Advances in Diagnostics of Head and Neck Cancer

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: closed (31 March 2022) | Viewed by 68897

Special Issue Editors

Department of Otorhinolaryngology and Laryngological Oncology in Zabrze, Medical University of Silesia Katowice, PL-41800 Zabrze, Poland
Interests: head and neck oncology; narrowings of the upper airways; vocal cord paralysis; sleep apnea; rhinosurgery
Special Issues, Collections and Topics in MDPI journals
Department of Medical and Molecular Biology, Medical University of Silesia, Katowice, Poland
Interests: molecular biology; genetics; epigenetics; diagnostics; head and neck cancers
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The relative 5-year survival rate for tumors in the head and neck area, including oral cavity, pharynx, sinonasal cavity, and salivary glands, has increased over the last 40 years. Tobacco smoke, alcohol abuse, and viral infection with human papillomavirus are risk factors. Molecular alterations regarding genetic and epigenetic aberrations in carcinogenesis of the head and neck have been identified. Head and neck cancer is a common disease and requires an interdisciplinary involvement of physicians from many specializations. Together with molecular biologists, geneticists, radiotherapists, and pathologists, surgeons deal with this issue. The main goal of this cooperation and a great deal of research conducted around the world is to develop diagnostic methods that shorten the patient’s waiting time for treatment proposals and allow the most effective treatment method to be used. This will make it possible to get better results in the treatment of patients with head and neck tumors. The growing number of tumors in the head and neck area is the main reason for searching for new diagnostic biomarkers. Moreover, the expanded knowledge of molecular pathogenesis for head and neck cancerogenesis can be exploited for improving the diagnosis and treatment of patients with head and neck cancer.

This Special Issue aims to enrich the research area of head and neck tumors by gathering participation to identify diagnostic biomarkers for head and neck tumors, and to discuss new research developments in the molecular pathology of head and neck malignancies.

To contribute to the knowledge base on diagnosis of head and neck malignancies, the following topics will be considered: the molecular biology of head and neck cancer, the tumor microenvironment, and the prognostic and predictive roles of biomarkers.

Prof. Dr. Maciej Misiolek
Prof. Dr. Joanna Katarzyna Strzelczyk
Guest Editors

Manuscript Submission Information

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Keywords

  • Head and Neck Cancer
  • Diagnostics
  • Biomarkers
  • Personalized Medicine
  • Epigenetics
  • Genetics
  • Genes
  • Tumor

Published Papers (22 papers)

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19 pages, 2944 KiB  
Article
Multi-Omics Analyses to Identify FCGBP as a Potential Predictor in Head and Neck Squamous Cell Carcinoma
by Yu-Hsuan Lin, Yi-Fang Yang and Yow-Ling Shiue
Diagnostics 2022, 12(5), 1178; https://doi.org/10.3390/diagnostics12051178 - 09 May 2022
Cited by 2 | Viewed by 2027
Abstract
(Purpose) Previous studies have pointed out the significance of IgG Fc binding protein (FCGBP) in carcinogenesis, cancer progression, and tumor immunity in certain malignancies. However, its prognostic values, molecular interaction, and immune characteristics in the head and neck squamous cell carcinoma [...] Read more.
(Purpose) Previous studies have pointed out the significance of IgG Fc binding protein (FCGBP) in carcinogenesis, cancer progression, and tumor immunity in certain malignancies. However, its prognostic values, molecular interaction, and immune characteristics in the head and neck squamous cell carcinoma (HNSC) remained unclear. (Methods) To evaluate the potential role of the FCGBP gene, we used GEPIA2 and UALCAN platforms to explore the differential levels, survivals, and genetic alteration through cBioPortal (based on The Cancer Genome Atlas dataset). STRING, GeneMania, and TIMER2.0 identified the interacting networks. LinkedOmics performed Gene enrichment analysis, and TISIDB and TIMER2.0 evaluated the role of FCGBP in the tumor microenvironment. (Results) The expression level of FCGBP is lower in cancer tissues. A high FCGBP level is significantly associated with better overall- and disease-specific-survivals, regardless of human papillomavirus infection. Low FCGBP levels correlated to a higher tumor protein p53 (TP53) mutation rate (p = 0.018). FCGBP alteration significantly co-occurred with that of TP53 (q = 0.037). Interacting networks revealed a significant association between FGFBP and trefoil factor 3 (TFF3), a novel prognostic marker in various cancers, at transcriptional and translational levels. Enrichment analyses identified that the top gene sets predominantly related to immune and inflammatory responses. Further investigation found that the FCGBP mRNA level positively correlated to the infiltration rates of B cells, Th17/CD8+ T lymphocytes, T helper follicular cells, mast cells, and expression levels of various immune molecules and immune checkpoints in HNSC. (Conclusions) We found that the FCGBP mRNA level negatively correlated to TP53 mutation status while positively correlated to the TFF3 level. Additionally, FCGBP may regulate the tumor microenvironment. These findings support the FCGBP as a potential biomarker to estimate HNSC prognoses. Full article
(This article belongs to the Special Issue Advances in Diagnostics of Head and Neck Cancer)
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10 pages, 576 KiB  
Article
Prognostic Value of Perineural Invasion on Survival and Recurrence in Oral Squamous Cell Carcinoma
by Steffen Spoerl, Silvia Spoerl, Stephanie Reil, Michael Gerken, Nils Ludwig, Juergen Taxis, René Fischer, Tobias Ettl, Torsten E. Reichert and Gerrit Spanier
Diagnostics 2022, 12(5), 1062; https://doi.org/10.3390/diagnostics12051062 - 24 Apr 2022
Cited by 4 | Viewed by 1766
Abstract
A diagnosis of perineural invasion (PNI) is widely accepted as an unfavorable prognostic factor in various solid malignancies. Although PNI has been described as a high-risk parameter in oral squamous cell carcinoma (OSCC), its role in the current staging manuals of the American [...] Read more.
