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Wu N, Li Y, Ma X, Huang Z, Chen Z, Chen W, Zhang R. High incidence of HPV infection in minors with oral squamous cell carcinoma. Diagn Pathol 2024; 19:51. [PMID: 38461286 PMCID: PMC10925008 DOI: 10.1186/s13000-024-01470-9] [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: 12/18/2023] [Accepted: 02/19/2024] [Indexed: 03/11/2024] Open
Abstract
BACKGROUND Oral squamous cell carcinoma in minors is considered to be a distinct entity from OSCC in older patients, with an uncertain etiology. Human papillomavirus (HPV) infection may trigger the initiation and promote the progression of OSCC, but these roles have not been firmly established.We aimed to explore the correlation between HPV infection and the development of oral squamous cell carcinoma in minors and know the characteristics of OSCC in young patients more thoroughly. METHOD From January 2013 to December 2022,6 cases of OSCC aged < 15 years were selected from the Department of Oral Pathology, Peking University School of Stomatology, Beijing, China. All cases underwent testing for high-risk HPV mRNA infection using the RNA scope technique, and immunohistochemical staining was performed to investigate the expression of p16, pan-cytokeratin (CK), CK5/6, CK7, CK8/18, epidermal growth factor receptor (EGFR), p53, and Ki-67. Furthermore, we reviewed the literature on OSCC in patients aged < 21 years. CONCLUSIONS Minors OSCC is associated with HPV infection, and that p16 can serve as an immunohistochemical marker of HPV positivity.
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Affiliation(s)
- Ningxiang Wu
- The Affiliated Stomatological Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China
- Jiangxi Province Key Laboratory of Oral Biomedicine, Nanchang, China
- Jiangxi Province Clinical Research Center for Oral Diseases, Nanchang, China
| | - Yonghui Li
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
| | - Xiaokun Ma
- Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital of Soochow University, Suzhou Stomatological Hospital, Suzhou, China
| | - Zhen Huang
- College of Life Sciences, Fujian Normal University, Fuzhou, China
| | - Zhuoxuan Chen
- The Affiliated Stomatological Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China
- Jiangxi Province Key Laboratory of Oral Biomedicine, Nanchang, China
- Jiangxi Province Clinical Research Center for Oral Diseases, Nanchang, China
| | - Weihua Chen
- The Affiliated Stomatological Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, China
- Jiangxi Province Key Laboratory of Oral Biomedicine, Nanchang, China
- Jiangxi Province Clinical Research Center for Oral Diseases, Nanchang, China
| | - Ran Zhang
- Department of Oral Pathology, Peking University School and Hospital of Stomatology, 22 South Zhongguancun Avenue, Haidian District, Beijing, 100081, China.
- Research Unit of Precision Pathologic Diagnosis in Tumors of the Oral and Maxillofacial Regions, Chinese Academy of Medical Sciences, Beijing, China.
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Baskurt D, Vural S, Ertekin SS, Baykal C. Oral mucosa involvement in pediatric patients with xeroderma pigmentosum: a comprehensive review. Int J Dermatol 2024; 63:59-72. [PMID: 37964400 DOI: 10.1111/ijd.16890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/29/2023] [Accepted: 10/17/2023] [Indexed: 11/16/2023]
Abstract
BACKGROUND Xeroderma pigmentosum (XP) is a rare autosomal recessive disorder presenting with an inability to repair UV-induced DNA damage. This can lead to the development of neoplasms affecting multiple organ systems, with onset often in childhood. Unfortunately, no cure currently exists for XP, and management strategies focus on sun protection and early intervention for malignancies. Although most skin problems in XP patients are UV induced, various oral lesions are also described. However, the literature has not extensively characterized the oral manifestations and their prognostic significance. METHODS We conducted a comprehensive review to evaluate the prevalence and nature of oral mucosal lesions in pediatric XP patients. RESULTS Our literature search yielded 130 pediatric XP patients with oral involvement and 210 associated tumoral or non-tumoral lesions. Squamous cell carcinoma was the most common type of oral mucosal tumor reported, with other malignancies including basal cell carcinoma, melanoma, angiosarcoma, fibrosarcoma, and trichilemmal carcinoma. CONCLUSION Given the potential morbidity and mortality associated with oral mucosal tumors in XP patients, our study aims to raise awareness of these manifestations. Early diagnosis and treatment are crucial for managing these lesions effectively, and routine oral exams should be considered a critical component of dermatological evaluations for XP patients, especially in the pediatric age group.
