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Neuroendocrine neoplasm (NEN) of the larynx consists of 0.6% of laryngeal cancer and is the second most common type after squamous cell carcinoma (SCC). Laryngeal NEN rarely secret calcitonin and should be differentiated from medullary thyroid carcinoma. It makes a diagnostic and therapeutic challenge. We describe a case of a laryngeal NEN with calcitonin hypersecretion. A 59‐year‐old man presented to our clinic with recurrent cough, dysphonia, hoarseness, cervical mass, and significant weight loss. Diagnostic workup showed a supraglottic mass. Biopsy of the lesion revealed large‐cell neuroendocrine neoplasm. Further diagnostic workup showed elevated serum calcitonin level. The patient underwent total laryngectomy, thyroidectomy, and modified radical neck dissection. During his follow‐up, new subcutaneous nodules appeared that were biopsy‐proven metastases. Then adjuvant chemoradiotherapy was performed. Laryngeal NEN with hypersecretion of calcitonin is a rare entity. In patients with elevated serum calcitonin levels and head and neck tumors, it should be considered a differential diagnosis of medullary thyroid carcinoma. As the management and prognosis of these two neoplasms are entirely different. Laryngeal NEN which consists of 0.6% of laryngeal cancer rarely secretes calcitonin and should be distinguished from medullary thyroid carcinoma. This poses diagnostic and therapeutic challenges as management and prognosis vary widely. [ABSTRACT FROM AUTHOR]

Schwannoma, otherwise known as neurilemmoma, is a benign tumor that originates from Schwann cells. Ancient Schwannoma is a long-standing Schwannoma with degenerative and xanthomatous changes. The Head and neck region is one of the most common sites for nerve sheath tumors but Involvement of the jaw is a considerably infrequent event. We report a rare case of intraosseous ancient Schwannoma of the mandible in a 24-year-old male patient which was initially misdiagnosed with carcinoma. The clinical features, radiographic findings, and treatment plan are discussed. Furthermore, a thorough literature review demonstrated nine published cases of intra-osseous ancient Schwannoma with their summarized features. Recognition of various histopathologic features of ancient Schwannoma is essential to prevent over-treatment. [ABSTRACT FROM AUTHOR]

Schwannoma, otherwise known as neurilemmoma, is a benign tumor that originates from Schwann cells. Ancient Schwannoma is a long-standing Schwannoma with degenerative and xanthomatous changes. The Head and neck region is one of the most common sites for nerve sheath tumors but Involvement of the jaw is a considerably infrequent event. We report a rare case of intraosseous ancient Schwannoma of the mandible in a 24-year-old male patient which was initially misdiagnosed with carcinoma. The clinical features, radiographic findings, and treatment plan are discussed. Furthermore, a thorough literature review demonstrated nine published cases of intra-osseous ancient Schwannoma with their summarized features. Recognition of various histopathologic features of ancient Schwannoma is essential to prevent over-treatment. [ABSTRACT FROM AUTHOR]

Introduction: During functional neck dissection, the surgeon tries to preserve the internal jugular vein (IJV); however, the incidence of its narrowing or obstruction following modified radical neck dissection (MRND) or selective neck dissection (SND) varies between 0% and 29.6%. The most distressing complication of IJV thrombosis (IJVT) is pulmonary embolism. This study aimed to evaluate the incidence of IJVT following selective or modified radical neck dissection. Materials and Methods: In this study, 109 neck dissections were performed with the preservation of the IJV on 89 patients from March 2011 to December 2012 in the Cancer Institute of Imam Khomeini Hospital Complex, Tehran, Iran. Ultrasound evaluation of the IJV was performed in the early postoperative period and three months after the surgery. Results: The study population consisted of 62 male and 27 female patients with a mean age of 57+17.57 years. Ultrasound evaluation of the IJV among the participants (109 veins) indicated thrombosis in nine veins (8.25%) in the early postoperative period, four of which remained thrombotic and without flow three months after the surgery. Moreover, 96.33% of the IJVs were patent with a normal blood flow three months after the neck dissection. Among the evaluated IJVs, the only factor that showed a significant association with IJVT was the incidence of postoperative complications, including hematoma and seroma (P=0.01). Conclusion: It seems that the most important factor for the prevention of the IJVT is a meticulous surgery and surgical complication avoidance during neck dissection. [ABSTRACT FROM AUTHOR]

In this study, we compared regional recurrence in patients who had a dissection of levels I-III or levels I-IV. Patients with tongue SCC who were node-negative both clinically and radiologically, and underwent elective supraomohyoid neck dissection (SOHND) or extended supraomohyoid neck dissection (ESOHND) between March 2012, and March 2015 were retrospectively reviewed. The two therapeutic groups were analyzed for the incidence of tumor recurrence and survival. The two groups had statistically similar demographic qualities. Surgery duration and complications were the same in both groups. Complications mainly included internal jugular vein and thoracic duct injury. Tumour size was 46.2% T1, 40.4 % T2, and 13.3% Tx, being statistically similar in both groups. Tumour size had no meaningful correlation with the occurrence of occult neck metastasis in both groups. Local recurrence was more in ESOHND patients, but regional recurrence was similar in both groups. The survival rate was alike in both groups. No significant differences in tumor recurrence and mortality rate were found between patients treated with SOHND versus ESOHND. Thus, SOHND could be considered as a sufficient treatment for early-stage tongue SCC. [ABSTRACT FROM AUTHOR]

