Early glottic tumours with anterior commissure involvement. Literature review and consensus document. Head and Neck and Skull Base Commission, SEORL-CCC. / Tumores glóticos precoces con afectación de la comisura anterior. Revisión bibliográfica y documento de consenso. Comisión de cabeza y cuello y base de cráneo. SEORL-CCC.

The choice of the most appropriate treatment in early-stage glottic cancer with anterior commissure involvement remains controversial. Its therapeutic management is complex because it is a significant prognostic indicator of local control with 37% recurrence, due to the difficulty in establishing tumour extension with understaging of up to 40%, and due to the comparison of results in series on tumours that behave variably as they progress, such as T1a, T1b and T2a with commissure involvement. Furthermore, the complexity of the surgical approach using transoral CO2 laser microsurgery requires surgical skill, appropriate equipment and experience. Aspects to be reviewed in this document are: an updated anatomical definition of the anterior commissure, tumour progression based on histopathological studies, usefulness of videostroboscopy and NBI in diagnostic accuracy, validity of imaging tests, oncological results published in series reviews, systematic reviews and meta-analyses, tumour margin treatment and voice evaluation.Finally, by way of a summary, the document includes a series of recommendations for the treatment of these tumours.

Tumores glóticos precoces con afectación de la comisura anterior. Revisión bibliográfica y documento de consenso. Comisión de cabeza y cuello y base de cráneo. SEORL-CCC / Early glottic tumours with anterior commissure involvement. Literature review and consensus document. Head and Neck and Skull Base Commission, SEORL-CCC

La elección del tratamiento más adecuado en el cáncer glótico en estadio precoz con afectación de la comisura anterior sigue siendo controvertida. La complejidad en su manejo terapéutico está justificada por ser un significativo indicador pronóstico de control local, con un porcentaje de recidiva del 37%, por la dificultad en establecer la extensión tumoral con una infraestadificación que llega a alcanzar el 40%, y por la comparación de resultados en series formadas por tumores de diferente comportamiento evolutivo, como son T1a, T1b y T2a con afectación comisural. A estos datos se suma la complejidad del abordaje quirúrgico mediante microcirugía transoral con láser CO2 que requiere habilidad quirúrgica, equipamiento adecuado y experiencia. Los aspectos a revisar en este documento son: definición anatómica actualizada de la comisura anterior, progresión tumoral en función de estudios histopatológicos, utilidad de la videoestroboscopia y la NBI en la precisión diagnóstica, validez de las pruebas de imagen, resultados oncológicos publicados en revisión de series, revisiones sistemáticas y metaanálisis, tratamiento de los márgenes y evaluación de la voz. Finalmente, y a modo de resumen, el documento incluye una serie de recomendaciones para el tratamiento de estos tumores

The choice of the most appropriate treatment in early-stage glottic cancer with anterior commissure involvement remains controversial. Its therapeutic management is complex because it is a significant prognostic indicator of local control with 37% recurrence, due to the difficulty in establishing tumour extension with understaging of up to 40%, and due to the comparison of results in series on tumours that behave variably as they progress, such as T1a, T1b and T2a with commissure involvement. Furthermore, the complexity of the surgical approach using transoral CO2 laser microsurgery requires surgical skill, appropriate equipment and experience. Aspects to be reviewed in this document are: an updated anatomical definition of the anterior commissure, tumour progression based on histopathological studies, usefulness of videostroboscopy and NBI in diagnostic accuracy, validity of imaging tests, oncological results published in series reviews, systematic reviews and meta-analyses, tumour margin treatment and voice evaluation.Finally, by way of a summary, the document includes a series of recommendations for the treatment of these tumours

A predictive model for recurrence in patients with glottic cancer implemented in a mobile application for Android.

