Head and Neck Cancers
Nasopharyngeal Carcinoma
Treatment options under clinical evaluation
Esthesioneuroblastoma
Thyroid Tumors
Oral Cancers
Salivary Gland Tumors
Laryngeal Cancer and Papillomatosis
Respiratory Tract Carcinoma Involving the NUT Gene on Chromosome 15
Note: Some citations in the text of this section are followed by a level of evidence. The PDQ editorial boards use a formal ranking system to help the reader judge the strength of evidence linked to the reported results of a therapeutic strategy. (Refer to the PDQ summary on Levels of Evidence for more information.)
Head and neck cancers include nasopharyngeal carcinoma, esthesioneuroblastoma, thyroid tumors, mouth
cancer, salivary gland cancer, laryngeal carcinoma, papillomatosis, and respiratory tract carcinoma involving the NUT gene on chromosome 15. The prognosis,
diagnosis, classification, and treatment of these head and neck cancers are
discussed below.
Nasopharyngeal Carcinoma
Nasopharyngeal cancer arises in the lining of the nasal cavity and pharynx.[1,2] This tumor accounts for about one-third of all cancers of the upper airways.
The incidence of this tumor is approximately 1 in 100,000 persons younger than 20 years in the United States.[3] There is a higher frequency of this tumor
in North Africa and Southeast Asia.
Nasopharyngeal carcinoma occurs in association with Epstein-Barr virus (EBV),
the virus associated with infectious mononucleosis.[4] The virus can be detected
in biopsy specimens of these cancers, and tumor cells can have EBV antigens on
their cell surface. Three histologic subtypes are recognized by the World
Health Organization. Type 1 is squamous cell carcinoma, type 2 is
nonkeratinizing carcinoma, and type 3 is undifferentiated carcinoma.
This cancer most frequently spreads to lymph nodes in the neck, which may alert
the patient, parent, or physician to the presence of this tumor. The tumor may
also spread to the nose, mouth, and pharynx, causing snoring, epistaxis,
obstruction of the eustachian tubes, or hearing loss; it may also invade the
base of the skull, causing cranial nerve palsy or difficulty with movements of
the jaw (trismus). Distant metastatic sites may include the bones, lungs,
and liver. The location of the primary tumor can be made by direct
inspection of the nasopharynx. A diagnosis can be made from a biopsy of the
primary tumor or of enlarged lymph nodes of the neck. Nasopharyngeal
carcinomas must be distinguished from all other cancers that can present with
enlarged lymph nodes and from other types of cancer in the head and neck area.
Thus, diseases such as thyroid cancer, rhabdomyosarcoma, non-Hodgkin
lymphoma, Hodgkin lymphoma, and Burkitt lymphoma must be considered, as
should benign conditions such as nasal angiofibroma, which presents with
epistaxis, and infections draining into the lymph nodes of the neck.
Diagnostic tests should determine the extent of the primary tumor and whether
there are metastases. Visualization of the nasopharynx by an ear-nose-throat
specialist using a mirror, examination by a neurologist, and magnetic resonance
imaging of the head and neck can be used to determine the extent of the
primary tumor. Evaluation of the chest and abdomen by computed tomography and bone scan should also be performed to determine whether there is metastatic
disease. The levels of EBV and antibody to EBV should also be measured.[1,5]
Tumor staging is performed utilizing the tumor-node-metastasis classification system
of the American Joint Committee on Cancer (AJCC).[6] The majority (>90%) of children and adolescents with nasopharyngeal carcinoma present with advanced disease (stage III/IV or T3/T4).[7] Metastatic disease at diagnosis is uncommon (stage IVC). Outcome is directly related to the stage of the disease, with overall survival ranging from 80% for stage I and stage II to 40% for stage III.[8] Other factors associated with an inferior outcome include node size larger than 6 cm, radiation dose less than 60 Gy, and poor response to chemotherapy.[8]
Surgery has a limited role in the management of nasopharyngeal carcinoma since the disease is usually considered unresectable because of extensive local spread. High-dose radiation therapy alone may have a role in the management of low-stage nasopharyngeal carcinoma; however, studies in both children and adults have shown that combined modality therapy with chemotherapy and radiation is the most effective way to treat nasopharyngeal carcinoma.[8-12] In a meta-analysis of studies adding chemotherapy to radiation therapy in adults with nasopharyngeal carcinoma, concomitant chemotherapy plus radiation therapy offered a significant benefit for survival, locoregional disease control, and reduction in distant metastases.[11] Neoadjuvant chemotherapy resulted in a significant reduction in locoregional recurrence only, while postradiation chemotherapy did not offer any benefit. In children, two studies utilizing preradiation chemotherapy with methotrexate, cisplatin, 5-fluorouracil (5-FU), and leucovorin with or without recombinant interferon-beta reported response rates of more than 90%.[13,14] Radiation therapy doses utilized in both studies were approximately 60 Gy. Additional drug combinations that have been used in children with nasopharyngeal carcinoma include bleomycin, epirubicin, and cisplatin, cisplatin and fluorouracil, and cisplatin, methotrexate, and bleomycin.[2] Incorporation of high-dose-rate brachytherapy into the chemoradiation therapy approach has been reported, but its role in the management of nasopharyngeal carcinoma in children is unknown.[15,16]
A preliminary report of the use of EBV-specific cytotoxic T-lymphocytes revealed minimal toxicity and evidence of significant antitumor activity in patients with relapsed or refractory nasopharyngeal carcinoma.[17] (Refer to the PDQ summary on Nasopharyngeal
Cancer Treatment for more information.)
