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August 1987, Vol 113, No. 8 >
ARTICLE | August 1987

Toluidine Blue Staining of the Esophagus: Title and subTitle BreakA Useful Adjunct in the Panendoscopic Evaluation of Patients With Squamous Cell Carcinoma of the Head and Neck FREE

William R. Hix, MD; William R. Wilson, MD
[+] Author Affiliations

Accepted for publication Feb 16, 1987.

Reprint requests to Department of Surgery, Division of Cardiothoracic Surgery, The George Washington University Medical Center, 2150 Pennsylvania Ave NW, Washington, DC 20037 (Dr Hix).


Arch Otolaryngol Head Neck Surg. 1987;113(8):864-865. doi:10.1001/archotol.1987.01860080070019
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• Carcinoma of the esophagus has a much higher incidence among patients with squamous cell carcinoma of the head and neck than among the population at large. Esophageal cancer has a low cure rate, and the possibility for increased survival can be enhanced primarily through early detection. Toluidine blue has proved to be effective in demonstrating early malignant lesions that would not be detectable otherwise. A technique has been developed for toluidine blue staining of the esophagus during panendoscopy. In this initial series of 18 patients with squamous cell carcinoma of the upper aerodigestive tract, we found a 17% incidence of early carcinoma of the esophagus. We believe this technique to be an important adjunct to the evaluation of these patients at high risk for esophageal carcinoma.

(Arch Otolaryngol Head Neck Surg 1987;113:864-865)

