This paper reviews 22 cases of minor salivary gland carcinoma of the oral cavity or oropharynx which were treated at Kurume University Hospital between 1976 and 2005. Minor salivary gland carcinoma was observed in eight of 362 patients with cancer of the oral cavity (2 per cent), and in 14 of 275 patients with cancer of the oropharynx (5 per cent). The five-year and 10-year survival rates of patients with oropharyngeal minor salivary gland carcinoma were 90 per cent. No statistically significant difference was observed between survival rates for oropharyngeal minor salivary gland carcinoma and for oropharyngeal squamous cell carcinoma (p = 0.06). The five- and 10-year survival rates of patients with oral cavity minor salivary gland carcinoma were 75 and 37 per cent, respectively. No statistically significant difference was observed between survival rates for oral cavity minor salivary gland carcinoma and oral cavity squamous cell carcinoma.Patients' survival results correlated well with the clinical stage of their lesions. A significant difference in survival was observed, comparing stage IV with stages I, II and III (p = 0.04). In contrast, no significant relationship was found between either survival and tumour type or survival and treatment. Adjuvant therapy is recommended for patients with grade III adenoid cystic carcinoma with perineural infiltration or intravascular infiltration.
This study reviewed 24 cases of parapharyngeal space tumour treated at Kurume University Hospital between 1990 and 2007. Histological diagnoses were generally obtained from the excised tumour (22/24). Seventy-seven per cent of the parapharyngeal space tumours were benign and 23 per cent were malignant. Thirty-eight per cent (eight of 22) of these tumours were pleomorphic adenomas and 23 per cent (five of 22) were schwannomas. A transparotidectomy and transcervical approach were used in 88 per cent (15/17) of benign tumours. A mandibular swing approach was used for one malignant tumour. Post-operative complications were identified in 16 of 22 patients. The most common complication, facial nerve paralysis, was identified in eight patients, and seven of these patients demonstrated first bite syndrome. In consideration of the high incidence of post-operative complications, the surgical approach should therefore be carefully selected when treating patients with parapharyngeal space tumours.
Epithelioid sarcoma is an aggressive, malignant tumour of the soft tissue which tends to arise in proximity to large tendons and aponeuroses. We report the case of a patient presenting with an epithelioid sarcoma arising in the neck. A 56-year-old man was referred with a three-year history of a sensory disorder as well as a slowly growing mass in his right neck. The patient underwent resection of the tumour by means of a conservative neck dissection. The final diagnosis, based on the histological and immunohistochemical findings, was epithelioid sarcoma. Radiotherapy was performed after the operation. The post-operative course was uneventful, and there was no local recurrence or distant metastasis.
The clinical characteristics of lymph node metastasis in maxillary cancer patients were analyzed. Thirty-eight (23%) of the 166 patients who received intial treatment at Kurume University Hospital between 1978 and 2003 had cervical lymph node metastasis at the time of diagnosis. The disease-specific 5-year survival rate was 63% in the lymph node metastasis negative group and 18% in the lymph node metastasis positive group (p<0.01). There was a statistically significant correlation between bone invasion and lymph node metastasis in the case of the group with bone invasion of the posterior wall of the maxillary sinus. Cervical neck lymph node metastasis developed in 38 (28%) of 135 posterior-wall-invasion-positive group and in none (0%) of the 31 patients in the negative group (p<0.01). Because distant metastasis is common in patients with lymph node metastasis, postoperative adjuvant chemotherapy is highly recommended.
In patients with glottic carcinoma, invasion of cancer into the paraglottic space or cricoid area is an important prognostic factor for the development of cervical lymph node metastasis.
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