Treatment options under clinical evaluation
-
ARAR0331: This Children's Oncology Group trial (COG-ARAR0331) is evaluating the efficacy of induction chemotherapy with cisplatin plus 5-FU followed by concomitant chemotherapy (cisplatin) plus radiation therapy with amifostine as a radioprotectant in patients with AJCC stages IIB to IV nasopharyngeal carcinoma. Patients with stages I to IIA disease will receive only radiation therapy with amifostine.
Esthesioneuroblastoma
Esthesioneuroblastoma (olfactory neuroblastoma) is a very rare, small round-cell tumor arising from the nasal neuroepithelium that is distinct from primitive neuroectodermal tumors.[18-21][Level of evidence: 3iiA] Most children present with a nasopharyngeal mass, which may have local extension into the orbits, sinuses, or frontal lobe, with associated symptoms. There appears to be a male predominance, and the average age of presentation is in adolescence. The youngest child reported with this diagnosis was aged 2 years. Metastatic disease is uncommon. The mainstay of treatment has been surgery and radiation. Newer techniques such as endoscopic sinus surgery, radiosurgery, and proton-beam therapy may play a role in the management of this tumor.[22] A retrospective analysis of data from the Surveillance, Epidemiology, and End Results program identified 311 patients with esthesioneuroblastoma.[23] Patients were staged by the extent of the tumor. Disease limited to the nasal cavity was considered the lowest stage and involvement of regional lymph nodes or metastasis was considered the highest stage. This staging system correlated well with outcome. A meta-analysis of 26 studies with a total of 390 patients, largely adults, with esthesioneuroblastoma indicates that higher histopathologic grade and metastases to the cervical lymph nodes may correlate with adverse prognostic factors.[24] Recent reports indicate increasing use of neoadjuvant chemotherapy.[18,19,25,26] Chemotherapy regimens that have been used with efficacy include etoposide (VP-16), ifosfamide, and cisplatin,[27] vincristine, actinomycin D and cyclophosphamide without doxorubicin, ifosfamide/etoposide, cisplatin plus etoposide or doxorubicin, [25] and irinotecan plus doxetaxel.[28][Level of evidence: 3iiA] The long-term survival rate appears to be approximately 60% to 80%. Local recurrences may occur later in life.
Thyroid Tumors
Tumors of the thyroid are classified as adenomas or carcinomas.[29-33] Adenomas
are benign growths that may cause enlargement of all or part of the gland,
which extends to both sides of the neck and can be quite large. Some of these
tumors may secrete hormones. Transformation to a malignant carcinoma may occur
in some cells, which then may grow and spread to lymph nodes in the neck or to
the lungs.
Although rare, thyroid cancers represent
about 1.5% of all tumors seen in the pediatric age group. Most thyroid carcinomas occur in girls.[34] Patients with thyroid cancer usually present with a thyroid mass with or without cervical adenopathy.[35-37] There is an
excessive frequency of thyroid adenoma and carcinoma in patients who previously
received radiation to the neck.[38,39] When occurring in patients with the multiple endocrine neoplasia syndromes, thyroid cancer may be associated with
the development of other types of malignant tumors. (Refer to the Multiple Endocrine Neoplasia Syndrome section of this summary for more information.) The American Thyroid Association Taskforce [40] has developed guidelines for management of thyroid nodules in older adolescents and adults, but it is not yet known how to apply these guidelines to thyroid nodules in children.[29]
Initial evaluation of a child or adolescent with a thyroid nodule should include an ultrasound of the thyroid. Tests of thyroid function are usually normal, but thyroglobulin can be elevated. Fine needle aspiration (FNA) is the initial diagnostic approach, though experience in FNA in pediatric hospitals may be limited, in which case open biopsy or lobe resection should be considered.[41,42] Open biopsy or resection may be preferable for young children as well.
