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Head and neck tumors in patients under the age of eighteen years

The management of the head and neck tumors in patients under 18 years of age is not uniform in the few reports of the literature. With the objective of showing and to discuss the experience on the treatment of fifty cases of the Head & Neck Service of Heliópolis Hospital, São Paulo, Brazil, between 1978 to 1994, the authors have prepared this retrospective study. The most frequent histologic types were the ones of epithelial origin (24 cases, 48%) and of them, the mucoepidermoid carcinoma. The rhabdomyosarcoma and the lymphomas were the most prevalent mesenchimal tumor. The oral cavity was the primary site more frequently involved (15 cases, 30%) and most of them were located on the lower geim. Ten patients with oral tumors were alive after a minimum of seven years of follow-up. In six cases the primary site was the parotid gland and in one case the tumor was of the submandibular gland. Unfortunately the prognosis of these cases could not be evaluated because only few cases had a closed ollow-up. The thyroid gland was the primary site in five patients, all with the pathologic diagnosis of papillary carcinoma and all of them were alive. The overall survival analysis show that of fifty cases, only 21 (42%) patients are alive and without disease for period of six months to 18 years of follow up. Fourteen (28%) patients died of the cancer,ten days to two years from the end of the treatment. The radiotherapy alone or in association with surgery should be evaluated very carefully in order to avoid the risk of complications and second primary tumors induced by irradiation. These tumors should not be considered as tumors of adulthood that developed in pediatric patients. They are a disease with well defined characteristics and need, as for adults, that the first approach for diagnosis or treatment be suitable and with high effectiveness.

Head and neck tumors; Cancer in childhood; Treatment of head and neck tumors; Carcinomas and sarcomas in children


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