Perineural spread of malignant head and neck tumors: review of the literature and analysis of cases treated at a teaching hospital.

Perineural tumor spread refers to the migration of tumor cells along nerve tissues. It worsens the prognosis, increases the recurrence rate, and diminishes 5-year survival by up to 30%. It is an important finding on imaging tests employed in the staging of patients with head and neck cancers, because it cannot be assessed by the surgeon alone. Nevertheless, it is frequently overlooked. In this study, we reviewed the literature regarding the imaging and pathophysiological aspects of this type of dissemination. We also analyzed ten imaging tests, obtained from a teaching hospital in Brazil, in which there were radiological signs of perineural tumor spread.

Disseminação perineural de tumores refere-se à extensão de células tumorais ao longo do tecido dos nervos. Acarreta um pior prognóstico, aumenta a taxa de recorrência e diminui a expectativa de vida em cinco anos em até 30%. É um achado importante em exames de imagem quando se estadia pacientes com cânceres de cabeça e pescoço, já que não pode ser avaliado somente pelo cirurgião. Todavia, é uma alteração que frequentemente passa despercebida. No presente estudo, revisamos trabalhos científicos da literatura médica sobre os achados de imagem e os aspectos fisiopatológicos desse tipo de disseminação e analisamos 10 exames de imagem com sinais radiológicos de disseminação perineural oriundos de um hospital-escola brasileiro.

Perineural spread of malignant head and neck tumors: review of the literature and analysis of cases treated at a teaching hospital / Disseminação perineural de tumores malignos de cabeça e pescoço: revisão da literatura e análise de casos de um hospital-escola

Abstract Perineural tumor spread refers to the migration of tumor cells along nerve tissues. It worsens the prognosis, increases the recurrence rate, and diminishes 5-year survival by up to 30%. It is an important finding on imaging tests employed in the staging of patients with head and neck cancers, because it cannot be assessed by the surgeon alone. Nevertheless, it is frequently overlooked. In this study, we reviewed the literature regarding the imaging and pathophysiological aspects of this type of dissemination. We also analyzed ten imaging tests, obtained from a teaching hospital in Brazil, in which there were radiological signs of perineural tumor spread.

Resumo Disseminação perineural de tumores refere-se à extensão de células tumorais ao longo do tecido dos nervos. Acarreta um pior prognóstico, aumenta a taxa de recorrência e diminui a expectativa de vida em cinco anos em até 30%. É um achado importante em exames de imagem quando se estadia pacientes com cânceres de cabeça e pescoço, já que não pode ser avaliado somente pelo cirurgião. Todavia, é uma alteração que frequentemente passa despercebida. No presente estudo, revisamos trabalhos científicos da literatura médica sobre os achados de imagem e os aspectos fisiopatológicos desse tipo de disseminação e analisamos 10 exames de imagem com sinais radiológicos de disseminação perineural oriundos de um hospital-escola brasileiro.

Partial lipectomy reduces dimethylhydrazine-induced carcinogenic initiation in the colon of rats.

This study investigated whether visceral adipose tissue directly modulates the development of preneoplastic lesions in the colon of carcinogen-treated rats. Wistar rats (n=64) were randomly assigned to 8 experimental groups in two experiments. In one experiment, 32 rats were exposed or not to either carcinogen treatment (dimethylhydrazine, DMH; 125 mg/kg) or high-fat diet (standard chow enriched with 14% lard) or both for 56 days. In a second experiment, 32 rats were exposed to a carcinogen or they underwent partial lipectomy or both for 30 days (partial lipectomy groups underwent ablation of mesenteric and parametrial fat pads, whereas sham groups did not; all rats were fed with standard chow). Colon was collected for histopathological analysis. After 56 experimental days a high-fat diet increased carcinogenic mutations in the colonic epithelia. Partial lipectomy reduced weight gain in carcinogen-exposed rats and decreased the de novo formation of mesenteric and parametrial fat pads. Partial lipectomy significantly inhibited the mutational process after 30 days: there were fewer colonic preneoplastic lesions and less proliferation, apoptosis, and inflammation. These data suggest that visceral adipose tissue promotes colon carcinogenesis and enhances the establishment and expansion of genetically mutated cells in colonic epithelia.