Site Of Squamous Cell Carcinoma Research Articles

Transoral Laser Microsurgery versus Robot-Assisted Surgery for Squamous Cell Carcinoma of the Tongue Base (Oncological and Functional Results)-A Retrospective GETTEC Multicenter Study.

The base of the tongue (BOT) is the second most common site for squamous cell carcinoma (SCC) in the oropharynx. There are currently no clear guidelines for the management of BOT SCC. Our main objective was to compare the oncological outcomes of two minimally invasive approaches, transoral laser microsurgery (TLM) and transoral robot-assisted surgery (TORS). This was a retrospective French GETTEC (Groupe d'Études des Tumeurs de la Tête et du Cou) multicenter study of patients with BOT SCC removed surgically either by TLM or TORS between 2005 and 2021. The study group included 16 patients treated by TLM and 38 by TORS, with median follow-up times of 14.4 and 37.2 months, respectively. The overall survival (OS) rates at 2 and 3 years were 67% in the TLM group and 90% at 2 years and 86% at 3 years in the TORS group (p = 0.42, p = 0.20). There was no significant difference in recurrence-free survival (RFS) between the two techniques after 2 and 3 years. The tumors removed by TORS were significantly larger. Operative times were significantly shorter in the TLM group. There were no differences in feeding resumption; none of the patients in the TLM group required a tracheotomy. Postoperative hemorrhagic complication rates were similar in the two groups (12% for TLM and 13% for TORS). Both TORS and TLM showed encouraging oncological, functional, and safety results in BOT SCC even in recurrence or second primary cancer patients, without a technique being found superior in terms of OS or RFS. Tumors removed by TORS were larger without an increase in postoperative bleeding, extending the possibilities of transoral treatment.

Prediction of distant organ metastasis and overall survival of lung cancer patients: a SEER population-based cohort study.

Distant organ metastasis is a common event in lung cancer (LC). However, the preferential metastatic pattern of different pathological types of LC and its effect on prognosis have not been comprehensively elucidated. This study aimed to explore the distant metastasis pattern and construct nomograms predicting the metastasis and survival of LC patients using the Surveillance, Epidemiology, and End Results (SEER) database. LC data were downloaded from the SEER database to conduct logistic regression and investigate risk factors for developing organ metastasis. A Cox regression analysis was conducted to investigate prognostic factors of LC. A Kaplan-Meier analysis was used to estimate overall survival outcomes. Nomograms were constructed to predict the probability of organ metastasis and the 1-, 3- and 5-year survival probability of LC patients. Receiver operating characteristic curves were used to evaluate the diagnostic accuracy of the nomograms. All statistical analyses were conducted within R software. The liver is the most common metastatic organ of small cell carcinoma. The brain is the most likely metastasis site of large cell carcinoma, and bone is the most likely metastasis site for squamous cell carcinoma and adenocarcinoma. Patients with triple metastases (brain-bone-liver) have the worst prognosis, and for nonsquamous carcinoma with single organ metastasis, liver metastases conferred the worst prognosis. Our nomograms based on clinical factors could predict the metastasis and prognosis of LC patients. Different pathological types of LC have different preferential metastatic sites. Our nomograms showed good performance in predicting distant metastasis and overall survival. These results will provide a reference for clinicians and contribute to clinical evaluations and individualized therapeutic strategies.

A Rare Case of Squamous Cell Carcinoma Presented with Multiple Discharging Sinus Over the Posterior Aspect of Left Thigh

Squamous cell carcinoma is the second most common cutaneous malignancy. The most important etiological factor is chronic exposure to the ultraviolet rays and hence exposed areas of the body are the most common site of squamous cell carcinoma. It is very uncommon for SCC to occur at unexposed areas of the body, and it is usually associated with long standing ulcers, sinus or immunosuppression. Here we are reporting a rare of Squamous Cell carcinoma which developed from multiple discharging sinus over the posterior aspect of left thigh in a 67 year old male.

