OBJECTIVES Prior studies showed that immune inhibitory CD34+ progenitor cells, whose numbers are increased in head and neck squamous cell carcinoma (HNSCC) patients, can be differentiated into immune stimulatory dendritic cells by culture with 1α,25-dihydroxyvitamin D3 (1,25[OH]2D3). This was extended to a pilot study to diminish intratumoral levels of CD34+ progenitor cells by inducing their maturation into dendritic cells with 1,25(OH)2D3. STUDY DESIGN Newly diagnosed HNSCC patients were untreated for 3 weeks or received 3 weeks of 1,25(OH)2D3 treatment befoer surgical treatment. SUBJECTS AND METHODS HNSCC tissue was collected by biopsy from six patients who had no prior 1,25(OH)2D3 treatment and at the time of surgical treatment from six untreated patients and 11 patients who completed 1,25(OH)2D3 treatment. Tissues were analyzed by immunohistochemistry for levels of CD34+ cells and dendritic cells. RESULTS After 1,25(OH)2D3 treatment, intratumoral levels of CD34+ cells and levels of immature dendritic cells declined. However, levels of intratumoral mature dendritic cells increased. Clinical effects of 1,25(OH)2D3 treatment are premature to analyze. CONCLUSIONS Treatment of HNSCC patients with 1,25(OH)2D3 reduced levels of immune inhibitory CD34+ cells while increasing maturation of dendritic cells. This supports added studies to determine the effect of 1,25(OH)2D3 on intratumoral immune competence.

Cranial neuropathy is a rare presentation of recurrent cutaneous neoplasms of the head and neck. Given this infrequent occurrence and shared features of presentation, these highly morbid tumors are often mistakenly diagnosed as Bell's palsy or trigeminal neuralgia. Our findings corroborate previous reports of diagnostic delay, increased tumor burden, and worsened morbidity and mortality associated with such cutaneous malignancies. The critical utility of radiologic imaging for staging and tumor delineation are also supported by our institutional data.

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Serial excision is a practical and reliable technique for treatment of facial hemangiomas which due to size and location are not feasibly excised and repaired in a single setting without the use of complex adjunctive reconstructive techniques.

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