Various histologies account for the general diagnostic category of carcinoma of
the thyroid,[43] but the vast majority of tumors are differentiated. These tumors comprise papillary carcinoma (60%–75%),[39] follicular carcinoma (10%–20%), medullary carcinoma (5%–10%), and
anaplastic carcinoma (<1%). Follicular carcinoma may be sporadic or
familial and medullary carcinoma is usually familial.[44] Papillary carcinoma often has multicentric origins and a very high rate of lymph node metastasis (70%–90%).[43] Follicular carcinoma is usually encapsulated and has a higher incidence of bone and lung metastasis. Follicular carcinoma and papillary carcinoma generally have a benign
course, with a 10-year survival rate of more than 95%.[45] Fifty percent of
medullary thyroid carcinomas in adults and children have hematogenous
metastases at diagnosis.[46] Patients with medullary carcinoma of the thyroid have a guarded
prognosis, unless they have very small tumors (microcarcinoma, defined as
<1.0 cm in diameter), which carry a good prognosis.[47]
Surgery by an experienced thyroid surgeon is the treatment required for all thyroid neoplasms.[45] Total or near-total thyroidectomy plus cervical lymph node dissection, when indicated, is the most common surgical approach.[35] For patients with obvious metastatic disease or heavy nodal invasion, total thyroidectomy and treatment with radioactive idodine is indicated. For patients with an isolated nodule in the thyroid, treatment may involve only a lobectomy.[35,48] During the 4- to 6-week period
following surgery, patients who received a total thyroidectomy may develop hypothyroidism. A radioactive iodine (I-131)
scan is then performed to search for residual, functionally active neoplasms. If there is no disease outside of the thyroid bed, an ablative dose of I-131 (approximately 29 mCi) is administered for total thyroid destruction. If there is evidence of nodal or disseminated disease, higher doses (100–200 mCi) of I-131 are required. In children, the I-131 dose may be adjusted for weight and other age-dependent safety factors.[49,50] After surgery and radioactive iodine therapy, hormone replacement therapy must be given to compensate
for the lost thyroid hormone and to suppress thyrotropin (TSH) production.[51]
Initial treatment (defined as surgery plus one radioactive iodine ablation plus thyroid replacement) is effective in inducing remission for 70% of patients. Extensive disease at diagnosis and larger tumor size predict failure to remit. With additional treatment, 89% of patients achieve remission.[52] Periodic evaluations are required to determine whether
there is metastatic disease involving the lungs. Lifelong follow-up is
necessary.[53] Thyroglobulin, T4, and TSH levels should be evaluated
periodically to determine whether replacement hormone is appropriately dosed.
Patients with differentiated thyroid cancer generally have an excellent survival with
relatively few side effects.[53-55] Recurrence is common (35%–45%), however, and is seen
more often in children younger than 10 years and in those with palpable cervical lymph nodes at diagnosis.[31,56,57] Of note, the sodium-iodide symporter (a membrane-bound glycoprotein cotransporter) essential for uptake of iodide and thyroid hormone synthesis, is expressed in 35% to 45% of thyroid cancers in children and adolescents. Patients with expression of the sodium-iodide symporter have a lower risk of recurrence.[58] Recurrent papillary thyroid cancer is usually responsive to treatment with radioactive iodine ablation.[59] Even patients with a tumor
that has spread to the lungs may expect to have no decrease in life span after
appropriate treatment. (Refer to the PDQ summary on adult Thyroid Cancer
Treatment for more information.)
Oral Cancers
Cancer of the oral cavity is extremely rare in children and adolescents.[3,60] The vast majority (>90%) of tumors and tumor-like lesions in the oral cavity are benign.[61-64] Benign odontogenic neoplasms include odontoma and ameloblastoma. The most common nonodontogenic neoplasms are fibromas, hemangiomas, and papillomas. Tumor-like lesions include lymphangiomas, granulomas, and eosinophilic granuloma (Langerhans cell histiocytoma [LCH]). Malignant tumors are found in 0.1% to 2% of a series of oral biopsies performed in children [61,62] and 3% to 13% of oral tumor biopsies.[63,64] Malignant tumor types include lymphomas (especially Burkitt) and sarcomas (including rhabdomyosarcoma and fibrosarcoma). Mucoepidermoid carcinomas have rarely been reported in the pediatric and adolescent age group. Most are low grade and have a high cure rate with surgery alone.[65][Level of evidence:3iiA] The most common type of primary oral cancer in adults, squamous cell carcinoma (SCC), is extremely rare in children. Only occasional case reports are found in the literature.[66,67] Adolescents with an oral SCC should be screened for Fanconi anemia.[68,69]
Treatment of benign oral tumors is surgical. Management of malignant tumors is dependent on histology and may include surgery, chemotherapy, and radiation.[70] LCH may require other treatment besides surgery. (Refer to the PDQ summaries on adult Oropharyngeal Cancer Treatment and Lip and Oral Cavity Cancer Treatment for more information.)
Salivary Gland Tumors
Most salivary gland neoplasms arise in the parotid gland.[71-75] About 15% of
these tumors may arise in the submandibular glands or in the minor salivary
glands under the tongue and jaw. These tumors are most frequently benign but
on very rare occasions may be malignant.[76] Sialoblastomas are usually benign tumors presenting in the neonatal period but can rarely metastasize.[77] A chemotherapy regimen of carboplatin, epirubicin, vincristine, etoposide, ifosfamide, and dactinomycin has been used in the treatment of metastatic sialoblastoma and has produced a response in one child.[78][Level of evidence: 3iiiDiv] The malignant lesions include
mucoepidermoid carcinoma,[79] acinic cell carcinoma, rhabdomyosarcoma, adenocarcinoma, and undifferentiated carcinoma. These tumors may occur after radiation therapy and chemotherapy are
given for treatment of primary leukemia or solid tumors.[80,81] Radical surgical
removal is the treatment of choice, whenever possible, with additional use of
radiation therapy and chemotherapy for high-grade tumors or tumors that have
spread from their site of origin.[79,82,83] Prognosis for patients with these
tumors is generally good.[74,84-86] (Refer to the PDQ summary on adult Salivary Gland
Cancer Treatment for more information.)
