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 review the clinical characteristics, diagnosis and treatments of primitive neuroectodermal tumor (PNET) in head and neck.

METHODSA retrospective review of the medical records for the cases of PNET in head and neck from 2004 to 2014. General clinical information including diagnosis and treatments was obtained and analyzed. A literature review was also conducted.

RESULTSA total of 5 cases diagnosed with PNET were included. Of 5 patients, one patient with lesion in the temporal field was treated with radical resection, followed by radiotherapy, and a 24-month follow-up showed no recurrence. Three patients presented with maxillary, infratemporal fossa or cheek invasion respectively, after diagnosed with pathological examination, one patient received preoperation radiotherapy plus radical resection and postoperative chemotherapy, and the lesions had no obvious progress with follow-up of 106 months; one patient was applied with preoperative chemotherapy plus extensive resection and postoperation radiotherapy, showed recurrence 15 months later, and was lost to follow-up; and another patient underwent chemotherapy plus radiotherapy and extensive resection, presented with pulmonary metastasis 5 months later, and died of brain metastasis within 25 months. One foreign patient presented with tumor involved submaxillary, mouth and tongue, the tumor was reduced obviously after chemotherapy, but he was lost to follow-up after getting home.

CONCLUSIONSPNET in head and neck is rare and the clinical profile of PNET is the presence of occupying and compression. The pathology examination is an only way to confirm the diagnosis of PNET. The combination of excision, radiotherapy and chemotherapy is the treatment choice.

Brain Neoplasms ; secondary ; Head and Neck Neoplasms ; diagnosis ; pathology ; therapy ; Humans ; Lost to Follow-Up ; Male ; Neoplasm Recurrence, Local ; Neuroectodermal Tumors, Primitive ; diagnosis ; pathology ; therapy ; Retrospective Studies

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

OBJECTIVETo assess the values of color Doppler and magnetic resonance imaging (MRI) in the identification of cervical lymph node micrometastasis of tongue cancer.

METHODSTotally 96 cases of tongue cancer with impalpable neck lymph node was examined with color Doppler and MRI within one week before surgery. Chi-square test was used to assess if the presence of regional lymph node micrometastasis, histopathological analysis as a golden standard lymph node micrometastasis.

RESULTSFor the diagnosis of cervical lymph node micrometastasis, color Doppler was significantly better than MRI in sensitivity (72.5% vs 50.0%, P = 0.039) and the accuracy (78.1% vs 64.6%, P = 0.038), but no significant difference in the specificity (82.1% vs 75.0%, P = 0.357), the positive predictive value (74.4% vs 58.8%, P = 0.159) and the negative predictive value (80.7% vs 67.7%, P = 0.108).

CONCLUSIONColor Doppler is better than MRI in the sensitivity and accuracy for the diagnosis of cervical lymph node micrometastasis of tongue cancer.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell ; diagnosis ; pathology ; Female ; Head and Neck Neoplasms ; diagnosis ; secondary ; Humans ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neck ; pathology ; Neoplasm Micrometastasis ; Tongue Neoplasms ; diagnosis ; pathology ; Ultrasonography, Doppler, Color

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