OBJECTIVES: The existing predictive models of laryngeal cancer recurrence present limitations for clinical practice. Therefore, we constructed, internally validated and implemented in a mobile application (Android) a new model based on a points system taking into account the internationally recommended statistical methodology. MATERIALS AND METHODS: This longitudinal prospective study included 189 patients with glottic cancer in 2004-2016 in a Spanish region. The main variable was time-to-recurrence, and its potential predictors were: age, gender, TNM classification, stage, smoking, alcohol consumption, and histology. A points system was developed to predict five-year risk of recurrence based on a Cox model. This was validated internally by bootstrapping, determining discrimination (C-statistics) and calibration (smooth curves). RESULTS: A total of 77 patients presented recurrence (40.7%) in a mean follow-up period of 3.4 ±â€¯3.0 years. The factors in the model were: age, lymph node stage, alcohol consumption and stage. Discrimination and calibration were satisfactory. CONCLUSION: A points system was developed to obtain the probability of recurrence of laryngeal glottic cancer in five years, using five clinical variables. Our system should be validated externally in other geographical areas.

Manifestación laríngea de linfoma no Hodgkin de células B / Laryngeal manifestation of B-cell non-Hodgkin lymphoma

Los linfomas laríngeos primarios son raros, representando menos del 1% de ellos. Los linfomas no Hodgkin (LNH) extranodales aparecen generalmente en lugares donde hay tejido linfoide como el intestino delgado o la parótida, siendo muy raros en órganos con poca o ausente cantidad de este tejido como la laringe. Cuando se encuentran en estadios avanzados, su debut laríngeo ha sido poco documentado. Presentamos el caso de un LNH linfocítico de células pequeñas en estadio IV E con primera manifestación clínica a nivel laríngeo, así como su manejo y seguimiento evolutivo(AU)

Laryngeal lymphomas are rare, involving less than 1% of all laryngeal tumours. Extranodal non-Hodgkin lymphomas generally appear in places where lymphoid tissue exists, such as the small bowel or parotid; they are very unusual in organs with little or no presence of lymphoid tissue, such as the larynx. When advanced stages are established, initial lymphoma manifestation at the laryngeal level has rarely been documented. We present a case of a small cell lymphocytic lymphoma at stage IV/E with initial laryngeal symptoms and indicate its management and follow up(AU)

Cordoma extraóseo de nasofaringe en edad pediátrica / Extraosseous chordoma of nasopharynx in paediatric age

Los cordomas intracraneales son tumores relativamente raros localmente agresivos, que probablemente se originan de remanentes embrionarios de la notocorda. La localización primaria más frecuente es el sacro, seguida en orden de frecuencia por el clivus. Cuando los cordomas de base de cráneo tienen una localización extraósea (sin destrucción lítica del hueso) mimetizan cualquier otra lesión de nasofaringe. Presentamos el caso de un cordoma extraóseo primario en edad pediátrica que se origina en la nasofaringe, con la intención de mejorar el diagnóstico y tratamiento postoperatorio de este raro tumor(AU)

Intracranial chordomas are relatively rare locally aggressive tumours that probably originate from embryonic remnants of the notochord. They typically arise from the sacrum and secondly in the skull base/clivus region. When skull base chordomas occur at an extraosseous location (without lytic bone destruction), they may mimic other lesions of the nasopharynx. We present a case of primarily extraosseous chordoma in paediatric age, involving the nasopharynx, to improve preoperative diagnosis and postoperative management of this rare tumour(AU)

Laryngeal manifestation of B-cell non-Hodgkin lymphoma.

Laryngeal lymphomas are rare, involving less than 1% of all laryngeal tumours. Extranodal non-Hodgkin lymphomas generally appear in places where lymphoid tissue exists, such as the small bowel or parotid; they are very unusual in organs with little or no presence of lymphoid tissue, such as the larynx. When advanced stages are established, initial lymphoma manifestation at the laryngeal level has rarely been documented. We present a case of a small cell lymphocytic lymphoma at stage IV/E with initial laryngeal symptoms and indicate its management and follow up.

Extraosseous chordoma of nasopharynx in paediatric age.

Intracranial chordomas are relatively rare locally aggressive tumours that probably originate from embryonic remnants of the notochord. They typically arise from the sacrum and secondly in the skull base/clivus region. When skull base chordomas occur at an extraosseous location (without lytic bone destruction), they may mimic other lesions of the nasopharynx. We present a case of primarily extraosseous chordoma in paediatric age, involving the nasopharynx, to improve preoperative diagnosis and postoperative management of this rare tumour.

