• Maxillofacial Plastic and Reconstructive Surgery
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• 제29권6호
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• pp.499-508
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• 2007

Background and Purpose: Some subtypes of malignant salivary gland tumors such as adenoid cystic carcinoma (ACC) frequently result in distant metastasis of vascular origin, which are main causes of treatment failure. The reasons for the affinity for vascular metastatic potential are unclear. Therefore, molecular characteristics that influence the dissemination of metastatic tumor cells are important for the design of more effective treatment of salivary ACC. Tumor angiogenesis has been known to be essential for the distant metastasis of malignant cells. So, we determined expressions of vascular metastasis related factors in orthotopic (parotid) murine models of parotid ACC and compared with those in ectopic (subcutis) tumors of athymic mice. Experimental Design: Using specimens from murine parotid (orthotopic, experimental group) and subcutaneous (ectopic, control group) tumors, which have developed via transplantation of tumor cells, originated from human parotid ACC, we performed immunohistochemical assays with anti-vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF, FGF2), matrix metalloproteinase (MMP)-9, and interleukin (IL)-8 antibodies. We also performed immunohistochemical assays with VEGF receptor (VEGFR)-1, VEGFR-2, VEGFR-3, and phosphorylated VEGFR-2. Results: Transplantation of human ACC tumor cell $(5{\times}10^5)$ into the parotid and subcutis successfully resulted in orthotopic (parotid) and ectopic (subcutaneous) tumors in athymic mice. Immunohistochemical staining demonstrated higher expression of major angiogenic factors (VEGF, bFGF, MMP-9) in the orthotopic tumors than in ectopic tumors (P<0.05). But the expression level of angiogenic receptors were same in orthotopic and ectopic tumors of parotid ACC. Conclusion: VEGF, bFGF, and MMP-9 could be a good candidates for antiangiogenic therapy for the contol of vascular metastatic lesions of salivary ACC.

• Archives of Plastic Surgery
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• 제48권2호
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• pp.213-216
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• 2021

Many surgeons have demonstrated the validity of sternocleidomastoid muscle flaps for the reconstruction of head and neck tumors. We present a case in which we used an island sternocleidomastoid muscle flap to reconstruct a cheek depression after excision of a malignant parotid tumor. A 44-year-old woman presented with a right malignant parotid tumor. We performed total resection of the parotid gland and facial nerve with the sural nerve and reconstructed the facial nerve and cheek depression with an island sternocleidomastoid muscle flap. The sternal head of the right sternocleidomastoid muscle was cut at the cranial and caudal segments to elevate it as an island flap. We used the superior thyroid artery as the sole pedicle for the island muscle flap. At 1 year and 3 months after the operation, the mimic muscles had gradually recovered and progressed without complications such as Frey syndrome, cervical motor dysfunction, or concave deformation of the neck and cheeks.

• 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.

• 대한두개안면성형외과학회지
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• 제11권2호
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• pp.99-102
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• 2010

Purpose: Primary malignant lymphomas of the salivary glands are uncommon, representing only 1.7% to 3.1% of all salivary neoplasms and 0.6% to 5% of all tumors and tumor-like lesions of the parotid gland. Lymphomas of the parotid glands are usually manifestations of a systemic disease process but primary lymphomas of the parotid glands are rare. Most of these lesions are classified as extranodal non-Hodgkin's lymphoma. We report the clinicopathological features of primary malignant lymphoma of the parotid gland based on an analysis of our cases. Methods: The subject was a 48-year-old male patient with a malignant lymphoma originating in the parotid gland, which had been slowly increasing in size over previous 6 months. The diagnosis was established by MRI and a superficial lobectomy. After diagnosis, the patient was referred to an oncologist for staging and medical treatment. Results: The stage was IIIA. The patient was treated with chemotherapy following surgery with rituximab and CHOP (Cyclophosphamide, Adriamycin, Vincristine, Prednisolone). The tumor was controlled successfully by chemotherapy. The patient was followed up for 1 year with no relapse. Conclusion: A case of primary non-Hodgkin's lymphoma of the parotid gland was treated with a superficial parotidectomy and chemotherapy. The disease was well controlled after a 1 year follow-up.

