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Pathologie der malignen Kopf-Hals-Tumoren

Epidemiologie und histologische Subtypen

Pathology of malignant head and neck tumors

Epidemiology and histological subtypes

Der Onkologe Aims and scope

Zusammenfassung

Hintergrund

Kopf-Hals-Tumoren bilden eine Gruppe sehr heterogener benigner und maligner Neoplasien unter Einschluss zahlreicher Karzinom-, Sarkom- und Lymphomentitäten. Die zuweilen verwirrende Vielfalt dieser Neoplasien erfordert in der Behandlung betroffener Patienten eine fundierte Kenntnis der Pathologie der Tumoren.

Ziel

Der vorliegende Beitrag gibt einen umfassenden Überblick über Epidemiologie und Histologie der Tumoren im Kopf-Hals-Bereich unter kritischer Würdigung besonders relevanter lokalisationsspezifischer Tumorentitäten.

Material und Methode

Relevante Literatur zum Thema Epidemiologie und Histologie wurde unter besonderer Berücksichtigung der aktuellen WHO-Vorgaben zusammengetragen und durch aktuelle epidemiologische Daten des Robert Koch-Instituts ergänzt.

Ergebnisse

Die zahlenmäßig häufigste und aus onkologischer Sicht bedeutsamste Tumorfamilie dieser Lokalisation bilden die Plattenepithelkarzinome des Larynx, Pharynx und der Mundhöhle. Jenseits des Plattenepithelkarzinoms ist darüber hinaus im Kopf-Hals-Bereich der großen Gruppe der zwar weniger häufigen, jedoch sowohl in der pathologischen Diagnostik als auch klinisch-therapeutisch komplexen Speicheldrüsentumoren eine gewisse Bedeutung beizumessen. Ergänzt werden diese beiden Tumorfamilien durch eine Reihe distinkter, vornehmlich an dieser Lokalisation anzutreffender onkologisch bedeutsamer Neoplasien unter Einschluss des Nasopharynxkarzinoms (NPC), des olfaktorischen Neuroblastoms, des nasalen NK-/T-Zell-Lymphoms und weiterer sehr seltener, aber gut definierter lokalisationsspezifischer Tumorentitäten sowie durch eine Vielzahl von Lymphomen und Sarkomen, die ihren Widerparts in anderen Körperregionen entsprechen. Morphologie und Häufigkeit der entsprechenden Entitäten werden in diesem Beitrag vorgestellt und diskutiert.

Schlussfolgerung

Die Kenntnis von Epidemiologie und Morphologie aller relevanten im Kopf-Hals-Bereich auftretenden Tumorentitäten ist die Grundlage für eine fundierte Differenzialdiagnostik und Therapie dieser Neoplasien und bildet daher einen der zentralen Pfeiler der onkologischen Behandlung von Patienten mit Kopf-Hals-Tumoren.

Abstract

Context

Tumors of the head and neck form a heterogeneous group of benign and malignant neoplasms that includes carcinomas, sarcomas and a variety of lymphomas. The somewhat confusing variety of these neoplasms requires profound knowledge of location-specific human tumor pathology to select of optimal treatment strategies for head and neck cancer patients.

Objective

This article gives a comprehensive overview on the epidemiology and histology of tumors in the head and neck region with an emphasis on location-specific tumor entities.

Material and methods

Relevant literature on the histology and epidemiology of head and neck cancers was screened with an emphasis on current World Health Organization (WHO) recommendations. Literature data was supplemented with up date epidemiological data for Germany from the Robert-Koch Institute.

Results

With respect to frequency and clinical importance, squamous cell carcinoma of the laryngopharyngeal region and oral cavity is clearly the most prominent malignant tumor in this anatomical region. Salivary gland neoplasms, although less frequent, constitute a second important pathologically and clinically complex group of tumors at this location. These two large tumor families are complemented by a distinct group of neoplasms which typically manifest in the head and neck region, such as nasopharyngeal carcinoma, olfactory neuroblastoma, NK/T-cell lymphoma of nasal type and by a variety of lymphomas and sarcomas which are morphologically indistinguishable from their counterparts elsewhere in the body. This article gives a comprehensive overview on the landscape of neoplasms in the head and neck region.

Conclusion

Knowledge on the histology and epidemiology of tumors in the head and neck region forms the basis for a profound differential diagnosis and therapeutic decision making and therefore constitutes the basis of oncological treatment strategies for patients with head and neck neoplasms.