Although lingual thyroid is the most common site for ectopic thyroid gland but carcinomas originating from lingual thyroid are extremely rare, accounting only for 1% of all ectopic thyroids. Here we represent a young female with a bleeding mass at the base of her tongue and review the diagnostic approach towards papillary thyroid carcinoma of lingual thyroid. The surgical treatment and follow up are discussed. A combination of radiological studies and histological evaluation should be deployed to investigate suspicious lingual thyroids. The perspective of diagnostic and therapeutic approaches for carcinomas of lingual thyroid is the same as orthotopic thyroid tissue. [ABSTRACT FROM AUTHOR]

The objective of this paper was that fine-needle aspiration (FNA) has become a well-liked modality in the diagnosis, staging, and follow-up of head and neck masses. Limited studies exist regarding the value of FNA in the diagnosis of head and neck masses. We aimed to evaluate the diagnostic value of head and neck lymphomas. This cross-sectional study method was performed in Imam Hospital and Cancer Institute affiliated to Tehran University of Medical Sciences. In a 5 years period between January 2006 and June 2010, we enrolled all patients with cervical mass (es) who had undergone FNA as the primary diagnostic modality and then underwent biopsy (excisional or open). Results of FNA were compared with histopathological study as a gold standard method. Finally, 47 patients were recruited. It was found that FNA had a sensitivity of 88% (CI 95% = 79-97), a specificity of 81.2% (CI 95% = 70-92), a positive predictive value of 84.6% (CI 95% = 75-95), a negative predictive value of 85.7% (CI 95% = 77-95) and an accuracy of 85.1% (CI 95% = 75-95) in the diagnosis of head and neck lymphoma. We conclude that FNA has a considerable value in differentiation of head and neck lymphoma from non-lymphoma etiologies and is recommended as a screening test for the diagnosis of head and neck lymphoma. [ABSTRACT FROM AUTHOR]

Background: Biomarkers that can predict outcome will improve the efficacy of treatment for HNSCC patients. In this regard, we retrospectively evaluated the prognostic effect of PD1, PD-L1, and CD45RO in tongue and larynx squamous cell carcinomas. Methods: FFPE tissue blocks of 63 larynx and 40 tongue squamous cell carcinoma samples were selected, cut into 3 µm sections, and immunohistochemically stained for PD1, PD-L1, and CD45RO. The slides were evaluated by an expert pathologist, and results were analysed using Chi-square, univariate, and multivariable Cox regression methods. Results: TC-PD-L1 expression (P = 0.001) and its expression intensity (P = 0.002) were significantly correlated with a higher percentage of PD-1 + tumor infiltrating lymphocytes. In univariate survival analysis, TC-PD-L1 and its expression intensity had a significant impact on both DFS (HR: 0.203; P = 0.003 and HR: 0.320; P = 0.005) and OS (HR: 0.147; P = 0.002 and HR: 0.322; P = 0.005). Based on the multivariate analysis, PD1 (DFS: HR: 3.202; P = 0.011, OS: HR: 2.671; P = 0.027) and TC-PD-L1 (DFS: HR: 0.174; P = 0.006, OS: HR: 0.189; P = 0.009) were found to be independent prognostic markers. In the second part, scoring systems were defined based on the expression status of PD1 and PD-L1. Patients with higher scores were expected to have longer DFS and OS. In multivariate analysis, the PD1/TC-PD-L1 (DFS: P = 0.001, OS: P = 0.003) scoring systems showed superior prognostic effects. Interestingly, at the highest levels of this score, none of the patients experienced recurrence or cancer-caused death. Conclusion: Collectively, this study suggests negative prognostic behaviour for TC-PD-L1 protein and introduces the PD-1/TC-PD-L1 scoring system as a strong prognostic marker in OS and DFS prediction of tongue and larynx HNSCC patients. [ABSTRACT FROM AUTHOR]

