Update On Craniofacial Cancers

The November/December issue of The Journal of Craniofacial Surgery presents a Special Section devoted to cancers of the head, face, and skull. Highlights include a review of giant congenital nevi, a relatively frequent problem that can pose a difficult challenge for surgeons; reports on a number of rare craniofacial cancers, including some unique challenges facing surgeons in non-Western countries; and some innovative treatment and reconstructive approaches.

Congenital nevi are birthmarks or moles that are present at birth small to medium-sized nevi are common and usually do not need surgery. However, a small percentage of infants have very large, or "giant" congenital nevi. These giant nevi have a high rate of transformation into malignant melanoma, an aggressive type of skin cancer.

Surgery to remove giant nevi avoids the risk of melanoma. However, the location and large size of the nevi make surgery highly challenging. The lead article in the special section highlights some of the other diseases and malformations that can be associated with giant nevi, as well as the along with the options for surgical treatment. Another article reports on the rapid development of a rare but very serious complication of giant congenital nevus, called neurocutaneous melanosis.

Other papers draw attention to rare or unusual cancers of the face, head, and neck. A study from Turkey reports on the evaluation and treatment of very large or extensive facial tumors some developing in patients who received no medical attention for many years. Although surgical reconstruction can achieve reasonably good results in such cases, "complex and long-lasting" operations should be reserved for younger patients, the authors believe. A group of Iranian surgeons describe the characteristics of cancers of the mouth in that country. They underscore the urgent need for efforts to improve early detection of oral cancers in Iran, since cancers diagnosed at an advanced stage are usually incurable.

Other studies report on rare conditions including nevus sebaceous of Jadassohn, a congenital lesion that is best recognized and removed early in life because of later cancer risk; and some rare complications of xeroderma pigmentosum, a condition that makes the skin highly sensitive to the damaging effects of ultraviolet radiation in sunlight.

The special section concludes with three reports on new scientific advances and techniques, including a study of the genetic effects of Medpor an artificial material used for bone reconstruction on bone-forming cells. Another study describes a new, gentler surgical approach to the difficult problem of removing tumors from the eye socket. The final paper reports on a new technique for preserving the colored part of the lip, or "vermilion border," for patients requiring surgery for tumors in that area.

"We hope the publication of this special section will help draw attention to some of the recent innovations and advances in the treatment of craniofacial cancers and encourage further work in this important area," comments Dr. Mutaz B. Habal, Editor-in-Chief of JCS.

About The Journal of Craniofacial Surgery

The Journal of Craniofacial Surgery serves as a forum of communication for all those involved in craniofacial and maxillofacial surgery. Coverage ranges from practical aspects of craniofacial surgery to the basic science that underlies surgical practice. Founded and edited by Mutaz B. Habal, MD, of Tampa, FL, the Journal is affiliated with major specialty societies worldwide, including the American Association of Pediatric Plastic Surgeons, the American Academy of Pediatrics Section of Pediatric Plastic Surgery, the American Society of Craniofacial Surgeons, the European Society of Craniofacial Surgery, the International Society of Craniofacial Surgery, the Japanese Society of Craniofacial Surgery, the Korean Society of Craniofacial Surgery, the Argentine Society of Plastic Surgery Section of Pediatric Plastic Surgery, the American Society of Maxillofacial Surgeons, the World Craniofacial Foundation, and the Brazilian Society of Craniomaxillofacial Surgery. Visit the journal website at http://www.jcraniofacialsurgery.com.

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