1.A dysfunctional larynx dilemma: Carcinoma recurrence or radiation-induced damage?
Patricia Ann U. Soriano ; Arsenio Claro A. Cabungcal ; Cesar Vincent L. Villafuerte, III ; Anna Claudine F. Lahoz
Acta Medica Philippina 2023;57(11):97-101
A 61-year-old male diagnosed with laryngeal squamous cell carcinoma presented with hoarseness, progressive dysphagia leading to aspiration, and dyspnea one month after definitive radiation therapy. Examination revealed a diffusely swollen glottis, paralyzed vocal cords, and post-radiation fibrosis. Several glottic biopsies yielded results negative for malignancy and favored radiation-induced changes. When presented with the option of further diagnostic testing with a positron emission tomography (PET) scan or an outright laryngectomy, the patient decided on the latter. Final histopathologic diagnosis was negative for recurrence of malignancy.
This case demonstrates treatment dilemmas for patients with laryngeal carcinoma with uncertain recurrence wherein radical surgical management may prove to be a viable option to achieve both diagnostic certainty and ultimate relief of symptoms.
Laryngeal Neoplasms
;
Laryngectomy
;
Radiotherapy
2.Characteristics of lymph node metastasis of right recurrent laryngeal nerve in thoracic esophageal squamous cell carcinoma.
Chinese Journal of Oncology 2023;45(6):508-513
Objective: To understand the characteristics and influencing factors of lymph node metastasis of the right recurrent laryngeal nerve in thoracic esophageal squamous cell carcinoma (ESCC), and to explore the reasonable range of lymph node dissection and the value of right recurrent laryngeal nerve lymph node dissection. Methods: The clinicopathological data with thoracic ESCC were retrospectively analyzed, and the characteristics of lymph node metastasis along the right recurrent laryngeal nerve and its influencing factors were explored. Results: Eighty out of 516 patients had lymph node metastasis along the right recurrent laryngeal nerve, the metastasis rate was 15.5%. Among 80 patients with lymph node metastasis along the right recurrent laryngeal nerve, 25 cases had isolated metastasis to the right recurrent laryngeal nerve lymph node but no other lymph nodes. The incidence of isolated metastasis to the recurrent laryngeal nerve lymph node was 4.8% (25/516). A total of 1 127 lymph nodes along the right recurrent laryngeal nerve were dissected, 115 lymph nodes had metastasis, and the degree of lymph node metastasis was 10.2%. T stage, degree of tumor differentiation and tumor location were associated with right paraglottic nerve lymph node metastasis (all P<0.05). The lymph node metastasis rate along the right recurrent laryngeal in patients with upper thoracic squamous cell carcinoma (23.4%, 26/111) was higher than that of patients with middle (13.5%, 40/296) and lower (12.8%, 14/109) thoracic squamous cell carcinoma (P=0.033). In patients with poorly differentiated ESCC (20.6%, 37/180) the metastasis rate was higher than that of patients with moderately (14.6%, 39/267) and well-differentiated (5.8%, 4/69; P<0.05). The lymph node metastasis rate of patients with stage T4 (27.3%, 3/11) was higher than that of patients with stage T1 (9.6%, 19/198), T2 (19.0%, 16/84) and T3 (18.8%, 42/1 223; P<0.05). Multivariate regression analysis showed that tumor location (OR=0.61, 95% CI: 0.41-0.90, P=0.013), invasion depth (OR=1.46, 95% CI: 1.11-1.92, P=0.007), and differentiation degree (OR=1.67, 95% CI: 1.13-2.49, P=0.011) were independent risk factors for lymph node metastasis along right recurrent laryngeal nerve of ESCC. Conclusions: The lymph node along the right recurrent laryngeal nerve has a higher rate of metastasis and should be routinely dissected in patients with ESCC. Tumor location, tumor invasion depth, and differentiation degree are risk factors for lymph node metastasis along right recurrent laryngeal nerve in patients with ESCC.
