Cancer of the head and neck includes malignant tumors of the upper aerodigestive tract, paranasal sinuses, and the major and minor salivary glands. In addition, tumors of the skin, soft tissue, bone, and neurovascular structures in the head and neck and tumors of the parapharyngeal space and thyroid and parathyroid glands are also considered head and neck cancer, but they will not be discussed in this report. Over 90 percent of all head and neck cancers are squamous cell carcinomas. Most of the remaining head and neck cancers are adenocarcinomas of salivary origin, melanomas, or tumors of somatic soft tissues.1 Cancer of the head and neck represents about four percent of all malignant tumors in the United States.2 However, in other parts of the world, the disease is much more prevalent. In India and Southeast Asia, cancer of the oral cavity represents about 35 percent of all malignant tumors. A similarly high incidence of head and neck cancer is noted in Brazil and other developing countries. Worldwide, head and neck cancer represents the sixth most prevalent cancer.3 In 1995 in the United States, it is estimated that about 50,000 newly diagnosed squamous carcinomas of the head and neck will occur (Fig. 1).2 This figure corresponds to an annual incidence of roughly 17 per 100,000 people. The maleto-female incidence ratio is greater than three to one. However, over the past several decades, the incidence of squamous carcinomas of all sites of the upper aerodigestive tract has risen in females and is attributed to a rising incidence of tobacco and alcohol consumption in this group (Fig. 2).4 A trend of increasing pharyngeal cancer in the black population has also been seen in the United States over the past 20 years.5 In 1995, it is estimated that 13,000 deaths will occur due to squamous carcinomas of the head and neck.2 The implied incidence-to-mortality ratio from these estimates is somewhat less than three to one. The use of tobacco and alcohol, frequently in combination, has been associated with over 95 percent of the cases of squamous carcinoma of the head and neck. Increasing alcohol and tobacco consumption significantly elevates the risk of the development of squamous cell carcinoma (Fig. 3).6 Exposure to various noxious fumes and chemicals also may predispose to cancer of the upper aerodigestive tract. Up to 15 percent of patients with head and neck cancer may have a viral etiology implicated in the genesis of their tumors.7 An association between Epstein-Barr virus (EBV) and nasopharyngeal carcinomas has been suggested by the high incidence of elevated EBV titers in patients with nasopharyngeal carcinoma.8 Many head and neck squamous carcinomas are preceded by various precanC A C a n c e r J C l i n 1 9 9 5 ; 4 5 : 3 5 2 3 6 8

Treatment of cancer of the head and neck.

Hereditary retinal diseases are now the leading cause of blindness certification in the working age population (age 16-64 years) in England and Wales, of which retinitis pigmentosa (RP) is the most common disorder. RP may be complicated by cystoid macular oedema (CMO), causing a reduction of central vision. The underlying pathogenesis of RP-associated CMO (RP-CMO) remains uncertain, however, several mechanisms have been proposed, including: (1) breakdown of the blood-retinal barrier, (2) failure (or dysfunction) of the pumping mechanism in the retinal pigment epithelial, (3) Muller cell oedema and dysfunction, (4) antiretinal antibodies and (5) vitreous traction. There are limited data on efficacy of treatments for RP-CMO. Treatments attempted to date include oral and topical carbonic anhydrase inhibitors, oral, topical, intravitreal and periocular steroids, topical non-steroidal anti-inflammatory medications, photocoagulation, vitrectomy with internal limiting membrane peel, oral lutein and intravitreal antivascular endothelial growth factor injections. This review summarises the evidence supporting these treatment modalities. Successful management of RP-CMO should aim to improve both quality and quantity of vision in the short term and may also slow central vision loss over time.

https://bjo.bmj.com/content/bjophthalmol/101/1/31.full.pdf

Retinitis pigmentosa-associated cystoid macular oedema: pathogenesis and avenues of intervention

Meningitis following cochlear implantation: pathomechanisms, clinical symptoms, conservative and surgical treatments.

Malignant cells of epithelial phenotype limited to thoracic lymph nodes

A case of a rare and unusual variant of neurofibroma, diffuse neurofibroma (paraneurofibroma), in a young patient is presented. The clinical, radiological and histopathological features of this case are reported. The magnetic resonance imaging (MRI) features of the diffuse neurofibroma are comparable with those described in other neurofibromas.

https://www.cambridge.org/core/services/aop-cambridge-core/content/view/S0022215100133122

Subcutaneous diffuse neurofibroma of the neck: a case report

Diseases of the head and neck : an atlas of histopathology

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Diseases of the head and neck : an atlas of histopathology