amphotericin-b and Laryngeal-Neoplasms

Blastomycosis is a relatively uncommon fungal disease that most commonly affects the lungs. Other organs may be involved, usually secondary to dissemination of the organism. Laryngeal blastomycosis may occur in isolation from active pulmonary disease. The signs, symptoms, clinical features, and pathological findings of laryngeal blastomycosis mimic those of squamous cell carcinoma. Misdiagnosis may result in inappropriate treatment with potential morbidity. Proper understanding of the clinical presentation and familiarity with the histopathologic features of this disease are therefore imperative. In this paper, we report 2 cases of laryngeal blastomycosis, 1 of which was misdiagnosed as squamous cell carcinoma, clinically and microscopically, with consequent radiotherapy and laryngectomy. In the other case, a clinical diagnosis of glottic squamous cell carcinoma was rendered. However, blastomycosis was identified in a biopsy specimen. We also review cases of isolated laryngeal blastomycosis that have been reported in the English-language literature during the last 80 years. A number of those cases were misdiagnosed clinically and microscopically as squamous cell carcinoma.

Topics: Amphotericin B; Antifungal Agents; Blastomyces; Blastomycosis; Carcinoma, Squamous Cell; Diagnosis, Differential; Diagnostic Errors; Female; Humans; Laryngeal Neoplasms; Laryngitis; Male; Middle Aged

Laryngeal leishmaniasis is an unusual form of the disease. We report the case of a patient who consulted for dysphonia and dysphagia in a context of asthenia and weight loss. The patient had lesions that were suggestive of laryngeal cancer but were revealed to be leishmaniasis by histopathology examination and polymerase chain reaction. Treatment with amphotericin B and miltefosine permitted complete resolution of the lesions and no recurrence during the 18-month follow-up period.

Topics: Aged; Amphotericin B; Antiprotozoal Agents; Deglutition Disorders; Diagnosis, Differential; Dysphonia; Humans; Laryngeal Neoplasms; Larynx; Leishmaniasis; Male; Phosphorylcholine

The effectiveness of carboplatin in the treatment of patients with tumors is limited by drug resistance. Because of that, there is a great interest to find a way to revert the resistance and improve the success of cancer treatment. The aim of the present study was to examine five potential modulators of carboplatin resistance with different mode of action: buthionine sulfoximine, ethacrinic acid, amphotericine B, cyclosporine A and aphidicoline. The effect of these compounds on the sensitivity of human laryngeal parental (HEp2) and carboplatin-resistant (HEp7T) cells to carboplatin was examined by MTT spectrophotometric assay. The results have shown that buthionin sulfoximine and, to a lesser extent, ethacrinic acid reduced the resistance of HEp7T cells to carboplatin. Aphidicolin increased the sensitivity of both HEp2 and HEp7T cells to carboplatin, but this effect was more expressed in parental HEp2 cells. Our data suggest that human laryngeal carcinoma cells treated with clinically relevant doses of carboplatin became resistant to this drug due to multifactorial molecular mechanisms. Accordingly, the resistance to carboplatin could be reduced by different modulators.

Topics: Amphotericin B; Antineoplastic Agents; Aphidicolin; Buthionine Sulfoximine; Carboplatin; Cyclosporine; Drug Resistance, Neoplasm; Drug Synergism; Ethacrynic Acid; Humans; Laryngeal Neoplasms; Tumor Cells, Cultured

Laryngeal candidiasis is very rare in the absence of other more proximal diseases in the aerodigestive tract. The lesion shows pseudoepitheliomatous hyperplasia or acanthosis and, given its rarity, may be confused with cancer. In the present paper we report on a 56-year-old male patient who presented with hoarseness. Physical examination of the larynx revealed a hyperplastic lesion involving both vocal cords. The clinical aspect and the risk factor profile of the patient (ten bottles of beer and 40 cigarettes per day) generated the clinical diagnosis of laryngeal cancer. A biopsy was taken. The histopathological examination of the specimen excluded a squamous cell carcinoma; however, it could not provide a clear diagnosis. Laryngeal papillomatosis and tuberculosis, which had been suspected, could be excluded. As the lesion progressed, further biopsies led to the diagnosis of candidiasis. Systemic antimycotic treatment with fluconazol and amphotericin caused a complete remission.