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Literatur

  1. Mehanna H, Paleri V, West CM, Nutting C (2010) Head and neck cancer – part 1: epidemiology, presentation, and prevention. BMJ 341:c4684

    Article  CAS  PubMed  Google Scholar 

  2. Barns L EJ, Reichart P, Sidransky D (2005) Classification of tumours: head and neck tumours. IARC Press, Lyon

  3. Curado MP, Boyle P (2013) Epidemiology of head and neck squamous cell carcinoma not related to tobacco or alcohol. Curr Opin Oncol 25:229–234

    PubMed  Google Scholar 

  4. Mehanna H, West CM, Nutting C, Paleri V (2010) Head and neck cancer – part 2: treatment and prognostic factors. BMJ 341:c4690

    Article  CAS  PubMed  Google Scholar 

  5. Marur S, D’Souza G, Westra WH, Forastiere AA (2010) HPV-associated head and neck cancer: a virus-related cancer epidemic. Lancet Oncol 11:781–789

    Article  PubMed  Google Scholar 

  6. Shiboski CH, Schmidt BL, Jordan RC (2005) Tongue and tonsil carcinoma: increasing trends in the U.S. population ages 20–44 years. Cancer 103:1843–1849

    Article  PubMed  Google Scholar 

  7. Listl S, Jansen L, Stenzinger A et al (2013) Survival of patients with oral cavity cancer in Germany. PLoS One 8:e53415

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  8. Brennan B (2006) Nasopharyngeal carcinoma. Orphanet J Rare Dis 1:23

    Article  PubMed Central  PubMed  Google Scholar 

  9. Marcus KJ, Tishler RB (2010) Head and neck carcinomas across the age spectrum: epidemiology, therapy, and late effects. Semin Radiat Oncol 20:52–57

    Article  PubMed  Google Scholar 

  10. Wang Y, Zhang Y, Ma S (2013) Racial differences in nasopharyngeal carcinoma in the United States. Cancer Epidemiol

  11. Lee AW, Ng WT, Chan YH et al (2012) The battle against nasopharyngeal cancer. Radiother Oncol 104:272–278

    Article  PubMed  Google Scholar 

  12. Guzzo M, Locati LD, Prott FJ et al (2010) Major and minor salivary gland tumors. Crit Rev Oncol Hematol 74:134–148

    Article  PubMed  Google Scholar 

  13. Mehanna H, McQueen A, Robinson M, Paleri V (2012) Salivary gland swellings. BMJ 345:e6794

    Article  PubMed  Google Scholar 

  14. Berrino F, De Angelis R, Sant M et al (2007) Survival for eight major cancers and all cancers combined for European adults diagnosed in 1995–99: results of the EUROCARE-4 study. Lancet Oncol 8:773–783

    Article  PubMed  Google Scholar 

  15. Leemans CR, Braakhuis BJ, Brakenhoff RH (2011) The molecular biology of head and neck cancer. Nat Rev Cancer 11:9–22

    Article  CAS  PubMed  Google Scholar 

  16. Seethala RR (2011) Histologic grading and prognostic biomarkers in salivary gland carcinomas. Adv Anat Pathol 18:29–45

    Article  PubMed  Google Scholar 

  17. Mills SE SE, Hunt JL (2012) Tumors of the upper aerodigestive tract and ear. ARP Press, Maryland

  18. Bryne M, Jenssen N, Boysen M (1995) Histological grading in the deep invasive front of T1 and T2 glottic squamous cell carcinomas has high prognostic value. Virchows Arch 427:277–281

    Article  CAS  PubMed  Google Scholar 

  19. Poeta ML, Manola J, Goldwasser MA et al (2007) TP53 mutations and survival in squamous-cell carcinoma of the head and neck. N Engl J Med 357:2552–2561

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  20. Orvidas LJ, Olsen KD, Lewis JE, Suman VJ (1998) Verrucous carcinoma of the larynx: a review of 53 patients. Head Neck 20:197–203

    Article  CAS  PubMed  Google Scholar 

  21. Fritsch VA, Lentsch EJ (2013) Basaloid squamous cell carcinoma of the oropharynx: an analysis of 650 cases. Otolaryngol Head Neck Surg 148:611–618

    Article  PubMed  Google Scholar 

  22. Silverman S Jr, Gorsky M, Lozada F (1984) Oral leukoplakia and malignant transformation. A follow-up study of 257 patients. Cancer 53:563–568

    Article  PubMed  Google Scholar 

  23. Silverman NA, Alexander JC Jr, Hollinshead AC, Chretien PB (1976) Correlation of tumor burden with in vitro lymphocyte reactivity and antibodies to herpesvirus tumor-associated antigens in head and neck squamous carcinoma. Cancer 37:135–140

