FNAC is a useful tool in the evaluation of parotid masses but should be used with caution in identifying neoplastic subtypes.

Background: Head and neck squamous cell carcinoma, and in particular hypopharyngeal squamous cell carcinoma, has long been associated with disfiguring treatment options, significant morbidity and limited long-term survival outcomes. Total pharyngolaryngectomy (TPL) with free flap reconstruction followed by post-operative radiation therapy or chemoradiotherapy is a widely accepted treatment of choice for advanced disease of the hypopharynx. Methods: Our unit undertook a 11-year review of all primary TPL patients aiming to provide an update on survival outcomes, morbidity, post-operative complications and evolving management strategies. We report one of the largest single-centre series to date with 89 patients undergoing primary TPL between 2003 and 2013, and compare these outcomes to 180 patients undergoing TPL at the same facility in the previous 23 years. Results: Between study periods, we saw a shift in patient population towards higher stage disease (T-stage 3 or 4

Previous research in the Drug Discovery laboratory at the QIMR Berghofer Medical Research Institute has demonstrated anti-tumoural action of a novel diterpene ester known as EBC-46 when injected intra-tumourally into a range of subcutaneous animal tumour models. The compound has recently completed a Phase I clinical trial in humans for treatment of cutaneous and subcutaneous malignancy, demonstrating safe administration as the primary endpoint and promising efficacy. Some trial patients experienced localised swelling and pain on injection of EBC-46, limiting the use of the compound where vital structures may be compromised. Hence, the aim of these studies was to investigate methods of limiting the inflammatory reaction either with concurrent use of antiinflammatory agents or by replacing EBC-46 with potentially slow-releasing prodrugs, developed in collaboration with chemist and industry researchers. In vivo murine studies aimed at reducing tumour swelling induced by intra-tumoural injection of EBC-46 by concurrent injection of anti-inflammatory agents did not show any statistically significant reduction in tumour swelling. Injection of EBC-46 into subcutaneous SCC tumours on the hindquarters of mice resulted in up to 470% increase in tumour volume within 60 minutes. Whilst concurrent anti-inflammatory treatment did not statistically reduce swelling, combined intratumoural and intra-peritoneal dexamethasone showed a clinically apparent reduction. Four synthetic C-20 esters of EBC-46, synthesised as potential slow-release drugs, were tested in vitro and in vivo to assess anti-tumour efficacy, Protein Kinase C (PKC) activity and induction of respiratory burst in human neutrophils. The four C-20 esters, known as EBC-1040, EBC-1073, EBC-1074, and EBC-1075 are differentiated by lengthening carboxylic acid chains on the C-20 ester of EBC-46. EBC-46 has previously been demonstrated to have strong activation of PKCβI and-βII and this was again demonstrated in our experimental work. The C-20 esters also demonstrated strong PKCβI and-βII activation however with reducing efficacy occurring with