• 제목/요약/키워드: Head and Neck cancer

검색결과 1,141건 처리시간 0.032초

외과적으로 처치한 갑상선 결절 (A Clinical Study of Surgically Managed Thyroid Nodule)

  • 홍관의;이명복;문철;김익수
    • 대한두경부종양학회지
    • /
    • 제10권2호
    • /
    • pp.91-101
    • /
    • 1994
  • Nodular thyroid disease is a common clinical problem. The problem in clinical practice is to distinguish malignant or potentially malignant tumor from harmless nodules. The cases of thyroid nodule surgically managed at Department of General Surgery, Soon Chun Hyang Univ. Hospital during the period Jan. 1985 to July. 1992 were reviewed retrospectively. To assess method of distinguishing malignant from benign lesions of the thyroid gland, we reviewed 162 patients with thyroid nodule. There were 61(37.7%) malignant nodules and 101(62.3%) benign nodules. According to the review, distinguishing the benign from the malignant nodule with history, physical examination, clinical manifestation, and duration of illness was not suggested sufficiently. In ultrasonogram of 73 cases, 57.5% of nodules were solid, 20.6% were cystic, 21.9% were mixed solid and cystic. Of these, 28.5% of the operated solid lesions, 12.5% of the mixed lesions, and only 6.7% of the cystic lesions were malignant. Thyroid scanning of 82 cases revealed cold nodules in 60 patients(73.2%), of which 26 cases were malignant(36.6%) 137 patients underwent fine needle aspiration cytology(FNAC), and these results were as follow: sensitiviey was 70.6%, specificity was 93.0%, false-positive rate was 14.3%, and false-negative rate was 15.8%. 41 patients underwent frozen biopsy, and the results as follow: sensitivity was 80.0%, specificity was 89.7%. Neither scintigraphy nor ultrasonogram has sufficient specificity to distinguish benign from malignant nodule. But FNAC and frozen biopsy have sufficient accuracy to differentiate benign from malignant nodule. In the benign nodules, the most common type of operation was total lobectomy (60.4%). Of the malignant nodules, total thyroidectomy with or without modified radical neck dissection was performed in 30 cases(49.2%). We conclude that the single technique used to determine the differential diagnosis of a thyroid nodule are unrealiable. It is therefore essential to combine all avaiable clinical and laboratory information.

  • PDF

Association between Alzheimer's Disease and Cancer Risk in South Korea: an 11-year Nationwide Population-Based Study

  • Lee, Ji Eun;Kim, DongWook;Lee, Jun Hong
    • 대한치매학회지
    • /
    • 제17권4호
    • /
    • pp.137-147
    • /
    • 2018
  • Background and Purpose: Previous studies have suggested a decreased cancer risk among patients with Alzheimer's disease (AD). There remains a lack of data on the specific types of cancer and risk factors for developing cancer in AD. We evaluated the association between AD and cancer risk, and we examined specific types of cancer. Methods: A population-based longitudinal study was conducted using the National Health Insurance Service-Senior cohort for 2002-2013. A total of 4,408 AD patients were included in the study, as were 19,150 matched controls. Potential associations between the risk of cancer and AD were analyzed using Cox proportional hazard regressions. Results: Cancer developed in 12.3% of the AD group patients and in 18.5% of control group subjects. AD was associated with a reduced risk of cancer (hazard ratio [HR], 0.70; 95% confidence intervals, 0.64-0.78). The risk of head and neck cancers was significantly reduced (HR, 0.49), as were risks for cancers of the digestive tract, including stomach cancer (HR, 0.42), colorectal cancer (HR, 0.61), liver and biliary tract cancers (HR, 0.68), and pancreatic cancer (HR, 0.55). Lung and prostate cancer risks were also significantly lower for the AD group (HR, 0.52 and HR, 0.72, respectively). Conclusions: Our results showed an inverse association between AD and cancer. Further research involving a large number of patients in a hospital based-study is needed to address the biological associations between cancer development and dementia, including AD.

