• Title/Summary/Keyword: Neck surgery

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A Case of Cervical Malignant Lymphoma Coexisted with Multicentric Castleman's Disease (다발성 캐슬만병과 공존한 경부 악성 림프종 1례)

  • Jang, Gyu Ho;Jung, Young Do;Seo, Youn Tae;Kim, Jeong Kyu
    • Korean Journal of Head & Neck Oncology
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    • v.32 no.2
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    • pp.35-39
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    • 2016
  • Castleman's disease (CD) is an uncommon lymphoproliferative disorder. The disease entity is classified into 2 clinical subtypes, unicentric and multicentric type. Prevalence of lymphoid malignancy in multicentric CD (MCD) is very low. In this case, we report a case of 77 years old woman who developed high fever and swelling in both side of her neck. Neck lymph node biopsy revealed plasma cell hyperplasia. Patient's symptom was subsided after treatment with Dexamethasone. Three months later, multiple lymph node enlargement was developed in abdomen and neck area again. Repeated neck lymph node biopsy confirmed diffuse large B cell lymphoma. The patient started chemotherapy.

Clinical Significance of the Expression of p53, p21, EGFR and c-erbB-2 in Squamous Cell Carcinoma of the Head and Neck (두경부 편평세포암종에서 p53, p21, EGFR 및 c-erbB-2 발현의 임상적 의의)

  • Lee Jun-Han;Do Nam-Yong;Park Sung-Yong;Kim Gun-Hyung;Cho Sung-Il
    • Korean Journal of Head & Neck Oncology
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    • v.21 no.2
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    • pp.139-145
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    • 2005
  • Background and Objectives: Because of squamous cell carcinoma of the head and neck undergoes a generally poor hospital course, the prognostic significance of the squamous cell carcinomas in head and neck have been evaluated to identify those features associated with aggressive biologic behavior according to the immunologic and histopathologic characteristics. Materials and Method: To assess the significance of EGFR, c-erbB-2, p21 and p53 protein in head and neck tumors and their correlation with prognostic factors, samples from 74 patients with squamous cell carcinomas of larynx, pharynx, and oral cavity were studied immunohistochemically. Results: EGFR, c-erbB-2, p21, and p53 protein were expressed 94.6%, 24.3%, 85.1%, and 55.4% in 74 cases of head and neck squamous cell carcinoma, respectively. The positive expression of EGFR was associated significantly with clinical stage and the negative expressions of p21 was associated significantly with histopathologic differentiation. There were no significant relationships between the reactivity of EGFR, c-erbB-2, p21, and p53 protein. Conclusion: The expression of EGFR, c-erbB-2, p21 and p53 protein could be related to oncogenesis, and the expression of p21 and EGFR protein can be used as a prognosticator in head and neck squamous cell carcinoma under certain limitations, but c-erbB-2 and p53 protein expression alone is not enough for evaluating prognosis of the carcinoma.

Prognostic Factor Analysis for Management of Chronic Neck Pain : Can We Predict the Severity of Neck Pain with Lateral Cervical Curvature?

  • Seong, Han Yu;Lee, Moon Kyu;Jeon, Sang Ryong;Roh, Sung Woo;Rhim, Seung Chul;Park, Jin Hoon
    • Journal of Korean Neurosurgical Society
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    • v.60 no.4
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    • pp.456-464
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    • 2017
  • Objective : Although little is known about its origins, neck pain may be related to several associated anatomical pathologies. We aimed to characterize the incidence and features of chronic neck pain and analyze the relationship between neck pain severity and its affecting factors. Methods : Between March 2012 and July 2013, we studied 216 patients with chronic neck pain. Initially, combined tramadol (37.5 mg) plus acetaminophen (325 mg) was administered orally twice daily (b.i.d.) to all patients over a 2-week period. After two weeks, patients were evaluated for neck pain during an outpatient clinic visit. If the numeric rating scale of the patient had not decreased to 5 or lower, a cervical medial branch block (MBB) was recommended after double-dosed previous medication trial. We classified all patients into two groups (mild vs. severe neck pain group), based on medication efficacy. Logistic regression tests were used to evaluate the factors associated with neck pain severity. Results : A total of 198 patients were included in the analyses, due to follow-up loss in 18 patients. While medication was successful in reducing pain in 68.2% patients with chronic neck pain, the remaining patients required cervical MBB. Lateral cervical curvature, such as a straight or sigmoid type curve, was found to be significantly associated with the severity of neck pain. Conclusion : We managed chronic neck pain with a simple pharmacological management protocol followed by MBB. We should keep in mind that it may be difficult to manage the patient with straight or sigmoid lateral curvature only with oral medication.

