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Liposarcomas of the head and neck are rare. There have been 25 previously reported patients in the literature. Four patients with head and neck liposarcomas, recently treated by the Head and Neck Surgery Service, Walter Reed Army Medical Center, are presented. Less than half of reported patients were noted to be living without evidence of disease. Prognosis generally corresponds to the cell type of the tumor. Intraoral, cheek and orbital tumors seem to have a worse prognosis compared to neck tumors. Wide local excision remains the treatment of choice. Advances in surgical techniques have allowed adequate therapy for most head and neck liposarcomas. Advanced lesions should be managed by conservative surgery and radical radiation therapy.

The prognosis of giant and spindle cell carcinoma of the thyroid is extremely poor. It does appear, however, that a multisciplinary approach to treatment of this aggressive cancer is more effective than a single-treatment modality. Operative ablation of gross tumor, postoperative irradiation therapy, and chemotherapy have demonstrated encouraging results. A different therapeutic approach with the addition of immunotherapy to surgical resection, postoperative irraditation, and chemotherapy is described in this case report. The preliminary result is encouraging.

The following case report describes a 22-year-old healthy man, non-smoker, non-drinker, who developed a squamous cell carcinoma of the buccal mucosa. The appearance of this unusual tumor in an unexpected clinical setting was unexplained until it was discovered that the patient had a lifetime habit of chewing plastic materials containing polyvinyl chloride (PVC). The extent and chronicity of his intense oral exposure to PVC is believed to be related to his subsequent development of an oral neoplasm. Attention is again focused on PVC as an important environmental toxin and carcinogenic agent. Clarification of the content of PVC in consumer products is urged. Physicians must remain aware of possible environmental carcinogens in patients presenting with unexpected or rare malignancies. Detection of such exposure may well prevent subsequent development of additional unexplained neoplasms.

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