Laryngeal Cancer and Papillomatosis
Benign tumors of the larynx are rare. Malignant
tumors, which are especially rare, may be associated with benign tumors such as polyps and
papillomas.[87,88] These tumors may cause hoarseness, difficulty swallowing,
and enlargement of the lymph nodes of the neck. Rhabdomyosarcoma is the most
common malignant tumor of the larynx in the pediatric age group. SCC of the larynx should be managed in the same manner as in adults with
carcinoma at this site, with surgery and radiation.[89] Laser surgery may be the
first type of treatment utilized for these lesions.
Papillomatosis of the larynx is a benign overgrowth of tissues lining the
larynx and is associated with the human papillomavirus (HPV), most commonly HPV-6 and HPV-11.[90] The presence of HPV-11 appears to correlate with a more aggressive clinical course than HPV-6.[91] This condition is not
cancerous, and primary treatment is surgical ablation with laser vaporization.[92] Frequent recurrences are common. If a patient requires more than four surgical procedures per year, treatment with interferon should be considered.[93] A pilot study of immunotherapy with HspE7, a recombinant fusion protein that has shown activity in other HPV-related diseases, has suggested a marked increase in the amount of time between surgeries.[94] These results, however, must be confirmed in a larger randomized trial. These tumors can cause
hoarseness because of their association with wart-like nodules on the vocal
cords and may rarely extend into the lung, producing significant morbidity. Malignant
degeneration may occur with development of cancer in the larynx and squamous cell lung cancer. (Refer to the
PDQ summary on adult Laryngeal Cancer Treatment for more information.)
Respiratory Tract Carcinoma Involving the NUT Gene on Chromosome 15
Researchers have described a group of young patients with midline carcinomas with a very poor prognosis. The tumors arise in midline epithelial structures including the thymus, mediastinum, airway structures, and bladder. They exhibit squamous differentiation. Tumors from 8 of 11 patients exhibited a balanced chromosomal translocation t(15;19) involving the BRD4 and the NUT genes. These patients had no response to chemotherapy and died very quickly. Tumors from the remaining three patients had a chromosomal break in the NUT gene on chromosome 15 but had normal chromosome 19. These patients were older and had a slightly longer survival than the eight patients exhibiting t(15;19).[95]
References
-
Vasef MA, Ferlito A, Weiss LM: Nasopharyngeal carcinoma, with emphasis on its relationship to Epstein-Barr virus. Ann Otol Rhinol Laryngol 106 (4): 348-56, 1997.
[PUBMED Abstract]
-
Ayan I, Kaytan E, Ayan N: Childhood nasopharyngeal carcinoma: from biology to treatment. Lancet Oncol 4 (1): 13-21, 2003.
[PUBMED Abstract]
-
Young JL Jr, Miller RW: Incidence of malignant tumors in U. S. children. J Pediatr 86 (2): 254-8, 1975.
[PUBMED Abstract]
-
Bar-Sela G, Ben Arush MW, Sabo E, et al.: Pediatric nasopharyngeal carcinoma: better prognosis and increased c-Kit expression as compared to adults. Pediatr Blood Cancer 45 (3): 291-7, 2005.
[PUBMED Abstract]
-
Naegele RF, Champion J, Murphy S, et al.: Nasopharyngeal carcinoma in American Children: Epstein-Barr virus-specific antibody titers and prognosis. Int J Cancer 29 (2): 209-12, 1982.
[PUBMED Abstract]
-
American Joint Committee on Cancer.: AJCC Cancer Staging Manual. 6th ed. New York, NY: Springer, 2002.
-
Casanova M, Ferrari A, Gandola L, et al.: Undifferentiated nasopharyngeal carcinoma in children and adolescents: comparison between staging systems. Ann Oncol 12 (8): 1157-62, 2001.
[PUBMED Abstract]
-
Laskar S, Sanghavi V, Muckaden MA, et al.: Nasopharyngeal carcinoma in children: ten years' experience at the Tata Memorial Hospital, Mumbai. Int J Radiat Oncol Biol Phys 58 (1): 189-95, 2004.
[PUBMED Abstract]
-
Al-Sarraf M, LeBlanc M, Giri PG, et al.: Chemoradiotherapy versus radiotherapy in patients with advanced nasopharyngeal cancer: phase III randomized Intergroup study 0099. J Clin Oncol 16 (4): 1310-7, 1998.
[PUBMED Abstract]
-
Wolden SL, Steinherz PG, Kraus DH, et al.: Improved long-term survival with combined modality therapy for pediatric nasopharynx cancer. Int J Radiat Oncol Biol Phys 46 (4): 859-64, 2000.
[PUBMED Abstract]
-
Langendijk JA, Leemans ChR, Buter J, et al.: The additional value of chemotherapy to radiotherapy in locally advanced nasopharyngeal carcinoma: a meta-analysis of the published literature. J Clin Oncol 22 (22): 4604-12, 2004.
