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A case of radiation-induced spindle cell sarcoma of tongue
Scientific Posters
searched our database to obtain the clinical records of patients admitted in the ENT department of Barros Luco Trudeau Hospital, Santiago, Chile, from 1990 to 2001. Selected information was extracted from this records and analized statistically. Results: A total of 86 records were completed and then selected for the study; 93% of patients were male and 7% female. The most frequent location was transglottic (32.6%) followed by the glottic location (31.4%). Smoking was found in 86% of the patients while alcohol consumption in 50%. The 5-year survival was 75% for the glottic location, 37.5% for supraglottic, 57.1% for transglottic, and 100% for hypopharyngeal tumors. Conclusion: The location frequency found in this study differs from that reported by most of the authors and we must confirm this with prospective protocols. Our survival rate is lower than reported in literature. That could be explained by the high proportion of advanced tumors that we admit in our center. Given the low percentage of complete records, we have to improve our registry system.
P217 Venous Malformation of the Sternomastoid Muscle: A Case Report and Review Erik H Waldman, MD (presenter); David Goldenberg, MD; Joseph Califano, MD; James J Sciubba, DMD, PhD; David E Tunkel, MD Perry Hall MD; Baltimore MD; Baltimore MD; Baltimore MD; Baltimore MD
Objectives: Intramuscular venous malformations occur rarely in the head and neck. Only 11 cases involving the sternomastoid muscle have been reported. Methods: We present a case involving a 12-year-old female. We review the literature and discuss diagnostic and therapeutic aspects of this unusual entity. Results: Definitive evaluation of venous malformations of the head and neck skeletal muscles is best accomplished with T1- and T2-weighted magnetic resonance imaging coupled with the clinical history and physical exam. Complete surgical excision is recommended and is usually curative, with little morbidity. Our patient first presented at the age of 4 with a nontender neck swelling within the sternomastoid muscle. The mass had enlarged dramatically by age 12, thereby necessitating surgical excision. Fine needle aspiration yielded gross blood. The mass was hyperintense on a T2-weighted magnetic resonance image consistent with a vascular malformation. Transcervical surgical excision was performed, dissecting the mass from feeding vessels within an envelope of attenuated sternomastoid muscle, preserving the spinal accessory nerve. Histologic evaluation revealed medium-sized and thin-walled channels that were lined with a flattened endothelial layer and surrounded by a poorly developed and variably evident smooth muscle sheath, consistent with a venous
malformation. She is doing well now 4 months after surgery without signs of recurrence or functional compromise. Conclusion: Venous malformations of skeletal muscle are frequently labeled as intramuscular hemangiomas. These are more accurately called intramuscular venous malformations based on clinical imaging and pathologic criteria. We add the twelfth case of a venous malformation of the sternomastoid muscle to the literature. P218 A Case of Radiation-Induced Spindle Cell Sarcoma of Tongue Masahiko Takeda, MD (presenter); Meijin Nakayama, MD; Kazuo Yao, MD; Makito Okamoto, MD Sagamihara Japan; Kanagawa Japan; Sagamihara Japan; Sagamihara Japan
Objectives: Sarcoma arising from tongue is rare. We have experienced a case of sarcoma possibly induced by previous radiation to the oral cavity. The clinical course and the management of this tumor is presented Methods: A 70-year-old male received chemoradiotherapy to his mesopharyngeal cancer (T3N1M0) in December 2000. The patient was well until July 2003 when he has had a rapidly growing mass lesion arising from the right edge of tongue. A couple of biopsies were done and the pathology showed granulation without malignancy. Because of the further rapidly growing tumor mass in October 2003, a radical excision of the tumor was done. Results: A 7 ⫻ 4 ⫻ 5.5 cm grayish elastic hard tumor was removed from his oral cavity. The tumor invaded deeply into the tongue and hence the right one third of the tongue was excised along with the tumor. Histopathologically, the tumor showed interwoven spindle-shaped cells with marked atypia. Part of the spindle cells infiltrated into the tongue tissues. Immunohistochemical stains showed AE1(-), CAM5.2(-), Vimentin(⫹), f¿-SMA(⫹). Radiation-induced spindle cell sarcoma was most suspected. Conclusion: We have experienced a case of spindle cell sarcoma possible induced by the previous radiation. Radical excision is crucial in the treatment of this tumor. P219 A Case of Primitive Neuroectodermal Tumor (PNET) of the Larynx Shunsuke Miyamoto, MD (presenter); Hisaya Nakadate, MD; Meijin Nakayama, MD; Kazuo Yao, MD; Makito Okamoto, MD Saitama Japan; Sagamihara Japan; Kanagawa Japan; Sagamihara Japan; Sagamihara Japan
Objectives: PNET (Primitive neuroectodermal tumor) is a malignant neoplasm that originates from the cells of the primitive neural crest. PNET mainly occurs in the brain, extremities, pelvis, and the chest wall. PNET in the cerebellum is also called medulloblastoma. The peripheral PNET is part of the Ewing’s
POSTERS
P310
Otolaryngology– Head and Neck Surgery August 2004
searched our database to obtain the clinical records of patients admitted in the ENT department of Barros Luco Trudeau Hospital, Santiago, Chile, from 1990 to 2001. Selected information was extracted from this records and analized statistically. Results: A total of 86 records were completed and then selected for the study; 93% of patients were male and 7% female. The most frequent location was transglottic (32.6%) followed by the glottic location (31.4%). Smoking was found in 86% of the patients while alcohol consumption in 50%. The 5-year survival was 75% for the glottic location, 37.5% for supraglottic, 57.1% for transglottic, and 100% for hypopharyngeal tumors. Conclusion: The location frequency found in this study differs from that reported by most of the authors and we must confirm this with prospective protocols. Our survival rate is lower than reported in literature. That could be explained by the high proportion of advanced tumors that we admit in our center. Given the low percentage of complete records, we have to improve our registry system.