초기 성문암 환자에서 소분할조사법의 방사선 치료 결과와 예후 인자 (A Result and Prognostic Factors of Hypofractionation Radiation Therapy in Early Glottic Cancer)

  • 이미조;김헌정;김우철;노준규
    • 대한두경부종양학회지
    • /
    • 제21권2호
    • /
    • pp.132-138
    • /
    • 2005
  • Purpose: The purpose of this study was to establish general guidelines for the treatment of patients with early glottic cancer(T1-2N0M0), by assessing the role of primary radiation therapy and by analyzing the tumor-related and treatment-related factors that influence treatment results. We also studied the results of hypofractionated radiation therapy for early glottic cancer. Material and Methods: This retrospective study comprised 48 patients who suffered from early glottic cancer and were treated by primary radiotherapy at Inha University Hospital, between May 1997 and October 2004. T-stage distribution showed 38 patients as T1 and 10 patients as stage T2. Thirty-eight patients underwent hypofractionated radiotherapy using a 6 MY photon beam, a total tumor dose of 63Gy, in 5 weekly fractions of 2.25Gy, with an overall radiation treatment time of 38 days. Ten patients in the T2 stage tolerated a total dose of 63-72 Gy(median 68.4Gy) in 5 weekly fractions of 1.8-2.0Gy, with an overall radiation treatment time of 40-87 days(median 51 days). All patients were followed up for at least 3 years. Univariate and multivariate analyses were performed to identify the prognostic factors affecting the treatment results. Result: The 5-year survival rate was 92% for all patients, 94% for T1 patients and 91% for T2 patients. The local control rate was 93.5% for all patients, 95% for T1 and 92.2% for T2 patients. Three patients suffered a relapse following radiotherapy, and underwent subsequent salvage surgery. We included T-stage, tumor location, total radiation dose, field size and overall radiation treatment time as potential prognostic factors. Only T-stage was found to be statistically significant in the univariate analysis, but in the multivariate analysis, it was not found to be significant. Conclusion: High curative and voice preservation rates were obtained with hypofractionated radiotherapy. Further study with a larger number of patients is needed to determine the prognostic factors affecting treatment results.

갑상선 미세 유두암의 수술 전 초음파 검사와 세침흡입검사의 결과에 따른 수술범위 선택의 타당성 검토 : 예비 보고 (Performance of Preoperative Sonography and Fine Needle Aspiration Cytology on Treatment of Thyroid Papillary Microcarcinoma : Preliminary Study)

  • 권중근;이상민;이호민;남정권;이태훈;이종철
    • 대한두경부종양학회지
    • /
    • 제27권1호
    • /
    • pp.38-41
    • /
    • 2011
  • Background and Objectives : Although it is well established that patients with papillary thyroid microcarcinoma (PTMC) have a highly favorable prognosis, the extent of thyroid surgery for PTMC remains unclear. According to the 2011 revised Korean Thyroid Association guideline, the choice of surgical strategy(total thyroidectomy versus lobectomy) for PTMC depends on solely preoperative diagnostic scrutinies-ultrasonography and fine needle aspiration cytology. We want to know how accurately these preoperative diagnostic scrutinies define the choice of surgical strategy for PTMC. Materials and Methods : For 119 patients who underwent total thyroidectomy with central neck dissection for PTMC, retrospectively, we compared the choice of surgery according to preoperative work up and postoperative pathologic findings. Results : Overall accuracy of the choice of surgery by preoperative work up was 61%. Among patients recommended lobectomy on preoperative work up, completion thyroidectomy on postoperative pathology might be necessary for 60% of patients and hidden central node metastasis was revealed in 31% of patients. Conclusions : The results of this study compel us to reinvestigate the current treatment guideline for PTMC. On current guideline according to the sonography and fine needle aspiration cytology, it might be thought to be better to choose more aggressive surgical strategy.

부갑상선암 (Parathyroid Carcinoma)