A diagnosis of perineural invasion (PNI) is widely accepted as an unfavorable prognostic factor in various solid malignancies. Although PNI has been described as a high-risk parameter in oral squamous cell carcinoma (OSCC), its role in the current staging manuals of the American Joint Committee on Cancer (AJCC) is rather subordinate. We analysed the prognostic value of PNI on survival and recurrence in a large, multicenter OSCC cohort and a population-based approach. A total of 493 OSCC patients with primary tumor resection to negative margins and concomitant neck dissection between 2010 and 2017 were enrolled. PNI was evaluated in relation to overall survival (OAS) and recurrence-free survival (RFS) using uni- and multi-variable Cox regression. The median follow-up time was 5.0 years and PNI was diagnosed in 48 patients (9.7%). A pathohistological verification of PNI correlated significantly with a deteriorated OAS in uni- (HR 2.312; 95% CI 2.312–3.493, p = 0.001) and multivariable Cox regression (HR 1.820; 95% CI 1.164–2.847, p = 0.009). Additionally, a diagnosis of PNI correlated with increased cumulative, as well as distant, metastasis 5-year-recurrence rates (p = 0.027 and p = 0.011, respectively). The application of adjuvant radiotherapy (RT) or radiochemotherapy (RCT) in patients with PNI did not alter OAS or RFS in survival analysis when compared to patients without PNI. The results underline the adverse impact of PNI on the survival and recurrence of surgically treated OSCC patients. Based on our findings, we highly recommend an emphasis on PNI in the TNM staging concept. Full article
(This article belongs to the Special Issue Advances in Diagnostics of Head and Neck Cancer)
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17 pages, 3488 KiB  
Article
Decision Support for Oropharyngeal Cancer Patients Based on Data-Driven Similarity Metrics for Medical Case Comparison
by Julia Buyer, Alexander Oeser, Nora Grieb, Andreas Dietz, Thomas Neumuth and Matthaeus Stoehr
Diagnostics 2022, 12(4), 999; https://doi.org/10.3390/diagnostics12040999 - 15 Apr 2022
Cited by 2 | Viewed by 1637
Abstract
Making complex medical decisions is becoming an increasingly challenging task due to the growing amount of available evidence to consider and the higher demand for personalized treatment and patient care. IT systems for the provision of clinical decision support (CDS) can provide sustainable [...] Read more.
Making complex medical decisions is becoming an increasingly challenging task due to the growing amount of available evidence to consider and the higher demand for personalized treatment and patient care. IT systems for the provision of clinical decision support (CDS) can provide sustainable relief if decisions are automatically evaluated and processed. In this paper, we propose an approach for quantifying similarity between new and previously recorded medical cases to enable significant knowledge transfer for reasoning tasks on a patient-level. Methodologically, 102 medical cases with oropharyngeal carcinoma were analyzed retrospectively. Based on independent disease characteristics, patient-specific data vectors including relevant information entities for primary and adjuvant treatment decisions were created. Utilizing the ϕK correlation coefficient as the methodological foundation of our approach, we were able to determine the predictive impact of each characteristic, thus enabling significant reduction of the feature space to allow for further analysis of the intra-variable distances between the respective feature states. The results revealed a significant feature-space reduction from initially 19 down to only 6 diagnostic variables (ϕK correlation coefficient ≥ 0.3, ϕK significance test ≥ 2.5) for the primary and 7 variables (from initially 14) for the adjuvant treatment setting. Further investigation on the resulting characteristics showed a non-linear behavior in relation to the corresponding distances on intra-variable level. Through the implementation of a 10-fold cross-validation procedure, we were further able to identify 8 (primary treatment) matching cases with an evaluation score of 1.0 and 9 (adjuvant treatment) matching cases with an evaluation score of 0.957 based on their shared treatment procedure as the endpoint for similarity definition. Based on those promising results, we conclude that our proposed method for using data-driven similarity measures for application in medical decision-making is able to offer valuable assistance for physicians. Furthermore, we consider our approach as universal in regard to other clinical use-cases, which would allow for an easy-to-implement adaptation for a range of further medical decision-making scenarios. Full article
(This article belongs to the Special Issue Advances in Diagnostics of Head and Neck Cancer)
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10 pages, 1772 KiB  
Article
Polyamine Metabolites as Biomarkers in Head and Neck Cancer Biofluids
by Brian C. DeFelice, Oliver Fiehn, Peter Belafsky, Constanze Ditterich, Michael Moore, Marianne Abouyared, Angela M. Beliveau, D. Gregory Farwell, Arnaud F. Bewley, Shannon M. Clayton, Joehleen A. Archard, Jordan Pavlic, Shyam Rao, Maggie Kuhn, Peter Deng, Julian Halmai, Kyle D. Fink, Andrew C. Birkeland and Johnathon D. Anderson
Diagnostics 2022, 12(4), 797; https://doi.org/10.3390/diagnostics12040797 - 24 Mar 2022
Cited by 5 | Viewed by 2477
Abstract
Background: Novel, non-invasive diagnostic biomarkers that facilitate early intervention in head and neck cancer are urgently needed. Polyamine metabolites have been observed to be elevated in numerous cancer types and correlated with poor prognosis. The aim of this study was to assess [...] Read more.
Background: Novel, non-invasive diagnostic biomarkers that facilitate early intervention in head and neck cancer are urgently needed. Polyamine metabolites have been observed to be elevated in numerous cancer types and correlated with poor prognosis. The aim of this study was to assess the concentration of polyamines in the saliva and urine from head and neck cancer (HNC) patients, compared to healthy controls. Methods: Targeted metabolomic analysis was performed on saliva and urine from 39 HNC patient samples and compared to 89 healthy controls using a quantitative, targeted liquid chromatography mass spectrometry approach. Results: The metabolites N1-acetylspermine (ASP), N8-acetylspermidine (ASD) and N1,N12-diacetylspermine (DAS) were detected at significantly different concentrations in the urine of HNC patients as compared to healthy controls. Only ASP was detected at elevated levels in HNC saliva as compared to healthy controls. Conclusion: These data suggest that assessment of polyamine-based metabolite biomarkers within the saliva and urine warrants further investigation as a potential diagnostic in HNC patients. Full article
(This article belongs to the Special Issue Advances in Diagnostics of Head and Neck Cancer)
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7 pages, 1370 KiB  
Article
Olfactory Neuroblastoma: Re-Evaluating the Paradigm of Intracranial Extension and Cyst Formation
by Rebecca A. Dumont, Miguel Fernando Palma Diaz, William Hsu and Ali R. Sepahdari
Diagnostics 2022, 12(3), 614; https://doi.org/10.3390/diagnostics12030614 - 01 Mar 2022
Cited by 3 | Viewed by 3267
Abstract
The purpose of the current study was to assess the prevalence of cyst formation at the brain-tumor interface in olfactory neuroblastoma. We used the UCLA patient-based Pathology and Radiology Head and Neck Database (UPP&R HAND) to identify the largest patient cohort reported to [...] Read more.
