Unexpected findings in the neck dissection specimens for primary head and neck squamous cell carcinoma

Year 2009, Volume: 19 Issue: 1, 9 - 15, 01.02.2009

Uğur Dokuzlar Levent Erişen Fikret Kasapoğlu Hamdi Hakan Coşkun Oğuz Basut Selçuk Onart İbrahim Hızalan

Abstract

Objectives: We aimed to determine the incidence of unexpected pathological findings observed during the histopathological examination of the neck dissection specimens performed for primary head and neck squamous cell carcinoma, and their impacts on the treatment and follow-up plans. Patients and Methods: We retrospectively reviewed 410 patients 369 males, 41 females; 169 patients unilateral, 241 patients bilateral with a diagnosis of squamous cell carcinoma of head and neck, who underwent 651 neck dissections. Results: Unexpected pathological findings were found in 3.2% of patients and 2% of neck dissections. These unexpected findings were tuberculosis in eight patients 2% , metastatic papillary thyroid carcinoma in three patients 0.7% , Warthin’s tumor in one patient and cystic hygroma in one patient. All patients who had metastatic papillary thyroid carcinoma received radioactive iodine treatment after thyroidectomy. In control examinations, none of these cases had problem related to neither primary disease nor thyroid pathology. Only two of eight patients who had tuberculosis in lymph nodes received medical treatment for tuberculosis, while the others were observed by clinical and radiological examinations. None of these patients had problems related to tuberculosis. We had no long-term follow-up results for cystic hygroma and Warthin’s tumor since these patients did not continue their routine examinations. Conclusion: During the pathologic examination of neck dissections, unexpected pathologic findings may occasionally be encountered. Most frequently seen unexpected findings were tuberculosis lymphadenitis and metastatic papillary thyroid carcinoma. However, these pathologic findings do not seem to affect the management of the primary disease.

Keywords

Head and neck neoplasms, neck dissection, squamous cell carcinoma

Primer baş ve boyun squamöz hücreli karsinomlarında boyun diseksiyonu örneklerinde beklenmedik bulgular

Abstract

Amaç: Primer baş-boyun yassı hücreli karsinomu nedeniyle yapılan boyun diseksiyonunda elde edilen örneklerin incelenmesi sırasında karşılaşılan beklenmedik patolojik bulguların ve görülme sıklığının, takip ve tedavi süreci üzerine etkileri ortaya kondu.Hastalar ve Yöntemler: Primer baş-boyun yerleşimli yassı hücreli karsinom nedeniyle 410 hastaya 369 erkek, 41 kadın; 169’u tek taraflı, 241’i iki taraflı yapılan toplam 651 boyun diseksiyonuna ait bilgiler hasta dosyalarında geriye dönük olarak incelendi.Bulgular: Olguların %3.2’sinde, boyun diseksiyonlarının ise %2’sinde beklenmedik patolojik bulgu saptandı. Beklenmedik bulgu olarak, sekiz olguda %2 granülomatöz iltihap tüberküloz ile uyumlu , üç olguda %0.7 papiller tiroid karsinomu yayılımı, birer olguda ise Warthin tümörü ve kistik higroma vardı. Tiroid papiller karsinomu saptanan olguların tümü tiroidektomi sonrası radyoaktif iyot tedavisi aldı. Bu olguların izlemlerinde primer tümör ve tiroid karsinomuyla ilgili sorun saptanmadı. Tüberküloz saptanan sekiz olgunun ikisi dışındakilere tüberküloz tedavisi verilmedi ve klinik takibe alındı. Bu hastaların hiçbirinde tüberküloz ile ilgili sorunla karşılaşılmadı. Kistik higroma ve Warthin tümörü saptanan olguların takiplere gelmemeleri nedeniyle uzun dönem takip sonuçları elde edilemedi.Sonuç: Primer baş-boyun yassı hücreli karsinomu nedeniyle yapılan boyun diseksiyonlarında ender de olsa beklenmedik bir başka patolojiye ait bulgular saptanabilir. Bu patolojiler içinde en sık rastlananları, tüberküloz lenfadenit ve tiroid papiller karsinom metastaz yayılımıdır. Ancak bu patolojilerin primer tümörün tedavi sürecini çok fazla etkilemediği düşünülmektedir

Keywords

Baş-boyun kanseri, boyun diseksiyonu, yassı hücreli karsinom

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