Creat membership Creat membership
Sign in

Forgot password?

Confirm
  • Forgot password?
    Sign Up
  • Confirm
    Sign In
home > search

Now showing items 1 - 16 of 394

  • Incidental Findings on FDG PET/CT in Head and Neck Cancer

    Britt, Christopher J.   Maas, Austin M.   Kennedy, Tabassum A.   Hartig, Gregory K.  

    Objective 18F-fluoro-deoxy-glucose positron emission tomography/computed tomography (FDG PET/CT) imaging is common in head and neck cancer and often identifies incidental findings that necessitate additional patient evaluations. Our goal was to assess the frequency and nature of these incidental imaging findings on FDG-PET/CT. Study Design Retrospective cohort study. Setting Tertiary medical center. Subjects and Methods All patients with head and neck cancer who had undergone FDG-PET/CT imaging between January 2014 and June 2015 at our institution were evaluated for incidental findings. Results A total of 293 patients met criteria; more than one-third (n =3D 103) had at least 1 finding unrelated to their head and neck cancer, for a total of 134 incidental findings. Incidental findings within the head and neck (33.5% of all) excluding the thyroid were most common: 35% incidental findings were concerning for malignancy; of these, 25.5% were malignant with further workup. Recommendations were given by the head and neck radiologist on 72 (53.7%) findings: 74.5% of potentially malignant findings and 42.5% of benign findings had recommendations for follow-up. Significantly more patients with findings described as malignant were given recommendations for follow-up (P =3D .0004). Conclusion Incidental findings on FDG-PET/CT are present in more than one-third of patients with head and neck cancer. More than one-third of incidental findings were concerning for malignancy. This study illustrates how the incidental findings discovered on FDG PET/CT frequently necessitate additional evaluations unrelated to the index head and neck cancer. The impact of these additional assessments on the cost and quality of health care warrants future evaluation.
    Download Collect
  • Auriculotemporal Nerve Involvement in Parotid Bed Malignancy

    Thompson, James D.   Avey, Gregory D.   Wieland, Aaron M.   Harari, Paul M.   Glazer, Tiffany A.   McCulloch, Timothy M.   Hartig, Gregory K.  

    Download Collect
  • Radiosensitization of Adenoid Cystic Carcinoma with MDM2 Inhibition

    Prabakaran, Prashanth J.   Javaid, Amal M.   Swick, Adam D.   Werner, Lauryn R.   Nickel, Kwangok P.   Sampene, Emmanuel   Hu, Rong   Ong, Irene M.   Bruce, Justine Y.   Hartig, Gregory K.   Wieland, Aaron M.   Canon, Jude   Harari, Paul M.   Kimple, Randall J.  

    Purpose: Adenoid cystic carcinoma (ACC) is a rare cancer arising from the major or minor salivary gland tissues of the head and neck. There are currently no approved systemic agents or known radiosensitizers for ACC. Unlike the more common head and neck squamous cell carcinomas that frequently harbor TP53 mutations, ACCs contain TP53 mutations at a rate of < 5%, rendering them an attractive target for MDM2 inhibition. Experimental Design: We report the successful establishment and detailed characterization of a TP53-WT ACC patient-derived xenograft (PDX), which retained the histologic features of the original patient tumor. We evaluated this model for response to the MDM2 inhibitor AMG 232 as monotherapy and in combination with radiotherapy. Results: AMG 232 monotherapy induced modest tumor growth inhibition, and radiation monotherapy induced a tran-sient tumor growth delay in a dose-dependent fashion. Strikingly, combination treatment ofAMG232 with radiotherapy (including low-dose radiotherapy of 2 Gy/fraction) induced dramatic tumor response and high local tumor control rates 3 months following treatment. Posttreatment analysis revealed that although both AMG 232 and radiotherapy alone induced TP53 tumor-suppressive activities, combination therapy amplified this response with potent induction of apoptosis after combination treatment. Conclusions: These data identify that MDM2 inhibition can provide potent radiosensitization in TP53-WT ACC. In light of the absence of effective systemic agents for ACC, the powerful response profile observed here suggests that clinical trial evaluation of this drug/radiotherapy combination may be warranted to improve local control in this challenging malignancy. (C) 2017 AACR.
    Download Collect
  • Metastatic synovial sarcoma of the scalp: Case report

    Lippert, Dylan C.   Britt, Christopher J.   Pflum, Zachary E.   Rush, Patrick S.   Hartig, Gregory K.  

