Background and Objectives: Laryngeal cancer imposes a disproportionate burden on speech, airway protection and long-term quality of life. Contemporary population-based data for Central and Eastern Europe remain scarce, and the post-pandemic trajectory is uncertain. Materials and Methods: We performed a nationwide, retrospective ecological time-series study using Romanian mortality registers and hospital-discharge files for 2017–2023. Crude and age-standardised mortality rates (ASMRs) were calculated, county-level indirect standardisation and spatial autocorrelation assessed and joinpoint regression quantified temporal trends. Forecasts to 2040 combined Holt–Winters/ARIMA models with Elliott-wave heuristics anchored to Fibonacci retracements. Results: In 2023, 798 laryngeal cancer deaths yielded a crude mortality of 3.65/100,000 (95% CI 3.41–3.91). Male mortality (7.07/100,000) exceeded female mortality 18-fold. Rural residents experienced a higher rate than urban counterparts (4.26 vs. 3.04/100,000), a difference unchanged after indirect age standardisation. National ASMR fell by 3.7% annually (p < 0.01), yet five counties formed a high-risk corridor (standardised mortality ratios 1.59–1.82); Moran’s I = 0.27 (p < 0.01) indicated significant spatial clustering. Pandemic-era surgical throughput collapsed by 48%, generating a backlog projected to persist beyond 2030. Ensemble forecasting anticipates a doubling of discharges and mortality between 2034 and 2037 unless smoking prevalence falls by ≥30% and radon exposure is curtailed. Conclusions: Although overall laryngeal cancer mortality in Romania is declining, the pace lags behind Western Europe and is threatened by geographic inequities and pandemic-related care delays. Aggressive tobacco control, radon-remediation policies and expansion of surgical and radiotherapeutic capacity are required to avert a forecasted surge in the next decade.

Background and Clinical Significance: Tuberculosis infection triggers a chronic inflammatory response that can create a favorable environment for the development of cancer cells. Chronic inflammation can lead to DNA damage, increased cell proliferation, and impaired immune surveillance. Nasopharyngeal carcinoma is an aggressive malignant tumor with a very poor prognosis, despite the current oncology therapy. Case Presentation: The case presents following clinical, imaging, and histopathological aspects, as well as the oncological follow-up of the patient over a period of 8 years. This paper presents the case of a 49-year-old patient diagnosed with cervical lymph node tuberculosis while biopsied for the diagnosis of nasopharyngeal carcinoma with cervical lymph node metastases. Conclusions: The overlap of this malignancy with an infection of mycobacterial etiology complicates the outcome of the disease even more, making treatment and prognosis difficult.

Background: Laryngeal cancer constitutes a major burden. Accurate staging is important to determine the optimal treatment approach. However, a head-to-head comparison of diagnostic performance between CT and MRI in patients with laryngeal cancer is lacking. Furthermore, the performance of CT and MRI in detecting the invasion of different laryngeal structures is yet to be determined. Objective: To compare the diagnostic performance of CT and MRI in patients with laryngeal cancer. Methods: We searched PubMed, Scopus, and Web of Science in November 2025 for cohort studies that compared both index tests (CT and MRI) to histopathological examination of laryngeal cancer. We assessed the quality of the included studies using the QUADAS 2 tool. A bivariate meta-analysis was performed using R and RevMan software to compare pooled sensitivity and specificity, with summary receiver operating characteristic (SROC) curves generated for each outcome. Results: We included eight studies. The pooled data showed that CT was significantly less sensitive compared to MRI in detecting invasion of the thyroid cartilage with an absolute difference of −0.43 (95% CI −0.59 to −0.26), cricoid cartilage −0.65 (95% CI −1.14 to −0.15), paraglottic space −0.5 (95% CI −0.68 to −0.32), and anterior commissure −0.48 (95% CI −0.1 to −0.86). Specificity was similarly high for both modalities across all structures. For arytenoid cartilage and epiglottis invasion, MRI showed a non-significant trend towards higher sensitivity. Summary receiver operating characteristic (SROC) curves indicated superior overall diagnostic accuracy for MRI. In T-staging, MRI consistently demonstrated a lower rate of understaging compared to CT across five studies. Conclusions: MRI had superior diagnostic performance compared to CT in detecting laryngeal cartilage and deep space invasion; it had significantly higher sensitivity, comparable specificity, and lower risk of understaging, thus supporting the use of MRI for accurate pretreatment T-staging. However, given the limited number of studies, the results should be interpreted with caution, and further studies are needed to confirm our findings.

