Jaime Alonso Reséndiz-Colosia

Evolution of maxillofacial brown tumors after parathyroidectomy in primary hyperparathyroidism

Brown tumor occasionally affects the facial bones. Clinically, these lesions can be mistaken for a neoplasm. Opinions are divided on the course of management of the bony lesions once parathyroidectomy has been carried out.

Elective neck dissection in oral tongue cancer

IntroductionTreatment to the neck of patients with oral tongue cancer (OTC) without palpable nodes (cN0) is controversial. Elective neck dissection (END) could lead to over-treating more than 50% and follow-up indicates high regional recurrence. Decision to perform the surgery depends on the risk of hidden node metastases (NM).ObjectiveThe objective of this study was to assess the prevalence of hidden NM in cN0-OTC patients undergoing END.Material and methodsPatients (n=22) with cN0-OTC were treated with partial glosectomy and END.ResultsOf these, 16 were free of node metastases (negative predictive value=73%) while the other 6 (27%) showed at least one NM. Risk was greater, although statistically not significant, in T3 than in T1-2. Overall survival was better in patients without NM having END (95% versus 38%).ConclusionscN0-OTC is associated with 27% of NM, which justifies END. It is necessary to select carefully the candidates for END so as to preclude over-treatment in 73% of patients. Perhaps lymph mapping and sentinel node biopsy will help the better identification of hidden NM.ResumenIntroducciónEl tratamiento del cuello en pacientes con cáncer oral de la lengua (COL) sin ganglios palpables (cN0) es controvertido. La disección electiva de cuello (DEC) sobretrata al 50% de pacientes y la vigilancia implica alta recurrencia regional. La decisión del tratamiento depende del riesgo de metástasis ganglionares ocultas.ObjetivoEl objetivo es conocer la prevalencia de metástasis ganglionares ocultas en pacientes con COL sometidos a DEC.Material y métodosA 22 pacientes con COL, cN0 se les efectuó glosectomía y DEC.ResultadosUn total de 16 de 22 pacientes no tuvieron metástasis ganglionares (valor predictivo negativo=72,7%), mientras que 6 (27%) tuvieron metástasis ganglionares ocultas (MGO). El riesgo fue mayor en T3 que en T1-2 (diferencia no significativa). La supervivencia es mejor en pacientes sin MGO en la DEC(95% frente al 38%).ConclusionesEl COL se asocia al 27% de MGO, lo que justifica la DEC; se debe identificar a los candidatos a DEC para evitar sobretratar al 73%. El mapeo linfático y biopsia del ganglio centinela podría identificar pacientes con MGO.