REFERENCES

1 +
Guo-Qing W:  Endoscopic diagnosis of early oesophageal carcinoma . J R Soc Med 1981;;74:502-503.
2 +
Lundgren J, Olofsson J, Hellquist H:  Toluidine blue: An aid in the microlaryngoscopic diagnosis of glottic lesions? Arch Otolaryngol Head Neck Surg 1979;;105:169-174.
3 +
Mashberg A:  Reevaluation of toluidine blue application as a diagnostic adjunct in the detection of asymptomatic oral squamous carcinoma: A continuing prospective study of oral cancer: III . Cancer 1980;;46:758-763.
4 +
Mashberg A:  Tolonium (toluidine blue) rinse—a screening method for recognition of squamous carcinoma: Continuing study of oral cancer IV . JAMA 1981;;245:2408-2410.
5 +
Monnier P, Savary M, Anani P:  Endoscopic morphology of 'early' esophageal carcinoma , in DeMeester TR, Skinner DB (eds): Esophageal Disorders: Pathophysiology and Therapy . New York, Raven Press, 1985;, pp 333-346.
6 +
Monnier P, Savary M, Pasche R, et al:  Endoscopic morphology of microinvasive squamous cell carcinoma of the esophagus . Clin Oncol 1982;;1:559-579.
7 +
Savary M, Miller G: The Esophagus: Handbook and Atlas of Endoscopy . Solothurn, Switzerland, Verlag Gassman, 1978;, p 39.
8 +
Silverman S Jr, Migliorati C, Barbosa J:  Toluidine blue staining in the detection of oral precancerous and malignant lesions . Oral Surg 1984;;57:379-382.
9 +
Vaughan CW:  Supravital staining in early diagnosis of carcinoma . Otolaryngol Clin North Am 1972;;5:301-302.
10 +
Berg JW, Schottenfeld D, Ritter F:  Incidence of multiple primary cancers: III. Cancers of the respiratory and upper digestive system as multiple primary cancers . JNCI 1970;;44:263-274.
11 +
Cahan WG:  Multiple primary cancers of the lung, esophagus and other sites . Cancer 1977;;40( (suppl) ):1954-1960.
12 +
Cahan WG, Castro EB, Rosen PP, et al:  Separate primary carcinomas of the esophagus and head and neck region in the same patient . Cancer 1976;;37:85-89.
13 +
Gluckman JL, Crissman JD:  Survival rates in 548 patients with multiple neoplasms of the upper aerodigestive tract . Laryngoscope 1983;;93:71-74.
14 +
Gluckman JL, Crissman JD, Donegan J:  Multicentric squamous cell carcinoma of the upper aerodigestive tract . Head Neck Surg 1980;;3:90-96.
15 +
Lefor AT, Bredenberg CE, Kellman RM, et al:  Multiple malignancies of the lung and head and neck . Arch Surg 1986;;121:265-270.
16 +
Marks PH, Schechter FG:  Multiple primary carcinomas of the head, neck, and lung . Ann Thorac Surg 1982;;33:324-332.
17 +
McGuirt WF:  Panendoscopy as a screening examination for simultaneous primary tumors in head and neck cancer: A prospective sequential study and review of the literature . Laryngoscope 1982;;92:569-576.
18 +
Shons AR, McQuarrie DG:  Multiple primary epidermoid carcinomas of the upper aerodigestive tract . Arch Surg 1985;;120:1007-1009.
19 +
Tepperman BS, Fitzpatrick PJ:  Second respiratory and upper digestive tract cancers after oral cancers . Lancet 1981;;2:547-549.
20 +
Vrabec D:  Multiple primary malignancies of the upper aerodigestive system . Ann Otol Rhinol Laryngol 1979;;88:846-854.
21 +
Yellin A, Hill RL, Benfield JR:  Bronchogenic carcinoma associated with upper aerodigestive cancers . J Thorac Cardiovasc Surg 1986;;91:674-683.
22 +
Moertel CG, Dockerty MB, Baggenstoss AH:  Multiple primary malignant neoplasms: III. Tumors of multicentric origin . Cancer 1961;; 14:238-248.
23 +
Wynder EL, Mushinski MH, Spivak JC:  Tobacco and alcohol consumption in relation to the development of multiple primary cancers . Cancer 1977;;40( (suppl) ):1872-1878.
24 +
Richart RM:  A clinical staining test for the in vivo delineation of dysplasia and carcinoma in situ . Am J Obstet Gynecol 1963;;86:703-712.
25 +
Beker S, Eslava F, Zerpa H, et al:  Endoscopic toluidine blue scattering method in the diagnosis of gastric lesions . Gastrointest Endosc 1977;;24:72-73.
26 +
Giler S, Kadish U, Urea I:  Use of tolonium chloride in the diagnosis of malignant gastric ulcers . Arch Surg 1978;;113:136-139.
27 +
Herlin P, Marnay J, Jacob JH, et al:  A study of the mechanism of the toluidine blue dye test . Endoscopy 1983;;15:4-7.
28 +
Leipzig B, Zellmer JE, Klug D:  The Panendoscopy Study Group: The role of endoscopy in evaluating patients with head and neck cancer . Arch Otolaryngol Head Neck Surg 1985;;111:589-594.
29 +
Naef A, in discussion, Yellin A, Hill LR, Benfield JR:  Bronchogenic carcinoma associated with upper aerodigestive cancers . J Thorac Cardiovasc Surg 1986;;91:674-683.

