Metastases in head and neck cancer
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書誌事項
Metastases in head and neck cancer
Springer, c2004
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注記
Includes bibliographical references and index
内容説明・目次
内容説明
The incidence of malignant tumors of the upper aerodigestive tract is increasing. The carcinomas of this area, mostly squamous cell carcinomas, are often accompanied by cervical lymph node metastases. Frequently, the primary tumor causes no discomfort and its existence is inferred from the presence of metastases. The present book offers an extensive overview of the differential diagnosis of lymph node diseases and their therapy for physicians in many disciplines - principally those that deal with oncology of the head and neck region, but also general medicine and pediatrics. Detailed descriptions of lymphologic principles create a basis for the understanding of the various lymph node diseases. High-quality photographs and tables underline the high instructive value of this volume.
目次
1 Basics of Lymphology.- 1.1 Embryology and Anatomy.- 1.1.1 Lymph Vessels.- 1.1.1.1 History.- 1.1.1.1 History.- 1.1.1.3 Morphology.- 1.1.1.4 Distribution.- 1.1.2 Lymph Nodes.- 1.1.2.1 Embryology.- 1.1.2.2 Morphology.- 1.1.2.3 Topography and Classification of Cervicofacial Lymph Nodes.- 1.1.2.4 Fascial System of the Neck.- 1.2 Physiology and Pathophysiology.- 1.2.1 Lymph Vessels.- 1.2.2 Lymph Nodes.- References.- 2 Lymphogenic Metastatic Spread.- 2.1 Squamous Cell Carcinomas.- 2.1.1 Nasal Cavity and Paranasal SinusesM.- 2.1.2 Lip and Oral Cavity.- 2.1.3 Nasopharynx.- 2.1.4 Oropharynx.- 2.1.5 Hypopharynx and Cervical Esophagus.- 2.1.6 Larynx and Trachea.- 2.1.7 Skin.- 2.2 Malignant Melanoma.- 2.3 Merkel Cell Carcinoma.- 2.4 Carcinomas of the Salivary Glands.- 2.5 Carcinomas of the Thyroid Gland.- References.- 3 The Pathology of Lymphogenic Metastatic Spread.- 3.1 Examination Methods.- 3.2 Squamous Cell Carcinomas of the Head and Neck.- 3.2.1 Conventional Squamous Cell Carcinoma.- 3.2.2 Cytologic Diagnosis.- 3.2.3 Variants of Squamous Cell Carcinomas of the Head and Neck.- 3.2.3.1 Basaloid Squamous Cell Carcinoma.- 3.2.3.2 Adenoid Squamous Cell Carcinoma.- 3.2.3.3 Undifferentiated (Lymphoepithelial) Carcinoma (Schmincke Tumor).- 3.2.3.4 Adenosquamous Carcinoma.- 3.2.3.5 Spindle Cell Carcinoma.- 3.2.4 Micrometastases of Squamous Cell Carcinomas.- 3.2.5 Extracapsular Extension of Lymph Node Metastases.- 3.2.6 Cystic Cervical Lymph Node Metastases.- 3.2.7 Changes of Cervical Lymph Node Metastases After Radiation and Chemotherapy.- 3.3 Metastases of Salivary Gland Tumors and Thyroid Gland Carcinomas.- 3.4 Uncommon Cervical Lymph Node Metastases.- 3.5 Non-Neoplastic Reactive Lymph Node Alterations.- References.- 4 Diagnostic Techniques.- 4.1 Introduction.- 4.2 Inspection and Palpation.- 4.2.1 Inspection.- 4.2.2 Palpation.- 4.3 B-Mode Sonography.- 4.3.1 Benign Lymphadenitis.- 4.3.2 Malignant Lymphomas.- 4.3.3 Lymph Node Metastases.- 4.3.3.1 Sonographic Criteria.- 4.3.3.2 Extracapsular Growth.- 4.3.3.3 Lymph Node Metastases of Non-Squamous Origin.- 4.3.3.4 Follow-Up.- 4.3.4 Sonographic Differential Diagnosis of Enlarged Cervical Lymph Nodes.- 4.3.5 Sonographically Controlled Fine Needle Aspiration Cytology.- 4.3.6 Future Technical Developments.- 4.3.6.1 Color-Coded Duplex Sonography.- 4.3.6.2 Signal Amplification.- 4.3.6.3 Digital Sonographic Procedures.- 4.4 Computed Tomography and Magnetic Resonance Imaging.- 4.4.1 Computed Tomography.- 4.4.2 Magnetic Resonance Imaging.- 4.4.3 CT/MRI for Benign Cervical Masses.- 4.4.4 CT/MRI for Lymph Node Metastases.- 4.5 Lymphoscintigraphy.- 4.5.1 Dynamic Scintigraphy of Lymphatic Drainage.- 4.5.2 Thallium-201 Scintigraphy.- 4.5.3 Sentinel Lymphadenectomy.- 4.5.4 Radioimmunoscintigraphy.- 4.6 Positron Emission Tomography.- 4.7 Lymphography.- 4.8 Lymph Node Biopsy.- 4.8.1 Lymph Node Extirpation.- 4.8.2 Scalene Node Biopsy.- 4.8.3 Mediastinoscopy.- 4.9 Conclusion.- References.- 5 Principles of Surgery.- 5.1 History and Classification of the Surgical Treatment of Cervicofacial Lymph Node Metastases.