RESUMEN
Tumour metastasis is one of the leading cause of cancer-related mortality. Circulating tumour cells (CTCs) have been implicated in loco-regional and distant metastasis and its role is being extensively studied in various malignancies, including those from the head and neck region. The main challenge in understanding their significance lies in the rarity of these cells in the blood. However, newer technologies have attempted to overcome these pitfalls. This review explores the evolution of CTC research and other related areas, including its biological significance, sustainability within the circulating vascular environment and possible clinical implications.
Asunto(s)
Productos Biológicos , Neoplasias de Cabeza y Cuello , Células Neoplásicas Circulantes , Recuento de Células , Humanos , Metástasis de la Neoplasia , Células Neoplásicas Circulantes/patologíaRESUMEN
BACKGROUND: Cervical necrotizing fasciitis is a progressive soft tissue infection with significant morbidity and mortality. METHODS: A case review of cervical necrotizing fasciitis managed at our institution (2007-2017) and a systematic review of PubMed, MEDLINE, and EMBASE databases using the algorithm "(cervical OR neck) AND necrotizing fasciitis." RESULTS: There were 1235 cases from 207 articles which were included in our clinical review. Mean age for cervical necrotizing fasciitis was 49.1 years (64.23% men). Etiology was odontogenic (47.04%), pharyngolaryngeal (28.34%), or tonsillar/peritonsillar (6.07%). There were 2 ± 0.98 organisms identified per patient; streptococci (61.22%), staphylococci (18.09%), and prevotella (10.87%). There were 2.5 ± 3.22 surgical debridements undertaken. Descending necrotizing mediastinitis occurred in 31.56% of patients. Mean length of stay in the hospital was 29.28 days and overall mortality was 13.36%. CONCLUSION: Physicians and surgeons must be vigilant of the diagnosis of cervical necrotizing fasciitis as early clinical findings may be subtle and prompt identification to facilitate aggressive intervention is required to preclude catastrophic local and systemic morbidity and mortality.
Asunto(s)
Fascitis Necrotizante/diagnóstico , Fascitis Necrotizante/terapia , Cuello , Adulto , Fascitis Necrotizante/etiología , Femenino , Humanos , Masculino , Persona de Mediana EdadAsunto(s)
Neoplasias de la Boca/diagnóstico , Neoplasias Primarias Desconocidas/diagnóstico , Fibrosis de la Submucosa Bucal/patología , Adulto , Biopsia , Humanos , Masculino , Mucosa Bucal/patología , Neoplasias de la Boca/etiología , Neoplasias Primarias Desconocidas/etiología , Tomografía Computarizada por Tomografía de Emisión de PositronesRESUMEN
Adequacy of surgical resection decided by the margin status is important in attaining a good local control and better survival in Head and neck Cancers. Conventionally, a measured distance between the tumor edge and the cut edge of the specimen is taken as the margin. A margin more than 5 millimeter (mm) is considered clear, less than 5 mm is close and less than one mm is denoted as involved. The concept of this adequacy varies between the different sites and subsites in head and neck. The purpose of this paper is to review the current evidence that describes the adequacy of surgical margin status and their variability among the sites and sub-sites in the head and neck.