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4 results

  • Bronchoscopy in panendoscopy: review and assessment

  • A Shahangian, E J Damrose
  • Journal:
    The Journal of Laryngology & Otology / Volume 129 / Issue 12 / December 2015
    Published online by Cambridge University Press:
    02 November 2015, pp. 1220-1223
    Print publication:
    December 2015
  • Objective:

    To determine the utility of bronchoscopy to identify synchronous primaries in head and neck cancer patients.

    Study design:

    Case series with chart review.

    Method:

    The charts of all patients undergoing bronchoscopy between January 2008 and December 2013 were reviewed. Only those undergoing bronchoscopy as part of panendoscopy for head and neck cancer were included. Operative reports, pathology reports and discharge summaries were reviewed for operative findings, complications and length of hospital stay.

    Results:

    A total of 404 charts were reviewed and 168 were included in the study. No synchronous primaries were identified. Bronchoscopy changed clinical management in one patient. There were no complications from bronchoscopy.

    Conclusion:

    Bronchoscopy is a safe and well-tolerated procedure commonly performed in the investigation of head and neck cancer patients, but it adds little additional useful clinical information. Routine performance of bronchoscopy in this setting should be weighed against its added costs, and tailored to the individual patient.

  • The added value of 18F-fluorodeoxyglucose positron emission tomography computed tomography in patients with neck lymph node metastases from an unknown primary malignancy

  • S J B Prowse, R Shaw, D Ganeshan, P M Prowse, R Hanlon, H Lewis-Jones, H Wieshmann
  • Journal:
    The Journal of Laryngology & Otology / Volume 127 / Issue 8 / August 2013
    Published online by Cambridge University Press:
    07 August 2013, pp. 780-787
    Print publication:
    August 2013
  • Background:

    The search for a primary malignancy in patients with a metastatic cervical lymph node is challenging yet ultimately of utmost clinical importance. This study evaluated the efficacy of positron emission tomography computed tomography in detecting the occult primary, within the context of a tertiary referral centre head and neck cancer multidisciplinary team tumour board meeting.

    Methods:

    Thirty-two patients (23 men and 9 women; mean and median age, 61 years) with a metastatic cervical lymph node of unknown primary origin, after clinical examination and magnetic resonance imaging, underwent positron emission tomography computed tomography.

    Results:

    The primary tumour detection rate was 50 per cent (16/32). Positron emission tomography computed tomography had a sensitivity of 94 per cent (16/17) and a specificity of 67 per cent (10/15). Combining these results with those of 10 earlier studies of similar patients gave an overall detection rate of 37 per cent.

    Conclusion:

    Positron emission tomography computed tomography has become an important imaging modality. To date, it has the highest primary tumour detection rate, for head and neck cancer patients presenting with cervical lymph node metastases from an unknown primary.

  • Unknown primary of the head and neck

  • Yoav P. Talmi, Gregory T. Wolf, Mark Hazuka, Charles J. Krause
  • Journal:
    The Journal of Laryngology & Otology / Volume 110 / Issue 4 / April 1996
    Published online by Cambridge University Press:
    29 June 2007, pp. 353-356
    Print publication:
    April 1996

  • The occurrence of metastases to the cervical lymph nodes from an unknown primary tumour is seen in approximately three to six per cent of patients with cervical adenopathy and the primary tumour commonly remains elusive. Single modality treatment is occasionally advocated but combined treatment seems to obtain the best results.

    A retrospective analysis of patients' charts with unknown primary of the head and neck in theUniversity of Michigan Medical Center was undertaken for the years 1978–1992. Forty-eight records met study criteria and were reviewed.

    Our series' size and heterogeneity prevents drawing conclusions regarding treatment effectiveness. The majority (67.5 per cent) of our patients were treated by surgery followed by irradiation. Our overall survival rates compare favourably with the general statistics although it should be noted that longer follow-up in our first group of patients may alter our results. Extracapsular spread did not adversely affect survival in our small series of five cases. We discovered six primary sites within one year and three additional cases within four years. The primary site was included in the radiation fields in all instances of squamous cell tumours that were eventually found. It has been suggested that eventual manifestation of the primary site adversely affects prognosis, which is in agreement with our results.