Author: Mihai Dumitru

Five-year Analysis of Head and Neck Non-Melanoma Skin Cancer Incidence, Demographics, and Site Distribution in a Tertiary Care Center

Introduction: Non-melanoma skin cancers (NMSC) represent a significant global public health burden, particularly in highincome countries. The increasing incidence of head and neck NMSC contributes to rising morbidity and necessitates multi-disciplinary management. Objectives: This study aims to evaluate the incidence, demographic distribution, histological subtypes, and seasonal variation of NMSC over a five-year period at a tertiary center in Romania. Materials and Methods: A retrospective observational study was conducted from January 2020 to December 2024, including 180 patients diagnosed and treated for malignant skin lesions. Data were extracted from clinical and histopathological records. Chi-square tests assessed seasonal distribution, and Mann-Whitney U tests compared lesion depth and surface area between demographic groups. Results: A total of 388 malignant lesions were recorded. Basal cell carcinoma (BCC) was the most common subtype (n = 168), followed by squamous cell carcinoma (SCC) (n = 25). Most patients resided in urban areas, particularly Bucharest. Males presented with significantly deeper lesions (mean: 1.5 mm) compared to females (mean: 1.25 mm; p = 0.009). Seasonal analysis revealed a significant variation in incidence, with the lowest number of cases in spring (χ² = 10.31, p = 0.016). Conclusion: The incidence of malignant skin lesions increased from 2020 to 2023, followed by a decline in 2024. Seasonal and sex-related differences were observed, with the face being the most frequent site of involvement. While the sex distribution was relatively balanced, males exhibited significantly greater lesion depths compared to females.

Tonsillar neoplasm: experience of the 2nd Otorhinolaryngology Clinic from Cluj-Napoca

Introduction. The primary tonsillar neoplasm is a common malignancy of the head and neck, alcohol and/or cigarette smoke and Human Papilloma Virus is the main etiological agent. This study offers a retrospective analysis of the tonsillar neoplasm cases in a tertiary medical center from Romania. Patients and methods. We present a 4-year (2015-2018) retrospective study on 72 patients diagnosed with tonsillar neoplasm in our clinic, previously untreated patients. The study was included only the patients diagnosed through histopathological evaluation with tonsillar neoplasm. We searched the cases in our clinic database, and we collected data about age, gender, symptoms on admission, findings of the objective physical examination, oro-pharyngoscopy, medical imaging examination results, histopathological results, stage of the disease, therapeutic management. Results. The group composition is: 75% men and 25% women, 62.5% of them are smokers. Dysphagia/swallowing discomfort was the most common symptom identified, and the non-keratinized squamous cell carcinoma was the most common histopathological form. Stage I tonsil carcinoma was diagnosed in 25% of the cases, stage II in 15.3%, while 47.2% of the cases had stage III or IV. None of the patients presented distant metastases. Lymphoma was diagnosed in 12.5% of the cases. We performed for all patients in stages I and II underwent total unilateral tonsillectomy. For the patients in stages III and IV, we performed surgery after radiotherapy-chemotherapy treatment or only radiotherapy-chemotherapy. Conclusions. In Romania, smoking is still the most important risk factor for tonsil cancer. The majority of patients have visited a doctor only when dysphagia and, above all, palpable cervical adenopathy, were present, and the tumor was in the advanced stage. In Romania, the ENT-oncology integrated medical services are few, in most cases patients are lost from otorhinolaryngological follow-up. 1 Department of Head-Neck Surgery and Otorhinolaryngology, University Clinical Hospital of Railway Company, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania 2 Department of Anatomy and Embryology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania 3 Department of Pathology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania 4 Department of Pathology, University Clinical Hospital of Railway Company, Cluj-Napoca, Romania 5 Department of Pathology, Ion Chiricuta Institute of Oncology, Cluj-Napoca, Romania 6 Department of Medical Oncology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania 7 Department of Head and Neck Surgery and Otorhinolaryngology, University Emergency Hospital, Bucharest, Romania 8 Department of Anatomy and Embryology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania 9 Department of Oral Health, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania 356

Clinicopathological Correlations and Predictors of Surgical Margins and Reconstruction in Head and Neck Non-Melanoma Skin Cancers: A retrospective study

Background: Head and neck keratinocyte carcinomas are frequently managed surgically; anatomic constraints may increase the risk of incomplete excision and influence reconstructive choices. Objectives: To describe the clinicopathological characteristics of head and neck non-melanoma skin cancers (NMSC) treated in a tertiary care dermatology department and to explore factors associated with resection status (R0 vs R1) and reconstructive approach after conventional excision. Methods: We performed a retrospective observational study of 117 patients undergoing excision of 134 primary head and neck NMSC between September 2025 and January 2026. Demographic, clinical, histopathological, and procedure-related variables were extracted from medical records and pathology reports. Margin status was assessed for conventionally excised lesions. Results: Most lesions were basal cell carcinomas (113/134, 84.3%) and were located on the cheek (31.3%) or nose (29.8%). Conventional excision was performed in 126/134 lesions (94%). Among conventionally excised lesions, 92% had complete resection (R0) and 8% had positive margins (R1), most commonly involving the lateral margin. Conclusions: In this single-center cohort, head and neck NMSC clustered in high-risk anatomic regions, and a small proportion of conventionally excised tumors showed positive margins. Clear reporting of margin involvement and reconstruction patterns may support quality improvement and guide future prospective follow-up.