Definitive Radiation Therapy Versus Postoperative Radiation Therapy for Patients With Maxillary Sinus Cancer Invading the Upper Jaw.

Maxillectomy following radiation therapy has the strongest local control over maxillary sinus cancer. However, in the advanced stage, complete resection is difficult with adequate margin and has the risk of functional disabilities after surgeries. The objective of the study was to determine the optimal treatment strategy for patients with maxillary sinus cancer invades the upper jaw. A total of 998 histologically confirmed maxillary sinus cancer invades the upper jaw patients were subjected to simple randomization. Patients were subjected to maxillectomy and received 150 mg/m/wk intra-arterial cisplatin for 4 weeks followed by radiotherapy (PR group, n = 499) or received the same chemotherapy and definitive radiotherapy only (DR group, n = 499). Disease status, overall survival, progression-free survival, and treatment-emergent adverse effects were evaluated in the follow-up period of 5 years. At the end of 5 years of follow-up, both the treatments had the same overall survival (P = 0.066). Demographic characters were independent parameters for the overall survival (P ≥ 0.05 for all). Postoperative radiotherapy had a higher progression-free survival than definitive radiotherapy (P = 0.018). Maxillectomy was useful in the reduction of the evidence of local recurrence of cancer (P = 0.027). Dysphagia, palate fistula, incomprehensible voice, and trismus were reported as treatment-emergent effects in the PR group. Definitive radiation therapy is recommended in maxillary sinus cancer that invades the upper jaw (Level of Evidence: I; research registry 4571 dated November 14, 2012).

Combined therapy after superselective arterial cisplatin infusion to treat maxillary squamous cell carcinoma.

OBJECTIVE: We sought to assess the efficacy of combined therapy after superselective arterial cisplatin infusion (SACI) therapy to treat the maxillary squamous cell carcinoma. STUDY DESIGN: We conducted a retrospective chart review of 50 patients. After completion of two courses of SACI, 25 of the patients were successively treated by concurrent SACI and radiotherapy (AR), while the other 25 patients were treated by surgery with postoperative radiotherapy (ASR). RESULTS: Patients with surgery (ASR) had an 88% local control rate with 75% disease-free survival rate at 60 months by Kaplan-Meier analysis, compared with 62% disease-free survival rate for patients with AR treatment. A particularly good outcome was obtained in T4 cases of the ASR group (n=8) whose 5-year survival rate was 87% and local control rate was 100%. CONCLUSION/SIGNIFICANCE: Combined SACI therapy is very effective for the treatment of maxillary squamous cell carcinomas and contributes to the improving prognoses of patients and organ preservation rates.

[Metastasis in maxilar sinus as only manifestation of disseminate renal adenocarcinoma]. / Metástasis en seno maxilar como única manifestación de adenocarcinoma renal diseminado.

Paranasal sinuses and nose metastasis are very uncommon. About 50 have been reported. Renal cell carcinoma is the primary neoplasm which most frequently metastasizes in the nasosinusal region, followed by breast and lug. Symptoms are unspecific, but the epistaxis constitutes the most common sign due to the significant vascularizations of the tumor. Prognosis is poor. The survival rate fluctuates between 15-30% at 5 years. Surgery is the elective treatment.

Squamous cell carcinoma of the maxillary sinus.

Eighty-five patients with squamous cell cancer of the maxillary sinus received all of their treatment at The University of Texas M.D. Anderson Cancer Center between the years 1971 and 1986. Their records were evaluated according to stage, disease at presentation, symptoms and signs at presentation, treatment, and outcome. There were no differences in locoregional control or survival between groups treated with surgery alone vs surgery plus radiotherapy. Careful analysis of the data indicates that there was almost certainly some selection bias for the patients undergoing combination therapy, as most of this group had historically adverse prognostic factors identified. Those patients who underwent radiotherapy alone or chemotherapy presented with either metastatic or locally advanced disease and were treated with palliative intent; therefore, comparison between this group and standard therapy groups was impossible in this retrospective review. Although it is tempting to speculate that combination therapy improved locoregional control and survival in patients with more advanced disease, none of the data presented in this review reach statistical significance. Furthermore, there is no difference in survival in this population compared with a study at this institution 20 years ago. Squamous cell cancer of the maxillary sinus continues to be a challenging neoplasm. Radiotherapy may improve locoregional control and survival in a group of patients with more advanced disease and may have its greatest utility in earlier-stage disease. A multi-institutional prospective trial is needed to find ways to improve outcome in this patient population.

Angiocentric T-cell lymphoma presenting as midface destructive lesion: case report and literature review.

A case of angiocentric T-cell lymphoma presenting as a midface destructive lesion is reported. Angiocentric T-cell lymphoma typically manifests as an aggressive, progressively destructive, and necrotizing disorder, often with a fatal outcome. This case was characterized microscopically by the presence of an atypical lymphoid population that expressed a CD45+, CD3+ cytoplasmic, CD5+, and CD56- T-cell phenotype within a background of a polymorphous inflammatory infiltrate. Because of the rarity of the disorder, the differential diagnosis is discussed. Recent advances in clinical immunodiagnostics, the variations in therapeutic modalities, and the prognosis of the disease as reported in the recent literature are reviewed.

