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1.
Ear Nose Throat J ; : 1455613241240935, 2024 Apr 14.
Artigo em Inglês | MEDLINE | ID: mdl-38616554

RESUMO

Objective: Facial nerve paralysis due to parotid carcinoma is sometimes misdiagnosed as Bell's palsy. This study aimed to compare patients with parotid carcinoma with and without accompanying facial nerve paralysis and to capture the features of patients misdiagnosed with Bell's palsy. Methods: Among 209 patients, 42 (20%) had facial nerve paralysis. Of these 42 patients, 14 had received treatment for facial nerve paralysis without being diagnosed with parotid carcinoma (pretreatment group); the remaining 28 patients had not received any pretreatment and were diagnosed with parotid carcinoma at the initial visit to our hospital (no pretreatment group). This study compared patients with and without facial nerve paralysis and the pretreatment and no pretreatment groups. Results: The 42 patients with facial nerve paralysis had a significantly higher frequency of pain/tenderness and adhesion with surrounding tissues, significantly higher proportions of deep lobe tumors, and a significantly higher proportion of high-grade malignancy. In addition, the disease-specific and disease-free 5 year survival rates were significantly poorer in patients with than in those without facial nerve paralysis. The comparison between the pretreatment and no pretreatment groups revealed no significant differences in any factors nor survival rate. Five patients in the pretreatment group complained of palpable masses or pain/tenderness at the time of their initial treatment for paralysis. Conclusion: Patients with parotid carcinoma who present with facial nerve paralysis at the initial visit have a significantly poorer prognosis. The number of cases in the pretreatment group can be reduced by performing a detailed examination, which can potentially improve the prognosis.

2.
Oral Oncol ; 151: 106751, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38479153

RESUMO

Parotid salivary duct carcinoma (SDC) is a rare and aggressive parotid gland carcinoma (PGC). SDC has two origins: de novo and ex pleomorphic adenoma (SDC ex PA); however, because of its rarity, the clinical and molecular features of the two types of SDC are not sufficiently understood. Here, we studied the differences in their clinicopathological and molecular features using clinical specimens while comparing them to those of adenoid cystic carcinoma (AdCC), an intermediate-grade PGC. Clinicopathological analysis of tissues from patients with PGC revealed significant associations between histological types and malignant phenotypes, including nodal metastasis, recurrence, vascular invasion, and neural invasion, and revealed more malignant phenotypes of de novo SDC than of SDC ex PA. The de novo SDC showed a significantly higher frequency of intra-neural invasion (intra-NI) and vascular invasion than AdCC and SDC ex PA. PGCs with high intra-NI were significantly correlated with malignant phenotypes and survival rates. Recently, we observed the overexpression of tropomyosin receptor kinase B (TRKB), a receptor tyrosine kinase, in PGC cells. Here, immunohistochemical and clinicopathological analyses showed that TRKB was highly expressed in SDC cells, particularly de novo SDC cells, and was significantly associated with poor survival and highly malignant phenotypes, including intra-NI and vascular invasion. Collectively, these data show that TRKB expression is significantly elevated in PGC, particularly in de novo SDC, and can be one of the biomarkers of their aggressiveness.


Assuntos
Adenoma Pleomorfo , Carcinoma Adenoide Cístico , Carcinoma Ductal , Neoplasias Parotídeas , Neoplasias das Glândulas Salivares , Humanos , Glândula Parótida/patologia , Tropomiosina , Ductos Salivares/patologia , Neoplasias das Glândulas Salivares/patologia , Adenoma Pleomorfo/patologia , Neoplasias Parotídeas/patologia , Carcinoma Adenoide Cístico/patologia , Carcinoma Ductal/patologia , Receptores Proteína Tirosina Quinases , Biomarcadores Tumorais/genética
3.
J Clin Med ; 11(21)2022 Oct 26.
Artigo em Inglês | MEDLINE | ID: mdl-36362538

