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Association between head-and-neck cancers and active and passive cigarette smoking

Health 2012年第9期4卷 619-624页

作者： yukiomi kushihashi Yoshiyuki Kadokura Syuhei Takiguchi Yoshiyuki Kyo Yoshihiro Yamada Miki Shino Masato Kano Harumi Suzaki Department of Internal Medicine Shinnakagawa Hospital Yokohama Japan Department of Otorhinolaryngology Showa University Northern Yokohama Hospital Yokohama Japan Department of Otorhinolaryngology Showa University Tokyo Japan

Although there have been many reports on the toxicity of tobacco smoke, fewer studies have reported the relationship between the smoke and carcinogenesis of head-and-neck cancers. It is assumed that direct stimulations due to tobacco smoke, such as chemical and mechanical stimulations, strongly influence the epithelium of the nasal cavity, paranasal sinuses, pharynx, and larynx. We investigated the influence of active and passive cigarette smoking on head-and-neck cancers. The subjects were 283 head-and-neck cancer patients examined at the otolaryngology department of Showa University Northern Yokohama Hospital in a 9-year and 2-month period from April 2001 to June 2010, in whom the presence or absence of active and passive cigarette smoking could be confirmed in detail. The active and passive smoking rates and the Brinkman index were retrospectively investigated according to the primary cancer site, gender, and histopathological classification. The active and passive smoking rates were high (about 90%) in patients with hypopharyngeal, laryngeal, and cervical esophageal cancers, and the Brinkman index was high in all. Squamous cell carcinoma (SCC) patients accounted for a high ratio of the head-and-neck cancer patients, and the active and passive smoking rates were significantly higher in SCC than in non-squamous cell carcinoma (non-SCC) patients (p < 0.0003). The active and passive smoking rates and the Brinkman index were high in patients with head-and-neck cancers in regions receiving strong direct stimulation from tobacco smoke, and the Brinkman index was also high in these patients, suggesting that carcinogenesis of head-and-neck cancers is strongly influenced by direct tobacco smoke stimulation.

关键词： Head-and-Neck Cancers Squamous Cell Carcinoma Active Smoking Rate Passive Smoking Rate Brinkman Index

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Photoimmunotherapy for Local Recurrence of Nasopharyngeal Carcinoma: A Case Report

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International Journal of Otolaryngology and Head & Neck Surgery 2022年第5期11卷 258-265页

作者： yukiomi kushihashi Tatsuo Masubuchi Isaku Okamoto Chihiro Fushimi Kenji Hanyu Mayu Yamauchi Yuichiro Tada Koki Miura Head and Neck Oncology Center International University of Health and Welfare Mita Hospital Tokyo Japan Department of Otorhinolaryngology Head and Neck Surgery Tokyo Medical University Tokyo Japan

Photoimmunotherapy (PIT), developed by the National Cancer Institute, involves Cetuximab sarotalocan sodium infusion followed by laser irradiation. PIT exerts specific antitumor effects on a variety of carcinomas that express epidermal growth factor receptors. PIT is a new cancer treatment option approved by Japan ahead of other countries worldwide. As of 2022, PIT is indicated in “unresectable, locally advanced, or locally recurrent head and neck cancer, with priority given to standard treatments such as chemotherapy when available”. The conventional treatment for unresectable locally advanced or locally recurrent head and neck cancer is palliative. Whether photoimmunotherapy can be curative for unresectable locally advanced head and neck cancers depends on the case. Herein, we report a case of locally recurrent nasopharyngeal carcinoma, treated with photoimmunotherapy via the nasal cavity, along with a literature review. Preoperative simulation provided considerable information on device selection, numbers of devices, and availability of working space. As a result, a complete response was obtained following a cylindrical diffuser puncture. Cases of local recurrence of nasopharyngeal carcinoma are considered a good indication for PIT. However, since the follow-up period after treatment was short in this case, we will continue to conduct strict follow-ups and accumulate more cases.