P217 Venous Malformation of the Sternomastoid Muscle: A Case Report and Review Erik H Waldman, MD (presenter); David Goldenberg, MD; Joseph Califano, MD; James J Sciubba, DMD, PhD; David E Tunkel, MD Perry Hall MD; Baltimore MD; Baltimore MD; Baltimore MD; Baltimore MD
Objectives: Intramuscular venous malformations occur rarely in the head and neck. Only 11 cases involving the sternomastoid muscle have been reported. Methods: We present a case involving a 12-year-old female. We review the literature and discuss diagnostic and therapeutic aspects of this unusual entity. Results: Definitive evaluation of venous malformations of the head and neck skeletal muscles is best accomplished with T1- and T2-weighted magnetic resonance imaging coupled with the clinical history and physical exam. Complete surgical excision is recommended and is usually curative, with little morbidity. Our patient first presented at the age of 4 with a nontender neck swelling within the sternomastoid muscle. The mass had enlarged dramatically by age 12, thereby necessitating surgical excision. Fine needle aspiration yielded gross blood. The mass was hyperintense on a T2-weighted magnetic resonance image consistent with a vascular malformation. Transcervical surgical excision was performed, dissecting the mass from feeding vessels within an envelope of attenuated sternomastoid muscle, preserving the spinal accessory nerve. Histologic evaluation revealed medium-sized and thin-walled channels that were lined with a flattened endothelial layer and surrounded by a poorly developed and variably evident smooth muscle sheath, consistent with a venous
malformation. She is doing well now 4 months after surgery without signs of recurrence or functional compromise. Conclusion: Venous malformations of skeletal muscle are frequently labeled as intramuscular hemangiomas. These are more accurately called intramuscular venous malformations based on clinical imaging and pathologic criteria. We add the twelfth case of a venous malformation of the sternomastoid muscle to the literature. P218 A Case of Radiation-Induced Spindle Cell Sarcoma of Tongue Masahiko Takeda, MD (presenter); Meijin Nakayama, MD; Kazuo Yao, MD; Makito Okamoto, MD Sagamihara Japan; Kanagawa Japan; Sagamihara Japan; Sagamihara Japan
Objectives: Sarcoma arising from tongue is rare. We have experienced a case of sarcoma possibly induced by previous radiation to the oral cavity. The clinical course and the management of this tumor is presented Methods: A 70-year-old male received chemoradiotherapy to his mesopharyngeal cancer (T3N1M0) in December 2000. The patient was well until July 2003 when he has had a rapidly growing mass lesion arising from the right edge of tongue. A couple of biopsies were done and the pathology showed granulation without malignancy. Because of the further rapidly growing tumor mass in October 2003, a radical excision of the tumor was done. Results: A 7 ⫻ 4 ⫻ 5.5 cm grayish elastic hard tumor was removed from his oral cavity. The tumor invaded deeply into the tongue and hence the right one third of the tongue was excised along with the tumor. Histopathologically, the tumor showed interwoven spindle-shaped cells with marked atypia. Part of the spindle cells infiltrated into the tongue tissues. Immunohistochemical stains showed AE1(-), CAM5.2(-), Vimentin(⫹), f¿-SMA(⫹). Radiation-induced spindle cell sarcoma was most suspected. Conclusion: We have experienced a case of spindle cell sarcoma possible induced by the previous radiation. Radical excision is crucial in the treatment of this tumor. P219 A Case of Primitive Neuroectodermal Tumor (PNET) of the Larynx Shunsuke Miyamoto, MD (presenter); Hisaya Nakadate, MD; Meijin Nakayama, MD; Kazuo Yao, MD; Makito Okamoto, MD Saitama Japan; Sagamihara Japan; Kanagawa Japan; Sagamihara Japan; Sagamihara Japan
Objectives: PNET (Primitive neuroectodermal tumor) is a malignant neoplasm that originates from the cells of the primitive neural crest. PNET mainly occurs in the brain, extremities, pelvis, and the chest wall. PNET in the cerebellum is also called medulloblastoma. The peripheral PNET is part of the Ewing’s
POSTERS
P310
Otolaryngology– Head and Neck Surgery August 2004