399 results match your criteria Management of the N0 Neck


Lower-Neck Sparing Using Proton Therapy in Patients with Uninvolved Neck Nasopharyngeal Carcinoma: Is It Safe?

J Clin Med 2022 Jun 9;11(12). Epub 2022 Jun 9.

Radiation Oncology, Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Strada Campeggi 53, 27100 Pavia, Italy.

Undifferentiated carcinoma of the nasopharynx (NPC) is a rare disease, which usually occurs in the Asian population. Due to its anatomic location, it is characterised by rich lymph node drainage and has a high incidence of cervical node metastasis. However, cervical nodal metastasis commonly involves retropharyngeal nodes and level II nodes, followed by level III nodes. Read More

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Radiomics Metrics Combined with Clinical Data in the Surgical Management of Early-Stage (cT1-T2 N0) Tongue Squamous Cell Carcinomas: A Preliminary Study.

Biology (Basel) 2022 Mar 18;11(3). Epub 2022 Mar 18.

Maxillofacial Surgery Operative Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, 80131 Naples, Italy.

Objective: To predict the risk of metastatic lymph nodes and the tumor grading related to oral tongue squamous cell carcinoma (OTSCC) through the combination of clinical data with radiomics metrics by computed tomography, and to develop a supportive approach in the management of the lymphatic cervical areas, with particular attention to the early stages (T1-T2). Between March 2016 and February 2020, patients with histologically confirmed OTSCC, treated by partial glossectomy and ipsilateral laterocervical lymphadenectomy and subjected to computed tomography (CT) before surgery, were identified by two centers: 81 patients (49 female and 32 male) with 58 years as the median age (range 19-86 years). Univariate analysis with non-parametric tests and multivariate analysis with machine learning approaches were used. Read More

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Sentinel lymph node biopsy with a handheld cordless magnetic probe following preoperative MR lymphography using superparamagnetic iron oxide for clinically N0 early oral cancer: A feasibility study.

J Stomatol Oral Maxillofac Surg 2022 Jan 8. Epub 2022 Jan 8.

Department of Oral and Maxillofacial Surgery/Orthodontics, Yokohama City University hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan.

Purpose: Radioisotope (RI) tracers are generally used for preoperative mapping of sentinel lymph node (SLN) and intraoperative detection with a portable γ probe. However, the use of RI has several limitations. Therefore, a method without RI is required for the widespread application of SLN biopsy. Read More

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January 2022

Randomized Trial of Radiotherapy Versus Transoral Robotic Surgery for Oropharyngeal Squamous Cell Carcinoma: Long-Term Results of the ORATOR Trial.

J Clin Oncol 2022 03 7;40(8):866-875. Epub 2022 Jan 7.

Department of Pathology, Western University, London, Ontario, Canada.

Purpose: The incidence of oropharyngeal squamous cell carcinoma (OPSCC) has risen rapidly, because of an epidemic of human papillomavirus infection. The optimal management of early-stage OPSCC with surgery or radiation continues to be a clinical controversy. Long-term randomized data comparing these paradigms are lacking. Read More

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Including Surgical Resection in the Multimodal Management of Very Locally Advanced Sinonasal Cancer.

Otolaryngol Head Neck Surg 2021 Dec 28:1945998211067503. Epub 2021 Dec 28.

Department of Radiation Oncology, NYU Langone Health, New York, New York, USA.

Objective: Sinonasal cancer often presents as locoregionally advanced disease. National guidelines recommend management of stage T4b tumors with systemic therapy and radiotherapy, but recent studies suggest that including surgical resection in the multimodal treatment of these tumors may improve local control and survival. We queried the National Cancer Database to examine patterns of care and outcomes in T4b sinonasal squamous cell carcinoma (SCC). Read More

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December 2021

Contralateral nodal failures in oropharyngeal cancers after TORS and unilateral neck management: a retrospective study.

J Otolaryngol Head Neck Surg 2021 Dec 23;50(1):71. Epub 2021 Dec 23.

Department of Otolaryngology Head and Neck Surgery, University of Toronto, 200 Elizabeth St., 8NU-883, Toronto, ON, M5G 2C4, Canada.

Background: Report the incidence of contralateral nodal failure rates in well-lateralized oropharyngeal carcinoma treated with upfront surgery and unilateral neck management.

Methods: Lateralized oropharyngeal carcinomas treated with upfront surgery using transoral robotic surgery (TORS) and unilateral neck management (unilateral neck dissection ± unilateral radiation treatment) were identified. Primary endpoint was contralateral regional control (CRC). Read More

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December 2021

Elective neck dissection improves the survival of patients with T2N0M0 oral squamous cell carcinoma: a study of the SEER database.

