Πέμπτη, 7 Νοεμβρίου 2019


  1. Radiation induced hypothyroidism – Why is early intervention necessary?

    In Press, Corrected Proof, Available online 7 November 2019
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  2. Response to R. Jayaraj

    In Press, Corrected Proof, Available online 2 November 2019
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  3. Complex midfacial defects: Is the extended Abbé flap the ideal solution to a tough problem?

    In Press, Corrected Proof, Available online 1 November 2019
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    Abstract
    Objectives
    The aim of this study was to investigate the role of the extended Abbé flap in the reconstruction of complex midfacial defects (upper lip, nasal base and medial cheek). We describe our personal experience with this method and present some interesting aspects from the relevant literature.
    Materials and methods
    Between 2003 and 2017 we retrospectively evaluated the records of all patients with defects of the upper lip and nasal base after the resection of malignant tumors or traumata and reconstruction by means of the extended Abbé flap. We looked for information on the origin of the defect, the functional result, the aesthetic outcome and postoperative complications. The functional result of the reconstruction of the oral commissure was assessed with regard to postoperative subjective speech integrity, preservation of competence of the oral sphincter and lip sensation. The aesthetic outcome was evaluated with regard to limitations in facial expression and scar formation.
    Results
    The study included 8 patients. Follow–up in the oncological cases was 85 months (range: 20–150 months). No tumor recurrences were detected. All patients achieved normal oral competence and mouth opening. No cases of blunting or microstomia were detected.
    Conclusion
    Reconstruction of the upper lip and nasal base with the extended Abbé flap is associated with an outstanding functional outcome that is cosmetically very acceptable.
  4. Verrucous dysplasia or verrucous hyperplasia: Clarity in terminology

    In Press, Corrected Proof, Available online 26 October 2019
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  5. Innovations in risk-stratification and treatment of Veterans with oropharynx cancer; roadmap of the 2019 Field Based Meeting

    In Press, Corrected Proof, Available online 22 October 2019
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  6. Immediate deltopectoral flap salvage of a failing anterolateral thigh free flap

    In Press, Corrected Proof, Available online 21 October 2019
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  7. Co-occurrence of Warthin’s tumor with oral squamous cell carcinoma – Overlapping risk factors and implications

    In Press, Corrected Proof, Available online 21 October 2019
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  8. Tubulopapillary hidradenoma-like tumor of the mandible: Two case reports of an underrecognized entity

    In Press, Corrected Proof, Available online 18 October 2019
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    Abstract
    Tubulopapillary hidradenoma-like tumor of the mandible is extremely rare, with only 3 cases published in the English-language literature. The clinicopathological characteristics and histogenesis of this tumor are unclear. Few pathologists and perhaps fewer clinicians are familiar with this entity, and it is likely underrecognized and under-reported. Herein, we present two additional cases, both misdiagnosed as malignancies preoperatively and postoperatively by different unwary pathologists. Awareness and knowledge of this enigmatic entity and its clinical and radiographic features, together with careful morphological assessment should enable the correct diagnosis and prevent unnecessary treatment.
  9. Immune checkpoint inhibitors: For how long do we need to release the brakes to achieve the optimum acceleration of immune-mediated anti-tumor response?

    In Press, Corrected Proof, Available online 18 October 2019
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    Abstract
    In recent years, cancer immunotherapy has emerged as the fourth pillar of cancer therapy alongside surgery, chemotherapy and radiotherapy. We here report an unusual scenario of a patient with advanced metastatic non-small cell lung cancer who was lost to follow up after two cycles of chemo-immunotherapy who later returned to clinic with complete response; suggesting that in some, all that was needed may have been just a few doses of therapy to “release the breaks.”
  10. Ibrutinib-associated oral ulcers

    In Press, Corrected Proof, Available online 17 October 2019
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  11. Second field tumors in oral submucous fibrosis: An abandoned phenomenon?

    In Press, Corrected Proof, Available online 16 October 2019
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  12. Oral melanomas in HIV-positive patients: Report of two cases and review of the literature

    In Press, Corrected Proof, Available online 29 July 2019
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    Abstract
    Oral melanoma in HIV-positive patients is exceedingly rare, with only two cases reported in the literature published in English. Herein, we report two additional cases of oral melanomas which occurred as oral masses in the upper gingiva and hard palate in 35- and 27-year-old HIV-positive women. Significant thrombocytopenia, anemia, reduced CD4 cells, and high HIV load occurred in both patients. Microscopically, the lesions showed a variable proliferation of fusiform and epithelioid-pigmented cells, with cellular pleomorphism and high mitotic index. The diagnosis of melanoma was supported by positive immunoreactivity for S-100, MelanA, and HMB-45. Both cases had an unfavorable outcome, and the patients died a few months after the initial diagnosis. Because of its rarity, oral melanoma occurring in HIV-positive patients can pose problems in diagnosis and should be clinically distinguished from Kaposi’s sarcoma, which is more common in the context of the immunodeficiency syndrome.
  13. Incidental finding of tongue cancer in a PET scan: A fusion of anatomic and metabolic imaging

    In Press, Corrected Proof, Available online 24 July 2019
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  14. Podoplanin and ABCG2 expression in oral erythroplakia revisited: Potential evidence for cancer stem cells driving the process of field cancerization