RESUMO

Background: The sphenoid sinus (SS) is located close to vital structures, such as the pituitary gland, and it has significant clinical relevance. This study aimed to clarify the growth pattern of the SS in Japanese children using three-dimensional computed tomography (CT). Methods: Seventy-eight participants with congenital, acquired, or external auditory canal cholesteatoma were recruited and underwent CT more than twice during their treatment. Using the volume-rendered images, the size and volume of the SS were measured. Furthermore, on the scout image, the morphological measurements of the cranial base were determined. Results: The size and volume of the SS increased with age, and peaked at the mean age of 15 years. For males, the volume of the SS was smaller than that of females aged <5 years. The growth rate of the SS was significantly higher in males than in females. The maximum growth rate was detected at the age of 12 years for males and 10 years for females. For females, the increase in the length of the anterior cranial base ceased at approximately 10 years of age and remained constant thereafter. In contrast, for males, the length of the anterior cranial base increased gradually until 15 years of age. Conclusions: Considering the similarity of the periods between the adolescent growth spurt and the maximum growth rate of the SS, changes in the size of the SS may be used as an indicator of the physical growth spurt.

4.
Sci Rep ; 12(1): 17553, 2022 10 20.
Artigo em Inglês | MEDLINE | ID: mdl-36266462

RESUMO

Parotid gland cancer (PGC) is a rare malignancy and its molecular characteristics remain poorly understood, which has precluded the development of effective drug therapies. Given the poor prognosis of many human cancers in which tropomyosin receptor kinase B (TRKB) is highly expressed, we investigated the involvement of brain-derived neurotrophic factor (BDNF)/TRKB pathway in PGC cells using clinical specimens and observed upregulation of TRKB and BDNF. In primary culture systems of patient-derived PGC cells and cancer-associated fibroblasts (CAFs), PGC cells co-cultured with CAFs exhibited significant upregulation of BDNF and epithelial-mesenchymal transition (EMT). Similar results were observed in PGC cells treated with conditioned medium from co-cultures of PGC cells with CAFs. Administration of TRK inhibitors suppressed BDNF-induced cell migration in PGC cells. Immunohistochemical and clinicopathological analyses of tumors from patients with PGC revealed that BDNF and TRKB were highly expressed in both tumor cells and stromal cells such as CAFs, and TRKB expression levels in PGC cells were significantly correlated with aggressive features, including vascular invasion, nodal metastasis, and poor prognosis. Collectively, these data suggest that the BDNF/TRKB pathway regulates PGC cell aggressiveness via crosstalk with CAFs and is a potential therapeutic target for PGC harboring invasive and metastatic features.


Assuntos
Fator Neurotrófico Derivado do Encéfalo , Fibroblastos Associados a Câncer , Receptor trkB , Neoplasias das Glândulas Salivares , Humanos , Fator Neurotrófico Derivado do Encéfalo/metabolismo , Fibroblastos Associados a Câncer/metabolismo , Linhagem Celular Tumoral , Meios de Cultivo Condicionados , Transição Epitelial-Mesenquimal , Glândula Parótida/metabolismo , Receptor trkB/metabolismo , Neoplasias das Glândulas Salivares/metabolismo , Neoplasias das Glândulas Salivares/patologia
5.
Ear Nose Throat J ; : 1455613221086020, 2022 Apr 06.
Artigo em Inglês | MEDLINE | ID: mdl-35384784

RESUMO

Facial palsy in acute lymphoblastic leukemia (ALL) patients is diagnosed as tumor cell invasion of the central nervous system (CNS) following the ALL guidelines. Facial palsy in a 6-year-old ALL patient was diagnosed as leukemia cell invasion into the CNS by hemato-oncologists. Pretreatment magnetic resonance image (MRI) revealed gadolinium enhancement of the first genu and meatal portion of the facial nerve. After chemotherapy, although the ALL tumor cells disappeared from both the blood and the cerebrospinal fluid, and the facial palsy resolved, a posttreatment MRI showed no change in terms of enhancement of the facial nerve. These findings indicated the possibility of herpetic viral reactivation in the geniculate ganglion of the facial nerve. We must be aware and discuss with hemato-oncologists the possibility that not only tumor cell invasion into the CNS, in accordance with the guidelines, but also that herpetic virus reactivation arising in the facial nerve may be causes of facial palsy.

