Hyoid bone involvement by squamous cell carcinoma: clinical and pathological features

Area of Science:

• Otolaryngology
• Head and Neck Surgery
• Surgical Oncology

Background:

• Hyoid bone involvement by neoplasia is poorly understood, impacting surgical planning for hyoid-preserving procedures.
• Accurate assessment of hyoid bone invasion is crucial for oncologic resections and functional outcomes.

Purpose of the Study:

• To determine the incidence of hyoid bone infiltration by tumors in laryngeal specimens.
• To analyze the primary tumor sites, patterns of invasion, and diagnostic challenges associated with hyoid bone involvement.
• To evaluate the feasibility of hyoid bone preservation in cases of neoplastic invasion.

Main Methods:

• Retrospective analysis of 755 whole-organ laryngeal specimens.
• Examination of documented hyoid bone infiltration by neoplasia.
• Correlation of invasion patterns with primary tumor location and imaging findings (computed tomography).

Main Results:

• Hyoid bone infiltration was identified in 11 (1.46%) specimens.
• Primary sites included the larynx, vallecula, pyriform fossa, and tongue base.
• The greater cornu was the most frequent site of invasion; 10 of 11 cases resulted from direct tumor spread.
• Computed tomography (CT) demonstrated limited utility in detecting hyoid invasion.
• Vascular and neural invasion were prominent features in these advanced carcinomas.

Conclusions:

• Hyoid bone invasion by neoplasia is a rare event, predominantly occurring via direct spread from adjacent structures.
• Despite association with poor prognosis, hyoid bone preservation is achievable in most cases.
• Further research is needed to improve diagnostic accuracy, particularly with advanced imaging techniques.