Papilomas y papilomatosis laríngea. Tratamiento con láser CO2. Nuestra experiencia en 15 años / Papillomas & laryngeal papillomatosis. Treatment with CO2 laser surgery. Our experience over 15 years

Objetivo: Mostrar la experiencia con microcirugía láser CO2 como tratamiento de la papilomatosis laríngea. Analizamos parámetros diversos, entre ellos: edad media, género, tasa de recidiva, serotipo viral. Material y método: Se realiza un estudio descriptivo retrospectivo, recogiendo 29 casos diagnosticados y tratados de papiloma laríngeo mediante microcirugía asistida con láser CO2, entre 1995 y 2010. Resultados: Esta patología es más prevalente en el sexo masculino, 65,5%; con leve predominio de única localización laríngea frente a multilocalización de lesiones. Se detectó DNA vírico del Virus del Papiloma Humano (HPV) en el 75,8% de los casos, predominaron los subgrupos 6 y 11, entre otros. Presentaron recidiva el 44,8% de los casos, con una media de recidiva de 2–3 episodios por paciente. Se encuentran en remisión (sin recidiva en últimos 2 meses) el 20,7% de casos; en aclaramiento (sin recidiva aparente en últimos 3 años) el 34,5% y en curación (sin recidiva en últimos 5 años) el 41,3%. Presentó malignización un caso. Conclusión: La papilomatosis se caracteriza por ser una patología de curso impredecible, con probabilidad baja de malignizar y en la que la microcirugía láser carbónico ha supuesto una revolución con respecto a su tratamiento sintomático, porque aún no se ha descubierto el tratamiento curativo (AU)

Objectives: The study goal was to evaluate the efficacy of CO2 laser surgery in the treatment of laryngeal papillomatosis. We analysed several parameters such as gender, average age, relapse rate and viral serotype. Material and methods: A total of 26 diagnosed patients were included in this retrospective descriptive review. All of them were treated with CO2 laser for laryngeal papillomas between 1995 and 2010. Results: This pathology was more prevalent in males (65.5%), with a slight predominance of a single larynx localisation over multiple lesion locations. Human papillomavirus (HPV) DNA was detected in 75.8% of the cases; genotypes 6 and 11 prevailed. Of the patients in this review, 44.8% relapsed; the relapse average was 2–3 episodes per patient. A total of 20.7% of cases were in remission (no relapse in the last 2 months); 34.5%, clearing (no apparent relapse in the last 3 years); and 41.3% in the healing stage (without relapse in the last 5 years). There was only one case that showed malignancy. Conclusion: Papillomatosis is characterised as a pathology with an unpredictable course and with a low probability of malignancy. CO2 laser surgery has meant a revolution in symptomatic treatment, but there is presently no curative treatment (AU)

[Papillomas & laryngeal papillomatosis. Treatment with CO2 laser surgery. Our experience over 15 years]. / Papilomas y papilomatosis laríngea. Tratamiento con láser CO2. Nuestra experiencia en 15 años.

OBJECTIVES: The study goal was to evaluate the efficacy of CO2 laser surgery in the treatment of laryngeal papillomatosis. We analysed several parameters such as gender, average age, relapse rate and viral serotype. MATERIAL AND METHODS: A total of 26 diagnosed patients were included in this retrospective descriptive review. All of them were treated with CO2 laser for laryngeal papillomas between 1995 and 2010. RESULTS: This pathology was more prevalent in males (65.5%), with a slight predominance of a single larynx localisation over multiple lesion locations. Human papillomavirus (HPV) DNA was detected in 75.8% of the cases; genotypes 6 and 11 prevailed. Of the patients in this review, 44.8% relapsed; the relapse average was 2-3 episodes per patient. A total of 20.7% of cases were in remission (no relapse in the last 2 months); 34.5%, clearing (no apparent relapse in the last 3 years); and 41.3% in the healing stage (without relapse in the last 5 years). There was only one case that showed malignancy. CONCLUSION: Papillomatosis is characterised as a pathology with an unpredictable course and with a low probability of malignancy. CO2 laser surgery has meant a revolution in symptomatic treatment, but there is presently no curative treatment.