The successful management of laryngeal and hypopharyngeal cancers requires accurate diagnosis, staging, assessment of patient wishes, and the selection of the most appropriate treatment for the individual patient. Imaging plays an important complementary role to clinical examination and endoscopy in the evaluation of laryngeal and hypopharyngeal cancers. The combined information allows the disease to be staged accurately. To correlate carcinoma larynx and hypopharynx clinically and radiologically and to know the accurate pre-therapeutic stage of the disease. A total of 50 cases were included in this study. After clinical TNM staging, CT scan was done to know the real extent of tumor, volume and nodal status. After that, TNM staging was revised based on radiological findings. The number of people who had been upstaged and downstaged after CT evaluation was measured. There were total of 50 cases of carcinoma larynx and hypopharynx in this study. There were 26 (52%) cases of carcinoma larynx and 24 (48%) cases of carcinoma hypopharynx. There were significant changes in T stage after radiological evaluation. Major changes were observed in T2 and T3 stages. Majority of cases (17) were having N1 disease after radiological evaluation. On comparing clinical and radiological staging of neck nodes, it was observed that upstaging occurred mainly in N0. Overall after radiological evaluation, 48% of our cases were upstaged, 48% remained in same stage and 4% were downstaged. By combining both clinical and radiological evaluation in laryngeal and hypopharyngeal cancers, a correct pre therapeutic staging can be obtained and thereby prompt treatment can be given. Keywords Carcinoma larynx Á Carcinoma hypopharynx Á Clinical staging Á Radiological staging Á CT scan Á Upstage Á Downstage
Schwannomas are benign, solitary and well-differentiated tumors originating from schwann cells. They may originate from any of the peripheral, cranial or autonomic nerves of the body with the exception of the olfactory and the optic nerves. This tumor most often presents as a slow growing asymptomatic solitary neck mass which rarely undergoes malignant transformation. Schwannomas arising from the cervicalsympathetic chain are very rare. Only < 65 cases have been reported in the literature to date. Computed tomography with contrast medium or magnetic resonance imaging is essential to the initial workup for cervical sympathetic chain schwannoma (CSCS). Surgical excision is the treatment of choice for this tumor. Only surgical observation of the lesion and the nerve from where it originates, and histologic examination of the specimen, can lead to a correct diagnosis. We report four cases of cervical sympathetic chain schwannomas presented in our department during last two and half years which were treated by surgical excision.
How to cite this article
Divya GM, Ramachandran K, Nampoothiri PM, Sunil Kumar KP. Four Cases of Cervical Sympathetic Chain Schwannoma and Review of Literature. Int J Head Neck Surg 2015;6(2):86-89.
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