Primary Malignant Tumors of Oral and Maxillofacial Region in Libyan Population: A single institution experience of 171 cases

background: Globally, a significantly high rate of mortality was caused by oral cancer; however, epidemiological data of oral cancer is still scanty, particularly in Arab countries. This retrospective study was designed to provide a systematic analysis of the histological subtypes of oral and maxillofacial malignant neoplasms in Libyan population during two decades, and to compare the results with previous reports from Libya and other countries.
 Method: data were gathered using patients medical record and biopsy files, and the histological slides were revaluated. The tumors were classified according WHO criteria (2017). 
 Results: Carcinoma was found in 145 patients, forming (84.7%) of all the malignant oral and maxillofacial neoplasms, followed by lymphoma and sarcoma (6.4%), and neural crest cell tumours (2.3%). Males were more affected than females at a ratio of 1.3:1. Most of the patients (70.8%) were above the age of 40 with a mean age of 51.7years old at the time of the diagnosis. Only 1% of the malignant neoplasms were odontogenic in origin. Squamous cell carcinoma (67.5%) was the most common epithelial neoplasm, followed by mucoepidermoid carcinoma (9.7%) and adenoid cystic carcinoma (4.1%). The tongue was the most common site for squamous cell carcinoma (41.1%), followed by buccal mucosa (16.8%).
 Conclusion: compared to previous reports from eastern and some western countries; the prevalence of malignant neoplasms of oral and maxillofacial region in Libyan populations is considerably low.

Prognosis of Distant Metastatic Sites in Anterior Skull Base Malignancies.

Objective This study aimed to provide information regarding the prognosis of patients presenting with metastatic anterior skull base malignancies based upon histology and site of distant metastasis (DM). Patients and Methods The National Cancer Database was queried for patients with anterior skull base malignant neoplasms with DM. Outcomes Prognosis was compared between site of DM and tumor histologies. A multivariable Cox proportional hazards model was used to identify prognostic factors for overall survival (OS). Results A total of 481 patients were identified. Lung was the most common site of DM (24.9%), followed by bone (22.2%), liver (5.6%), and brain (2.5%). Lung was the most common site for squamous cell carcinoma (SCCa) (28.3%), melanoma (37.7%), and adenoid cystic carcinoma (ACC; 31.4%). The median survival for patients presenting with metastatic disease regardless of tumor histology was 9.0 months (95% confidence interval [CI]: 8.2-10.3), and patients with metastasis to the liver had the best median survival at 15.5 months (95% CI: 10.5-25.6). The median survivals for the most common histologies, SCCa, melanoma, and ACC were 8.2 months (95% CI: 5.5-10.2), 10.5 months (95% CI: 8.7-14.1), and 15.0 months (95% CI: 11.1-61.1), respectively. Multivariable analysis demonstrated worse overall survival (OS) for older patients, higher Charlson-Deyo comorbidity scores, and tumors with higher grade and T stage. Compared with metastasis to bone, lung metastasis had better OS on multivariable analysis (hazard ratio [HR]: 0.70, 95% CI: 0.51-97). Adenoid cystic carcinoma had improved OS compared with SCCa (HR: 0.62, 95% CI: 0.39-99). Conclusion Tumor histology, metastatic sites, and several disease factors affected prognosis in anterior skull base malignancies with DM.

DMP-1 promoter-associated antisense strand non-coding RNA, panRNA-DMP-1, physically associates with EGFR to repress EGF-induced squamous cell carcinoma migration.

Accumulating evidence suggests that specific non-coding RNAs exist in many types of malignant tissues, and are involved in cancer invasion and metastasis. However, little is known about the precise roles of non-coding RNAs in squamous cell carcinoma (SQCC) invasion and migration. Recently, the dentin matrix protein-1 (DMP-1) gene locus was identified as a transcriptionally active site in squamous cell carcinoma (SQCC) tissue and cells. However, it is unclear whether RNA associated with cell migration exist at the DMP-1 gene locus in SQCC cells. We identified a novel promoter-associated non-coding RNA in the antisense strand of DMP-1 gene locus, promoter-associated non-coding RNA (panRNA)-DMP-1, by the RACE method in SQCC cells and tissues, and characterized the functions of panRNA-DMP-1 in EGF-driven SQCC cell migration. The inhibition of endogenous panRNA-DMP-1 expression by specific siRNAs and exogenous over-expression of panRNA-DMP-1 resulted in increased and suppressed cellular migration toward EGF in SQCC cells, respectively, and nuclear expression of panRNA-DMP-1 was induced by EGF stimulation. Mechanistically, suppression of panRNA-DMP-1 expression increased EGFR nuclear localization upon EGF treatment and nuclear panRNA-DMP-1 physically interacted with EGFR, which was confirmed by RNA immunoprecipitation assay using a bacteriophage-delivered PP7 RNA labeling system. Furthermore, co-immunoprecipitation assay revealed that suppression of panRNA-DMP-1 stabilized EGFR interaction with STAT3, a known co-transcription factors of EGFR, to induce migratory properties in many cancer cells. Based on these findings, panRNA-DMP-1 is an EGFR-associating RNA that inhibits the EGF-induced migratory properties of SQCC possibly by regulating EGFR nuclear localization and EGFR binding to STAT3.

