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Results for “NECK NEOPLASMS”

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PubMed1986

Neck neoplasms: MR imaging. Part II. Posttreatment evaluation.

Thirty-three patients who had undergone prior surgery and/or radiation therapy for malignant neoplasms of the neck were studied with magnetic resonance (MR) imaging. Twenty-seven of these patients were also evaluated with computed tomography (CT). Ten patients were healthy posttreatment volunteers, and 23 had documented tumor recurrence. MR images better demonstrated normal muscular landmarks, especially in patients with obliterated fat planes. Areas of posttreatment fibrosis or scarring were low in signal intensity with all MR pulse sequences. However, in three patients, high signal intensity from postradiation edema of the supraglottic area mimicked neoplasm. In patients with recurrent tumor, MR imaging was superior to CT in defining the relationship of tumor and muscle and in demonstrating vascular anatomy when no intravenous contrast material was given during the CT examination. In two patients tumor and fibrosis were separated on MR images because of signal intensity differences. CT scans, however, showed adjacent bone and cartilage anatomy better. Our data indicate that an MR examination may be helpful in patients in whom CT is indeterminate either because of anatomical distortion or suboptimal demonstration of vascular anatomy.

Head and Neck Neoplasms↗
PubMed1997

Comparison of dynamic contrast-enhanced gradient-echo and spin-echo sequences in MR of head and neck neoplasms.

PURPOSE: To investigate the utility of dynamic contrast-enhanced gradient-echo MR imaging of head and neck lesions and to compare this technique with the commonly used spin-echo contrast-enhanced fat-saturation technique. METHODS: Twenty-two patients with a total of 23 head and neck neoplasms underwent dynamic gradient-echo and spin-echo MR imaging studies. The spin-echo and dynamic gradient-echo images were compared in each case by consensus of three observers for differences in tumor conspicuity and delineation of margins, particularly with regard to invasion of adjacent structures. When possible, pathologic and/or surgical confirmation of tumor extent was obtained. Relative contrast was also calculated to determine objectively the degree of tumor enhancement with respect to background mucosa. RESULTS: The dynamic gradient-echo images showed better or equal delineation of the tumor margins by subjective observation in all but two cases. Temporally different enhancement patterns were noted for lesions, background mucosa, and adjacent reaction and edema. The dynamic gradient-echo technique provided better relative contrast than the spin-echo technique in 17 (77%) of 22 lesions. CONCLUSION: Dynamic gradient-echo MR imaging is superior to conventional contrast-enhanced spin-echo imaging in delineating the margins and extent of tumor. This technique provided observers with added confidence in their interpretations and suffered from fewer technical limitations.

Adult↗
PubMed2003

[Postoperative rupture of carotid artery in head and neck neoplasms].

OBJECTIVE: To explore the treatment of neoplasms in head and neck invaded the carotid artery. METHODS: Four cases with postoperative rupture of carotid artery invaded by the head and neck cancer were reviewed. The tumours were taken off from the carotid arteries and the carotid artery remained. RESULT: Rupture of carotid artery occurred in 4 patients within one week after radical neck dissection. One patient died because of its rupture again after repair. The other three survived after ligating the artery. CONCLUSION: The carotid artery involved by tumour of head and neck should be prepared for resection before operation. If the artery was obviously invaded by the tumour, both the tumour and artery should be resected together. Once the rupture of the artery occurred after operation, the artery must be ligated instead of being repaired.

Carotid Artery Diseases↗
PubMed1998

[Diagnostic imaging of the salivary glands in patients undergoing radiotherapy of head and neck neoplasms].