Slow-release local chemotherapeutic regimen for maxillary sinus cancer.

Silicone foam containing BLM and implanted in the cavity resulting from the resection of a tumor seemed to act against any tumor cells remaining in the resection site in microscopic amounts by slowly releasing this carcinostatic agent. The silicone foam is molded in precise accordance with the shape of the wound surface as it foams and hardens, leaving no space between the material and the wound surface. The carcinostatic agent released can, therefore, act on the entire surface of the wound, and the implantation also has a hemostatic effect. High tissue concentrations of the agent can be maintained for a long time due to the slow-release properties of the silicone foam. Systemic side effects of the procedure seem to be negligible. Local recurrence of cancer was observed in 11 (33.4%) of our 32 patients. Three-year survival was seen in 1 (50%) of the 2 patients with T2 lesions, 11 (68.7%) of the 16 with T3 lesions and 4 (66.6%) of the 6 with T4 lesions.

Burkitt's lymphoma presenting as mandibular swelling--report of a case and review of publications.

Burkitt's lymphoma in a 4-year-old Chinese boy presented with acute mandibular swelling but no associated systemic disturbance. A review of published reports shows that the diagnosis should be suspected in jaw lesions with no obvious cause.

A case of facial swelling and proptosis.

A case of high-grade B cell lymphoma of the maxillary sinus in a 74-year-old Caucasian male patient is described. Initial presentation of the tumour commonly simulates odontogenic infection. Dental surgeons should maintain a high degree of suspicion for early diagnosis of maxillary sinus tumours. Appropriate use of CT scans and surgical biopsy is essential in the management of such cases.

[High-grade osteosarcoma of the maxillary sinus. A case report]. / Fallbericht eines high-grade Osteosarkoms der Kieferhöhle.

BACKGROUND: Osteosarcoma of the jaw (JOS) constituting 5% to 13% of all osteosarcoma is a locally aggressive malignant mesenchymal tumor with high tendency to local recurrence and the ability to produce tumor osteoid. Compared to osteosarcoma of the remaining skeleton (SOS) JOS metastasizes relatively rarely and relatively late. It differs significantly from SOS in its biological behaviour. CASE REPORT: The presented case deals with a 60-year-old male patient suffering from a newly occurred polypous mucosal tumor of the right-sided maxillary alveolar ridge bioptically diagnosed as a granulation tissue polyp first. After transmaxillary resection of the tumor and consultation of a bone tumor reference center the final diagnosis of a high-grade chondroblastic osteosarcoma could be made. The recommended radical resection of the tumor was declined by the patient because of the expected cosmetic consequences. After surgical reduction of the rapidly growing sarcoma chemotherapy according to the COOS/EURO-B.O.S.S. protocol was initiated at a stage when computed tomography showed diffuse metastatic disease to the lungs. Chemotherapy could delay the progress of the disease only temporarily. The patient died from respiratory insufficiency. CONCLUSION: In JOS radical surgical resection is the therapy of first choice. For substantiation of the diagnosis and central registration of the cases a bone tumor reference center should be contacted.

Osteoradionecrosis of sphenoid and temporal bones in a patient with maxillary sinus carcinoma: a case report.

A case of radionecrosis of sphenoid and temporal bones is reported. The patient received a combination of surgery, radiotherapy, and chemotherapy for his left maxillary sinus carcinoma. After the combined therapy, necrosis accompanying inflammation developed in the maxillary and temporal regions. Excision of the necrotic tissues was done, and the left ascending ramus of the mandible was resected because of persistent tumor mass at the left infratemporal fossa. Although the excision wound of the maxilla healed by epithelialization, an area of nonvital bone remained exposed in the temporal region, where progressive osteonecrosis with infection led to breakdown of the skin. The necrotic bones of the zygomatic arch and the sphenotemporal sutural region became visible through the skin defect, and computerized tomography scan revealed bone necrosis involving the inferolateral area and the base of the skull. Excision of the necrotic bone and reconstruction with sternocleidomastoid myocutaneous flap were performed.

Linfoma no Hodgkin de células grandes no hendidas de la cavidad bucal: reporte de un caso / Big-cell non-Hodgkin lymphoma of the oral cavity: report of a case

Los Linfomas No Hodgkin de la cavidad bucal son un grupo representativo de neoplasias que tienen diversidad en antecedentes, manera de presentación, respuesta al tratamiento y pronóstico. Se expone un caso evaluado en el Servicio de Clínica Estomatológica y en el Servicio de Cirugía Bucal de la Facultad de Odontología de la U.C.V., correspondiente a un paciente masculino de 81 años, con lesión de aspecto clínico tumoral en el reborde alveolar superior izquierdo. Basado en el estudio clínico, histopatológico e inmunohistoquímico, fue diagnosticado como Linfoma No Hodgkin de Células Grandes no Hendidas. La conducta a seguir después de realizado el diagnóstico fue, referencia al Hospital Oncológico Luis Razetti en donde le planificaron una combinación de tratamientos (Quimioterapia, Radioterapia)