Invasive Lower Lip Squamous Cell Carcinoma Mimicking Traumatic Fibroma: Case Report

Carcinoma of lip develops due to formation of malignant cells in the lips and it is the most common site for squamous cell carcinoma (SCC) in the head and neck region. Oral cavity is among top five leading sites of cancer, regardless of gender distribution across India. Squamous cell carcinoma of lip occurs at myriad locations along the upper or lower lip or commissure of lip, but majority (80% to 95%) of cases are seen on the lower lip region. Majority of oral cavity carcinoma cases (> 90%) are seen in patients above the age of 45, having a male predilection in distribution. Lesions that includes up to one third of the lower lip are typically treated with V-type or W-type excisions. Lesions affecting between one to two thirds of the lower lip are typically treated by regional flaps of Abbe or Estlander. Larger lesions involving more than two thirds of the lower lip are treated with Bernard flap for middle lesions and nasolabial transpositional flap for lateral lesions. Alternatively, definitive radiotherapy can be used for local control of early-stage epithelial malignancies of the lips such as basal cell and squamous cell carcinomas, but usually reserved for selected situations, also side effects of irradiation limits its use. Local resection along with elective SOHND is mandatory for long term survival rate and to avoid substantial worse prognosis. This case report describes an unusual presentation of carcinoma of lip mimicking benign soft tissue swelling.

Altered Coagulation Pattern in Different Histological Grades of Squamous Cell Carcinoma

Background: The incidence of squamous cell carcinoma has doubled in the last three decades associated with a high rate of morbidity and mortality. The incidence of bleeding and/or thrombosis in advanced stage cancer necessitates a need for research in blood coagulation abnormalities in malignancy. The objective of the present study was to determine the alteration in coagulation pattern among patients diagnosed with squamous cell carcinoma (SCC).
 Material and Methods: This cross-sectional study was conducted in Pathology department of Isra University Hospital, Hyderabad over a period of 06 months. A total of 126 samples were selected through non-probability convenient sampling. Both male and female patients of all age groups having SCC of skin, gastrointestinal and genital tract were included. The coagulation profile was analyzed by Sysmax CA 50 and Nycocard reader II. Data was entered into SPSS version 22.0 and results were analyzed.
 Results: The mean age of the patients with SCC in the present study was 55.5 ± 12 years with more male patients (n=81; 64.3%) as compared to females (n=45; 35.7%). Oral SCC was found to be the most common site of squamous cell carcinoma (43.7%). Majority of the patients had well differentiated SCC (42.1%) followed by moderately differentiated (40.5%) and poorly differentiated SCC (17.4%). The comparison of severity of SCC with coagulation profile revealed that PT (P=0.01), APTT (P=0.001), D-dimers (P=0.01 and TT (P=0.01) were significantly increased, whereas fibrinogen was significantly decreased (P=0.001).
 Conclusions: The histological differentiation of SCC (from well differentiated to poorly differentiated tumors) showed a highly significant association with different coagulation profile parameters like PT, APTT, BT, CT, D-dimer, TT, and fibrinogen levels.

Distinguishing between HPV-Associated Metastatic Anal Squamous Cell Cancer and HPV-Associated Oropharyngeal Cancer

The histology and immunohistochemistry (IHC) of primary and metastatic diseases from a human papilloma virus- (HPV-) related anal squamous carcinoma (ASCC) would typically demonstrate the same histology as an HPV-related oropharyngeal squamous carcinoma (OPSCC). However, determining whether a site of squamous cell carcinoma represents distant metastatic ASCC versus a metastatic HPV-related metastasis from an OPSCC to a regional lymph node carries profound prognostic and therapeutic implications. A patient with a history of locally advanced ASCC treated with standard concurrent radiation therapy and chemotherapy in 2015 is described. In 2018, an enlarged supraclavicular lymph node was excised demonstrating squamous cell carcinoma and radiographic staging revealed no other areas suspicious for malignancy. Direct laryngoscopy with operating telescope and biopsies demonstrated squamous cell carcinoma at the tongue base. Described here are assays that might be considered in distinguishing between whether a focus distant from a previously identified ASCC represents metastatic disease or instead a separate primary HPV-related cancer.

