Carcinoma of the piriform fossa - Erler Zimmer 3D anatomy Series MP2051

This dissection model highlighting a Carcinoma of the piriform f ossa is part of the exclusive Monash 3D anatomy series, a comprehensive series of human dissections reproduced with very high resolution color 3D printing.

Clinical History.

A 74-year-old man presented with a 2-month history of dysphagia, dysphonia and weight loss. He had a history of heavy alcohol consumption and smoked 40 cigarettes a day for 40 years. Investigation discovered a laryngeal tumor. He received radiotherapy but his tumor recurred. She died 9 months after her initial presentation.

Pathology

The specimen consisted of tongue, pharynx, larynx, esophagus and trachea and was mounted in the coronal plane. The esophagus and trachea were opened from the posterior side. A 5 x 4 x 2 cm fungal carcinoma extending into both pyriform fossae is evident. The surface of the tumor is irregular with shaggy areas of necrosis. The tumor originates from the larynx and involves both vocal cords, the left ariepiglottic fold and both piriform fossae.

Additional Information.

More than 95% of laryngeal cancers are squamous cell carcinomas. The tumor usually develops on the vocal cords but can occur above or below the cords, on the epiglottis, on the ariepiglottic folds or in the pits piriformis. The cancer usually begins as squamous cell carcinoma in situ, progresses to invasive ulcerated and fungal carcinoma with continued exposure to carcinogens. The major risk factors for the development of laryngeal cancer are tobacco smoking and alcohol consumption. Human papilloma virus (HPV) infection, asbestos exposure, and irradiation have also been shown to be associated with a higher incidence of head and neck squamous cell carcinoma (HNSCC). Males are affected more than females. It occurs most frequently in the sixth decade of life. Laryngeal cancer can spread by invading surrounding structures, by lymphatics usually to local cervical lymph nodes, or hematogenous metastasis most commonly to the lungs. Common symptoms of HNSCC at presentation include dysphonia, dysphagia, odinophagia, globus, and cough. Less commonly, hemoptysis, stridor, dyspnea, and halitosis may be described.
Treatment varies according to the stage of the disease. Smoking and alcohol cessation are important for all stages of the disease. In the early stages of the disease, laryngeal preservation treatments may include laser therapy, microsurgery, and radiation therapy. Later stage disease treatments may involve a combination of laryngectomy, radiation therapy and chemotherapy.
HPV-related HNSCC has better outcomes than those cancers that are not HPV-positive. HPV vaccination programs have been introduced in several countries, including Australia and the United Kingdom, for both boys and girls to reduce the risk of HNSCC.

What advantages does the Monash University anatomical dissection collection offer over plastic models or plastinated human specimens?

• Each body replica has been carefully created from selected patient X-ray data or human cadaver specimens selected by a highly trained team of anatomists at the Monash University Center for Human Anatomy Education to illustrate a range of clinically important areas of anatomy with a quality and fidelity that cannot be achieved with conventional anatomical models-this is real anatomy, not stylized anatomy.
• Each body replica has been rigorously checked by a team of highly trained anatomists at the Center for Human Anatomy Education, Monash University, to ensure the anatomical accuracy of the final product.
• The body replicas are not real human tissue and therefore not subject to any barriers of transportation, import, or use in educational facilities that do not hold an anatomy license. The Monash 3D Anatomy dissection series avoids these and other ethical issues that are raised when dealing with plastinated human remains.