• 대한두경부종양학회지
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• 제29권2호
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• pp.71-74
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• 2013

Neck mass is a common manifestation from head and neck malignancy, most of which come from mucosal squamous cell carcinomas in the upper aero-digestive tract. However, once aspiration cytology suggests atypical malignant cells in the neck mass rather than metastatic squamous cell carcinomas, it is confusing to decide the adequate diagnostic work-ups and treatment planning. Here, we report a 29-year-old woman presenting with a growing neck mass mimicking malignancy of unknown origin, which was finally diagnosed as primary lymphoepithelial carcinoma in the parotid gland with multiple metastases to the lymph nodes. The patient underwent comprehensive neck dissection and total parotidectomy and the adjuvant radiation treatment was given. Our report highlight that the primary salivary gland cancer should be considered as the potential tumor origin in case of malignancy of unknown origin in the head and neck region and neck mass suggestive of atypical carcinomas.

• 대한두경부종양학회지
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• 제20권1호
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• pp.44-48
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• 2004

Primary malignancies of hard palate are rare, espicially adenocarcinoma of minor salivary gland in hard palate. The clinical stage of the tumor and its histologic grade at the time of treatment were significant predictors of survival. A 33-year-old woman was diagnosed with stage II, polymorphous low-grade adenocarcinoma of the hard palate and treated with surgery. We thougt that she would have excellent prognosis. After that, there was no definite evidence of recurrence during 3 months. Since then, the patient herself decided to discontunue follow-up. 9 years after that she came to the hospital due to both submandibular mass without any sign of local recurrence. CT scan and biopsy of the mass revealed multiple cervical metastatic adenocarcinoma without distant metastasis and the histologic findings were similar to that of the primary hard palate adenocarcinoma. So, we present this case with the review of literature.

• Tuberculosis and Respiratory Diseases
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• 제43권3호
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• pp.440-448
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• 1996

Bronchial carcinoid tumors are uncommon, constituting approximately 3-5% of all primary lung cancers. Classification of these tumors has evolved substantially as our understanding of the cellular, biologic, and clinical aspects of these neoplasms has improved. Initially, bronchial carcinoids were thought to be benign and therefore were classified as bronchial adenomas. Currently, however, they are well recognized as having the potential for both local invasion and distant metastatic involvement. Consequently, carcinoid tumors are frankly malignant. Thus bronchial adenoma is a misnomer that should no longer be used for bronchial carcinoids. Most investigators currently favor classifying carcinoid tumors as a type of neuroendocrine neoplasm because of their potential to secrete a variety of chemical substances found in both the central nervous system and the epithelial cells of numerous organs. Bronchial carcinoids are usually characterized by a slow growth pattern and a low incidence of metastasis, and histologically conformed by the azurophil staining and the presence of the characteristic neurosecretary granule on electron microscopy. Atypical carcinoid tumor was first defined by Arrigoni et al, who proposed the following criteria for separation of atypical carcinoid from typical carcinoid tumor : 1) increased mitotic activity with 1 mitotic figure per 1-2 high power fields(or 5-10 mitoses /10 HPF), 2) nuclear pleomorphism, hyperchromatism, and an abnormal nuclear-cytoplasmic ratio, 3) areas of increased cellularity with disorganization of the architecture, and 4) tumor necrosis. In contrast, typical carcinoid tumor may have focal cytologic pleomorphism, but necrosis is absent and mitotic figures are rare. Recently we experienced a case of atypical bronchial carcinoid with multiple distant metastasis, so we report this case with a review of the literature.

• Annals of Clinical Neurophysiology
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• 제4권1호
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• pp.74-77
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• 2002

Collet-Sicard Syndrome is one of the variant of the jugular foramen syndromes in which the last four cranial nerves are involved whereas the sympathetic plexus is spared. The possible causes of these multiple lower cranial nerve palsy are variable, including metastasis of systemic malignancy to the base of skull, primary tumor of head and neck, vascular complication, trauma and so on. We experienced two men visited to our clinic with symptoms of headache, hoarsness, swallowing difficulty and showed the evidence of cranial nerve palsy on neurologic examination. Magnetic resonance imaging and computed tomography demonstrated oropharyngeal and hypopharyngeal tumor and electrodiagnostic study supported the diagnosis.