Metastasis to Submandibular Salivary Gland in Oral Carcinoma

Objective: To determine the frequency of involvement of the submandibular gland as a metastatic site in squamous cell carcinoma of oral cavity, mechanism of its involvement and factors associated with it. Method: We reviewed the medical and pathologic records of patients who underwent neck dissection (unilateral or bilateral) for oral cavity squamous cell carcinomas (SCC) from January 2009 to July 2017 at the Liaquat National Hospital in Karachi. Cases of histopathologically confirmed SCC of oral cavity and cases of primary tumor in which excision of the submandibular gland (SMG) was done along with neck dissection were included. Those cases with previous surgery for oral cancer and those with previous chemo-radiotherapy were excluded. Results: Median age at presentation was 49.50 years (IQR= 42-58 years). Males were more commonly affected (n=167, 79.5%). The most frequent involved site was buccal mucosa (n=110, 52.4%). Out of 210 neck dissections, SMG was involved by the tumor metastasis in only 8 (3.8%) of the cases. Most common method of involvement was direct invasion by the primary tumor (n=5, 62.5%). Floor of mouth (p<0.001) and level 1 lymph node involvement (p<0.001) were significantly associated with SMG involvement. Conclusion: SMG is the major source of unstimulated saliva. Saliva plays an important role in maintaining oral hygiene and health. Especially in patients of oral cavity SCC who receive post-operative radiotherapy its removal can aggravate xerostomia which can lead to severe discomfort. In this study there was no involvement of SMG in cases in which floor of mouth was not involved and in cases with clinically negative neck. So we concluded that efforts should be made to preserve SMG in these cases to reduce post-operative morbidity associated with its removal.

Differentiation Between Benign and Metastatic Cervical Lymph Nodes Using Ultrasound.

Purpose:The oral cavity is the most common site for squamous cell carcinoma, which has a distinct predilection for lymphatic spread before distant systemic metastasis. The cervical lymph node status is a very important consideration in the assessment of squamous cell carcinoma. Ultrasound is a noninvasive and inexpensive technique that can be used to differentiate between the benign and metastatic nodes. So the aim of this study was to evaluate reliability of ultrasound for such differentiation and to correlate them with histopathological finding.Materials and Methods:A total of 200 lymph nodes from 38 patients histopathologically proven for oral squamous cell carcinoma who underwent surgical neck dissection were considered. The patients underwent ultrasound examination of cervical lymph nodes prior to surgical neck dissection. The lymph nodes were differentiated into benign and metastatic based on the assessment of size, shape, shortest diameter/longest diameter (S/L ratio), margin, and internal architecture, and also the internal echo structure of the lymph nodes and histopathological findings were analyzed.Results:On correlation of ultrasonographic diagnosis with histopathological evaluation for metastatic lymph nodes, the overall accuracy of ultrasonographic analyses was 77.83%, and the sonographic criterion of irregular margin showed the highest predictability followed by the size. The correlation of internal echo structure with histopathological findings was highly variable.Conclusion:The ultrasound parameters such as size, shape, margin, S/L ratio, and internal echo structure might assist in differentiation between benign and metastatic lymph nodes. Combining these findings should raise the accuracy, as each sonographic parameter has some limitation as a sole criterion.

DCE-MRI for Pre-Treatment Prediction and Post-Treatment Assessment of Treatment Response in Sites of Squamous Cell Carcinoma in the Head and Neck.

