Squamous cell carcinoma of the head and neck in children. (February 2019)

• Record Type: Journal Article
• Authors: Dombrowski, Natasha D.; Wolter, Nikolaus E.; Irace, Alexandria L.; Robson, Caroline D.; Perez-Atayde, Antonio R.; Mack, Jennifer W.; Rahbar, Reza
• Is Part Of: International journal of pediatric otorhinolaryngology. Volume 117(2019:Feb.)
• Page Start: 131
• Page End: 137
• Publication Date: 2019-02
• Subjects: Squamous cell carcinoma -- Head and neck -- Pediatric; Otolaryngology -- Periodicals; Pediatrics -- Periodicals; Otolaryngology -- Periodicals; Pediatrics -- Periodicals; Oto-rhino-laryngologie -- Périodiques; Pédiatrie -- Périodiques; 618.9209751
• DOI: 10.1016/j.ijporl.2018.11.019
• Languages: English
• ISSNs: 0165-5876

Abstract

Abstract: Objective: To discuss the presentation, evaluation, and management of squamous cell carcinoma of the head and neck in the pediatric population. Methods: Medical records of pediatric (≤20 years) patients treated for squamous cell carcinoma of the head and neck between 1996 and 2016 were reviewed. Data pertaining to clinical presentation, diagnostic methods, treatment plan, complications, recurrence, follow-up, or outcome were collected. Results: Eleven patients were diagnosed with squamous cell carcinoma. Seven of these patients had medical histories significant for prior malignancies, immunosuppressant therapy, and/or genetic syndromes. Lesions were identified in the oral cavity (n = 5, 45.5%), lip/upper lip (n = 3, 27.3%), larynx (n = 2, 18.2%), and nasal cavity (n = 1, 9.1%). Tumors were most commonly treated with surgical excision alone. Three patients underwent irradiation (2 adjuvant and 1 without surgery) and chemotherapy (1 adjuvant, 1 neoadjuvant, and 1 without surgery). Of these patients, one reported complications of hearing loss, loss of dentition, and laryngeal stenosis. Two patients developed local recurrence at 1 month and 5 years post-operatively, respectively. One patient developed an orocutaneous fistula and subsequently died. No other complications were reported. Median follow-up time was 4.6 years (interquartile range: 2.4–8.4 years). Complications of radiation included: laryngeal stenosis, wound breakdown, and orocutaneous fistula. Conclusion: Squamous cell carcinoma is rare in the pediatric population. Most frequently, it is associated with previous malignancies, immunosuppressant therapy, and/or genetic conditions. Complete surgical excision is recommended to obviate the need for radiation whenever possible.