• 제목/요약/키워드: Adenoid Cystic Carcinoma

검색결과 150건 처리시간 0.03초

기관지 선종의 외과적 치료[17례 보고] (Surgical Treatment of Bronchial Adenoma - Reports of 17 Cases -)

  • 문석환
    • Journal of Chest Surgery
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    • 제25권3호
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    • pp.247-257
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    • 1992
  • Bronchial adenoma, firstly described by Muller[1882] had been reported on the subject stressed their benign nature prior to 1940`s, but these tumors including carcinoid tumor, mucoepidermoid carcinoma, adenoid cystic carcinoma, pleomorphic adenoma are now known to possess the various degree of malignant natures from benign course, low grade malignant potential to distant lymphatic or hematogenous metastasis or combination. Although histologically diffeerent, four varieties except carcinoid tumor which is a spectrum of neu-roendocrine tumor originating Kulchitsky cell of the bronchial epithelium and form the part of the APUD tumor spectrum, are morphologically and in many respects clinically similar to the corresponding tumor of the salivary gland is a specific varient of adenocarcinoma that occurs most commonly in the major and minor salivary gland and less frequently tra-cheobronchial tree, esophagus etc. To better understand the clinical characteristics and assess more precisely the malignat nature of bronchial adenoma, we studied 17 cases of bronchial adenoma, which had been experienced at the Department of Thoracic and Cardiovascular surgery of Catholic University Medical College from April 1977 to september 1991. Seventeen cases of bronchial adenoma consist of 2 carcinoid tumors, 6 adenoid cystic carcinomas, 8 mucoepidermoid carcinomas and one pleomorphic adenoma. There is a slight predominace of male patients[10/17] and the age of pt studied varied with a higher incidence occurring between the ages of 40 years and 60 years[mean age, 46.5 years]; the youngest being 15 years and oldest 69 years. Their leading complaints were hemoptysis[4], exertional dyspnea[8], fever & chilness [4], and symptoms mimicking the bronchial asthma[4]. Diagnosis was aided by the radiologic studies such as chest X-ray, polytomography, CT scan, brochography and bronchoscopy. The preferred locations of fumor were in the trachea[4], main stem bronchus[3], bronchus intermedius[3], bronchus of RUL[2], LUL[1], RLL[1], LLL[3] with no peripheral location. Modalities of treatments were single or combination of surgical resection, radiation therapy, chemotherapy. Complete resections were permitted in 12 cases with late recurrences of 4 cases ranging from 6 months to 10 years: pneumonectomy[4], lobectomy[4], bil-obectomy[2], sleeve resection[2]. Gross findings of resected specimens in 14 cases showed that 4 cases were polyp-like pedunculated mass[entirely intraluminal mass] with intact mucosa, 8 cases were broad-bas-ed sessile mass[predominatly intraluminal] and the main portions were located below the mucosa similar to tip of iceburg[predominantly extraluminal] in 2 cases. Follow-up information was availble in all 17 cases ; eight were alive without evidence of disese ranging from 1 month to 13 years. But seven cases died of the causes related to tumor[6 cases within 12 months, one case 10 years after pneumonectomy]. We concluded that 8 cases[47%] of 17 cases were metastasizing bronchial adenoma and precise survival rate cannot be answered by the scanty materials available for study.

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이하선 악성종양에 대한 방사선 치료의 효과 (Radiation Therapy in Malignant Tumors of the Parotid Gland)