Background and PurposeIt is important to identify patients with head and neck squamous cell carcinoma (SCC) who fail to respond to chemoradiotherapy so that they can undergo post-treatment salvage surgery while the disease is still operable. This study aimed to determine the diagnostic performance of dynamic contrast enhanced (DCE)-MRI using a pharmacokinetic model for pre-treatment predictive imaging, as well as post-treatment diagnosis, of residual SCC at primary and nodal sites in the head and neck.Material and MethodsForty-nine patients with 83 SCC sites (primary and/or nodal) underwent pre-treatment DCE-MRI, and 43 patients underwent post-treatment DCE-MRI, of which 33 SCC sites had a residual mass amenable to analysis. Pre-treatment, post-treatment and % change in the mean Ktrans, kep, ve and AUGC were obtained from SCC sites. Logistic regression was used to correlate DCE parameters at each SCC site with treatment response at the same site, based on clinical outcome at that site at a minimum of two years.ResultsNone of the pre-treatment DCE-MRI parameters showed significant correlations with SCC site failure (SF) (29/83 sites) or site control (SC) (54/83 sites). Post-treatment residual masses with SF (14/33) had significantly higher kep (p = 0.05), higher AUGC (p = 0.02), and lower % reduction in AUGC (p = 0.02), than residual masses with SC (19/33), with the % change in AUGC remaining significant on multivariate analysis.ConclusionPre-treatment DCE-MRI did not predict which SCC sites would fail treatment, but post-treatment DCE-MRI showed potential for identifying residual masses that had failed treatment.

Spinal cord metastasis of squamous cell carcinoma of the maxillary sinus

IntroductionSquamous cell carcinomas arising from the maxillary sinus have been rarely reported. The authors report the original case of a patient with squamous cell carcinoma of this site with an unusual clinical course. Case reportA woman presented with squamous cell carcinoma of the maxillary sinus that was only diagnosed 6 months after onset of symptoms. At the time of diagnosis, the tumour had spread to the brain via the maxillary nerve and to the skin. The patient was treated by chemotherapy and radiotherapy. Four months after stopping treatment, the patient presented Brown-Sequard syndrome, for which imaging examinations were performed, demonstrating a spinal cord metastasis from her squamous cell carcinoma. DiscussionThis case of squamous cell carcinoma presents several unusual features: the maxillary sinus is a rare site of squamous cell carcinoma and progression and distant metastasis have been only exceptionally described in the literature.

Surviving Primary Pancreatic Squamous Cell Carcinoma: A Rare Entity: Presidential Poster

Introduction: The pancreas is devoid of any squamous cells and the origin of a pancreatic carcinoma with primary squamous morphology is rarely described with little known about the natural history following treatment. Case Report: A 76-year-old Caucasian male, presented with a history of weight loss, painless jaundice and abdominal pain. His liver enzyme elevation was consistent with a cholestatic pattern. A CT abdomen revealed a 4.1 x 4.9 x 5.0 cm enhancing inhomogeneous malignant-appearing mass in the head of the pancreas with dilation of the common bile duct. Endoscopic retrograde cholangiopancreatography identified a biliary stricture and an ampullary stent was placed. Brushings from the stricture did not reveal any malignant cells. Cytological examination of an endosonographically-guided fine needle aspiration specimen confirmed the diagnosis revealing a moderately differentiated squamous cell carcinoma with no glandular differentiation and positive immunostaining for CK 5/6 and p63. No other primary site for squamous cell carcinoma was identified. Since the tumor was in close proximity to the superior mesenteric artery, the surgical risk was high. The patient was treated with concurrent chemotherapy (5-fluorouracil) and radiotherapy. The patient was closely followed with biliary stent changes and surveillance imaging. He has shown a progression free survival of 13 months, the longest so far reported in the literature. Pure pancreatic squamous cell cancer is very uncommon with an incidence of 0.5% to 2% of all exocrine pancreatic neoplasms. It is often presumed to be metastatic from another primary site unless proven otherwise. It is postulated to originate either in squamous metaplasia in a setting of chronic pancreatitis, in a pre-existing adenocarcinoma or differentiation of primitive multipotent cells with malignant transformation. CT imaging is helpful in staging or determining primary malignancies elsewhere if any. Enhancement of tumor on contrast CT and tumor blush on angiography helps to differentiate squamous cell from adenocarcinoma due to its rich vascularity. It is an aggressive tumor with a dire prognosis. Surgical resection is the best curative option but often limited by local and/or distant metastasis. Chemotherapeutic options include 5-fluorouracil, Gemcitabine and platinum based regimens, with variable success rates and a reported median survival of 3 months. We present a rare case of an aggressive primary pancreatic squamous cell cancer with the longest reported cancer free survival following chemotherapy.

