Neck Mass Came Back Cancer... Now What?

It is not uncommon that an adult patient presents with a neck mass to an ENT clinic. Unfortunately, upon workup which typically includes a needle biopsy, the neck mass comes back showing cancer, usually, a type of cancer called squamous cell carcinoma, although lymphoma, mucoepidermoid carcinoma, etc occasionally occurs as well. In this blog article, we will focus specifically on the case of the neck mass being squamous cell carcinoma. At this point, the patient's main concern is wha…

5/01/2019 0

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Swab Culture is Inaccurate Test for Determining Tonsillitis

A fascinating study came out in June 2017 that compared the bacteria found on the tonsil surface by swab versus bacteria found within a core needle biopsy versus bacteria found within the dissected tonsil's core. The take home finding is that a swab culture poorly identifies the bacteria causing recurrent tonsillitis . Based on 54 children who underwent tonsillectomy , researchers performed a swab, needle biopsy, and core dissection of all tonsils removed. Culture results obtained from…

6/28/2017 0

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Parkinson's Disease Diagnosed by Salivary Gland Biopsy

Taken from Wikipedia Diagnosing Parkinson's Disease (a degenerative neurological disorder) is hard, usually a clinical exam and assessment of symptoms by a neurologist with at best about an 80% accuracy rate. There is no "test" per se that can diagnose Parkinson's Disease... until now. In patients with Parkinson's Disease, an uniquely abnormal protein called alpha-synuclein protein can be found in the submandibular spit gland located under the jawline. By obtainin…

5/02/2016 0

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10 Ways to Remove a Facial Skin Lesion [VIDEO]

There are many different ways to remove a skin lesion from the facial region depending on location, size, and orientation. This video demonstrates the ten most popular techniques to remove a skin lesion. Shave Biopsy Fusiform Excision Rhomboid Flap Bilobed Flap Geometric Broken Line W-plasty Note Flap Z-plasty Rotation Flap Advancement Flap Most ENTs, dermatologists, and plastic surgeons are familiar with all these techniques.

9/21/2015 0

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Large Thyroid Nodules Have Higher Risk of Cancer Even if Needle Biopsy is Normal

A recent 2015 study revealed that large thyroid nodules (over 3cm) have a higher risk of cancer and that needle biopsies are not very accurate in diagnosing cancer in such large nodules. This is hardly the first study to demonstrate this. In a 2009 study , surgeons at the University of Wisconsin found that fine needle aspiration  biopsy  (FNAB) in 26 of 52 FNAB reported as benign (50.0%) turned out to be either neoplastic (22) or malignant (4) on final pathologic analysis after  thyroidect…

1/27/2015 1

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Joan Rivers Underwent Unplanned Vocal Cord Biopsy Without Consent

Image by  David Shankbone  of  Wikipedia When it was first reported 8/28/14 that comedian Joan Rivers suffered some type of respiratory arrest during some type of sedated endoscopic procedure, it was unclear exactly what was done and what happened. According to initial reports, the endoscopy was done to "check her vocal cords." Media reports have emerged citing an anonymous source that state an unplanned, un-consented vocal cord biopsy was done during the planned endoscopy pr…

9/10/2014 1

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Diagnose Cancer with Flash of a Light!

Traditionally, cancer is diagnosed by a surgical biopsy  with pathology results taking days later. Supportive evidence for a cancer is also determined based on visualizing the lesion as well as radiological studies (CT, MRI, Ultrasound, etc). However, there is a very exciting breakthrough technology that may be able to make a cancer determination under 1 second with only a flash of a light... meaning no biopsy with associated pain and scar to go along with it. Called Verisante Aura , a p…

3/15/2013 0

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Why Do Biopsy Results Take So Long? [video]

One of the most common questions I get after a surgical procedure is how long it takes before biopsy results are back... especially when a mass was removed and there is a cancer concern. Does it take a few hours? 24 hours? Days? Disappointingly, it can take up to 7 days if not longer. You want to know why? Well, rather than explaining, watch a 6-minute video that explains the numerous steps that goes into providing a diagnosis after a mass is removed... in this particular case, a neck …

2/28/2013 1

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Parkinson's Disease Diagnosed by Salivary Gland Biopsy

Taken from Wikipedia Currently, diagnosing Parkinson's Disease (a degenerative neurological disorder) is hard, usually a clinical exam and assessment of symptoms by a neurologist with at best about an 80% accuracy rate. There is no "test" per se that can diagnose Parkinson's Disease... until possibly now. PLEASE NOTE THAT A NEW BLOG ARTICLE HAS BEEN WRITTEN 5/2/16 UPDATING INFO ON THIS BLOG ARTICLE WRITTEN IN 2013. According to a study released in advance of its pres…

1/11/2013 1

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Needle Biopsy of Thyroid Masses Misidentifies 50% of Thyroid Cancers!

Surgeons at the University of Wisconsin found that fine needle aspiration biopsy (FNAB) in 26 of 52 FNAB reported as benign (50.0%) turned out to be either neoplastic (22) or malignant (4) on final pathologic analysis after thyroidectomy . Among patients with nondiagnostic FNAB results, the risk of malignant neoplasms was 27.3%. Even for smaller thyroid masses , FNAB is still not 100% accurate with a falsely negative rate of around 10% . Why is that? Well, one must keep in mind that the…

7/26/2009 0

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RANDOM: Michelangelo's David Statue Has a Goiter???

So, I was looking at a picture of The David statue by Michelangelo standing in front of the Palazzo Vecchio when I noticed something on the neck... a bulge just off the midline and below the thyroid cartilage. Could it be a thyroid goiter or mass ? If David was alive today, I most definitely would obtain a thyroid ultrasound and perhaps a fine needle aspirate if a nodule was found. Thyroid cancer would be the concern I would counsel David about. Read more about the surgery  here  or  wa…

7/04/2009 0

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