The purpose of the current study was to assess the prevalence of cyst formation at the brain-tumor interface in olfactory neuroblastoma. We used the UCLA patient-based Pathology and Radiology Head and Neck Database (UPP&R HAND) to identify the largest patient cohort reported to date with imaging and pathology data. Eighteen of thirty-one patients (58.1%) had evidence of intracranial extension on MRI, while four (22.0%) demonstrated cyst formation at the brain–tumor interface. The extent of intracranial extension was by far the strongest predictor for intracranial cyst formation, regardless of Hyams tumor grade, using a binary logistics regression model (p = 0.002) and ROC curve analysis (AUC 94.6%). Cyst formation at the brain-tumor interface was an uncommon imaging finding, and tends to occur with a larger component of intracranial tumor extension. Full article
(This article belongs to the Special Issue Advances in Diagnostics of Head and Neck Cancer)
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10 pages, 1111 KiB  
Article
Concordance between Three PD-L1 Immunohistochemical Assays in Head and Neck Squamous Cell Carcinoma (HNSCC) in a Multicenter Study
by Elena Guerini Rocco, Albino Eccher, Ilaria Girolami, Paolo Graziano, Gabriella Fontanini, Elena Vigliar, Giancarlo Troncone, Massimo Barberis, Patrizia Morbini and Maurizio Martini
Diagnostics 2022, 12(2), 477; https://doi.org/10.3390/diagnostics12020477 - 13 Feb 2022
Cited by 12 | Viewed by 2278
Abstract
The introduction of immunotherapy targeting the programmed death-1 (PD-1)/programmed death-ligand-1 (PD-L1) axis has represented a turning point in the treatment of HNSCC. Harmonization studies comparing the different antibodies and immunohistochemistry platforms available for the evaluation of PD-L1 expression with Combined Positive Score (CPS) [...] Read more.
The introduction of immunotherapy targeting the programmed death-1 (PD-1)/programmed death-ligand-1 (PD-L1) axis has represented a turning point in the treatment of HNSCC. Harmonization studies comparing the different antibodies and immunohistochemistry platforms available for the evaluation of PD-L1 expression with Combined Positive Score (CPS) in HNSCC are strongly required. Tissue microarrays (TMA) constructed from formalin-fixed, paraffin-embedded (FFPE) tissue blocks of HNSCC tumor were stained with two commercial in-vitro diagnostic (IVD) PD-L1 immunohistochemical assays (22C3 pharmDx on Autostainer Link48 and Omnis platforms, and SP263) and were reviewed by seven trained pathologists to assess CPS. We found a very similar distribution for PD-L1 expression between 22C3 pharmDx assay with both platforms and SP263 assay and a strong significant correlation between the two assays in different platforms (p < 0.0001). The interobserver reliability among pathologists for the continuous scores of CPS with intraclass correlation coefficient (ICC) and the correlation between the two assays were both good. Moreover, the agreement rate between assays was high at all cut-offs, while the kappa values were from substantial to almost perfect. These data suggest the interchangeability of the two antibodies and of the different immunohistochemical platforms in the selection of patients with HNSCC for immunotherapy. Full article
(This article belongs to the Special Issue Advances in Diagnostics of Head and Neck Cancer)
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8 pages, 926 KiB  
Article
Metabolic Tumour Volume as a Predictor of Survival for Sinonasal Tract Squamous Cell Carcinoma
by Hidenori Suzuki, Tsuneo Tamaki, Takeshi Kodaira, Masami Nishio, Daisuke Nishikawa, Shintaro Beppu, Hoshino Terada, Michi Sawabe and Nobuhiro Hanai
Diagnostics 2022, 12(1), 146; https://doi.org/10.3390/diagnostics12010146 - 07 Jan 2022
Cited by 2 | Viewed by 1093
Abstract
Background: High uptake of F18-fluorodeoxyglucose parameters for glucose metabolism is related to shorter survival in sinonasal tract cancer with various histological classifications. We investigated whether F18-fluorodeoxyglucose uptake parameters are associated with survival outcomes for patients with only squamous cell carcinoma (SCC) in the [...] Read more.
Background: High uptake of F18-fluorodeoxyglucose parameters for glucose metabolism is related to shorter survival in sinonasal tract cancer with various histological classifications. We investigated whether F18-fluorodeoxyglucose uptake parameters are associated with survival outcomes for patients with only squamous cell carcinoma (SCC) in the sinonasal tract that are treated either with surgery or nonsurgery. Methods: We retrospectively observed F18-fluorodeoxyglucose uptake parameters on positron emission tomography with computed tomography for the primary tumour of SCC in 39 patients. Log-rank test or a Cox regression model with 95% confidence interval (95%CI) and hazard ratio (HR) were used for monovariable or multivariable analysis, respectively. We determined cut-off values of the F18-fluorodeoxyglucose uptake parameters using the lowest p value for monovariable sinonasal tract cancer-specific survival analysis. Results: Monovariable analysis showed that patients with metabolic tumour volume (MTV) ≥ 21.8 had a shorter cancer-specific, disease-free and local recurrence-free survival than those with MTV < 21.8. After adjusting for age, gender, clinical stage and treatment group in the multivariable analysis, MTV (≥21.8/<21.8) was related to shorter cancer-specific (HR: 3.69, 95%CI: 1.17–12.0), disease-free (HR: 3.38, 95%CI: 1.19–9.71) and local recurrence-free (HR: 5.42, 95%CI: 1.59–20.3) survivals. Conclusions: MTV as advances in diagnostics of sinonasal tract SCC is a predictor. Full article
(This article belongs to the Special Issue Advances in Diagnostics of Head and Neck Cancer)
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16 pages, 1085 KiB  
Article
Head and Neck Paragangliomas in the Czech Republic: Management at the Otorhinolaryngology Department
by Anasuya Guha and Martin Chovanec
Diagnostics 2022, 12(1), 28; https://doi.org/10.3390/diagnostics12010028 - 23 Dec 2021
Cited by 2 | Viewed by 2108
Abstract
Head and neck paragangliomas (HNPGLs) are rare neuroendocrine tumors, comprising only 3% of all head and neck tumors. Early diagnosis forms an integral part of the management of these tumors. The two main aims of any treatment approach are long-term tumor control and [...] Read more.
