Despite aggressive regimens, the clinical outcome of head and neck squamous cell carcinoma remains poor. The detection of circulating tumor cells could potentially improve the management of patients with disseminated cancer, including diagnosis, treatment strategies, and surveillance. Currently, CellSearch® is the most widely used and the only Food and Drug Administration-cleared system for circulating tumor cells detection in patients with metastatic breast, colorectal, or prostate cancer. In most cases of head and neck squamous cell carcinoma, only low counts of circulating tumor cells have been reported. A 56-year-old white male with no particular medical history, was diagnosed with a squamous cell carcinoma of oral cavity. According to the imaging results (computed tomography and 18F-fluorodeoxyglucose positron emission tomography / computed tomography) and panendoscopy, the TNM staging was classified as T4N2M0. A non-interruptive pelvimandibulectomy was conducted according to the multidisciplinary meeting advices and the postoperative observations were normal. The patient complained of a painful cervical edema and a trismus 6 weeks after the surgery. A relapse was found by computed tomography and the patient died two weeks later. The search for circulating tumor cells in peripheral venous blood by using the CellSearch® system revealed a very high count compared with published reports at three time points (pre-operative: 400; intra-operative: 150 and post-operative day 7: 1400 circulating tumor cells). Of note, all detected circulating tumor cells were epidermal growth factor receptor negative. We report here for the first time a rare case of oral squamous cell carcinoma with extremely high circulating tumor cells counts using the CellSearch® system. The absolute number of circulating tumor cells might predict a particular phase of cancer development as well as a poor survival, potentially contributing to a personalized healthcare.

Salvage surgeries of head and neck cancer are often complicated and do not always show decent results. This type of procedure is tough on the patient, as many crucial organs can be affected. A long period of reeducation usually follows the surgery because of the need to rehabilitate functions such as speech or swallowing. In order to lighten the journey of the patients, it is important to develop new technologies and techniques to ease the surgery and limit its damages. This seems even more crucial since progress has been made in the past years, allowing more salvage therapy to take place. This article aims at showing the available tools and procedures for salvage surgeries, such as transoral robotic surgery, free-flap surgery, sentinel node mapping, and many others, that help the work of the medical team to operate or obtain a better understanding of the status of the cancer when taken in charge. Yet, the surgical procedure is not the only thing determining the outcome of the operation. The patient themself and their cancer history also play an important part in the care and must be acknowledged.

Introduction and importance: Lichen planus is an inflammatory and chronic disease with multifactorial causes. Hypertrophic subtype of lichen planus is an extremely rare lesion when found in the larynx. This article describes the case of a man with such a lesion. Case presentation: A 54-year-old man presented after respiratory distress with a suspicious mass on the left hemilarynx. The patient consumed a lot of tobacco and alcohol. He underwent nasofibroscopy, CT scan and numerous direct laryngoscopies with biopsy. Histopathological analysis finally revealed a mucosal hypertrophic lichen planus. Nowadays, the patient has undergone a partial laryngectomy. Clinical discussion: Lichen planus is a chronic immune disease with multifactorial causes like stress or genetic susceptibility, for example. Presentations may vary, and histological features include hyperkeratosis and lymphocytic infiltration, which could be the primary cause of tissue damage. Hypertrophic lichen planus is an extremely rare laryngeal lesion, and there are few examples of how it is treated. As in topical treatments for other types of lichen planus, corticosteroids may be helpful. In addition, the potential carcinogenic transformation of this type of lesion is not well known, and follow-up care is therefore required. Conclusion: A patient presented with a hypertrophic lichen planus lesion in the larynx, which is an extremely rare location. Thus far, he has undergone surgery to treat it. Highlights:

Introduction and importance: Oncocytic cysts are benign lesions seldom found in the region of the larynx. The phenomenon leading to their appearance is currently not well known but could be linked with aging and smoking. This article describes the case of a patient in whom a laryngeal oncocytic cyst was found. Case presentation: A 52-year-old man presented during a screening for upper aerodigestive tract cancer with a lesion on the anterior third of the left vocal cord. He reported no symptoms but had tobacco use. Other medical history was unremarkable. Laryngoscopy revealed a cyst arising from the left vocal cord. It was excised with CO ₂ laser and measured 0,3 × 0,2 × 0,1 cm. Histopathology revealed that the cyst was composed of oncocytic cells lining the epithelium, with eosinophilic and granular aspect in the cytoplasm, with a small and dark nucleus. Thus far, there is no sign of recurrence with this patient. Clinical discussion: Laryngeal oncocytic cysts are unusual lesions which can appear with different types of symptoms or with no symptoms. They are formed with oncocytes, with eosinophilic cytoplasm and dark nuclei. Oncocytic cysts have generally no recurrence, but follow-up care is required for mechanisms of such lesions are not well known. Metaplasia in this type of lesions would be caused by physiological exhaustion and inflammation. Conclusion: A patient presented with an oncocytic cyst fortuitously discovered and underwent CO ₂ laser to remove it. The causes may have been smoking and aging, but it remains a rare and atypical case. Highlights:

Introduction and importance: Chondrosarcoma is a tumor which arises from cartilage, and whose apparition can occur in any site. However, it remains rare in the larynx. Management depends on the grade and the stage of the tumor at the time of the presentation. Here is described the case of a 73-year-old man, who presented with a one-month history of dyspnea due to a low-grade (grade I) laryngeal chondrosarcoma. The tumor was successfully treated through a laser and radiofrequency ablation. Case report: A 73-year-old man presented with dyspnea that appeared one month earlier. He underwent clinic examination and CT-scan analysis, which revealed a laryngeal lesion. Histological analysis of the lesion led to the conclusion of a low-grade chondrosarcoma. A non-surgical management was chosen during a multidisciplinary consultation meeting, to preserve laryngeal functions. The patient underwent repeated laser and radiofrequency ablation, to reduce the tumor volume. At present, there is still a mass in the area, but the patient doesn't present any other symptoms. However, he has a close follow up, in order that the signs of an early tumoral evolution are promptly detected. Clinical discussion: Total laryngectomy is often used for laryngeal chondrosarcoma, but it leads to a complete loss of the laryngeal functions, among which we can quote the speaking. Thereby, it would be better for patients to find other ways of conservative management. Consequently, our case presents the success of laser and radiofrequency ablation in the treatment of a laryngeal chondrosarcoma, which allowed to protect laryngeal functions. Nevertheless, this is a non-curative method showing some limitations but improving surgery outcomes and patient quality of life. Conclusion: This report highlights the importance of quick grading in primary laryngeal chondrosarcoma. In this case, localized low-grade chondrosarcoma was treated without surgery, with a successful outcome thanks to laser and radiofrequency ablation. Highlights: