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Poster Session Poster Session and adjuvant therapy has been questioned. Conclusion: This tumor may PS-001 SGP: 7771 be misdiagnosed, usually with melanomas. These patients may benefit from neck dissection and adjuvant therapy. Video-assisted resection of branchial cysts Author(s): Flavia Pereira Fleming, Leonardo Guimarães Rangel Keywords: congenital abnormalities, cysts, video-assisted surgery. PS-004 SGP: 7844 Traditional surgical techniques for branchial cyst resection yield unsatisfac- Occupational laryngopathy. What to Suspect? Submucous Vocal tory aesthetic results because of the size of the required incision. There is Fold Cyst also higher associated morbidity due to excessive surgical manipulation. Video-assisted resection - a recent surgical technique - is minimally invasive, Author(s): Fábio Silva Alves, Carlos Eduardo Monteiro Zappelini, Luana Gonçalves Oliveira, Luciana Campoy Basile, Ari de Paula e Silva, José Maria causes less morbidity, and has superior aesthetic results. Moraes de Rezende Keywords: disease, laryngeal mucosa, larynx. PS-002 SGP: 7806 Benign diseases of the larynx that are associated with specific professional activities have been reported for many years. Difficulties in establishing a Thrombosis of the internal jugular vein in the differential diagno- medical-legal link between structural abnormalities and phono-articulatory sis of neck tumors effort have raised issues that were only clarified as knowledge about the Author(s): Janaina Guidotti, Márcio Gomes Cunha, Fábia Carla Guidotti physiology of voice emission and its intricate intervening factors developed. Keywords: jugular veins, neck, venous thrombosis. The vocal fold cyst is an epithelium-lined structure the content of which is separate from the medium within which it is immersed. It is an abnormal Thrombosis of the internal jugular vein is a serious vascular complication development of the superficial part of the lamina propria under the epi- that may present as a nonspecific neck mass in the physical examination. thelium but outside the voice muscle. It may be unilateral and is classified This case report describes a patient in an emergency unit of a town in Sao according to its site; it is usually found in the superficial submucosal layer. Paulo state who presented pain and a mass of sudden onset in the right side SLM, a white single female patient aged 31 years, a teacher in Salvador, Bahia, of the neck; there were few inflammatory signs and no apparent triggering complained of dysphonia within the last year. She had taught in an basic factor. The physical examination revealed a warm hard mass of imprecise education private school for the past 10 years. One year ago she presented contours that was painful upon palpation; the remaining otolaryngological spasmodic coughing and constant dysphonia which worsened periodically. examination was normal. Computed tomography revealed a thrombus in The patient did not smoke, there was no alcohol or drug abuse, and she the right internal jugular vein. The differential diagnosis of neck masses did not use medication on a continuous basis. She practiced aerobic sports includes congenital conditions, infections, primary neoplasms, and metas- - running and swimming. After 3 months of medical treatment and speech tases. Thrombosis of the internal jugular vein is often unnoticed, which may therapy the patient reported a significant improvement of voice quality; the result in delayed treatment. vocal fold cyst was slightly smaller. We may state that submucosal vocal fold cysts may be a manifestation of work-related laryngeal disease, and should be checked regularly by voice professionals. PS-003 SGP: 7809 Clear cell sarcoma of the parotid region: case report PS-005 SGP: 7849 Author(s): Evandro Maccarini Manoel, Rafael Reiser, Fábio Brodskyn, Marcel das Neves Palumbo, Onivaldo Cervantes, Márcio Abrahão, Marcello Franco Carcinoma ex pleomorphic adenoma of minor salivary glands in Keywords: clear cell, head and neck neoplasms, local, neoplasm recurrence, parotid region, the parapharyngeal space sarcoma. Author(s): Vinicius Belchior Lima, André Alencar Araripe Nunes, Marcos Rabelo Clear Cell Sarcoma(CCS), also known as Malignant Melanoma of Soft Parts, de Freitas, Sebastião Diógenes Pinheiro, João Paulo Catunda Bastos is an aggressive tumor that is rarely found in the head and neck. Case Keywords: adenoma, carcinoma, minor, oropharynx, pleomorphic, salivary glands. Report: A 43 year-old white female patient presented only progressive Background: Carcinoma ex pleomorphic adenoma (CXPA) is a rare ag- swelling of the right parotid area. Computed Tomography (FIG. 1) revealed gressive neoplasm that develops from a primary or recurrent pleomorphic a contrast-enhanced 5-cm heterogeneous mass on the right