Publications by authors named "Ellen L Tokarz"

3 Publications

  • Page 1 of 1

Not Your Typical Tonsil: Metastatic Merkel Cell Carcinoma or Primary Disease?

Cureus 2021 Apr 21;13(4):e14604. Epub 2021 Apr 21.

Otolaryngology - Head and Neck Surgery, Tufts Medical Center, Boston, USA.

Merkel cell carcinoma (MCC) is a rare, aggressive neuroendocrine tumor that almost always presents as a cutaneous lesion in the sun-exposed areas on the bodies of elderly white males. Metastasis to lymph nodes in the presence or absence of a known primary site and occurrence of these tumors in non-sun-exposed sites have also been described; however, an incidence of recurrent disease arising in the palatine tonsil in the absence of any detectable primary lesion has never been reported in the literature. In this report, we discuss a case of a 72-year-old female who was found to have a single axillary lymph node, which was resected and proved to be positive forMCC of unknown primary (MCCUP). Since there was no evidence of additional disease, the patient elected not to pursue adjuvant therapies. Six and a half months later, she presented with a complaint of dysphagia and a right-sided exophytic tonsillar mass. Tonsillectomy revealed MCC with no detectable primary cutaneous lesion. She received adjuvant therapy with avelumab and demonstrated a complete response after one year of bi-weekly treatments. Seven months following cessation of adjuvant treatments, surveillance positron emission tomography (PET) revealed enlarged retroperitoneal, pretracheal, periaortic, and left axillary lymph nodes concerning for recurrence. She elected to forgo additional biopsies and restarted avelumab the following month. She continues to be followed up on a monthly basis.
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http://dx.doi.org/10.7759/cureus.14604DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8139134PMC
April 2021

Sinonasal Renal Cell-Like Adenocarcinoma.

Cureus 2021 Apr 4;13(4):e14285. Epub 2021 Apr 4.

Otolaryngology - Head and Neck Surgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, USA.

Sinonasal renal cell-like adenocarcinoma (SNRCLA) is a newly defined, rare malignant tumor of the nasal cavity. The clinical course and response to treatment remain uncertain. The purpose of this study is to report a new case of SNRCLA and review the literature to determine clinical characteristics, treatment options, and outcomes. A 26-year-old male presented with headache, epistaxis, and nasal obstruction. Physical examination revealed a tumor involving bilateral ethmoid sinuses and MRI revealed extension through the cribriform plate. Surgical excision with endonasal and a bifrontal craniotomy was performed followed by adjuvant radiotherapy (RT). After RT, the patient had persistent disease requiring salvage surgery. There are few previously reported cases of SNRCLA. A literature review yielded 14 previously reported cases with convincing diagnostic evidence of SNRCLA. Common presenting symptoms were epistaxis and nasal obstruction. Surgical excision was the primary treatment in fourteen cases, nine received RT, and none received chemotherapy. However, three cases had persistent or recurrent disease. Surgical excision is the mainstay of treatment for SNRCLA and adjuvant RT has been used in some patients with varying outcomes. The tumor is low grade with no reported cases of metastases or death. The best practice for treatment is yet to be determined.
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http://dx.doi.org/10.7759/cureus.14285DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8094930PMC
April 2021

Nasopharyngeal Carcinoma Ex Pleomorphic Adenoma: Case Report and Comprehensive Literature Review.

Case Rep Otolaryngol 2021 26;2021:8892280. Epub 2021 Feb 26.

State University of New York at Buffalo, Department of Otolaryngology-Head and Neck Surgery, Buffalo, NY, USA.

Carcinoma ex pleomorphic adenoma (CXPA) is an epithelial malignancy that transforms from benign pleomorphic adenomas (PA) at a rate of 1.5% after 5 years and 10% after 15 years. The average age of reported nasopharyngeal CXPA is 56.7 years. However, the present case describes a 19-year-old making this case exceptionally rare. Standard treatment is wide local excision with adjuvant treatment. We report the demographics, presentation, treatment, and outcomes of 8 cases of nasopharyngeal CXPA. While surgical excision is the mainstay of treatment, negative margins can be difficult to obtain at the skull base, and we report a recurrence rate of 50% in nasopharyngeal primaries. Due to the aggressive nature of the disease and high rate of recurrence, the majority of patients in our review received adjuvant radiation with some receiving adjuvant chemotherapy in addition.
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http://dx.doi.org/10.1155/2021/8892280DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7935586PMC
February 2021