Leiomyosarcoma is an uncommon tumor which arises from various sites including uterus, stomach, retroperitoneum, superficial soft tissues, bladder, kidney, and lung. Primary hepatic leiomyosarcoma is a very rare tumor and fewer than 70 cases of primary hepatic leiomyosarcoma have been reported since the first publication in Japan. And there was only one case report of cutaneous metastasis from hepatic leiomyosarcoma. We recently experienced a case of primary hepatic leiomyosarcoma presenting as subcutaneous palpable mass. Herein we report this case with a review of literatures.
Head and Neck Neoplasms/*secondary ; Humans ; Leiomyosarcoma/diagnosis/*secondary ; Liver Neoplasms/diagnosis/*pathology ; Male ; Middle Aged ; *Scalp ; Skin Neoplasms/*secondary

No abstract available.
Carcinoma, Squamous Cell/*diagnosis/*pathology/*secondary ; Early Detection of Cancer/*statistics & numerical data ; Esophageal Neoplasms/*diagnosis/*secondary ; Female ; Head and Neck Neoplasms/*pathology ; Humans ; Male

No abstract available.
Carcinoma, Squamous Cell/*diagnosis/*pathology/*secondary ; Early Detection of Cancer/*statistics & numerical data ; Esophageal Neoplasms/*diagnosis/*secondary ; Female ; Head and Neck Neoplasms/*pathology ; Humans ; Male

OBJECTIVE: To analyze the clinical feature of cervical metastatic carcinoma of unknown primary site (CCUP) for guiding clinical diagnosis and treatment. METHOD: Twenty-seven cases of CCUP during May 2007 to September 2013 in department were analyzed retrospectively. Kaplan-Meier method and Log-rank test were used for survival analysis, multivariate analysis using the Cox regression model. RESULT: There is no significant influence among gender, age and the mass position on the median survival time. Median survival time of patients with different pathological types was statistically significant (P < 0.05). Treatment affected the median surial significantly (P < 0.05) and also was the independent prognostic factors (P < 0.05). CONCLUSION The early establishment of pathological type and primary focal position can improve the prognosis. Taking treatment according to pathological types can increase the patient's survival rate. Combined treatment can prolong the patient's survival time.
Carcinoma ; diagnosis ; secondary ; Combined Modality Therapy ; Head and Neck Neoplasms ; diagnosis ; secondary ; Humans ; Multivariate Analysis ; Neoplasms, Unknown Primary ; pathology ; Prognosis ; Retrospective Studies ; Survival Analysis ; Survival Rate

OBJECTIVETo analyze the clinical feature and prognosis of primary branchial carcinoma.

METHODSThe main method of this study was reviewing the clinical feature, diagnosis, treatment methods and prognosis of 5 patients suffered from primary branchial carcinoma.

RESULTSAll of the tumors were excised extensively. All of the patients received radical neck dissection and post-operative radiotherapy. 3 patients had pathologic evident of metastasis in lymph nodes of cervical region. 2 patients died of local recurrence of tumor and metastasis to lung. 1 patient died after post-operative 2 years. 2 patients were still alive after 5 years' follow-up.

CONCLUSIONPrimary branchial carcinoma has the very similar clinical feature with branchial cyst. The diagnosis should be considered if painless mass and swollen lymph nodes were found in upper neck region of patients. Rapid frozen pathologic section should be made regularly to make the diagnosis clear. The treatment should include extensive excision of tumor and radical neck dissection to improve the cure rate and survival rate.

Adult ; Branchioma ; diagnosis ; secondary ; surgery ; Carcinoma, Squamous Cell ; diagnosis ; secondary ; surgery ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Head and Neck Neoplasms ; diagnosis ; pathology ; surgery ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Neck Dissection ; Prognosis ; Retrospective Studies ; Survival Rate

OBJECTIVETo raise the vigilance not to believe easily the diagnosis of a primary branchial cleft carcinoma.

METHODSFour cases of cystic metastatic squamous cell carcinoma in the neck misdiagnosed as branchiogenic carcinoma from 1993 to 2002 in our hospital were analyzed retrospectively.