  • 조은철;서진학;정웅윤;김호근;박정수
    • 대한두경부종양학회지
    • /
    • 제17권2호
    • /
    • pp.205-209
    • /
    • 2001
  • Purpose: Most cases of primary hyperparathyroidism are due to parathyroid adenoma or parathyroid hyperplasia. Parathyroid carcinoma is a very rare cause of hyperparathyroidism. Although the diagnosis of parathyroid carcinoma is usually established by pathologic criteria especially of vascular or capsular invasion, some clinical and biochemical features differentiate it from benign forms of hyperparathyroidism. We under-took a retrospective study in 6 patients with parathyroid carcinoma, with the aim of conveying experience from management for this rare cause of hyperparathyroidism. Methods: Clinical symptoms, biochemical laboratory, radiologic, and intraoperative findings, local recurrence and distant metastasis were analyzed in 6 patients diagnosed pathologically as a parathyroid carcinoma after operation from 1992 to 2001. Results: Mean age was 50.2 years (33.0-60.0 years) and male to female ratio was 1:1. Neck mass was found in 5 patients, multiple bone pain in 3 patients and renal stone in 1 patient. One case has suffered from chronic renal failure for 19 years. Although preoperative laboratory evaluations showed the aspects of hyperparathyroidism in all cases, mean serum calcium level was 11.2mg/dl(10.5-12.1mg/dl), slightly elevated. Laboratory values after surgery were within the normal range in 5 cases. However, in one case with chronic renal failure, serum PTH levels, serially checked, were above the normal range. Any of imaging methods failed to suggest a parathyroid carcinoma preoperatively. Parathyroid adenoma was suspected in 3 cases, thyroid cancer in the other cases before surgery. The extent of resection was radical resection of parathyroid lesion with more than unilateral thyroid lobectomy and central compartment neck node dissection and in 2 cases, the resection of recurrent laryngeal nerve or strap muscles was added. During follow-up period, any local or systemic recurrence were not evident in all the cases. Conclusion: Although parathyroid carcinoma is a rare disease and its preoperative diagnosis, in our experience, could not easily be made, the understanding of characteristic clinical and biochemical feature could help diagnosis at first surgery. Radical resection without remaining residual tumor is most important for the management of the parathyroid cancer.

  • PDF

Short-course hypofractionated radiochemotherapy for unresectable locally advanced cancer of the base of tongue: palliation only? A case report and short review of the literature

  • Kalogeridi, Maria-Aggeliki;Kouloulias, Vassilios;Zygogianni, Anna;Kyrgias, George
    • Radiation Oncology Journal
    • /
    • 제32권2호
    • /
    • pp.99-102
    • /
    • 2014
  • We present a case of unresectable cancer of the base of tongue treated with hypofractionated 3D conformal radiotherapy and concomitant chemotherapy. Based on the excellent tumour response in this radiotherapy regimen and international experience in short course treatments we shortly reviewed, we propose that this therapeutic approach could be considered in a curative setting for patients unsuitable for the a standard long course radiochemotherapy schedule.

Provil과 cerrobend을 이용한 electron 차폐물 제작 (The Fabrication of Internal Shielding using Provil and Cerrobend)

  • 김종화;이강현;손정혜
    • 대한방사선치료학회지
    • /
    • 제8권1호
    • /
    • pp.37-39
    • /
    • 1996
  • The skin cancer is a highly curable disease which frequently occurs in the head and neck region exposed to the sun. When the eyelid is treated usually eye shield made of lead is used to protect the eyeball as a internal shield. For the same reason on internal shield should be used when the nose is treated when electron to protect the nasal mucosa. Our hospital made an internal shield for the treatment of the skin cancer on the nose using provil and cerrobend. The characteristics of the internal shield were examined.

  • PDF

혀의 점막하에 발생한 신경초종 환자의 치험례 (Submucosal Schwannoma of Tongue: A Case Report and Brief Review of Literature)

  • 박성원;전재호;박주용;최성원;김수호
    • Maxillofacial Plastic and Reconstructive Surgery
    • /
    • 제34권6호
    • /
    • pp.480-483
    • /
    • 2012
  • Schwannoma is a benign, slow-growing, tumor of the peripheral nerves without specific symptoms, so that early diagnosis may be difficult. Though approximately 25~40% of all schwannomas occur extracranially in the head and neck region, only 1% of schwannomas are reported in the oral cavity. An 18-years-old female patient visited our clinic with a mass on the middle-right-dorsal surface of the tongue slowly growing for 1.5 years. The patient underwent the surgical removal of the neoplasia under general anesthesia. The mass was well capsulated and a cleavage plane was easily found. There was no recidivation during the course of a one-year follow-up. The treatment for schwannoma is surgical excision of the lesion and recurrence after excision of schwannoma is rare. The final diagnosis is made after a histological examination. Differential diagnoses must be made in relation to malignant tumors and in relation to numerous benign neoformations based on epithelial and connective tissues.