BMC Cancer 2021 Dec 7;21(1):1309. Epub 2021 Dec 7.

Department of Oral & Maxillofacial Surgery, Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases Shanghai Stomatological Hospital,, Fudan University, 356 Beijing East Road, Shanghai, 200001, PR China.

Background: Treatment of clinical N0 neck tumours is controversial in early-stage oral squamous cell carcinoma (OSCC), possibly because T1N0M0 and T2N0M0 merge together at early stages. The purposes of this study were to compare survival outcomes only for T2N0M0 cases based upon treatment elective neck dissection versus neck observation.

Methods: T2N0M0 OSCC cases were identified in the Surveillance, Epidemiology, and End Results database of the United States National Cancer Institute between 2004 and 2015. Read More

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December 2021

Omitting elective neck irradiation in clinically N0 sinonasal adenoid cystic carcinoma: A propensity score-matched analysis.

Oral Oncol 2022 01 3;124:105653. Epub 2021 Dec 3.

Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. Electronic address:

Objective: To explore the effects of elective neck irradiation (ENI) in clinically node-negative (cN0) sinonasal adenoid cystic carcinoma (SNACC).

Materials And Methods: Between January 2000 and December 2016, 60 patients with cN0 sinonasal adenoid cystic carcinoma receiving surgery combined with radiotherapy were analyzed retrospectively, there were 39 received ENI (ENI group) and 21 with no ENI (non-ENI group). Propensity score matching (PSM) was performed to balance clinical factors and match patients. Read More

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January 2022

Systematic review and meta-analysis of randomized controlled trials comparing elective neck dissection versus sentinel lymph node biopsy in early-stage clinically node-negative oral and/or oropharyngeal squamous cell carcinoma: Evidence-base for practice and implications for research.

Oral Oncol 2022 01 30;124:105642. Epub 2021 Nov 30.

Department of Radiation Oncology, ACTREC/TMH, Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, INDIA.

Purpose: Management of clinically node-negative (N0) neck in early-stage (T1-T2) oral and/or oropharyngeal squamous cell carcinoma (OOSCC) has been controversial. The purpose of this systematic review and meta-analysis was to compare sentinel lymph node biopsy (SLNB) with elective neck dissection (END) in early-stage OOSCC.

Methods: Studies comparing SLNB versus END in early-stage clinically node-negative OOSCC were identified using validated search strategy. Read More

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January 2022

Elective neck dissection may not necessarily reduce recurrence and improve survival in all cases of early stage (CT1/2 N0 M0) oral squamous cell carcinoma.

J Evid Based Dent Pract 2021 06 22;21(2):101573. Epub 2021 Apr 22.

Article Title And Bibliographic Information: Oh LJ, Phan K, Kim SW, Low TH, Gupta R, Clark JR. Elective neck dissection vs observation for early-stage oral squamous cell carcinoma: Systematic review and meta-analysis. Oral Oncol. Read More

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Carcinosarcomas of the larynx: systematic review of the literature of a rare nosologic entity.

Eur Arch Otorhinolaryngol 2022 Mar 5;279(3):1167-1173. Epub 2021 Aug 5.

Department of Oral and Maxillofacial Sciences, Sapienza University, Rome, Italy.

Purpose: Carcinosarcoma, also known as Spindle Cell Carcinoma (SpCC), is a rare type of malignant tumor. Generally, this type of pathology occurs in the urogenital tract, the gastrointestinal tract, respiratory tract and mammary gland; in the larynx, SpCC represents only 2-3% of all malignancies. Due to its rarity, there is currently no generally acceptable treatment guideline for this disease. Read More

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Sentinel lymph node biopsy versus elective neck dissection in squamous cell carcinoma of the oral cavity with a clinically N0 neck: Systematic review and meta-analysis of prospective studies.

Head Neck 2021 10 10;43(10):3185-3198. Epub 2021 Jul 10.

State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, China.

Sentinel lymph node biopsy (SLNB) is an emerging strategy for managing early-stage oral squamous cell carcinoma (SCC) with a clinically N0 (cN0) neck. However, the role of SLNB in this scenario is debatable. Herein, relevant literature was systematically reviewed, and a meta-analysis was performed to evaluate the potential dividends of SLNB compared to elective neck dissection (END) for these patients. Read More

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October 2021

Total Thyroidectomy with Central Node Dissection is a Valuable Option in Papillary Thyroid Cancer Treatment.

