RESUMEN
Leiomyosarcoma is a malignant mesenchymal tumour of smooth muscle origin. It is extremely rare as a primary thyroid cancer with only 33 cases previously described in the literature. We present the case of a 69-year-old Caucasian man who presented with a 5-month history of left cervical lymphadenopathy and a suspicious mass in the left thyroid lobe on ultrasound scan. Left hemithyroidectomy confirmed the diagnosis of leiomyosarcoma. A review of current understanding and approaches to management of this rare condition are discussed.
Asunto(s)
Leiomiosarcoma , Neoplasias de la Tiroides , Anciano , Humanos , Leiomiosarcoma/diagnóstico por imagen , Leiomiosarcoma/cirugía , Masculino , Neoplasias de la Tiroides/diagnóstico por imagen , Neoplasias de la Tiroides/cirugía , Tiroidectomía , UltrasonografíaRESUMEN
PURPOSE: TNM8 introduced a new staging system for HPV positive oropharyngeal squamous cell carcinoma (OPSCC). This study aimed to investigate whether the changes made in TNM8 offer the perceived benefit in prognostication when compared to TNM7 in a specific patient population in the North East of England. METHODS: A retrospective cohort comparison study of all patients with HPV positive OPSCC (n = 106) through the Newcastle Head and Neck MDT between January 2012 to December 2014. Overall survival (OS) and Disease specific survival (DSS) data at 3 years was gathered for both TNM7 and TNM8. Log rank test was used to compare survival curves. Harrell's C-index adjusted for age and smoking status was used to assess prognostic ability of the two staging methods. RESULTS: TNM8 downstages disease (TNM7 stage IV patients n = 74, TNM8 stage IV patients n = 2) but gives a more even distribution of patients across disease stages. Survival for TNM8 stage II and III is similar. In our small cohort, the log-rank test detected differences in OS between stages for both scoring methods (TNM7 p = 0.006, TNM8 p < 0.001) and similarly for DSS (TNM7 p = 0.001, TNM8 p < 0.001). Harrell's C-index was similar for both models for OS (TNM7 0.71, TNM8 0.71) and DSS (TNM7 0.74, TNM8 0.70). CONCLUSION: TNM8 downstages disease and prognosticates well for stage I disease but does not differentiate between stage II and III disease when compared to TNM7. Further adaptation is required to address this to make TNM8 a more accurate prognostic tool.
Asunto(s)
Alphapapillomavirus , Neoplasias Orofaríngeas , Infecciones por Papillomavirus , Inglaterra , Humanos , Estadificación de Neoplasias , Neoplasias Orofaríngeas/etiología , Neoplasias Orofaríngeas/patología , Infecciones por Papillomavirus/complicaciones , Infecciones por Papillomavirus/epidemiología , Infecciones por Papillomavirus/patología , Estudios Retrospectivos , Carcinoma de Células Escamosas de Cabeza y Cuello/etiología , Reino Unido/epidemiologíaRESUMEN
The sclerosing variant of mucoepidermoid salivary gland carcinoma is extremely rare. It is nearly impossible to diagnose this condition preoperatively. We present a case of a 23-year-old woman with a 1-year history of left parotid enlargement with inconclusive fine-needle aspiration cytology results. MRI showed an irregular parotid mass, and subsequent partial parotidectomy confirmed the diagnosis. We discuss the diagnostic pitfalls of this condition and provide a review of the literature surrounding its pathogenesis and management.