    In Press, Corrected Proof, Available online 10 July 2019
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    Abstract
    A model of field cancerization orchestrated by the cancer stem cells (CSC) was proposed. Podoplanin and ABCG2 are promising marker of CSCs for head and neck cancer. We revisited the correlation of the two markers with the follow-up data of the patients with oral erythroplakia (OE). Strikingly, we observed that the expression of podoplanin and ABCG2 within a single pre-neoplastic OE lesion significantly correlate with subsequently developing multiple and multifocal carcinomas, thus to some extent demonstrating the concept of field cancerization. Collectively, a point to highlight was that a preliminary evidence that provided by this revisited study supported the perspective on cancer stem cells driving the process of field cancerization.
  15. Current evidence on DNA aneuploidy cytology in noninvasive detection of oral cancer

    In Press, Corrected Proof, Available online 10 July 2019
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    Abstract
    DNA-aneuploidy cytology as a promising noninvasive tool in diagnosing oral precancer and cancer has been proposed in 2015. In this letter, we identified 9 studies on DNA aneuploidy cytology with special emphasis on using fresh tissue sample in detection of oral precancer and cancer. Evidence was updated as follows, for detection of OSCC in general oral lesions, the pooled sensitivity and specificity was 84.8 and 99.0 respectively; for discrimination of dysplasia and OSCC form oral lesions, the sensitivity and specificity was 75.7 and 76.8 respectively. On the whole, current evidence on the theme is not robust, and multicenter prospective studies are needed to consolidate the evidence.
  16. Nivolumab in patients with rare head and neck carcinomas: A single center’s experience

    In Press, Corrected Proof, Available online 9 July 2019
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    Abstract
    Immunotherapy (IO) with anti-PD1 inhibitors is available for the treatment of recurrent/metastatic squamous cell carcinomas of the head and neck (SCCHD) since 2016. Both nivolumab and pembrolizumab were tested in phase 3 randomized trials in adults progressing on or after platinum-based therapy and were found to confer an overall survival benefit compared to investigator’s choice. However, very limited data exist concerning IO use in rare subtypes of head and neck carcinoma, like salivary gland carcinoma.
    We retrospectively collected clinical data of all patients diagnosed with rare subtypes of head and neck carcinoma, who were treated with immune checkpoint inhibitors in our department during the last 5 years. We analyzed safety and efficacy of these therapies.
    We identified six patients who received nivolumab for recurrent or metastatic head and neck carcinomas, between 31 and 57 years old. All patients had received at least one line of platinum-chemotherapy, as well as radiation therapy. Treatment was administered every 2 weeks, at a dose of 3 mg per kilogram of body weight. Number of nivolumab cycles varied between 2 and 18. Progression-free survival varied from 1 to 12 months and overall survival from 4 to 24 months. Tolerance was very good, except for one case of diabetes and hypothyroidism requiring medication.
    There is currently insufficient evidence regarding the optimal treatment of the rare non-squamous cell carcinoma of the head and neck. Our case series supports a role for immunotherapy in these patients. However, larger collaborative studies are needed to evaluate this treatment.
  17. Different responses to nivolumab therapy between primary and metastatic tumors in a patient with recurrent hypopharyngeal squamous cell carcinoma

    In Press, Corrected Proof, Available online 9 July 2019
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    Abstract
    We report the case of a 70-year-old man with primary and metastatic tumors, showing clinically progressive disease and complete response to nivolumab therapy, respectively. He underwent total pharyngo-laryngectomy, bilateral neck dissection, and reconstruction with free-jejunum after nivolumab therapy failure, and had no recurrent or newly arising lesions 8 months after the surgery. Immunohistochemistry analysis revealed that metastatic neck tumor with the clinical complete response to nivolumab showed higher PD-L1 expression with higher CD8+ TIL density, while primary lesion with progressive disease showed lower PD-L1 expression with lower CD8+ TIL density. This represents the first case reported on head and neck squamous cell carcinoma treated with salvage surgery after nivolumab therapy failure.
  18. Comment on “Resolution without surgery of an advanced stage of medication-related osteonecrosis of the jaw (MRONJ) in a patient who could not suspend her treatment for osteoporosis”, by Sarmiento (2019)

    In Press, Corrected Proof, Available online 3 July 2019
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  19. Combined parameter SUVmax/ADCmean predicts microvessel density in head and neck squamous cell carcinoma. Preliminary results

    In Press, Corrected Proof, Available online 3 July 2019
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  20. Complete response with neoadjuvant avelumab in Merkel cell carcinoma – A case report

    In Press, Corrected Proof, Available online 2 July 2019
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    Abstract
    Merkel cell carcinoma (MCC) is a rare but aggressive neuroendocrine skin malignancy. We report here a case of localized MCC achieving pathologic complete response upon treatment with avelumab in the neoadjuvant setting. Preclinical and clinical studies have revealed a close relationship between MCC and the immune system, thus supporting a role for PD-1/PD-L1 inhibitors in MCC. This neoadjuvant use of PD-1/PD-L1 inhibitors can avoid potentially disfiguring surgery in MCC. As the incidence of MCC is rising, clinical trials are needed to evaluate the efficacy and safety of immunotherapy in resectable disease.

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