Head and neck paragangliomas (HNPGLs) are rare neuroendocrine tumors, comprising only 3% of all head and neck tumors. Early diagnosis forms an integral part of the management of these tumors. The two main aims of any treatment approach are long-term tumor control and minimal cranial nerve morbidity. The scope of this article is to present our case series of HNPGLs to stress most important clinical aspects of their presentation as well as critical issues of their complex management. Thirty patients with suspected HNPGLs were referred to our otorhinolaryngology clinic for surgical consultation between 2016–2020. We assessed the demographical pattern, clinicoradiological correlation, as well as type and outcome of treatment. A total of 42 non-secretory tumors were diagnosed—16.7% were incidental findings and 97% patients had benign tumors. Six patients had multiple tumors. Jugular paragangliomas were the most commonly treated tumors. Tumor control was achieved in nearly 96% of operated patients with minimal cranial nerve morbidity. Surgery is curative in most cases and should be considered as frontline treatment modality in experienced hands for younger patients, hereditary and secretory tumors. Cranial nerve dysfunction associated with tumor encasement is a negative prognostic factor for both surgery and radiotherapy. Multifocal tumors and metastasis are difficult to treat, even with early detection using genetic analysis. Detecting malignancy in HNPGLs is challenging due to the lack of histomorphological criteria; therefore, limited lymph node dissection should be considered, even in the absence of clinical and radiological signs of metastasis in carotid body, vagal, and jugular paragangliomas. Full article
(This article belongs to the Special Issue Advances in Diagnostics of Head and Neck Cancer)
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18 pages, 1229 KiB  
Article
The Prevalence of High- and Low-Risk Types of HPV in Patients with Squamous Cell Carcinoma of the Head and Neck, Patients with Chronic Tonsillitis, and Healthy Individuals Living in Poland
by Joanna Katarzyna Strzelczyk, Krzysztof Biernacki, Jadwiga Gaździcka, Elżbieta Chełmecka, Katarzyna Miśkiewicz-Orczyk, Natalia Zięba, Janusz Strzelczyk and Maciej Misiołek
Diagnostics 2021, 11(12), 2180; https://doi.org/10.3390/diagnostics11122180 - 24 Nov 2021
Cited by 4 | Viewed by 1896
Abstract
Human papillomavirus (HPV) is a virus with the potential to infect human epithelial cells and an etiological agent of many types of cancer, including head and neck cancer. The aim of the study was to determine the prevalence of HPV infection in patients [...] Read more.
Human papillomavirus (HPV) is a virus with the potential to infect human epithelial cells and an etiological agent of many types of cancer, including head and neck cancer. The aim of the study was to determine the prevalence of HPV infection in patients with head and neck squamous cell carcinoma (HNSCC), patients with chronic tonsillitis, and healthy individuals, and to establish high- and low-risk HPV genotypes in these groups. The objectives also comprised the delineation of the relationship between the infection with high- or low-risk HPV subtypes and clinicopathological and demographic characteristics of the study groups. This study was composed of 76 patients diagnosed with HNSCC, 71 patients with chronic tonsillitis, and 168 cases without either of these conditions (the control group). HPV detection and identification of subtypes were performed on isolated DNA using a test which allowed detection of 33 common high-risk and low-risk HPV subtypes. The prevalence of HPV infection was 42.1%, 25.4%, and 37.5% in HNSCC, chronic tonsillitis, and control groups, respectively. HPV 16 was the most prevalent genotype in all groups and the non-oncogenic HPV 43/44 was frequent in HNSCC patients. This analysis provides insight into the prevalence of oral oncogenic and non-oncogenic HPVs in patients with head and neck cancer, patients with chronic tonsillitis and healthy individuals, and leads to the conclusion that further investigations are warranted to examine a larger cohort of patients focusing on high- and low-risk HPV genotypes. Efforts should be focused on screening and prevention strategies, and therefore, it is important to introduce tools for effective detection of HPV genotypes. Furthermore, given the role of vaccines against oral HPV infection, our observations lead to the suggestion that HPV vaccination should be of considerable importance in public health strategies. Full article
(This article belongs to the Special Issue Advances in Diagnostics of Head and Neck Cancer)
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15 pages, 2905 KiB  
Article
Computed Tomography Angiography (CTA) before Reconstructive Jaw Surgery Using Fibula Free Flap: Retrospective Analysis of Vascular Architecture
by Michael Knitschke, Anna Katrin Baumgart, Christina Bäcker, Christian Adelung, Fritz Roller, Daniel Schmermund, Sebastian Böttger, Hans-Peter Howaldt and Sameh Attia
Diagnostics 2021, 11(10), 1865; https://doi.org/10.3390/diagnostics11101865 - 11 Oct 2021
Cited by 8 | Viewed by 6322
Abstract
Computed tomography angiography (CTA) is widely used in preoperative evaluation of the lower limbs’ vascular system for virtual surgical planning (VSP) of fibula free flap (FFF) for jaw reconstruction. The present retrospective clinical study analysed n = 72 computed tomography angiographies (CTA) of [...] Read more.
Computed tomography angiography (CTA) is widely used in preoperative evaluation of the lower limbs’ vascular system for virtual surgical planning (VSP) of fibula free flap (FFF) for jaw reconstruction. The present retrospective clinical study analysed n = 72 computed tomography angiographies (CTA) of lower limbs for virtual surgical planning (VSP) for jaw reconstruction. The purpose of the investigation was to evaluate the morphology of the fibular bone and its vascular supply in CTA imaging, and further, the amount and distribution of periosteal branches (PB) and septo-cutaneous perforators (SCPs) of the fibular artery. A total of 144 lower limbs was assessed (mean age: 58.5 ± 15.3 years; 28 females, 38.9%; 44 males, 61.1%). The vascular system was categorized as regular (type I-A to II-C) in 140 cases (97.2%) regarding the classification by Kim. Absent anterior tibial artery (type III-A, n = 2) and posterior tibial artery (type III-B, n = 2) were detected in the left leg. Stenoses were observed mostly in the fibular artery (n = 11), once in the anterior tibial artery, and twice in the posterior tibial artery. In total, n = 361 periosteal branches (PBs) and n = 231 septo-cutaneous perforators (SCPs) were recorded. While a distribution pattern for PBs was separated into two clusters, a more tripartite distribution pattern for SCPs was found. We conclude that conventional CTA for VSP of free fibula flap (FFF) is capable of imaging and distinguishing SCPs and PBs. Full article
(This article belongs to the Special Issue Advances in Diagnostics of Head and Neck Cancer)
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13 pages, 4785 KiB  
Article
Systemic Investigation Identifying Salivary miR-196b as a Promising Biomarker for Early Detection of Head-Neck Cancer and Oral Precancer Lesions
by Ann-Joy Cheng, Guo-Rung You, Che-Jui Lee, Ya-Ching Lu, Shang-Ju Tang, Yi-Fang Huang, Yu-Chen Huang, Li-Yu Lee, Kang-Hsing Fan, Yen-Chao Chen, Shiang-Fu Huang and Joseph Tung-Chieh Chang
Diagnostics 2021, 11(8), 1411; https://doi.org/10.3390/diagnostics11081411 - 04 Aug 2021
Cited by 7 | Viewed by 2267
Abstract
Background: Liquid biopsy is a rapidly growing field, for it may provide a minimally invasive way to acquire pathological data for personalized medicine. This study developed a systemic strategy to discover an effective salivary biomarker for early detection of patients with head-neck squamous [...] Read more.
