History Of Squamous Cell Carcinoma Research Articles

Association between atopic dermatitis and squamous cell carcinoma: a case-control study.

Conflicting data have been published on whether an association exists between atopic dermatitis (AD) and nonmelanoma skin cancer. This study aimed to determine whether individuals with AD had an increased risk of squamous cell carcinoma (SCC) development. We conducted a retrospective, case-control study of patients residing in Olmsted County, Minnesota. Cases were selected from patients seen at Mayo Clinic (Rochester, Minnesota) who had an initial SCC diagnosis (either invasive SCC or SCC insitu) from January 1, 1996, through December 23, 2010. Age- and sex-matched controls were selected from patients seen at Mayo Clinic with no history of SCC before the case event date. Three hundred ninety-nine individuals with a documented history of SCC were identified and matched with 780 controls who did not have a history of SCC. After adjusting for race, smoking history, ionizing radiation exposure, corticosteroid and cyclosporine use, and non-SCC skin cancers, the odds ratio for SCC development between patients with history of AD versus patients without history of AD was 1.75 (95% CI, 1.05-2.93). Our findings support an increased risk of SCC development in the setting of AD.

Lip reconstruction technique: A modified Abbe-Estlander with a myomucosal advancement flap

Lip cancer represents between 12–15% of all oral cavity cancers; 95% affect the lower lip. The main objectives in lip reconstruction after tumoral mass resection are functionality and esthetics. We present the case of an 81-year-old male with a past medical history of squamous cell carcinoma of the maxilla. The patient consults with the Maxillofacial Surgery Department due to a hypertrophic lesion in the left oral commissure. The defect is considered intermediate in size (between 50% and two-thirds). For reconstruction of the lip, a classical rotation flap (Estlander flap) is used together with a myomucosal flap, which is both innervated and expandable. According to medical literature, for intermediate defects of the lower lip advancement or rotation flaps should be used. One of these is the Abbe-Estlander flap, a rotation flap dependent of the superior or the inferior labial artery. The Karapandzic flap and Johansen's staircase flap are other recommended techniques.

Non-atherosclerotic aortic mural thrombus: a rare source of embolism

A 54-year-old man presented to the emergency department with acute left-sided chest pain and left upper quadrant abdominal pain. He had a significant history of squamous cell carcinoma of the...

Nonmelanoma skin cancer and risk of all-cause and cancer-related mortality: a systematic review.

Some reports suggest that a history of nonmelanoma skin cancer (NMSC) may be associated with increased mortality. NMSCs have very low fatality rates, but the high prevalence of NMSC elevates the importance of the possibility of associated subsequent mortality from other causes. The variable methods and findings of existing studies leave the significance of these results uncertain. To provide clarity, we conducted a systematic review to characterize the evidence on the associations of NMSC with: (1) all-cause mortality, (2) cancer-specific mortality, and (3) cancer survival. Bibliographic databases were searched through February 2016. Cohort studies published in English were included if adequate data were provided to estimate mortality ratios in patients with-versus-without NMSC. Data were abstracted from the total of eight studies from independent data sources that met inclusion criteria (n = 3 for all-cause mortality, n = 2 for cancer-specific mortality, and n = 5 for cancer survival). For all-cause mortality, a significant increased risk was observed for patients with a history of squamous cell carcinoma (SCC) (mortality ratio estimates (MR) 1.25 and 1.30), whereas no increased risk was observed for patients with a history of basal cell carcinoma (BCC) (MRs 0.96 and 0.97). Based on one study, the association with cancer-specific mortality was stronger for SCC (MR 2.17) than BCC (MR 1.15). Across multiple types of cancer both SCC and BCC tended to be associated with poorer survival from second primary malignancies. Multiple studies support an association between NMSC and fatal outcomes; the associations tend to be more potent for SCC than BCC. Additional investigation is needed to more precisely characterize these associations and elucidate potential underlying mechanisms.