INTRODUCTION: Radiotherapy of head and neck cancers changes the shape and function of the salivary glands included in the treated region. We investigated the morphological and functional alterations in the major salivary glands in 15 patients treated with radiotherapy for head and neck cancers (total dose: 55-66 Gy). MATERIAL AND METHODS: All the patients underwent B-mode and power Doppler US, CT and 99mTC salivary scintigraphy, before, at the end, and 60-80 days after radiotherapy. RESULTS: At the end of treatment, US showed irregular margins and inhomogeneous parenchymal echogenicity in 13 parotid and in eight submandibular glands. Doppler US showed of focal hyperemia and focally decreased or no intraparenchymal flow in nine parotid and in two submandibular glands. CT demonstrated parenchymal inhomogeneity with increased and decreased density areas, cancers irregular margins, and gland atrophy in 15 parotid and in eight submandibular glands. Salivary scintigraphy depicted injuries of the major salivary glands detecting their reduced pertechnetate uptake in 12 parotid and in eight submandibular glands, with a decreased drug excretion in 12 parotid and in 12 submandibular glands. DISCUSSION AND CONCLUSION: Our findings confirm that the major salivary glands are affected by radiotherapy, which makes their morphological and structural monitoring of vital importance. US is the technique of choice for its low cost and easy execution, and it is well accepted by the patients because it requires no exposure to ionizing radiations. Power Doppler provided no relevant information, but it confirmed the high resistance of small and middle caliber vessels after radiotherapy. Scintigraphy clearly showed the glands involvement demonstrating decreased uptake technetium secretion and excretion. In conclusion, US and CT are both extremely useful in the study of the morphological changes of the major salivary glands.

Adult↗
PubMed1985

Immunohistochemical localization of keratin in head and neck neoplasms and normal tissues.

Immunohistochemical localization of keratin antigens using keratin antisera and the immunoperoxidase technique have been shown to be helpful in identifying certain epithelial cells. Our study was designed to evaluate the application of this technique to head and neck neoplasms and normal tissues using two keratin antibody preparations. Our data indicate that the keratin antibodies stained normal epithelial structures in the head and neck except for cells with active secretory functions such as mucus, cerumen, or salivary secretion. Neoplasms of the head and neck showed keratin antibody staining for epithelial neoplasms and negative staining for mesenchymal neoplasms. The immunohistologic demonstration of keratin is useful in distinguishing undifferentiated or poorly differentiated epithelial malignancies from sarcomas or lymphomas and demonstrating myo-epithelial cells in salivary neoplasms.

Animals↗
PubMed1993

Reirradiation of head and neck neoplasms using twice-a-day scheduling.

Between 1985 and 1988, we have explored the value of twice-a-day (BID) irradiation for the retreatment of head and neck neoplasms. In this pilot study of ten patients we used a schedule of BID irradiation at fraction sizes between 1.4 and 1.6 Gy separated by at least 6 h. Of the four patients were treated with curative intent, three patients received 30 Gy in 20 fractions over twelve days followed within ten days by an interstitial/intracavitary Ir-192 implant boost to doses of 30 to 40 Gy and one patient was treated with a 32 Gy BID boost. Four patients were reirradiated with aggressive palliation and received 45 Gy in 30 fractions over 26 days including a break in the third week. The remaining two patients were treated with palliative intent to 30 Gy in 20 fractions over twelve days. Eight patients were treated for recurrent/persistent or second carcinomas, one for a recurrent glomus jugulare tumor. At a median follow-up of 36 months, ranging from six to 61 months, nine of ten patients experienced excellent symptomatic relief. Five patients are alive and free of tumor, one patient is alive with distant metastases, and two each are dead from local or systemic tumor progression. All four patients retreated for cure are alive with no evidence of local disease. The tolerance and tumor control rate of the BID reirradiation schedule were good with severe late sequelae in only one patient.

Aged↗
PubMedDate not supplied

Preoperative embolization of hypervascular head and neck neoplasms using microfibrillar collagen.

Microfibrillar collagen is a bovine collagen material that promotes hemostasis. When mixed with contrast material it makes a fine slurry that is easily injected through small catheters. Experience with preoperative embolization of head and neck neoplasms in six patients indicates that microfibrillar collagen slurry is a highly effective, easy to use embolic material for occlusion of highly vascular neoplasms.

Adolescent↗
PubMed2002

Effect of multileaf collimator leaf width on physical dose distributions in the treatment of CNS and head and neck neoplasms with intensity modulated radiation therapy.