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Affiliation(s)
- Defne Baskurt
- School of Medicine, Koç University, Istanbul, Turkey
| | - Secil Vural
- School of Medicine, Koç University, Istanbul, Turkey
- Department of Dermatology and Venereology, Koç University School of Medicine, Istanbul, Turkey
| | - Sümeyre S Ertekin
- Department of Dermatology and Venereology, Koç University School of Medicine, Istanbul, Turkey
| | - Can Baykal
- Department of Dermatology and Venereology, Istanbul University, Faculty of Medicine, Istanbul, Turkey
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Squamous Cell Carcinoma of the Tongue in Young Patients: A Case Series and Literature Review. J Oral Maxillofac Surg 2020; 79:1270-1286. [PMID: 33450194 DOI: 10.1016/j.joms.2020.12.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 12/10/2020] [Accepted: 12/11/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE The purpose of this study was to describe 3 cases of tongue cancer in patients less than 21 years of age. Secondarily, a literature review was performed to examine disease presentation, risk factors, prognosis, and treatment strategies for young persons with tongue cancer. METHODS The authors presented 3 cases of childhood tongue cancer between 2009 and 2020 at the University of Michigan Department of Oral and Maxillofacial Surgery (Ann Arbor, MI). An electronic literature review was conducted via PubMed, Embase, Web of Science, and MLibrary. RESULTS Including the present case series, 64 studies reporting 108 cases were identified. Age at presentation ranged from newborn to 20 years, with a mean age of 14.5 years. The majority of patients were female (52.2%); 68.1% of patients presented with T1 or T2 disease. Nodal metastases were seen in 56.1% of patients. The most commonly identified predisposing factors included Fanconi anemia (13.9%), bone marrow transplant (9.3%), tobacco use (6.5%), and xeroderma pigmentosum (4.6%). Most patients received surgery alone (37.5%), followed by surgery with adjuvant radiation (33.8%); 60.6% underwent neck dissection. Overall survival was 60.3% at 1 year and 43.6% at 5 years. CONCLUSIONS Oral tongue cancer in the young is a rare disease with poorly understood etiology. There is a need for oncologists and maxillofacial surgeons to collaborate in the study of genetic, social, environmental, and medical risk factors contributing to the disease. All patients should undergo high-throughput genetic sequencing to expand our understanding of the disease process and allow for targeted treatment strategies.
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Carneiro MC, Kimura TDC, Tolentino EDS, Pieralisi N, Veltrini VC. Unusual intraoral cancer with unexpected outcome in a patient with xeroderma pigmentosum: An alert for antineoplastic treatment. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 129:e1-e11. [PMID: 31706804 DOI: 10.1016/j.oooo.2019.09.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 09/03/2019] [Accepted: 09/28/2019] [Indexed: 10/25/2022]
Abstract
Xeroderma pigmentosum (XP) is a rare autosomal disorder characterized by extreme sensitivity to ultraviolet radiation. DNA repair mechanisms are impaired, and minimal sun exposure can lead to the development of cutaneous neoplasms in very young patients. Intraoral carcinomas are uncommon and, when present, are located mainly at the tongue tip. We report an unprecedented case of squamous cell carcinoma (SCC) in the floor of mouth of a 23-year-old woman with XP. The patient was referred to the oncologist, and 2 months after surgical resection, she underwent a single session of chemotherapy plus radiotherapy. However, she died 73 hours after undergoing her first chemotherapy session. Considering the unexpected outcome of this case, we also investigated possible exacerbated adverse effects of antineoplastic treatments (especially cisplatin-based chemotherapy) in patients with XP and reviewed the main characteristics of the disease, especially cases with oral manifestations reported in the literature.