6.
Auris Nasus Larynx ; 49(6): 1093-1097, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34657776

RESUMO

Thyroid tuberculosis is a rare disease, very few cases have been reported. It is difficult to diagnose because of no typical characteristics. We report on a patient who underwent surgery for suspected thyroid carcinoma, but who was then diagnosed with thyroid tuberculosis. The patient was a woman in her 70s. She had been diagnosed with chronic renal failure and had been on peritoneal dialysis. She complained of fever and a painful left anterior neck swelling. Computed tomography showed thyroid tumor with cervical lymph node swelling, ultrasound-guided fine needle aspiration cytology was suspected for papillary thyroid carcinoma. We performed surgery to confirm the diagnosis and determine treatment. Procedures for thyroid carcinoma were followed, including left lobectomy of the thyroid gland, central lymph node dissection and right cervical lymph node resection. Pathological examination found no malignant findings in the thyroid tissue but did find a granulation layer even in the right cervical lymph node. Tuberculosis-specific IFN-γ assay was positive, we diagnosed thyroid and cervical lymph node tuberculosis. Postoperatively, the neck pain and fever improved, she was treated as an outpatient with antituberculosis drugs therapy. Thyroid tuberculosis must be considered in patients with immunocompromised, such as this patient, who was on peritoneal dialysis.


Assuntos
Carcinoma Papilar , Febre de Causa Desconhecida , Neoplasias da Glândula Tireoide , Tuberculose , Carcinoma Papilar/diagnóstico , Carcinoma Papilar/diagnóstico por imagem , Feminino , Febre de Causa Desconhecida/etiologia , Febre de Causa Desconhecida/cirurgia , Humanos , Linfonodos/diagnóstico por imagem , Linfonodos/patologia , Metástase Linfática , Câncer Papilífero da Tireoide/complicações , Câncer Papilífero da Tireoide/diagnóstico por imagem , Câncer Papilífero da Tireoide/cirurgia , Neoplasias da Glândula Tireoide/complicações , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia , Tuberculose/cirurgia
7.
Ear Nose Throat J ; : 1455613211064013, 2021 Dec 28.
Artigo em Inglês | MEDLINE | ID: mdl-34961349

RESUMO

OBJECTIVE: Parotid tumors are rare neoplasms in adults but are exceedingly infrequent in adolescents. We aimed to determine the clinical characteristics and outcomes of parotid tumors in adolescents under 20 years old. METHODS: Between 1999 and 2020, 979 cases of benign parotid tumors and 236 cases of malignant parotid tumors were treated surgically in our department. Of these, 12 benign cases (1.2%) and 9 malignant cases (3.8%) were in adolescents. There were no benign or malignant cases for those aged under 10 years. RESULTS: Regarding the histological type, all benign tumors were pleomorphic adenomas. About half of malignant tumors were mucoepidermoid carcinomas, and excluding one high-grade case, the grade of malignancy was all low/intermediate. The accuracy of fine-needle aspiration cytology among adolescents showed no significant difference with that of adults. In contrast to adults, adolescent benign tumor cases showed a markedly high rate of pleomorphic adenomas and no postoperative facial nerve palsy. Malignant tumors in adolescents had a different trend than adults; low/intermediate-grade malignancies were common and thus few symptoms/signs of malignancy could be observed. As well, the accuracy of fine-needle aspiration cytology was poor. All cases had a good prognosis and are disease-free survival. CONCLUSION: Parotid tumors in adolescents are rare but have several characteristics that are distinct from adults. As long-term observation is required posttreatment in adolescent patients, recurrence in benign pleomorphic adenomas and poor long-term prognosis in malignant tumors, especially for those with low/intermediate-grade malignancy, are more likely to be observed.