GLYCOGEN-RICH CLEAR CELL SQUAMOUS CELL CARCINOMA ORIGINATING IN THE ORAL CAVITY

Clear cell squamous cell carcinoma (CCSCC) is a rare histological subtype of squamous cell carcinoma (SCC) that was originally described in the skin. Here, we report a case of a 66-year-old female patient who presented with a fungating ulcerative mass of the left lateral tongue extending anteriorly to the floor of the mouth, and posteriorly to the left retromolar fossa and the oropharynx. The patient had a history of SCC of the left posterior tongue that was treated with partial glossectomy and adjuvant radiotherapy. Representative biopsies were obtained from the floor of the mouth, tongue and retromolar fossa. The examined biopsies showed various degrees of dysplastic surface epithelium with transition into infiltrating epithelial tumor nests and cords with clear cytoplasm and malignant cellular features. Pancytokeratin, CK5/6, and p63 were all diffusely positive. S-100, Calponin, and smooth muscle actin (SMA) were negative. PAS stain was diffusely positive and diastase labile in the tumor clear cells. Sparse areas of mucicarmine positivity were noted. Based on these findings a final diagnosis of a glycogen-rich CCSCC was given. This case represents a very rare histological variant of oral SCC, which is significant for the histological differential diagnosis of clear cell tumors of the oral cavity.

Ultrasound-Guided Phrenic Nerve Block for Intractable Hiccups following Placement of Esophageal Stent for Esophageal Squamous Cell Carcinoma

Hiccups are actions consisting of sudden contractions of the diaphragm and intercostals followed by a sudden inspiration and transient closure of the vocal cords. They are generally short lived and benign; however, in extreme and rare cases, such as esophageal carcinoma, they can become persistent or intractable, up to and involving significant pain, dramatically impacting the patient’s quality of life. This case involves a 60-year-old man with a known history of squamous cell carcinoma of the esophagus. He was considered to have high surgical risk, and therefore he received palliative care through the use of fully covered metallic esophageal self-expandable stents due to a spontaneous perforated esophagus, after which he developed intractable hiccups and associated mediastinal pain. Conservative treatment, including baclofen, chlorpromazine, metoclopramide, and omeprazole, provided no relief for his symptoms. The patient was referred to pain management from gastroenterology for consultation on pain control. He ultimately received an ultrasound-guided left phrenic nerve block with bupivacaine and depomedrol, and 3 days later underwent the identical procedure on the right phrenic nerve. This led to complete resolution of his hiccups and associated mediastinal pain. At followup, 2 and 4 weeks after the left phrenic nerve block, the patient was found to maintain complete alleviation of the hiccups. Esophageal dilatation and/or phrenic or vagal afferent fiber irritation can be suspected in cases of intractable hiccups secondary to esophageal stenting. Regional anesthesia of the phrenic nerve through ultrasound guidance offers a long-term therapeutic option for intractable hiccups and associated mediastinal pain in selected patients with esophageal carcinoma after stent placement. Key words: Esophageal stent, esophageal stenting, intractable hiccups, intractable singultus, phrenic nerve block, phrenic nerve, ultrasound, palliative care, esophageal carcinoma

Dual-focus versus conventional magnification endoscopy for the diagnosis of superficial squamous neoplasms in the pharynx and esophagus: a randomized trial.

Conventional magnification narrow-band imaging (CM-NBI) endoscopy has demonstrated high diagnostic accuracy for superficial squamous neoplasms in the pharynx and esophagus. This study aimed to evaluate the diagnostic utility of the newly developed dual-focus NBI (DF-NBI) compared with that of CM-NBI. We recruited patients with squamous cell carcinoma (SCC) in the head and neck, or esophagus, or with a history of SCC. The primary endpoint of this prospective controlled non-inferiority trial was the sensitivity of DF-NBI and CM-NBI for detecting superficial carcinoma in the pharynx and esophagus. Secondary endpoints included other diagnostic values and the resolving power of each endoscope. Superficial carcinoma was defined as high grade dysplasia and SCC invading up to the submucosal layer. The study included 93 patients. A total of 28 superficial carcinomas were detected in the pharynx and esophagus. The sensitivities of DF-NBI and CM-NBI for superficial carcinoma were 82 % and 71 %, respectively. The lower limit of the 90 % confidence interval for the difference between the sensitivities exceeded the non-inferiority threshold. The specificity and overall accuracy of DF-NBI vs. CM-NBI were 93 % vs. 90 % and 91 % vs. 86 %, respectively (both non-significant differences). The maximum resolving power of a conventional magnification endoscope was significantly higher than a dual-focus endoscope (7.2 µm vs. 11.6 µm: P < 0.001). The findings indicate the non-inferiority of DF-NBI versus CM-NBI in detecting superficial carcinoma in the pharynx and esophagus. DF-NBI appears to have a resolving power that, although significantly lower, is sufficient to achieve high diagnostic accuracy, comparable to that of CM-NBI.University Hospital Medical Information Network (UMIN, No. 000007585).

