Tsuyoshi Matsunaga

Six Cases of Malignant Melanoma in the Head and Neck Region.

Six cases of malignant melanoma occurring in the head and neck region, and treated at National Defense Medical College from 1989 to 1997, are presented. Patient age ranged from 42 to 79 years and all cases were male.The location of the tumor was the nasal mucosa in 3 patients, oral mucosa in 1 patient and laryngeal mucosa in 2 patients. The 2 cases of laryngeal tumor were considered to be metastatic. Histologically, three cases were diagnosed as amelanotic melanoma, 2 cases as melanotic melanoma and 1 case as amelanotic and melanotic melanoma. Two patients were treated with chemotherapy. One patient was treated with chemotherapy and immunotherapy. One patient was treated with surgery and immunotherapy. One patient was treated with surgery and chemotherapy. One patient was treated with surgery, radiation and immunotherapy. Five cases died of metastasis. Only one patient remains alive on having tumor as of June, 1997.

Fine Needle Aspiration Biopsy of Head and Neck Lesions; Review of 461 cases.

Ectasia of the jugular system is unusual in children. We present here a pediatric case with internal jugular vein phlebectasia, and an adult case with a venous aneurysm. These two ectasias were observed as nonpulsatile, elongated or round neck masses that enlarges with the Valsalva maneuver or speaking. Computed tomography (CT), magnetic resonance imaging (MRI), ultrasound and angiography have all been used in the diagnosis of ectasia. However, CT with a contrast agent make it possible to obtain a clear diagnosis, and allows the detection of thrombus formation.In our adult case, a thrombus in the aneurysm was suggested. After CT with a contrast agent, angiography was useful to detect the thrombosis and its connection with the internal jugular vein. Surgical resection of the jugular aneurysm was undertaken to avoid the risk of embolization in this case. In our pediatric case, the phlebectasia has been examined regularly because the lesion was stable in size, and there was no thrombus formation. We recommend surgical resection only if the lesion forms a thrombus, increases in size, or causes cosmetic deformity.