[Show abstract][Hide abstract] ABSTRACT: Congenital epiglottic cyst, although rare, may potentially cause severe airway obstruction. Major symptoms include mild stridor, trouble eating, chest retraction, apnea, and cyanosis. We report a case presenting with hydramnios in which a congenital epiglottic cyst caused severe airway obstruction and asphyxiation at birth. After surgical removal of the cyst, no airway obstruction has recurred in the half year of follow-up. It appears likely that a large congenital epiglottic cyst caused hydramnios with dysphagia. We therefore suggest that hydramnios is considered a possible sign of congenital epiglottic cyst, and that it is necessary to prepare to maintain the airway in cases of airway obstruction at birth.
[Show abstract][Hide abstract] ABSTRACT: We report a 65-year-old female case of low-grade non-intestinal type adenocarcinoma of the nasal cavity with bilateral metastases to the cervical lymph nodes(T3N2cM0: Stage IV A). Chemoradiotherapy administered as first-line therapy yielded only a partial response in the primary tumor and metastatic lesions, and subsequent chemotherapy with S-1(at a dose of 80 mg per day)alone was applied as tumor dormancy therapy(TDT)on an outpatient basis. Adverse events during S-1 medication were limited to a decrease in leukocyte count and hemoglobin level, both of which were grade 1. The tumor has not enlarged, and the patient has survived 29 months since the beginning of chemotherapy with S-1 alone without any decrease in quality of life. Although the effectiveness of S-1 for adenocarcinoma of the head and neck has not been fully demonstrated, S-1 might be useful in patients with advanced head and neck adenocarcinoma for the purpose of TDT.
No preview · Article · Jan 2009 · Gan to kagaku ryoho. Cancer & chemotherapy
[Show abstract][Hide abstract] ABSTRACT: Spindle cell carcinoma (SpCC) of the tongue is a relatively rare malignancy. We treated a patient with metachronous early squamous cell carcinoma (SCC) in both margins of the tongue (right side first followed by left side). Eight years after treatment for the first SCC by surgery and radiotherapy, the second SCC occurred in the contralateral margin of the tongue. Surgical resection was performed for the second SCC, with local recurrence 8 months later associated with pathological change from SCC to SpCC. The SpCC was completely resected with wide surgical margins in combination with bilateral neck dissection. However, the patient developed pulmonary metastasis and died of respiratory failure 4 months after the final surgery. Postoperative inflammatory reaction followed by scar formation in the previously irradiated surgical site might have caused the transition from SCC to SpCC during the process of recurrence.
No preview · Article · Jun 2008 · Acta Oto-Laryngologica
[Show abstract][Hide abstract] ABSTRACT: One hundred three patients with peritonsillar abscess treated between January 2001 and June 2005 were clinically analysed. Seventy-four patients were male and 29 were female. The male to female ratio was 2.5:1. Patient ages ranged from 10 to 76 years old. The average age was 32.4 years old. Fourty nine patients were affected in the right side, and 54 in the left side. Sixty-four of 103 patients were referred to us by other doctors. The local findings deteriorated during the course of treatment in 4 of 103 patients are these four patients developed recurrent peritonsillar abscess. Only 2 patients were diabetic.All patients were treated with a peritonsillar incision and retropharyngeal incision if retropharyngeal abscess was seen, and at the same time antibiotics were administered intravenously. The most common etiological bacteria was Genus Streptococcus viridans seen in 32 patients, i. e. 33% of 97 patients examined. The second most common was Streptococcus pyogenes seen in 18 patient.Deep neck infection due to peritonsillar abscess was seen in 8 patients, that is, 8% of this series. Of these 8 patients, all but one were over 40 years old. Four patients had cellulitis and the other 3 had an abscess in the retrophalyngeal space. The former were incised independently from the peritonsillar incision, and the latter were incised from the peritonsillar to retropharyngeal region. Another patient had cellulitis in the parapharyngeal space and was cured with a peritonsillar incision and intravenous antibiotics alone without an external skin incision. This finding was considered an indication that peritonsillar abscess should be correctly treated before deterioration of deep neck infection, especially in patients over 40 years old.