Ebstein-Barr Virus-Negative Clonal Plasma Cell Proliferations Associated With Systemic Involvement of Primary Cutaneous T-Cell Lymphoma

We describe a 66-year-old man with a long-standing history of squamous cell carcinoma of the head and neck region who developed nodular-sclerosing subtype of classical Hodgkin lymphoma and primary cutaneous CD8-positive, cytotoxic variant of mycosis fungoides over a 1-year period of time. Within a few months of his diagnosis of primary cutaneous T-cell lymphoma, he developed systemic involvement of T-cell lymphoma in an axillary lymph node, bone marrow and lung. Interestingly, his lung infiltrates had an Ebstein-Barr virus (EBV)-negative, mature clonal plasma cell proliferations intermingled with neoplastic T cells. It showed cytoplasmic κ light chain restriction by in situ hybridization and also revealed clonal immunoglobulin light chain rearrangements in both κ and λ. No morphological or immunohistochemical evidence of his prior Hodgkin lymphoma was identified in the bone marrow or lung. In the short available follow-up (2 months to date), the patient is doing well and being evaluated for possible allogeneic stem cell transplant. The association of EBV-positive B-cell expansions in T-cell lymphomas, especially angioimmunoblastic T-cell lymphoma, is well recognized. However, EBV-negative, clonal B-cell or plasma cell proliferations in T-cell lymphoma may represent a specific phenomenon and its significance still needs further clarification. J Hematol. 2016;5(4):129-137 doi: https://doi.org/10.14740/jh300w

Simplified criteria for diagnosing superficial esophageal squamous neoplasms using Narrow Band Imaging magnifying endoscopy.

AIMTo simplify the diagnostic criteria for superficial esophageal squamous cell carcinoma (SESCC) on Narrow Band Imaging combined with magnifying endoscopy (NBI-ME).METHODSThis study was based on the post-hoc analysis of a randomized controlled trial. We performed NBI-ME for 147 patients with present or a history of squamous cell carcinoma in the head and neck, or esophagus between January 2009 and June 2011. Two expert endoscopists detected 89 lesions that were suspicious for SESCC lesions, which had been prospectively evaluated for the following 6 NBI-ME findings in real time: “intervascular background coloration”; “proliferation of intrapapillary capillary loops (IPCL)”; and “dilation”, “tortuosity”, “change in caliber”, and “various shapes (VS)” of IPCLs (i.e., Inoue’s tetrad criteria). The histologic examination of specimens was defined as the gold standard for diagnosis. A stepwise logistic regression analysis was used to identify candidates for the simplified criteria from among the 6 NBI-ME findings for diagnosing SESCCs. We evaluated diagnostic performance of the simplified criteria compared with that of Inoue’s criteria.RESULTSFifty-four lesions (65%) were histologically diagnosed as SESCCs and the others as low-grade intraepithelial neoplasia or inflammation. In the univariate analysis, proliferation, tortuosity, change in caliber, and VS were significantly associated with SESCC (P < 0.01). The combination of VS and proliferation was statistically extracted from the 6 NBI-ME findings by using the stepwise logistic regression model. We defined the combination of VS and proliferation as simplified dyad criteria for SESCC. The areas under the curve of the simplified dyad criteria and Inoue’s tetrad criteria were 0.70 and 0.73, respectively. No significant difference was shown between them. The sensitivity, specificity, and accuracy of diagnosis for SESCC were 77.8%, 57.1%, 69.7% and 51.9%, 80.0%, 62.9% for the simplified dyad criteria and Inoue’s tetrad criteria, respectively.CONCLUSIONThe combination of proliferation and VS may serve as simplified criteria for the diagnosis of SESCC using NBI-ME.

Prosthetic Rehabilitation of Squamous Cell Carcinoma of Orbit: A Clinical Report.

A 61-year-old male patient reported with a chief complaint of loss of left eye [Table/Fig-1a]. The patient had a history of squamous cell carcinoma involving the left orbit. Patient consent was obtained prior to treatment. Surgical treatment was conducted by orbital exenteration and external beam radiotherapy, with a total dose of 4000 cGy delivered at a dose of 200 cGy in 20 daily fractions. Thereafter, the patient was referred for fabrication of an orbital prosthesis. The patient did not present with any systemic diseases and no evidence of known allergies or recurrence of tumor was evident.

