Introduction: To enable head and neck cancer to be detected and treated early to improve treatment outcomes, it needs to be more widely and accurately recognized by the general public.
Methods: As a project to raise recognition of head and neck cancer by the Public Relations Committee of the Japan Society for Head and Neck Cancer, a questionnaire survey was administered to 1,574 members of the general public at an event held on Conquer Head and Neck Cancer Day.
Results: Recognition of head and neck cancer was 45.6％, higher among the elderly and not different by gender. Pharyngeal and laryngeal cancers were recognized as head and neck cancers by about 80％, while tongue and thyroid cancers were recognized by about 30％. The most common means of gathering medical information were from their family doctor （74.3％）, the internet （42.9％）, and friends who are medical professionals （35.4％）, followed by TV, newspapers, SNS, and friends who are not medical professionals. There were no differences in collection methods by age or gender.
Discussion: To increase the degree of recognition of head and neck cancer, it is important to raise recognition among physicians in other departments and medical professionals and to disseminate information via the internet.

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Radiation therapy （RT） for early-stage glottic cancer （Stage Ⅰ, Ⅱ） achieves high local control and voice preservation rates. While standard fractionated RT （2Gy/fr） is still widely used, hypofractionated RT, which completes treatment in a shorter period, is gaining attention. This study retrospectively examined the efficacy and safety of a 52.5Gy/16fr （3.28Gy/fr） hypofractionated regimen performed at our institution. Nineteen patients who underwent a 16 fraction hypofractionated regimen for early-stage laryngeal cancer between 2011 and 2024 were included. The five-year local control and laryngeal preservation rates were both 100％, with overall survival rates of 100％ at 1 year, 81％ at 3 years, and 56％ at 5 years. Progression-free survival rates were 95％ at 1 year, 77％ at 3 years, and 53％ at 5 years. Acute adverse events included dermatitis （Grade 1/2/3＝15/4/0 patients） and mucositis （Grade 1/2/3＝4/14/1 patients）. Late adverse effects included 2 cases of Grade 1 dysphagia, with no other late adverse events observed. These findings suggest that the 52.5Gy/16 fraction hypofractionated RT is a safe and effective treatment option for patients who require a shorter treatment period.

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Mandibular reconstruction in patients with lost mandibular continuity due to segmental resection is essential for both functional and aesthetic recovery. One reconstruction method involves the use of a titanium mesh plate and autogenous bone grafting. Mandibular reconstruction using this method has several advantages, including procedural simplicity and shorter operative time. Additionally, this method allows the reconstruction of a shape close to the anatomical contour of the mandible, making prosthetic treatment easier. However, there are few reports on the long-term outcomes of cases in which occlusal loading was achieved after reconstruction.
In this study, we conducted a clinical evaluation of long-term cases in which mandibular reconstruction was performed using titanium mesh and autogenous iliac bone grafting, followed by implant-supported prosthetic treatment. The results showed that in cases of benign tumors, no complications related to the titanium mesh occurred during the long-term follow-up （mean duration of 16 years and 8 months）. However, in 40％ of cases involving malignant tumors, removal of the titanium mesh was necessary.
When using titanium mesh in malignant tumor cases, it is recommended to either remove the titanium mesh after bone regeneration or ensure adequate soft tissue reconstruction during initial surgery.

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The patient was a 58-year-old man diagnosed with nasopharyngeal carcinoma （T1N3M1, stage ⅣB）. He received 15 courses of pembrolizumab, an immune checkpoint inhibitor. Two months after treatment, he presented to the emergency department with complaints of nausea, vomiting, and fatigue. A chest computed tomography scan revealed pericardial effusion. The patient was hospitalized for suspected pericarditis or myocarditis due to immune-related adverse events （irAE）, and was started on 60mg of prednisolone. However, six hours after admission, he exhibited symptoms of seizures and deterioration in cardiac function. Therefore, a steroid pulse with 1,000mg of methylprednisolone was administered for 3 days. Subsequently, the prednisolone dose was tapered from 60mg, and he was discharged on hospital day 22. Although the fatality rate for irAE myocarditis is reported to be around 50％, in this case, early therapeutic intervention resulted in successful survival. Moreover, it has been reported that ICIs show higher antitumor efficacy in cases where irAE occurs. Also, in this case, both the primary and metastatic lesions have remained reduced in size.

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We report a case of refractory SIADH associated with carboplatin administration. The patient was a 74-year-old woman with a local recurrence of nasopharyngeal carcinoma. Pembrolizumab was administered to treat the local recurrence, but the disease progressed. Carboplatin, 5-FU, and cetuximab were administered as secondary treatment. The patient presented with headache and anorexia on the 7th day of administration, and lethargy, upper limb convulsions and severe hyponatremia （110mEq/L） on the 8th day. 3％ hypertonic saline was administered, and consciousness improved 6 hours after administration. The results of the examination on the 8th day met the diagnostic criteria for the syndrome of inappropriate antidiuretic hormone secretion （SIADH）, which required differentiation from renal salt wasting syndrome （RSWS）. There was no obvious dehydration, so the patient was diagnosed with SIADH. From the 11th day, serum sodium decreased again. Although fluid restriction was implemented from the 18th day, serum sodium sometimes fell below the reference value, so a vasopressin V₂ receptor antagonist was administered from the 23rd day. Serum sodium improved to within the normal range on the 29th day, and the patient was discharged on the 30th day.

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Total thyroidectomy is recommended for high-risk papillary thyroid cancer. However, there is a risk of bilateral recurrent laryngeal nerve paralysis when both lobes are resected initially. Some reports from foreign countries described the significance of staged thyroidectomy intraoperatively for prevention of bilateral recurrent laryngeal nerve paralysis. We present a case in whom recurrent nerve paralysis was not observed preoperatively, but bilateral recurrent nerve invasion by tumors was suspected from preoperative images. To prevent bilateral recurrent nerve paralysis, planned staged thyroidectomy was conducted. When the left lobe was resected, the left recurrent laryngeal nerve that was invaded by the tumor could be preserved under a surgical microscope. Because recurrent nerve palsy was not observed postoperatively, the right lobe was resected secondarily. Only one funicle of the right recurrent nerve could be protected from invasion of the tumor. Though right recurrent nerve paralysis was observed postoperatively, mobility of the vocal cords was recovered 3 months later. The prognosis of papillary thyroid cancer is not affected by staged thyroidectomy, therefore, planned staged surgery should be considered when selecting total thyroidectomy to prevent bilateral recurrent nerve paralysis.

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HER2 overexpression is also seen in cases of adenocarcinoma, breast cancer, gastric cancer, etc. Amongst head and neck cancers, salivary duct carcinoma is the most well-known histological type. However, reports of HER2 positive primary unknown adenocarcinoma with cervical lymph node metastasis are extremely rare. We experienced a case of HER2 positive primary unknown adenocarcinoma with cervical lymph node metastasis. A 56-year-old male, who complained of a neck mass, had multiple lymph node enlargement, a tumor in the left lobe of the thyroid and multiple pulmonary nodules. Lymphadenectomy showed GCDFP-15 positive adenocarcinoma with apocrine differentiation. Primary tumor was not indicated by various examinations, and no result suggested a diagnosis of thyroid cancer or salivary duct cancer. While starting to treat the patient as primary unknown cancer, we performed comprehensive genome profiling. ERBB2 was highly amplified, and immunostaining showed HER2（3＋）. Following treatment as HER2 positive breast cancer, the patient has shown a partial response for 3 years until now.

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