Acta Clin Croat 2020 Jun;59(Suppl 1):102-107

1Division of Head and Neck Surgery, Department of Surgical Oncology, University Hospital for Tumors, "Sestre milosrdnice" University Hospital Centre; 2Division of Radiology, University Hospital for Tumors, "Sestre milosrdnice" University Hospital Centre; 3Division of Pathology, University Hospital for Tumors, "Sestre milosrdnice" University Hospital Centre.

Introduction: Papillary thyroid cancer is one of the cancers with favorable prognosis, although the long-term recurrence rate in the paratracheal region is reported to be as high as 30%. The use of I is considered to be a reliable treatment option for lymph node metastases in the paratracheal region. According to the majority of internationally accepted guidelines, it is not recommended to perform central node dissection (CND) routinely. Read More

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The Role of Elective Neck Treatment in the Management of Sinonasal Carcinomas: A Systematic Review of the Literature and a Meta-Analysis.

Cancers (Basel) 2021 Apr 13;13(8). Epub 2021 Apr 13.

Department of Otorhinolaryngology, Careggi University Hospital, Largo Brambilla 3, 50134 Florence, Italy.

The impact of elective neck treatment (ENT), whether by irradiation or dissection, on the prognosis of patients with cN0 sinonasal carcinomas (SNCs) remains an understudied issue. METHODS: A systematic review and meta-analysis of the literature were performed according to PRISMA guidelines in order to assess regional nodal relapse rate after ENT compared to observation in cN0 SNCs patients. Twenty-six articles for a total of 1178 clinically N0 patients were analyzed. Read More

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Research on neck dissection for oral squamous-cell carcinoma: a bibliometric analysis.

Int J Oral Sci 2021 04 1;13(1):13. Epub 2021 Apr 1.

State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu, China.

Neck dissection for oral squamous-cell carcinoma (OSCC) is a clinically controversial issue and has therefore been the subject of abundant research. However, no one has performed a bibliometric study on this topic to date. The aim of this study was to assess the development of research on neck dissection for OSCC in terms of the historical evolution, current hotspots and future directions, particularly including research trends and frontiers from 2010 to 2019. Read More

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Life Expectancy and Treatment Patterns in Elderly Patients With Low-Risk Papillary Thyroid Cancer: A Population-Based Analysis.

Endocr Pract 2021 Mar 14;27(3):228-235. Epub 2020 Dec 14.

Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, New York. Electronic address:

Objective: Guidelines endorse active surveillance for low-risk papillary thyroid carcinoma (PTC), but this is not commonly utilized. Those with limited life expectancy due to age and comorbidity may be best suited for active surveillance given their higher likelihood of other-cause mortality compared to disease-specific mortality.

Methods: Surveillance, epidemiology, and end results-Medicare was queried for patients >65 years with T1, N0, M0 PTC who received surgery. Read More

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Reduced-Dose Radiation Therapy for HPV-Associated Oropharyngeal Carcinoma (NRG Oncology HN002).

J Clin Oncol 2021 03 28;39(9):956-965. Epub 2021 Jan 28.

Stanford University, Stanford, CA.

Purpose: Reducing radiation treatment dose could improve the quality of life (QOL) of patients with good-risk human papillomavirus-associated oropharyngeal squamous cell carcinoma (OPSCC). Whether reduced-dose radiation produces disease control and QOL equivalent to standard chemoradiation is not proven.

Patients And Methods: In this randomized, phase II trial, patients with p16-positive, T1-T2 N1-N2b M0, or T3 N0-N2b M0 OPSCC (7th edition staging) with ≤ 10 pack-years of smoking received 60 Gy of intensity-modulated radiation therapy (IMRT) over 6 weeks with concurrent weekly cisplatin (C) or 60 Gy IMRT over 5 weeks. Read More

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Improved survival after pancreatic re-resection of positive neck margin in pancreatic cancer patients. A systematic review and network meta-analysis.

Eur J Surg Oncol 2021 Jun 13;47(6):1258-1266. Epub 2021 Jan 13.

Vita Salute San Raffaele University Milan, Italy; Division of Pancreatic Surgery, IRCCS San Raffaele Scientific Institute, Milan, Italy.

