• Journal of the Korean Society of Radiology
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• v.17 no.1
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• pp.63-69
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• 2023

In head and neck radiation therapy, the thermoplastic immobilization mask used for fixing the patient's posture and reproducibility causes scattered rays by being in close contact with the skin. To investigate the increase in skin dose due to the scattered rays generated from the immobilization mask, we evaluated dose reduction by decreasing contact between face skin and immobilization mask in computerized radiotherapy planning system with CT scanned images. In addition, to confirm the reproducibility problem of the setup due to the decrease in the cover area of immobilizing, the difference of each setup was confirmed using DRR and CT images. As the mask area covered for immobilizing was reduced, the dose on the skin surface significantly decreased, and it was confirmed that there was no significant difference in reproducibility even if the entire face was not covered and fixed.

• Radiation Oncology Journal
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• v.23 no.3
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• pp.131-136
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• 2005

Purpose: The aim of this study was to evaluate the clinical results of postoperative radiotherapy for parotid gland malignancy, and determine prognostic factors for locoregional control and survival. Materials and Methods: Between 1980 and 2002, 130 patients with parotid malignancy were registered In the database of the Department of Radiation Oncology, Seoul National University Hospital. The subjects of this analysis were the 72 of these 130 patients who underwent postoperative Irradiation, There were 42 males and 30 females, with a median age of 46.5 years. The most common histological type was a mucoepidermoid carcinoma. There were 6, 23, 23 and 20 patients in Stages I, II, III and IV, respectively. The median dose to the tumor bed was 60 Gy, with a median fraction size of 1.8 Gy. Results: The overall 5 and 10 year survival rates were 85 and $76\%$, respectively, The five-year locoregional control rate was $85\%$, which reached a plateau phase after 6 years. Sex and histological type were found to be statistically significant for overall survival from a multivariate analysis. No other factors, Including age, facial nerve palsy and stage, were related to overall survival. For locoregional control, nodal involvement and positive resection margin were associated with poor local control. Histological type, tumor size, perineural invasion and type of surgery were not significant for locoregional control. Conclusion: A high survival rate of parotid gland malignancies, with surgery and postoperative radiotherapy, was confirmed. Sex and histological type were significant prognostic factors for overall survival. Nodal Involvement and a positive resection margin were associated with poor locoregional control.

• Korean Journal of Head & Neck Oncology
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• v.15 no.2
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• pp.182-188
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• 1999

Purpose: To investigate the treatment results' and patterns of failure according to the pathologic type of the parotid malignancy who were treated with radical sugery and postoperative radiation therapy. Materials and Methods: Fifty-two patients with various type of the parotid malignancy, who were treated with combined radical surgery and post-operative irradiation at Yonsei Cancer Center, between 1981 and 1995, were retrospectively reviewed after completion treatment, all but one patients were follow up with the median follow up period of 49 months. Results: We found that pathologically confirmed neck node metastasis rate was 28.8% all case and level II was most common site. Overall failure rate was 26.9%, local recurrence rate was 13.5%, node failure rate was 7.7%, and distant failure rate was 5.8%. Five-year disease free survival rate was 70.9%, and overall survival rate was 73.8%. Recurrence rate was low in adenoid cystic carcinoma and acinic cell carcinoma. However distant metastasis was very high in undifferentiated carcinoma. Local recurrence was main pattern of failure in mucoepidermoid carcinoma and nodal failure was frequently observed in adenocarcinoma. Conclusion: Individualized treatment plan may be required to improve a treatment outcome by pathologic subtype of the parotid malignancy.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.18 no.3
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• pp.443-447
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• 1996

Angiolymphoid hyperplasia with eosinophilia(ALHE) is an uncommon, benign vascular proliferation with the background of a stroma which is heavily infiltrated by lymphocytes and eosinophils and includes lymphatic follicles with prominent germinal centers. ALHE primarily involves the skin and subcutis in head and neck as various forms of nodules. There has been considerable controversy about the relationship between ALHE and Kimura's disease. Kimura's disease, originally reported by Kimura et el., is an unusual granulation with proliferation of lymphoid tissue. Wells and Whimster published the first report describing a condition that resembled Kimura's disease and designated it as ALHE. For a time being two lesions are thought to be same lesion, but recently they are considered as two different entities, histopathologically. The cause of this disease remains unknown, and physicians have used a variety of treatment modalities including cryosurgery, steriod therapy, electrodesiccation, curettage, radiotherapy, laser therapy and surgical excision. But any treatment modality leaves problem of recurrence because the lesion is not well encapsulated. Being poorly encapsulated, the lesion's remnants are apt to be left and this markes some problems : recurrence and possible adjacent organ injury. In this case we misdiagnosed the lesion as well encapsulated benign mass. We performed excisional biopsy and experienced prolonged operation time and unwanted mentalis muscle injury. We think that the importance of poor encapsulation of ALHE should be stressed. So we report our experience with literature review.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.37 no.1
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• pp.67-71
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• 2011

Myxofibrosarcoma, also known as a myxoid variant of a malignant fibrous histiocytoma (MFH), is one of the most common sarcomas in the extremities of elderly people. The lesion is characterized by a high frequency of local recurrence but is uncommon in the head and neck regions. Low-grade myxofibrosarcoma, which is commonly misinterpreted as being benign, has a tendency for histological and biological progression in local recurrences, highlighting the importance of an accurate diagnosis and wide surgical excision of the primary lesion. We report a rare case of low-grade myxofibrosarcoma of the mandible located in the left mandibular body and angle area. The tumor was first diagnosed as a myxofibroma and was resected initially. After the final biopsy the patient underwent combined chemo-radiotherapy. The progress of the patent was uneventful until the one year follow up.