  • 김원동;박찬일;김광현
    • Radiation Oncology Journal
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    • 제12권1호
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    • pp.43-50
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    • 1994
  • 1979년 3월부터 1989년 7월사이에 서울대학교병원 치료방사선과에서 55명의 환자가 이하선에 생긴 악성종양으로 치료를 받았다. 이 환자들을 대상으로 방사선 치료의 효과를 알아보기 위해 저자들은 후향성조사를 하였으며 다음과 같은 결과를 얻었다. 8명의 환자는 수술이 불가능하거나 재발한 경우로 방사선 치료만 받았으며 나머지 47명에게는 수술후 방사선 치료를 추가하였다. 이 환자들의 중앙추적기간은 48개월이었다. 조직학적으로는 mucoepidermoid ca가 25명으로 제일 많았으며 malignant mixed tumor와 adenoid cystic ca가 각각 12명, 6명이었다. 모든 환자에 있어서 국소치유율은 10년에 65.7%였으며 수술과 방사선 치료를 병합한 군이 방사선 단독 치료군보다 양호한 결과를 나타내었다(71.8% 대 28.6%). 조직학적 grade 및 종양의 크기, 임파절의 전이 여부가 국소치유율을 결정하는 요인이었으며 안면신경의 절제유무는 국소치유율에 영향을 주지 못했다. 원격전이는 환자의 23.6%에서 일어났으며 주로 high grade 병변에서 폐를 침범하였다. 전체생존율은 10년에 72.2%였으며 5년이후에는 plateau를 이루었다. 무병생존율은 10년에 49.4%였으며 수술과 방사선 치료를 병합한 군과 low grade 병변에서 좀 더 양호한 결과를 나타내었다. 결론적으로 이하선 악성종양의 치료에 있어서 이하선 절제술과 적절한 방사선치료를 병합함으로써 수술 혹은 방사선 단독 치료군보다 국소치유율의 향상 및 안면신경의 기능유지를 도모할 수 있으며 환자의 생존율을 높이기 위해서는 원격전이시 보다 효과적으로 작용하는 항암제의 개발이 시급하다 하겠다.

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구강암 환자에서 $^{18}F$ FDG-PET/CT의 경부 림프절 전이 평가 유용성 (USEFULNESS OF $^{18}F$-FDG PET/CT IN THE EVALUATION OF CERVICAL LYMPH NODE METASTASIS IN PATIENTS WITH ORAL CANCER)

  • 유민기;유선열
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제35권4호
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    • pp.213-220
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    • 2009
  • Purpose: The present study was aimed to examine the usefulness of 18F-FDG PET/CT in the evaluation of cervical lymph node metastasis in patients with oral cancer. Materials and methods: Twenty-two patients who underwent neck dissection to treat oral cancer were subjected for examination. The cervical node metastasis was evaluated by means of clinical examination, CT scan, PET, and histologic examination. By comparing the results of each examination modality with those of histologic examination, it's sensitivity, specificity, positive predictive value, and negative predictive value were determined. Results: The oral cancer was more frequent in males with a ratio of 2.14:1. The sixth decade showed the highest incidence in age distribution with mean of $56{\pm}16$. Histologic findings showed that squamous cell carcinoma was the most common (15 patients), and mucoepidermoid carcinoma (3), malignant melanoma (2), and adenoid cystic carcinoma and ghost cell odontogenic carcinoma (1 each), in order. In most cases, wide surgical excision of the primary cancer and neck dissection was performed, followed by reconstruction with free flaps when necessary. When comparing the results of each examination modality with those of the histologic examination, clinical examination showed sensitivity, specificity, positive predictive value, and negative predictive value at 11%, 85%, 33%, and 58%, respectively. CT scans showed at 67%, 77%, 67%, and 77%, while $^{18}F$-FDG PET/CT at 78%, 77%, 70%, and 83%, respectively. Conclusions: These results suggest that PET is more useful, compared with clinical examination and CT scans, in the evaluation of cervical lymph node metastasis in patients with oral cancer.

타액선 선양낭성암종에서 상피성장인자 신호전달 단백의 발현에 관한 면역조직화학적 연구 (IMMUNOHISTOCHEMICAL ASSAYS FOR THE EXPRESSION OF EPIDERMAL GROWTH FACTOR-SIGNALING PROTEINS IN ADENOID CYSTIC CARCINOMAS OF HUMAN SALIVARY GLANDS)