Background: Preoperative assessment of Head and Neck Squamous Cell Carcinoma (HNSCC) aggressiveness is often hindered by the sampling errors of incisional biopsies. While Contrast-Enhanced Computed Tomography (CECT) is the standard for staging, its potential to serve as a non-invasive complementary radiological tool of the entire tumor volume remains underutilized. Objective: To evaluate the predictive performance of preoperative CECT-derived tumor volume, densitometric values, and morphological features as predictors of histopathological grade and lymph node metastasis (pN) in HNSCC. The primary outcome was predicting lymph node metastasis (pN+), and the secondary outcome was predicting histopathological grade. Methods: This retrospective observational study analyzed 42 patients with SCC of the oral cavity, larynx, or maxilla. Quantitative (3D volume, Hounsfield Units [HU], HU Delta) and qualitative (margins, lobulations, necrosis) CT parameters were correlated with definitive histopathology. Diagnostic performance was assessed using Receiver Operating Characteristic (ROC) curve analysis and Spearman’s rank correlation. Results: High-grade tumors (G2/G3) demonstrated significantly larger median volumes (18.1 vs. 2.9 cm³, p = 0.006), lower contrast density (55 vs. 68 HU, p = 0.010), and reduced vascular wash-in (23 vs. 30 HU Delta, p = 0.008) compared to G1 lesions. ROC analysis identified a volume threshold of ≥9.43 cm³ for high-grade disease (AUC = 0.865; sensitivity 67.6%, specificity 100%). For regional metastasis (pN+), tumor volume was the only significant predictor (25.4 vs. 6.2 cm³, p = 0.036), with an optimal cut-off of ≥6.76 cm³ (AUC = 0.769; sensitivity 100%). Strong negative correlations were observed between contrast enhancement and internal necrosis (r = −0.812, p < 0.001). Conclusions: Preoperative CECT parameters show promise as non-invasive imaging surrogates of HNSCC aggressiveness. A paradoxical reduction in contrast enhancement characterizes high-grade biology, reflecting disorganized neo-angiogenesis and internal hypoxia. Integrating 3D volumetric analysis and morphological markers shows potential as a complementary exploratory tool that, pending future prospective validation, may support risk stratification and surgical planning alongside traditional histopathological assessment.

Background and Objectives: Laryngeal cancer imposes substantial inpatient costs in middle-income health systems. We described recent trends in laryngeal cancer hospitalizations in Romania, estimated hospital expenditure, and modeled the impact of prevention scenarios to 2035. Methods: We conducted an ecological analysis of 20,056 discharges diagnosed as laryngeal cancer (ICD-10 C32.x) between 2019 and 2023. Each episode was assigned a mean unit cost of 1100 USD, with age- and residence-specific adjustments, and re-priced using EU (3900 USD) and US (30,000 USD) tariffs. We derived annual costs and projected 2035 expenditure under three prevention scenarios. Results: Annual discharges fell from 5408 in 2019 to 3151–3212 in 2020–2021, then rose to 4409 in 2023, while inpatient spending ranged from 3.47 to 5.95 million USD, reaching 4.85 million USD in 2023 (22,200 USD/100,000 population). Re-pricing 2023 activity at EU and US unit costs yielded counterfactual totals of 17.20 and 132.27 million USD. Older adults (≥65 years) generated 47.6% of discharges and 49.1% of spending in 2023, and urban residence increased the odds of age ≥65 by 48% (OR 1.48, 95% CI 1.40–1.57). Without new prevention, costs are projected to reach 12.60 million USD by 2035; a 30% smoking reduction and a combined package including radon mitigation and dysphonia screening would lower 2035 costs to 10.33 and 9.07 million USD. Conclusions: Demographic aging and sustained case volume will markedly increase hospital costs, while prevention scenarios are associated with lower projected inpatient expenditure.

Background/Objectives: Oral squamous cell carcinoma (OSCC) is a tumor characterized by heterogeneous clinical behavior and prognosis. The tumor immune microenvironment plays a significant role in tumor progression and patient prognosis. p16 expression has been investigated as a surrogate biomarker in certain subtypes of head and neck squamous cell carcinomas, but its prognostic significance in oral squamous cell carcinoma remains incompletely elucidated. Methods: A retrospective cohort of 59 patients diagnosed with primary oral squamous cell carcinoma was analyzed. Tumor samples were evaluated for p16 expression and immunohistochemical markers associated with immune cell populations. Associations between immune microenvironment features, p16 status, and clinical outcomes such as recurrence and survival rate were analyzed. Results: p16-positive tumors were predominantly associated with immunotype A and exhibited higher densities of CD8+ cytotoxic T lymphocytes and natural killer (NK) cells. In contrast, immunotype B tumors showed similar characteristics regardless of p16 status, with no significant differences between p16-positive and p16-negative cases. Distinct immune profiles were variably associated with clinicopathological features and patient outcomes. Conclusions: These findings suggest that the immunological phenotype of oral squamous cell carcinoma may represent a potential prognostic factor.