Browsing by Author "Thompson, Lester D. R."
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- Cervical lymph node metastasis in adenoid cystic carcinoma of oral cavity and oropharynx: A collective international reviewPublication . Suarez, Carlos; Barnes, Leon; Silver, Carl E.; Rodrigo, Juan P.; Shah, Jatin P.; Triantafyllou, Asterios; Rinaldo, Alessandra; Cardesa, Antonio; Pitman, Karen T.; Kowalski, Luiz P.; Robbins, K. Thomas; Hellquist, Henrik; Medina, Jesus E.; Bree, Remco de; Takes, Robert P.; Coca-Pelaz, Andres; Bradley, Patrick J.; Gnepp, Douglas R.; Teymoortash, Afshin; Strojan, Primoz; Mendenhall, William M.; Eloy, Jean Anderson; Bishop, Justin A.; Devaney, Kenneth O.; Thompson, Lester D. R.; Hamoir, Marc; Slootweg, Pieter J.; Vander Poorten, Vincent; Williams, Michelle D.; Wenig, Bruce M.; Skalova, Alena; Ferlito, AlfioThe purpose of this study was to suggest general guidelines in the management of the NO neck of oral cavity and oropharyngeal adenoid cystic carcinoma (AdCC) in order to improve the survival of these patients and/or reduce the risk of neck recurrences. The incidence of cervical node metastasis at diagnosis of head and neck AdCC is variable, and ranges between 3% and 16%. Metastasis to the cervical lymph nodes of intraoral and oropharyngeal AdCC varies from 2% to 43%, with the lower rates pertaining to palatal AdCC and the higher rates to base of the tongue. Neck node recurrence may happen after treatment in 0-14% of AdCC, is highly dependent on the extent of the treatment and is very rare in patients who have been treated with therapeutic or elective neck dissections, or elective neck irradiation. Lymph node involvement with or without extracapsular extension in AdCC has been shown in most reports to be independently associated with decreased overall and cause-specific survival, probably because lymph node involvement is a risk factor for subsequent distant metastasis. The overall rate of occult neck metastasis in patients with head and neck AdCC ranges from 15% to 44%, but occult neck metastasis from oral cavity and/or oropharynx seems to occur more frequently than from other locations, such as the sinonasal tract and major salivary glands. Nevertheless, the benefit of elective neck dissection (END) in AdCC is not comparable to that of squamous cell carcinoma, because the main cause of failure is not relaied to neck or local recurrence, but rather, to distant failure. Therefore, END should be considered in patients with a cN0 neck with AdCC in some high risk oral and oropharyngeal locations when postoperative RT is not planned, or the rare AdCC-high grade transformation. (C) 2016 Elsevier Ireland Ltd. All rights reserved.
- Cervical lymph node metastasis in adenoid cystic carcinoma of the larynx: a collective international reviewPublication . Coca-Pelaz, Andres; Barnes, Leon; Rinaldo, Alessandra; Cardesa, Antonio; Shah, Jatin P.; Rodrigo, Juan P.; Suarez, Carlos; Eloy, Jean Anderson; Bishop, Justin A.; Devaney, Kenneth O.; Thompson, Lester D. R.; Wenig, Bruce M.; Strojan, Primoz; Hamoir, Marc; Bradley, Patrick J.; Gnepp, Douglas R.; Silver, Carl E.; Slootweg, Pieter J.; Triantafyllou, Asterios; Vander Poorten, Vincent; Williams, Michelle D.; Skalova, Alena; Hellquist, Henrik; Teymoortash, Afshin; Medina, Jesus E.; Robbins, K. Thomas; Pitman, Karen T.; Kowalski, Luiz P.; de Bree, Remco; Mendenhall, William M.; Takes, Robert P.; Ferlito, AlfioAdenoid cystic carcinoma (AdCC) of the head and neck is a well-recognized pathologic entity that rarely occurs in the larynx. Although the 5-year locoregional control rates are high, distant metastasis has a tendency to appear more than 5 years post treatment. Because AdCC of the larynx is uncommon, it is difficult to standardize a treatment protocol. One of the controversial points is the decision whether or not to perform an elective neck dissection on these patients. Because there is contradictory information about this issue, we have critically reviewed the literature from 1912 to 2015 on all reported cases of AdCC of the larynx in order to clarify this issue. During the most recent period of our review (1991-2015) with a more exact diagnosis of the tumor histology, 142 cases were observed of AdCC of the larynx, of which 91 patients had data pertaining to lymph node status. Eleven of the 91 patients (12.1%) had nodal metastasis and, based on this low proportion of patients, routine elective neck dissection is therefore not recommended.