The purpose of this work is to examine physical radiation dose differences between two multileaf collimator (MLC) leaf widths (5 and 10 mm) in the treatment of CNS and head and neck neoplasms with intensity modulated radiation therapy (IMRT). Three clinical patients with CNS tumors were planned with two different MLC leaf sizes, 5 and 10 mm, representing Varian-120 and Varian-80 Millennium multileaf collimators, respectively. Two sets of IMRT treatment plans were developed. The goal of the first set was radiation dose conformality in three dimensions. The goal for the second set was organ avoidance of a nearby critical structure while maintaining adequate coverage of the target volume. Treatment planning utilized the CadPlan/Helios system (Varian Medical Systems, Milpitas CA) for dynamic MLC treatment delivery. All beam parameters and optimization (cost function) parameters were identical for the 5 and 10 mm plans. For all cases the number of beams, gantry positions, and table positions were taken from clinically treated three-dimensional conformal radiotherapy plans. Conformality was measured by the ratio of the planning isodose volume to the target volume. Organ avoidance was measured by the volume of the critical structure receiving greater than 90% of the prescription dose (V(90)). For three patients with squamous cell carcinoma of the head and neck (T2-T4 N0-N2c M0) 5 and 10 mm leaf widths were compared for parotid preservation utilizing nine coplanar equally spaced beams delivering a simultaneous integrated boost. Because modest differences in physical dose to the parotid were detected, a NTCP model based upon the clinical parameters of Eisbruch et al. was then used for comparisons. The conformality improved in all three CNS cases for the 5 mm plans compared to the 10 mm plans. For the organ avoidance plans, V(90) also improved in two of the three cases when the 5 mm leaf width was utilized for IMRT treatment delivery. In the third case, both the 5 and 10 mm plans were able to spare the critical structure with none of the structure receiving more than 90% of the prescription dose, but in the moderate dose range, less dose was delivered to the critical structure with the 5 mm plan. For the head and neck cases both the 5 and 10 x 2.5 mm beamlets dMLC sliding window techniques spared the contralateral parotid gland while maintaining target volume coverage. The mean parotid dose was modestly lower with the smaller beamlet size (21.04 Gy v 22.36 Gy). The resulting average NTCP values were 13.72% for 10 mm dMLC and 8.24% for 5 mm dMLC. In conclusion, five mm leaf width results in an improvement in physical dose distribution over 10 mm leaf width that may be clinically relevant in some cases. These differences may be most pronounced for single fraction radiosurgery or in cases where the tolerance of the sensitive organ is less than or close to the target volume prescription.

Dose-Response Relationship, Radiation↗
PubMed1992

[Evaluation of frequency of recurrence in malignant head and neck neoplasms in the years 1980-1990].

During the years 1980-1990 in the Otolaryngological Department of the Silesian Medical Academy in Katowice 452 patients with malignant neoplasms of the head and neck were treated. 154 (35%) patients treated by radiotherapy. 140 (30%) were operated, 133 (29%) were treated by both methods and 25 (6%) were treated symptomatically. 139 (30%) out of them have had the recurrencies after the treatment. The authors made the analysis of frequency of recurrencies in years 1980-86 in comparison with period 1987-90. The statistically significant increase of frequency of recurrencies in years 1987-1990 was found.

Adolescent↗
PubMed1988

The anaesthetic management of patients undergoing free flap reconstructive surgery following resection of head and neck neoplasms--a review of 64 patients.

A retrospective study was made of 64 patients who underwent free flap reconstructive surgery following resection of neoplasms, mainly in the head and neck region, over a period of approximately 4 years, from 1983 to 1987, in the Royal Marsden Hospital, London. A brief history of free flap surgery is presented, followed by a description of the anaesthetic technique used, and the results of the study. The various ways in which anaesthetic management may influence the results of surgery are discussed.

Adolescent↗
PubMed1995

[The accuracy of fine needle aspiration biopsy (BAC) for pathomorphological diagnosis of head and neck neoplasms].

The authors present the results of fine needle aspiration biopsy in 58 patients with tumors of head and neck. Cytological and pathomorphological correlation was evaluated in all patients. The highest accuracy of cyto-pathomorphological was obtained in parotid gland tumors, both benign and malign, and in lymph nodes of the neck. The lowest accuracy was obtained in tumors of the orbit.

Biopsy, Needle↗