[PUBMED Abstract]
-
Venkitaraman R, Ramanan SG, Sagar TG: Nasopharyngeal cancer of childhood and adolescence: a single institution experience. Pediatr Hematol Oncol 24 (7): 493-502, 2007 Oct-Nov.
[PUBMED Abstract]
-
Mertens R, Granzen B, Lassay L, et al.: Treatment of nasopharyngeal carcinoma in children and adolescents: definitive results of a multicenter study (NPC-91-GPOH). Cancer 104 (5): 1083-9, 2005.
[PUBMED Abstract]
-
Rodriguez-Galindo C, Wofford M, Castleberry RP, et al.: Preradiation chemotherapy with methotrexate, cisplatin, 5-fluorouracil, and leucovorin for pediatric nasopharyngeal carcinoma. Cancer 103 (4): 850-7, 2005.
[PUBMED Abstract]
-
Nakamura RA, Novaes PE, Antoneli CB, et al.: High-dose-rate brachytherapy as part of a multidisciplinary treatment of nasopharyngeal lymphoepithelioma in childhood. Cancer 104 (3): 525-31, 2005.
[PUBMED Abstract]
-
Louis CU, Paulino AC, Gottschalk S, et al.: A single institution experience with pediatric nasopharyngeal carcinoma: high incidence of toxicity associated with platinum-based chemotherapy plus IMRT. J Pediatr Hematol Oncol 29 (7): 500-5, 2007.
[PUBMED Abstract]
-
Straathof KC, Bollard CM, Popat U, et al.: Treatment of nasopharyngeal carcinoma with Epstein-Barr virus--specific T lymphocytes. Blood 105 (5): 1898-904, 2005.
[PUBMED Abstract]
-
Kumar M, Fallon RJ, Hill JS, et al.: Esthesioneuroblastoma in children. J Pediatr Hematol Oncol 24 (6): 482-7, 2002 Aug-Sep.
[PUBMED Abstract]
-
Theilgaard SA, Buchwald C, Ingeholm P, et al.: Esthesioneuroblastoma: a Danish demographic study of 40 patients registered between 1978 and 2000. Acta Otolaryngol 123 (3): 433-9, 2003.
[PUBMED Abstract]
-
Dias FL, Sa GM, Lima RA, et al.: Patterns of failure and outcome in esthesioneuroblastoma. Arch Otolaryngol Head Neck Surg 129 (11): 1186-92, 2003.
[PUBMED Abstract]
-
Nakao K, Watanabe K, Fujishiro Y, et al.: Olfactory neuroblastoma: long-term clinical outcome at a single institute between 1979 and 2003. Acta Otolaryngol Suppl (559): 113-7, 2007.
[PUBMED Abstract]
-
Unger F, Haselsberger K, Walch C, et al.: Combined endoscopic surgery and radiosurgery as treatment modality for olfactory neuroblastoma (esthesioneuroblastoma). Acta Neurochir (Wien) 147 (6): 595-601; discussion 601-2, 2005.
[PUBMED Abstract]
-
Jethanamest D, Morris LG, Sikora AG, et al.: Esthesioneuroblastoma: a population-based analysis of survival and prognostic factors. Arch Otolaryngol Head Neck Surg 133 (3): 276-80, 2007.
[PUBMED Abstract]
-
Dulguerov P, Allal AS, Calcaterra TC: Esthesioneuroblastoma: a meta-analysis and review. Lancet Oncol 2 (11): 683-90, 2001.
[PUBMED Abstract]
-
Eich HT, Müller RP, Micke O, et al.: Esthesioneuroblastoma in childhood and adolescence. Better prognosis with multimodal treatment? Strahlenther Onkol 181 (6): 378-84, 2005.
[PUBMED Abstract]
-
Loy AH, Reibel JF, Read PW, et al.: Esthesioneuroblastoma: continued follow-up of a single institution's experience. Arch Otolaryngol Head Neck Surg 132 (2): 134-8, 2006.
[PUBMED Abstract]
-
Kim DW, Jo YH, Kim JH, et al.: Neoadjuvant etoposide, ifosfamide, and cisplatin for the treatment of olfactory neuroblastoma. Cancer 101 (10): 2257-60, 2004.
[PUBMED Abstract]
-
Kiyota N, Tahara M, Fujii S, et al.: Nonplatinum-based chemotherapy with irinotecan plus docetaxel for advanced or metastatic olfactory neuroblastoma: a retrospective analysis of 12 cases. Cancer 112 (4): 885-91, 2008.
[PUBMED Abstract]
-
Dinauer C, Francis GL: Thyroid cancer in children. Endocrinol Metab Clin North Am 36 (3): 779-806, vii, 2007.
[PUBMED Abstract]
-
Vasko V, Bauer AJ, Tuttle RM, et al.: Papillary and follicular thyroid cancers in children. Endocr Dev 10: 140-72, 2007.
[PUBMED Abstract]
-
Grigsby PW, Gal-or A, Michalski JM, et al.: Childhood and adolescent thyroid carcinoma. Cancer 95 (4): 724-9, 2002.