The oncological benefit of achieving a negative pancreatic neck margin through re-resection after a positive frozen section (FS) is debated. Aim of this network meta-analysis is to evaluate the survival benefit of re-resection after intraoperative FS neck margin examination following pancreatectomy for ductal adenocarcinoma. A systematic search of studies comparing different strategies for the management of positive FS was performed. Read More

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High Expression of KLF10 Is Associated with Favorable Survival in Patients with Oral Squamous Cell Carcinoma.

Medicina (Kaunas) 2020 Dec 28;57(1). Epub 2020 Dec 28.

School of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan.

Background And Objectives: Krüppel-like transcription factor 10 (KLF10) plays a vital role in regulating cell proliferation, including the anti-proliferative process, activation of apoptosis, and differentiation control. KLF10 may also act as a protective factor against oral cancer. We studied the impact of KLF10 expression on the clinical outcomes of oral cancer patients to identify its role as a prognostic factor in oral cancer. Read More

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December 2020

Occult Nodal Metastasis in Oral Cavity Cancers.

Cureus 2020 Nov 23;12(11):e11640. Epub 2020 Nov 23.

Otolaryngology and Head and Neck Surgery, Aga Khan University Hospital, Karachi, PAK.

Introduction:  In squamous cell carcinoma (SCC) of the oral cavity, there is always a risk of occult metastasis to neck nodes in the clinically and radiologically negative neck (N0). Therefore, elective neck dissection (END) has ever been under discussion since the beginning of their routine use for the management of neck for oral carcinomas. The purpose of the current study is to identify the percentage of occult nodal metastasis to neck levels I-V in the cases of oral carcinoma who were treated for the N0 with END. Read More

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November 2020

Attempting to define sentinel node micrometastasis in oral squamous cell carcinoma.

Fukushima J Med Sci 2020 Dec 2;66(3):143-147. Epub 2020 Dec 2.

Department of Head and Neck Surgery and Otolaryngology, Asahi University Hospital.

Objective: The aim of this supplemental study of a sentinel node (SN) biopsy (SNB) trial for oral squamous cell carcinoma (OSCC) was to assess the effectiveness in identifying micrometastasis and determining whether elective neck dissection (END) is necessary.

Materials And Methods: Twenty-three patients with pathologically positive SNs were included. The sizes of the metastatic lesions in positive SNs (SMSNs) were classified and the rates of occult metastasis of non-SNs were compared. Read More

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December 2020

Predictive factors of cervical nodal metastases in N0 squamous cell carcinomas of the mobile tongue - A cohort study.

Ann Med Surg (Lond) 2020 Dec 10;60:403-407. Epub 2020 Nov 10.

Department of Otorhinolaryngology, Head and Neck Surgery, Ibn Rochd Hospital, King Hassan II University, Morocco.

Squamous cell carcinoma (SCC) of the tongue is one of the most common cancers in the oral region, most frequently associated with lymph nodes metastases which influence the most the prognosis. The identification of predictive factors of occult cervical nodal metastases for N0 tumors will allow to adapt the treatment to the patient, avoiding over or under management. From 2014 to 2019, a cohort of 26 patients with SCC of the mobile tongue was reviewed by analysing the medical history, the epidemiological and clinical parameters, the tumor sites, aspects, diameters, depths of invasion, pathological degree, degree of differentiation, T classification and results of neck dissections. Read More

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December 2020

Adjuvant management of locally advanced oral squamous cell carcinoma - real-world challenges and opportunities.

Br J Oral Maxillofac Surg 2021 10 20;59(8):952-958. Epub 2020 Aug 20.

Head and Neck Unit, Aintree University Hospital NHS Foundation Trust, Longmoor Lane, Fazakerly, Liverpool, L9 7AL, United Kingdom; Liverpool Head & Neck Centre, Department of Molecular and Clinical Cancer Medicine, University of Liverpool Cancer Research Centre, University of Liverpool, Liverpool, L69 3BX, United Kingdom.

Patients with locally advanced oral squamous cell cancer (LAOSCC) are treated with adjuvant radiotherapy (RT) or chemoradiotherapy (CRT) following surgical ablation. This depends on the pathological risk factors and aims to reduce the risk of local recurrence and improve survival. Delivery of these aggressive treatments is, however, challenging particularly following major surgery. Read More

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October 2021

Impact of submandibular gland preservation in neck management of early-stage buccal squamous cell carcinoma on locoregional control and disease-specific survival.

BMC Cancer 2020 Oct 27;20(1):1034. Epub 2020 Oct 27.

Department of Head Neck and Thyroid, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, Henan, People's Republic of China.