• Journal of Gastric Cancer
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• 제24권3호
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• pp.291-299
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• 2024

Purpose: Gastric cancer treated with curative resection exhibits several recurrence patterns. The peritoneum is the most common site of recurrence. Some reports have indicated different prognostic influences according to the recurrence sites in other cancers, such as esophageal and colorectal cancers. This study investigated whether the recurrence sites influenced the prognosis of patients with recurrent gastric cancer. Materials and Methods: The data of 115 patients who experienced tumor recurrence after curative gastrectomy were retrospectively reviewed. The sites of recurrence were divided into 4 groups: lymph node (LN), peritoneum, other single organs, and multiple lesions. Clinicopathological features were compared between the sites of recurrence. Prognosis after resection and recurrence were also compared. Results: The peritoneum was the primary site of recurrence in 38 patients (33%). The tumor differentiation and pathological stages were significantly different. Survival after surgery did not show a statistically significant difference (hazard ratio [HR] of LN: 1, peritoneum: 1.083, other single organs: 1.025, and multiple lesions: 1.058; P=1.00). Survival after recurrence was significantly different (HR of LN, 1; peritoneum, 2.164; other single organs, 1.092; multiple lesions, 1.554; P=0.01), and patients with peritoneal and multiple lesion recurrences had worse prognosis. Furthermore, peritoneal recurrence seemed to occur later than that at other sites; the median times to recurrence in LN, peritoneal, other single-organ, and multiple lesions were 265, 722, 372, and 325 days, respectively. Conclusions: The sites of gastric cancer recurrence may have different prognostic effects. Peritoneal recurrence may be less sensitive to chemotherapy and occur during the late phase of recurrence.

• Advances in pediatric surgery
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• 제5권1호
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• pp.1-14
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• 1999

Among 60 children with teratoma, forty-three (71.7 percent) were girls and 17 (28.3 percent) boys, Primary sites were sacrococcygeal in 30 patients (50 percent), retroperitoneal in 12 (20 percent), ovarian in 11 (18.3 percent), testicular in 3 (5 percent), and one in each of nasopharyngeal, gastric, hepatic and pancreatic (1.6 percent, respectively). Fifty-five (91.7 percent) teratomas were benign and 5 (8.3 percent) malignant. Malignant teratomas W8,re detected only in the sacrococcygeal region (16.7 percent). Age greater than 2 mouths at diagnosis, presence of urinary or colonic obstructive symptoms, multiple masses and elevated serum alpha-fetoprotein were indicators of malignancy in the sacrococcygeal region. Tumor size, presence of calcification, and gross apperance (cystic or solid) did not correlate with malignancy. Thirteen (21.7 percent) cases were associated with other anomalies. For the immature teratoma, operative resection without adjuvant chemotherapy was adequate treatment. Three patients with malignant tumors survived, one who received chemotherapy survived 3 years and the others without chemotherapy survived for 5 and 10 years.

• 대한두경부종양학회지
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• 제22권2호
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• pp.167-170
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• 2006

Extramedullary plasmacytoma is rare tumor of plasma cell tumor, which involve soft tissue without any signs of systemic spread and occurs predominantly in the head and neck, especially the nasal cavity and the paranasal sinuses. Ten to twenty percent of extramedullary plasmacytoma have regional lymph metastasis at the time of diagnosis and approximately one third of patients with extramedullary plasmacytoma will subsequently develop multiple myeloma during long-term follow-up. Primary treatment modality is moderate-dose radiation and surgery is rarely used. Extramedullary plasmacytoma has good prognosis, but requires long-term systemic evaluation and follow-up. We report a case of extramedullary plasmacytoma of the sinonasal cavity with a review of literature.

