Intracranial lipomas located in the cerebellopontine angle are extremely rare. These tumors are maldevelopmental lesions which can cause slowly progessive neurological symptoms. The clinical management of these tumours differs significantly from other lesions in this region. A 45 year old man presented with a 3-month history of vertigo and tinnitus in the left ear. In T1-weighted magnetic resonance imaging, the lesion was hyperintense and did not enhance after application of gadolinium. The patient was treated with medical therapy with good response. We present a review of the literature, with particular regard to management. Conservative treatment is recommended and limited surgery is usually indicated if the patients suffer from disabling neurological symptoms and signs e.g., vertigo, nausea, trigeminal neuralgia, facial weakness or facial spasm.
Cerebellopontine Angle ; Ear ; Gadolinium ; Humans ; Lipoma* ; Magnetic Resonance Imaging ; Middle Aged ; Nausea ; Spasm ; Tinnitus ; Trigeminal Neuralgia ; Vertigo

BACKGROUND/OBJECTIVES: Despite multiple approaches of treatments for salivary duct carcinoma, there has been a need for more successful treatment methods because of its poor prognosis. Treatment options like immunotherapy using new technologies have been attempted. Based on recent study results indicating that targeting programmed death receptors are effective in treating various cancers, this study aimed to identify the frequency of PD-L1 expression and its impact on survival rate in salivary duct carcinoma.MATERIALS #SPCHAR_X0026; METHODS: We studied 33 patients with salivary gland cancer who were available for histologic specimens. We examined the expression of PD-L1 in the tissues and analyzed the association with the survival rate and the association with various clinical parameters.RESULTS: According to this study and review of similar studies, we discovered that the expression of PD-L1 in salivary duct carcinoma was lower than other types of cancers. The impact of PD-L1 on survival rate also showed inconsistency in salivary duct carcinoma.CONCLUSION: Immunotherapy by PD-1/PD-L1 checkpoint blockade in salivary duct carcinoma needs further evaluation for clinical application.
Humans ; Immunotherapy ; Prognosis ; Receptors, Death Domain ; Salivary Ducts ; Salivary Gland Neoplasms ; Survival Rate

Primary malignant lymphomas of the salivary glands are uncommon. The parotid gland was most frequently involved, followed by the submandibular gland, minor salivary glands and sublingual gland. The most common subtype is mucosa-associated lymphoid tissue (MALT) lymphoma. MALT lymphoma is a relatively indolent disease and tends to remain localized for prolonged period of time. But, we experienced a case of a multifocal salivary MALT lymphoma involving both parotid glands and right submandibular gland during its progression of disease. We report a case with a review of the literature.
Lymphoid Tissue ; Lymphoma ; Lymphoma, B-Cell, Marginal Zone ; Parotid Gland ; Salivary Glands ; Salivary Glands, Minor ; Sublingual Gland ; Submandibular Gland

BACKGROUND AND OBJECTIVES: Acoustic neuroma (AN) is commonly encountered in the cerebello-pontine angle (CPA) and AN arises principally from the vestibular division of the nerve, which can show not only hearing disturbance but also various vestibular symptoms and laboratory findings by affecting central and peripheral vestibular system. Vestibular testing is reported not to be a useful screening test for AN, but can be helpful in defining whether the tumor arises from the superior or inferior division and identifying the cause of dizziness or vertigo. MATERIALS AND METHOD: We are presenting four patients with CPA tumors accompanied by various abnormal findings of vestibular function tests including head-shaking nystagmus, vibration-induced nystagmus, hyperventilation- induced nystagmus and vestibular evoked myogenic potential and subjective visual vertical, which can enable us to understand the pathomechanism of the abnormal results. RESULTS: All patients presented hearing loss and mild dizziness. Caloric test, head thrust test and vibration-induced nystagmus was helpful in localizing the disease, but head-shaking nystagmus and hyperventilation-induced nystagmus was less helpful. Otolith tests did not always show abnormal results. CONCLUSION: We should consider abnormal results of the vestibular function tests in a whole to estimate the status of vestibular compensation in patients with CPA tumors.
Caloric Tests ; Compensation and Redress ; Dizziness ; Head Impulse Test ; Hearing ; Hearing Loss ; Humans ; Mass Screening ; Neuroma, Acoustic ; Otolithic Membrane ; Vertigo ; Vestibular Function Tests*

OBJECTIVES: To evaluate the oncologic and functional results of larynx-preserving partial pharyngectomy (LPP) via lateral pharyngotomy approach as a primary treatment for small (T1 or T2) hypopharyngeal squamous cell carcinoma (HPSCC). METHODS: We performed a retrospective review of 23 patients who underwent LPP through lateral pharyngotomy approach for small HPSCC at the our department between January 1991 and June 2007. Fourteen (61%) patients had adjuvant postoperative radiotherapy. RESULTS: The 2-years and 5-years disease specific survival rate was 77% and 61%, respectively. Nine patients (39%) had tumor recurrence. The most common pattern of recurrence was isolated distant failure (n=4, 44%) followed by local (n=2, 22%) and loco-regional (n=3, 34%) recurrence. The ultimate cure rate of the primary tumor was 87% (20 of 23). Twenty-two of the 23 patients (95%) could be decannulated, tolerate an oral diet, and had acceptable postoperative phonatory function. CONCLUSION: LPP via lateral pharyngotomy approach appears to be a feasible procedure for selected small HPSCC patients in terms of both oncologic and functional outcomes.
Carcinoma, Squamous Cell ; Diet ; Humans ; Hypopharyngeal Neoplasms ; Pharyngectomy ; Radiotherapy, Adjuvant ; Recurrence ; Retrospective Studies ; Survival Rate