[PUBMED Abstract]
-
Skinner MA: Cancer of the thyroid gland in infants and children. Semin Pediatr Surg 10 (3): 119-26, 2001.
[PUBMED Abstract]
-
Halac I, Zimmerman D: Thyroid nodules and cancers in children. Endocrinol Metab Clin North Am 34 (3): 725-44, x, 2005.
[PUBMED Abstract]
-
Shapiro NL, Bhattacharyya N: Population-based outcomes for pediatric thyroid carcinoma. Laryngoscope 115 (2): 337-40, 2005.
[PUBMED Abstract]
-
Thompson GB, Hay ID: Current strategies for surgical management and adjuvant treatment of childhood papillary thyroid carcinoma. World J Surg 28 (12): 1187-98, 2004.
[PUBMED Abstract]
-
Harness JK, Sahar DE, et al.: Childhood thyroid carcinoma. In: Clark O, Duh Q-Y, Kebebew E, eds.: Textbook of Endocrine Surgery. 2nd ed. Philadelphia, PA: Elsevier Saunders Company, 2005., pp 93-101.
-
Rachmiel M, Charron M, Gupta A, et al.: Evidence-based review of treatment and follow up of pediatric patients with differentiated thyroid carcinoma. J Pediatr Endocrinol Metab 19 (12): 1377-93, 2006.
[PUBMED Abstract]
-
Cotterill SJ, Pearce MS, Parker L: Thyroid cancer in children and young adults in the North of England. Is increasing incidence related to the Chernobyl accident? Eur J Cancer 37 (8): 1020-6, 2001.
[PUBMED Abstract]
-
Kaplan MM, Garnick MB, Gelber R, et al.: Risk factors for thyroid abnormalities after neck irradiation for childhood cancer. Am J Med 74 (2): 272-80, 1983.
[PUBMED Abstract]
-
Cooper DS, Doherty GM, Haugen BR, et al.: Management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 16 (2): 109-42, 2006.
[PUBMED Abstract]
-
Flannery TK, Kirkland JL, Copeland KC, et al.: Papillary thyroid cancer: a pediatric perspective. Pediatrics 98 (3 Pt 1): 464-6, 1996.
[PUBMED Abstract]
-
Willgerodt H, Keller E, Bennek J, et al.: Diagnostic value of fine-needle aspiration biopsy of thyroid nodules in children and adolescents. J Pediatr Endocrinol Metab 19 (4): 507-15, 2006.
[PUBMED Abstract]
-
Feinmesser R, Lubin E, Segal K, et al.: Carcinoma of the thyroid in children--a review. J Pediatr Endocrinol Metab 10 (6): 561-8, 1997 Nov-Dec.
[PUBMED Abstract]
-
Skinner MA: Management of hereditary thyroid cancer in children. Surg Oncol 12 (2): 101-4, 2003.
[PUBMED Abstract]
-
Hung W, Sarlis NJ: Current controversies in the management of pediatric patients with well-differentiated nonmedullary thyroid cancer: a review. Thyroid 12 (8): 683-702, 2002.
[PUBMED Abstract]
-
Hill CS, Ibanez ML, Samaan NA, et al.: Medullary (solid) carcinoma of the thyroid gland: an analysis of the M.D. Anderson Hospital experience with patients with the tumor, its special features, and its histogenesis. Medicine 52(2): 141-171, 1973.
-
Krueger JE, Maitra A, Albores-Saavedra J: Inherited medullary microcarcinoma of the thyroid: a study of 11 cases. Am J Surg Pathol 24 (6): 853-8, 2000.
[PUBMED Abstract]
-
Newman KD, Black T, Heller G, et al.: Differentiated thyroid cancer: determinants of disease progression in patients <21 years of age at diagnosis: a report from the Surgical Discipline Committee of the Children's Cancer Group. Ann Surg 227 (4): 533-41, 1998.
[PUBMED Abstract]
-
Luster M, Lassmann M, Freudenberg LS, et al.: Thyroid cancer in childhood: management strategy, including dosimetry and long-term results. Hormones (Athens) 6 (4): 269-78, 2007 Oct-Dec.
[PUBMED Abstract]
-
Parisi MT, Mankoff D: Differentiated pediatric thyroid cancer: correlates with adult disease, controversies in treatment. Semin Nucl Med 37 (5): 340-56, 2007.
[PUBMED Abstract]
-
Yeh SD, La Quaglia MP: 131I therapy for pediatric thyroid cancer. Semin Pediatr Surg 6 (3): 128-33, 1997.
[PUBMED Abstract]
-
Powers PA, Dinauer CA, Tuttle RM, et al.: Tumor size and extent of disease at diagnosis predict the response to initial therapy for papillary thyroid carcinoma in children and adolescents. J Pediatr Endocrinol Metab 16 (5): 693-702, 2003.
[PUBMED Abstract]
-
Vassilopoulou-Sellin R, Goepfert H, Raney B, et al.: Differentiated thyroid cancer in children and adolescents: clinical outcome and mortality after long-term follow-up. Head Neck 20 (6): 549-55, 1998.
