• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1993년도 제27차 학술대회 초록집
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• pp.96-96
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• 1993

두경부 종양의 1%를 차지하는 타액선 종양은 조직학적인 다양성 때문에 진단과 치료결정이 어렵고 자세한 병력이 중요하다. 1987년 1월부터 1992년 12월까지 본원 이비인후과에서 조직학적으로 확진된 타액선 종양 70례를 대상으로 후향적인 방법으로 성별 분포, 연령별 분포, 부위별 분포, 양성종양의 크기, 병리조직학적 분류, 중상발현 기간, 임상증상, 경부 림프절전이, 병기별 분포, 치료, 안면신경마비 및 재발 둥을 비교 분석하여 다음과 같은 결과를 얻었다. 1) 이하선에 35례(50%), 악하선에 16례(23%), 부타액선에 19례(27%) 발생했다. 2) 양성종양이 55례(79%), 악성종양이 15례(21%) 였고, 양성종양은 다형성선종이 49례(89%), 악성종양은 선낭포암이 6례(40%)로 가장 많았다. 3)증상발현 기간은 1-5년이 29례(41%)로 가장 많았다. 4) 이하선과 악하선 수술후 안면신경마비가 9례(18%)에서 있었고, 재발은 4례(6%)에서 발생하였다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제32권4호
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• pp.384-390
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• 2006

Pleomorphic adenoma is the most common salivary benign tumor, constituting over 60% of parotid gland tumor, 25% of sublingual gland tumor and 50% of minor salivary gland tumor. It is somewhat more frequent in the fourth to sixth decades. The recurrent rate which enforces only a simple enucleation is very high $(20{\sim}45%)$. Histologically, it contains the epithelial cell, the myo-epithelial cell and mesenchymal ingredient, which is various aspect. We analyzed clinicopathologically and immunohistochemically the patients(34 cases) who are diagnosed with pleomorphic adenoma in Dept. of Oral & Maxillofacial Surgery, College of Dentisty, Dankook university since 1998. The results are as follow: 1. The incidence of the tumor was most frequent in age 30 to 50. The ratio of male to female was 1:1.43. 2. The most chief complain was a painless mass(94.1%) and the duration time was more than decade in 18 cases(52.9%). 3. Palate(soft & hard palate) was the most occurred site(64.7%). In major salivary glands, the parotid gland was the most frequent site(17.6%). 4. The tumor size was 2 to 3cm on the average. Most of tumors were with capsule(91.2%). 5. Surgical excision was a main treatment method(20 cases, 58.8%) and 14 cases were excised with a glandectomy, 1 case was treated with a partial maxillectomy. Only 1 case of all cases was recurred. 6. Histopathologically, 9 cases(26.5%) were cellular type, 11 cases(32.4%) were intermediate(classic) type and 14 cases(41.1%) were myxoid type. 7. Immunohistochemically, the specimen of all tumors reacted positively to cytokeratin and vimentin marker.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제34권3호
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• pp.245-249
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• 2008

Epidermal growth factor is a single-chain polypeptide consisting of 53 amino acids and has a potent mitogenic activity that stimulates proliferation of various normal and neoplastic cells through the interaction with its specific receptor(epidermal growth factor receptor, EGFR). Pleomorphic adenoma is the most common salivary benign tumor and histologically, it contains the epithelial cell, the myo-epithelial cell and mesenchymal ingredient, which is various aspect. Adenoid cystic carcinoma is an infiltrative malignant salivary gland tumor with three different histological patterns: cribriform, tubular or solid. The tumor cell structure composed of modified myoepithelial cell, and basaloid cell. In this study, we used an immunohistochemical technique to investigate the expression of EGF in 6 specimens of adenoid cystic carcinoma and 10 specimens of pleomorphic adenoma taken from patients treated at Dept. of Oral and Maxillofacial Surgery, Dankook University. The results were as follows. 1. In pleomorphic adenoma, ductal structure and scattered spindle cells in hyalinized stroma, disclosing myxoid stroma and hyalin, cartilage formation were observed. Immunohistologically, weak EGF expression in ductal structure and negative in stromal area were observed. 2. Cribriform type of adenoid cystic carcinoma showed numerous pseudocyst surrounded by dark small neoplastic cells in the back-ground of fibrous connective tissue and moderate EGF expression of dark cells adjacent to pseudo lumen in cribriform pattern, while weak expression in other most cells. 3. Tubular type of adenoid cystic carcinoma showed numerous ductal pattern surrounded by two layered neoplastic cells in the back-ground of fibrous connective tissue and strong EGF expression in luminal cells of ductal structure, while weak expression in outer cells. From the results obtained, we suggest that EGF is mainly biosynthesized in cells forming duct like structures of tubulo-ductal type or cribriform adenoid cystic carcinoma and it may play a role, as a cell mitogen in adenoid cystic carcinoma growth.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제31권2호
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• pp.170-177
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• 2005