Background: The feasibility of submandibular gland (SMG) preservation in oral squamous cell carcinoma (SCC) has occasionally been analyzed, but the differences in survival associated with the presence or absence of SMG preservation remain unknown. We aimed to prospectively evaluate the oncologic results of SMG preservation in cT1-2 N0 buccal SCC.

Methods: This was a prospective, non-randomized cohort study. Read More

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October 2020

Long-term outcomes of patients with papillary thyroid cancer who did not undergo prophylactic central neck dissection.

J Cancer Res Ther 2020 Sep;16(5):1077-1081

Department of Head and Neck Surgery, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.

Aims: The role of prophylactic central neck dissection (CND) in the management of papillary thyroid carcinoma (PTC) is controversial. This study reports outcomes of an observational approach in PTC patients without clinical evidence of lymph node metastasis.

Materials And Methods: Patients with PTC who had surgery (without prophylactic CND) between January 2000 and December 2008 were included in this study. Read More

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September 2020

Indications and outcomes of superselective neck dissection: A review and analysis of the literature.

Laryngoscope Investig Otolaryngol 2020 Aug 25;5(4):672-676. Epub 2020 Jun 25.

Department of Otolaryngology-Head and Neck Surgery Emory University Atlanta Georgia USA.

Superselective neck dissection, defined as dissection of two or less contiguous neck levels, has recently been introduced to reduce surgical morbidity of neck dissection while maintaining favorable oncologic outcomes. The purpose of this review is to report the results of superselective neck dissection when applied to specific settings: the management of regional disease after chemoradiation, head and neck squamous cell carcinoma with clinical N0 necks, and high risk papillary thyroid carcinoma. Read More

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Accuracy of the preoperative diagnostic workup in patients with head and neck cancers undergoing neck dissection in terms of nodal metastases.

Eur Arch Otorhinolaryngol 2021 Jun 29;278(6):2041-2046. Epub 2020 Aug 29.

Department of Otorhinolaryngology, Head and Neck Surgery, Semmelweis University, Szigony Str. 36, Budapest, 1083, Hungary.

Purpose: The presence of cervical lymph node metastases is one of the most influential prognostic factors in head and neck squamous cell carcinomas. The management of clinically N0 neck in patients with head and neck cancer remains controversial: elective neck dissection has relatively high morbidity, adversely affecting the quality of life, however, abandoning elective neck dissection is known to compromise overall survival in numerous primaries. The purpose of this study was to evaluate the accuracy of the conventional imaging modalities (CT, MRI, US) and fine-needle aspiration cytology (FNAC) in the detection of lymph node metastases in the neck. Read More

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Retro-auricular endo assisted selective neck dissection (how I do it).

Oral Oncol 2020 11 19;110:104942. Epub 2020 Aug 19.

Observer Head and Neck Services, Tata Memorial Hospital, Dr E Borges Road, Parel, Mumbai, Maharashtra, India.

Elective neck dissection (END) is preferred in all treatment naïve patients with invasive oral squamous cell carcinoma (OSCC), including the early stage, node negative cases (T1/T2 N0). Usually the conventional horizontal neck crease incision leads to a faintly visible scar in the neck. However sometimes, the neck scar is hypertrophic and is highly unaesthetic and psychologically distressing to the patient. Read More

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November 2020

Management of the clinically N neck in early-stage oral squamous cell carcinoma (OSCC). An EACMFS position paper.

J Craniomaxillofac Surg 2020 Aug 2;48(8):711-718. Epub 2020 Jul 2.

Department of Head & Neck Surgery, University College London Hospital, London, UK. Electronic address:

Metastasis of oral squamous cell carcinoma (OSCC) to the cervical lymph nodes has a significant impact on prognosis. Accurate staging of the neck is important in order to deliver appropriate treatment for locoregional control of the disease and for prognosis. The management of the neck in early, low volume disease (clinically T/T oral cavity tumours) has long been debated. Read More

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A rare coexistence of papillary carcinoma and anaplastic carcinoma of thyroid in multinodular goitre: Case report and literature review.

Ann Med Surg (Lond) 2020 Aug 27;56:161-164. Epub 2020 Jun 27.

Otorhinolaryngology Head and Neck Surgery, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal.

Introduction: Multinodular goiter is defined as multiple discrete nodules in the thyroid gland. The incidence of Papillary carcinoma thyroid was found to be highest out of total Multinodular Goiter cases while that of Anaplastic carcinoma was the least. We report a rare coexistence of Papillary carcinoma and Anaplastic carcinoma in adult patient with a long-standing Multinodular Goiter. Read More

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