8.
Auris Nasus Larynx ; 47(5): 800-806, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32475630

RESUMO

OBJECTIVE: Avoidance of iatrogenic injury to the facial nerve is crucial during ear surgery. The anatomical relationship between the tympanic portion of the facial canal (FC) and the mastoid portion of the facial nerve was analyzed using multi-slice computed tomography (CT) scans to avoid iatrogenic facial nerve injury. METHODS: In total, 364 ears of 351 patients who underwent CT scans were enrolled. The 364 ears were divided into two groups: 281 ears with middle ear inflammation (MEI) and 83 ears without middle ear inflammation (non-MEI). The anatomical relationship between the tympanic portion of the FC and mastoid portion of the facial nerve was analyzed on multi-slice CT images. The ears were categorized into three subgroups based on the course of the mastoid portion of the facial nerve to the tympanic portion of the FC: ("lateral running course", LRC), "on the tympanic line course" (OL), and "medial running course" (MRC). The proportions of ears in each subgroup were compared between the MEI and non-MEI groups. RESULTS: Overall, 15% of ears were categorized as LRC, 30% were OL, and 55% were MRC. In the MEI group, the proportions of LRC, OL, and MRC ears were 17%, 32%, and 51%, respectively, whereas they were 7%, 24%, and 69% in the non-MEI group. The proportion of LRC ears in the MEI group was significantly higher than that in the non-MEI group. CONCLUSIONS: Especially in patients with MEI, a more LRC for the facial nerve increases the risk of facial nerve injury during posterior tympanotomy or canal wall down mastoidectomy. The course of the facial nerve in the temporal bone should be evaluated before surgery on multi-slice CT images.


Assuntos
Orelha Média/anatomia & histologia , Nervo Facial/anatomia & histologia , Procedimentos Cirúrgicos Otológicos , Osso Temporal/inervação , Tomografia Computadorizada por Raios X , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Orelha Média/diagnóstico por imagem , Nervo Facial/diagnóstico por imagem , Traumatismos do Nervo Facial/prevenção & controle , Feminino , Humanos , Doença Iatrogênica/prevenção & controle , Complicações Intraoperatórias/prevenção & controle , Masculino , Processo Mastoide/anatomia & histologia , Processo Mastoide/diagnóstico por imagem , Mastoidectomia/efeitos adversos , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Otológicos/efeitos adversos , Osso Temporal/anatomia & histologia , Osso Temporal/diagnóstico por imagem , Adulto Jovem
9.
Eur Arch Otorhinolaryngol ; 276(12): 3281-3286, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31520164

RESUMO

OBJECTIVE: Electroneurography (ENoG) reliably predicts the prognosis of facial palsy. However, the results of ENoG are dependent on the location, where the wave is detected, as a compound muscle action potential (CMAP) arising from the facial muscles. To minimize errors in prognostic prediction, we analysed the latencies of facial CMAPs. MATERIALS AND METHODS: Fifty-seven patients with unilateral peripheral facial palsy and 24 healthy volunteers were enrolled. Amplitudes, negative peak latencies (NPL), and rise latencies (RL) of CMAPs were measured on the paralysed and healthy sides in patients and in healthy volunteers. The relationships of these latencies with ENoG values and the lowest House-Brackmann (H-B) scores were also analysed. RESULTS: The amplitude of CMAP on the paralysed side was smaller, and NPL and RL were longer, than those on the healthy side in patients and healthy volunteers (p < 0.01). In patients, there was no difference in NPL between the ENoG < 40% group and the ENoG ≥ 40% group. Conversely, there was a significant difference in RL between the ENoG < 40% group and ENoG ≥ 40% group (p = 0.03). No relationships were observed between NPL or RL and the lowest H-B score. CONCLUSIONS: NPL and RL of CMAP on the paralysed side were equivalent or longer than those on the healthy side. During ENoG for facial palsy, CMAP should be measured on the healthy side first, and then detected (and the amplitude measured) on the paralysed side with reference to CMAP latency on the healthy side, to reduce errors in detecting facial CMAPs.


