Browsing by Author "Summerlin, Don-John"

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    Feasibility of Desorption Electrospray Ionization Mass Spectrometry for Diagnosis of Oral Tongue Squamous Cell Carcinoma
    (Wiley, 2017) D'Hue, Cedric; Moore, Michael; Summerlin, Don-John; Jarmusch, Alan; Alfaro, Clint; Mantravadi, Avinash; Bewley, Arnaud; Farwell, D. Gregory; Cooks, R. Graham; Pathology and Laboratory Medicine, School of Medicine
    Rationale Desorption electrospray ionization mass spectrometry (DESI-MS) has demonstrated utility in differentiating tumor from adjacent normal tissue in both urologic and neurosurgical specimens. We sought to evaluate if this technique had similar accuracy in differentiating oral tongue squamous cell carcinoma (SCC) from adjacent normal epithelium due to current issues with late diagnosis of SCC in advanced stages. Methods Fresh frozen samples of SCC and adjacent normal tissue were obtained by surgical resection. Resections were analyzed using DESI-MS sometimes by a blinded technologist. Normative spectra were obtained for separate regions containing SCC or adjacent normal epithelium. Principal Component Analysis and Linear Discriminant Analysis (PCA-LDA) of spectra were used to predict SCC versus normal tongue epithelium. Predictions were compared with pathology to assess accuracy in differentiating oral SCC from adjacent normal tissue. Results Initial PCA score and loading plots showed clear separation of SCC and normal epithelial tissue using DESI-MS. PCA-LDA resulted in accuracy rates of 95% for SCC versus normal and 93% for SCC, adjacent normal and normal. Additional samples were blindly analyzed with PCA-LDA pixel-by-pixel predicted classifications as SCC or normal tongue epithelial tissue and compared against histopathology. The m/z 700–900 prediction model showed a 91% accuracy rate. Conclusions DESI-MS accurately differentiated oral SCC from adjacent normal epithelium. Classification of all typical tissue types and pixel predictions with additional classifications should increase confidence in the validation model.
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    Head and Neck Juxtacortical Chondrosarcoma: A Systematic Review
    (SciTeMed, 2019-03) Jones, Alexander Joseph; Alwani, Mohamedkazim; Summerlin, Don-John; Otolaryngology -- Head and Neck Surgery, School of Medicine
    Objective: To present a case and systematically evaluate trends in clinical presentation, imaging, histopathology, and management modalities and outcomes of all head and neck juxtacortical chondrosarcoma (HNJCS) cases reported in the existing literature. Methods: We describe a rare case of HNJCS from our tertiary referral center following which the PubMed, MEDLINE, Embase, and Web of Science databases were searched for all HNJCS reports. Relevant titles and abstracts were screened. Resulting full-text articles were assessed for eligibility, and remaining studies were included for data extraction, summarization, and analysis. Results: Potential studies were identified dating from May 1946 to February 2019. A total of nine cases were included in our systematic review, eight of which were identified from full-text articles and one recruited from our tertiary referral center. The median presentation age was 41 years with a 66.7% male preponderance. The commonest presenting sign was a painless, isolated swelling after a median symptom duration of 2.5 months. CT imaging revealed hypodense lesions with peripheral enhancement and micro-calcifications. T1-weighted MRI showed hypo- to iso-intense, lobulated masses with peripheral and/or septal enhancement. The masses were diffusely hyper-intense on T2-weighted MRI. Histopathology demonstrated septated lobules of malignant hyaline cartilage with a peripheral fibrous capsule. Most tumors were low- or intermediate-grade tumors with average diameter of 4.3 cm. Local recurrence was identified in only one case (four years after initial resection). No distal and/or nodal metastases were identified. All tumors were managed by wide- or narrow-margin surgical excision. Two reports employed adjuvant treatment. There was no evidence of disease at final follow-up (median of 1.5 years). Conclusion: To the best of our knowledge, only nine cases of HNJCS have been adequately described. HNJCS have relatively consistent clinical and diagnostic profile regardless of location in the body. Surgical management yields excellent outcomes with low recurrence rates.