Transoral Robotic Surgery Experience in 44 Cases

To report a single institution's experience with transoral robotic surgery (TORS) and its clinical outcomes. This was a retrospective study carried out at a university-affiliated teaching hospital. Forty-four consecutive TORS patients with benign and malignant diseases were reviewed. Data on demographics, clinical parameters, and diet were collected. Surgical margins, local and regional recurrence, distant metastasis, 2-year disease-free survival rate, and 2-year survival data were reviewed for the malignant cases. Nine benign and 35 proven squamous cell carcinoma (SCCA) cases underwent TORS. The set-up time was 17.12 minutes (range, 10-40 minutes), and operative time was 53 minutes (range, 10-300 minutes). Average length of stay was 2.5 days. There were seven (6.8%) grade 3 surgical complications. Surgical infection rate was 2.3%. Benign cases were on a regular diet after TORS. Of the malignant cases, 94% were taking peroral diet immediately after the TORS procedure. There were no intraoperative complications and no 30-day postoperative mortalities. The mean follow-up time was 25.2 months (range, 16-38 months) for malignant disease. The SCCA sites were in the oropharynx (30/35), larynx (2/35), and unknown primary with neck metastasis (3/35). Unknown primary patients were excluded in the surgical margin analyses. Negative margins were achieved in 91% of cases. The local and regional recurrence rates were 6.3% (2/32) and 3.1% (1/32), respectively. Two patients (6.3%) developed distant metastasis. Oropharyngeal SCCA cases were reviewed, of which 23 were human papillomavirus (HPV)/p16 positive and 7 were HPV/p16 negative. The 2-year actual survival for HPV-positive and -negative patients was 96% (22/23) and 86% (6/7), respectively. The 2-year disease-free survival for HPV-positive and -negative cases was 91% (21/23) and 71.4% (5/7), respectively. All malignant cases that underwent TORS received postoperative adjuvant therapy. TORS is a safe procedure with minimal complications and acceptable clinical and functional outcomes.

A prospective case series of secondary intention healing for surgical wounds on the dorsum of the hand

The dorsum of the hand is a common site for squamous cell carcinoma, and excision with appropriate margins often results in surgical defects that cannot be repaired by primary side-to-side closure. To assess healing time, complications and resulting scars when surgical wounds on the dorsum of the hand were allowed to heal by secondary intention. This was a prospective study of 28 surgical defects on the dorsum of the hand, which were allowed to heal by secondary intention. Patients were followed up on days 2, 7 and 14, and then every 2 weeks until the wounds healed. Wound dressings were changed 2-3 times per week. Patients' tolerance of this treatment and their degree of satisfaction with the final results was determined. The defect diameters ranged from 15 to 46 mm (median 24 mm). The time to heal was determined in 24 patients, and ranged from 22 to 63 days (median 44 days). There were no cases of postoperative bleeding. Two patients developed erythema of the wound edge; wound swabs for culture were negative in both cases. Overgranulation developed in 12 of 28 wounds, which settled with the application of a potent topical steroid and discontinuation of the hydrocolloid dressing. Patients were either 'very satisfied' (12/18) or 'satisfied' (6/18) with the resulting scar. Secondary intention healing of surgical wounds on the dorsum of the hand is a useful management option, which is well tolerated by patients, has a low rate of complications, and gives good cosmetic results.

Metastatic squamous cell carcinoma of jejunum of unknown primary masquadering as superior mesentric artery syndrome: A case report

Introduction: Metastatic squamous cell carcinoma of proximal jejunum is rare presentation, in which the diagnosis is made only after biopsy. A rare case of metastatic squamous cell carcinoma of jejunum with unknown primary is reported here. Case Report: A 75­year­ old female was presented with recurrent episodes of nausea and vomiting. On the basis of radiological investigation, diagnosis of superior mesenteric artery syndrome was made. On exploration growth was present in proximal jejunum. Resection of the growth with adequate margins and primary anastomosis was done. Histopathology showed metastatic squamous cell carcinoma. Whole body positron emission tomography scan shows no evidence of primary. Conclusion: Jejunum is rare site for squamous cell carcinoma of metastatic origin of unknown primary and can be confirmed only on biopsy.