    BackgroundSynovial sarcoma is a malignant tumor of soft tissue that is rarely found in the head and neck. Even less common are metastasis within the head and neck. MethodsWe describe a case of a delayed metastatic synovial sarcoma to the scalp. A man who had been diagnosed and treated 16 years previously for monophasic synovial sarcoma of the groin, presented with a new scalp lesion confirmed to be metastatic monophasic synovial sarcoma. Wide local excision and sentinel lymph node biopsy (SLNB) were performed and adjuvant radiation therapy was deferred. ResultsA positron emission tomography (PET)/CT was obtained 3 months after surgery and showed no evidence of local recurrence or metastatic disease. ConclusionThis case report describes a rare case of synovial sarcoma metastasizing to the scalp. The genetic, histopathologic, and clinical features of synovial sarcoma are reviewed with a focus on their manifestation and management within the head and neck. (c) 2015 Wiley Periodicals, Inc. Head Neck 38: E45-E48, 2016
    Download Collect
  • Is HPV-Associated Oropharyngeal Cancer Becoming More Common in Older Patients?

    Thompson, James D.   Harari, Paul M.   Hartig, Gregory K.  

    Objective To evaluate changing age demographics over a 15-year period for patients with HPV-associated oropharyngeal squamous cell carcinoma (OPSCC). Study Design Retrospective review of patients identified with p16-positive OPSCC at our institution over a 15-year timeframe. Materials/Methods: p16-positive immunohistochemistry was used as a surrogate for HPV-associated OPSCC. Patients were categorized according to year of diagnosis (2002-2010 versus 2011-2016). Mean age and proportion of patients over age 65 were statistically evaluated and compared. Results From 2002 to 2010, 100 patients were identified with p16-positive OPSCC, mean age at diagnosis was 55.2, and the proportion of patients over 65 was 10.0%. From 2011 to 2016, 188 patients were identified with p16-positive OPSCC, mean age was 58.5, and the proportion of patients over 65 was 19.6%. Both the mean age difference and the difference in proportion of patients over 65 were statistically significant (P =3D .001 and P =3D .034, respectively). Conclusion The mean age at diagnosis and proportion of patients over 65 has increased over the past 15 years at our institution. This data suggests that HPV-associated OPSCC is being diagnosed more frequently in older persons and that the age demographic may be shifting. Confirmation of this trend with larger patient numbers on a national level will be valuable. This study highlights the importance of maintaining a high clinical suspicion for HPV-associated OPSCC regardless of patient age. Level of evidence 4
    Download Collect
  • Is HPV-Associated Oropharyngeal Cancer Becoming More Common in Older Patients?

    Thompson, James D.   Harari, Paul M.   Hartig, Gregory K.  

    Download Collect
  • Chondroradionecrosis of the larynx:24-year University of Wisconsin experience

    Gessert, Thomas G.   Maas, Austin M. W.   Wieland, Aaron M.   Harari, Paul M.   Hartig, Gregory K.  

    Background. Chondroradionecrosis (CRN) is an uncommon but significant complication of laryngeal radiotherapy that presents a diagnostic challenge to clinicians through its similarity in presentation to cancer recurrence.Methods. Two hundred ninety-four patients underwent primary, adjuvant, or salvage radiation for laryngeal cancer from 1991 to 2015 at the University of Wisconsin. Medical records were reviewed to identify and characterize patients with a diagnosis of CRN.Results. Of the 294 patients, 7 cases (2.4%) of CRN were identified. Development of CRN was associated with the presence of cartilage invasion by tumor (p =3D .038) and ongoing alcohol use postradiotherapy ( p =3D .036). Additionally, a trend between development of CRN and ongoing smoking postradiotherapy was observed (p =3D .067).Conclusion. The diagnosis of CRN is challenging, and the likelihood of successful resolution is modest. A high premium should be placed on efforts directed at prevention, such as tobacco and alcohol cessation. (C) 2017 Wiley Periodicals, Inc.
    Download Collect
  • Tracheoinnominate Fistula: Successful Management with Endovascular Stenting

    Shepard, Peter M.   Phillips, Jeffrey M.   Tefera, Girma   Hartig, Gregory K.  

    Download Collect
  • Therapeutic selective neck dissection outcomes

    Shepard, Peter M.   Olson, Jordan   Harari, Paul M.   Leverson, Glen   Hartig, Gregory K.  