Humans
;
Esophageal Squamous Cell Carcinoma/pathology*
;
Lymphatic Metastasis/pathology*
;
Esophageal Neoplasms/pathology*
;
Recurrent Laryngeal Nerve/pathology*
;
Retrospective Studies
;
Lymph Node Excision
;
Lymph Nodes/pathology*
;
Carcinoma, Squamous Cell/pathology*
;
Esophagectomy
3.Identification of biomarkers in laryngeal cancer by weighted gene co-expression network analysis.
Fengyu ZHANG ; Li SHE ; Donghai HUANG
Journal of Central South University(Medical Sciences) 2023;48(8):1136-1151
OBJECTIVES:
Laryngeal cancer (LC) is a globally prevalent and highly lethal tumor. Despite extensive efforts, the underlying mechanisms of LC remain inadequately understood. This study aims to conduct an innovative bioinformatic analysis to identify hub genes that could potentially serve as biomarkers or therapeutic targets in LC.
METHODS:
We acquired a dataset consisting of 117 LC patient samples, 16 746 LC gene RNA sequencing data points, and 9 clinical features from the Cancer Genome Atlas (TCGA) database in the United States. We employed weighted gene co-expression network analysis (WGCNA) to construct multiple co-expression gene modules. Subsequently, we assessed the correlations between these co-expression modules and clinical features to validate their associations. We also explored the interplay between modules to identify pivotal genes within disease pathways. Finally, we used the Kaplan-Meier plotter to validate the correlation between enriched genes and LC prognosis.
RESULTS:
WGCNA analysis led to the creation of a total of 16 co-expression gene modules related to LC. Four of these modules (designated as the yellow, magenta, black, and brown modules) exhibited significant correlations with 3 clinical features: The age of initial pathological diagnosis, cancer status, and pathological N stage. Specifically, the yellow and magenta gene modules displayed negative correlations with the age of pathological diagnosis (r=-0.23, P<0.05; r=-0.33, P<0.05), while the black and brown gene modules demonstrated negative associations with cancer status (r=-0.39, P<0.05; r=-0.50, P<0.05). The brown gene module displayed a positive correlation with pathological N stage. Gene Ontology (GO) enrichment analysis identified 77 items, and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis identified 30 related signaling pathways, including the calcium signaling pathway, cytokine-cytokine receptor interaction, neuro active ligand-receptor interaction, and regulation of lipolysis in adipocytes, etc. Consequently, central genes within these modules that were significantly linked to the overall survival rate of LC patients were identified. Central genes included CHRNB4, FOXL2, KCNG1, LOC440173, ADAMTS15, BMP2, FAP, and KIAA1644.
CONCLUSIONS
This study, utilizing WGCNA and subsequent validation, pinpointed 8 genes with potential as gene biomarkers for LC. These findings offer valuable references for the clinical diagnosis, prognosis, and treatment of LC.
Humans
;
Laryngeal Neoplasms/genetics*
;
Rosaniline Dyes
;
Biomarkers
;
Adipocytes
;
Gene Regulatory Networks
;
Gene Expression Profiling
4.A case of laryngeal carcinoma complicated with Hodgkin's lymphoma.
Mo CHEN ; Tingting YU ; Yongliang TENG ; Xiangyan CUI ; Xin WANG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2023;37(8):667-670
A case of laryngeal cancer complicated with Hodgkin's lymphoma treated in the Department of Otolaryngology Head and neck surgery of the First Hospital of Jilin University was reported. Under general anesthesia, right vertical partial laryngectomy, bilateral neck lymph node functional dissection and temporary tracheotomy were performed. No recurrence was found in laryngoscope and color Doppler ultrasound of neck lymph nodes 3 and 5 months after operation.
Humans
;
Laryngeal Neoplasms/surgery*
;
Hodgkin Disease/complications*
;
Neck/pathology*
;
Neck Dissection
;
Lymph Nodes/pathology*
;
Laryngectomy
;
Carcinoma/pathology*
5.Application of peroral endoscopic-assisted laryngeal microsurgery in children with laryngeal neurofibromas.