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Affiliation(s)
| | | | | | - Neli Pieralisi
- Department of Dentistry, State University of Maringá, Maringá, PR, Brazil
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Acharya S, Ekalaksananan T, Vatanasapt P, Loyha K, Phusingha P, Promthet S, Kongyingyoes B, Pientong C. Association of Epstein-Barr virus infection with oral squamous cell carcinoma in a case-control study. J Oral Pathol Med 2014; 44:252-7. [PMID: 25169715 DOI: 10.1111/jop.12231] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND Besides the well-known risk factors, Epstein-Barr virus (EBV) might play a significant role in oral squamous cell carcinoma (OSCC). To explore the role of EBV in OSCC, the prevalence of EBV infection in oral exfoliated cells of OSCC cases and controls in northeastern Thailand was investigated, and the association of EBV in tumor lesion cells was further confirmed. METHODS Oral exfoliated cells were collected from OSCC cases and non-cancer controls. Cells from tumor lesions were taken from OSCC patients for further strong confirmation of the association of EBV with OSCC. EBV DNA was detected by polymerase chain reaction (PCR) using primers specific for EBV DNA polymerase. The EBV DNA positive samples were confirmed further by nested PCR. RESULTS Epstein-Barr virus was detected in the oral exfoliated cells of 45.05% of OSCC patients and 18.08% of the non-cancer control (P < 0.001). Similarly, EBV was detected in 32.5% of the tumor lesions. Betel quid chewing was statistically significantly associated with EBV prevalence (OR = 2.08), whereas no association with tobacco smoking and alcohol consumption. Alcohol consumption and betel quid chewing were significantly associated with OSCC (OR = 3.05 and OR = 5.05, respectively), but tobacco smoking was not associated. Interestingly, EBV was significantly associated with OSCC (OR = 3.76). CONCLUSIONS Epstein-Barr virus prevalence is associated with OSCC and seems to be enhanced by betel quid chewing, suggesting that EBV may, together with betel quid chewing, act as an important etiological risk factor of OSCC.
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Affiliation(s)
- Sulav Acharya
- Department of Microbiology, Faculty of Medicine, Khon Kaen University, Thailand
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Oral squamous cell carcinoma in patients twenty years of age or younger – Review and analysis of 186 reported cases. Oral Oncol 2014; 50:84-9. [DOI: 10.1016/j.oraloncology.2013.11.001] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Revised: 11/07/2013] [Accepted: 11/11/2013] [Indexed: 11/18/2022]
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Shamaa AA, Zyada MM, Wagner M, Awad SS, Osman MM, Abdel Azeem AA. The significance of Epstein Barr virus (EBV) & DNA topoisomerase II alpha (DNA-Topo II alpha) immunoreactivity in normal oral mucosa, oral epithelial dysplasia (OED) and oral squamous cell carcinoma (OSCC). Diagn Pathol 2008; 3:45. [PMID: 19021895 PMCID: PMC2611966 DOI: 10.1186/1746-1596-3-45] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2008] [Accepted: 11/20/2008] [Indexed: 12/04/2022] Open
Abstract
Background Head and neck cancer including oral cancer is considered to develop by accumulated genetic alterations and the major pathway is cancerization from lesions such as intraepithelial dysplasia in oral leukoplakia and erythroplakia. The relationship of proliferation markers with the grading of dysplasia is uncertain. The involvement of EBV in oral carcinogenesis is not fully understood. Aim The present study was designed to investigate the role of EBV and DNA Topoisomerase II∝ (DNA-Topo II∝) during oral carcinogenesis and to examine the prognostic significance of these protein expressions in OSCCs. Methods Using specific antibodies for EBV and DNA-Topo II∝, we examined protein expressions in archival lesion tissues from 16 patients with oral epithelial dysplasia, 22 oral squamous cell carcinoma and 20 normal oral mucosa by immunohistochemistry. Clinical information was obtained through the computerized retrospective database from the tumor registry. Results DNA-Topo II∝ was expressed in all examined specimens. Analysis of Variance ANOVA revealed highly significant difference (P < 0.01) in young aged labial tissues and significant (P ≤ 