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Surgery in head and neck lymphomas
Radiation therapy and/or chemotherapy are the treatment modalities of choice in lymphomas. Except for Burkitt's tumor, surgery is usually indicated only when percutaneous biopsy fails to establish the histologic diagnosis. We have described a patient with glomerulonephritis and anasarca secondary to an IgM-producing parapharyngeal lymphoma. After resection of all palpable tumor by an excisional biopsy, the monoclonal gammopathy and secondary nephrosis promptly cleared. With chemotherapy and mantle irradiation, the patient is in remission at three years. It is not now clear whether surgery will become useful as an adjunctive therapy for localized head and neck lymphomas. This will depend on whether local failure rates can be improved solely by using new combinations of irradiation and/or cytotoxic agents, and whether the morbidity of such therapy will outweigh the therapeutic gain.
Radiation therapy and/or chemotherapy are the treatment modalities of choice in lymphomas. Except for Burkitt's tumor, surgery is usually indicated only when percutaneous biopsy fails to establish the histologic diagnosis. We have described a patient with glomerulonephritis and anasarca secondary to an IgM-producing parapharyngeal lymphoma. After resection of all palpable tumor by an excisional biopsy, the monoclonal gammopathy and secondary nephrosis promptly cleared. With chemotherapy and mantle irradiation, the patient is in remission at three years. It is not now clear whether surgery will become useful as an adjunctive therapy for localized head and neck lymphomas. This will depend on whether local failure rates can be improved solely by using new combinations of irradiation and/or cytotoxic agents, and whether the morbidity of such therapy will outweigh the therapeutic gain.