Prevalence of Allergic Disease in Korean Adults: Results from the Korea National Health and Nutrition Examination Survey (2010-2012) (한국 성인의 알레르기 질환 유병률: 국민건강영양조사 2010-2012)

  • Im, Donghyuk;Yang, Young Soo;Choi, Hye Rang;Choi, Seongjun;Nahm, Hyunjoo;Han, Kyujin;Hong, Seok-Chan;Kim, Jin Kook;Cho, Jae Hoon
    • Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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    • v.60 no.10
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    • pp.504-511
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    • 2017
  • Background and Objectives In this study, we evaluated differences in the prevalence of allergic rhinitis, asthma, atopic dermatitis and specific immunoglobuline E (IgE) value for some respiratory antigens in Korean adults. Subjects and Method The study was conducted using data from the 5th National Health and Nutrition Survey (2010-2012). All subjects who were aged 19 years or older completed questionnaires on asthma, atopic dermatitis and allergic rhinitis. The subjects were first divided into male and female, and then into age groups of 19-29, 30-39, 40-49, 50-59, 60-69, ${\geq}70$ each. The lifetime and current prevalence rates for allergic rhinitis, asthma, and atopic dermatitis were calculated for each age group. The total and specific IgE level for Dermatophagoides farinae (DF), cockroach, and dog dander were also calculated. Results Final participants of 17542 were analyzed for the prevalence rate among the total of 25534 participants. The mean IgE level was calculated from 2028 subjects from the final participants. In asthma, the lifetime prevalence and current prevalence increased with age, but decreased with atopic dermatitis and allergic rhinitis. Total IgE level increased with age, but IgE level of DF reached its peak at 20-29 years, and then decreased rapidly thereafter. There was no clear trend for cockroach and dog dander. Conclusion The prevalence of allergic diseases in adults varies widely by age group. Asthma has a low prevalence after age 20 and gradually increases after age 50. Atopic dermatitis and allergic rhinitis are the most prevalent in their 20s and gradually decrease thereafter.

Castleman's Disease of the Neck (경부 Castleman씨 병(거대 림프절 증식증) 1예)

  • Yang Yoon-Soo;Lee Sang-Heon;Hong Ki-Hwan
    • Korean Journal of Head & Neck Oncology
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    • v.20 no.2
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    • pp.194-197
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    • 2004
  • Castleman's disease was first described from Benjamin Castleman in 1956. The disease today is enumerated among lymphoproliferative disorders and has unknown etiology. Although the mediastinum is a their most common location, they also occurs in other areas of the body, usually where lymph nodes are normally found. Castleman's disease of the neck is very rare. We describe a case of Castleman's disease of the neck in a middle aged man, and discuss the clinical presentation, radiological findings, and pathological features.

Major Salivary Glands Tumors:A 10-Year Experience (주 타액선 종양에 대한 10년 간의 경험)

  • Kong, Il-Gyu;Chang, Dong-Yeop;Jung, Eun-Jung;Jung, Young-Ho;Hah, J.Hun;Sung, Myung-Whun;Kim, Kwang-Hyun
    • Korean Journal of Head & Neck Oncology
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    • v.22 no.2
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    • pp.142-146
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    • 2006
  • Background and Objectives : This study reports our clinicopathological experiences of major salivary gland tumors. Materials and Methods : This study included 302 patients with major salivary gland tumors who had got the diagnosis from January 1995 through December 2004. Medical records were reviewed retrospectively. Results : We found 244 benign and 58 malignant major salivary gland tumors. Among 267 parotid tumors, the most common benign parotid tumor was pleomorphic adenoma. Mucoepidermoid carcinoma, adenoid cystic carcinoma, and acinic cell carcinoma were three most common parotid malignancies. Among 33 submandibular gland tumors, 20 cases were benign and 13 were malignant. There were one benign and one malignant sublingual gland tumors. The duration of symptom of submandibular gland tumors was longer than that of parotid tumors. Most patients presented with asymptomatic mass. Seventy-one percent of salivary gland malignancies underwent postoperative radiation therapy. Five-year disease free survival rate of parotid malignant tumors seemed to be higher than that of submandibular one, although there was no statistical significance. Conclusion : Malignancy rate of each salivary gland followed old axiom that it is inversely related with the size of gland. Submandibular gland tumor tends to be delayed to reach diagnosis. Clinicians must be alert about this finding because submandibular gland tumors are known to have poorer prognosis than parotid tumors.

Synchronous Mucoepidermoid Carcinoma of Parotid Gland and Unicentric Cervical Cathleman's Disease : A Case Report (점액표피양 암종과 동반된 경부 캐슬만 병 1예)

  • Noh, Min Ho;Bae, Kong Geun;Ban, Myung Jin;Park, Jae Hong;Lee, Seung Won;Park, Ki Nam;Kim, Jae Wook;Koh, Yoon Woo
    • Korean Journal of Head & Neck Oncology
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    • v.31 no.1
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    • pp.14-17
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    • 2015
  • Castleman's disease is an uncommon lymphoproliferative disorder. The disorder can be classified based on histological subtype, such as hyaline vascular type, plasma cell type, and mixed type, and can also be clinically divided into either unicentric or multicentric type. Its exact pathophysiology is not clearly identified. The unicentric type is able to be treated by surgical resection. However, there is no standard treatment modlity for the multicentric type. Treatment of multicentric type includes anti-cancer chemotherapy and radiation therapy. Recently, authors have experienced a rare case of unicentric type of Castleman's disease accompanying a mucoepidermoid carcinoma of parotid gland and report a case which is discussed with references.

