dinoprost and Head-and-Neck-Neoplasms

An original route for prostaglandin F2 alpha administration for midtrimester pregnancy termination is presented. The diagnosis of nuchal cystic hygroma in a hydropic fetus with severe oligohydramnios was made by real-time ultrasonography. Forty milliliters of fluid was aspirated for laboratory studies and prostaglandin F2 alpha was injected into the nuchal cysts to induce abortion. The pregnancy was successfully terminated 8 hours later.. Although the use of prostaglandins (PGs) in 2nd-trimester abortions is well established, less clear is the optimal route of administration. The literature includes reports of intra- and extraamniotic, intracervical, intravaginal, intravenous, intramuscular, and oral administration. This article describes a case in which PG F-2-alpha was injected into the nuchal cysts of a fetus with cystic hygroma, edema anasarca, and oligohydramnios. Nuchal cystic hygroma, a congenital malformation of the lymphatic system involving a jugular lymphatic obstruction sequence, was diagnosed in the 27-year-old patient by real- time ultrasonography performed at 21 weeks' gestation. Since there was no pouch of amniotic fluid, intraamniotic PG instillation was not an option. However, the severe cystic hygroma and hydrops offered an alternative site for PG instillation. During the abortion procedure, 40 ml of fluid contained in the cysts was aspirated for laboratory studies and 40 mg of PG F-2-alpha was injected under ultrasonographic guidance. Uterine contractions began 2 hours later and the injection-abortion interval was 8 hours. The administration of meperidine and atropine sulfate to prevent pain and PG-associated side effects was effective. This successful outcome in this case suggests a need for further investigation of intrafetal PG administration.

Topics: Abortion, Induced; Adult; Amniotic Fluid; Dinoprost; Female; Fetal Diseases; Head and Neck Neoplasms; Humans; Hydrops Fetalis; Injections, Intralesional; Lymphangioma; Pregnancy; Pregnancy Trimester, Second; Prenatal Diagnosis; Ultrasonography

There is evidence suggesting a role of eicosanoids in the growth of certain tumors. In this study, tissue samples were collected from basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs) of the skin. Both BCCs and SCCs contained more prostaglandin E2 and F2 alpha (PGE2 and PGF2 alpha) than normal epidermis. In vitro incubation of tumor samples with arachidonic acid also resulted in PGE2 and PGF2 alpha formation. Basal cell carcinomas exhibiting a histologically aggressive growth pattern contained higher levels of prostaglandins than those with a nonaggressive growth pattern, both in vivo and after in vitro incubation. Lipoxygenase products (12- and 15-hydroxyeicosatetraenoic acid) were present in smaller amounts than cyclo-oxygenase products (PGE2 and PGF2 alpha) in vivo. Compared with normal epidermis, SCCs and, particularly, BCCs produced smaller amounts of 12-hydroxyeicosatetraenoic acid during in vitro incubation with arachidonic acid. The levels of lipoxygenase products were not related to the tumor growth pattern. These results indicate that excessive prostaglandin levels in BCCs may be associated with an aggressive growth pattern.

Topics: 12-Hydroxy-5,8,10,14-eicosatetraenoic Acid; Animals; Arachidonic Acids; Breast Neoplasms; Carcinoma, Basal Cell; Carcinoma, Squamous Cell; Chromatography, High Pressure Liquid; Dinoprost; Dinoprostone; Head and Neck Neoplasms; Humans; Hydroxyeicosatetraenoic Acids; In Vitro Techniques; Mice; Prostaglandins; Prostaglandins E; Prostaglandins F; Rabbits; Radioimmunoassay; Skin Neoplasms

Abnormalities of 5 cyclooxygenase products were studied in tumours from patients with head and neck cancer. The studies were designed to measure tissue prostaglandin content (ng/g wet tissue) as well as production in vitro by tumour microsomes (ng/mg protein/10 min). Head and neck tumours contained large amounts of 5 eicosanoids in the order. PGE2 greater than PGE1 greater than 6-keto-PGF1 alpha greater than PGF2 alpha greater than TXB2. When tumours less than or equal to 2 cm were compared with tumours equal to or more than 3 cm in size, amounts of all but PGF2 alpha were higher in the larger tumours. However, the capacity of tumour microsomes to synthesize PGs in vitro was inversely related to tumour size. These results suggest a defect in removal of eicosanoids from large tumours. The physiological significance of this increase in local levels of eicosanoids remains to be determined in head and neck cancer.

Topics: 6-Ketoprostaglandin F1 alpha; Alprostadil; Dinoprost; Dinoprostone; Head and Neck Neoplasms; Humans; Microsomes; Prostaglandins; Prostaglandins E; Prostaglandins F

Patterns and mechanisms of local bone invasion by squamous carcinomas of the head and neck have been investigated. Detailed surgical pathology has shown that these tumors invade contiguous skeletal or metaplastic bone principally through an indirect process; the normal bone resorbing cells of the host (osteoclasts) are activated and erode bone in front of the advancing tumor edge. Tumor cells take over the destructive process when the osteoclast response has waned. These morphologic patterns have been reproduced in an in vitro model where calcium-45-labelled mouse calvaria, cocultured with a tumor for 3 days, are resorbed by osteoclasts. Freshly excised tumors, established tumor cell lines, and tumor xenografts release osteolysins in vitro which act as osteoclastic stimulants. They include both prostaglandins E2 and F2 alpha, and nonprostaglandin factors, and are derived from tumor cells and from the associated host stroma. Virtually all the tumors examined released osteolysins and resorbed bone in vitro independent of their site, size, degree of differentiation, and the presence or absence of clinical bone invasion.

Topics: Bone Neoplasms; Calcium; Carcinoma, Squamous Cell; Cell Line; Cells, Cultured; Dinoprost; Dinoprostone; Head and Neck Neoplasms; Humans; In Vitro Techniques; Laryngeal Neoplasms; Osteolysis; Prostaglandins E; Prostaglandins F

Mechanisms of bone invasion by squamous carcinomas of the head and neck have been investigated using fresh tumours and established tumour cell lines in an in vitro bone resorption assay with 45Ca-labelled mouse calvaria. Fresh tumours regularly resorb bone in vitro. Activity is consistently reduced by indomethacin. The tumours release E2 prostaglandins (PGE2) in amounts sufficient to account for approximately 50% of the bone resorption observed. Small amounts of non-prostaglandin (indomethacin-resistant) osteolytic factors are also produced. Control non-neoplastic tissues show a variable capacity to resorb bone in vitro; PGE2 levels in these tissues may be related to their content of inflammatory cells. Tumour cell lines also resorb bone in vitro but, for most lines, activity is not significantly blocked by indomethacin and PGE2 levels are generally insufficient to account for the osteolysis observed. Non-prostaglandin bone resorbing factors thus predominate. It is concluded that most squamous cancers of the head and neck are osteolytic in vitro and release a mixture of prostaglandin and non-prostaglandin factors which stimulate osteoclastic bone resorption. These factors are derived from both neoplastic and stromal elements, and are "tumour-associated" rather than "tumour-specific". In vitro bone resorption and prostaglandin release does not correlate with pathological features of the tumour or with post-operative survival.

Topics: Animals; Bone Resorption; Carcinoma, Squamous Cell; Cell Line; Culture Media; Culture Techniques; Dinoprost; Dinoprostone; Fibroblasts; Head and Neck Neoplasms; Humans; Indomethacin; Mice; Mice, Inbred BALB C; Prostaglandins E; Prostaglandins F; Skin