The basaloid variant of squamous cell carcinoma of the larynx.

INTRODUCTION: Basaloid squamous cell carcinoma (BSCC) is a rare subtype of squamous cell carcinoma (SCC). Because of its rarity, both clinical and prognostic features of this variant are not well known. OBJECTIVE: In this study, we aimed to determine the frequency of BSCC and other SCC variants among all laryngeal SCC cases, and to determine clinical and prognostic features of BSCC variant. STUDY DESIGN: retrospective cohort study. Evidence level: Level 2b. MATERIAL AND METHODS: Records of the patients who had laryngeal SCC surgically treated at our institute between 2007 and 2013 were retrospectively reviewed. RESULTS: Among 198 subjects who had laryngeal SCC surgically treated, the frequency of the variants of SCC other than classical variant was 10.1% (20/198). The most common SCC variant was BSCC (6.6%). Eleven (84.6%) patients with BSCC were at an advanced stage at the presentation (p > 0.05). The 3-year overall survival and disease-free survival rates were 63% and 53% respectively. CONCLUSION: BSCC variant may be more common than previously reported. Since almost the half of patients experiences disease recurrence in the early period, multimodal treatment strategies should be employed at initial treatment, and a close follow-up is strongly recommended for this aggressive SCC variant.

The basaloid variant of squamous cell carcinoma of the larynx / O basaloide variante do carcinoma de células escamosas da laringe

INTRODUCTION: Basaloid squamous cell carcinoma (BSCC) is a rare subtype of squamous cell carcinoma (SCC). Because of its rarity, both clinical and prognostic features of this variant are not well known. OBJECTIVE: In this study, we aimed to determine the frequency of BSCC and other SCC variants among all laryngeal SCC cases, and to determine clinical and prognostic features of BSCC variant. Study design: retrospective cohort study. Evidence level: Level 2b. MATERIAL AND METHODS: Records of the patients who had laryngeal SCC surgically treated at our institute between 2007 and 2013 were retrospectively reviewed. RESULTS: Among 198 subjects who had laryngeal SCC surgically treated, the frequency of the variants of SCC other than classical variant was 10.1% (20/198). The most common SCC variant was BSCC (6.6%). Eleven (84.6%) patients with BSCC were at an advanced stage at the presentation (p > 0.05). The 3-year overall survival and disease-free survival rates were 63% and 53% respectively. CONCLUSION: BSCC variant may be more common than previously reported. Since almost the half of patients experiences disease recurrence in the early period, multimodal treatment strategies should be employed at initial treatment, and a close follow-up is strongly recommended for this aggressive SCC variant. .

INTRODUÇÃO: O carcinoma escamoso basaloide (CEB) é um raro subtipo do carcinoma de célula escamosa (CCE). Em decorrência de sua raridade, os aspectos clínicos e prognósticos dessa variante não são bem conhecidos. OBJETIVO: Determinar a frequência de CEB e de outras variantes do CCE entre todos os casos de CCE da laringe, assim como os aspectos clínicos e prognósticos da variante CEB. MÉTODOS: Trata-se de um estudo de coorte retrospectivo. Nível de evidência: 2b Os registros dos pacientes tratados cirurgicamente para CCE de laringe em nossa instituição entre 2007 e 2013 foram retrospectivamente revisados. RESULTADOS: Foram anotados 198 pacientes tratados cirurgicamente para CCE de laringe. A frequência das variantes de CCE diferentes da variante clássica foi 10,1% (20/198). A variante de CCE mais comum foi CEB (6,6%). Por ocasião da apresentação inicial, 11 (84,6%) pacientes com CEB estavam em estágio avançado (p > 0,05). Os percentuais de sobrevida geral após três anos e de sobrevida livre da doença foram 63% e 53%, respectivamente. CONCLUSÃO: A variante CEB pode ser mais comum do que o informado anteriormente. Considerando que praticamente metade dos pacientes sofre recorrência da doença em seu período inicial, devem ser introduzidas estratégias terapêuticas multimodais no tratamento inicial; além disso, recomendamos enfaticamente um cuidadoso seguimento para essa agressiva variante do CCE. .

[Vascular compression syndromes: our 24 year endoscope-assisted microvascular decompression experiences]. / Vasküler kompresyon sendromlari: 24 yillik endoskop yardimli mikrovasküler dekompresyon deneyimlerimiz.

OBJECTIVES: This study aims to report our experience on endoscope-assisted microvascular decompression experiences performed due to vascular compression syndromes such as hemifacial spasm, trigeminal neuralgia, and cochleovestibular nerve compression. PATIENTS AND METHODS: Between March 1999 and June 2013, 55 patients (34 females, 21 males; mean age 44 years; range 24 to 77 years) underwent endoscope-assisted microvascular decompression surgery through a retrosigmoid approach due to vascular compression syndromes in our clinic. The diagnosis was based on history, neurological examination, magnetic resonance imaging findings and audio-vestibular tests. RESULTS: A total of 49 patients (89.1%) had complete relief of the symptoms and two had (3.6%) a partial relief, while four had (7.3%) no relief of the symptoms. Only two patients had (3.6%) cerebrospinal fluid leakages as a perioperative complication. The major offending vessels were anterior and inferior cerebellar arteries in 14 patients. Four patients with essential hypertension became normotensive after decompression of the left medulla oblongata as well. CONCLUSION: Microvascular decompression surgery provides a significant relief of the symptoms in patients with vascular compression syndromes. An angled endoscope as an adjunct to microscope contributes to the diagnosis of the offending vessel in the root entry zone of the cranial nerve.