• 대한두경부종양학회지
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• 제33권2호
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• pp.85-88
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• 2017

Mammary analogue secretory carcinoma (MASC) is a rare malignant tumor of the salivary gland, which was first described in 2010. In this case report, we describe a 62-year-old woman with a MASC of the parotid gland, who initially presented with an asymptomatic preauricular mass. At first, computed tomography (CT) and fine needle aspiration cytology were performed; these suggested a possible Warthin's tumor but also some suspicious malignant findings. For the main treatment, adequate parotidectomy was conducted via modified Blair incision to remove the tumor. Postoperative pathology report revealed a MASC of the parotid gland. Specific MASC findings were observed upon immunohistochemical examination.

• Archives of Plastic Surgery
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• 제32권5호
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• pp.653-655
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• 2005

Epithelial-myoepithelial carcinoma (EMC) of the salivary gland is a rare tumor that comprises approximately 1% of all salivary gland tumors. It has a distinctive histological appearance comprising ductal structures with an inner epithelial cell component and an outer layer of myoepithelial cells. We report a case of EMC of the parotid gland in a 41- year-old man. He presented left-sided subauricular swelling developed 3-month earlier. Neck CT scans revealed a well-defined mass in the left superficial parotid gland. He underwent superficial parotidectomy and was diagnosed as EMC. He was taken postoperative radiotherapy. There was no evidence of recurrence during a follow-up period of 12 months. A EMC is a low grade malignant tumor which can cause diagnostic confusion during workup and also frequently misdiagnosed as other benign or malignant tumor.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제30권2호
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• pp.165-169
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• 2004

본 증례는 우측 이하선에 종물을 가진 50세 여자 환자에서 술전에 시행한 세침흡인검사와 전산화단층촬영 소견 및 술중에 시행한 동결생검에서 괴사소견으로 인해 점액표피양암종으로 진단되어 우측 이하선 전적출술과 경부청소술 등을 시행하였으나 수술 후 조직병리학적 검사에서 괴사를 동반한 다형성 선종으로 최종 진단되었다. 괴사를 동반한 다형성 선종에서 보이는 편평 상피세포는 점액표피양암종에서 나타나는 편평세포의 특징으로 오진할 수 있으므로 주의해야 한다. 본 증례는 악성종양으로 잘못 진단할 수 있는 다형성 선종의 괴사와 조직병리학적 특징들을 이해함으로써 임상의사들의 오진 가능성을 예방하고 다형성 선종의 진단과 치료에 주의해야 함을 시사한다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제37권6호
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• pp.505-509
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• 2011

Epithelial-myoepithelial carcinoma (EMC) is a low-grade malignant salivary gland neoplasm that was first described in 1972. EMC occurs in the older age group, there is a female predilection and mainly involves the parotid gland. Most authors recommend superficial parotidectomy as a treatment for low-grade malignant tumor in the superficial lobe of parotid gland. The treatment of epithelial-myoepithelial tumors typically includes surgical excision aimed at achieving a R0 resection. This paper reports a case of EMC of the parotid gland treated only by a conservational surgical excision. The lesion was exposed by the retromandibular approach and detached. After the parotid gland envelop was exposed, the mass was observed and was easy to remove due to capsulation. The preoperative diagnosis was a pleomorphic adenoma on the left parotid gland. The tumor was removed surgically with a conservative extracapsular dissection. The postoperative diagnosis was EMC, so superficial parotidectomy or radiation therapy was considered. Nevertheless, the patient was observed and no additional treatment was attempted because the patient was old and a successfully excision of the tumor had been achieved.

• 대한두경부종양학회지
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• 제6권2호
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• pp.97-100
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• 1990

Malignant mixed tumor of the parotid gland account for a very small number of the head and neck malignancies. Authors had experienced the recurrent malignant mixed tumor on 70 years old female patient. The first surgical removal was done before the 5years ago and at that time, histological diagnosis was the malignant mixed tumor. We had done the second operation, and histopathological diagnosis was malignant mixed tumor.

• 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.