Thyroglossal duct cyst carcinoma case series-Management strategy and outcomes / Serie de casos de carcinoma del conducto tirogloso: estrategias de tratamiento y resultados

Objective: To review the clinical presentation, diagnosis, pathology and management strategies in a modern cohort of patients with thyroglossal duct cyst carcinoma. Study design: Retrospective case series following PROCESS Guidelines. Setting Comprehensive cancer centre. Methods: Data recorded included: gender, age at diagnosis, clinical presentation, thyroid function, diagnostic investigations, cytological results, final histology, staging and follow up status. The risk of malignancy in cytological analysis was stratified according to the Royal College of Pathologists classification in United Kingdom. Results: Twelve patients were included. The majority of patients (66.7%) presented with an isolated thyroglossal duct cyst. Only 4 patients had preoperative cytological suspicion of carcinoma (sensitivity: 33.3%). At the time of presentation all patients were euthyroid. Following diagnosis of malignancy, a total thyroidectomy was performed in all patients, with the exception of 2, who had a thyroglossal duct cyst carcinoma of less than 10mm. Among the 10 patients who underwent total thyroidectomy, 7 (70%) patients had proven carcinoma in the thyroid gland, 3 with deposits of less than 10mm. The average size of the thyroid cancer deposits was 7.2mm (1–20mm). With a mean follow-up of is 44 months (5–120), all patients were alive and free of recurrence at the end of the study period. Conclusion: Thyroglossal duct cyst carcinoma is a rare condition and its management should be discussed in a multidisciplinary meeting. As with differentiated thyroid cancer originating in the thyroid gland, it bears extraordinary survival rates. Accordingly, the management of these cancers has shifted towards a more conservative approach although its peculiarities must be taken into account: ease of extracystic invasion and possible different lymph node invasion. (AU)

Objetivo: Revisar la presentación clínica, el diagnostico, la histología y las estrategias de tratamiento en una cohorte moderna de pacientes con carcinoma del conducto tirogloso. Diseño del estudio: Serie de casos retrospectiva utilizando PROCESS Guidelines. Localización: Unidad de cáncer de cabeza y cuello. Métodos: Los datos incluidos fueron: sexo, edad al diagnóstico, presentación clínica, función tiroidea, investigaciones diagnósticas, resultados citológicos, histología final, estadificación y estado durante el seguimiento. El riesgo de malignidad en el análisis citológico fue estratificado de acuerdo con la clasificación del Royal College of Pathologists del Reino Unido. Resultados: Se incluyeron 12 pacientes. La mayoría de ellos (66,7%) presentaron solamente un quiste del conducto tirogloso al diagnóstico. Solamente 4 pacientes tuvieron sospecha de malignidad de acuerdo con los resultados de la citología preoperatoria. En el momento de la presentación, todos los pacientes tenían función tiroidea normal. Después del diagnóstico, se realizó tiroidectomía total a todos los pacientes menos dos, que tuvieron carcinoma del conducto tirogloso menor de 10mm. Entre los 10 pacientes que recibieron tiroidectomía total, 7 (70%) sufrieron carcinoma en la glándula tiroides, 3 de ellos con depósitos menores de 10mm. El tamaño medio de los depósitos de carcinoma en la glándula tiroides fue de 7,2mm (1-20mm). Con una media de seguimiento de 44meses (5-120), todos los pacientes estaban vivos y libres de recidiva al final del periodo estudiado. Conclusión: El carcinoma del conducto tirogloso es una entidad poco frecuente y su manejo debe ser realizado por un equipo multidisciplinario. Igual que en el carcinoma diferenciado de tiroides que se origina en la glándula tiroides, las tasas de supervivencia son excelentes. ... (AU)

Don't stop the champions of research now: a brief history of head and neck pathology developments.

The field of head and neck pathology was just developing 50 years ago but has certainly come a long way in a relatively short time. Thousands of developments in diagnostic criteria, tumor classification, malignancy staging, immunohistochemistry application, and molecular testing have been made during this time, with an exponential increase in literature on the topics over the past few decades: There were 3506 articles published on head and neck topics in the decade between 1969 and 1978 (PubMed source), with a staggering 89266 manuscripts published in the most recent decade. It is daunting and impossible to narrow the more than 162000 publications in this field and suggest only a few topics of significance. However, the breakthrough in this anatomic discipline has been achieved in 3 major sites: oropharyngeal carcinoma, salivary gland neoplasms, and sinonasal tract tumors. This review will highlight selected topics in these anatomic sites in which the most profound changes in diagnosis have occurred, focusing on the information that helps to guide daily routine practice of surgical pathology.

Surgical treatment of head and neck cancers in the ancient world.

OBJECTIVE: This paper attempts to chart the history of head and neck cancers and their surgical treatment, starting from ancient Egypt and concluding with Galen. CONCLUSION: The ancient Egyptians appear to have treated head and neck cancers with local applications. The ancient Greek corpus contains a reference to treating pharyngeal carcinoma with cautery, but the description is too vague to establish the diagnosis conclusively. The ancient Romans moved away from surgical treatments, with Galen establishing a prejudice against surgery that would last through the Middle Ages.

Soothing and balmy, cure without disfigurement: Benjamin Bye, false promises, and head and neck cancer.