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1 +
Guo-Qing W:  Endoscopic diagnosis of early oesophageal carcinoma . J R Soc Med 1981;;74:502-503.
2 +
Lundgren J, Olofsson J, Hellquist H:  Toluidine blue: An aid in the microlaryngoscopic diagnosis of glottic lesions? Arch Otolaryngol Head Neck Surg 1979;;105:169-174.
3 +
Mashberg A:  Reevaluation of toluidine blue application as a diagnostic adjunct in the detection of asymptomatic oral squamous carcinoma: A continuing prospective study of oral cancer: III . Cancer 1980;;46:758-763.
4 +
Mashberg A:  Tolonium (toluidine blue) rinse—a screening method for recognition of squamous carcinoma: Continuing study of oral cancer IV . JAMA 1981;;245:2408-2410.
5 +
Monnier P, Savary M, Anani P:  Endoscopic morphology of 'early' esophageal carcinoma , in DeMeester TR, Skinner DB (eds): Esophageal Disorders: Pathophysiology and Therapy . New York, Raven Press, 1985;, pp 333-346.
6 +
Monnier P, Savary M, Pasche R, et al:  Endoscopic morphology of microinvasive squamous cell carcinoma of the esophagus . Clin Oncol 1982;;1:559-579.
7 +
Savary M, Miller G: The Esophagus: Handbook and Atlas of Endoscopy . Solothurn, Switzerland, Verlag Gassman, 1978;, p 39.
8 +
Silverman S Jr, Migliorati C, Barbosa J:  Toluidine blue staining in the detection of oral precancerous and malignant lesions . Oral Surg 1984;;57:379-382.
9 +
Vaughan CW:  Supravital staining in early diagnosis of carcinoma . Otolaryngol Clin North Am 1972;;5:301-302.
10 +
Berg JW, Schottenfeld D, Ritter F:  Incidence of multiple primary cancers: III. Cancers of the respiratory and upper digestive system as multiple primary cancers . JNCI 1970;;44:263-274.
11 +
Cahan WG:  Multiple primary cancers of the lung, esophagus and other sites . Cancer 1977;;40( (suppl) ):1954-1960.
12 +
Cahan WG, Castro EB, Rosen PP, et al:  Separate primary carcinomas of the esophagus and head and neck region in the same patient . Cancer 1976;;37:85-89.
13 +
Gluckman JL, Crissman JD:  Survival rates in 548 patients with multiple neoplasms of the upper aerodigestive tract . Laryngoscope 1983;;93:71-74.
14 +
Gluckman JL, Crissman JD, Donegan J:  Multicentric squamous cell carcinoma of the upper aerodigestive tract . Head Neck Surg 1980;;3:90-96.
15 +
Lefor AT, Bredenberg CE, Kellman RM, et al:  Multiple malignancies of the lung and head and neck . Arch Surg 1986;;121:265-270.
16 +
Marks PH, Schechter FG:  Multiple primary carcinomas of the head, neck, and lung . Ann Thorac Surg 1982;;33:324-332.
17 +
McGuirt WF:  Panendoscopy as a screening examination for simultaneous primary tumors in head and neck cancer: A prospective sequential study and review of the literature . Laryngoscope 1982;;92:569-576.
18 +
Shons AR, McQuarrie DG:  Multiple primary epidermoid carcinomas of the upper aerodigestive tract . Arch Surg 1985;;120:1007-1009.
19 +
Tepperman BS, Fitzpatrick PJ:  Second respiratory and upper digestive tract cancers after oral cancers . Lancet 1981;;2:547-549.
20 +
Vrabec D:  Multiple primary malignancies of the upper aerodigestive system . Ann Otol Rhinol Laryngol 1979;;88:846-854.
21 +
Yellin A, Hill RL, Benfield JR:  Bronchogenic carcinoma associated with upper aerodigestive cancers . J Thorac Cardiovasc Surg 1986;;91:674-683.
22 +
Moertel CG, Dockerty MB, Baggenstoss AH:  Multiple primary malignant neoplasms: III. Tumors of multicentric origin . Cancer 1961;; 14:238-248.
23 +
Wynder EL, Mushinski MH, Spivak JC:  Tobacco and alcohol consumption in relation to the development of multiple primary cancers . Cancer 1977;;40( (suppl) ):1872-1878.
24 +
Richart RM:  A clinical staining test for the in vivo delineation of dysplasia and carcinoma in situ . Am J Obstet Gynecol 1963;;86:703-712.
25 +
Beker S, Eslava F, Zerpa H, et al:  Endoscopic toluidine blue scattering method in the diagnosis of gastric lesions . Gastrointest Endosc 1977;;24:72-73.
26 +
Giler S, Kadish U, Urea I:  Use of tolonium chloride in the diagnosis of malignant gastric ulcers . Arch Surg 1978;;113:136-139.
27 +
Herlin P, Marnay J, Jacob JH, et al:  A study of the mechanism of the toluidine blue dye test . Endoscopy 1983;;15:4-7.
28 +
Leipzig B, Zellmer JE, Klug D:  The Panendoscopy Study Group: The role of endoscopy in evaluating patients with head and neck cancer . Arch Otolaryngol Head Neck Surg 1985;;111:589-594.
29 +
Naef A, in discussion, Yellin A, Hill LR, Benfield JR:  Bronchogenic carcinoma associated with upper aerodigestive cancers . J Thorac Cardiovasc Surg 1986;;91:674-683.

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