TWO CASES OF PRIMARY SQUAMOUS CELL CARCINOMA OF NASALVESTIBULUM A CONCEPT IN THE TREATMENT OF CANCER

Abstract

Two cases of primary squamous cell carcinoma of thenasal vestibulum were observed. In both cases, the tumor was obviously localized and the tumor cell infiltration was minimal. An incorrect working diagnosis as an inflammatory lesion was made because of remarkable ulcerative change of the lesion. Both cases healed satisfactorily by a simple excision, which was not radical procedure, and the excision of regional lymph nodes was not done. In one case, lymphnode metastasis was deveioped and the node was excised but no hematogenous dissemination was observed. The other case did not show any metastatic lesions. lesions. Both cases received CO60 radiation after the surgery.It has been considered that the cancer developed gradually grow, infiltrate and extend. However, the type of the cancerand the resistance of the body should be considered. In the skin cancer, 1) Basal cell carcinoma is localized and rarely develop the metastasis, 2) Squamous cell carcinomaextend to regional lymph nodes but hoes not develop the genrealizek metastasis, 3) Melanocarcino-ma shows the generalized hernatogenous extension even when the primary lesion is found. Treating the skin cancer, 1) Basal cell carcinoma can be cured by the local treatment regardless to thecourse of the lesion, 2) Squamous cell carcinama can be cured by the excision of the primary lesion and local metastatic lesions, 3) in Melano-carcinoma, even an early diagnosis and radical surgery are not curative, (Biologic Predeterminism, MacDonald 1951). Same concept might be applied to the malignancy in the field of oto-rhino-laryngology. An evaluation of the type and localization of the cancer and its prognosis might be able to change the method of treatment in individual cases.