Assuntos
Potenciais de Ação/fisiologia , Paralisia de Bell/diagnóstico , Paralisia de Bell/fisiopatologia , Músculos Faciais/fisiopatologia , Nervo Facial/fisiopatologia , Paralisia Facial/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Estimulação Elétrica , Eletrodiagnóstico/instrumentação , Eletrodiagnóstico/métodos , Face , Músculos Faciais/inervação , Paralisia Facial/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico
11.
Auris Nasus Larynx ; 46(3): 437-442, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30466760

RESUMO

OBJECTIVE: To investigate the clinical feature of the poorly differentiated thyroid papillary carcinoma. METHODS: We investigate retrospectively 276 thyroid papillary carcinoma patients who underwent initial treatment at our Department who underwent initial treatment at our Department during the 13-year period from 2000 to 2012. We examine the pathological samples of papillary carcinoma retrospectively to investigate the prevalence of a poorly differentiated component in the tumor. Then the disease-specific survival rate, metastasis-free survival rate, and relapse-free survival rate were compared between patients with or without a poorly differentiated component. In addition, well differentiated carcinoma and poorly differentiated carcinoma were compared in relation to the age, sex, TNM stage, and recurrent laryngeal nerve infiltration. RESULTS: It was considered appropriate to define tumors with a poorly differentiated component of 10% or more as poorly differentiated carcinoma. There was a significant difference of the T classification but not the N classification between well and poorly differentiated thyroid papillary carcinomas. The disease-specific survival rate, metastasis-free survival rate, and relapse-free survival rate of patients with poorly differentiated carcinoma was significantly lower than that of patients with well differentiated carcinoma, and we considered that this might be due to the higher frequency of local infiltration in patients with poorly differentiated tumors. CONCLUSION: The higher relapse rate compared with well differentiated carcinoma suggests that careful postoperative follow-up of patients with poorly differentiated carcinoma is important, particularly surveillance of distant metastasis.


Assuntos
Câncer Papilífero da Tireoide/patologia , Neoplasias da Glândula Tireoide/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Intervalo Livre de Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Recidiva Local de Neoplasia/epidemiologia , Estadiamento de Neoplasias , Intervalo Livre de Progressão , Nervo Laríngeo Recorrente/patologia , Estudos Retrospectivos , Taxa de Sobrevida , Câncer Papilífero da Tireoide/mortalidade , Neoplasias da Glândula Tireoide/mortalidade , Adulto Jovem
12.
Oncotarget ; 9(38): 25225-25243, 2018 May 18.
Artigo em Inglês | MEDLINE | ID: mdl-29861866

RESUMO

It has been reported that one of the neurotrophin receptors, tropomyosin receptor kinase B (TRKB), is frequently overexpressed in various tumor tissues including oral squamous cell carcinoma (OSCC), and that its upregulation promotes tumor progression in human cancers. However, the correlation between TRKB overexpression and clinicopathological characteristics is not fully elucidated. Here, we present the correlation between the expression levels of TRKB and/or its secreted ligand, brain-derived neurotrophic factor (BDNF), and clinicopathological characteristics, especially regarding tumor differentiation, tissue invasion, and disease-free survival in patients with OSCC. The results obtained through immunohistochemical analysis of human OSCC tumor specimens showed that the expression levels of TRKB and/or BDNF, were significantly higher in moderately and poorly differentiated OSCC (MD/PD-OSCC) tumor cells than in well differentiated cells (WD-OSCC). Moreover, the OSCC tumors highly expressing TRKB and/or BDNF exhibited promotion in tissue invasion and reduction in disease-free survival in the patients. In an orthotopic transplantation mouse model of human OSCC cell lines, administration of a TRKB-specific inhibitor significantly suppressed the tumor growth and invasion in PD-OSCC-derived tumor cells, but not in WD-OSCC-derived tumor cells. Moreover, the TRKB inhibitor selectively blocked BDNF-induced tumor cell proliferation and migration accompanied with the suppression of TRKB phosphorylation in PD-OSCC but not in WD-OSCC in vitro. Taken together, these data suggest that the BDNF/TRKB signaling pathway may regulate tumor progression in poorly differentiated OSCC. Expression levels of signal molecules may be an accurate prognosis marker for tumor aggressiveness, and the molecules may be an attractive target for new OSCC therapies.

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