Hana Binková

Prognostic significance of the tumour-adjacent tissue in head and neck cancers.

Even with significant advances in operative skills and adjuvant therapies, the overall survival of patients suffering with head and neck squamous cancers (HNSCC) is unsatisfactory. Accordingly, no clinically useful prognostic biomarkers have been found yet for HNSCC. Many studies analysed the expression of potential markers in tumour tissues compared to adjacent tissues. Nevertheless, due to the sharing of the same microenvironment, adjacent tissues show molecular similarity to tumour tissues. Thus, gene expression patterns of 94 HNSCC tumorous tissues were compared with 31 adjacent tissues and with 10 tonsillectomy specimens of non-cancer individuals. The genes analysed at RNA level using quantitative RT-PCR and correlated with clinico-pathological conditions were as follows: EGF, EGFR, MKI67, BCL2, BAX, FOS, JUN, TP53, VEGF, FLT1, MMP2, MMP9, MT1A and MT2A. The elevated MT2A, BAX, EGF and JUN expression was associated with the influence of tumour cells on the rearrangement of healthy tissues, as well as a significant shift in the BAX/BCL2 ratio. Our investigation also indicated that adjacent tissues play an important role in cancerogenesis by releasing several tumour-supporting factors such as EGF. A gradual increase in the metallothionein expression, from the lowest one in tonsillectomy samples to the highest ones in tumour samples, suggests that MT expression might be tissue reaction to the presence of tumour cells. The results of this study confirmed the significance of metallothionein in tumori-genesis and gave evidences for its use as a potential HNSCC biomarker. Furthermore, this study highlighted the importance of histologically normal tumour-adjacent tissue in prediction of HNSCC progress.

Metastases of a Breast Cancer to Skull Base

BACKGROUND Breast cancer (BC) is a frequent malignant disease which tends to develop distant metastases, but only very rarely in the head and neck region. CASE REPORT We present two case reports of patients with metastases of invasive BC in this area. They are of different clinical manifestation with different time relation to the primary tumor and different symptomatology. In the case of the first patient, a few years without evidence of malignant disease after treatment of primary tumor in complete remission. In the case of the second patient, as the first symptom of undiagnosed disease. Metastases were clinically observed in the skull base and maxillary sinus, manifesting neurologically with foramen jugulare syndrome and orbital symptoms, resp. In both cases, correlations between histological and clinical findings were essential for diagnosis. Palliative multimodal treatment was then employed. CONCLUSION Metastases of BC in the head and neck region occur only very rarely. The extremely variable symptomatology depends on the location of the metastasis and the affected structures. This might be a pitfall for diagnostics, especially in cases of an unidentified primary breast tumor, which may result in a delay of correct diagnosis. In addition, the correlation between histopathological and clinical findings might be of great relevance in these cases. Key words: skull base metastasis - breast cancer - foramen jugulare syndrome.