RESUMO
Diseases of the temporal bone causing lower cranial nerve palsies are uncommon. In the presence of bony erosion, they are highly suggestive of a malignant process. However, when there is a clear history of otitis externa in an immunocompromised or diabetic patient, a diagnosis of osteomyelitis and secondary inflammatory mass should be considered. We report 4 separate cases of infective skull base lesions causing multiple lower cranial nerve palsies in elderly patients who were not immunocompromised or diabetic, highlighting that this condition is not exclusive to this population.
Assuntos
Doenças dos Nervos Cranianos/microbiologia , Osteomielite/diagnóstico , Base do Crânio/microbiologia , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Sedimentação Sanguínea , Proteína C-Reativa/análise , Transtornos de Deglutição/etiologia , Dor de Orelha/etiologia , Feminino , Humanos , Infecções por Klebsiella/diagnóstico , Infecções por Klebsiella/tratamento farmacológico , Klebsiella pneumoniae , Contagem de Leucócitos , Masculino , Osteomielite/tratamento farmacológico , Osteomielite/microbiologia , Infecções por Pseudomonas/diagnóstico , Infecções por Pseudomonas/tratamento farmacológicoRESUMO
Head and neck squamous cell carcinoma (HNSCC) demonstrates significant differences in the biological and clinical behaviour of tumours found at different sub-sites. We investigated the genetic profiles of 68 carcinomas (larynx n=35, hypopharynx n=19, oropharynx n=14) using chromosomal comparative genomic hybridisation in order to identify sub-site specific differences. Multiple genetic aberrations were found throughout the tumour genomes, including +3q (82%), -3p (75%), +8q (66%), +5p (49%), +7q (49%), +1q (47%), -4p (46%), -11q (46%), -13q (46%), -5q (44%), +11q (43%) and +12p (43%). The mean number of chromosomal arms with at least one aberration was 15. Laryngeal carcinomas (LSCC) were found to have significantly more aberrations on chromosomal arms than oropharyngeal carcinomas (OpSCC); (mean of 17 vs. 11, respectively (p=0.011). It was noted that -4p, +8q, +12q, and -18q were significantly associated with LSCC when compared with both hypopharyngeal SCC (HpSCC) and OpSCC. HpSCC was significantly associated with -2q whereas no aberrations were found to be significantly associated with OpSCC. In conclusion a large number of common chromosomal aberrations are associated with HNSCC however in addition further aberrations are significantly associated with individual sub-sites of head and neck cancer. These aberrations may be responsible for the diverse biological behaviour of these different tumour types. Further research is required to identify the specific genes associated with these chromosomal regions and evaluate their individual impact on disease progression.
Assuntos
Carcinoma de Células Escamosas/genética , Aberrações Cromossômicas/estatística & dados numéricos , Neoplasias de Cabeça e Pescoço/genética , Neoplasias Laríngeas/genética , Hibridização de Ácido Nucleico , Oncogenes/genética , Carcinoma de Células Escamosas/patologia , Progressão da Doença , Dosagem de Genes , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Neoplasias Laríngeas/patologia , Neoplasias Bucais/genética , Neoplasias Bucais/patologia , Neoplasias Faríngeas/genética , Neoplasias Faríngeas/patologiaRESUMO
Information from the genetic analysis of head and neck cancer has grown enormously in the last 20 years. The advent of high-resolution genetic analysis techniques such as microarray technology will further expand this field in the future. Here we review the data on chromosomal aberrations of head and neck squamous cell carcinoma, focusing on the data generated by comparative genomic hybridization analysis, and suggest how such findings will be taken forward over the next decade. With the search engine PUBMED, the key words "comparative genomic hybridisation," "head and neck," "oral," "hypopharyngeal," "laryngeal," and "squamous cell carcinoma" were used. Publications unavailable in English were excluded.