Qiyuan ZOU ; Hongbing YAO ; Yang YANG ; Xinye TANG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2023;37(12):960-963
Objective:To investigate the clinical manifestations and the effect of peroral endoscopic-assisted laryngeal microsurgery for children with laryngeal neurofibroma, and to provide clinical reference for the diagnosis and treatment of this disease. Methods:The clinical data of 4 children with laryngeal tumors admitted to the Department of Otorhinolaryngology, Children's Hospital of Chongqing Medical University from January 2021 to June 2023 were retrospectively analyzed. Laryngeal tumors were removed by peroral endoscopic-assisted laryngeal microsurgery. One case underwent tracheotomy at the same time, and one case was simultaneously performed with laryngeal T tube placement and tracheotomy. Results:Surgical resection is the best treatment for laryngeal neurofibroma, and laryngeal microsurgery should be actively used for patients with surgical indications.This surgical method has the advantages of good efficacy, minimal invasion, aesthetics and preservation of laryngeal function, which not only ensures safety, but also improves the quality of life after surgery, and has the value of development and promotion.
Child
;
Humans
;
Laryngeal Neoplasms/pathology*
;
Laryngoscopy/methods*
;
Microsurgery/methods*
;
Retrospective Studies
;
Quality of Life
;
Neurofibroma/diagnosis*
6.Advances in the treatment of infantile hemangiomas of the larynx.
Xing GAO ; Xiaojun ZHAN ; Qinglong GU
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2023;37(12):972-976
Infantile hemangiomas are relatively common soft tissue tumors in infants and young children, with a prevalence of about 4.5% in full-term newborns. Subglottic Hemangioma (SGH) is a relatively rare type of hemangioma, and its special location often causes respiratory distress and potentially life-threatening conditions in infants. Therefore, it is necessary for clinicians to make an accurate diagnosis and formulate a detailed treatment plan based on the clinical manifestations, the auxiliary examinations, the medical history and the vital signs evaluation of patients.This review describes the pathophysiological mechanism of infantile hemangioma and provides a detailed discussion on commonly used treatment methods in detail.
Child, Preschool
;
Humans
;
Infant
;
Infant, Newborn
;
Hemangioma/diagnosis*
;
Hemangioma, Capillary
;
Laryngeal Neoplasms/surgery*
;
Larynx/pathology*
;
Soft Tissue Neoplasms
7.Pediatric supraglottic laryngeal hamartoma: a case report and literature review.
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2023;37(12):993-997
Laryngeal hamartoma is a benign proliferative tumor-like lesion that occurs in the larynx. A case of supraglotic laryngeal hamartoma admitted by our department and 12 cases of laryngeal hamartoma reported in literature were retrospectively analyzed, the pathogenesis, clinicalmanifestation, diagnosis, treatment and prognosis of laryngeal hamartoma was explored, aiming to improve the understanding and diagnosis and treatment.of this disease.
Humans
;
Child
;
Retrospective Studies
;
Larynx/pathology*
;
Laryngoscopy
;
Prognosis
;
Hamartoma
;
Laryngeal Neoplasms/surgery*
8.Prognostic impact of different tumor invasion patterns in the surgical treatment of T3 glottic laryngeal cancer.
Zhiming LING ; Guohua HU ; Zhihai WANG ; Wei MA ; Xiaoqiang WANG ; Jiang ZHU ; Quan ZENG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2023;37(12):998-1004
Objective:To investigate the prognostic impact of different tumor invasion patterns in the surgical treatment of T3 glottic laryngeal cancer. Methods:A retrospective analysis was conducted on the clinical data of 91 patients with T3 glottic laryngeal cancer. Results:Among the 91 patients, 58 cases (63.7%) had anterior invasion and 33 cases (36.3%) had posterior invasion. The posterior invasion was significantly correlated with invasions of the dorsal plate of cricoid cartilage (P<0.001), arytenoid cartilage (P= 0.001), and subglottic region(P = 0.001). There was no statistical difference in survival outcomes between the total laryngectomy group and the partial laryngectomy group. But in the partial laryngectomy group, the 5-year disease-free survival(DFS) of patients with anterior invasive tumors was better than that of patients with posterior invasion tumors (HR: 4.681, 95%CI 1.337-16.393, P=0.016), and subglottic invasion was associated with worse loco-regional recurrence-free survival(LRRFS)(HR: 3.931, 95%CI 1.054-14.658, P=0.041). At the same time, we found that involvement of the dorsal plate of cricoid cartilage was an independent risk factor for postoperative laryngeal stenosis in partial laryngectomy patients (HR:11.67, 95%CI 1.89-71.98,P=0.008). Conclusion:Compared with total laryngectomy, selected partial laryngectomy can also achieve favorable oncological outcomes. Posterior invasion and subglottic extension are independent prognostic factors for recurrence of partial laryngectomy in T3 glottic laryngeal cancer, and the involvement of the dorsal plate of cricoid cartilage is associated with postoperative laryngeal stenosis. The tumor invasion pattern of laryngeal cancer should be further subdivided in order to select a more individualized treatment plan.