OBJECTIVES: To evaluate the oncologic and functional results of larynx-preserving partial pharyngectomy (LPP) via lateral pharyngotomy approach as a primary treatment for small (T1 or T2) hypopharyngeal squamous cell carcinoma (HPSCC). METHODS: We performed a retrospective review of 23 patients who underwent LPP through lateral pharyngotomy approach for small HPSCC at the our department between January 1991 and June 2007. Fourteen (61%) patients had adjuvant postoperative radiotherapy. RESULTS: The 2-years and 5-years disease specific survival rate was 77% and 61%, respectively. Nine patients (39%) had tumor recurrence. The most common pattern of recurrence was isolated distant failure (n=4, 44%) followed by local (n=2, 22%) and loco-regional (n=3, 34%) recurrence. The ultimate cure rate of the primary tumor was 87% (20 of 23). Twenty-two of the 23 patients (95%) could be decannulated, tolerate an oral diet, and had acceptable postoperative phonatory function. CONCLUSION: LPP via lateral pharyngotomy approach appears to be a feasible procedure for selected small HPSCC patients in terms of both oncologic and functional outcomes.
Carcinoma, Squamous Cell ; Diet ; Humans ; Hypopharyngeal Neoplasms ; Pharyngectomy ; Radiotherapy, Adjuvant ; Recurrence ; Retrospective Studies ; Survival Rate

Schwannoma arising from cervical sympathetic chain is relatively uncommon and can be occasionally misdiagnosed as carotid body tumor. On MR images, schwannoma shows generally hypointense features on the T1-weighted images and hyperintense features on the T2-weighted images. Occasionally, however, contrast administration, which lets schwannoma show marked enhancement, may make it difficult to differentiate schwannoma from carotid body tumor. A 41-year-old woman presented a neck mass on the left. MR images of the neck and carotid angiography revealed a well-enhancing ovoid tumor, which separated the internal carptod arteries from the external carotid arteries at the level of carotid bifurcation. Complete tumor resection was performed and histopathology findings confirmed a schwannoma originating from the sympathetic chain. Postoperatively, miosis and facial anhydrosis of the left side were noted without ptosis, enophthalmos or other neurologic deficits. We report this case with a review of the literatures.
Adult ; Angiography ; Arteries ; Carotid Artery, External ; Carotid Body Tumor* ; Enophthalmos ; Female ; Humans ; Linear Energy Transfer ; Miosis ; Neck ; Neurilemmoma* ; Neurologic Manifestations

Fibrolipomas are a rare microscopic variant of lipomas, characterized by mature adipose tissue interspersed with dense fibrous connective tissue. These lesions are rarely observed in the head and neck region and represent <0.6% of all benign tumors of the larynx and hypopharynx. Their clinical presentation depends on the location and size of lesions. Patients present with variable symptoms; however, fibrolipomas of the larynx and hypopharynx are clinically important because these tumors can cause unpredictable airway obstruction, particularly during general anesthesia induction. We present a case of a hypopharyngeal fibrolipoma in a 61-year-old patient with frequent dyspnea, dysphagia, and muffled voice. Laryngoscopy revealed a well-demarcated pedunculated ovoid mass involving the larynx. We performed laryngomicrosurgery using a carbon dioxide laser for surgical excision and subsequent evaluation confirmed the diagnosis of fibrolipoma. We report a case of hypopharyngeal fibrolipoma, together with a literature review.

Liposarcoma is a very rare malignant tumor affecting the head and neck area. Since it is an invasive and life-threatening disease, active treatments is necessary. However, differential it from lipoma, its corresponding benign counterpart, may be difficult. Herein, we report a rare case of posterior neck myxoid liposarcoma in a 72-year-old man who was initially misdiagnosed with lipoma, including a literature review of differential diagnosis between lipoma and liposarcoma.

Laryngeal chondrosarcoma is a cartilaginous malignant tumor which is rarely encountered in the head and neck. They occur most often in the paranasal sinus, mandibule, and larynx. The cricoid cartilage is the most common site of the laryngeal chondrosarcoma. Complete surgical resection and postoperative radiotherapy are generally recommended. Almost all cases of the laryngeal chondrosarcoma are detected early because of the rapid development of symptoms such as dyspnea, dysphagia and hoarseness, which are caused by the anatomic location. Authors experienced a case of laryngeal chondrosarcoma that originated from the cricoid cartilage in a 67 year-old male without any symptoms. The mass was found on a routine esophagogastroduodenoscopy examination. Hemicricoidectomy with complete excision of tumor was performed via laryngofissure approach. The patient did not undergo radiotherapy, since all margins of the resected mass were tumor-free. There was no evidence of recurrence or metastasis 12 months after surgery.
Chondrosarcoma ; Cricoid Cartilage ; Deglutition Disorders ; Dyspnea ; Endoscopy, Digestive System ; Head ; Hoarseness ; Humans ; Larynx ; Male ; Neck ; Neoplasm Metastasis ; Recurrence