  • 박영욱;김정환
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제28권6호
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    • pp.499-510
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    • 2006
  • 인간 타액선 선양낭성암종 조직 18례에 대한 면역조직화학적 염색을 시행하여 종물 주변의 정상 타액선 조직과 비교, 분석하여 다음과 같은 결과를 도출하였다. 1) EGF는 타액선 도관세포와 암종 조직의 50%에서 발현 되었으며, 정상 타액선 조직과 비교하여 암종 조직에서 발현이 증가되어 있지 않았다. 2) $TGF-{\alpha}$는 타액선 도관세포와 선포세포, 그리고 거의 모든 암종 조직에서 발현되었으며, 정상 타액선 조직과 비교하여 암종 조직에서 그 발현이 유의하게 증가되었다(P<0.05). 3) EGFR은 타액선 도관세포와 대부분의 암종 조직에서 발현되었으나, 발현의 강도에서 정상 타액선 조직과 암종 조직간의 차이는 없었다. 4) pEGFR은 정상 타액선 조직에서는 발현되지 않았으며, 암종 조직의 종양세포에서 그 발현이 증가되었다(P<0.05). 5) ErbB2/HER2는 타액선 도관세포와 거의 모든 암종 조직에서 발현되었으며, 정상 타액선 조직과 비교하여 암종 조직에서 그 발현이 유의하게 증가되었다 (P<0.05). 6) 검색된 인자들 중 $TGF-{\alpha}$와 ErbB2/HER2는 관사상체형 암종 조직에서와는 달리 충실형 암종 조직에서 100% 발현되어, 충실형 선양낭성암종의 증가된 악성도에 중요한 역할을 함을 암시하였다. 7) 종물 내의 종양관련 혈관내피세포에서도 위의 인자들이 모두 발현되어 종양관련 혈관내피세포는 선양낭성암종의 증식과 전이에 중요한 역할을 함을 알 수 있었다. 8) 종양 기질 내의 면역관련 세포들에서도 역시 위의 인자들이 발현되어 이들 세포들이 종양의 증식과 생존에 영향을 미칠 것이라는 추론을 가능하게 하였다. 위의 연구결과들을 종합하면 상피성장인자 신호전달계에 관여하는 인자들 중 $TGF-{\alpha}$, pEGFR, 그리고 ErbB2/HER2가 타액선 선양낭성암종에서 과발현 되었다. 따라서 이들 인자들이 타액선 선양낭성암종의 증식과 생존, 그리고 전이 과정에서 중요한 역할을 할 것이라는 추론을 가능하게 하였다. 추후 면역조직화학적 연구의 한계와 오류를 극복할 수 있는 기법으로 이들 인자들에 대한 재검색이 필요하리라 생각된다. 또한 과연 이들 인자들이 암생물학적으로 뿐만 아니라 임상적으로도 전이 및 환자 생존율과 관계된 인자로서의 가치가 있는지 평가해 보아야 할 것이다.

주 타액선 종양에 대한 10년 간의 경험 (Major Salivary Glands Tumors:A 10-Year Experience)

  • 공일규;장동엽;정은정;정영호;하정훈;성명훈;김광현
    • 대한두경부종양학회지
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    • 제22권2호
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    • pp.142-146
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    • 2006
  • Background and Objectives : This study reports our clinicopathological experiences of major salivary gland tumors. Materials and Methods : This study included 302 patients with major salivary gland tumors who had got the diagnosis from January 1995 through December 2004. Medical records were reviewed retrospectively. Results : We found 244 benign and 58 malignant major salivary gland tumors. Among 267 parotid tumors, the most common benign parotid tumor was pleomorphic adenoma. Mucoepidermoid carcinoma, adenoid cystic carcinoma, and acinic cell carcinoma were three most common parotid malignancies. Among 33 submandibular gland tumors, 20 cases were benign and 13 were malignant. There were one benign and one malignant sublingual gland tumors. The duration of symptom of submandibular gland tumors was longer than that of parotid tumors. Most patients presented with asymptomatic mass. Seventy-one percent of salivary gland malignancies underwent postoperative radiation therapy. Five-year disease free survival rate of parotid malignant tumors seemed to be higher than that of submandibular one, although there was no statistical significance. Conclusion : Malignancy rate of each salivary gland followed old axiom that it is inversely related with the size of gland. Submandibular gland tumor tends to be delayed to reach diagnosis. Clinicians must be alert about this finding because submandibular gland tumors are known to have poorer prognosis than parotid tumors.