Background: In the last ten years, many countries have started to develop constructive systems for registering common diseases and cancers. In this research, we intended to determine and identify the minimum data set (MDS) required for the design of the oral and lip squamous cell cancer registration system in Iran. Methods and material: At first, primary information elements related to disease registries were extracted using scientific papers published in reliable databases. After reviewing the books, related main guidelines, and 42 valid articles, the initial draft of a researcher-made questionnaire was compiled. To validate the questionnaire, two focus group meetings were held with 29 expert panel members. The final version of this questionnaire was prepared by extracting different questions and categories and receiving numerous pieces of feedback from specialists. Lastly, a final survey was conducted by the experts who were present at the previous stage. Results: Out of 29 experts participating in the study, 17 (58.62%) were men and 12 (40.37%) were women. The age range of experts varies from 34 to 58 years. One hundred-fourteen items, which are divided into ten main parts, were considered the main information elements of the registry design. The main minimum data sets have pertained to the demographic and clinical information of the patient, information related to the consumed drugs, initial diagnostic evaluations of the patient, biopsy, tumor staging at the time of diagnosis, clinical characteristics of the tumor, surgery, histopathological characteristics of the tumor, pathologic stage classification, radiotherapy details, follow-up information, and disease registry capabilities. The distinctive characteristics of the oral and lip squamous cell cancer registry systems, such as the title of the disease registration programme, the population being studied, the geographic extent of the registration, its primary goals, the definition of the condition, the technique of diagnosis, and the kind of registration, are all included in a model. Conclusion: The benefits of designing and implementing disease registries can include timely access to medical records, registration of information related to patient care and follow-up of patients, the existence of standard forms and the existence of standard information elements, and the existence of an integrated information system at the country level. [ABSTRACT FROM AUTHOR]

Purpose: Brachytherapy is a cost-effective method for the management of oral cavity cancers in low to middle income countries. We aimed to evaluate the clinical outcomes of high-dose-rate interstitial brachytherapy (HDR-IBT) in patients with oral cavity cancer. Material and methods: From 2009 to 2013, 78 patients (49 combined external beam radiotherapy [EBRT] plus IBT and 29 IBT monotherapy) with oral cavity cancers had been treated in our center. Slightly more than half the patients were male, and the median age was 54 years. The treatment was planned based on the Paris system. The main outcomes were disease-free and overall survival. Results: The median follow-up duration was 36.5 months (range, 1.17-54.23). The actuarial four-year overall and disease-free survival rates were 83% and 65%, respectively. The local and locoregional control was achieved among 89.74% and 87.17% of patients, respectively. None of the factors including tumor size, node status, gender, and radiation modality (IBT alone vs. IBT + EBRT) had a significant statistical correlation to the local control rate. All the patients tolerated the planned treatment in the IBT alone group. Late complications included a case of trismus and three cases of catheter insertion site fibrosis. Conclusions: HDR-IBT as a monotherapy or in combination with EBRT is an appropriate option for the management of oral cavity squamous cell carcinomas, and supports the improvement in treatment outcomes and toxicity profiles in adjuvant settings. [ABSTRACT FROM AUTHOR]

Background Debate still persists on the relation between olfactory bulb volume (OBV) and olfactory function. Many studies suggest that olfactory deprivation decreases the OBV. The aim of this study was to compare the olfactory threshold and OBV of patients with nasal polyps to healthy individuals and to evaluate the impact of functional endoscopic sinus surgery (FESS) on OBV and olfactory threshold. Methods A longitudinal study was carried out in Tehran between 2011 and 2012. Twenty-two patients with nasal polyps were compared with 37 healthy individuals. Olfactory threshold test and magnetic resonance imaging (MRI) were performed on all participants. Twenty-two patients in case group were followed for 6 months after FESS. OBV and olfactory threshold were measured after 6 months. Results There was no significant difference between the age, gender, and OBV of the 2 groups. However, the difference between olfactory threshold was significant ( p = 0.005). The olfactory threshold showed no significant relation with OBV ( p > 0.05). The correlation between Lund-Mackay score and the mean total OBV and left OBV was significant ( r = −0.15, p = 0.045; r = −0.22, p = 0.047; respectively). The decrease in olfactory threshold measured after FESS was statistically significant. Right, left, and total OBV significantly increased after FESS. Conclusion The results of our study show that FESS has a significant impact on OBV increment and olfactory threshold decrement. The olfactory bulb is a plastic structure and improvement in peripheral olfactory function results in increase in OBV. However, further studies are mandated, in order to establish this result. [ABSTRACT FROM AUTHOR]

Introduction: Otorrhea and granulation tissue in Canal Wall Down mastoidectomy (CWD) is the common problem in cholesteatoma removal and leads to many discomfort for both the patient and the physician. The main objective in CWD is creating the dry cavity, so the topical antibiotic and acetic acid in variable saturations are used for this purpose. In this study we evaluate the effectiveness of topical MMC and chemical cautery by acetic acid. Materials and Methods: Study population consists of 50 patients with cholesteatoma whom underwent CWD. All patient allocated randomly in two study groups, MMC and acetic acid. After 3 weeks, the first visit is planned, extension of granulation tissue and dryness of cavity are evaluated and topical drugs are used in blind fashion. MMC in 4% and acetic acid in 12.5% saturation are applied. Other visits are completed at next month and 3 months later. Results: Both methods are effective in treatment of granulation tissue. In each group both treatment were effective too but MMC was more effective than acid acetic in the treatment of granulation tissue after 4 weeks. Conclusion: Based on our findings, it is clear that topical MMC is very effective in the treatment of granulation tissue and in CWD. It results in dry cavity much better than acetic acid without any complication. [ABSTRACT FROM AUTHOR]