Despite the higher sensitivity of serum CT measurement, as compared with FNAC to diagnose MTC (98% vs. 63%), only 9% of patients might have escaped to surgery based on FNAC results. However, indication for surgery based on suspicious FNAC may not alert the surgeon for the need of a TT and exploration of nodes at least in the central compartment.
There has been an increase in the incidence of carcinoma of the tongue, particularly among alcohol and tobacco non-users. However, the number of studies that would allow a better understanding of etiological factors and clinical features, particularly in the Portuguese population, is very limited. This study was based on patients with squamous cell carcinoma of the anterior two thirds of the tongue that were treated at the Department of Head and Neck Surgery of the "Instituto Portugues de Oncologia de Lisboa - Francisco Gentil" (IPOLFG) in Lisbon, Portugal, between January 1, 2001 and December 31, 2009. The patients were divided in alcohol and tobacco users and non-users in order to evaluate the differences between these 2 groups based on gender, age, tumor location, denture use, and tumor size, metastasis and stage. Of the 354 cases, 208 were users and 146 were non-users. The main location in both groups was the lateral border of the tongue. Denture use showed no significant effect in both study groups. It was possible to conclude that patients who did not drink or smoke were older and presented with smaller tumor size, lower incidence of ganglion metastasis and lower tumor stage compared with alcohol and tobacco users.
Thirty-nine cases of mucoepidermoid carcinoma of the salivary glands were reviewed for a reappraisal of the influence of the grade of differentiation on the outcome of the disease. The age of the patients ranged between 7 and 84 years. Fifteen patients were females and 24 males. The tumors were located at the parotid gland (n = 30), the submaxillary gland (n = 1), the soft palate (n = 5) and the oral mucosa NOS (n = 3). At presentation 4 tumors were intraglandular and 35 extraglandular; three patients had lymph node metastases and one patient lung metastases. The grade of differentiation was assessed using the criteria of Healey et al. Twelve tumors were classified as grade I, 17 as grade II, and 10 as grade III. Follow-up information was obtained with a duration of 5-144 months (mean 44.7 months). Six cases recurred locally and 5 developed metastases. Five years cumulative survival was 100% for grade I, 70.1% for grade II, and 47.2% for grade III. The results point to the usefulness of the assessment of the grade of differentiation as a guide to anticipate the outcome of the disease.
The finding of higher PDS, TPO and TSH-R mRNA expression in paediatric vs. adult primary tumour tissues supports the hypothesis that this might contribute to the increased functional activity of metastases in the paediatric group. The finding that mRNA expression of the target genes in NTT was not age dependent does not provide an explanation for the higher susceptibility in the paediatric group.
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