0.05) in gingival and not significant (P > 0.05) in inferior surface of tongue and in hard palatal tissues. Significant differences were observed between OEDs and NSE (P < 0.001) and SCCs and controls (P < 0.001), also, significant differences could be observed between SCCs and OEDs. DNA-Topo II∝ expression was significantly higher in tumors of low differentiation versus tumors of moderate and high differentiation (P < 0.001), DNA-Topo II∝ expression was correlated with age, tumor size, tumor stage, node metastasis and tumor differentiation, but not with gender and tumor site. None of normal squamous epithelium (NSE) expressed EBV. Heterogenous reactivity for EBV was observed through the series of dysplasia and squamous cell carcinoma. Its expression increased progressively with lymph node metastasis and low tumor differentiation, but no significant association could be observed with other clinicopathological parameters. EBV protein expression was increased with elevated Topo II-∝ LI in OEDs and OSCCs. A tendency to positive correlation between EBV and Topo II∝ expression was observed in OEDs but not in OSCCs. Conclusion EBV and DNA Topo II-αLI expression are possible indicators in oral carcinogenesis and may be valuable diagnostic and prognostic indices in oral carcinoma.
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Affiliation(s)
- Ali A Shamaa
- Oral Biology Department, Faculty of Dentistry, Minia University, Minia, Egypt.
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Abstract
BACKGROUND Epstein-Barr virus (EBV) infection has been implicated in the pathogenesis of certain subtypes of salivary gland tumors in the adult population. However, to the authors' knowledge its role in pediatric salivary gland tumors, a rare disease, has not been explored previously. METHODS Thirteen cases of primary tumors of the salivary gland occurring in children were retrieved from the tumor registry at the St. Jude Children's Research Hospital in Memphis, Tennessee. Clinical data were analyzed from the medical records and formalin fixed, paraffin embedded tumor tissues were examined by the in situ hybridization (ISH) technique for the presence of latent EBV infection. RESULTS Twelve of 13 tumors originated from the parotid gland and 1 originated from the submandibular gland. Mucoepidermoid carcinoma was the predominant tumor type; it was observed in seven patients, rhabdomyosarcoma was the diagnosis in three patients, acinic cell carcinoma was noted in two patients, and malignant fibrous histiocytoma was diagnosed in one patient. The ages of the patients ranged from 4.1-29.2 years, with a median age of 11 years. The outcome was excellent with all patients alive and free of disease at the time of last follow-up. The ISH tested negative in all tumor samples. CONCLUSIONS Based on the results of the current study, EBV infection does not appear to play a major role in the pathogenesis of pediatric salivary gland tumors.
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Affiliation(s)
- L Venkateswaran
- Department of Hematology-Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
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Yariş N, Kutluk T, Akçören Z, Yalçin B, Göğüş S, Büyükpamukçu M. Primary non-Hodgkin lymphoma of the tongue in a child. MEDICAL AND PEDIATRIC ONCOLOGY 1998; 30:372-3. [PMID: 9589088 DOI: 10.1002/(sici)1096-911x(199806)30:6<372::aid-mpo15>3.0.co;2-k] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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10
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Scully C. New aspects of oral viral diseases. CURRENT TOPICS IN PATHOLOGY. ERGEBNISSE DER PATHOLOGIE 1996; 90:29-96. [PMID: 8791748 DOI: 10.1007/978-3-642-80169-3_2] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- C Scully
- Eastman Dental Institute for Oral HealthCare Sciences, University of London, England
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11
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Abstract
The pathogenesis of oral squamous cell carcinoma involves recognised carcinogens in tobacco and/or alcohol but other factors, including viruses, may also have a role. This paper reviews the gene changes revealed in oral carcinoma, the evidence implicating viruses, and mechanisms whereby viruses may affect gene function.
