Predictive factors for survival and treatment outcomes of patients with minor salivary gland malignancies: a retrospective study.

INTRODUCTION: Aim of this study was to explore the incidence, pathology, clinical behaviour and evaluate factors predictive on survival and treatment outcomes in a cohort of patients with minor salivary gland (MiSG) malignancies treated at a single center over a period of 25 years. MATERIALS AND METHODS: Patients who had received primary treatment for MiSG malignancy during 25 years observation period were identified. Outcomes that were evaluated were overall survival (OS), disease specific survival (DSS), recurrence free survival (RFS), locoregional recurrence free survival (LRFS) and distant metastasis free survival (DFS). RESULTS: A total of 88 patients with MSG malignancies were included in the study. The most common location for MiSG malignancies was the oral cavity (65 tumors; 77%). Cumulative OS for 5 and 10 year follow up period was 82% and 62% respectively. Cumulative DSS for 5 and 10 year follow up period was 85% and 73% respectively. Twenty one (23%) patients developed distant metastases during follow-up. High-grade pathology and tumor stage were significant variables on multivariate analysis for all survival and treatment outcomes. CONCLUSIONS: Minor salivary gland malignancies are minor only by name. Tumor histological grade, AJCC tumor stage and pT stage were the strongest predictive factors for survival and treatment outcomes. The elective neck dissection could be considered therapeutic approach for selected cases of high grade MiSG malignancies. Distant metastases were the main cause of death and treatment failure.

INTRANASAL PLEOMORPHIC ADENOMA ARISING FROM THE LATERAL NASAL WALL.

Pleomorphic adenoma is very rare in the sinonasal region, with the most common localization on the nasal septum, followed by lateral nasal wall. In the case presented, a 72-year-old woman was complaining of the right sided nasal obstruction without any other symptoms. The symptom started a year before and increased progressively. Anterior rhinoscopy revealed a mucosa-covered, smooth-surfaced, soft, polypoid, pale, grayish-pink in color mass in the right nasal cavity, approximately 2x2 cm in size. Nasal endoscopy showed the mass to have a broad base on the lateral nasal wall. Computerized tomography scan showed a homogeneous, solid soft tissue mass, 25x18x12 mm in size, which was attached to the lateral nasal wall, behind the nasal vestibule, just in front of the inferior turbinate. Endonasal endoscopic complete tumor excision was performed, during which some spillage of the tumor occurred. Histology diagnosis was pleomorphic adenoma of minor salivary glands. The patient was followed up on regular basis and had no tumor recurrence in the 6th postoperative year. Intranasal pleomorphic adenoma arising from the lateral nasal wall in front of the inferior turbinate is extremely rare, so the presented case is probably the first ever published.

Metastasis of the Mucionous adenocarcinoma of breast to the mandibular gingiva: Rare case report.

INTRODUCTION: Mucinous adenocarcinoma (MAC) is a rare type of cancer in which more than 50% of the tumor is composed of extracellular mucin and malignant epithelial cells. MACs account for only 1.8% of all breast cancer cases. Most breast cancers present as localized diseases and are well-differentiated. Breast MAC has a better 5- and 10-year survival rate than ductal and lobular carcinomas. Distant metastasis in breast MAC is rare, especially in the oral cavity. Only 1% of all oral malignancies present with metastases to the oral cavity. The bony structures are more involved than the soft tissues. Involvement of the oral soft tissue is rare, accounting for less than 0.1% of oral metastases. CASE DESCRIPTION: This report describes a rare case of mucinous breast adenocarcinoma with metastasis to the mandibular molar region. Diagnosis was established based on anamnesis, clinical presentation, tumor biopsy, computed tomography, mammography, and core biopsy of the breast tumor. The patient was sent to the oncology committee for breast disease where chemotherapy was indicated. DISCUSSION: The clinical presentation of oral metastasis is not pathognomonic, and pyogenic granuloma, periodontal abscesses, sarcomas, and squamous carcinoma must be considered in the differential diagnosis. This is a rare case of oral metastasis of breast MAC, which was indicated for detection of the primary tumor.

PENTALOGY OF CANTRELL IN TWINS: A CASE REPORT.

UNLABELLED: INTRODUCTION. Pentalogy of Cantrell is a very rare congenital multiple malformation with the poor outcome. Syndrome included the following pentad: abdominal wall defect, a defect of the lower sternum, anterior diaphragm defect, ectopia cordis, as well as a variety of intracardiac anomalies. CASE REPORT: In the fifteenth week of the twin pregnancy, ultrasound examination showed multiple anomalies in one, as well as the absence of the nose apex in the other twin. The autopsy of the fetuses was performed after the abortion had been approved by the Ethics Committee. The external examination of the fetus number one showed ectopic heart and omphalocele. The internal examination revealed the existence of sternum cleft, ectopic heart and part of the left lung outside the thoracic cavity, the presence of diaphragmatic hernia with protrusion of abdominal organs, heart with only one large vessel and the horseshoe kidney. The full expression of the Pentalogy of Cantrell was confirmed. The external and internal examination of the other twin showed just agenesis of the nose apex. CONCLUSION: Recognition and diagnosis of the syndrome is of the exceptional importance. Proper and timely diagnosis should contribute to good outcome of the pregnancy and delivery.