The pleomorphic adenoma is well recognized as the most common salivary neoplasm. We examined 49 patients who had received surgical excision of the pleomorphic adenoma from 1989 to 1998 with over 5 years follow-up period. We retrospectively evaluated the patients' age, sex, chief complaints, surgical methods, and recurrence or complication rates after analysis of one's clinical and surgical records. The results are as follows : 1. There were 15 cases in parotid gland, 23 cases in palate, 8 cases in submandibular gland, and 3 cases in cheek. The ratio of male to female was 1 : 1.13. The mean age was 44. The tumor of submandibular gland occurred in more younger age than that of other salivary gland. 2. In 15 patients of parotid pleomorphic adenoma, there was 1 case(6.7%, 1/15) of recurrence. That was transformed into the malignant pleomorphic adenoma after 4 years of first surgery. We performed superficial parotidectomy of 9 cases(56.2%, 9/16), total parotidectomy of 6 cases(37.5%, 6/16), and radical parotidectomy of 1 case(6.3%, 1/16). 3. We used the rotational Sternocleidomastoid muscular flap to cover the exposed facial nerve in 12 cases(75%) after parotidectomy(7 cases of superficial parotidectomy and 5 cases of total parotidectomy). We could see 3 cases(18.7%) of facial nerve palsy and 1 case(6.3%) of Frey's syndrome after parotidectomy. We examined Frey's syndrome in only 1 case which was not used SCM muscular flap after parotidectomy. 4. In 23 patients of palatal pleomorphic adenoma, there were 2 cases(8.7%) of recurrence. In recurrence cases, We performed re-excision after 4 and 5 years of first surgery, respectively. We preserved partial thin overlying palatal mucosa during tumor excision in 5 cases(20%), which were proved as benign mixed tumor in preoperative biopsy. That mucosa-preserved cases had thick palatal mucosa, did not show mucosa ulceration and revealed well encapsulated lesions in preoperative CT. 5. In palatal tumors, we could see the 13 cases(52%) of bony invasion in preoperative CT views and the 4 cases(16%) of oro-nasal fistula after tumor excision. In two cases of recurrence, one(20%, 1/5) was in palatal mucosa-preserved group and the other(5.5%, 1/18) was in palatal mucosa-excised group. 6. We excised tumors with submandibular glands in the all cases of submandibular pleomorphic adenoma. There was no specific complication or recurrence in these cases. 7. After excision of the cheek pleomorphic adenomas, we could not see any complication or recurrence.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제28권1호
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• pp.1-12
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• 2006

Pleomorphic adenoma is the most common benign tumor in salivary glands, and occurred in frequency of 60% in parotid gland tumors, and 50% in submandibular gland tumors, and 25% in sublingual gland tumors. Histopathologically, pleomorphic adenoma is composed of epithelial cells and mesenchymal tissues, and called 'mixed tumor' because of morphological divergency. The cell structures of luminal area are composed of polyhedral and cuboidal secretory epithelial cells and modified myoepithelial cells around it, and mesenchymal tissue is composed of some myoepithelial cells and stromal tissue. In stromal tissue, myxoid change, chondroid change, or hyalinization can be seen even if bone tissue. In many studies, tumor cells of pleomorphic adenoma containing modified myoepithelial cell participate in synthesis of glycosaminoglycans. In this study, tissue sample of pleomorphic adenoma of human salivary gland were obtained from 20 surgical specimens, and all specimens were routinely fixed in 10% formalin and embedded. Serial 4-8${\mu}m$ thick sections were cut from paraffin blocks. The histopathologic evaluation was done with light microscopy. And, with immunohistochemical staining, characteristics of glycosaminoglycan were observed. And, for biochemical analysis of glycosaminoglycan, isolation of crude glycosaminoglycan from tumor tissue and immuno-blot analysis were carried out. With transmission electromicroscopy, tumor cells and biologic behavior of pleomorphic adenoma were observed with distribution and expression of glycosaminoglycan in tumor cells, The results were obtained as follows: 1. In immunohistochemical study, chondroitin 4-sulfate is highly postively stained in myxoid stromal tissue, and chondroitin 6-sulfate is highly positively stained in chondroid mesenchymal tissue, both glycosaminoglycans are positively stained in non-luminal cell of ductal area. 2. Dermatan sulfate and keratan sulfate is positively stained in periductal non-luminal tumor cells. 3. In immunohistochemical study, heparan sulfate is weakly stained in luminal cells and non-luminal cells around duct, and chondroid mesenchymal tissue. 4. In transmission electromicroscopic view, the tumor cells are composed of modified myoepithelial cells, and contain many microfilaments and well developed rough endoplasmic reticulum. 5. In Immuno-Blot analysis, the expression of glycosaminoglycans is expressed mostly in chondroitin 6-sulfate and chondroitin 4-sulfate. From the results obtained in this study, tumor cells of pleomorphic adenoma are composed of modified myoepithelial cells, and glycosaminoglycans of chondroitin 4-sulfate and chondroitin 6-sulfate mostly participate in the development of pleomorphic adenoma, but dermatan sulfate, keratan sulfate and heparan sulfate glycosaminoglycans were expressed variably.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제31권6호
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• pp.501-508
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• 2005

21세 여자의 이하선에 발생한 다형성 선종과 15세 남자의 이하선에 발생한 신경섬유종에 대하여 변형된 이내 및 경부접근법을 사용한 외과적 절제술을 시행하였다. 우리가 사용한 변형된 이내 및 경부접근법은 Starck 등의 변형된 이내접근법과 Gutierrez의 경부 연장술을 병용한 새로운 접근법이다. 우리는 이 접근법을 사용하여 특별한 문제없이 이하선에 접근하여 종양을 절제하였고, 수술 후 반흔은 외이와 머리카락 내에 감춰져 심미적으로 만족할 만하였다. 이 접근법은 이하선 종양에 이용될 수 있을뿐 아니라 경부 연장을 하지 않고 변형된 이내접근법만을 시행할 경우 악관절수술에도 이용될 수 있다.