[Extranodal Metastases of Renal Cell Carcinoma to the Head and Neck: A Diagnostic Challenge]. / Extranodale Metastasen von Nierenzellkarzinomen in der Kopf-Hals-Region.

BACKGROUND: Single case reports about extranodal renal cell carcinoma (RCC) metastasis to the head and neck (HN) often implicating unusual clinical follow-ups are well known. Subject of our investigation is to ascertain the true meaning of RCC for differential diagnostic of the head and neck surgion. METHODS: We retrospectively review the reports of 612 patients with RCC treated in a 13-years period in the department of urology. RESULTS: Of the 612 RCC 191 (31%) were metastatic, 3 female and 4 male (mean 66.8a, 56a-78a) presented with extranodal metastases within the HN. Extranodal locations were parotid and thyroid glands (2 ×), tongue, forehead scin, bone and paranasal sinus. Occurrence of metastases were observed in mean 40.8 months (5-87) after the primary. In one patient metastasis to the parotid gland was the only manifestation of RCC 78 month treated before, the others presented with further metastases to infraclavicular organs. DISCUSSION: According to our results extranodal metastases of RCC to the HN are uncommon (1.1%). Therefore and because of the unusual location extranodal metastases of RCC remain a diagnostic challenge for the ENT specialist and the pathologist with peculiar knowledge of the oncological history of the patient remaining an essential condition. We found exclusive metastasis to the HN in only one of 7 cases. Nevertheless surgical treatment has to be considered in curative and symptomatic treatment strategies.

[Quality of life after primary radiation/radiochemotherapy vs. operation therapy in an oropharyngeal cancer]. / Lebensqualität nach primärer RT/RCT vs. operativer Therapie bei Oropharynxkarzinom.

Not only in oropharyngeal carcinoma, but particularly in head and neck cancer the evaluation of quality of life does not only belong to the clinical trials but also finds its way into everyday clinical life. Research findings of numerous clinical trials of the last 20 years demonstrate that EORTC Core Questionnaire QLQ-C30 and in addition QLQ-H&N35 asserted themselves as outstanding base. A tendency of improved quality of life of operated patients with oropharyngeal carcinoma compared to advanced states of disease of primary radiochemotherapy can be ascertained.

[Acute dyspnea in malignant melanoma]. / Akute Dyspnoe bei malignem Melanom der Haut.

Metastases to the larynx are rare. The current article presents the case of a 75-year-old patient with a history of shortness of breath due to a supraglottic exophytic lesion that was identified as a metastasis of a cutaneous melanoma treated 2.5 years previously. As a result of our medline analysis we found approximately 30 cases of metastatic melanoma to the larynx published to date. Primary tumors are always cutaneous in origin and spread over the whole integument of trunk and extremities. The time interval between diagnosis of the primary and the laryngeal metastasis is often several years. In most reports a supraglottic exophytic, red coloured lesion is described. Diagnosis can only be proven by histological examination. Laryngeal metastasis is usually an indication of tumor dissemination and always has a fatal prognosis.

[Small cell carcinoma of parotid gland--a case report]. / Kleinzelliges Karzinom der Glandula parotis--ein Fallbeispiel.

BACKGROUND: Small cell carcinoma of the major salivary glands are very seldom. If there is such a tumor always have in mind that it can be a metastatic process of another small cell carcinoma in other locations of the body. That's why first of all a primary in the bronchial system has to be excluded with special diagnostics. CASE REPORT: We present the case of a 72-year-old woman suffering from a small cell carcinoma of Parotid gland. Because a surgical therapy was impossible she underwent a radiotherapy. CONCLUSION: First choice for therapy of tumors of the major salivary glands is surgical therapy in combination with radiation/chemotherapy. If this is not possible a primary radiotherapy sometimes in combination with chemotherapy seems to be another therapeutic option.