• Journal of Oral Medicine and Pain
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• 제39권1호
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• pp.26-28
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• 2014

Nasopharyngeal cancer is malignant tumor of nasopharyngeal area that is characterized of lymphadenopathy, pain, otitis media, hearing loss and cranial nerve palsy and may present symptoms similar to temporomandibular disorder such as facial pain and trismus. In this case, the patient with symptoms similar to temporomandibular disorder after surgery for otitis media presented with facial paresthesia and masticatory muscle weakness. Examinaion of trigemimal nerve was shown sensory and motor abnormaility. The patient was referred to a neurologist. Nasopharyngeal cancer was suspected on computed tomography and magnetic resonance imaging and was confirmed by biopsy. If the patient presenting with paresthesia and muscle weakness the cranial nerve examination should be performed regardless of typical temporomandibular disorder symptom. The neurologic symptom can be caused by neoplasm such as brain tumor and nasopharyngeal cancer. Nasopharyngeal cancer on rosenmuller fossa can develop otitis media. Therefore, the patient with otitis media history should be consulted to otorhinolaryngologist to examin the nasopharyngeal area.

• Journal of Korean Neurosurgical Society
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• 제61권3호
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• pp.333-342
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• 2018

Intracranial germ cell tumors (iGCTs) are a heterogeneous group of tumors with peculiar characteristics clearly distinguished from other brain tumors of neuroepithelial origin. Diverse histology, similarity to gonadal GCT, predilection to one sex, and geographic difference in incidence all present enigmas and fascinating challenges. The treatment of iGCT has advanced for germinoma to date; thus, clinical attention has shifted from survival to long-term quality of life. However, for non-germinomatous GCT, current protocols provide only modest improvement and more innovative therapies are needed. Recently, next-generation sequencing studies have revealed the genomic landscape of iGCT. Novel mutations in the KIT-RAS-MAPK and AKT-MTOR pathways were identified. More importantly, methylation profiling revealed a new method to assess the pathogenesis of iGCT. Molecular research will unleash new knowledge on the origin of iGCT and solve the many mysteries that have lingered on this peculiar neoplasm for a long time.

• Journal of Chest Surgery
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• 제36권8호
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• pp.614-618
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• 2003

흉막폐아세포종은 소아에 국한하여 생기는 매우 드문 원발성 악성종양이며 극히 나쁜 예후를 보인다. 주 증상은 흉부불쾌감, 호흡곤란, 반복적인 상기도 감염, 발열, 마른기침, 그리고 흉통 등이다. 흉막폐아세포종은 매우 빠른 진행양상을 보이며, 폐문 및 종격 림프절에 전이될 수 있다. 원격전이는 뇌, 골조직, 그리고 복강 내 장기들에서 보인다 흉막폐아세포종의 치료는 다각적 접근을 요한다 수술에 의한 종괴의 일차적 제거가 우선적인 치료법이나, 종양의 크기나 침범 범위로 인해 일차적으로 수술적 제거가 힘든 경우 수술 전 신보조항암요법으로 종양의 크기를 줄일 수 있으며, 이후 수술적인 완전절제를 고려할 수 있다. 본원에서는 소아에서 발생한 흉막폐아세포종에 대해 신보조항암요법, 수술적 절제 및 보조항암요법을 통해 성공적으로 치료한 2예를 경험하고 이를 보고하고자 한다.

• 대한두개안면성형외과학회지
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• 제21권3호
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• pp.198-201
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• 2020

Primary lung cancer commonly metastasizes to the brain, bones, liver, and adrenal glands. In some cases, bone metastasis serves as the first presenting sign of lung cancer with bone pain and headache, but it is not common. The incidence of skull metastasis in lung squamous cell carcinoma (SCC) is low, and there have been only a few cases of skull metastases serving as the first sign of malignancy with skull mass and epidural bleeding; however, no similar cases have been reported regarding that of hematoma. We report a case of an 84-year-old man who first presented with a simple forehead hematoma and was eventually diagnosed with SCC of the lung.