Background: Liquid biopsy is a rapidly growing field, for it may provide a minimally invasive way to acquire pathological data for personalized medicine. This study developed a systemic strategy to discover an effective salivary biomarker for early detection of patients with head-neck squamous carcinoma (HNSC) and oral precancer lesion (OPC). Methods: A total of 10 miRNAs were examined in parallel with multiple independent cohorts. These included a training set of salivary samples from HNSC patients, the TCGA-HNSC and GSE31277 cohorts to differentiate miRNAs between tumor and normal tissues, and groups of salivary samples from healthy individuals, patients with HNSC and OPC. Results: The combined results from the salivary training set and the TCGA-HNSC cohort showed that four miRNAs (miR-148b, miR-155, miR-196b, and miR-31) consistently increased in HNSC patients. Further integration with the GSE31277 cohort, two miRNAs (miR-31 and miR-196b) maintained at high significances. Further assessment showed that salivary miR-196b was a prominent diagnostic biomarker, as it remarkably discriminated between healthy individuals and patients with HNSC (p < 0.0001, AUC = 0.767, OR = 5.64) or OPC (p < 0.0001, AUC = 0.979, OR = 459). Conclusion: Salivary miR-196b could be an excellent biomarker for diagnosing OPC and early detection of HNSC. This molecule may be used for early screening high-risk groups of HNSC. Full article
(This article belongs to the Special Issue Advances in Diagnostics of Head and Neck Cancer)
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19 pages, 1162 KiB  
Article
Comorbidity, Radiation Duration, and Pretreatment Body Muscle Mass Predict Early Treatment Failure in Taiwanese Patients with Locally Advanced Oral Cavity Squamous Cell Carcinoma after Completion of Adjuvant Concurrent Chemoradiotherapy
by Yu-Ching Lin, Hang Huong Ling, Pei-Hung Chang, Yi-Ping Pan, Cheng-Hsu Wang, Wen-Chi Chou, Fang-Ping Chen and Kun-Yun Yeh
Diagnostics 2021, 11(7), 1203; https://doi.org/10.3390/diagnostics11071203 - 02 Jul 2021
Cited by 1 | Viewed by 1572
Abstract
Few prospective cohort trials have evaluated the potential risk factors of early treatment failure of locally advanced oral cavity squamous cell carcinoma (LAOCSCC) patients following the completion of postoperative adjuvant concurrent chemoradiotherapy (CCRT). We collected clinicopathological variables, nutrition-inflammatory markers and total body composition [...] Read more.
Few prospective cohort trials have evaluated the potential risk factors of early treatment failure of locally advanced oral cavity squamous cell carcinoma (LAOCSCC) patients following the completion of postoperative adjuvant concurrent chemoradiotherapy (CCRT). We collected clinicopathological variables, nutrition-inflammatory markers and total body composition data assessed by dual-energy X-ray absorptiometry (DXA) before and after CCRT. A factor analysis was used to reduce the number of DXA-derived parameters. Cox proportional hazard models were applied to determine the risk factors associated with early treatment failure defined as tumor progression or death within 180 days of CCRT completion. A total of 69 patients were eligible for analysis. After CCRT, the body weight, body mass index, nutritional markers, and muscle mass decreased, whereas C-reactive protein level increased. Five factors reflecting different body composition statuses were identified. A total of 21 patients (30.4%) developed early treatment failure. Comorbidities (hazard ratio ((HR)), 2.699; 95% confidence interval ((CI)), 1.005–7.913; p = 0.044), radiation duration (HR, 1.092; 95% CI, 1.015–1.174; p = 0.018) and the pretreatment body muscle mass (HR, 0.578; 95% CI, 0.345–0.957; p = 0.037) independently contributed to early treatment failure. Comorbidities, longer radiation duration, and lower pretreatment body muscle mass are predictive factors for early treatment failure in LAOCSCC patients following postoperative adjuvant CCRT completion. Full article
(This article belongs to the Special Issue Advances in Diagnostics of Head and Neck Cancer)
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12 pages, 2229 KiB  
Article
Nestin Expression Is Associated with Relapses in Head and Neck Lesions
by Mario Pérez-Sayáns, Cintia M Chamorro-Petronacci, Fátima Baltazar, Fabio Ramoa Pires, Ángel Ínsua, Juan A Suárez-Quintanilla and José M Suárez-Peñaranda
Diagnostics 2021, 11(4), 583; https://doi.org/10.3390/diagnostics11040583 - 24 Mar 2021
Cited by 1 | Viewed by 1940
Abstract
Background: The aim was to investigate the clinical significance of nestin immunohistochemical expression in head and neck area lesions and to study its role in patient survival and recurrence. Methods: 39 (44.3%) nasosinus, 37 (42%) major salivary gland (6 submandibular and 31 parotid) [...] Read more.
