Assessing the Prevalence and Implications of Fungal Colonization in Chondroradionecrosis of the Larynx

Abstract

• Five of the 112 (4.5%) patients in the study were given the diagnosis of chondroradionecrosis, of which 2 (40%) showed microscopic evidence of Candidiasis on H&E staining. • Of note, the two patients who exhibited candidiasis on H&E staining had concomitant Hepatitis C infections.• Eighteen percent (9/50) of the persistent tumors had a pathologic report that mentioned evidence of chondroradionecrosis (necrosis, ulceration), with an additional 22% (11/50) showing "post radiation changes" (fibrosis, hyalinization).• None of these pathology reports for persistent tumor mentioned fungal colonization nor invasion on H&E stains. • Of the thirty one previously irradiated larynges with persistent disease, twenty (64.5%) were positive for fungal invasion seen after special staining.• In comparison, none of the primary surgical specimens evidenced invasion, and only two showed non-invasive fungal elements.• A two-tailed unpaired t-test showed no statistical difference between the chondroradionecrosis and persistent disease group regarding time until resection after radiation, t(53) = 0.12, p=0.9.

Local resectability assessment of head and neck cancer: Positron emission tomography/MRI versus positron emission tomography/CT

“…As a result, the irradiated field inevitably becomes susceptible to fungal infection, which is known to contribute to radiation necrosis. 26 Two of the 3 patients with radiation necrosis in our cohort had fungal infection. There currently is no imaging study with a sufficient sample size to address this phenomenon.…”

“…Radiation causes tissue fibrosis and microvascular obliteration. As a result, the irradiated field inevitably becomes susceptible to fungal infection, which is known to contribute to radiation necrosis . Two of the 3 patients with radiation necrosis in our cohort had fungal infection.…”