Squamous Cell Carcinoma Following Photodynamic Therapy for Cutaneous Bowen's Disease in a Series of 105 Patients.

Photodynamic therapy (PDT) is an alternative to surgery for Bowen's disease. This monocentric retrospective study included 105 patients with Bowen's disease, treated with PDT between 2007 and 2013, who received a total of 151 different PDT fields. Comparison of immunocompromised and non-immunocompromised patients revealed that the former often had a previous history of squamous cell carcinoma (SCC; p = 0.004) and received more PDT fields (p = 0.007) than the latter. At least one SCC occurred post-PDT in 16 out of 105 patients in a PDT field. However, many of the patients were at risk of SCC and the possibility that the lesion did not have a mixed histology at baseline, but might simply be a transformation of non-PDT-responsive Bowen's disease, cannot be excluded. Although it is rare, patients should be closely monitored for SCC post-PDT.

Endoscopic Ultrasound-Guided Fine Needle Aspiration (EUS-FNA) and Biopsy (EUS-FNB) for Evaluation of Mediastinal Masses Causing Esophageal Obstruction: A Case Series

Case 1: A 77-year-old female with a history of squamous cell carcinoma of the lung status post chemotherapy presented to our hospital with persistent dyspnea and hypoxemia. She also noted mild dysphagia. CT chest revealed circumferential thickening of the esophageal wall at the level of the carina with a soft tissue mass in the subcarinal region. The patient underwent an esophagogastroduodenoscopy (EGD) that showed extrinsic compression in the mid-esophagus with a small mucosal break containing a fistulous tract. EUS-FNB was performed and biopsies confirmed squamous cell carcinoma. The patient will be started on palliative chemotherapy and radiation and hospice care was initiated. Case 2: A 50-year-old male admitted to our hospital with decreased appetite, weight loss and pain and numbness involving the right upper extremity. CT chest confirmed a large right lung mass extending into the mediastinum and causing superior vena cava syndrome. The patient underwent EGD showing an extrinsic compression in the proximal and mid-esophagus. EUS-FNA was performed and pathology confirmed small cell lung carcinoma. The patient commenced chemotherapy and radiation for limited stage small cell carcinoma. Case 3: A 56-year-old male was admitted to our hospital with dysphagia. A CT chest revealed a large mediastinal mass as well as extensive mediastinal lymphadenopathy. On EGD there was an extrinsic compression of the proximal esophagus. EUS confirmed a large hypoechoic mediastinal mass with subcarinal and aortopulmonary adenopathy. FNA was performed with pathology showing small cell lung carcinoma. The patient was started on palliative chemotherapy and radiation but passed away less than two months after the EUS. Discussion: In this case series we describe three patients presenting with esophageal obstruction due to lung cancer. Esophageal obstruction is an uncommon complication of mediastinal masses occurring with extrinsic compression into the esophageal lumen. While EUS-guided fine needle sampling of mediastinal masses has been well-described, to our knowledge few if any reports exist of this technique for patients with overt esophageal obstruction. In our experience, EUS-FNA/FNB provides a minimally invasive approach with a high diagnostic yield in these patients (Table 1).Table 1: EUS-FNA/FNB resultsEUS-FNA/FNB results:

When a Tattoo Reaction Turns out to Be a Good Pre-EUS-FNA Warning Sign

Malignant melanoma is one of the aggressive malignancies which can metastasize to multiple sites. Endoscopic ultrasound is a good modality to diagnose metastatic lesions as it can access multiple sites in chest and abdomen. Developing a new mass lesion in chest or abdomen in patients with melanoma can be challenging to diagnose, EUS can help in obtaining tissue sample for accurate diagnosis. Our case is a 26 year-old female patient presented for evaluation after positive PET scan results. She had history of persistent lump in the right axillary area for about 5-6 months for which she underwent biopsy which showed metastatic melanoma. She was a previous smoker. Her paternal grandfather had history of melanoma and her father had history of squamous cell carcinoma of the mandible. PET-CT scan showed an active spot in the left adrenal gland concerning of metastatic melanoma in addition to abnormal activity in the right axilla (Figure 1). Patient was referred for endoscopic ultrasound which showed left adrenal gland mass measured 16 x 17 mm (Figure 2a). EUS-guided FNA was done. Cytology confirmed the diagnosis of metastatic melanoma (Figure 2b). Patient underwent right complete axillary lymph node dissection and left laparoscopic adrenalectomy. After discussing the treatment options with the patient, she was started on Ipilimumab and finished 2 cycles. Because the patient was having intermittent RUQ pain, abdomen and chest CT scan was done which showed new mediastinal lymph nodes, along with multiple pulmonary and peritoneal nodules. On detailed questioning, the patient also reported developing new skin nodules at her right thigh tattoo (Figure 3). To identify whether these new changes were secondary to metastatic disease versus immunological reaction from the chemotherapy, EUS guided FNA of mediastinal lymph nodes in addition to biopsy of the skin lesions at the tattoo site were done. Both biopsies showed non-necrotizing granulomas consistent with immunological reaction with no evidence of malignancies. The patient was started on prednisone and had complete resolution of the skin tattoo nodules and marked improvement in her abdominal pain. Repeated CT scan showed improvement on mediastinal lymph nodes. The combination of detailed medical history taking and clinical evaluation, in addition to the valuable use of EUS guided FNA, were essential for correct diagnosis of this patient condition to guide the appropriate management.Figure 1Figure 2Figure 3

Actinomycose bronchique pseudo-tumorale simulant une ré-évolution d’un cancer bronchique 14 ans après la prise en charge thérapeutique initiale : à propos d’un cas

A patient with a history of squamous cell carcinoma of the right upper lung lobe treated 14 years before by concomitant chemo-radiotherapy was referred on account of dyspnea. Bronchial endoscopy revealed complete obstruction of the right main bronchus highly suggestive of a tumor recurrence. However, biopsy samples only showed inflammatory and necrotic tissue with no evidence of malignancy. Despite complete tissue resection by rigid bronchoscopy, a rapid and complete recurrence occurred requiring the placement of a Y-shaped bronchial prosthesis. Repeat histological, bacteriological and mycological analyses were negative. The patient was soon readmitted to hospital for a lung infection due to recurrence of obstruction inside and around the prosthesis. Bacterial examination of biopsy samples identified Actinomyces meyeri. Appropriate antibiotic therapy led to a complete regression of the bronchial obstruction. Unfortunately, the patient died a few months later due to massive hemoptysis after the removal of the prosthesis. Autopsy examination showed a fistula between the right main bronchus and pulmonary artery, with no evidence of neoplastic recurrence nor the persistence of lesions associated with actinomycosis.

Immune profiling and cancer post transplantation.

Half of all long-term (> 10 year) australian kidney transplant recipients (KTR) will develop squamous cell carcinoma (SCC) or solid organ cancer (SOC), making cancer the leading cause of death with a functioning graft. At least 30% of KTR with a history of SCC or SOC will develop a subsequent SCC or SOC lesion. Pharmacological immunosuppression is a major contributor of the increased risk of cancer for KTR, with the cancer lesions themselves further adding to systemic immunosuppression and could explain, in part, these phenomena. Immune profiling includes; measuring immunosuppressive drug levels and pharmacokinetics, enumerating leucocytes and leucocyte subsets as well as testing leucocyte function in either an antigen specific or non-specific manner. Outputs can vary from assay to assay according to methods used. In this review we define the rationale behind post-transplant immune monitoring assays and focus on assays that associate and/or have the ability to predict cancer and rejection in the KTR. We find that immune monitoring can identify those KTR of developing multiple SCC lesions and provide evidence they may benefit from pharmacological immunosuppressive drug dose reductions. In these KTR risk of rejection needs to be assessed to determine if reduction of immunosuppression will not harm the graft.