Background: The aim was to investigate the clinical significance of nestin immunohistochemical expression in head and neck area lesions and to study its role in patient survival and recurrence. Methods: 39 (44.3%) nasosinus, 37 (42%) major salivary gland (6 submandibular and 31 parotid) and 12 (13.6%) oral cavity lesions of paraffin-embedded samples were retrospectively included. Results: The expression was categorized into grades, negative for 55 (62.5%) cases, grade 1 in 10 cases (11.4%), grade 2 in 12 cases (13.6%), and grade 3 in 11 cases (12.5%); 100% of pleomorphic adenomas were positive for nestin with grade 3 intensity, 100% of polyps and inverted papillomas were negative (p < 0.001). The lowest estimate of disease-free-survival (DFS) was for grade 1 expression, with 50 months, confidence interval (CI): 95% 13.3–23.9 months and the highest for grade 3 expression, 167.9 months (CI: 95% 32.1–105 months; Log-Rank = 14.846, p = 0.002). ROC (receiver operating characteristic) curves revealed that the positivity for nestin (+/−) in relation to malignancy, presented a sensitivity of 50.98%, a specificity of 81.08%, with an area under the curve of 0.667 (p = 0.009). Conclusions: Nestin could be a useful marker to detect the presence of stem cells in head and neck tumors that have a role in tumor initiation and progression. Full article
(This article belongs to the Special Issue Advances in Diagnostics of Head and Neck Cancer)
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12 pages, 1539 KiB  
Article
Cyclist Effort Features: A Novel Technique for Image Texture Characterization Applied to Larynx Cancer Classification in Contact Endoscopy—Narrow Band Imaging
by Nazila Esmaeili, Axel Boese, Nikolaos Davaris, Christoph Arens, Nassir Navab, Michael Friebe and Alfredo Illanes
Diagnostics 2021, 11(3), 432; https://doi.org/10.3390/diagnostics11030432 - 03 Mar 2021
Cited by 9 | Viewed by 1839
Abstract
Background: Feature extraction is an essential part of a Computer-Aided Diagnosis (CAD) system. It is usually preceded by a pre-processing step and followed by image classification. Usually, a large number of features is needed to end up with the desired classification results. In [...] Read more.
Background: Feature extraction is an essential part of a Computer-Aided Diagnosis (CAD) system. It is usually preceded by a pre-processing step and followed by image classification. Usually, a large number of features is needed to end up with the desired classification results. In this work, we propose a novel approach for texture feature extraction. This method was tested on larynx Contact Endoscopy (CE)—Narrow Band Imaging (NBI) image classification to provide more objective information for otolaryngologists regarding the stage of the laryngeal cancer. Methods: The main idea of the proposed methods is to represent an image as a hilly surface, where different paths can be identified between a starting and an ending point. Each of these paths can be thought of as a Tour de France stage profile where a cyclist needs to perform a specific effort to arrive at the finish line. Several paths can be generated in an image where different cyclists produce an average cyclist effort representing important textural characteristics of the image. Energy and power as two Cyclist Effort Features (CyEfF) were extracted using this concept. The performance of the proposed features was evaluated for the classification of 2701 CE-NBI images into benign and malignant lesions using four supervised classifiers and subsequently compared with the performance of 24 Geometrical Features (GF) and 13 Entropy Features (EF). Results: The CyEfF features showed maximum classification accuracy of 0.882 and improved the GF classification accuracy by 3 to 12 percent. Moreover, CyEfF features were ranked as the top 10 features along with some features from GF set in two feature ranking methods. Conclusion: The results prove that CyEfF with only two features can describe the textural characterization of CE-NBI images and can be part of the CAD system in combination with GF for laryngeal cancer diagnosis. Full article
(This article belongs to the Special Issue Advances in Diagnostics of Head and Neck Cancer)
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11 pages, 1214 KiB  
Article
Role of the Appendicular Skeletal Muscle Index for Predicting the Recurrence-Free Survival of Head and Neck Cancer
by Kun-Yun Yeh, Hang Huong Ling, Shu-Hang Ng, Cheng-Hsu Wang, Pei-Hung Chang, Wen-Chi Chou, Fang-Ping Chen and Yu-Ching Lin
Diagnostics 2021, 11(2), 309; https://doi.org/10.3390/diagnostics11020309 - 14 Feb 2021
Cited by 5 | Viewed by 1779
Abstract
Background: This study investigates whether the appendicular skeletal muscle index (ASMI) was an independent prognostic predictor for patients with locally advanced head and neck cancer (LAHNC) receiving concurrent chemoradiotherapy (CCRT) and whether there were any differences in lean mass loss in different body [...] Read more.
Background: This study investigates whether the appendicular skeletal muscle index (ASMI) was an independent prognostic predictor for patients with locally advanced head and neck cancer (LAHNC) receiving concurrent chemoradiotherapy (CCRT) and whether there were any differences in lean mass loss in different body regions during CCRT. Methods: In this prospective study, we analyzed the clinicopathological variables and the total body composition data before and after treatment. The factors associated with the 2-year recurrence-free survival rate (RFSR) were analyzed via logistic regression analysis. Results: A total of 98 patients were eligible for analysis. The body weight, body mass index, and all parameters of body composition significantly decreased after CCRT. The pretreatment ASMI was the only independent prognostic factor for predicting the 2-year RFSR (hazard ratio, 0.235; 95% confidence interval, 0.062–0.885; p = 0.030). There was at least 5% reduction in total lean and fat mass (p < 0.001); however, the highest lean mass loss was observed in the arms (9.5%), followed by the legs (7.2%), hips (7.1%), waist (4.7%), and trunk (3.6%). Conclusions: The pretreatment ASMI was the only independent prognostic predictor for the 2-year RFSR of LAHNC patients undergoing CCRT. Asynchronous loss of lean mass may be observed in different body parts after CCRT. Full article
(This article belongs to the Special Issue Advances in Diagnostics of Head and Neck Cancer)
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Review

Jump to: Research, Other

14 pages, 566 KiB  
Review
Diagnostics of HNSCC Patients: An Analysis of Cell Lines and Patient-Derived Xenograft Models for Personalized Therapeutical Medicine
by Ramona Gabriela Ursu, Ionut Luchian, Costin Damian, Elena Porumb-Andrese, Nicolae Ghetu, Roxana Gabriela Cobzaru, Catalina Lunca, Carmen Ripa, Diana Costin, Igor Jelihovschi, Florin Dumitru Petrariu and Luminita Smaranda Iancu
Diagnostics 2022, 12(5), 1071; https://doi.org/10.3390/diagnostics12051071 - 25 Apr 2022
Cited by 4 | Viewed by 2586
Abstract
Head and neck squamous cell carcinomas (HNSCC) are very frequent worldwide, and smoking and chronic alcohol use are recognized as the main risk factors. For oropharyngeal cancers, HPV 16 infection is known to be a risk factor as well. By employing next-generation sequencing, [...] Read more.