Trends in head and neck cancer incidence in Denmark, 1978–2007: Focus on human papillomavirus associated sites

The aim of our study was to assess the overall trends in the incidence of head-and-neck cancer (HNC) among Danish men and women in 1978-2007, to describe the distribution and incidences of HNCs at different anatomical sites, and to determine whether the incidence of human papillomavirus (HPV)-associated cancers is increasing. Data were extracted from the nationwide Cancer Registry database. To assess the possible impact of HPV infection, the sites of squamous cell carcinomas were categorized as HPV-associated, potentially HPV-associated or HPV-unrelated. In total, 26,474 incident cases were identified and the overall incidence increased throughout the period. Significantly increasing incidence rates were notably seen for tumors in the oral cavity (2.2% per year), tonsils (4.8% per year), oropharynx (3.5% per year) and hypopharynx (4.4% per year). A significantly decreasing incidence of lip cancer was observed among men (-5.0% per year). Cancers at HPV-associated sites (n = 3650) showed strongly increasing incidence rates, primarily in individuals < 60 years. In contrast, HNCs at sites not related to HPV infection showed a significant decrease (in men) or virtually no change in incidence (in women). Our results suggest a marked impact of HPV infection on the epidemiology of HNCs in Denmark. HPV16 is the type most often found in HNCs; thus, the recent introduction of vaccination against HPV may in the future prevent HPV-associated cancers of the head and neck.

Squamous Cell Carcinoma of the Breast: A Case Report and Literature Review

Squamous cell carcinoma of the breast (SCCB) is an extremely rare malignant neoplasm. The diagnosis is established when the malignant cells are entirely of squamous type, and overlying skin malignancies or other primary sites of squamous cell carcinoma have been excluded. These tumors are extremely aggressive and refractory to treatment. We report a case of a 58 year old white female with SCCB managed to date successfully with a extensive partial mastectomy and close observation.

Frequency and Pattern of Oral and Maxillo-facial Carcinomas

Objective : To determine the frequency and pattern of carcinomas in Oral and Maxillofacial region, in particular relation to the primary sub site and involvement of the level of lymph nodes in the neck. Study Design : Descriptive study. Place and Duration of the Study : Oral and Maxillofacial Surgery Department, King Edward Medical University/ Mayo Hospital Lahore and Institute of Nuclear Medicine and Oncology Lahore (INMOL), from 1 st October 2007 to 30 th September 2008. Patients and Methods: Inclusion criteria: patients of all age groups and gender with biopsy (incisional or excisional) proven carcinomas of the oral and maxillofacial region. Exclusion criteria: Irradiated patients and patients with metastatic carcinomas in head and neck region. Results : Squamous cell carcinoma was found in 84.28% (n = 118) patients out of 140 cases, Adenocarcinoma was 5.7% (n = 8), Basal cell carcinoma was 0.7% (n = 1), Acinic cell carcinoma was 1.4% (n = 2), Adenoid cystic carcinoma was 3.6% (n = 5), Mucoepidermoid carcinoma was 3.6% (n = 5) and Verrucous carcinoma was found in 0.7% (n = 1) patients. The levels of lymph nodes involved were as follows; level I 35.7% (n = 50), level II 24% (n = 34), level III 11.4% (n = 16), level IV 6.4% (n = 9) and level V 3.5% (n = 5) in all 140 cases. There were 10% (n = 14) cases of parotid gland tumors, 28.6% (n = 39) tongue carcinomas, 11.4% (n = 16) maxilla, 22.1% (n = 31) buccal mucosa, 15% (n = 21) mandible, 8.5% (n = 12) floor of the mouth and 4.3% (n = 6) cases of palate. Most of the patients with Squamous cell carcinoma presented with T3 and T4 which were 33.9% (n=40) and 43% (n=51) respectively. Histopathologically, SCC with well-differentiated, moderately differentiated and poorly differentiated varieties were 27.12% (n = 32), 33.9% (n = 40) and 38.98% (n = 46) respectively. Most of the SCC patients were of stage stage-III or stage IV 41.5% (n = 49) and 35.5% (n = 42) respectively. Conclusion : Squamous cell carcinoma is the most common cancer of oral and maxillofacial region and most frequent site for squamous cell carcinoma is oral tongue. Key words: Oral carcinoma, squamous cell carcinoma, precancerous lesions, TNM staging.