• Walter Adriano Bianchini, Albina Maria Altemani, and Jorge Rizzato Paschoal.
• Department of Otorhinolaryngology, Hospital das Clínicas, Universidade Estadual de Campinas, Campinas, São Paulo, Brazil. ccoccp@terra.com.br
• Sao Paulo Med J. 2003 Nov 6; 121 (6): 244247244-7.

ContextUndifferentiated head and neck and skull base tumors are not unusual. They can arise in mucosa as well as in salivary glands, soft tissues or lymph nodes. Suitable therapy and prognosis for each case depends upon precise histopathological diagnosis.ObjectiveTo evaluate the role of immunohistochemical techniques in determining the conclusive diagnosis. The occurrence of these tumors in our service and the way in which they were distributed according to cell pattern, patient's age and tumor location was also evaluated.Type Of StudyCross-sectional study.SettingHospital das Clínicas, Universidade Estadual de Campinas, Campinas, São Paulo, Brazil.Participants43 biopsies performed between January 1990 and December 1997, diagnosed as undifferentiated head and neck tumors.ProceduresWe applied an immunohistochemical panel in accordance with the avidin-biotin-peroxidase complex method. The final diagnosis was achieved after new analysis in conjunction with biopsies stained using the hematoxylin-eosin technique.Main MeasurementsThis study evaluated undifferentiated tumors in head and neck, and the way in which they were distributed, according to cell pattern, patient's age and tumor location.ResultsThe most frequent locations for undifferentiated tumors were the lymph nodes, 20.9%; pharynx and neck, 16.3%; paranasal sinus, 14%; and nose, 11.6%. They were most prevalent during the seventh decade of life (34.9%), and twice as prevalent in men as in women. The immunohistochemical technique allowed conclusive diagnosis for 60.5% of the tumors and was suggestive for 20.9% of the biopsies. The most prevalent cell pattern was round cells (51.2%), followed by epithelioid cells (20.9%), spindle cells (16.3%), myxoid pattern (9.3%) and pleomorphic cells (2.3%).ConclusionOur results demonstrate the fundamental role of the immunohistochemical technique for conclusive diagnosis of undifferentiated tumors.

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