    OBJECTIVE: To evaluate the effectiveness of selective neck dissection in patients with nodal metastases from head and neck squamous cell carcinoma. STUDY DESIGN: Historical cohort study. SETTING: Academic medical center. SUBJECTS AND METHODS: A chart review was performed on 156 subjects with clinically positive regional nodal metastases managed initially with surgery, including neck dissection. Sixty-nine subjects underwent selective neck dissection (less than 5 levels), and the majority received postoperative radiotherapy (80%). Primary outcomes included Kaplan-Meier three-year ipsilateral regional control and five-year overall survival. Cox proportional univariate and multivariate analyses were performed to determine those factors associated with outcome. RESULTS: There were two ipsilateral regional recurrences among those undergoing selective neck dissection, yielding a regional control rate of 95.9 percent. Among those undergoing comprehensive neck dissection, nine ipsilateral regional recurrences occurred, yielding a control rate of 86.0 percent (P = 0.053). No selective neck dissection recurrences occurred in a preserved level. Selective neck dissection, as compared to comprehensive neck dissection, was not adversely associated with regional recurrence, survival, or distant metastasis, even after adjusting for possible confounders (hazard ratio 0.21, P = 0.055). CONCLUSION: These results demonstrate high rates of regional disease control (96%) following selective neck dissection and radiotherapy in patients with positive neck node metastases. In this population, performing selective neck dissection with adjuvant radiotherapy for the majority of patients is supported as an effective treatment approach. (C) 2010 American Academy of Otolaryngology-Head and Neck Surgery Foundation. All rights reserved.
    Download Collect
  • Fibrovascular polyp of the cervical esophagus

    Been, Mark J.   Hinsely, Matthew L.   Hartig, Gregory K.  

    Download Collect
  • Planned postradiotherapy neck dissection: Rationale and clinical outcomes

    Sewall, Gregory K.   Palazzi-Churas, Kerrin L.   Richards, Gregory M.   Hartig, Gregory K.   Harari, Paul M.  

    Objectives: In this study, we examine pathology results and clinical outcome for patients with locoregionally advanced squamous cell carcinoma of the head and neck (SCCHN) who present with advanced neck disease and undergo planned postradiotherapy neck dissection. Study Design: Review of all patients with SCCHN treated with primary radiation (or chemoradiation) and postradiotherapy neck dissection at the University of Wisconsin between 1992 to 2005 was performed. One hundred seven neck dissections were identified in 93 patients, 79 unilateral and 14 bilateral. All major treatment and outcome parameters were examined with particular emphasis on the postradiotherapy neck dissection. Results. Thirty of 107 neck dissection specimens (28%) showed evidence of residual carcinoma on pathologic review. The mean number of lymph nodes identified at neck dissection for the entire cohort was 21 per specimen (range, 1-60) with 1.3 nodes per positive neck dissection demonstrating residual carcinoma. No correlation was found between the type of neck dissection performed and the presence of residual nodal disease. Eighty-two evaluated patients (93%) remain free of regional disease recurrence, whereas six patients have subsequently manifested neck recurrence. Four of the six patients who developed regional recurrence showed residual carcinoma in their neck dissection specimen. Five of these patients underwent comprehensive neck dissection (levels I-V); one underwent selective neck dissection (
    Download Collect
  • Parotidectomy: Ten-year review of 237 cases at a single institution

    Upton, David C.   McNamar, Justin P.   Connor, Nadine P.   Harari, Paul M.   Hartig, Gregory K.  

    OBJECTIVE: To review a single surgeon's experience with parotidectomy with an emphasis on examining the appropriate use of partial superficial parotidectomy and the differences in early outcomes observed with the various types and extent of parotidectomy used. STUDY DESIGN AND SETTING: A series of 237 patients who underwent parotidectomy over a 10-year period was reviewed. RESULTS: Postoperative complications included facial nerve weakness (18%), sialocele (6.3%), wound infection (3.8%), hematoma (3.8%), and symptomatic Frey's syndrome (1.7%). More extensive surgical procedures, including complete superficial or total parotidectomy, were associated with a 2.7 times greater incidence of immediate postoperative facial nerve weakness compared with partial superficial parotidectomy. CONCLUSION: Partial superficial parotidectomy is associated with a decreased incidence of transient postoperative facial nerve weakness compared with more extensive procedures such as complete superficial or total parotidectomy. Intraoperative frozen section was an accurate means of selecting patients for the partial superficial parotidectomy procedure. SIGNIFICANCE: Partial superficial parotidectomy is an effective method for treating benign tumors confined to the superficial lobe. (C) 2007 American Academy of Otolaryngology-Head and Neck Surgery Foundation. All rights reserved.
    Download Collect
  • In-Office Biopsy of Upper Airway Lesions:Safety,Tolerance,and Effect on Time to Treatment

    Lippert, Dylan   Hoffman, Matthew R.   Dang, Phat   McCulloch, Timothy M.   Hartig, Gregory K.   Dailey, Seth H.  

