal sleep evaluation and polysomnography (PSG) from 2006 to 2011, 56 patients with tumors in the head and neck region were identified. Clinical characteristics, sleep-related history, and PSG data were reviewed. RESULTS Most patients had active cancer (80%), and the majority had squamous pathology (68%). Prominent symptoms included daytime fatigue (93%), daytime sleepiness (89%), and snoring (82%). Comorbid conditions primarily included hypertension (46%) and hypothyroidism (34%). Significant sleep-related breathing disorder was noted in 93% of patients, and 84% met clinical criteria for OSA. A male predominance (77%) was noted, and patients were not obese (body mass index <30 kg/m(2) in 52%). The majority of patients (79%) underwent radiation prior to sleep study, of which 88% had OSA, and in the group without prior radiation, 67% had OSA. Adherence to positive airway pressure (PAP) therapy was slightly better when compared with the general population. A subset of patients with persistent hypoxia despite advanced forms of PAP required tracheostomy. Multivariate analysis revealed that patients with active disease and radiation prior to PSG were more likely to have OSA. CONCLUSION Sleep-related breathing disorder was common in patients with tumors in the head and neck region referred for evaluation of sleep disruption, and most met clinical criteria for OSA. Daytime fatigue and sleepiness were the most common complaints. OSA was prevalent in male patients, and most with OSA were not obese. Architectural distortion from the malignancy and/or treatment may predispose these patients to OSA by altering anatomic and neural factors. A heightened clinical suspicion for sleep-related breathing disorder and referral to a sleep specialist would be beneficial for patients with these complaints.
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Affiliation(s)
- Saadia A Faiz
- Departments of Pulmonary Medicine, Head & Neck Surgery, Biostatistics, Radiation Oncology, and Thoracic/Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Diwakar Balachandran
- Departments of Pulmonary Medicine, Head & Neck Surgery, Biostatistics, Radiation Oncology, and Thoracic/Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Amy C Hessel
- Departments of Pulmonary Medicine, Head & Neck Surgery, Biostatistics, Radiation Oncology, and Thoracic/Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Xiudong Lei
- Departments of Pulmonary Medicine, Head & Neck Surgery, Biostatistics, Radiation Oncology, and Thoracic/Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Beth M Beadle
- Departments of Pulmonary Medicine, Head & Neck Surgery, Biostatistics, Radiation Oncology, and Thoracic/Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - William N William
- Departments of Pulmonary Medicine, Head & Neck Surgery, Biostatistics, Radiation Oncology, and Thoracic/Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Lara Bashoura
- Departments of Pulmonary Medicine, Head & Neck Surgery, Biostatistics, Radiation Oncology, and Thoracic/Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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Alicandri-Ciufelli M, Mattioli F, Molteni G, Trebbi M, Presutti L. Giant retropharyngeal liposarcoma. ANZ J Surg 2009; 79:485-7. [PMID: 19566875 DOI: 10.1111/j.1445-2197.2009.04952.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Navazo Eguía AI, Huelga Ruíz MA, Terán Santos J, Ruíz de la Parte A. Liposarcoma retrofaríngeo: a propósito de un caso de apneas-hipopneas durante el sueño. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2009; 60:295-7. [DOI: 10.1016/j.otorri.2008.12.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2007] [Accepted: 12/10/2008] [Indexed: 11/16/2022]
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Ozawa H, Soma K, Ito M, Ogawa K. Liposarcoma of the retropharyngeal space: Report of a case and review of literature. Auris Nasus Larynx 2007; 34:417-21. [PMID: 17386988 DOI: 10.1016/j.anl.2007.01.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2006] [Revised: 08/28/2006] [Accepted: 01/19/2007] [Indexed: 11/22/2022]
Abstract
Liposarcoma is a soft tissue malignant tumor that is common in adults, though the incidence of this type of tumor in the head and neck region is extremely low. Herein, we report a case of myxoid liposarcoma occurring in the retropharyngeal space. We were unable to make a proper diagnosis of this tumor prior to surgery because of the radiographic findings and the anatomical location resembled those of neurogenic tumor. Myxoid liposarcoma often recurs. So its excision must be carried out carefully and radical dissection is recommended. In the past, liposarcomas arising in the retropharyngeal space were not radically resected because the extent of resection in the head and neck area risked poor functional outcome. In the present case, functional resection and radiotherapy were performed and proved to be efficacious in that no recurrence was observed for 2 years.
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MESH Headings
- Combined Modality Therapy
- Follow-Up Studies
- Humans
- Incidental Findings
- Liposarcoma, Myxoid/diagnosis
- Liposarcoma, Myxoid/pathology
- Liposarcoma, Myxoid/radiotherapy
- Liposarcoma, Myxoid/surgery
- Magnetic Resonance Imaging
- Male
- Middle Aged
- Neoplasm Recurrence, Local/diagnosis
- Neoplasm Recurrence, Local/pathology
- Neoplasm Recurrence, Local/radiotherapy
- Neoplasm Recurrence, Local/surgery
- Pharyngeal Neoplasms/diagnosis
- Pharyngeal Neoplasms/pathology
- Pharyngeal Neoplasms/radiotherapy
- Pharyngeal Neoplasms/surgery
- Pharynx/pathology
- Pharynx/surgery
- Radiotherapy, Adjuvant
- Tomography, X-Ray Computed
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Affiliation(s)
- Hiroyuki Ozawa
- Department of Otolaryngology, School of Medicine Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
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