Squamous Carcinomas of the Head and Neck: Some Patterns of Spread

Abstract

Summary: Patterns of tumour spread are examined in 160patients with squamous carcinomas of the head and neck with reference to perineural infiltration, direct invasion of bone and ossified cartilage, and lymph node metastases in the previously irradiated neck. Perineural spread is comparatively common in large (T3, T4) tumours; it may be apparent early in the disease; it is often detectable clinically; and it is an adverse prognostic feature which may modify clinical management. Direct bone invasion is described with particular reference to tumours of the oral cavity. Most bone destruction is mediated by osteoclasts which appear to be stimulated by materials such as prostaglandins released in the vicinity of the tumour. The numbers of involved lymph nodes in surgical dissections from the irradiated neck are usually few and restricted to the submandibular and jugular groups; nodes in the posterior triangle are infrequently involved by metastatic carcinoma. Transcapsular spread and keratin granulomas are common. The scope of modified neck dissections in this group of patients is discussed.

Some mechanisms of local bone destruction by squamous carcinomas of the head and neck

“…The slides were coded beforehand, but histological differences between the 2 groups were readily apparent (Fig. 4) Carter & Pittam, 1980;Carter & Tanner, 1979). These morphological features are not specific, and the changes observed are comparable to those associated with the growth of blood-borne skeletal metastases of various kinds (Galasko, 1975(Galasko, , 1976.…”

“…The morphological process of direct bone invasion by squamous carcinomas of the head and neck involves 3 phases Carter & Pittam, 1980). The periosteum is first breached and tumour cells infiltrate into the underlying bone.…”

Ten human carcinoma cell lines derived from squamous carcinomas of the head and neck

“…Detailed clinicopathological studies of the patterns of spread of squamous carcinomas of the head and neck into perineural spaces, bone and cartilage, and to regional lymph nodes, have been reported Carter & Pittam, 1980;Tanner et al, 1980); current investigations are concerned with some of the underlying mechanisms, with particular respect to tumourassociated destruction of soft tissues and bone (Tsao et al, 1981). The information that can be obtained from examining fresh tumours is somewhat limited, and access to a number of continuous cell lines derived from squamous carcinomas of the head and neck would considerably facilitate investigations of the behaviour and properties of these tumours.…”

Release of Proteinases by Cultures of Human Cell Lines Derived from Squamous Carcinomas of the Tongue and Larynx

“…On the basis of clinicopathological studies, the patterns of spread of these carcinomas have been re ported [3][4][5]16]. Particular interest was con cerned with the mechanisms of invasion, as the tumor-associated destruction of soft tis sues and bone [17], the production of pro teinases, with emphasis to the collagénases [10,11] and plasminogen activators [7], and the locomotory activity of squamous carci noma cells [8].…”