Myojo Kanaji

Adenosquamous Carcinoma of the Larynx

Adenosquamous carcinoma (AX) is a rare malignant epithelial tumor characterized by the simultaneous presence of adenocarcinoma and squamous cell carcinoma. Less than 40 cases in the upper aerodigestive tract, and only 20 cases in the larynx, have been reported. This neoplasm is histopathologically similar to mucoepidermoid carcinoma and adenoid squamous cell carcinoma, but it is even more malignant and has poorer prognosis than these carcinomas. In this article, an extremely rare case of ASC arising in the larynx is reported, and the literature is reviewed. ministered. After the completion of this radiotherapy, the tumor vanished. However, 6 months later tumor recurrence at the primary site was noted. Total laryngectomy with bilateral neck dissection was performed. Macroscopic examination of the extirpated larynx showed that the tumor extended to the subglottic area in the submucosal layer and advanced out of the larynx through the cricothyroid membrane. The ultimate histological diagnosis was ASC. One lymph node metastasis of 1 cm in diameter was noted in the left paratracheal region. The histological diagnosis of this metastasis was adenocarcinoma. Five months postoperatively, the patient remained free of recurrence.

Reconstruction of the anterior commissure with a free mucosal flap

INTRODUCTION To prevent stenosis and adhesion of the anterior commissure in the laryngeal reconstruction, we devised a technique of relining using a free labial mucosal graft and human fibrin glue. MATERIALS AND METHODS A single large piece of mucosal flap was prepared, folded at the anterior commissure, and sutured onto the raw wound of the larynx from both sides of the posterior glottis. Alternate suturing from both right and left sides was performed anteriorly, and the wound on the laryngeal lumen was fully covered by the mucosal graft. We applied this technique on a patient with laryngeal stenosis and two patients with laryngeal cancer. RESULTS Without the use of a stent, we successfully reconstructed the anterior commissure and obtained a good result in voice quality in each case. CONCLUSION Large mucosal defects including the anterior commissure should be relined to acquire good voice quality. Relining using a free mucosal flap was a useful method since there were no limitations to size and placement. The adhesive property of human fibrin glue was indispensable in this procedure.

Liposarcoma of the Pharynx; A Case Report.

A 72-year-old male visited our hospital complaining of foreign body sensation in the throat. On fiberscopic examination, we found a round smooth mass with a pedicle arising from the posterior wall of the mesopharynx. The tumor was resected along its capsule using an oral approach, with a preoperative diagnosis of benign tumor. The pathological diagnosis was a liposarcoma of the myxoid type, and radiation therapy was performed postoperatively.Although liposarcoma is the second most common soft-tissue sarcoma in adults, the incidence of liposarcoma of the head and neck is low. There have been 41 reported cases of head and neck liposarcoma in Japan, among which only two cases arising from the pharynx have been detected.

The Usefulness of MRI in the Diagnosis of a Buccal Wooden Foreign Body; A Case Report.

Our patient suffered a left buccal lesion in a fall. A fragment of a leaf was removed by her family doctor. However, a trismus continued. Ten days after the injury, she was referred to our hospital. There was fistula formation with purulent discharge from the wound. No foreign bodies were reliably detected by a CTscan. We then used MRI for the diagnosis of a foreign body. A wooden foreign body with a high signal was found in the masseteric muscle on T2-weighted imaging. After the removal of the foreign object, the trismus recovered quickly.MRI is not necessarily recommended as a routine examination in the diagnosis of a foreign body. However, if a wooden foreign body is suspected and cannot be detected by CT scan, then MRI should be applied.

Castleman's Lymphoma of the Neck. A Case Report.

Castlemans lymphoma is an uncommon disease of benign lymphnode hyperplasia which usually affects the mediastinum. We recently treated a 63-year-old female with the plasma cell type of Castlemans lymphoma of the neck.It is very difficult to diagnose Castlemans lymphoma preoperatively. There have been no reports of fine needle aspiration biopsy (FNA) of this lymphoma. We perfomed FNA in this patient and found plasma cells without atypia. This finding was consistent with the plasma cell type of Castlemans lymphoma.

Surgical Treatment for Vocal Cord Defect Caused by Laser Cordectomy. A Case Report

Koichi Omori 1), Hisayoshi Kojima 1), Mitsuharu Nonomura 2 ), Kazuhiko Shoji n and Myoj o Kanaji 1 A 75-year-old man developed severe hoarseness following laser cordectomy for glottic cancer . The left vocal cord was deficient and scar formation was found at the anterior commissure extending to the subglottis. The right vocal cord was atrophic . His voice was quite breathy because of these laryngeal deformities. We employed two surgical procedures. First, we applied the omohyoid muscle flap for the recon struction of the vocal cord bulging on the left . In the second step, thyroplasty type I was performed on both sides. After the surgeries, the maximum phonation time was prolonged from 3 sec to 10 sec and the breathy voice was remarkably improved . For the treatment of glottic insufficiency after cordectomy , it is most important to examine the laryngeal findings carefully and choose a suitable surgical method .