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Affiliation(s)
- C Scully
- University Department of Oral Medicine, Pathology and Microbiology, Bristol Dental Hospital and School, England
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Tyan YS, Liu ST, Ong WR, Chen ML, Shu CH, Chang YS. Detection of Epstein-Barr virus and human papillomavirus in head and neck tumors. J Clin Microbiol 1993; 31:53-6. [PMID: 8380183 PMCID: PMC262620 DOI: 10.1128/jcm.31.1.53-56.1993] [Citation(s) in RCA: 71] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
The presence of Epstein-Barr virus (EBV) DNA and human papillomavirus (HPV) DNA in 74 head and neck tumor tissues was examined by the polymerase chain reaction and DNA sequencing analysis. EBV DNA sequence was detected in all 30 nasopharyngeal-carcinoma tissue samples and in 30 of 44 other head and neck tumor samples. HPV DNA sequence was detected in 14 of 30 nasopharyngeal-carcinoma tissue samples and in 11 of 44 other tumor samples. Coinfection of both viruses was observed in 14 nasopharyngeal-carcinoma tissue samples but only in 5 other head and neck tumor samples including 3 hypopharyngeal-carcinoma tissue samples. Our data indicate that EBV is closely associated with nasopharyngeal- carcinoma and may also be related to hypopharyngeal-carcinoma. In addition, a relatively high percentage of EBV-positive nasopharyngeal- and hypopharyngeal-carcinoma tissue specimens contained HPV sequence. The significance of the coexistence of EBV and HPV in these tumor tissues requires further study.
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Affiliation(s)
- Y S Tyan
- Department of Microbiology and Immunology, Chang-Gung Medical College, Kwei-shan, Taoyuan, Republic of China
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Scully C. Viruses and oral squamous carcinoma. EUROPEAN JOURNAL OF CANCER. PART B, ORAL ONCOLOGY 1992; 28B:57-9. [PMID: 1422472 DOI: 10.1016/0964-1955(92)90014-r] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- C Scully
- University of Bristol Dental Hospital and School
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14
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Scully C, Epstein J, Porter S, Cox M. Viruses and chronic disorders involving the human oral mucosa. ORAL SURGERY, ORAL MEDICINE, AND ORAL PATHOLOGY 1991; 72:537-44. [PMID: 1745511 DOI: 10.1016/0030-4220(91)90490-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Viruses have been implicated in the etiology of several chronic disorders of the oral mucosa. Most of these associations have been with DNA viruses, particularly certain herpesviruses, which are associated, for example, with some cases of erythema multiforme and with hairy leukoplakia. Papillomaviruses are associated with various papillomatous lesions, focal epithelial hyperplasia, and possibly with some carcinomas. Viruses may possibly be associated with recurrent aphthae, Behçet's syndrome, and some dermatoses. The literature concerning these possible associations is reviewed. However, much more research needs to be done before the full story of viral associations with oral mucosal disorders can be written.
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Affiliation(s)
- C Scully
- University Department of Oral Medicine, Surgery and Pathology, Bristol Dental School and Hospital, England
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Usenius T, Vornanen M, Kärjä J, Collan Y. Extranodal head and neck non-Hodgkin's lymphomas in children in Finland. Acta Oncol 1990; 29:529-31. [PMID: 2390278 DOI: 10.3109/02841869009090045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
During the 20-year period from 1961 to 1980, 17 cases of extranodal head and neck non-Hodgkin's lymphoma in children under 15 years of age were diagnosed in Finland. Eight cases had tumours in tonsils or nasopharyngeal adenoids and 9 cases lymphomas of other sites of the head and neck. The age-adjusted annual incidence rate for all cases was 0.69 and for tumours of the pharyngeal lymphatic tissue 0.35 per 10(6) children. Seven of the 17 tumours were undifferentiated lymphomas (Burkitt's and non-Burkitt's types) and 5 lymphoblastic lymphomas. The overall 5-year disease-free survival rate was 37%. Five of the 9 patients with tonsillar or adenoid lymphomas were disease-free more than 5 years.
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Affiliation(s)
- T Usenius
- Department of Pathology, University of Kuopio, Finland
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