The utility of ultrasonographic surveillance in management of a presumed branchial cleft cyst later confirmed HPV-associated oropharyngeal cancer.

Autor: Ferraro T; Division of Otolaryngology-Head and Neck Surgery, The George Washington University School of Medicine and Health Sciences, 2300 M St NW, 4(th) Floor, Washington, DC 20037, USA; Drexel University College of Medicine, Philadelphia, PA, USA. Electronic address: tferraro@mfa.gwu.edu., Pershad AR; Division of Otolaryngology-Head and Neck Surgery, The George Washington University School of Medicine and Health Sciences, 2300 M St NW, 4(th) Floor, Washington, DC 20037, USA., Arora S; Division of Otolaryngology-Head and Neck Surgery, The George Washington University School of Medicine and Health Sciences, 2300 M St NW, 4(th) Floor, Washington, DC 20037, USA., Lee E; Division of Otolaryngology-Head and Neck Surgery, The George Washington University School of Medicine and Health Sciences, 2300 M St NW, 4(th) Floor, Washington, DC 20037, USA., Joshi A; Division of Otolaryngology-Head and Neck Surgery, The George Washington University School of Medicine and Health Sciences, 2300 M St NW, 4(th) Floor, Washington, DC 20037, USA.
Jazyk: angličtina
Zdroj: Oral oncology [Oral Oncol] 2024 Apr; Vol. 151, pp. 106743. Date of Electronic Publication: 2024 Mar 08.
DOI: 10.1016/j.oraloncology.2024.106743
Abstrakt: While branchial cleft cysts are often considered benign pathologies, the literature discusses cases of squamous cell carcinoma (SCC) arising from these cystic lesions as either a primary or metastatic tumor. We illustrate our institutional experience and review the current literature to identify recommendations for best diagnostic, surveillance, and treatment guidelines for SCC identified in a branchial cleft cyst. A 61-year-old male presented with a right sided neck mass, with suspicion of a branchial cleft cyst due to benign findings on fine needle aspiration. Following surgical excision, a focus of SCC was found on surgical pathology. Despite PET/CT and flexible laryngoscopy, no primary tumor was identified prompting routine surveillance every 3 months with cervical ultrasonography and flexible nasolaryngoscopy. Two and a half years following his initial presentation, pathologic right level II lymphadenopathy was detected on ultrasound without evidence of primary tumor. Subsequent transoral robotic surgery with right tonsillectomy and partial pharyngectomy, with right lateral neck dissection revealed a diagnosis of pT1N1 HPV-HNSCC and he was referred for adjuvant chemotherapy and radiation. To our knowledge there are less than 10 cases of confirmed HPV-associated oropharyngeal SCC arising from a branchial cleft cyst. Here we demonstrate the utility of ultrasound as a surveillance tool and emphasize a higher index of suspicion for carcinoma in adult patients with cystic neck masses.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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