Humans
;
Prognosis
;
Laryngeal Neoplasms/pathology*
;
Retrospective Studies
;
Laryngostenosis/surgery*
;
Carcinoma, Squamous Cell/pathology*
;
Postoperative Complications/surgery*
;
Laryngectomy
9.Clinicodemographic and computed tomography scan findings associated with thyroid gland invasion among patients with laryngeal squamous cell carcinoma
Anna Kristina M. Hernandez ; Cindy Pearl J. Sotalbo ; Antonio Marlo P. Nievera ; Ryner Jose C. Carrillo
Acta Medica Philippina 2023;57(12):26-31
Objective:
We aim to determine the association between preoperative CT scan findings of thyroid cartilage invasion, cricoid cartilage invasion, and paraglottic space involvement with tumor extension to the thyroid gland on final histopathology among patients with laryngeal squamous cell carcinoma (SCC) in a tertiary hospital in the Philippines.
Methods:
Patients with histopathologically-confirmed laryngeal SCC who underwent total laryngectomy with
thyroidectomy while admitted at the public ward of the Department of Otorhinolaryngology, Philippine General
Hospital, from January 2013 to December 2019 were included. CT scans were reviewed by 2 blinded independent radiologists. CT scan data including subsite/s involved, thyroid cartilage/cricoid cartilage erosion, paraglottic space involvement, thyroid gland involvement, and thyroid gland involvement on final histopathology were gathered. Clinicopathologic data such as age, T Stage, early tracheostomy, and time between CT scan and surgery were also collected and analyzed. Fisher’s exact test was computed for both clinicopathologic and CT scan data with a significant value having p<0.05. Cramer’s V and phi coefficient were computed for nondichotomous and dichotomous variables, respectively. Odds ratio was also computed for dichotomous variables with p<0.05 on Fisher’s exact test.
Results:
Fifty-nine (59) men and 4 women were included, aged 43 to 81 years old. Most patients were classified
as T3 (n=18) and T4 (n=41) (total=93.7%), with most having transglottic primary tumors (n=29, 46%), and only 8
(12.7%) patients having subglottic tumor involvement on final histopathology. Thyroid cartilage erosion or invasion were noted in 63.4% (n=40) of patients’ CT scans and 58.7% (n=37) of patients’ final histopathology reports. Cricoid cartilage and paraglottic space involvement were often not reported on final histopathology results. Thyroid gland involvement was only noted in the final histopathology reports of 5 patients (7.9%). Significant association between cricoid cartilage findings (p=0.032, Cramer’s V=0.318) or thyroid gland involvement on CT scan (p=0.018, Phi=0.384; OR 13 95% CI 1.797, 94.035) with thyroid gland involvement on final histopathology was noted. The rest of the variables had no significant association with thyroid gland involvement on final histopathology.
Conclusion
Cricoid cartilage involvement (erosion or invasion) and thyroid gland involvement on CT scan are
associated with thyroid gland involvement on final histopathology in patients with laryngeal SCC. Patients with these CT scan findings may stand to benefit more from thyroidectomy to ensure good margins of resection.
Laryngeal Neoplasms
;
Thyroidectomy
;
Carcinoma
;
Epithelial Cells


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