- 5.1.1 History.- 5.1.2 Neck Dissection Classification.- 5.2 Decision Points in Neck Dissection.- 5.2.1 Pre- and Perioperative Care.- 5.2.1.1 Facets of Preoperative Lymph Node Biopsy.- 5.2.1.2 Diagnostics of Therapeutic Carotid Occlusion.- 5.2.2 Timing of Neck Dissection.- 5.2.3 Patient Age and Neck Dissection.- 5.2.4 Infectious Prophylaxis.- 5.2.5 Operative Approaches.- 5.2.5.1 Radical Neck Dissection.- 5.2.5.2 Modified Radical Neck Dissection.- 5.2.5.3 Selective Neck Dissection.- 6 Radiation Therapy: Principles and Treatment.- 6.1 Elective Neck Irradiation.- 6.2 Postoperative Radiation of the Node Positive Neck.- 6.3 Intensity-Modulated Radiation Therapy.- 6.3.1 IMRT in Nasopharynx Cancer.- 6.3.2 IMRT of Oropharynx Cancer.- 6.3.3 IMRT of Paranasal Sinus Cancers.- 6.3.4 IMRT in Other Situations.- 6.4 Future Potential Applications.- References.- 7 Surgical Treatment Concepts.- 7.1 The Role of Neck Dissection in the Treatment of Squamous Cell Carcinomas of the Upper Aerodigestive Tract.- 7.1.1 Clinical No Neck.- 7.1.2 Contralateral No Neck in the Case of an Ipsilateral N+ Neck.- 7.1.2.1 Anterior Oral Cavity.- 7.1.2.2 Oropharynx.- 7.1.2.3 Supraglottis.- 7.1.2.4 Glottis.- 7.1.2.5 Hypopharynx.- 7.1.3 Verified Lymph Node Metastases (N+ Neck).- 7.1.3.1 N1 and N2 Neck.- 7.1.3.2 Fixed Lymph Node Metastases.- 7.1.3.3 Neck Dissection Following Primary Radio(Chemo)Therapy.- 7.1.3.4 Peristomal Recurrence.- 7.1.3.5 Retropharyngeal Lymph Nodes in Metastases from Head and Neck Cancers.- 7.2 Neck Dissection for Lymphoepithelial Carcinomas.- Neck Dissection for Skin Malignancies.- 7.3.1 Squamous Cell Carcinomas.- 7.3.2 Malignant Melanoma.- 7.3.3 Merkel Cell Carcinoma.- 7.4 Neck Dissection for Carcinomas of the Salivary Glands.- 7.5 Neck Dissection for Carcinomas of the Thyroid Gland.- 7.6 Sentinel Node Biopsy.- 7.6.1 Marking of the Sentinel Node.- 7.6.2 Intraoperative Detection of Activity.- 7.6.3 Limits and Sources of Errors.- 7.7 Conclusion.- References.- 8 Complications.- 8.1 Surgical Complications.- 8.1.1 General Considerations.- 8.1.2 Preoperative Informed Consent.- 8.1.3 Wound Healing Impairment.- 8.1.4 Vascular System.- 8.1.6 Vasovagal Response.- 8.1.7 Chylus Fistula and Chylothorax.- 8.1.8 Increased Intracranial Pressure.- 8.1.9 Visual Loss and Blindness.- 8.1.10 Lymphedema.- 8.1.11 Clavicular Fracture.- 8.1.12 Postoperative Care.- 8.2 Complications from Radiation Therapy.- 8.2.1 Clinically Evident Acute Toxicities.- 8.2.2 Delayed Radiation Effects.- References.- 9 Cancer of Unknown Primary Sites.- 9.1 General Considerations.- 9.2 Topography of Lymph Node Metastases in Cancer of Unknown Primary.- 9.3 Diagnostics.- 9.4 Prognosis in Patients with Cancer of Unknown Primary Site.- 9.4.1 Metastases in Squamous Cell Carcinoma of Unknown Primary.- 9.4.2 Metastases in Adenocarcinoma of Unknown Primary.- 9.4.3 Metastases in Malignant Melanoma of Unknown Primary.- 9.5 Treatment Concepts of Lymph Node Metastases in Sqamous Cell Carcinoma of Unknown Primary Site.- 9.5.1 Primary Radio(chemo)therapy.- 9.5.2 Combined Radiotherapy and Surgery.- 9.5.3 Treatment Concept of Cervical N1 Lymph Node Metastasis in Squamous Cell Carcinomas of the Head and Neck.- 9.5.4 Treatment Concept of the Contralateral Neck Side (No).- 9.6 Treatment Concepts of Lymph Node Metastases in Adenocarcinoma.- 9.7 Treatment Concepts of Lymph Node Metastases in Occult Malignant Melanoma.- 9.8 Value of Post-Therapeutic Appearance of the Primary Cancer.- 9.9 Branchiogenic Carcinoma.- References.- 10 Distant Metastases.- 10.1 Nasopharynx.- 10.2 Lips and Anterior Oral Cavity.- 10.3 Oropharynx.- 10.4 Larynx and Hypopharynx.- 10.5 Cervical Esophagus.- 10.6 Salivary Glands.- 10.7 Thyroid Gland.- References.- 11 Post-Therapeutic Follow-Up Principles.- 11.1 General Considerations.- 11.2 Follow-Up Interval.- 11.3 Type, Extent and Costs of Follow-up Examinations.- 11.3.1 The Upper Aerodigestive Tract.- 11.3.2 Neck.- 11.3.3 Thorax.- 11.3.4 Abdomen and Scintigraphy of the Skeletal Bones.- 11.3.5 Possible Strategies.- References.
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