RESULTSThe primary sites of these 4 cases were later discovered, 2 in the aryepiglottic fold, 1 in faucial tonsil and 1 in the skin of the head, respectively. The discovery of the primary sites ranged from the day of initial surgery to 41 months.

CONCLUSIONNone of the cases reviewed in this study was a branchiogenic carcinoma. Therefore, the diagnosis of a primary branchial cleft carcinoma requires the fulfillment of strict criteria both clinically and pathologically.

Adult ; Branchioma ; diagnosis ; Carcinoma, Squamous Cell ; diagnosis ; secondary ; Diagnostic Errors ; Epiglottis ; Female ; Head and Neck Neoplasms ; diagnosis ; secondary ; Humans ; Laryngeal Neoplasms ; pathology ; Male ; Middle Aged ; Retrospective Studies ; Tonsillar Neoplasms ; pathology

Lateral neck node metastasis is an important prognostic factor in thyroid carcinoma. We developed a scoring system for use in prediction of lateral neck node metastasis from papillary thyroid cancer. In this study, 161 consecutive patients were included in the training data set. This scoring system, named the Yonsei Estimated Value (YEV) for lymph node metastasis in papillary thyroid cancer, was developed on the basis of results from multivariate logistic regression analysis of preoperative clinical and radiologic data. Sixty eight consecutive patients were included for testing of the validity of the scoring system. The equation for prediction of lateral neck node metastasis was follows: YEV (Yonsei Estimated Value) = 1/(1+X) X = Exp (5.333-[0.902 x sex]+[0.036 x age]-[1.020 x tumor size]-[0.177 x lymph node size]-[0.032 x lymph node density]) When the YEV was 0.3 or more, the probability of lateral neck node metastasis was 79.0%, with sensitivity of 76.3%, specificity of 69.8%, positive predictive value of 56.7%, and negative predictive value of 85.1% in the training set. When fine needle aspiration biopsy for suspicious lateral neck nodes is not possible, or the results are inadequate, our scoring system for prediction of lateral neck node metastasis can be helpful in optimization of the surgical extent for each patient.
Adolescent ; Adult ; Aged ; Algorithms ; Female ; Head and Neck Neoplasms/*diagnosis/secondary ; Humans ; Logistic Models ; Lymphatic Metastasis/*diagnosis ; Male ; Middle Aged ; *Predictive Value of Tests ; Thyroid Neoplasms/*pathology/radiography ; Tomography, X-Ray Computed

OBJECTIVETo improve the accuracy of preoperative evaluation of cervical lymph node metastasis in thoracic esophageal squamous carcinoma.

METHODSForty-two patients with thoracic esophageal squamous carcinoma underwent neck ultrasonography. Enlarged lymph nodes with their long axis greater than 10 mm and a short-to-long axis ratio greater than 0.5 were considered as metastatic.

RESULTSPreoperative neck ultrasonography revealed the enlarged lymph nodes in 16 patients, but only in 5 (31%) cases the nodes were palpable. Among them 9 were classified as metastatic (cM(1-LN)), including 4 patients with palpable nodes. In 5 cM(1-LN) patients surgical intervention was canceled and the remaining 37 patients underwent trans-thoracic esophagectomy. Cervical node metastasis (pM(1-LN)) was confirmed pathologically in 6 surgical patients, 4 with tumors invading the adventitia (pT3) and the other 2 into the surrounding structure (pT(4)) (pT(1), pT(2) vs. pT(3), pT(4), P = 0.020). All 6 pM(1-LN) patients had concomitant mediastinal node metastasis and 4 of them had upper abdominal node metastasis. Statistically significant relationship was detected between cervical and abdominal nodal status (r = 0.536, P = 0.007). In comparison with the results of pathological examination and treatment response, the accuracy and sensitivity were 81% and 95% (P = 0.043), 36% and 82% (P = 0.081), respectively, for palpation and ultrasonography. Five out of 39 (13%) patients had their therapy changed due to ultrasonographic findings.

CONCLUSIONSNeck ultrasonography for cervical lymphadenopathy is of high sensitivity and accuracy, which plays an important role in the preoperative evaluation and therapeutic decision-making.