    Article  CAS  PubMed  Google Scholar 

  24. Stenzinger A, Penzel R, Endris V, Weichert W (2013) Molecular diagnostics in pathology. Dtsch Med Wochenschr 138:1061–1068

    Article  CAS  PubMed  Google Scholar 

  25. Gillison ML, Shah KV (2003) Chapter 9: role of mucosal human papillomavirus in nongenital cancers. J Natl Cancer Inst Monogr 57–65

  26. Weichert W, Schewe C, Denkert C et al (2009) Molecular HPV typing as a diagnostic tool to discriminate primary from metastatic squamous cell carcinoma of the lung. Am J Surg Pathol 33:513–520

    Article  PubMed  Google Scholar 

  27. Guzzo M, Andreola S, Sirizzotti G, Cantu G (2002) Mucoepidermoid carcinoma of the salivary glands: clinicopathologic review of 108 patients treated at the National Cancer Institute of Milan. Ann Surg Oncol 9:688–695

    Article  PubMed  Google Scholar 

  28. Verdorfer I, Fehr A, Bullerdiek J et al (2009) Chromosomal imbalances, 11q21 rearrangement and MECT1-MAML2 fusion transcript in mucoepidermoid carcinomas of the salivary gland. Oncol Rep 22:305–311

    CAS  PubMed  Google Scholar 

  29. Norberg-Spaak L, Dardick I, Ledin T (2000) Adenoid cystic carcinoma: use of cell proliferation, BCL-2 expression, histologic grade, and clinical stage as predictors of clinical outcome. Head Neck 22:489–497

    Article  CAS  PubMed  Google Scholar 

  30. West RB, Kong C, Clarke N et al (2011) MYB expression and translocation in adenoid cystic carcinomas and other salivary gland tumors with clinicopathologic correlation. Am J Surg Pathol 35:92–99

    Article  PubMed Central  PubMed  Google Scholar 

  31. Shah AA, LeGallo RD, Zante A van et al (2013) EWSR1 genetic rearrangements in salivary gland tumors: a specific and very common feature of hyalinizing clear cell carcinoma. Am J Surg Pathol 37:571–578

    Article  PubMed  Google Scholar 

  32. Batsakis JG, Suarez P (2001) Schneiderian papillomas and carcinomas: a review. Adv Anat Pathol 8:53–64

    Article  CAS  PubMed  Google Scholar 

  33. Potter BO, Sturgis EM (2003) Sarcomas of the head and neck. Surg Oncol Clin N Am 12:379–417

    Article  PubMed  Google Scholar 

  34. O’Neill JP, Bilsky MH, Kraus D (2013) Head and neck sarcomas: epidemiology, pathology, and management. Neurosurg Clin N Am 24:67–78

    Article  Google Scholar 

  35. Bree R de, Waal I van der, Bree E de, Leemans CR (2010) Management of adult soft tissue sarcomas of the head and neck. Oral Oncol 46:786–790

    Article  PubMed  Google Scholar 

  36. Beasley MJ (2012) Lymphoma of the thyroid and head and neck. Clin Oncol (R Coll Radiol) 24:345–351

    Google Scholar 

  37. William BM, Armitage JO (2013) International analysis of the frequency and outcomes of NK/T-cell lymphomas. Best Pract Res Clin Haematol 26:23–32

    Article  CAS  PubMed  Google Scholar 

  38. Harabuchi Y, Takahara M, Kishibe K et al (2009) Nasal natural killer (NK)/T-cell lymphoma: clinical, histological, virological, and genetic features. Int J Clin Oncol 14:181–190

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

Die Autoren bedanken sich bei Herrn PD Dr. Philippe Federspil (HNO-Klinik, Universitätsklinikum Heidelberg), Herrn Prof. Dr. Dr. Kolja Freier (MKG-Chirurgie, Universitätsklinikum Heidelberg) und Frau Dr. Mogler (Pathologie, Universitätsklinikum Heidelberg) für die Überlassung von Bildmaterial und für eine Diskussion des Manuskripts.

Ethische Richtlinien

Interessenkonflikt. W. Weichert, A. Stenzinger, M. Kriegsmann und K. Kraywinkel geben an, dass kein Interessenkonflikt besteht. Das vorliegende Manuskript enthält keine Studien an Menschen oder Tieren.

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Correspondence to W. Weichert.

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Stenzinger, A., Kriegsmann, M., Kraywinkel, K. et al. Pathologie der malignen Kopf-Hals-Tumoren. Onkologe 20, 116–129 (2014). https://doi.org/10.1007/s00761-013-2584-z

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  • DOI: https://doi.org/10.1007/s00761-013-2584-z

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