The purpose of this study was to clarify the role of inflammatory blood markers in the management of earlystage (T1-T2) oral squamous cell carcinoma (OSCC) of the tongue in patients with a clinically negative neck. Materials and methodsWe undertook a retrospective chart review of 102 patients with early-stage OSCC of the tongue, subjected to tumor resection and elective neck dissection. Based on postsurgical histopathological examination results, we divided our cohort into pN+ and pN0 groups. Afterwards, we analyzed the role of pretreatment inflammatory blood markers in predicting occult neck metastasis. We also evaluated neutrophil-lymphocyte ratio (NLR) association with the depth of invasion (DOI) of the primary tumor. ResultsWe found a significant association of NLR (p=0.001) and monocyte-lymphocyte ratio (p=0.011) with neck status on univariate analysis. Multivariate analysis showed that only NLR (p=0.02) was an independent risk factor for occult metastasis among inflammatory blood markers. Receiver Operating Characteristic curve analysis and Younden's Index determined the NLR value of 2.96 as the most adequate cut-off value for neck status prediction. NLR values of pretreatment workup also had a significant association with the DOI of the primary tumor (p=0.018). ConclusionOur study supports the role of pretreatment NLR in predicting occult neck metastasis in early-stage OSCC of the tongue. It also sheds some light over the potential of NLR as a predictor of the primary tumor's DOI.
Primary acinic cell carcinoma arising in the nose is exceptionally rare. In this report, we present a unique case of an acinic cell carcinoma of the nasal lateral wall, and it is only the second such case to be reported. We also engage in a systematic review of all 18 cases of acinic cell carcinoma of the nose reported in the literature in English so far.
Mesenchymal chondrosarcoma (MCS) is a rare histological variant of chondrosarcoma, with aggressive behaviour. Due to the unique nature of this disease, management strategies are not well established. Li-Fraumeni syndrome (LFS) is a rare cancer predisposition syndrome with a wide tumour spectrum, associated with TP53 germline mutations. We report a case of MCS of the maxilla, treated with surgical excision and adjuvant chemotherapy, in a patient with a past medical history of choroid plexus papilloma and a family history of early age first-degree cervical uterine cancer, that led to the clinical suspicion of a cancer predisposition syndrome and the subsequent diagnosis of LFS. This is the first MCS described in a LFS case. It demonstrates that adjuvant chemotherapy should be considered, in conjunction with surgical excision, in MCS and that cancer predisposition syndromes should be suspected in patients with multiple neoplasms and a strong family history of cancer.
Introduction The COVID-19 pandemic has forced Portuguese healthcare institutions to adapt management protocols and prioritize resources. These adjustments had a significant impact, affecting both clinical care and also training programs. The aim of this study was to access the maxillofacial surgery resident’s perspective on the pandemic’s impact on specialty training. Methods We designed a nationwide questionnaire to evaluate surgical activity of maxillofacial surgery residents, the impact on surgical training and the perceived effect on their future. Results We collected results of all maxillofacial surgery residents currently in training. Three out of 32 reported a decline in surgical activity of 90-100%, 11 stated a reduction of 75%, 12 expressed a decrease of 50% and 6 described a decline of 25%. Discussion The majority of residents stated the need to consider an extension of training time. Alternative training tools such as virtual activities and simulation training should be considered as formal complements to residency programs. Conclusion We found a significant decrease in surgical activity among all trainees coupled with a unanimous concern regarding their training progression.
El uso de lentes de contacto es una tendencia que en la actualidad tiene auge en la industria médica. Incluso la venta de los mismos sin receta médica en el caso de lentes de contacto estéticos para el cambio de color del iris es algo común. Sin embargo, es importante tener en cuenta los riesgos que conlleva el uso inapropiado, tales como cambios en la forma de la estructura corneal, lesiones por rascado o mala calidad de la lágrima.
Parapharyngeal space primary neoplasias are infrequent findings in clinics, and schwannoma derived from a peripheral nerve is even rarer in this anatomic area [1]. The presented case is a patient who was referred to our department with a 3 months progressive soft palate enlargement without related symptoms. The challenge, in these cases, due to the anatomic complex area, is to catch a suitable approach to remove the tumor, according to dimension and surrounding structures. Prognosis and follow-up will depend on histopathologic evaluation.
Meningiomas are benign tumours common in the central nervous system. Primary extracranial meningiomas in the jaws are extremely rare. We performed a systematic review of all the primary extracranial meningioma arising in the jawbones reported in the English-language literature including indexed and non-indexed journals and we report a unique case in our hospital of a man with two primary extracranial meningiomas, the first frontal intradiploic and 16 years later, a second located in the mandible. We found 14 cases with primary jaws meningioma and we report another one. A mandibular predominance was observed with only four cases in the maxilla. Most of them occurred in women, with a mean age of 35.9 years. It is the first published case of a patient with two primary extracranial meningiomas one of them in the mandible, which the gender, age and laterality of the lesion are less frequent.
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