[PUBMED Abstract]
-
Wiersinga WM: Thyroid cancer in children and adolescents--consequences in later life. J Pediatr Endocrinol Metab 14 (Suppl 5): 1289-96; discussion 1297-8, 2001.
[PUBMED Abstract]
-
Jarzab B, Handkiewicz-Junak D, Wloch J: Juvenile differentiated thyroid carcinoma and the role of radioiodine in its treatment: a qualitative review. Endocr Relat Cancer 12 (4): 773-803, 2005.
[PUBMED Abstract]
-
Alessandri AJ, Goddard KJ, Blair GK, et al.: Age is the major determinant of recurrence in pediatric differentiated thyroid carcinoma. Med Pediatr Oncol 35 (1): 41-6, 2000.
[PUBMED Abstract]
-
Borson-Chazot F, Causeret S, Lifante JC, et al.: Predictive factors for recurrence from a series of 74 children and adolescents with differentiated thyroid cancer. World J Surg 28 (11): 1088-92, 2004.
[PUBMED Abstract]
-
Patel A, Jhiang S, Dogra S, et al.: Differentiated thyroid carcinoma that express sodium-iodide symporter have a lower risk of recurrence for children and adolescents. Pediatr Res 52 (5): 737-44, 2002.
[PUBMED Abstract]
-
Powers PA, Dinauer CA, Tuttle RM, et al.: Treatment of recurrent papillary thyroid carcinoma in children and adolescents. J Pediatr Endocrinol Metab 16 (7): 1033-40, 2003.
[PUBMED Abstract]
-
Berstein L, Gurney JG: Carcinomas and other malignant epithelial neoplasms. In: Ries LA, Smith MA, Gurney JG, et al., eds.: Cancer incidence and survival among children and adolescents: United States SEER Program 1975-1995. Bethesda, Md: National Cancer Institute, SEER Program, 1999. NIH Pub.No. 99-4649., Chapter 11, pp 139-148. Also available online. Last accessed April 19, 2007.
-
Das S, Das AK: A review of pediatric oral biopsies from a surgical pathology service in a dental school. Pediatr Dent 15 (3): 208-11, 1993 May-Jun.
[PUBMED Abstract]
-
Ulmansky M, Lustmann J, Balkin N: Tumors and tumor-like lesions of the oral cavity and related structures in Israeli children. Int J Oral Maxillofac Surg 28 (4): 291-4, 1999.
[PUBMED Abstract]
-
Tröbs RB, Mader E, Friedrich T, et al.: Oral tumors and tumor-like lesions in infants and children. Pediatr Surg Int 19 (9-10): 639-45, 2003.
[PUBMED Abstract]
-
Tanaka N, Murata A, Yamaguchi A, et al.: Clinical features and management of oral and maxillofacial tumors in children. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 88 (1): 11-5, 1999.
[PUBMED Abstract]
-
Perez DE, Pires FR, Alves Fde A, et al.: Juvenile intraoral mucoepidermoid carcinoma. J Oral Maxillofac Surg 66 (2): 308-11, 2008.
[PUBMED Abstract]
-
Torossian JM, Beziat JL, Philip T, et al.: Squamous cell carcinoma of the tongue in a 13-year-old boy. J Oral Maxillofac Surg 58 (12): 1407-10, 2000.
[PUBMED Abstract]
-
Bill TJ, Reddy VR, Ries KL, et al.: Adolescent gingival squamous cell carcinoma: Report of a case and review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 91 (6): 682-5, 2001.
[PUBMED Abstract]
-
Oksüzoğlu B, Yalçin S: Squamous cell carcinoma of the tongue in a patient with Fanconi's anemia: a case report and review of the literature. Ann Hematol 81 (5): 294-8, 2002.
[PUBMED Abstract]
-
Reinhard H, Peters I, Gottschling S, et al.: Squamous cell carcinoma of the tongue in a 13-year-old girl with Fanconi anemia. J Pediatr Hematol Oncol 29 (7): 488-91, 2007.
[PUBMED Abstract]
-
Sturgis EM, Moore BA, Glisson BS, et al.: Neoadjuvant chemotherapy for squamous cell carcinoma of the oral tongue in young adults: a case series. Head Neck 27 (9): 748-56, 2005.
[PUBMED Abstract]
-
Johns ME, Goldsmith MM: Incidence, diagnosis, and classification of salivary gland tumors. Part 1. Oncology (Huntingt) 3 (2): 47-56; discussion 56, 58, 62, 1989.
[PUBMED Abstract]
-
Ethunandan M, Ethunandan A, Macpherson D, et al.: Parotid neoplasms in children: experience of diagnosis and management in a district general hospital. Int J Oral Maxillofac Surg 32 (4): 373-7, 2003.
[PUBMED Abstract]
-
da Cruz Perez DE, Pires FR, Alves FA, et al.: Salivary gland tumors in children and adolescents: a clinicopathologic and immunohistochemical study of fifty-three cases. Int J Pediatr Otorhinolaryngol 68 (7): 895-902, 2004.