Topics: Amphotericin B; Antifungal Agents; Biopsy; Candidiasis; Diagnosis, Differential; Fluconazole; Follow-Up Studies; Humans; Hyperplasia; Laryngeal Diseases; Laryngeal Neoplasms; Laryngoscopy; Male; Middle Aged; Papilloma; Vocal Cords

Within the upper aerodigestive tract, histoplasmosis often mimics carcinoma, making prompt and accurate diagnosis imperative. More severe and potentially lethal infections with Histoplasma capsulatum are now being seen as the numbers of patients at the extremes of age, as well as those with compromised immune systems, increase. We reviewed the cases of 115 hospitalized patients with disseminated histoplasmosis. Of these, 9 patients were identified with otolaryngologic manifestations: 4 were infected with human immunodeficiency virus (HIV), 1 was diabetic, and 3 were renal transplant patients. Sites of involvement included the larynx (in 2 cases) and the oral cavity and oral pharynx (in 7 cases). Eight of the 9 patients had a positive biopsy result; the other, a positive culture. Treatment with amphotericin B was generally effective, while the use of newer azole anti-fungal agents were less effective. As the number of immunocompromised patients continues to increase in modern clinical practice, histoplasmosis will undoubtedly be encountered more frequently in the head and neck area.

Topics: Amphotericin B; Histoplasmosis; HIV Infections; Humans; Itraconazole; Laryngeal Diseases; Laryngeal Neoplasms; Laryngoscopy; Male; Middle Aged; Retrospective Studies; Stomatognathic Diseases; Treatment Outcome

The aim of this study was to examine whether resistance to cisplatin [cis-diamminedichloroplatinum (II)] (CDDP) could be overcome by amphotericin B, cyclosporin A and aphidicolin in two sublines of human larynx carcinoma HEp2 cells. The sensitivity of parental and cisplatin-resistant CA3 and CK2 cells to amphotericin B, cyclosporin A and aphidicolin, and also the effects of these drugs (given in maximal nontoxic concentrations) on cisplatin sensitivity were determined by clonogenic survival assay. CA3 and CK2 cells were sensitive to amphotericin B, and resistant to cyclosporin A and aphidicolin, compared with their parental cells. Amphotericin B increased cisplatin toxicity 2-fold in CA3 cells and 2.7-fold in CK2 cells, while it had no effect in parental HEp2 cells. Cyclosporin A did not influence the sensitivity of examined cells to cisplatin. The sensitizing effect of aphidicolin was more obvious in cisplatin-resistant cells. Cisplatin toxicity was increased by aphidicolin: 1.5-fold in HEp2 cells, 2-fold in CA3 cells, and 1.9-fold in CK2 cells. Therefore, the resistance to cisplatin in human larynx carcinoma CA3 and CK2 cells can be partially reversed by amphotericin B and aphidicolin.

Topics: Amphotericin B; Aphidicolin; Cell Survival; Cisplatin; Cyclosporine; Drug Resistance; Humans; Laryngeal Neoplasms; Tumor Cells, Cultured; Tumor Stem Cell Assay

Topics: Adult; Aged; Amphotericin B; Blastomycosis; Diagnosis, Differential; Histoplasmosis; Humans; Laryngeal Diseases; Laryngeal Neoplasms; Lip Diseases; Male; Middle Aged; Mouth Diseases; Mouth Neoplasms; Mycoses

Topics: Amphotericin B; Biopsy; Candidiasis; Chondrosarcoma; Humans; Laryngeal Neoplasms; Laryngectomy; Laryngoscopy; Male; Middle Aged; Prognosis