关键词： Photoimmunotherapy Nasopharyngeal Carcinoma Head and Neck Carcinoma Cetuximab Sarotalocan Sodium

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A Case of Secretory Carcinoma That Occurred in the Buccal Submucosa

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International Journal of Otolaryngology and Head & Neck Surgery 2019年第6期8卷 191-197页

作者： Saito Yoshiro Kurasawa Yuya Moriya Takashi Ikeda Kenitiro kushihashi yukiomi Egawa Shunya Katsuta Hideyuki Shimane Toshikazu Head and Neck Oncology Center Showa UniversityTokyoJapan Department of Oral and Maxillofacial Surgery Division of Oral OncologyShowa UniversitySchool of DentistryTokyoJapan Department of Otorhinolaryngology Showa University School of MedicineTokyoJapan

Secretory carcinoma (SC) is a malignant salivary gland tumor that has been first reported by Skalova et al. in 2010. Histologically, it shows solidity infiltrated with very small cystic cavities and cribriform and papillary features and includes periodic acid-Schiff stain-positive, acid-fast secretions. The cells have oval nuclei, and vacuolated cytoplasm and foamy secretions are seen. Anaplasia is not strong and mitotic figures are rarely seen. These features closely resemble AciCC. Immunohistologically, it is thought to be positive for S-100 protein, vimentin, and mammaglobin and negative for DOG1. The presence of the ETV6-NTRK3 fusion gene is essential in diagnosing secretory carcinoma. In this report, we describe a case of SC in a 52-year-old woman. She was referred to our center because of a mass in left buccal mucosa. A soft and elastic submucosal mass measuring approximately 10 mm × 10 mm in size with a smooth surface was seen in the buccal mucosa in an area corresponding to the left mandibular canine to premolars. The imaging findings revealed that a high-intensity lesion was seen on T2-weighted images. Immunohistochemicalstaing for S-100 protein and vimentin were positive. Furthermore, genetic examination detected the presence of the ETV6-NTRK3 fusion gene. Based on these findings, the definitive diagnosis was secretory carcinoma.

关键词： Secretory Carcinoma ETV6-NTRK3 Fusion Gene Buccal Mucosa

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Case Report of a Clear-Cell Variant of Follicular Thyroid Carcinoma

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International Journal of Otolaryngology and Head & Neck Surgery 2020年第2期9卷 68-77页

作者： yukiomi kushihashi Kenichiro Ikeda Syunya Egawa Yoshiro Saito Yuya Kurasaa Takashi Moriya Sawa Arai Takefumi Yui Hideyuki Katsuta Toshikazu Shimane Head and Neck Oncology Center Showa UniversityTokyoJapan Department of Otorhinolaryngology Showa University School of MedicineTokyoJapan Department of Oral and Maxillofacial Surgery Division of Oral OncologyShowa UniversitySchool of DentistryTokyoJapan

Clear-cell variants of follicular carcinoma are rare subtypes of thyroid cancer. There is no unified view of the histopathological features of clear cell variants, but follicular carcinomas composed predominantly of clear cells are distinguished from clear cell variants. In clinical practice, it is important to determine whether clear cell variants arise primarily from the thyroid gland or are thyroid metastases of other clear cell carcinomas, such as renal cell carcinoma. We present a case in which a patient with initially suspected anaplastic thyroid carcinoma due to a rapidly progressive anterior neck mass was diagnosed with a clear cell variant of follicular carcinoma after a tissue biopsy. The patient was treated with lenvatinib, then his performance status improved, and he was discharged from the hospital. On day 188 after discharge, a contrast-enhanced computed tomography (CECT) scan of the neck showed further shrinkage of the tumor. However, a CECT scan of the chest revealed multiple lung metastases. On day 233 after discharge, the patient developed severe pneumonia resulting from tracheal rupture due to intratumoral necrosis. It was difficult to decide whether lenvatinib should have been discontinued or reduced when lung metastasis appeared. It is necessary to accumulate additional cases to make informed decisions about continuing lenvatinib therapy.