[PUBMED Abstract]
-
Shapiro NL, Bhattacharyya N: Clinical characteristics and survival for major salivary gland malignancies in children. Otolaryngol Head Neck Surg 134 (4): 631-4, 2006.
[PUBMED Abstract]
-
Ellies M, Schaffranietz F, Arglebe C, et al.: Tumors of the salivary glands in childhood and adolescence. J Oral Maxillofac Surg 64 (7): 1049-58, 2006.
[PUBMED Abstract]
-
Laikui L, Hongwei L, Hongbing J, et al.: Epithelial salivary gland tumors of children and adolescents in west China population: a clinicopathologic study of 79 cases. J Oral Pathol Med 37 (4): 201-5, 2008.
[PUBMED Abstract]
-
Williams SB, Ellis GL, Warnock GR: Sialoblastoma: a clinicopathologic and immunohistochemical study of 7 cases. Ann Diagn Pathol 10 (6): 320-6, 2006.
[PUBMED Abstract]
-
Scott JX, Krishnan S, Bourne AJ, et al.: Treatment of metastatic sialoblastoma with chemotherapy and surgery. Pediatr Blood Cancer 50 (1): 134-7, 2008.
[PUBMED Abstract]
-
Rahbar R, Grimmer JF, Vargas SO, et al.: Mucoepidermoid carcinoma of the parotid gland in children: A 10-year experience. Arch Otolaryngol Head Neck Surg 132 (4): 375-80, 2006.
[PUBMED Abstract]
-
Kaste SC, Hedlund G, Pratt CB: Malignant parotid tumors in patients previously treated for childhood cancer: clinical and imaging findings in eight cases. AJR Am J Roentgenol 162 (3): 655-9, 1994.
[PUBMED Abstract]
-
Whatley WS, Thompson JW, Rao B: Salivary gland tumors in survivors of childhood cancer. Otolaryngol Head Neck Surg 134 (3): 385-8, 2006.
[PUBMED Abstract]
-
Kamal SA, Othman EO: Diagnosis and treatment of parotid tumours. J Laryngol Otol 111 (4): 316-21, 1997.
[PUBMED Abstract]
-
Rogers DA, Rao BN, Bowman L, et al.: Primary malignancy of the salivary gland in children. J Pediatr Surg 29 (1): 44-7, 1994.
[PUBMED Abstract]
-
Bentz BG, Hughes CA, Lüdemann JP, et al.: Masses of the salivary gland region in children. Arch Otolaryngol Head Neck Surg 126 (12): 1435-9, 2000.
[PUBMED Abstract]
-
Ribeiro Kde C, Kowalski LP, Saba LM, et al.: Epithelial salivary glands neoplasms in children and adolescents: a forty-four-year experience. Med Pediatr Oncol 39 (6): 594-600, 2002.
[PUBMED Abstract]
-
Guzzo M, Ferrari A, Marcon I, et al.: Salivary gland neoplasms in children: the experience of the Istituto Nazionale Tumori of Milan. Pediatr Blood Cancer 47 (6): 806-10, 2006.
[PUBMED Abstract]
-
McGuirt WF Jr, Little JP: Laryngeal cancer in children and adolescents. Otolaryngol Clin North Am 30 (2): 207-14, 1997.
[PUBMED Abstract]
-
Bauman NM, Smith RJ: Recurrent respiratory papillomatosis. Pediatr Clin North Am 43 (6): 1385-401, 1996.
[PUBMED Abstract]
-
Siddiqui F, Sarin R, Agarwal JP, et al.: Squamous carcinoma of the larynx and hypopharynx in children: a distinct clinical entity? Med Pediatr Oncol 40 (5): 322-4, 2003.
[PUBMED Abstract]
-
Kashima HK, Mounts P, Shah K: Recurrent respiratory papillomatosis. Obstet Gynecol Clin North Am 23 (3): 699-706, 1996.
[PUBMED Abstract]
-
Maloney EM, Unger ER, Tucker RA, et al.: Longitudinal measures of human papillomavirus 6 and 11 viral loads and antibody response in children with recurrent respiratory papillomatosis. Arch Otolaryngol Head Neck Surg 132 (7): 711-5, 2006.
[PUBMED Abstract]
-
Andrus JG, Shapshay SM: Contemporary management of laryngeal papilloma in adults and children. Otolaryngol Clin North Am 39 (1): 135-58, 2006.
[PUBMED Abstract]
-
Avidano MA, Singleton GT: Adjuvant drug strategies in the treatment of recurrent respiratory papillomatosis. Otolaryngol Head Neck Surg 112 (2): 197-202, 1995.
[PUBMED Abstract]
-
Derkay CS, Smith RJ, McClay J, et al.: HspE7 treatment of pediatric recurrent respiratory papillomatosis: final results of an open-label trial. Ann Otol Rhinol Laryngol 114 (9): 730-7, 2005.
[PUBMED Abstract]
-
French CA, Kutok JL, Faquin WC, et al.: Midline carcinoma of children and young adults with NUT rearrangement. J Clin Oncol 22 (20): 4135-9, 2004.
[PUBMED Abstract]
Back to Top
< Previous Section | Next Section > |