Cervical Metastasis in Parotid Squamous Cell Carcinoma

Cervical Metastasis in Parotid Squamous Cell Carcinoma

P180 Otolaryngology-Head and Neck Surgery, Vol 143, No 2S2, August 2010 tients had ectopic parathyroid adenomas in the anterior mediastinum ranging ...

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P180

Otolaryngology-Head and Neck Surgery, Vol 143, No 2S2, August 2010

tients had ectopic parathyroid adenomas in the anterior mediastinum ranging in size from 7-9 mm. Three patients elected to proceed with surgery where imaging correlated favorably with intraoperative localization, confirmed by appropriate turbo PTH decreases and pathology identification of parathyroid adenoma. One patient elected to proceed with interventional transarterial ablation of her mediastinal parathyroid adenoma. CONCLUSION: The cardiac gated 4D CT is an excellent adjunct study for patients with non-localizing Sestamibi scans with ectopic parathyroid adenomas in the mediastinum. Central Neck Dissection: Impact on Parathyroid Hormone Level Luc Morris, MD (presenter); Sara Immerman, MD; Arnold Komisar, MD, DDS, MS; Gady Har-El, MD OBJECTIVE: 1) Evaluate the change in postoperative rapid parathyroid hormone (PTH) levels with the addition of central compartment neck dissection (CND) compared to total thyroidectomy alone for well-differentiated thyroid cancer (WDTC). 2) Determine the impact of central neck dissection on long-term hypocalcemia. METHOD: Eighty-four consecutive patients undergoing primary total thyroidectomy were included and divided into 3 study groups: 35 patients with WDTC who underwent CND (C⫹/CND⫹), 13 patients with WDTC without CND (C⫹/ CND-), and 36 patients with benign disease (C-/CND-). Rapid PTH levels were measured immediately prior to surgery and 4 hours after specimen removal. Percent reduction in PTH values and percentage of patients with PTH ⬍10pg/ml postoperatively were calculated. Statistical significance was determined using ANOVA and chi-square analyses. Relative risk (RR) for each group was determined. Factors for postoperative hypocalcemia (gender, age, and size of nodule) were evaluated using multivariate analyses. RESULTS: Mean percent reduction in PTH in the C⫹/ CND⫹ group was 56.7%, compared to 47.0% (C⫹/CNDgroup) and 50.5% (C-/CND- group) (p⫽0.21). Postoperative PTH level 2months). There were no patients with permanent hypocalcemia. CONCLUSION: Our findings suggest that the addition of CND during total thyroidectomy can produce a decrease in PTH levels, and if not corrected with calcium supplementation, it potentially may result in hypocalcemia. However, there is no clinical impact on the occurrence of prolonged or permanent hypocalcemia. Cervical Metastasis in Parotid Squamous Cell Carcinoma Lavanya Varatharajan, BSc (presenter); Prince Modayil, MS, MRCS, DOHNS; Balakrishnan Kalyanasundaram, MS, DNB, FRCS; Jonathan Williams, FRCPath; Michael Lee, MB, ChB, FRCSEd, FRCS

OBJECTIVE: Evaluate the risk of cervical nodal metastasis and probable risk factors for parotid squamous cell carcinoma. METHOD: A retrospective review of case notes was carried out of patients treated for parotid SCC between 1989 and 2009 in a tertiary referral hospital. RESULTS: 10 males (71%) and 4 females (29%) were identified. Mean age at diagnosis was 79 years (range 64-87 years). 10 (71%) patients were Caucasian. 9 patients (64%) had primary parotid SCC and 5 patients (36%) had metastasis from a known primary site. Facial nerve palsy was noted in 5 patients (36%). 4 patients (44%) had early (T2), 8 patients (57%) had late (T3 and T4) stage disease and the staging was unknown in 2 patients. Regional lymph node metastasis was noted in 8 patients (57%) and no patient had distant metastasis. All patients underwent parotidectomy and 11 patients (79%) had simultaneous neck dissection. 11 patients (79%) had postoperative radiotherapy. Disease recurrence occurred in 2 patients (14%) and 6 patients (43%) have died. Overall 2 and 5 years survival rates are 87% and 53%, respectively. CONCLUSION: In our study, primary SCC is more common than metastatic SCC of the parotid gland. Being male and Caucasian are probable risk factors for parotid SCC. With over half of our patient cohort having neck node metastasis, parotidectomy with simultaneous neck dissection appears to be mandatory for the optimum surgical treatment of this disease. Clinical Characteristics of HPV in Tonsillar Carcinoma Min-Sik Kim, MD, PhD (presenter); Kwang-Jae Cho; Young-Hoon Joo; Jun-Ook Park OBJECTIVE: To determine the role of high risk human papillomavirus (HPV) in the pathogenesis of squamous cell carcinoma (SCC) of the tonsil in a Korean population. METHOD: The study included 54 subjects with SCC of the tonsil. High risk HPV in situ hybridization was performed to detect HPV infection. We evaluated the relationship between high risk HPV and clinico-pathological factors. RESULTS: The positive rate of high risk HPV in situ hybridization was 31.5% (17/54). Significant correlations were found between high risk HPV and younger age (younger than 50 years of age) and non-smoking status (p⫽0.008 and p⫽0.042, respectively). However, there was no significant correlation between gender (p⫽0.173), alcohol abuse (p⫽0.371), primary tumor stage (p⫽0.091), cervical metastasis (p⫽0.233), tumor cell differentiation (p⫽0.057), extracapsular spread (p⫽0.437), perineural invasion (p⫽0.384), perivascular invasion (p⫽0.491) and high risk HPV. In those patients followed for more than 12 months there was a 5-year overall and disease-specific survival of 67% and 70%. High risk HPV was not associated with the disease-specific survival (p⫽0.194). CONCLUSION: High risk HPV infection is significantly associated with the SCC of the tonsil among young patients and