Head and neck squamous cell carcinomas (HNSCC) are very frequent worldwide, and smoking and chronic alcohol use are recognized as the main risk factors. For oropharyngeal cancers, HPV 16 infection is known to be a risk factor as well. By employing next-generation sequencing, both HPV-positive and negative HNSCC patients were detected as positive for PI3K mutation, which was considered an optimal molecular target. We analyzed scientific literature published in the last 5 years regarding the newly available diagnostic platform for targeted therapy of HNSCC HPV+/−, using HNSCC-derived cell lines cultures and HNSCC pdx (patient-derived xenografts). The research results are promising and require optimal implementation in the management of HNSCC patients. Full article
(This article belongs to the Special Issue Advances in Diagnostics of Head and Neck Cancer)
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15 pages, 712 KiB  
Review
Qualitative and Quantitative Diagnosis in Head and Neck Cancer
by Fernando López, Antti Mäkitie, Remco de Bree, Alessandro Franchi, Pim de Graaf, Juan C. Hernández-Prera, Primoz Strojan, Nina Zidar, Margareta Strojan Fležar, Juan P. Rodrigo, Alessandra Rinaldo, Barbara A. Centeno and Alfio Ferlito
Diagnostics 2021, 11(9), 1526; https://doi.org/10.3390/diagnostics11091526 - 24 Aug 2021
Cited by 8 | Viewed by 3351
Abstract
The diagnosis is the art of determining the nature of a disease, and an accurate diagnosis is the true cornerstone on which rational treatment should be built. Within the workflow in the management of head and neck tumours, there are different types of [...] Read more.
The diagnosis is the art of determining the nature of a disease, and an accurate diagnosis is the true cornerstone on which rational treatment should be built. Within the workflow in the management of head and neck tumours, there are different types of diagnosis. The purpose of this work is to point out the differences and the aims of the different types of diagnoses and to highlight their importance in the management of patients with head and neck tumours. Qualitative diagnosis is performed by a pathologist and is essential in determining the management and can provide guidance on prognosis. The evolution of immunohistochemistry and molecular biology techniques has made it possible to obtain more precise diagnoses and to identify prognostic markers and precision factors. Quantitative diagnosis is made by the radiologist and consists of identifying a mass lesion and the estimation of the tumour volume and extent using imaging techniques, such as CT, MRI, and PET. The distinction between the two types of diagnosis is clear, as the methodology is different. The accurate establishment of both diagnoses plays an essential role in treatment planning. Getting the right diagnosis is a key aspect of health care, and it provides an explanation of a patient’s health problem and informs subsequent decision. Deep learning and radiomics approaches hold promise for improving diagnosis. Full article
(This article belongs to the Special Issue Advances in Diagnostics of Head and Neck Cancer)
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14 pages, 2229 KiB  
Review
Current Trends and Controversies in the Management of Warthin Tumor of the Parotid Gland
by Miquel Quer, Juan C. Hernandez-Prera, Carl E. Silver, Maria Casasayas, Ricard Simo, Vincent Vander Poorten, Orlando Guntinas-Lichius, Patrick J. Bradley, Wai Tong-Ng, Juan P. Rodrigo, Antti A. Mäkitie, Alessandra Rinaldo, Luiz P. Kowalski, Alvaro Sanabria, Remco de Bree, Robert P. Takes, Fernando López, Kerry D. Olsen, Ashok R. Shaha and Alfio Ferlito
Diagnostics 2021, 11(8), 1467; https://doi.org/10.3390/diagnostics11081467 - 13 Aug 2021
Cited by 15 | Viewed by 9505
Abstract
Purpose: To review the current options in the management of Warthin tumors (WTs) and to propose a working management protocol. Methods: A systematic literature search was conducted using PubMed and ScienceDirect database. A total of 141 publications were selected and have been included [...] Read more.
Purpose: To review the current options in the management of Warthin tumors (WTs) and to propose a working management protocol. Methods: A systematic literature search was conducted using PubMed and ScienceDirect database. A total of 141 publications were selected and have been included in this review. Publications were selected based on relevance, scientific evidence, and actuality. Results: The importance of parotid WTs is increasing due to its rising incidence in many countries, becoming the most frequently encountered benign parotid tumor in certain parts of the world. In the past, all WTs were treated with surgery, but because of their slow growth rate, often minimal clinical symptoms, and the advanced age of many patients, active observation has gradually become more widely used. In order to decide on active surveillance, the diagnosis of WT must be reliable, and clinical, imaging, and cytological data should be concordant. There are four clear indications for upfront surgery: uncertain diagnosis; cosmetic problems; clinical complaints, such as pain, ulceration, or recurrent infection; and the patient’s wish to have the tumor removed. In the remaining cases, surgery can be elective. Active surveillance is often suggested as the first approach, with surgery being considered if the tumor progresses and/or causes clinical complaints. The extent of surgery is another controversial topic, and the current trend is to minimize the resection using partial parotidectomies and extracapsular dissections when possible. Recently, non-surgical options such as microwave ablation, radiofrequency ablation, and ultrasound-guided ethanol sclerotherapy have been proposed for selected cases. Conclusions: The management of WT is gradually shifting from superficial or total parotidectomy to more conservative approaches, with more limited resections, and to active surveillance in an increasing number of patients. Additionally, non-surgical treatments are emerging, but their role needs to be defined in future studies. Full article
(This article belongs to the Special Issue Advances in Diagnostics of Head and Neck Cancer)
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16 pages, 909 KiB  
Review
Current Insights into Oral Cancer Diagnostics
by Yee-Fun Su, Yi-Ju Chen, Fa-Tzu Tsai, Wan-Chun Li, Ming-Lun Hsu, Ding-Han Wang and Cheng-Chieh Yang
Diagnostics 2021, 11(7), 1287; https://doi.org/10.3390/diagnostics11071287 - 16 Jul 2021
Cited by 24 | Viewed by 9537
Abstract
Oral cancer is one of the most common head and neck malignancies and has an overall 5-year survival rate that remains below 50%. Oral cancer is generally preceded by oral potentially malignant disorders (OPMDs) but determining the risk of OPMD progressing to cancer [...] Read more.