关键词： Clear Cell Variant Follicular Carcinoma Thyroid Carcinoma Lenvatinib

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A Case of Bilateral Secondary Pneumothorax Shortly after the Completion of Concurrent Chemoradiotherapy for Tongue Cancer

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International Journal of Otolaryngology and Head & Neck Surgery 2020年第3期9卷 93-100页

作者： Yoshiro Saito Hideyuki Katsuta Takashi Moriya Yuya Kurasawa Hitoshi Sato Shunya Egawa yukiomi kushihashi Kenichiro Ikeda Toshikazu Shimane Head and Neck Oncology Center Showa University Tokyo Japan Department of Oral and Maxillofacial Surgery Division of Oral Oncology Showa University School of Dentistry Tokyo Japan Department of Otorhinolaryngology Showa University School of Medicine Tokyo Japan

Metastatic lung tumours rarely lead to development of pneumothorax, and no case of bilateral secondary pneumothorax due to lung metastases arising from tongue cancer has been reported. Here, we report a case of a patient with tongue cancer with lung metastases complicated by bilateral secondary pneumothorax soon after the completion of concurrent chemoradiotherapy. A 39-year-old man with cervical lymph node metastases originating from pT2N0M0 tongue cancer underwent neck dissection and postoperative concurrent chemoradiotherapy. Shortly after the completion of chemoradiotherapy, he developed bilateral secondary pneumothorax. Subsequently, he underwent partial lung resection for the pulmonary fistulae for diagnostic and therapeutic purposes;nodular lesions found in both the lungs. The diagnosis of secondary pneumothorax was based on histopathological findings. Although all pulmonary fistulae disappeared after partial lung resection, he died of the primary disease despite our best efforts to control the metastatic pulmonary lesions.

关键词： Tongue Cancer Metastatic Lung Tumour Pneumothorax Concurrent Chemoradiotherapy

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A Study of 100 Cases of Cervical Schwannoma Treated with Inter-Capsular Resection

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International Journal of Otolaryngology and Head & Neck Surgery 2020年第2期9卷 61-67页

作者： Toshikazu Shimane Shunya Egawa yukiomi kushihashi Hitoshi Sato Yoshiro Saito Yuya Kurasawa Takashi Moriya Hirano Koujiro Hideyuki Katsuta Kenichiro Ikeda Showa University Head and Neck Oncology Center Tokyo Japan Department of Otorhinolaryngology Showa University School of Medicine Tokyo Japan Department of Oral and Maxillofacial Surgery Division of Oral Oncology Showa University School of Dentistry Tokyo Japan

Background: Cervical schwannoma is a relatively rare disease, and it is difficult to experience many surgical cases because it may be followed up without surgery. We examined 100 patients who underwent inter-capsular resection for cervical schwannomas at our center and classified the patients according to the nerve of origin. Methods: We retrospectively reviewed 100 patients who underwent inter-capsular resection for cervical schwannoma at our center from April 2005 to September 2019. We examined the patient’s characteristics including age, sex, tumor size (maximum diameter), origin nerve, preoperative symptoms, and postoperative neurological deficits for all cases. We classified the cases according to the nerve of origin and the occurrence of postoperative neurological deficits. Results: The occurrence of postoperative neurological deficit for all cases was as follows: “none” was 73%, “temporary paralysis” was 21%, and “permanent paralysis” was 6%. In the case of vagus nerve: “none” was 65.4%, “temporary paralysis” was 23.1%, “permanent paralysis” was 11.5%. In the case of sympathetic nerve: “none” was 64.7%, “temporary paralysis” was 29.4%, “permanent paralysis” was 5.9%. In the case of brachial plexus: “none” was 87.0%, “temporary paralysis” was 13.0%, “permanent paralysis” was 0%. In the case of cervical and accessory nerves: “none” was 86.4%, “temporary paralysis” was 13.6%, “permanent paralysis” was 0%. In the case of facial nerve: “none” was 0%, “temporary paralysis” was 80.0%, “permanent paralysis” was 20%. In the case of lingual nerve: “none” was 80.0%, “temporary paralysis” was 20.0%, “permanent paralysis” was 0%. Conclusions: Inter-capsular resection is useful for the treatment of cervical schwannoma and a simple comparison is difficult, but probably with good results. This study provides information that will be useful for the treatment of cervical schwannoma.