• Investigative Magnetic Resonance Imaging
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• 제19권2호
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• pp.117-121
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• 2015

Chordoid glioma is a rare, low-grade brain neoplasm typically located in the third ventricle. Herein, we report an unusual case of histologically confirmed chordoid glioma located in the pituitary fossa and suprasellar region, not attached to the third ventricle. A 57-year-old woman presented with a 2-month history of headache and visual disturbance. Magnetic resonance imaging revealed an ovoid mass in the pituitary fossa and suprasellar region, compressing the optic chiasm without involvement of the third ventricle. The tumor showed low signal intensity on T1-weighted images and iso- to high signal intensity on T2-weighted images, with strong and homogenous contrast enhancement. Subtotal resection was performed via the transcranial approach, and the patient subsequently received adjuvant gamma knife radiosurgery. However, the residual mass showed disease progression 5 months after the initial surgery.

• 임상이비인후과
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• 제29권2호
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• pp.281-285
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• 2018

Columnar cell variant of papillary thyroid carcinoma (CCV-PTC) is a rare variant representing 0.15-0.2% of all PTCs. The CCV is aggressive, due to its rapid growth, high local recurrence rate, and frequent lung, brain and bone metastasis. Aggressive surgical and medical management are recommended for these neoplasias. The authors experienced a case of CCV-PTC in a 45-year-old man. We performed total thyroidectomy with neck dissection. The patient received radiation and radioactive iodine therapy. There were no recurrences or complications in the following 24 months after the operation. The patient will closely undergo continuous follow up. We present the clinical characteristics, pathology, treatment, and prognosis of the tumor with a review of the literature.

• 대한두개안면성형외과학회지
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• 제23권5호
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• pp.237-240
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• 2022

A 67-year-old man visited our plastic surgery clinic complaining of a palpable protruding mass (2.0×2.5 cm) in the right occipital region. To establish an appropriate treatment plan for the cystic mass, brain magnetic resonance imaging was performed. A 2.2 cm nodular lesion with peripheral enhancement in the right occipital region of the scalp was confirmed. In addition, two rim-enhancing nodular lesions up to 9 mm with marked perilesional edema in the right frontal lobe were confirmed. The findings suggested metastasis from cancer. After further evaluations, a mass in the right lower lung field was identified as adenocarcinoma of the lung. Histological examination characterized the excised lesion as a cutaneous metastasis from lung adenocarcinoma. This case report shows that a cystic mass, which commonly occurs in the scalp, may indicate lung cancer. In particular, if a cystic mass of the scalp is identified in a person at high risk for lung cancer, appropriate evaluation and urgent treatment should be performed.

• 대한두개안면성형외과학회지
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• 제24권5호
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• pp.240-243
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• 2023

Metastasis of lung cancer to the skin is uncommon, presenting in 0.22% to 12% of lung cancer patients, and it is extremely rare for skin metastasis to be the first clinical manifestation of lung cancer. In the few cases where skin metastasis has been reported as the first sign of lung cancer, the patients were typically heavy smokers or had preexisting respiratory diseases and symptoms. This prompted clinicians to consider skin metastasis of a pulmonary malignancy. Large cell neuroendocrine carcinoma (LCNEC) is a rare type of lung cancer that accounts for approximately 3% of lung cancers. LCNEC mainly metastasizes to visceral organs, such as the liver, bone, and brain, and it only shows metastasis to the skin in very rare cases. Herein, we report an unusual case of a metastatic skin lesion as the first sign of primary pulmonary LCNEC, in a 63-year-old woman with no pulmonary symptoms or personal history of smoking or pulmonary disease.

• Journal of Korean Neurosurgical Society
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• 제64권6호
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• pp.983-994
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• 2021