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Clinical Characteristics of Papillary Thyroid Microcarcinoma Involving Posterior Thyroidal Capsule (갑상선 후방 피막을 침범하는 갑상선미세유두암의 임상양상에 대한 고찰)

  • Jang, Seong Uk;Oh, Jung Ho;Kim, Seo Bin;Kim, Sung Won;Lee, Hyoung Shin;Noh, Woong Jae;Lee, Kang Dae
    • Korean Journal of Head & Neck Oncology
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    • v.31 no.2
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    • pp.6-10
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    • 2015
  • Background and Objective : Papillary thyroid microcarcinoma(PTMC) is known as slow growing cancer with good prognosis. However, extrathyroidal extension may increase the risk of cervical lymph node metastasis and local invasion to surrounding structures. The aim of this study was to assess the characteristic features of the tumor invading the posterior thyroid capsule. Material and Methods : We made a retrospective review of 123 PTMC patients with thyroid capsule invasion, pathologically staged as T3 or T4. 74 patients (60.2%) had invasion to posterior thyroid capsule (group A) while 49 patients (39.8%) had invasion to-anterior thyroid capsule or anterior wall of trachea (group B). We assessed the clinicopathologic factors of the patients according to the location of capsular invasion of PTMC. Results : There was no difference regarding age, gender, T and N classification and incidence of lymph node metastasis between two groups. Local invasion rate to recurrent laryngeal nerve was 6.8% in patients with posterior thyroid capsule invasion, while the incidence was zero in those with capsular invasion to other locations Conclusion : Increased risk of local invasion to the recurrent laryngeal nerve should be considered in patients with PTMC presenting invasion of the posterior capsule.

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Management of Thyroid Cancer with Laryngotracheal Invasion (후두와 기관을 침범한 갑상선암의 치료)

  • Kim Kwang-Hyun;Sung Myung-Whun;Roh Jong-Lyel;Chung Won-Ho;Kim Chun-Dong;Suh Jung-Ho
    • Korean Journal of Head & Neck Oncology
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    • v.12 no.1
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    • pp.8-15
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    • 1996
  • When thyroid carcinoma invades the larynx or trachea, the proper treatment is needed because of significant morbidity and mortality due to airway obstruction. Hemoptysis and dyspnea are the result of intraluminal extension of the tumor and call for immediate investigation with endoscopic examination and CT. If the thyroid carcinoma with extracapsular spread invades only outer perichondrium of the tracheal or laryngeal cartilage, the shaving operation would be sufficient, but if the tumor invades the cartilage or if there is intraluminal invasion, it is mandatory to remove partial or total part of some aerodigestive tract structures. We retrospectively analyzed 14 surgical cases of the thyroid cancer with laryngotracheal invasion(12 papillary carcinomas and 2 anaplastic carcinomas) at the Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital. The analysis was focused on clinical manifestation, pathologic findings, types of management and results. Survival result was not adequately analyzed due to some recently operated cases.

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Reconstruction of the Head and Neck Region Using Lower Trapezius Musculocutaneous Flaps

  • Yoon, Soo Kwang;Song, Seung Han;Kang, Nakheon;Yoon, Yeo-Hoon;Koo, Bon Seok;Oh, Sang-Ha
    • Archives of Plastic Surgery
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    • v.39 no.6
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    • pp.626-630
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    • 2012
  • Background Recent literature has indicated that free flaps are currently considered the preferred choice for head and neck reconstruction. However, head and neck cancer patients are frequently treated with chemoradiotherapy, which is often associated with a poor general and local condition, and thus, such patients are ineligible for free flap reconstruction. Therefore, other reconstruction modalities should be considered. Methods We used lower trapezius musculocutaneous (LTMC) flap based on the dorsal scapular artery to reconstruct head and neck defects that arose from head and neck cancer in 8 patients. All of the patients had undergone preoperative chemoradiotherapy. Results There were no complications except one case of partial flap necrosis; it was treated with secondary intention. Healing in the remaining patients was uneventful without hematoma, seroma, or infection. The donor sites were closed primarily. Conclusions The LTMC flap is the preferred flap for a simple, reliable, large flap with a wide arc of rotation and minor donor-site morbidity. The authors recommend this versatile island flap as an alternative to microvascular free tissue transfer for the reconstruction of defects in the head and neck region, for patients that have undergone preoperative chemoradiotherapy.