Adult ; Aged ; Carcinoma, Squamous Cell ; diagnostic imaging ; secondary ; surgery ; Esophageal Neoplasms ; pathology ; surgery ; Female ; Head and Neck Neoplasms ; diagnostic imaging ; secondary ; surgery ; Humans ; Lymph Node Excision ; methods ; Lymph Nodes ; diagnostic imaging ; Lymphatic Metastasis ; diagnosis ; Male ; Middle Aged ; Neck ; diagnostic imaging ; Sensitivity and Specificity ; Ultrasonography

OBJECTIVETo evaluate the symptoms and surgical management results of metastatic disease in the retropharyngeal space.

METHODSSix patients with malignant tumors were collected, in which enlarged lymph nodes presented both in neck and retropharyngeal space. They consisted of two supraglottic carcinoma (T3N2MO), one thyroid carcinoma (TXN2MO), one nasal melanoma (TXN2MO), one oropharyngeal carcinoma (T2N2M0) and one hypopharyngeal carcinoma (T3N2MO). The enlarged nodes in the retropharyngeal space were measured with CT and (or) MRI, which ranged from 1.5-2.5 cm in diameter. Based on the control of the primary and neck disease, the mass in the retropharyngeal space was dissected and sent for pathologic exam separately.

RESULTSMetastasis in the retropharyngeal space was pathologically proved in all of them, along with the involved internal jugular lymph nodes of 3/15, 3/17, 4/19, 5/19, 6/20, and 6/23, respectively. No serious complications occurred, such as fistula and central nerve damage. The patient with hypopharyngeal carcinoma died of lung metastasis 2 years after operation. The one suffering nasal malignant melanoma was out of follow-up in the 14th months. The patient with oropharyngeal carcinoma locally relapsed in the 18th months and died at the 24th months postoperatively. The rest was alive with tumor free within the follow-up period from 2 to 4 years.

CONCLUSIONSCT or Mifi are the mainstay of diagnosis of the metastatic disease in the retropharyngeal space and can he surgically controlled with safety.

Aged ; Carcinoma, Squamous Cell ; pathology ; Female ; Head and Neck Neoplasms ; pathology ; secondary ; Humans ; Lymph Node Excision ; Lymphatic Metastasis ; diagnosis ; prevention & control ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Pharynx ; pathology ; Tomography, X-Ray Computed

BACKGROUND/AIMS: The efficacy of surveillance for esophageal squamous cell neoplasia (ESCN) in patients with head and neck squamous cell carcinoma (HNSCC) remains controversial. Our study aimed to provide clinical data concerning the necessity of surveillance for detecting early ESCN in patients with HNSCC. METHODS: We retrospectively reviewed the data from 714 patients who were pathologically confirmed as having HNSCC (n=236 oral cavity cancers, 137 oropharyngeal cancers, 87 hypopharyngeal cancers, and 254 laryngeal cancers). RESULTS: Of 714 patients, during a median follow-up of 31 months, 48 ESCNs (37 synchronous and 11 metachronous) were detected in 36 patients (5%). Fifteen synchronous lesions (40.3%) were early ESCN, whereas nine metachronous lesions (81.8%) were early ESCN. The 3-year survival rates of HNSCC only and HNSCC combined with ESCN were 71.2% and 48.2%, respectively (p<0.001). Among 36 patients with ESCN, the 3-year survival rates for early and advanced ESCN were 77.7% and 21.7%, respectively (p=0.01). In the multivariate analysis, alcohol consumption and hypopharyngeal cancer were significant factors associated with the development of ESCN. CONCLUSIONS: HNSCC patients with early ESCN were similar in prognosis with patients without ESCN, in contrast to patients with advanced ESCN. Therefore, surveillance for the early detection of ESCN in patients with HNSCC, especially in alcohol drinkers and those with hypopharyngeal cancer, is warranted.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Alcohol Drinking/adverse effects ; Carcinoma, Squamous Cell/*diagnosis/mortality/*pathology/*secondary ; Early Detection of Cancer/*statistics & numerical data ; Esophageal Neoplasms/*diagnosis/mortality/*secondary ; Female ; Head and Neck Neoplasms/mortality/*pathology ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Prognosis ; Retrospective Studies ; Risk Factors ; Survival Rate ; Young Adult