picibanil and Tongue-Neoplasms

Lymphangioma of the tongue is a rare and benign tumour involving congenital and cystic abnormalities derived from lymphatic vessels. Treatment modalities include surgery and a large number of different intralesional injections of sclerosing agents. Presently, OK-432 (Picibanil(®)) is the preferred sclerosant and when administered intralesionally will result in inflammation, sclerosis, and cicatricial contraction of the lesion. We report a case of microcystic lymphangioma of the tongue in a 5-year-old boy treated with an intralesional injection of OK-432. In the immediate postoperative period, the patient suffered severe diffuse swelling, progressive upper airway obstruction with inspiratory stridor, and respiratory distress requiring emergency fiberoptic nasotracheal intubation. Although OK-432 injections are found to be safe and effective as a first line of treatment for lymphangiomas, local swelling with potentially life-threatening airway compromise should be anticipated, especially when treating lesions near the upper airway.

Topics: Airway Obstruction; Child, Preschool; Humans; Injections, Intralesional; Intubation, Intratracheal; Lymphangioma, Cystic; Male; Picibanil; Sclerosing Solutions; Tongue Neoplasms; Tracheostomy; Treatment Outcome

This report presents the treatment of an extensive lymphatic malformation of the tongue. Sclerosing agents are now widely used as the first-line treatment of lymphatic malformation. However, treatment of lymphatic malformation involving the face and the vital structures such as the airway remains to be challenging. A 4-year-old boy underwent a total of 15 OK-432 injection sclerotherapy treatments over a 2-year period, having slow progress until sudden enlargement of the tongue was noted shortly after the last injection. Partial excision of the lesion was performed. This case demonstrates the risk in treating large microcystic lymphatic malformation of the tongue with sclerotherapy and provides an insight in the management protocol.

Topics: Antineoplastic Agents; Child, Preschool; Follow-Up Studies; Humans; Lymphangioma, Cystic; Male; Neoplasm Recurrence, Local; Picibanil; Sclerosing Solutions; Sclerotherapy; Tongue Neoplasms; Treatment Outcome

Priming with tumor antigens is one of the most important strategies in cancer immunotherapy. To enhance tumor antigenicity, OK-432, a streptococcal preparation, was coupled to squamous cell carcinoma (KLN-205) by means of a 0.2% glutaraldehyde method. The purpose of this study was to investigate whether OK-432-conjugated tumor vaccines could induce tumor-specific immunity. Our originally developed mouse tongue cancer model was used throughout this work for the analysis of antitumor effects. Prepared OK-432-conjugated KLN-205 vaccines were immunized 3 times to DBA/2 mice. The results showed that the KLN-205 vaccines induced cytolytic activity and strongly suppressed both KLN-205 tumor incidence and growth, and survival of the mice was improved. Moreover, the histological results showed that a greater number of lymphocytes had infiltrated around tumor cells by 24 hours after tumor inoculation in the vaccine group. These results suggest that immunizations with KLN-205 vaccines increase the antitumor effects against tongue cancer.

Topics: Animals; Antigens, Neoplasm; Antineoplastic Agents; Cancer Vaccines; Carcinoma, Squamous Cell; Disease Models, Animal; Female; Immunization; Lymphocytes; Mice; Mice, Inbred DBA; Picibanil; Survival Rate; Tongue Neoplasms; Vaccines, Conjugate

The authors present two cases of lymphangioma of the cervicofacial region, treated with a new investigational drug in North America, OK-432 (picibanil), a sclerosing agent intralesionally injected. Both patients had been treated surgically and had recurrence of the tumor. Intralesional injection of OK-432 without aspiration was employed for the first patient, and after aspiration in the second patient. A change in consistency of the tumor, manifested by softening, was followed by marked shrinkage. No complication either locally or systemically has occurred during the follow-up period (10 to 16 months). In both cases, satisfactory results were obtained, resulting in definite reduction in size and improvement in cosmetic appearance. The authors recommend OK-432 intralesional injection for surgically challenging lymphangioma. Their results support those of a recent Japanese study using OK-432 as sclerosing therapy for unresectable lymphangioma.

Topics: Adolescent; Adult; Antineoplastic Agents; Esthetics; Facial Neoplasms; Follow-Up Studies; Head and Neck Neoplasms; Humans; Injections, Intralesional; Lymphangioma; Lymphangioma, Cystic; Male; Neoplasm Recurrence, Local; Picibanil; Sclerosing Solutions; Sclerotherapy; Suction; Tongue Neoplasms

According to the effect of preoperative chemotherapy for tongue cancer, if the operation method is modified, the modality of treatment for tongue cancer will contribute to preserve the tongue in terms of function and aesthetics as well as improve the quality of life. A clinicopathologic study on 81 patients with tongue cancer was conducted to elucidate the relationship between clinical and histological effects of preoperative chemotherapy with a single agent and multiple-drug regimens, in order to determine the safe surgical margins in the resection of squamous cell carcinoma of the tongue. Fifty patients were treated with bleomycin alone, sixteen with bleomycin and methotrexate and another fifteen with bleomycin, OK-432 and cisplatin. Multiple-drug regimens resulted in greater response rates than the single agent, but there was not always agreement in the relationship between the tumor regression rate and the histological effects of chemotherapy. The histological effects, including the residual aspects of the tumor cell population, were associated with the grade of histological malignancy according to the mode of tumor cell invasion, mitotic index of tumor cell, the tumor differentiation, the degree of stromal lymphocyte infiltration and cellular atypism. These data indicate that special consideration should be also given to the degree of histological malignancy for biopsied specimen, in addition to the tumor regression rate, in determining safe surgical margins and in the modality of treatment of tongue cancer.

Topics: Adult; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Carcinoma, Squamous Cell; Chemotherapy, Adjuvant; Cisplatin; Drug Administration Schedule; Female; Humans; Male; Middle Aged; Picibanil; Preoperative Care; Tongue Neoplasms

A secondary metastasis after surgery was uncovered in 12 out of 73 cases of oral squamous cancer. The clinical and histological characteristic tendencies of the metastasis of these 12 cases were the tongue as the tumor site (11/12), and an aggressive invasion in the tumor-host borderline with 2 of Gr, 3, 5 of Gr. 4C and 5 of Gr. 4D, according to the grading of Yamamoto and Kohama (1982). The control of these metastases was not easy because of their multiple and extra-nodal spread. Tumor-free survival occurred in 4 out of 11 (36.3%). Therefore, in some situations, a prophylactic neck dissection would seem to be recommended.

Topics: Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols; Bleomycin; Carcinoma, Squamous Cell; Cisplatin; Female; Humans; Lymphatic Metastasis; Male; Methotrexate; Middle Aged; Mouth; Mouth Neoplasms; Neck Dissection; Neoplasm Invasiveness; Picibanil; Postoperative Period; Tongue Neoplasms