parotid area. adenoma. The CXPA comprises 11.7% of salivary gland malignancies. Tu- The patient first treated by superficial parotidectomy; the initial diagnosis mors of the parapharyngeal space are rare, comprising about 0.5% of head was a peripheral nerve sheath malignant neoplasm that was positive for the and neck tumors. Minor salivary gland tumors account for 6% to 22% of all S-100 protein in the immunochemical evaluation (FIG. 2). An international salivary gland neoplasms; about 82% of these are malignant. Case Report: expert was asked to assess the case and suggested metastatic malignant A female patient aged 80 years presented dysphagia for solid foods only, a melanoma as a diagnosis. The final diagnosis, however, was reached by mildly sore throat, and a foreign body sensation in the throat for 6 months. applying the FISH cytogenetic test (FIG. 3). Eight months later, local and The physical examination revealed bilateral grade I tonsils and a submuco- regional recurrence was detected. The patient underwent radical right neck sal smooth fibroelastic non-pulsatile mass adhered to deep planes behind dissection. Following surgery, external radiotherapy was applied (total dose the palatopharyngeal arc to the right. Computed tomography of the neck - 6600 cGy). Six months after the second procedure there were no signs or revealed a hypodense mass to the right in the parapharyngeal space that symptoms of local or regional recurrence. Discussion: Despite similarities contrasted heterogeneously; it extending medially to the oropharynx and with melanoma, these are different types of tumors. This is the fourth case inferiorly to the ipsilateral pyriform sinus. Transoral excision biopsy was reported in this area. The tumor has a high local and regional recurrence carried out for pathology, which showed a malignant infiltrating complex rate and its prognosis is considered poor. Surgery remains the best approach, 11 Anais_41CBO(ing).indb 11 21/12/2011 15:02:35 (mixed) with pseudoglandular or squamous carcinomatous transformation. Its likely origin was glandular, and it resembled carcinoma ex mixed tumor. PS-008 SGP: 7878 Immunohistochemistry was done to assess AE1/AE3, Vimentin, p63, and PS100; it suggested carcinoma with adenocarcinomatous differentiation - Sentinel node biopsy in larynx cancer: a new perspective ex pleomorphic adenoma. Discussion: A comprehensive review of the Author(s): Guilherme Machado de Carvalho, Carlos Takahiro Chone, Agrício literature revealed few case reports of tumors arising from carcinoma ex Nubiato Crespo, Vanessa Gonçalves Silva, Celso Dario Ramos, Elba Etchehe- pleomorphic adenoma of minor salivary glands; the parapharyngeal space bere, Albina Altemani, Leandro L. Freitas, Flávio Mignonne Gripp, Hugo F. Kohler is an unusual location. Keywords: carcinoma, laryngeal neoplasms, neck dissection, recurrence, sentinel lymph node biopsy, squamous cell. PS-006 SGP: 7850 Management of the clinically and radiologically negative neck in patients with early head and neck squamous cell carcinoma (HNSCC) remains Elongated Styloid Process. What to Investigate? A Case Report of controversial. Although about 30% of patients harbor occult disease in the neck, most patients undergo elective neck dissection, with no benefit.1 As the Eagle syndrome in several other solid tumors, sentinel lymph node biopsy (SLB) is emerging Author(s): Fábio Silva Alves, Luana Gonçalves Oliveira, Carlos Eduardo Mon- as a potentially useful method for staging lymphatic metastasis in HNSCC.2,3 teiro Zappelini, Luciana Campoy Basile, Ana Cecília Macedo, Carlos Eduardo It has been shown that sentinel node status predicts the presence of me- Maibashi, José Maria Moraes de Rezende tastasis in other nodes within the nodal basin.4 Multiple validation studies Keywords: palatine tonsil, swallowing disorders, toothache. have reported over 95% sentinel node detection rates and 95% negative predictive values for negative sentinel nodes in HNSCC.5 Objective: To The styloid process is a thin projection of bone originating from the temporal evaluate the accuracy of this method in laryngeal squamous cell carcinoma bone medial and anterior to the styloid foramen; it connects through the and to compare the neck status after SNB followed by elective neck dissec- styloid ligament to the inferior horn of the hyoid bone. Elongation of the tion (END) and SNB alone. Subjects: Patients with SCC of larynx without styloid process, or calcification of the styloid or stylomandibular ligament, neck metastases Results: Conclusion: SNB in larynx cancer had a 100% was first described by Eagle in 1937, who considered it rare. Eagle’s syn- negative predictive value, a 100% accuracy rate and a 0% recurrence rate. drome is characterized by the presence of symptoms, the
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