• International Journal of Oral Biology
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• v.49 no.1
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• pp.18-25
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• 2024

Despite advancements in therapeutic approaches, radiotherapy and cisplatin-based chemotherapy remain primary noninvasive treatments for patients with oral squamous cell carcinoma (OSCC). Moreover, the 5-year survival rate for patients with OSCC has remained almost unchanged for several decades, and many side effects of chemotherapy still exist. In this study, three-dimensional (3D) models of OSCC were established using fibroblasts, and the efficacy of various biological inhibitors was evaluated. A culture of epithelial cells with two types of fibroblasts (hTERT-hNOFs and cancer-associated fibroblasts) within a type I collagen matrix resulted in the formation of a continuous layer of tightly packed cells compared to models without fibroblasts. Furthermore, the effects of biological chemicals, including Y27632, latrunculin A, and verteporfin, on these models were investigated. The stratified formation of the epithelial layer and invasion in OSCC 3D-culture models were effectively inhibited by verteporfin, whereas invasion was weakly inhibited by Y27632 and latrunculin. Collectively, the developed OSCC 3D-culture models established with fibroblasts demonstrated the potential for drug screening, with verteporfin showing promising efficacy.

• Journal of Korean Neurosurgical Society
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• v.44 no.4
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• pp.273-276
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• 2008

Although adenoid cystic carcinoma (ACC) of the lacrimal gland is a rarely encountered orbital tumor, it invades intracranially more frequently than carcinomas of other glands in the head and neck. A 52-year-old man underwent orbital exenteration and resection of intracranially extended tumor via a fronto-orbito-zygomatic approach in combination with a transfacial approach. Histopathologically, the tumor showed perineural, vascular, and lymphatic invasion. Additionally, he received radiotherapy (60 Gy) and adjuvant systemic cisplatin and 5-fluorouracil chemotherapy due to residual tumor in the orbit and systemic metastases (lung, ribs, and spines). He was free of progression and recurrence at 6 months after treatment. The authors report a case of skull base invasion by an ACC of the lacrimal gland to remind neurosurgeons planning intervention that this disease shows a tendency to invade intracranially.

• Archives of Craniofacial Surgery
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• v.23 no.3
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• pp.125-129
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• 2022

Most malignant lymphomas of the head and neck region are non-Hodgkin lymphomas (NHL), and diffuse large B-cell lymphoma is the most common subtype. The prevalence of malignant lymphoma among parotid tumors is low, approximately 1% to 4%. The most common symptom of parotid lymphoma is a unilateral, non-tender, firm mass that slowly grows in size over time. As its clinical manifestations are nonspecific, a comprehensive assessment is required for an accurate diagnosis. The initial work-up includes imaging tools, such as computed tomography and magnetic resonance imaging. However, NHL of the parotid gland is difficult to distinguish from other types of benign tumors prior to biopsy; histopathological evaluation and subsequent immunohistochemical staining are needed for the final diagnosis. Once a definitive diagnosis is established, patients should be referred to an oncologist for staging. Treatment is mainly based on systemic chemotherapy, whereas radiotherapy is indicated for certain cases. Here, we report the case of a 53-year-old man who presented with a progressively enlarging mass in the right parotid area, which was later diagnosed as malignant lymphoma of the parotid gland after superficial parotidectomy.

• Journal of the Korean Society of Radiology
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• v.12 no.3
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• pp.351-357
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• 2018

During radiation therapy, the patient is exposed to secondary radiation by scattered and leakage radiation. For the diagnostic radiation, guidelines for reducing the patient's exposure as the diagnostic reference level are provided. However, in the case of therapeutic radiation, even though the radiation dose by the secondary radiation is considerable, the prescription dose is not limited because of the reason of the therapeutic efficiency. The purpose of this study was to evaluate the secondary radiation that the patient could be received at the peripheral tissue during the radiotherapy using the linear accelerator with the radiophotoluminescent glass dosimeter. In addition, we measured the degree of saturation of the luminescent amount according to the build-up characteristic of the radiophotoluminescent glass dosimeter. As a result of carrying out this study, the exposure dose decreased drastically farther away from the treatment field. When the head was irradiated with 1 Gy, the neck could be exposed to 18.45 mGy. When the same dose was irradiated at the neck, 15.55 mGy of the head and irradiated at the chest, 14.26 mGy of the neck and irradiated at the pelvis, 1.14 mGy of the chest were exposed separately. The degree of saturation of the luminescent intensity could be overestimated by 1.8 ~ 4.8% depending on time interval for 3 days.

• The Korean Journal of Pain
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• v.6 no.1
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• pp.100-104
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• 1993

Malignant tumors of the paranasal sinuses are quite rare entity, with maxillary neoplasms accounting for less than 1 percent of all head and neck malignancies. When considering the paranasal sinuses alone, 77 percent of cancers arise in the maxillary sinuses. There is no situation more frustrating than the management of the patients with chronic facial pain due to cancer. The initial step in managing patients with cancer pain is the use of oncologic therapy in the form of radiotherapy, surgery, chemotherapy, alone or combined, either to effect a cure or decrease the size of the tumor and thus decrease or eliminate the pain. When oncologic therapy is ineffective in providing relief, the pain must be treated by one or more of the followings: Systemic analgesics and adjuvant drugs, psychologic techniques of analgesia, neurostimulating techniques, neuroablative surgical procedures, regional analgesia with local anesthetics or neurolytic blocks. An 82-year old patient had severe pain of the orbital and infraorbital region due to squamous cell carcinoma of the maxillary sinus. We successfully treated this patient with the percutaneous retrogasserian ethanol gangliolysis by a H$\ddot{a}$rtel approach, and the analgesia lasts until the death of the patient.