Complications in the treatment of oropharyngeal carcinoma in patients with systemic sclerosis: A case report
Identifieur interne : 004241 ( Pmc/Curation ); précédent : 004240; suivant : 004242Complications in the treatment of oropharyngeal carcinoma in patients with systemic sclerosis: A case report
Auteurs : Ales O Ek [République tchèque] ; Ales Hahn [République tchèque] ; Miloslav Ambruš [République tchèque] ; Marie Valešová [République tchèque]Source :
- Oncology Letters [ 1792-1074 ] ; 2014.
Abstract
Systemic sclerosis is a chronic, progressive disease with an extremely poor prognosis. The incidence of malignant tumors in patients with systemic sclerosis is increased when compared with that of the general population. In certain malignancies, systemic sclerosis presents as a paraneoplastic process. The symptoms of sclerosis in the organs of the head and neck often overlap with symptoms of malignant diseases, which may increase the difficulty of a differential diagnosis. Additionally, the presence of sclerosis may complicate standard examination procedures, due to poor access to the oral cavity and oropharynx. When considering treatment options, it is important to evaluate the surgical and oncological risks to soft tissues of the head and neck with regard to both diseases, as well as the relatively poor prognosis for systemic sclerosis and oropharyngeal cancer. The low incidence of patients with systemic sclerosis and oropharyngeal carcinoma together presents a clear case for a casuistic approach. Based upon our own experience, we can attest to the difficulty of treating such patients. However, we have no evidence to indicate that these patients have reduced tolerance to surgical treatments. The current study presents the case of a 47-year-old female with systemic sclerosis, who was diagnosed with oropharyngeal carcinoma. The patient initially tolerated radiotherapy treatment well, however post-radiotherapy complications occurred. Despite many enigmatic indications to the contrary, it appears that the complications in this instance may be due to late toxicity from radiotherapy.
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DOI: 10.3892/ol.2014.2627
PubMed: 25435929
PubMed Central: 4246633
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<front><div type="abstract" xml:lang="en"><p>Systemic sclerosis is a chronic, progressive disease with an extremely poor prognosis. The incidence of malignant tumors in patients with systemic sclerosis is increased when compared with that of the general population. In certain malignancies, systemic sclerosis presents as a paraneoplastic process. The symptoms of sclerosis in the organs of the head and neck often overlap with symptoms of malignant diseases, which may increase the difficulty of a differential diagnosis. Additionally, the presence of sclerosis may complicate standard examination procedures, due to poor access to the oral cavity and oropharynx. When considering treatment options, it is important to evaluate the surgical and oncological risks to soft tissues of the head and neck with regard to both diseases, as well as the relatively poor prognosis for systemic sclerosis and oropharyngeal cancer. The low incidence of patients with systemic sclerosis and oropharyngeal carcinoma together presents a clear case for a casuistic approach. Based upon our own experience, we can attest to the difficulty of treating such patients. However, we have no evidence to indicate that these patients have reduced tolerance to surgical treatments. The current study presents the case of a 47-year-old female with systemic sclerosis, who was diagnosed with oropharyngeal carcinoma. The patient initially tolerated radiotherapy treatment well, however post-radiotherapy complications occurred. Despite many enigmatic indications to the contrary, it appears that the complications in this instance may be due to late toxicity from radiotherapy.</p>
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<pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Oncol Lett</journal-id>
<journal-id journal-id-type="iso-abbrev">Oncol Lett</journal-id>
<journal-id journal-id-type="publisher-id">OL</journal-id>
<journal-title-group><journal-title>Oncology Letters</journal-title>
</journal-title-group>
<issn pub-type="ppub">1792-1074</issn>
<issn pub-type="epub">1792-1082</issn>
<publisher><publisher-name>D.A. Spandidos</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">25435929</article-id>
<article-id pub-id-type="pmc">4246633</article-id>
<article-id pub-id-type="doi">10.3892/ol.2014.2627</article-id>
<article-id pub-id-type="publisher-id">ol-09-01-0025</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Articles</subject>
</subj-group>
</article-categories>
<title-group><article-title>Complications in the treatment of oropharyngeal carcinoma in patients with systemic sclerosis: A case report</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>ČOČEK</surname>
<given-names>ALES</given-names>
</name>
<xref ref-type="aff" rid="af1-ol-09-01-0025">1</xref>
<xref ref-type="corresp" rid="c1-ol-09-01-0025"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>HAHN</surname>
<given-names>ALES</given-names>