Un cas de dégénérescence maligne de kyste amygdaloïde

An amygdaloid cyst is a rare high laterocervical cystic tumor arising from the second branchial cleft. It accounts for 2% of laterocervical tumors and up to 85% of second branchial cleft abnormalities [1]. The incidence of intracystic squamous cell carcinoma ranges from 4 to 22% [2]. The diagnosis of primary carcinoma or intracystic metastasis is a controversial issue. We report a rare case of degenerate amygdaloid cyst meeting the diagnostic criteria for intracystic squamous cell carcinoma determined by Martin and Khafif. A 73-year-old female patient consulted for a left cervical swelling in 2010; the diagnosis was an amygdaloid cyst. She had a history of squamous cell carcinoma of the hard palate (T1NoMo) surgery and radiation therapy in 2009, without recurrence. Three years later, the swelling increased to a large size without any cervical node involvement. An exploratory cervicotomy with histological study revealed intracystic squamous cell degeneration. Primary squamous cell carcinoma location in the wall of an amygdaloid cyst is extremely rare and a highly controversial issue. The challenge is to be able to discriminate between a cystic metastasis of squamous cell carcinoma of the aerodigestive tract and a primary squamous cell carcinoma located in the wall of an amygdaloid cyst. Martin and Khafif defined specific criteria to confirm the diagnosis of primary branchiogenic carcinoma.

Buschke-Löwenstein tumor of the vulva in a patient with a history of squamous cell carcinoma of the cervix

Background Buschke-Lowenstein tumor (BLT) is a very rare sexually-transmitted disease associated with human papillomavirus (HPV) type 6 and 11, but rare cases of oncogenic HPV types including HPV 16 and HPV 18 were also reported. It is characterized by slow, locally invasive growth and clinically presents as exophytic masses with a cauliflower-like morphology. It usually occurs in uncircumcised men and location in sites other than the penis is very rare. It is a premalignant disorder with a low incidence of metastasis but with a considerable risk of malignant transformation to squamous cell carcinoma (SCC).

Importance of High Clinical Suspicion in Diagnosing a Marjolin's Ulcer with an Unusual Presentation

Importance of High Clinical Suspicion in Diagnosing a Marjolin's Ulcer with an Unusual Presentation

Multiple lesions of granular cell basal cell carcinoma: a case report

Granular cell change in basal cell carcinoma (BCC) occurs rarely. Only 11 such cases have been reported; all of them were solitary nodular BCC. We report herein a case of multiple granular cell BCC with infundibulocystic features. The tumors presented as papules on the anterior neck of a 44-year-old female with a prior history of a well-differentiated squamous cell carcinoma (SCC) of the tongue and radiation involving the area in which BCC developed. Microscopically, the tumors were circumscribed small dermal nodules composed of epithelial cords with granular eosinophilic cytoplasm and entrapped infundibular keratocysts. Given the eosinophilic appearance of the tumor, history of SCC and the lesions multiplicity, the initial biopsy was first interpreted as metastatic SCC. The correct diagnosis of granular cell BCC was established upon rereview of the slides at a cancer center. Given the diagnostic controversy, immunohistochemical stains were performed. The tumor cells expressed Ber-EP4, CD63 (NKI/C3) and CD68. The tumors were compared to the prior SCC finding different morphologies. Extensive clinical evaluation showed no evidence of recurrent SCC. This report expands the clinicopathologic spectrum of granular cell variant of BCC and documents for the first time eruption of multiple such tumors in a localized area.

A Major Pitfall to Avoid: Retroclival Hematoma due to Odontoid Fracture

Retroclival hematoma (RCH) is a rare occurrence. The hemorrhage is usually small and hidden and can be easily missed on CT scan. Here, we report the association of a RCH with an odontoid fracture. Case report and review of the literature. We describe a case of a 75-year-old man with a history of squamous cell carcinoma of the tongue base, treated with chemo-radiation. He was on warfarin for atrial fibrillation. He presented to the hospital 6weeks after falling from standing height, with headache, neck pain, and stiffness. Clinical examination did not show any focal neurologic deficits. INR measured 4days before admission was 6.0, but therapeutic at 2.4 on the day of admission. CT scan of the head showed a RCH. CT angiogram of the neck unexpectedly showed a type II odontoid fracture with instability of the upper cervical spine and extension of the hematoma to the upper cervical spine. Anticoagulation was reversed with factor IX complex (Bebulin). He underwent C1-C2 fusion without any complications. The immediate post-operative period was unremarkable. Unfortunately, he succumbed to airway obstruction due to mucus plugging 14days into hospitalization. In the appropriate clinical setting, when a RCH is found, further imaging should be considered to rule out fracture of the cervical spine. Odontoid fractures can lead to compression of the spinal cord or lower medulla. To prevent neurologic injury and subsequent complications, prompt recognition of type II odontoid fracture should lead to immediate spine stabilization.