[Clinicopathologic study of malignant tumors in head and neck region complicated by fungal infection].
OBJECTIVE
To study the clinicopathologic features of malignant tumors in head and neck region complicated by fungal infection.


METHODS
Twenty-one cases of malignant tumors occurring in head and neck region complicated by fungal infection were retrieved from the archival file. The light microscopic findings were reviewed. Histochemical (for PAS and GMS) and immunohistochemical (for MUC5B) studies were carried out. Fungal culture results were available in 13 of the 21 cases.


RESULTS
The age of the patients ranged from 12 to 72 years (median = 48 years). The male-to-female ratio was 17:4. Eight cases (38.1%) were complicated by invasive fungal sinusitis, with orbital involvement in 6 cases and brain involvement in 1 case. The primary tumors in such cases included leukemia (n = 7) and nasopharyngeal carcinoma (n = 1). The fungi belonged to Zygomycete in 5 cases and Aspergillus in 3 cases. These patients had history of chemotherapy/radiotherapy or antibiotics usage. The remaining 13 cases of fungal infection often affected necrotic tumor tissue in nasal cavity, paranasal sinuses, pharynx, larynx and palate. The fungi involved were Aspergillus (n = 6) and Candida (n = 4). Seven of such patients had received radiotherapy. Fungal culture was positive in 9 cases. Fourteen patients had follow-up information available and six of them died of the disease.


CONCLUSIONS
Malignant tumors occurring in head and neck region can be complicated by fungal infection. Invasive fungal sinusitis (due to Zygomycetes and Aspergillus) often occurs in patients with leukemia, tends to involve orbit and is associated with poor prognosis. On the other hand, Aspergillus and Candida are the commonest fungi found in the necrotic tumor tissue. Pathologic examination remains the hallmark in confirming the diagnosis and fungal typing.
Department of Pathology, Beijing Tongren Hospital, Capital Medical University, China.
Li-li
LL
Li
Hong-gang
HG
Liu
Ying-shi
YS
Piao
Chun-yan
CY
He
Quan
Q
Zhou
Yang
Y
Zhang
D000293:Adolescent; D000328:Adult; D000368:Aged; D000935:Antifungal Agents / Q000627:therapeutic use; D001228:Aspergillosis / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology; D001230:Aspergillus / Q000302:isolation & purification; D002175:Candida / Q000302:isolation & purification; D002177:Candidiasis / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology*; D006801:Humans; D007938:Leukemia / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology*; D054391:Lymphoma, Extranodal NK-T-Cell / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology*; D012189:Retrospective Studies; D012852:Sinusitis / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology*; D055815:Young Adult; D020096:Zygomycosis / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology
D000935:Antifungal Agents