• Archives of Plastic Surgery
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• 제50권1호
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• pp.10-16
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• 2023

Background The chest wall defects can be caused by various reasons. In the case of malignant tumor resection of the chest wall, it is essential to reconstruct the chest wall to cover the vital tissue and restore the pulmonary function with prevention of paradoxical motion. With our experience, we analyzed and evaluated the results and complications of the chest wall reconstructions followed by malignant tumor resection. Methods From 2013 to 2022, we reviewed a medical record of patients who received chest reconstruction due to chest wall malignant tumor resection. The following data were retrieved: patients' demographic data, tumor type, type of operation, method of chest wall reconstruction of the soft and skeletal tissue and complications. Results There were seven males and six female patients. The causes of reconstruction were 12 primary tumors and one metastatic carcinoma. The pathological types were seven sarcomas, three invasive breast carcinoma, and three squamous cell carcinomas. The skeletal reconstruction was performed in six patients. The series of the flap were eight pedicled latissimus dorsi (LD) myocutaneous flaps, two pectoralis major myocutaneous flap, two vertical rectus abdominis myocutaneous free flap, and one LD free flap. Among all the cases, only one staged reconstruction and successful reconstruction without flail chest. Most of the complications were atelectasis. Conclusion In the case of accompanying multiple ribs and sternal defect, skeletal reconstruction would need skeletal reconstruction to prevent paradoxical chest wall motion. The flap for soft tissue defect be selected according to defect size and location of chest wall. With our experience, we recommend the reconstruction algorithm for chest wall defect due to malignant tumor resection.

• Asian Pacific Journal of Cancer Prevention
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• 제16권8호
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• pp.3533-3538
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• 2015

Background: Multiple primary malignancies (MPM) have become increasingly prevalent worldwide. This investigation was aimed at establishing the clinicopathological characteristics of MPM patients and evaluating the impact of the living environment on MPM in the Taiwanese population. Materials and Methods: From January 2009 to December 2013, a total of 8,268 cancer patients were identified in our institutional center. Of these, 125 were diagnosed as MPM and thus enrolled. Data for clinicopathological features and treatment approaches for these MPM patients living in urban or suburb zone were obtained. Findings for the air pollution status in Taiwan were also collected. Results: The most common cancer match of MPM was esophageal cancer with hypopharyngeal cancer (12.8%), followed by colorectal cancer with gastric cancer (6.4%) and colorectal cancer with breast cancer (5.6%). The air quality was significantly worse in the urban than in the suburban zone and there was a remarkably higher portion of MPM patients in the urban zone suffering from grade III and IV post-chemotherapeutic neutropenia (30.8% vs 15.1%, P=0.036). Conclusions: The tumor frequency and site distribution should be taken into the clinical evaluation because there is a relatively high risk of developing MPM. This study also highlighted the potential influence of environmental factors on post-chemotherapeutic neutropenia for patients with MPM.

• Journal of Gastric Cancer
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• 제3권4호
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• pp.214-220
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• 2003

Purpose: The aim of this study was to investigate the frequency of loss of heterozygosity and the microsatellite instability at multiple tumor suppressor gene loci in gastric adenocarcinomas. Materials and Methods: Loss of heterozygosity and the microsatellite instability at several tumor suppressor gene loci were analyzed in 29 primary gastric carcinomas by using microdissection and the polymerase chain reaction. Results: Twenty-three ($79\%$) of the 29 cases demonstrated loss of heterozygosity at one or more loci. The frequency of loss of heterozygosity at the p53 locus was the highest ($63\%$) and those at the VHL, APC, p16, Rb, MEN1, BRCA1, DPC4, 3p21, and 16p13 region were $41\%,\;36\%,\;19\%,\;29\%,\;33\%,\;26\%,\;21\%,\;32\%,\;and\;11\%$, respectively. Compared with histological type, loss of heterozygosity was more common in diffuse-type gastric cancer (P<0.01). Interestingly, 9 of 10 tumors with allelic deletion at the p53 locus showed loss of heterozygosity at other tumor suppressor gene loci. The microsatellite instability was also detected in 6 ($20\%$) of the 29 cases at one or more loci. Conclusion: These data suggest that frequent loss of heterozygosity and the microsatellite instability at multiple tumor suppressor genes might be required for the development and the progression of gastric carcinomas and that p53 allelic loss may be the most frequent event in the development of gastric carcinomas.