| ORIGINAL ARTICLE | |
| 1. | The management of glottic and supraglottic cancers of the larynx in relation to neck metastasis Ali Vefa Yücetürk, Onur Çelik, Görkem Eskiizmir Pages 129 - 133 FREE FULL TEXT Objectives: We evaluated the management of glottic and supraglottic laryngeal cancers in relation to neck metastasis. Patients and Methods: Fifty-two patients (51 males, 1 female; mean age 59.2 years; range 27 to 82 years) underwent surgery for primary laryngeal cancers. Preoperative and postoperative TNM classification and staging were made according to the AJCC 1997 criteria. The mean followup period was 39.4 months (range 6 to 74 months). Results: The tumors were glottic in 31 patients and supraglottic in 21 patients. Laryngectomies were partial in 34 patients and total in 18 patients. All the patients with supraglottic tumors and those with glottic T2- 4 tumors underwent neck dissection, as well. Radiotherapy was administered to 22 patients with established N2 or N3 tumors. Clinical assessment was in agreement with the pathological result in 63.5%; 13.5% and 23.1% of cases were underdiagnosed and overdiagnosed, respectively. The rates of neck metastasis were 0% in T1, 25% in T2, 75% in T3, and 66.7% in T4 supraglottic tumors. The corresponding rates for glottic cancers were 0%, 16.7%, 28.6%, and 60%, respectively. The overall rate of N+ tumors was 28.9%. Four patients (7.7%) developed local, two patients (3.9%) developed regional recurrences. Mortality occurred in eight patients (15.4%) due to following causes: laryngeal recurrence (T4N2, T4N2, T3N1), regional recurrence ( T4N2), a second primary malignancy in one patient, and other causes in three patients. Five- and two-year disease-specific survival rates (Kaplan-Meier analysis) were 90.7%, and overall survival rates were 73.7% and 87.3%, respectively. Conclusion: Neck metastasis and advanced stage of the tumor were the most effective prognostic factors. |
| 2. | Detection of Epstein-Barr virus DNA by polymerase chain reaction in surgical specimens of patients with squamous cell carcinoma of the larynx and vocal cord nodules Üzeyir Gök, Aykut Özdarendeli, Erol Keleş, Yasemin Bulut, Bengü Çobanoğlu Pages 134 - 138 FREE FULL TEXT Objectives: We investigated the incidence of Epstein- Barr virus (EBV) infection in surgical specimens of squamous cell carcinoma of the larynx and vocal cord nodules. Patients and Methods: Formalin-fixed, paraffin- embedded tissue samples randomly selected from 22 patients with squamous cell carcinoma of the larynx (20 males, 2 females; mean age 52 years) and from 17 patients with vocal cord nodules (14 males, 3 females; mean age 38 years) were examined by the polymerase chain reaction. The patients were assessed in terms of localization of the disease, smoking habits, duration of smoking, and the presence or absence of EBV DNA. Results: Twenty-one patients with laryngeal carcinoma and nine patients with vocal cord nodules were smokers. Polymerase chain reaction showed EBV DNA in 11 patients (50%) with laryngeal carcinoma and in seven patients (41.2%) with vocal cord nodules. No significant differences were found with respect to EBV DNA positivity, smoking habits, smoking period, the number of cigarettes consumed daily, localization of disease, and tumor stage (p>0.05). Conclusion: Epstein-Barr virus does not seem to be directly associated with the pathogenesis of laryngeal squamous cell carcinoma, but its role in the etiology of laryngeal proliferative diseases needs more elucidation. |
| 3. | Causes of dysphonia in patients above 60 years of age Tolga Kandoğan, Levent Olgun, Gürol Gültekin Pages 139 - 143 FREE FULL TEXT Objectives: We evaluated the causes of hoarseness in patients above 60 years of age. Patients and Methods: The study included 98 patients (40 females, 58 males; mean age 64 years; range 60 to 77 years) who presented with hoarseness. All the patients were examined by videolaryngoscopy. Temporary hoarseness secondary to respiratory tract infections was excluded. Results: The most common cause of hoarseness was benign vocal fold lesions (28.6%) followed by malignant lesions (27.6%), vocal fold paralysis (25.5%), functional dysphonia (10.2%), and presbyphonia (8.2%). Laryngopharyngeal reflux was found in 13 patients (13.3%). Fourteen male and 11 female patients had paralysis of the recurrent laryngeal nerve. Malignancies that caused hoarseness without paralyzing the vocal folds were larynx carcinoma (n=18), hypopharynx carcinoma (n=8), and multiple malignancy (n=1). Conclusion: Our data show that dysphonia develops due to disease processes associated with aging rather than to physiologic aging alone. Considering adverse influences of dysphonia on the quality of life of elderly population, efforts should be directed to elucidation of the cause and to performing appropriate treatment. |