Objective : The effectiveness of gamma knife radiosurgery (GKR) in the treatment of brain metastases is well established. The aim of this study was to evaluate the efficacy and safety of maximizing the radiation dose in GKR and the factors influencing tumor control in cases of small and medium-sized brain metastases from non-small cell lung cancer (NSCLC). Methods : We analyzed 230 metastatic brain tumors less than 5 mL in volume in 146 patients with NSCLC who underwent GKR. The patients had no previous radiation therapy for brain metastases. The pathologies of the tumors were adenocarcinoma (n=207), squamous cell carcinoma (n=18), and others (n=5). The radiation doses were classified as 18, 20, 22, and 24 Gy, and based on the tumor volume, the tumors were categorized as follows : small-sized (less than 1 mL) and medium-sized (1-3 and 3-5 mL). The progression-free survival (PFS) of the individual 230 tumors and 146 brain metastases was evaluated after GKR depending on the pathology, Eastern Cooperative Oncology Group (ECOG) performance score (PS), tumor volume, radiation dose, and anti-cancer regimens. The radiotoxicity after GKR was also evaluated. Results : After GKR, the restricted mean PFS of individual 230 tumors at 24 months was 15.6 months (14.0-17.1). In small-sized tumors, as the dose of radiation increased, the tumor control rates tended to increase (p=0.072). In medium-sized tumors, there was no statistically difference in PFS with an increase of radiation dose (p=0.783). On univariate analyses, a statistically significant increase in PFS was associated with adenocarcinomas (p=0.001), tumors with ECOG PS 0 (p=0.005), small-sized tumors (p=0.003), radiation dose of 24 Gy (p=0.014), synchronous lesions (p=0.002), and targeted therapy (p=0.004). On multivariate analyses, an improved PFS was seen with targeted therapy (hazard ratio, 0.356; 95% confidence interval, 0.150-0.842; p=0.019). After GKR, the restricted mean PFS of brain at 24 months was 9.8 months (8.5-11.1) in 146 patients, and the pattern of recurrence was mostly distant within the brain (66.4%). The small and medium-sized tumors treated with GKR showed radiotoxicitiy in five out of 230 tumors (2.2%), which were controlled with medical treatment. Conclusion : The small-sized tumors were effectively controlled without symptomatic radiation necrosis as the radiation dose was increased up to 24 Gy. The medium-sized tumors showed potential for symptomatic radiation necrosis without signifcant tumor control rate, when greater than 18 Gy. GKR combined targeted therapy improved the tumor control of GKR-treated tumors.

• Journal of Korean Neurosurgical Society
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• 제63권1호
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• pp.119-135
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• 2020

Objective : To investigate the epidemiology of newly-diagnosed, histologically-confirmed (NDHC) central nervous system (CNS) tumours and its changes over a 21-year period in a regional hospital in Hong Kong. Methods : This is a single-institute retrospective descriptive study of patients undergoing surgery for CNS tumours in a regional hospital of Hong Kong in the period from January 1996 to December 2016. The histological definition of CNS tumours was according to the World Health Organization classification, while the site definition for case ascertainment of CNS tumours was as set out by the Central Brain Tumour Registry of the United States. Patients of any age, who had NDHC CNS tumours, either primary or secondary, were included. The following parameters of the patients were retrieved : age at diagnosis, gender, tumour location, and histological diagnosis. Population data were obtained from sources provided by the Government of Hong Kong. The incident rate, estimated by the annual number of cases per 100000 population, for each histology grouping was calculated. Statistical analyses, both including and excluding brain metastases, were performed. Statistical analysis was performed with Microsoft Excel, 2016 (Microsoft, Redmond, WA, USA). Results : Among the 2134 cases of NDHC CNS tumours, there were 1936 cases of intracranial tumours and 198 cases of spinal tumours. The annual number of cases per 100000 population of combined primary intracranial and spinal CNS tumours was 3.6 in 1996, and 11.1 in 2016. Comparing the 5-year average annual number of cases per 100000 population of primary CNS tumours from the period 1996-2000 to 2011-2015, there was an 88% increase, which represent an increase in the absolute number of cases by 4.52 cases/100000 population. This increase was mainly contributed by benign histologies. In the aforementioned periods, meningiomas increased by 1.45 cases/100000 population; schwannomas by 1.05 cases/100000 population, and pituitary adenomas by 0.91 cases/100000 population. While gliomas had a fluctuating 5-year average annual number of cases per 100000 population, it only had an absolute increase of 0.51 cases/100000 population between the 2 periods, which was mainly accounted for by the change in glioblastomas. Conclusion : This retrospective study of CNS tumour epidemiology revealed increasing trends in the incidences of several common CNS tumour histologies in Hong Kong, which agrees with the findings in large-scale studies in Korea and the United States. It is important for different geographic locations to establish their own CNS tumour registry with well-defined and structured data collection and analysis system to meet the international standards.