주타액선 종양의 임상적 고찰 (Clinical Investigations of Major Salivary Gland Tumors)

  • 김은서;김영수
    • 대한두경부종양학회지
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    • 제17권2호
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    • pp.210-215
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    • 2001
  • 저자들은 약 4년에 걸친 주타액선 종양에 대한 치료 경험을 통하여, 성공적인 치료를 위한 필요조건으로 다음과 같은 내용들을 고려하여야 할 것으로 생각하였다. 즉 타액선 종양은 다양한 조직학적 특징과 임상 경과를 보이는 질환군이므로 수술 전 세침흡인생검 등에 의한 정확한 병리조직학적 진단의 뒷받침이 필수적이라는 점이다. 또한 악성 종양의 경우, 질병분류 및 병기설정 방식이 완전히 통일되어 있지 아니한 상황에서 특정 질환의 특정 병기에 한 가지 치료방법을 고집하기보다는 다양한 종류의 치료를 복합적으로 사용하는 데에 적극적일 필요가 있다고 생각하였다. 특히 예후에 부정적인 영향을 미치는 요소를 가지고 있을 경우에는 적극적인 외과적 절제 및 수술 후 방사선 치료 등을 통하여 생존율을 높이는데 관심을 기울여야 할 것으로 생각되었다. 더 나아가 절개선 등 수술흔이 가지는 미용적 문제점 등도 고려하여 전체적인 치료의 만족도를 향상시키는데 기여해야 할 것으로 생각하였다.

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Is Immunohistochemical Sex Hormone Binding Globulin Expression Important in the Differential Diagnosis of Adenocarcinomas?

  • Bulut, Gulay;Kosem, Mustafa;Bulut, Mehmet Deniz;Erten, Remzi;Bayram, Irfan
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권18호
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    • pp.8203-8210
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    • 2016
  • Adenocarcinomas (AC) are the most frequently encountered carcinomas. It may be quite challenging to detect the primary origin when those carcinomas metastasize and the first finding is a metastatic tumor. This study evaluated the role of sex hormone binding globulin (SHBG) positivity in tumor cells in the subclassification and detection of the original organ of adenocarcinomas. Between 1994 and 2008, 64 sections of normal tissue belonging to ten organs, and 116 cases diagnosed as adenoid cystic carcinoma and mucoepidermoid carcinoma of the salivary gland, lung adenocarcinoma, invasive ductal carcinoma of the breast, adenocarcinoma of stomach, colon, gallbladder, pancreas and prostate, endometrial adenocarcinoma and serous adenocarcinoma and mucinous adenocarcinoma of the ovary, were sent to the laboratory at the Department of Pathology at the Yuzuncu Yil University School of Medicine, where they were stained immunohistochemically, using antibodies against SHBG. The SHBG immunoreactivity in both the tumor cells and normal cells, together with the type, diffuseness and intensity of the staining were then evaluated. In the differential diagnosis of the adenocarcinomas of the organs, including the glandular structures, impressively valuable results are encountered in the tumor cells, whether the SHBG immunopositivity is evaluated alone or together with other IHC markers. Further extensive research with a larger number of cases, including instances of cholangiocarcinoma and cervix uteri AC [which we could not include in the study for technical reasons] should be performed, in order to appropriately evaluate the role of SHBG in the differential diagnosis of AC.

주타액선 종양의 임상적 고찰 (A Clinical Analysis of Major Salivary Gland Tumors)

  • 유영삼;우훈영;윤자복;최정환;조경래;정상원;한동훈
    • 대한두경부종양학회지
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    • 제18권1호
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    • pp.56-59
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    • 2002
  • Background and Objective: Even though major salivary gland tumor is a rare disease, the diversity of histopathologic characteristics makes treatment decisions difficult. The aim of this study is to analysis the clinical experience of our major salivary gland tumor and to suggest a guideline of treatment. Materials and Method: Sixty-eight major salivary gland tumors and tumor-like glandular enlargements treated at Sanggye Paik Hospital during the past seven years between June, 1995 and January, 2002 are analyzed for histopathologic diagnosis, treatment modality, clinical manifestation, local control, and treatment-related morbidity, recurrence rate, retrospectively. Results: In twenty-eight patients the swellings were diagnosed as non-tumorous condition. The clinical features, diagnostic and surgical management of fourty salivary neoplasms involving the parotid and submandibular glands are correlated with their histological features. Conclusion: We have concluded that salivary gland neoplasms are needed multimodal treatment, because of their highly variable biologic behavior in each tumor type. Thirty-four cases were benign and six cases were malignant. Most of benign cases were pleomorphic adenoma and they showed wide age-distribution. In six malignant cases, there were acinic cell carcinoma, adenocarcinoma, carcinoma ex-plemorphic adenoma, myoepithelioma, and adenoid cystic carcinoma.