关键词： Cervical Schwannoma Inter-Capsular Resection Origin Nerve Neurologi-cal Deficit Complication

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MR imaging of cheek lesions of Kimura’s disease: Focusing on the signal abnormalities and the relationship with superficial musculoaponeurotic systems

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Modern Research in Inflammation 2013年第4期2卷 69-74页

作者： Ryutarou Ukisu Yuichiro Kawahara Norihiro Hashizume Tamio kushihashi Yoshinori Yamada Yoshiyuki Kadokura Department of Otolaryngology Showa University Northern Yokohama Hospital Yokohama Japan Department of Radiology Showa University Northern Yokohama Hospital Yokohama Japan

Background and Purpose: Kimura’s Disease (KD) is a rare benign chronic eosinophlic inflammatory disorder, characterized by angiolymphoid proliferation with peripheral eosinophilia and elevated serum immunoglobulin E. Most lesions occur in the head and neck regions. To the best of our knowledge, the relationship between subcutaneous cheek lesion of KD and the surrounding structures including superficial musculoaponeurotic systems (SMAS) has never been reported. The purpose of this study was to describe MR imaging findings of cheek subcutaneous lesion of KD and adjacent SMAS. Materials and Methods: Seven cheek subcutaneous lesions of 5 patients histopathologically proved KD were evaluated. We retrospectively evaluated the MR imaging findings of subcutaneous lesions for signal intensity in each imaging sequence, the border of the lesions, and appearance of SMAS. Results: All cheek lesions were displacing normal fat tissue. These lesions showed ill-defined border (7/7), slightly high signal intensity on T1-weighted images (7/7), and intermediate (1/7) or high signal intensity (6/7) on T2-weighted images. Cheek lesions were enhanced by intravenous injection of gadolinium to signal intensity close to that of fat tissue (3/4), and in one case, the avid enhancement of the mass was seen (1/4). All lesions attached to the outer surface of SMAS, however, only one out of 7 lesions distributed below the SMAS without tearing of the layers. SMAS below the lesion showed high signal intensity on T2-weighted images in two lesions (2/7). Conclusion: KD should be included in the differential diagnosis when a cheek mass presents with non-specific signal intensities and irregular border, which attaches to but does not interrupt SMAS on MR imaging.

关键词： Kimura’s Disease SMAS (Superficial Musculoaponeurotic Systems) MRI

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Gigantic Nasal Fibroma: CT and MR Imaging Findings with Histopathological Correlation

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Open Journal of Medical Imaging 2013年第3期3卷 102-104页

作者： Ryutarou Ukisu Yuichiro Kawahara Norihiro Hashizume Ryuichiro Fukuhara Madoka Tonouchi Hiroki Takenaka Tamio kushihashi Department of Radiology Showa University Northern Yokohama Hospital Yokohama Japan

A 79-year-old woman with gradually worsening left nasal obstruction, purulent rhinorrhea and severe headaches for 6 months admitted to the hospital. A gray-white and huge mass occupying the left nasal cavity was found in physical examination. CT revealed a soft-tissue-density mass in the left nasal cavity with erosion of adjacent bone structures. On T2-weighted MR images, the lesion showed homogenous extreme low signal intensity. The patient underwent successful surgical removal of huge sinonasal soft tissue mass measuring 50 × 45 × 40 mm. The final diagnosis of fibroma was made histologically. MR imaging studies showed characteristic signal intensities corresponding to histopathological components. To the best of our knowledge, this is the first report regarding the MR imaging findings of huge nasal fibroma in the English literature.

关键词： Fibroma Nasal Cavity CT MRI

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