Head and neck squamous cell carcinoma in childhood

Abstract

Background Squamous cell carcinoma (SCC) of the head and neck region is rare in young patients and even less frequent in children 15 years or younger children. The patients reported in the literature are isolated cases and their management is always difficult because there is no large experience or a convincing theory to support treatment decisions for every child. Procedures and Results. Four patients aged 15 years or younger were treated for SCC of head and neck between 1977 and 1995 at the Head and Neck Service of Heliópolis Hospital, São Paulo, Brazil, and with this paper we are reporting our experience with their treatment, including a genetic investigation in two cases (immunohistochemical analysis using monoclonal antibodies against p53 and c‐erbB‐2 oncogenes). These patients had no history of tobacco or ethanol abuse and no history of cancer in their families. Many authors attribute an unusual aggressiveness to SCC in childhood, with propensity to locoregional recurrence and high death rates and therefore, propose aggressive multidisciplinary therapy. Our cases, with the exception of one, had an early diagnosis and were treated using the same method we use for adults; the results were very good. Conclusions. We recommend for these cases the same protocol as for older patients. In these cases, however, the primary lesion is resected with a safety margin which is usually 2 to 3 mm larger than usual safety margins and selective neck dissection is routinely indicated. This management is adopted in an attempt to avoid postoperative irradiation which may prove to be dangerous in the future for young patients. On the other hand, we recognize that due to a small number de patients, definitive treatment recommendations cannot be made at this time. Med. Pediatr. Oncol. 31:96–99, 1998. © 1998 Wiley‐Liss, Inc.

Hypopharyngeal squamous cell carcinoma in a child

“…They may be mistakenly attributed to commonly occurring upper respiratory tract infections or to normal pubertal hoarseness [2]. Our patient was admitted to a local hospital with progressively increasing dysphagia and a bilateral painless cervical mass.…”

“…It is extremely rare in children and only a handful of cases have been reported. It is localized in the larynx, hypopharynx, and esophagus [1][2][3][4][5]. To date, five cases of hypopharyngeal squamous cell carcinoma have been reported [4][5][6].…”

Outcomes of oral cavity squamous cell carcinoma in pediatric patients

“…Oral cavity squamous cell carcinoma (OCSCC) is rare in pediatric patients (defined by the American Academy of Pediatrics as patients under age 21), accounting for approximately 1 in 1,000 cases1–4. OCSCC in pediatric patients is believed to be etiologically distinct from adult OCSCC, because the usual risk factors such as tobacco and alcohol exposure are typically absent5.…”

“…Many clinicians believe that this disease is particularly aggressive in young patients, and is associated with poorer survival compared to adults3,5–8. Because of the rarity of OCSCC in pediatric patients, the literature consists entirely of isolated case reports, many of which report poor outcomes1,3,8–16. Much of the opinion regarding OCSCC in this age group has been extrapolated from studies of young adults under 40 years of age7,17–22.…”

Pediatric squamous cell carcinoma arising in an alpha‐fetoprotein‐producing mature cystic teratoma of the mandible

“…Children with these lesions require prompt and proactive multidisciplinary therapy [10]. A squamous cell carcinoma arising in an intravertebral and paravertebral teratoma in a 7-year-old male was reported.…”