- Cervical lymph node metastasis in high-grade transformation of head and neck adenoid cystic carcinoma: a collective international reviewPublication . Hellquist, Henrik; Skalova, Alena; Barnes, Leon; Cardesa, Antonio; Thompson, Lester D. R.; Triantafyllou, Asterios; Williams, Michelle D.; Devaney, Kenneth O.; Gnepp, Douglas R.; Bishop, Justin A.; Wenig, Bruce M.; Suarez, Carlos; Rodrigo, Juan P.; Coca-Pelaz, Andres; Strojan, Primoz; Shah, Jatin P.; Hamoir, Marc; Bradley, Patrick J.; Silver, Carl E.; Slootweg, Pieter J.; Vander Poorten, Vincent; Teymoortash, Afshin; Medina, Jesus E.; Robbins, K. Thomas; Pitman, Karen T.; Kowalski, Luiz P.; de Bree, Remco; Mendenhall, William M.; Eloy, Jean Anderson; Takes, Robert P.; Rinaldo, Alessandra; Ferlito, AlfioAdenoid cystic carcinoma (AdCC) is among the most common malignant tumors of the salivary glands. It is characterized by a prolonged clinical course, with frequent local recurrences, late onset of metastases and fatal outcome. High-grade transformation (HGT) is an uncommon phenomenon among salivary carcinomas and is associated with increased tumor aggressiveness. In AdCC with high-grade transformation (AdCC-HGT), the clinical course deviates from the natural history of AdCC. It tends to be accelerated, with a high propensity for lymph node metastasis. In order to shed light on this rare event and, in particular, on treatment implications, we undertook this review: searching for all published cases of AdCC-HGT. We conclude that it is mandatory to perform elective neck dissection in patients with AdCC-HGT, due to the high risk of lymph node metastases associated with transformation.
- Emerging entities and new diagnostic markers for head and neck soft tissue and bone tumorsPublication . Franchi, Alessandro; Thompson, Lester D. R.; Hernandez-Prera, Juan C.; Agaimy, Abbas; Williams, Michelle D.; Mikkelsen, Lauge H.; Bishop, Justin A.; Willems, Stefan M.; Hellquist, Henrik; Ferlito, AlfioBone and soft tissue tumors of the head and neck are relatively uncommon tumors that often represent a diagnostic challenge because of the wide range of entities that must be considered in the differential diagnosis. Over the past few years, classification of bone and soft tissue tumors has evolved primarily because of substantial contributions from molecular genetics, with the identification of new markers that are increasingly used to complement histopathologic findings in the routine diagnostic workup. This review focuses on the recently described mesenchymal tumors that preferentially involve the head and neck region, with a focus on the most relevant novel immunohistochemical and molecular findings, including gene fusions and mutations, that can help in the diagnosis and in the assessment of clinical behavior.
- The impact of histopathology on prognosis of squamous cell carcinoma of the larynx: can we do better?Publication . Zidar, Nina; Thompson, Lester D. R.; Agaimy, Abbas; Stenman, Göran; Hellquist, Henrik; Nadal, Alfons; Mäkitie, Antti A.; Fernando, López; Strojan, Primož; Ferlito, AlfioDespite decades of progress, laryngeal squamous cell carcinoma (SCC) is still associated with significant morbidity and mortality worldwide. Additional biomarkers are needed to apply precision medicine and predict the clinical course. We reviewed and summarised routinely reported histopathologic features (e.g. subtypes of laryngeal SCC) along with promising potential biomarkers not yet routinely assessed using international guidelines. These include extra- vs intratumoural vascular and perineural invasion, tumour budding, depth of invasion, and tumour-infiltrating lymphocytes. We also address the problem of specimen quality and type (open approach vs endoscopic surgery) and the related limitations. High-risk human papillomavirus infection is another controversial issue to be discussed, being rare in laryngeal SCC, with an indeterminate prognostic significance and less reliable p16 overexpression as a surrogate marker of HPV infection. Further studies are warranted to address the applicability and to see which of the described parameters may help to better stratify patients with laryngeal SCC and should therefore be included in the pathology report.
