| Endoscopic ultrasonography in the diagnosis and staging of neoplasms of the head and neck. | |
| | |
MedLine Citation:
|
PMID: 15243886 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND AND STUDY AIMS: Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is a minimally invasive and highly accurate method of detecting mediastinal lymph-node metastases in gastrointestinal and lung cancer. Little information is available regarding the use of EUS-FNA to stage tumors in the head and neck region. This study reports experience with EUS in the diagnosis and staging of these tumors and their mediastinal spread. PATIENTS AND METHODS: The records of patients who underwent EUS for diagnosis and/or staging of head and neck tumors were reviewed. Referral criteria were suspected invasion of the esophagus by a lower-neck mass on cervical computed tomography (CT) or magnetic resonance imaging (MRI), or mediastinal lymphadenopathy > 10 mm on a chest CT. RESULTS: Thirty-two patients (23 men, nine women; mean age 65 years, range 44 - 80) were referred and underwent 35 EUS examinations. In one patient, EUS was not possible due to a benign esophageal stricture. In 17 patients with suspected esophageal invasion on CT scans, EUS demonstrated invasion of the esophagus in four cases and of the pleura in one; 12 tumors showed no visible invasion of adjacent structures. The other 17 examinations were carried out for suspected mediastinal metastatic disease. In eight cases, EUS-FNA confirmed metastatic disease, whereas only benign changes were shown in the other nine cases. EUS-FNA also provided the first tissue diagnosis in two primary tumors and identified malignancy in one patient with no CT suspicion of positive mediastinal lymph nodes. EUS avoided the need for more invasive investigations in all patients with mediastinal lymphadenopathy, and it changed the management in 12 of the 17 patients (71 %) with suspected esophageal invasion and in eight of the 17 patients (47 %) with suspected mediastinal disease. CONCLUSIONS: EUS with FNA provides a viable approach to the diagnosis and staging of tumors in the head and neck region when there is a suggestion of esophageal invasion on CT or MRI, or enlarged mediastinal lymph nodes. EUS with FNA may avoid the need for mediastinoscopy or other more invasive techniques for staging of these neoplasms. |
| | |
Authors:
|
S M Wildi; W E Fickling; T A Day; C D Cunningham; N Schmulewitz; S Varadarajulu; S S Roberts; B Ferguson; B J Hoffman; R H Hawes; M B Wallace |
Related Documents
:
|
15733796 - Solitary mediastinal lymph node metastasis of hepatocellular carcinoma: mr imaging find... 19546836 - The usefulness of perfusion-weighted magnetic resonance imaging in advanced pancreatic ... 20706046 - Response assessment of hormonal therapy in prostate cancer by [11c] choline pet/ct. 8585826 - Sacrococcygeal chordoma in a 9-year-old boy. 7626836 - Viral infections of the brain. 19435576 - Epileptic negative myoclonus: spect, pet, and video/eeg studies and the dramatic effect... |
Publication Detail:
|
Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
|
Title: Endoscopy Volume: 36 ISSN: 0013-726X ISO Abbreviation: Endoscopy Publication Date: 2004 Jul |
Date Detail:
|
Created Date: 2004-07-09 Completed Date: 2004-10-05 Revised Date: 2006-11-15 |
Medline Journal Info:
|
Nlm Unique ID: 0215166 Medline TA: Endoscopy Country: Germany |
Other Details:
|
Languages: eng Pagination: 624-30 Citation Subset: IM |
Affiliation:
|
Digestive Disease Center, Medical University of South Carolina, Charleston, SC, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Aged Aged, 80 and over Biopsy, Fine-Needle Endosonography* Esophageal Neoplasms / secondary, ultrasonography Female Head and Neck Neoplasms / pathology, ultrasonography* Humans Lymphatic Metastasis Male Mediastinal Neoplasms / secondary, ultrasonography Mediastinum Middle Aged Neoplasm Invasiveness Neoplasm Recurrence, Local / ultrasonography Neoplasm Staging |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Endosonography versus helical computed tomography for locoregional staging of gastric cancer.
Next Document: Influence of endoscopic papillary balloon dilation and endoscopic sphincterotomy on sphincter of odd...