| CASE REPORTS | |
| 4. | A case of Ewing’s sarcoma in the mandible and the skull base M. Tayyar Kalcıoğlu, Semih Öncel, Murat Cem Miman, Tamer Erdem, Bülent Mızrak Pages 144 - 147 FREE FULL TEXT A thirteen-year-old boy with Ewing’s sarcoma was presented. The treatment was considerably delayed because of the initial diagnostic difficulties due to its insidious presentation and the unwillingness of the child’s parents to further investigations and treatment. During a three-year delay, the tumor turned out to be a gross painful mass from a painless lesion. Cranial computed tomography and magnetic resonance imaging with contrast showed a destructive lesion extensively involving the right mandible and the skull base, with invasion to the intracranial space. Facial and intratemporal portions of the mass were removed totally, but the intracranial extension could not be totally excised because of cavernous sinus involvement. Histologic and immunohistochemical findings were consistent with the diagnosis of Ewing’s sarcoma. The patient received systemic chemotherapy and radiotherapy following surgery. A month after radiation therapy, radiologic investigations showed a lung mass suggestive of metastasis. He died two days after hospitalization, from an intracranial hemorrhage associated with the intracranial mass. |
| 5. | A case of carotid body tumor Arif Şanlı, Mehmet Eken, Sedat Aydın, Mustafa Paksoy, Mehmet Yıldırım Pages 148 - 151 FREE FULL TEXT A thirty-five-year-old woman had an asymptomatic, slow growing mass that pushed the right tonsilla palatina and was pulsatile in the oropharyngeal region. Magnetic resonance imaging showed a vascular mass at the carotid bifurcation, causing displacement of the external and internal carotid arteries. The diagnosis of a carotid body tumor was confirmed by magnetic resonance angiography. Surgery included a subadventitial dissection at the carotid bifurcation, preserving the hypoglossal and vagal nerves. The patient developed loss of function of the tenth cranial nerve postoperatively. After a year follow-up period there was no change in the function of the tenth cranial nerve. |
| 6. | Thyroid metastasis from renal cell carcinoma eight years after radical nephrectomy: a case report Canan Uzel, Halil Coşkun, Tarık Terzioğlu, Necdet Aras Pages 152 - 156 FREE FULL TEXT A forty-five-year-old female patient presented with thyroid nodules eight years after radical nephrectomy for renal cell carcinoma (T2N0M0, grade 2, clear cell subtype) in the right kidney. Ultrasonography of the neck showed multiple hypoechoic macronodules. There was no lymphadenomegaly. During total thyroidectomy following an initial diagnosis of multinodular goiter, frozen section analysis was made, which showed metastasis from renal cell carcinoma. Immunohistochemical studies demonstrated that the tumor cells were negative for thyroglobulin staining. No recurrences or other metastatic disease were seen during a follow-up period of 12 months. Although clinically the thyroid gland is a rare site for tumor metastasis, this possibility should be kept in mind in patients with a previous history of renal cell carcinoma. |
| 7. | Kimura’s disease in the parotid and submandibular regions: two case reports Selma Kurukahvecioğlu, Sumru Yardımcı, Osman Kurukahvecioğlu, Erdal Yılmaz Pages 157 - 160 FREE FULL TEXT Two male patients (aged 13 and 50 years) who presented with a complaint of painless mass in the parotid and submandibular regions, respectively, were found to have eosinophilia and increased blood immunoglobulin E (IgE) levels. Following ultrasonographic examination of the masses, surgical excision was performed. Histopathologic evaluation revealed massive lymphocytic and eosinophilic infiltration. Histopathologic findings and the presence of peripheral eosinophilia and high IgE levels led to a diagnosis of Kimura’s disease. Postoperatively, no recurrences were detected within a year follow-up. |