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    Proton Therapy for Head and Neck Adenoid Cystic Carcinoma: Initial Clinical Outcomes
    (Wiley, 2015-01) Linton, Okechukwu R.; Moore, Michael G.; Brigance, Joseph S.; Summerlin, Don-John; McDonald, Mark W.; Department of Otolaryngology Head & Neck Surgery, IU School of Medicine
    Background The purpose of this study was to report outcomes of proton therapy in head and neck adenoid cystic carcinoma. Methods We conducted a retrospective analysis of 26 patients treated between 2004 and 2012. Twenty patients (77%) had base of skull involvement; 19 (73%) were treated for initial disease and 7 (27%) for recurrent disease. Twenty patients were treated postoperatively, 6 after biopsy alone and 24 had positive margins or gross residual disease. Median dose delivered was 72 Gy (relative biological effectiveness [RBE]). Results Median follow-up was 25 months (range, 7–50 months). The 2-year overall survival was 93% for initial disease course and 57% for recurrent disease (p = .19). The 2-year local control was 95% for initial disease and 86% for recurrent disease (p = .48). The 2-year distant metastatic rate was 25%. Late toxicity of grade 0 or 1 was seen in 17 patients, grade 2 in 5, grade 3 in 2, grade 4 in 1, and grade 5 in 1. Conclusion Initial outcomes of proton therapy are encouraging. Longer follow-up is required.
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    A Systematic Review Including an Additional Pediatric Case Report: Pediatric Cases of Mammary Analogue Secretory Carcinoma
    (Elsevier, 2017-09) Ngouajio, Amanda L.; Drejet, Sarah M.; Phillips, Ryan; Summerlin, Don-John; Dahl, John P.; Department of Otololaryngology-Head and Neck Surgery, School of Medicine
    Importance Mammary Analogue Secretory Carcinoma (MASC) is a newly characterized salivary gland carcinoma resembling secretory carcinoma of the breast. Prior to being described, MASC was most commonly misdiagnosed as Acinic Cell Carcinoma. Though MASC is predominantly an adult neoplasm, cases have been reported in the pediatric population. Reporting and summarizing of known cases is imperative to understand the prognosis and clinical behavior of MASC. Objective (1) Report a rare case of pediatric MASC. (2) Review and consolidate the existing literature on MASC in the pediatric population. Evidence review Web of Science, Medline, EMBASE, and The Cochrane Library were searched for studies that included pediatric cases of MASC. Data on clinical presentation, diagnosis and management, and pathology were collected from all pediatric cases. Findings Case Report 14 year old with left-sided parotid mass diagnosed as MASC based on histology and immunohistochemistry. He was managed surgically with left superficial parotidectomy with selective neck dissection. Literature review The majority of MASC cases have been identified via retrospective reclassification of previously misclassified salivary gland tumors. Of all the pediatric cases (N=11) of MASC, the female-to-male ratio is 1:1.2 with an age range of 10-17 years old. The most common clinical presentation was a slowly growing, fixed, and painless mass of the parotid gland, often detected incidentally on physical examination. Common pathological features include eosinophilic vacuolated cytoplasm within cystic, tubular, and/or papillary architecture. Immunohistochemistry showed positivity for S100, mammaglobin, cytokeratin 19, and vimentin. The diagnosis was confirmed by the detection of the characteristic ETV6-NTRK6 fusion gene via fluorescent in-situ hybridization (FISH). Only 4 cases discussed treatment. Each of these underwent successful surgical resection alone with or without lymph node dissection. Conclusions and relevance Since the first case of MASC in the pediatric population was described in 2011, only 12 cases, including this one, have been described in the literature. With this paucity of information, much remains unknown regarding this new pathologic diagnosis. The collection of clinical outcomes data of children with MASC is needed to better understand the behavior of this malignancy as well as determine optimal treatment regimens.