주 타액선 종양 315예의 임상적 고찰 (A Clinical Review on 315 Cases of Major Salivary Gland Tumor)

  • 채명석;백낙환;김상효
    • 대한두경부종양학회지
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    • 제15권2호
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    • pp.205-210
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    • 1999
  • Objectives: Major salivary gland tumor mainly develops in the parotid gland and pleomorphic adenoma is a large percentage. The aim of this study is to get clinicopathologic characteristics of overall major salivary gland tumors and suggestions regarding surgical management through collective review of 315 cases. Materials and Methods: This is a clinicopathologic review of 315 cases of major salivary gland tumor who were treated surgically at Department of Surgery, Head and Neck Clinic, Pusan Paik Hospital, Inje University during the period of 18 years from 1980 to 1997. Analysis was performed regarding the incidence, classification, surgery and its complications, and survival rate of salivary gland cancer. Results : 1) Parotid gland was the most prevalent site of salivary gland tumor(78%) and submandibular gland(21%) was next in order. Benign tumors were 257cases(81%) and malignant tumors were 58 cases(19%). 2) Male to female sex ratio was 1:1.2, the most prevalent age group was 3rd decade and the second group was 4th decade. 3) Histopathologically, the most common benign salivary gland tumor was pleomorphic adenoma. Warthin's tumor was next common. Among the malignant tumors, mucoepidermoid carcinoma was most common, and the next were adenoid cystic carcinoma and acinic cell carcinoma. 4) In pleomorphic adenoma, superficial parotidectomy was performed in 129 cases, and extracapsular tumorectomy was performed in 3 cases. In non-pleomorphic benign tumor, tumorectomy was performed in 21 cases. In 40 cases of deep lobe tumor, total parotidectomy was performed in only 2 cases and deep parotidectomy was performed in 38 cases. 5) Surgical complications were facial nerve injury 19 cases, Frey syndrome 13 cases, and salivary fistula 3 cases. 6) Overall 5-year survival rate of salivary gland cancer was 63%. Conclusion: Postoperative recurrence rate is low in benign tumor, but high in cancer of salivary gland tumor. Surgical procedure should not be aggressive in benign tumor, especially in parotid tumor, but should be aggressive in malignant salivary gland tumors.

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구강저암의 임상적 고찰 (A Clinical Study on floor of Mouth Cancer)

  • 이국행;심윤상;오경균;이용식
    • 대한기관식도과학회:학술대회논문집
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    • 대한기관식도과학회 1993년도 제27차 학술대회 초록집
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    • pp.93-93
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    • 1993
  • 저자들은 1985년 1월부터 1992년 12월까지 원자력병원 이비인후과를 방문하여 병리 조직학적 확진을 받은 100명의 환자를 후향적으로 조사하여, 그 임상상과 병기별 분류, 치료에 따른 결과와 생존율에 대해 보고하고자 한다. 연령별로는 50대, 60대의 순이었으며, 남녀비는 4.6:1로 남자에서 많았다. 흡연자가 95명이었고, 하루에 필터담배 1갑 이상을 흡연하는 경우가 13명이었다. 음주의 경우 하루에 2홉들이 소주 1병 이상을 섭취하는 음주자가 51명이었다. 대부분의 경우인 95례에서 편평세포암종이었고, 그 이외에 선양낭포암종, 점액표피양암종 등이 있었다. 병기별로는 4기가 62례로 가장 많았고, 림프절 전이의 경우 71례에서 병리 조직학적으로 확진되었다. 2례에서 원격전이가 있었고, 1례에서 다발암이 확인되었다. 치료방법에 따른 5년 생존율은 주로 초기 암종의 경우 외과 단독요법만을 시행하였고, 71.4%의 좋은 결과를 얻었다. 항암약물요법에 상관없이 방사선조사를 시행한 경우는 대다수가 진행성 암종이었고, 전례에서 사망하였다. 방사선 외과 복합요법의 경우, 5년 생존율은 32.4%이었다.

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