Oral cancer is one of the most common head and neck malignancies and has an overall 5-year survival rate that remains below 50%. Oral cancer is generally preceded by oral potentially malignant disorders (OPMDs) but determining the risk of OPMD progressing to cancer remains a difficult task. Several diagnostic technologies have been developed to facilitate the detection of OPMD and oral cancer, and some of these have been translated into regulatory-approved in vitro diagnostic systems or medical devices. Furthermore, the rapid development of novel biomarkers, electronic systems, and artificial intelligence may help to develop a new era where OPMD and oral cancer are detected at an early stage. To date, a visual oral examination remains the routine first-line method of identifying oral lesions; however, this method has certain limitations and as a result, patients are either diagnosed when their cancer reaches a severe stage or a high-risk patient with OPMD is misdiagnosed and left untreated. The purpose of this article is to review the currently available diagnostic methods for oral cancer as well as possible future applications of novel promising technologies to oral cancer diagnosis. This will potentially increase diagnostic options and improve our ability to effectively diagnose and treat oral cancerous-related lesions. Full article
(This article belongs to the Special Issue Advances in Diagnostics of Head and Neck Cancer)
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10 pages, 2130 KiB  
Review
Prognostic Value of C-Reactive Protein-to-Albumin Ratio in Head and Neck Cancer: A Meta-Analysis
by Chih-Wei Luan, Hsin-Yi Yang, Yao-Te Tsai, Meng-Chiao Hsieh, Hsin-Hsu Chou and Kuo-Su Chen
Diagnostics 2021, 11(3), 403; https://doi.org/10.3390/diagnostics11030403 - 26 Feb 2021
Cited by 18 | Viewed by 2249
Abstract
The C-reactive protein-to-albumin ratio is a proven prognostic predictor of nasopharyngeal carcinoma. However, the role of the C-reactive protein-to-albumin ratio in other head and neck cancers remains unclear. This meta-analysis explored the prognostic value of the C-reactive protein-to-albumin ratio in head and neck [...] Read more.
The C-reactive protein-to-albumin ratio is a proven prognostic predictor of nasopharyngeal carcinoma. However, the role of the C-reactive protein-to-albumin ratio in other head and neck cancers remains unclear. This meta-analysis explored the prognostic value of the C-reactive protein-to-albumin ratio in head and neck cancers. A systematic search was conducted. Outcomes of interest included overall survival, disease-free survival, and distant metastasis–free survival. The hazard ratio with 95% confidence interval was pooled using a random-effects model. A total of 11 publications from the literature were included, allowing for the analysis of 7080 participants. Data pooling demonstrated that pretreatment C-reactive protein-to-albumin ratio had a hazard ratio of 1.88 (95% CI: 1.49−2.37, p < 0.001) for predicting overall survival, 1.91 (95% CI: 1.18−3.08, p = 0.002) for disease-free survival, and 1.46 (95% CI: 1.08−1.96, p = 0.001) for distant metastasis–free survival. Subgroup analysis showed that the C-reactive protein-to-albumin ratio is a significant prognostic marker for various head and neck cancers. An elevated pretreatment C-reactive protein-to-albumin ratio predicts a worse prognosis for patients with head and neck cancers. Therefore, the C-reactive protein-to-albumin ratio could serve as a potential prognostic biomarker facilitating treatment stratification. Full article
(This article belongs to the Special Issue Advances in Diagnostics of Head and Neck Cancer)
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11 pages, 3818 KiB  
Case Report
Epithelial-Myoepithelial Carcinoma of the Minor Salivary Glands: Case Series with Comprehensive Review
by Kohei Okuyama, Yasuyuki Michi, Yoshihisa Kashima, Hirofumi Tomioka, Hideaki Hirai, Misaki Yokokawa, Yuko Yamagata, Takeshi Kuroshima, Yuriko Sato, Maiko Tsuchiya, Kou Kayamori, Tohru Ikeda and Hiroyuki Harada
Diagnostics 2021, 11(11), 2124; https://doi.org/10.3390/diagnostics11112124 - 16 Nov 2021
Cited by 8 | Viewed by 2856
Abstract
Epithelial-myoepithelial carcinoma (EMC) is a rare salivary gland tumor that is histologically characterized by biphasic tubular structures composed of inner ductal and outer clear myoepithelial cells, which is especially uncommon in the minor salivary glands (MSG). Because of its histologic variety, complexity, and [...] Read more.
Epithelial-myoepithelial carcinoma (EMC) is a rare salivary gland tumor that is histologically characterized by biphasic tubular structures composed of inner ductal and outer clear myoepithelial cells, which is especially uncommon in the minor salivary glands (MSG). Because of its histologic variety, complexity, and heterogeneity, it is sometimes challenging to make the accurate diagnosis. Here, we report a literature review of EMC of the MSGs with our experience of two cases. Incisional biopsy was suggestive of pleomorphic adenoma in Case 1 and pleomorphic adenoma or a low-grade salivary gland carcinoma in Case 2. Both cases were performed intraoral tumor resection, and they have good postoperative courses and are alive with no evidence of local recurrence or metastasis at 31 and 16 months, respectively. Considering that the anatomy, structure, and size of salivary glands are quite different from MSGs, it might be difficult to predict EMCs of the MSG similarly to EMCs of the major salivary glands. This comprehensive review also reports the features of EMC of the MSG cases and the trends of diagnosis and discusses treatment strategy. Full article
(This article belongs to the Special Issue Advances in Diagnostics of Head and Neck Cancer)
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6 pages, 1321 KiB  
Case Report
Complex Component of Oncocytic and Non-Oncocytic Lipoadenomas in the Parotid Gland: A Case Report
by Fuyuki Sato, Takashi Nakajima and Takashi Sugino
Diagnostics 2021, 11(8), 1478; https://doi.org/10.3390/diagnostics11081478 - 15 Aug 2021
Viewed by 1700
Abstract
Oncocytic lipoadenoma of the salivary gland is a rare tumor that develops mainly in the parotid gland. We report a case of oncocytic lipoadenoma of the parotid gland in a 70-year-old woman. The tumor measured 30 × 20 mm and had a well-circumscribed [...] Read more.
Oncocytic lipoadenoma of the salivary gland is a rare tumor that develops mainly in the parotid gland. We report a case of oncocytic lipoadenoma of the parotid gland in a 70-year-old woman. The tumor measured 30 × 20 mm and had a well-circumscribed tan-brown surface. The tumor was histologically composed of oncocytic and lipomatous lesions without atypia. In addition to the oncocytic lipoadenoma, a small lipomatous tumor, measuring 10 × 7 mm, was found in the resected parotid gland. Macroscopically, this tumor was yellow and indistinguishable from the parotid gland. Microscopically, the tumor was rich in fats and contained an area of conglomerated duct-like proliferation and salivary gland components. Therefore, the tumor was diagnosed as a non-oncocytic lipoadenoma with a sialoadenoma component. We report the first case of double component oncocytic and non-oncocytic lipoadenomas of the salivary gland. Full article
(This article belongs to the Special Issue Advances in Diagnostics of Head and Neck Cancer)
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