One century ago, patients dreaded a diagnosis of head and neck cancer, fearing not only the progression of the disease but also the prospect of surgery. A cadre of charlatans preyed upon these fears to make a profit. We unearth the tale of Benjamin Bye, an Indianapolis doctor peddling the Combination Oil Cure. His collection of creams applied to the face offered unsuspecting patients a painless cure of their head and neck cancer. Bye eventually came under the fire of muckrakers as well as the federal government. Not long thereafter, Bye's practice was declared fraudulent, and the US Postmaster General refused to send his products. Bye's story recalls a time in which curative options were few and fear of malignancy was pervasive. Today, as our treatment armamentarium grows, we are reminded to critically assess efficacy, honestly discuss options with patients, and ensure that charlatanism remains a shadow of the past.

A review of the management of lymphangiomas.

INTRODUCTION: Lymphangioma is a rare benign cyst caused by congenital malformation of the lymphatic systems that often occurs in the cervicofacial region. There is no consensus on its management: Observation, aspiration, injection, cryotherapy, electrocautery, radiation, laser, ligation and excision. METHODS: We performed a literature search with the keywords "cystic hygroma", "lymphangioma", "management", "OK 432" and "picibanil" from Medline, Embase and PubMed databases. RESULTS: We present a review of the history, signs and symptoms, diagnosis, histology, classification and management options of cystic hygroma. CONCLUSION: There is no consensus on the treatment options. It should be individualised depending on the size of the lesion, anatomic localisation and complications.

[Laryngology in the late 19th century: using the treatment of Frederick III as an example]. / Laryngologie im ausgehenden 19. Jahrhundert: Das Beispiel der Behandlung Friedrich III.

INTRODUCTION: In 1887, the future Emperor Frederick III developed a laryngeal carcinoma. The long history of this case, from his incipient hoarseness in January 1887 to his death in June 1888, is documented in detail owing to the prominent position of this patient and provides insights into laryngology in the late 19th century. MATERIALS AND METHODS: The team of attending German physicians led by the English physician Dr. Mackenzie wrote reports about the treatment of Frederick III and the circumstances surrounding it, which were published in 1888 by the Imperial Printing House ("Reichsdruckerei"). These reports were analyzed with regard to the assumptions underlying treatment at the time as well as the diagnostic and therapeutic techniques used. RESULTS: The passages cited from these records provide a historical perspective shedding light on the premises underlying treatment and the procedures adopted for diseases of the larynx in the late 19th century. DISCUSSION: The analysis of this illustrative example reveals the similarities and differences between laryngology in the 19th century and that of today. Many of the techniques and assumptions developed back then can still be regarded as the foundation for modern treatment options. Other procedures, however, are now obsolete.

[Head and neck cancer--history]. / Nowotwory glowy i szyi--historia.

According to epidemiological data head and neck cancers constitute for 12% of all malignancies in the world. It is estimated that a total of 400 000 cases of the mouth and throat and of 160 000 cases of laryngeal cancer, 300 000 people die each year. History of head and neck cancers developed and underwent many changes at the turn of the century. Treatment, pathogenesis and possessed state of knowledge on the subject has changed. Starting from the ancient times there were texts on how to treat and examine patients. The Edwin Smith and Ebers Papyrus are two of the oldest medical documents describing the treatment of cancer patients. Hippocrates was the first person who used the word "cancer" and probably he was the first who divided the tumors into benign and malignant. In a document known as the Doctrine of Hippocrates he described skin cancer and cancer treatments. Over the next centuries, medical science did not develop because of religious concerns about autopsy and surgical procedures. The 17th century is a period in which there were a lot of new information about how to treat such oral cancer. Cancer of the tongue was removed by cauterization, which in the 18th century was replaced by the use of surgical instruments. In the same age glossectomy has been accepted as the treatment of choice performed in the treatment of cancer. The 19th century brought a major breakthrough in the treatment of surgical, diagnostic, anesthetic techniques and understanding of the pathological mechanisms. Histological evaluation of tumors has become mandatory and standard practice in the assessment of cancer. Laryngectomy and neck lymph nodes removal has become commonplace. Modified Radical Neck Dissection (MRND), became popularized as another cancer treatment technique. Describing ways to treat cancer, radiotherapy can not be ignored - there are several new techniques such as Intensity Modulated Radiotherapy (IMRT) and hypofractionation currently used. Chemotherapy and the introduction of many new drugs have changed the outlook for patients suffering from cancer. Recently there are expectations about the targeted therapy, especially in medicaments blocking epidermal growth factor receptor (EGFR).

Otolaryngology and the American presidency: a medical legacy.

The various medical histories of eminent members of state have been well documented and explored. Such accounts provide interesting insights into advances in treatment and management of disease. Moreover, historical cases serve as a timely reminder of how the central tenets of good medical practice do not change with time. Two American presidents, Ulysses S. Grant and Grover Cleveland, were afflicted with diseases of the head and neck, and one would subsequently die from his illness. Here we examine their diagnosis, treatment and their disease in the context of modern management.

Head and neck cancer in two American presidents: Case reports.

Two former U.S. presidents, Ulysses S. Grant and Grover Cleveland, were diagnosed with head and neck cancer in 1884 and 1893, respectively. A historical review of the risk factors, diagnoses, and treatments is examined and compared with modern-day interpretations. A comparison was made using the original diagnoses with today's equivalent diagnosis. Different treatment outcomes at the time of the original diagnoses relative to today's treatment are reviewed. Clinicians must be familiar with risk factors, signs, symptoms, diagnosis, and treatment of head and neck cancer.