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Challenges and Complications in the Management of Advanced Oropharyngeal Carcinoma: Role of Post-Mortem Diagnosis and Future Perspectives
被引:2
|作者:
Consalvo, Francesca
[1
,2
,3
]
De Simone, Matteo
[1
,2
]
Scarpa, Alfonso
[1
]
Acerra, Alfonso
[1
,4
]
Salzano, Francesco Antonio
[1
,4
]
Fineschi, Vittorio
[5
]
Santurro, Alessandro
[1
,3
]
机构:
[1] Univ Salerno, Dept Med Surg & Dent, I-84081 Salerno, Italy
[2] BrainLab srl, I-84085 Mercato San Severino, Salerno, Italy
[3] Univ Hosp San Giovanni Dio & Ruggi Aragona, Unit Legal Med, I-84081 Salerno, Italy
[4] Univ Hosp San Giovanni Dio & Ruggi Aragona, Unit Otolaryngol, I-84081 Salerno, Italy
[5] Sapienza Univ Rome, Dept Anat Histol Forens & Orthopaed Sci, I-00161 Rome, Italy
关键词:
head and neck;
oropharyngeal carcinoma;
squamous-cell cancer;
lingual artery bleeding;
autopsy investigation;
post-mortem diagnosis;
TRANSORAL ROBOTIC SURGERY;
SQUAMOUS-CELL CARCINOMA;
NECK-CANCER;
PERSONALIZED MEDICINE;
RADIATION-THERAPY;
CAROTID-ARTERY;
HEAD;
CHEMOTHERAPY;
RADIOTHERAPY;
DISEASE;
D O I:
10.3390/jcm13175198
中图分类号:
R5 [内科学];
学科分类号:
1002 ;
100201 ;
摘要:
Oropharyngeal squamous-cell carcinoma (OPSCC) poses significant challenges in diagnosis, treatment, and management and has important medico-legal and forensic implications. In particular, the management of OPSCC and its treatment-related complications can often be challenging. In cases with advanced OPSCC, a loco-regional extension of the tumor can contribute to the destruction of oral cavity tissues, while the radiotherapy treatment can induce profound changes in tissue morphology and structure. These changes, which resemble tumor neoplasms and endovascular effects, are related to a higher risk of fatal bleeding, as reported in the case study illustrated, in which a hemorrhage occurred from a lingual artery, originating from an ulcerative, necrotic, hemorrhagic lesion on the tongue. Bleeding complications in OPSCC and prolonged radiotherapy are associated with high mortality and require comprehensive management strategies to improve survival and quality of life. Autopsy investigations, contributing to the definition of post-mortem diagnosis, can provide valuable insights into the pathogenetic mechanisms underlying bleeding and guide therapeutic decisions and preventive measures. The integration of autopsy and histopathological investigation into clinical practice should be considered as a necessary support to optimize the management of complications in advanced OPSCC patients, emphasizing the importance of a patient-centered approach and continued research.
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