Isao Uno

Osteosarcoma of the mandible; a case report.

A 26-year-old male visited our hospital, complaining of swelling of the left cheek. The first biopsy revealed normal cartilagenous tissue. A diagnosis of malignant bone tumor was made on the basis of the second biopsy, so surgical resection was performed, followed by chemotherapy with high doses of methotrexate. In spite of these treatments, he died of uncontrollable local recurrence. Immediately after death an autopsy was performed. The difficulty in diagnosing this disease and the unfavorable prognosis indicate that we should pay particular attention to the atypia of infiltrating cells in the histologic specimen of a bone tumor, even if it looks benign.

Analysis of patients with lung metastasis from head and neck cancers.

In our ORL clinic during the past 11 years (1976-1986) we saw 417 patients with head and neck cancers, 32 of whom developed lung metastases.1) Metastasis was most common in patients with carcinoma of the nasopharynx, tongue, oral cavity, hypopharynx and major salivary glands. Adenoid cystic carcinoma was the most frequent histological diagnosis.2) The progression of the lesions of adenoid cystic carcinoma was found to be gradual, even in patients with metastasis. Therefore their survival periods were relatively long.3) Longer survival periods were noted in patients who received some treatment for their metastases than in those without any treatment.4) Radiotherapy and chemotherapy for metastatic lesions resulted in longer survival periods than did surgical excision alone.5) The choice and performance of therapy for these metastatic cases should be individualized by a joint conference of radiologist, chest surgeon and otolaryngologist.

A case of laryngitis phlegmonosa acuta.

The patient was a 49-year-old female who was admitted to the Dept. of Internal Medicine of Osaka Medical College with sore throat and sustained fever.Laboratory examination revealed granurocytopenia, and treatment was begun immediately, but her sore throat presisted, and she developed dyspnea.She was transferred to the Dept. of Otolaryngology and a diagnosis was made of laryngitis phlegmonosa acuta. Tracheostomy was perfomed and conservative therapy was continued. However, antibiotics could not be administrate deffectively because of the possibility that antibiotics were the cause of the granulocytopenia.Sore throat and fever receded 5 weeks later, but fistula from the vallecula to the lower neck appeared, and part of the hyoid bone was ejected spontaneously.The fistula was closed operatively and the disease was cured with some deformity of the larynx. She was discharged 2 months later with no dysphagia or hoarseness.Since laryngitis phlegmonosa acuta is rare disease in the era of antibiotic therapy, were ported this unusual case.