Sarcomas of the head and neck in adult patients: current concepts and future perspectives

Abstract

Sarcomas comprise a heterogeneous and biologically diverse group of malignant neoplasms having as a common denominator their origin from mesenchymal cells. Head and neck sarcomas account for 4 to less than 20% of total body sarcomas depending on the criteria, such as age of patients (pediatric vs adult population), type of sarcomas (soft-tissue vs bony sarcomas) and site of location. Although head and neck sarcomas occur infrequently in adults, in the pediatric population one in three sarcomas will occur in the head and neck region. Most head and neck sarcomas are of the soft-tissue type, with only 20% being of bony or cartilaginous origin. Sarcomas display a diverse array of histologies and a wide spectrum of clinical behavior, ranging from relatively slow growing lesions to aggressive locally and regionally destructive tumors with the potential for systemic metastases. Osteosarcomas, rhabdomyosarcomas, pleomorphic sarcomas (malignant fibrous histiocytomas), fibrosarcomas and angiosarcomas are among the most common histologic types of sarcoma found in the head and neck. Surgery has been the primary therapeutic approach for the management of head and neck sarcomas. Survival rates for head and neck sarcomas suggest worse outcomes than for their extremity counterparts. Lymph node metastasis only occurs in 3-10% of sarcomas of the head and neck. An improvement in local disease control has recently been suggested with the combined use of surgery and radiotherapy. Conflicting results have been reported on the benefit from the use of chemotherapy as an adjuvant or neoadjuvant regimen, especially for high-grade sarcomas in long-term survival or local disease control. Encouraging results have recently been reported with the use of molecular targeted therapies with tyrosine kinase inhibitors and antiangiogenetic agents.

Diagnosis and Treatment of Head and Neck Sarcomas: Personal Experiences

“…It occur in all ages, with a peak in the fifth decade. There is a 3:2 female:male gender predilection [7]. Usually, it appears as a painless firm mass of the scalp, face, or neck [24][25][26].…”

“…Synonyms of malignant peripheral nerve sheath tumor are neurogenic sarcoma, malignant schwannoma, neurofibrosarcoma, Triton's tumor [7]. It is a spindle cell sarcoma usually arising in proximity to peripheral nerves or shows nerve sheath differentiation.…”

“…These malignancies occur in the nasal cavity, paranasal sinuses, nasopharynx, hypopharnyx, oropharynx, ear, scalp, oral cavity and salivary glands [6]. The most common histological types are: osteosarcoma, rhabdomyosarcoma, pleomorphic sarcoma and angiosarcoma [7][8]. The histopathological examination of the lesions is important for their treatment.…”

The acromion thoracic flap: A reconstructive resource after exeresis of a parotid fibrosarcoma

“…Non-epithelial tumors account for less than 5% of the tumors in this location, 90% of which are benign. Sarcomas are malignant non-epithelial tumors; in the head and neck, they are a nosological entity that occurs relatively infrequently, with those of the soft parts of the neck and those of the parotid gland are the most common (1)(2)(3). Microscopically, this types of tumors showed an intense proliferation of spindle-shaped cells, varying a little in size and shape and arranged in parallel bands, partly crossing each other (4).…”

A Review of Scientific Papers About Head and Neck Cancers

“…Thus radiotherapy is the treatment of choice for tumors of the glottis and small lesions of supraglottis (Nomiya et al, 2008). In the other situations where surgical treatment is selected, post-surgical radiotherapy may be administered (Lim et al, 2008;Rapidis, 2008). The interest of the scientific community in a specific subject can be evaluated by the analysis of the number and the quality of papers published about the topic.…”