Olsen, Kerry D.

Studies of the immunohistochemical profiles and clinical course of desmoplastic melanoma have produced conflicting results. We identified 28 cases of desmoplastic melanoma after a search of our files for spindle cell neoplasms of the head and neck from 1960 through 1995. The 17 male (61%) and 11 female (39%) patients averaged 65 years of age. The cheek was the most common location (12 cases, 43%). The average length of follow-up was 5 years. Overall 5-year survival rate was 46%. Melan A and tyrosinase positivity (P = 0.0195), smooth muscle actin positivity (P = 0.0328), tumor size (P = 0.0297), and tumor thickness (P = 0.0419) were significantly associated with local progression-free survival. No histologic or immunohistochemical marker was associated with overall or metastasis-free survival.

OBJECTIVEThis study reviewed patients with unilateral facial paralysis and normal clinical and imaging findings who underwent diagnostic facial nerve exploration.STUDY DESIGN AND SETTINGFifteen patients with facial paralysis and normal findings were seen in the Mayo Clinic Department of Otorhinolaryngology.RESULTSEleven patients were misdiagnosed as having Bell palsy or idiopathic paralysis. Progressive facial paralysis with sequential involvement of adjacent facial nerve branches occurred in all 15 patients. Seven patients had a history of regional skin squamous cell carcinoma, 13 patients had surgical exploration to rule out a neoplastic process, and 2 patients had negative exploration. At last follow‐up, 5 patients were alive.CONCLUSIONSPatients with facial paralysis and normal clinical and imaging findings should be considered for facial nerve exploration when the patient has a history of pain or regional skin cancer, involvement of other cranial nerves, and prolonged facial paralysis.SIGNIFICANCEOccult malignancy of the facial nerve may cause unilateral facial paralysis in patients with normal clinical and imaging findings. (Otolaryngol Head Neck Surg 2004;130:459–65.)

OBJECTIVESCD62L was evaluated as a determinant of human pre‐effector T cells.STUDY DESIGN AND SETTINGPhenotype and cytokine secretion profiles of CD62L cells were determined based on activation status.RESULTSCD62LLow T cells demonstrated significantly higher secretion of interleukin (IL)‐10 and interferon (IFN)‐Γ than did CD62LHigh T cells. After activation, the majority of cells expressed high levels of the CD62L surface marker. Postactivation levels of IL‐10 production remained elevated or unchanged. In a murine B16 melanoma model, freshly isolated CD62LLow tumor draining lymph nodes (TDLN) T cells showed increased secretion of IL‐2 and IL‐4 but not of IL‐10 or IFN‐γ. The surface expression of CD62L and cytokine secretion patterns were maintained after activation with concomitant increases in IL‐10.CONCLUSIONOur results provide evidence that CD62LLow T cells in TDLNs of progressively growing squamous cell carcinoma of the head and neck differ phenotypically and functionally from those of mouse origin.SIGNIFICANCECharacterization of this human CD62LLow T cell population provides initial insight regarding novel surface markers in TDLN T cells that might correlate with antitumor reactivity.