- Metastatic cutaneous squamous cell carcinoma accounts for nearly all squamous cell carcinomas of the parotid glandPublication . Bradley, Patrick J.; Stenman, Göran; Thompson, Lester D. R.; Skálová, Alena; Simpson, Roderick H. W.; Slootweg, Pieter J.; Franchi, Alessandro; Zidar, Nina; Nadal, Alfons; Hellquist, Henrik; Williams, Michelle D.; Leivo, Ilmo; Agaimy, Abbas; Ferlito, AlfioPrimary squamous cell carcinoma of the parotid gland (pSCCP) has long been recognized as a separate entity and is included in the WHO classifications of salivary gland tumors. However, it is widely accepted among head and neck pathologists that pSCCP is exceptionally rare. Yet, there are many publications describing series of pSCCP and data from SEER and other cancer register databases indicate erroneously an increasing incidence of pSCCP. Importantly, pSCCP and metastatic (secondary) squamous cell carcinoma to the parotid gland (mSCCP) have nearly identical histological features, and the diagnosis of pSCCP should only be made after the exclusion of mSCCP. Moreover, all of the histological diagnostic criteria proposed to be in favor of pSCCP (such as, for example, dysplasia of ductal epithelium) can be encountered in unequivocal mSCCP, thereby representing secondary growth along preexistent ducts. Squamous cell differentiation has also been reported in rare genetically defined primary parotid carcinomas, either as unequivocal histological squamous features (e.g., NUT carcinoma, mucoepidermoid carcinoma), by immunohistochemistry (e.g., in NUT carcinoma, adamantinoma-like Ewing sarcoma, basal-type salivary duct carcinoma, mucoepidermoid carcinoma), or a combination of both. Another major issue in this context is that the International Classification of Diseases (ICD) coding system does not distinguish between primary or metastatic disease, resulting in a large number of patients with mSCCP being misclassified as pSCCP. Immunohistochemistry and new molecular biomarkers have significantly improved the accuracy of the diagnosis of many salivary gland neoplasms, but until recently there were no biomarkers that can accurately distinguish between mSCCP and pSCCP. However, recent genomic profiling studies have unequivocally demonstrated that almost all SCCP analyzed to date have an ultraviolet light (UV)-induced mutational signature typical of mSCCP of skin origin. Thus, mutational signature analysis can be a very useful tool in determining the cutaneous origin of these tumors. Additional molecular studies may shed new light on this old diagnostic and clinical problem. This review presents a critical view of head and neck experts on this topic.
- Rhabdomyoblastic Differentiation in Head and Neck Malignancies Other Than RhabdomyosarcomaPublication . Bishop, Justin A.; Thompson, Lester D. R.; Cardesa, Antonio; Barnes, Leon; Lewis, James S., Jr.; Triantafyllou, Asterios; Hellquist, Henrik; Stenman, Goran; Hunt, Jennifer L.; Williams, Michelle D.; Slootweg, Pieter J.; Devaney, Kenneth O.; Gnepp, Douglas R.; Wenig, Bruce M.; Rinaldo, Alessandra; Ferlito, AlfioRhabdomyosarcoma is a relatively common soft tissue sarcoma that frequently affects children and adolescents and may involve the head and neck. Rhabdomyosarcoma is defined by skeletal muscle differentiation which can be suggested by routine histology and confirmed by immunohistochemistry for the skeletal muscle-specific markers myogenin or myoD1. At the same time, it must be remembered that when it comes to head and neck malignancies, skeletal muscle differentiation is not limited to rhabdomyosarcoma. A lack of awareness of this phenomenon could lead to misdiagnosis and, subsequently, inappropriate therapeutic interventions. This review focuses on malignant neoplasms of the head and neck other than rhabdomyosarcoma that may exhibit rhabdomyoblastic differentiation, with an emphasis on strategies to resolve the diagnostic dilemmas these tumors may present. Axiomatically, no primary central nervous system tumors will be discussed.
- Sinonasal undifferentiated carcinoma (SNUC): from an entity to morphologic pattern and back again-a historical perspectivePublication . Agaimy, Abbas; Franchi, Alessandro; Lund, Valerie J.; Skalova, Alena; Bishop, Justin A.; Triantafyllou, Asterios; Andreasen, Simon; Gnepp, Douglas R.; Hellquist, Henrik; Thompson, Lester D. R.; Rinaldo, Alessandra; Ferlito, AlfioSince the first description of sinonasal undifferentiated carcinoma (SNUC) as a distinctive highly aggressive sinonasal neoplasm with probable origin from the sinonasal mucosa (Schneiderian epithelium), SNUC has been the subject of ongoing study and controversy. In particular, the SNUC category gradually became a "wastebasket" for any undifferentiated or unclassifiable sinonasal malignancy of definite or probable epithelial origin. However, with the availability of more specific and sensitive immunohistochemical antibodies and increasing implementation of novel genetic tools, the historical SNUC category became the subject of progressive subdivision leading to recognition of specific genetically defined, reproducible subtypes. These recently recognized entities are characterized by distinctive genetic aberrations including NUTM1-rearranged carcinoma (NUT carcinoma) and carcinomas associated with inactivation of different members of the SWI/SNF chromatin-remodeling gene complex such as SMARCB1-deficient and less frequently SMARCA4-deficient carcinoma. The ring became almost closed, with recent studies highlighting frequent oncogenic IDH2 mutations in the vast majority of histologically defined SNUCs, with a frequency of 82%. A review of these cases suggests the possibility that "true SNUC" probably represents a distinctive neoplastic disease entity, morphologically, phenotypically, and genetically. This review addresses this topic from a historical perspective, with a focus on recently recognized genetically defined subsets within the SNUC spectrum.