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Tongue base mucosectomy for carcinoma of unknown primary using endoscopic electrocautery: rationale for wider implementation of an institutionally restricted technique.
- Source :
-
Journal of Laryngology & Otology . Dec2018, Vol. 132 Issue 12, p1138-1142. 5p. - Publication Year :
- 2018
-
Abstract
- Background: Cervical metastasis from an unknown primary site invariably results in pan-mucosal irradiation if a primary tumour is not identified. Transoral robotic and laser-assisted mucosectomy are valid techniques to increase diagnostic rates, but these remain restricted to certain centres. This paper describes, in detail, a technique in which mucosectomy is performed via endoscopic electrocautery. Methods: Patients were prospectively recruited between May 2017 and June 2018. Inclusion criteria stipulated biopsy-proven metastatic cervical squamous cell carcinoma, with negative findings on magnetic resonance imaging and positron emission tomography/computed tomography, in addition to examination under anaesthetic, tonsillectomy and 'blind' tongue base biopsies without tumour identification, prior to mucosectomy. Results: Of nine patients, a mucosal primary was identified in four (44.4 per cent), for which ipsilateral intensity-modulated radiotherapy was advocated in three and completion tongue base resection in the fourth. Dysplasia was demonstrated in two further patients, which provided information relevant to radiotherapy fields and post-treatment surveillance. No surgical complications were identified. Conclusion: Tongue base mucosectomy using electrocautery and conventional tonsillectomy equipment is a safe, effective technique in the identification of cervical metastasis from an unknown primary site. It expands the potential breadth of use, quickens prolonged diagnostic pathways and obviates the necessity for pan-mucosal irradiation. [ABSTRACT FROM AUTHOR]
- Subjects :
- *ELECTROCOAGULATION (Medicine)
*BIOPSY
*COMPUTED tomography
*ENDOSCOPY
*HEAD tumors
*LONGITUDINAL method
*MAGNETIC resonance imaging
*POSTOPERATIVE period
*NECK tumors
*PUBLIC health surveillance
*RADIOTHERAPY
*POSITRON emission tomography
*SQUAMOUS cell carcinoma
*TONGUE diseases
*TONSILLECTOMY
*CANCER of unknown primary origin
*SURGICAL robots
*GENERAL anesthesia
*DIAGNOSIS
*SURGERY
TONGUE surgery
Subjects
Details
- Language :
- English
- ISSN :
- 00222151
- Volume :
- 132
- Issue :
- 12
- Database :
- Academic Search Index
- Journal :
- Journal of Laryngology & Otology
- Publication Type :
- Academic Journal
- Accession number :
- 134255844
- Full Text :
- https://doi.org/10.1017/S0022215118002062