    Objectives/HypothesisDefinitive tissue diagnosis for lesions warranting biopsy is shifting from the operating room to the office. Safety, tolerance, factors related to successful biopsy, and time to treatment are not well-defined. MethodsRetrospective review of 116 patients undergoing in-office biopsy of oropharynx, larynx, or hypopharynx were included. Logistic regression determined if demographics, site, T-stage, or approach (transoral/transnasal) were related to success. Time to definitive treatment was also analyzed. ResultsNinety-two transnasal and 24 transoral biopsies were performed on 73 laryngeal, 35 oropharyngeal, and 8 hypopharyngeal lesions. Of those, 97 of 116 diagnoses were made in-office. There were no complications; two patients did not tolerate the procedure. Success was not related to age (P=3D0.374), site (P=3D0.527), T-stage (P=3D0.587), or approach (P=3D0.566). Time to treatment was 24.213.9 days with successful office biopsy and 48.849.4 days without. ConclusionsHigh procedural completion rate was observed across patients, sites, and approaches. All patients should be considered for in-office biopsy, a more time- and cost-effective option leading to earlier treatment. Level of Evidence4. Laryngoscope, 125:919-923, 2015
    Download Collect
  • Personalized Treatment for Lacrimal Sac Adenoid Cystic Carcinoma: Case Report and Literature Review

    Bowen, Randy C.   Ko, Huaising C.   Avey, Gregory D.   Hartig, Gregory K.   Hu, Rong   Harari, Paul M.   Lucarelli, Mark J.  

    Download Collect
  • Defining the boundaries and expanding the utility of head and neck cancer patient derived xenografts

    Swick, Adam D.   Stein, Andrew P.   McCulloch, Timothy M.   Hartig, Gregory K.   Ong, Irene M.   Sampene, Emmanuel   Prabakaran, Prashanth J.   Liu, Cheng Z.   Kimple, Randall J.  

    Background: Patient derived xenografts (PDXs) represent an essential tool in oncologic research, and we sought to further expand our repertoire of head and neck squamous cell carcinoma (HNSCC) while determining potential boundaries for this system. Methods: We consented new patients for PDX development and determined if a 24-h time delay from tumor excision to xenograft implantation affected PDX establishment. We developed a tissue microarray (TMA) from formalin fixed, paraffin embedded PDXs and their subsequent passages and carried out quantitative immunohistochemistry for EGFR, pEGFR, pAkt, pERK and ERCC1. First and last passaged PDXs were compared via a paired t-test to examine for the stability of protein expression across passages. We performed a similar comparison of the mutational profile of the patient tumor and resulting xenografts using a targeted sequencing approach. Results: No patient/tumor characteristics influenced PDX take rate and the 24-h time delay from tumor excision to xenograft implantation did not affect PDX establishment, growth or histology. There was no significant difference in biomarker expression between the first and last passaged PDXs for EGFR, pEGFR, pAkt, and ERCC1. For pERK there was a significant difference (p =3D 0.002), but further analysis demonstrated this only arose in three of 15 PDXs. Targeted sequencing revealed striking stability of passenger and likely driver mutations from patient to xenograft. Conclusions: The stability of protein expression across PDX passages will hopefully allow greater investigation of predictive biomarkers in order to identify ones for further pre-clinical and clinical investigation. (C) 2016 Elsevier Ltd. All rights reserved.
    Download Collect
  • Radiology quiz case 1 - Stafne bone cyst (also referred to as a Stafne bone cavity or defect)

    Upton, David C.   Sewall, Gregory K.   Hartig, Gregory K.  

    Download Collect
1 2 3 4 5 6 7 8 9 10

Contact

If you have any feedback, Please follow the official account to submit feedback.

Turn on your phone and scan

Submit Feedback