</name>
<xref ref-type="aff" rid="af1-ol-09-01-0025">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>AMBRUŠ</surname>
<given-names>MILOSLAV</given-names>
</name>
<xref ref-type="aff" rid="af2-ol-09-01-0025">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>VALEŠOVÁ</surname>
<given-names>MARIE</given-names>
</name>
<xref ref-type="aff" rid="af3-ol-09-01-0025">3</xref>
</contrib>
</contrib-group>
<aff id="af1-ol-09-01-0025"><label>1</label>
ENT Clinic, Charles University Third Medical School and Královské Vinohrady Teaching Hospital, 100 34 Prague 10, Czech Republic</aff>
<aff id="af2-ol-09-01-0025"><label>2</label>
Radiotherapy and Oncology Clinic, Charles University Third Medical School and Královské Vinohrady Teaching Hospital, 100 34 Prague 10, Czech Republic</aff>
<aff id="af3-ol-09-01-0025"><label>3</label>
First Internal Medicine Clinic, Charles University Third Medical School and Královské Vinohrady Teaching Hospital, 100 34 Prague 10, Czech Republic</aff>
<author-notes><corresp id="c1-ol-09-01-0025">Correspondence to: Dr Ales Čoček, ENT Clinic, Charles University Third Medical School and Královské Vinohrady Teaching Hospital, 50 Šrobárova, 100 34 Prague 10, Czech Republic, E-mail: <email>ales.cocek@seznam.cz</email>
</corresp>
</author-notes>
<pub-date pub-type="ppub"><month>1</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="epub"><day>22</day>
<month>10</month>
<year>2014</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>22</day>
<month>10</month>
<year>2014</year>
</pub-date>
<pmc-comment> PMC Release delay is 0 months and 0 days and was based on the
. </pmc-comment>
<volume>9</volume>
<issue>1</issue>
<fpage>25</fpage>
<lpage>28</lpage>
<history><date date-type="received"><day>14</day>
<month>2</month>
<year>2014</year>
</date>
<date date-type="accepted"><day>08</day>
<month>9</month>
<year>2014</year>
</date>
</history>
<permissions><copyright-statement>Copyright © 2015, Spandidos Publications</copyright-statement>
<copyright-year>2015</copyright-year>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/3.0"><license-p>This is an open-access article licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License. The article may be redistributed, reproduced, and reused for non-commercial purposes, provided the original source is properly cited.</license-p>
</license>
</permissions>
<abstract><p>Systemic sclerosis is a chronic, progressive disease with an extremely poor prognosis. The incidence of malignant tumors in patients with systemic sclerosis is increased when compared with that of the general population. In certain malignancies, systemic sclerosis presents as a paraneoplastic process. The symptoms of sclerosis in the organs of the head and neck often overlap with symptoms of malignant diseases, which may increase the difficulty of a differential diagnosis. Additionally, the presence of sclerosis may complicate standard examination procedures, due to poor access to the oral cavity and oropharynx. When considering treatment options, it is important to evaluate the surgical and oncological risks to soft tissues of the head and neck with regard to both diseases, as well as the relatively poor prognosis for systemic sclerosis and oropharyngeal cancer. The low incidence of patients with systemic sclerosis and oropharyngeal carcinoma together presents a clear case for a casuistic approach. Based upon our own experience, we can attest to the difficulty of treating such patients. However, we have no evidence to indicate that these patients have reduced tolerance to surgical treatments. The current study presents the case of a 47-year-old female with systemic sclerosis, who was diagnosed with oropharyngeal carcinoma. The patient initially tolerated radiotherapy treatment well, however post-radiotherapy complications occurred. Despite many enigmatic indications to the contrary, it appears that the complications in this instance may be due to late toxicity from radiotherapy.</p>
</abstract>
<kwd-group><kwd>oropharyngeal carcinoma</kwd>
<kwd>systemic sclerosis</kwd>
<kwd>autoimmune diseases</kwd>
</kwd-group>
</article-meta>
</front>
<floats-group><fig id="f1-ol-09-01-0025" orientation="portrait" position="float"><label>Figure 1</label>
<caption><p>(A) No tumor was visible on the CT axial scan. (B) PET CT axial scan revealed a tonsillar tumor (right side). CT, computed tomography; PET, positron emission tomography.</p>
</caption>
<graphic xlink:href="OL-09-01-0025-g00"></graphic>
</fig>
<fig id="f2-ol-09-01-0025" orientation="portrait" position="float"><label>Figure 2</label>
<caption><p>(A) MRI T2 axial scan revealed a suspected tumor recurrence on the right side of tongue. (B) MRI coronal scan of the tumor of the right side of the tongue. MRI, magnetic resonance imaging.</p>
</caption>
<graphic xlink:href="OL-09-01-0025-g01"></graphic>
</fig>
<fig id="f3-ol-09-01-0025" orientation="portrait" position="float"><label>Figure 3</label>
<caption><p>Positron emission tomography-computed tomography axial scan did not reveal any tumor recurrence.</p>
</caption>
<graphic xlink:href="OL-09-01-0025-g02"></graphic>
</fig>
</floats-group>
</pmc>
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