• Title/Summary/Keyword: Neck tumor

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Effectiveness of Intraoperative Neuromonitoring According to the Mechanism of Recurrent Laryngeal Nerve Injury During Thyroid Surgery (갑상선 수술 중 반회후두신경의 손상 기전에 따른 신경 감시술의 효용성)

  • Shin, Sung-Chan;Lee, Byung-Joo
    • Korean Journal of Head & Neck Oncology
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    • v.36 no.1
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    • pp.9-14
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    • 2020
  • Visual identification of recurrent laryngeal nerve (RLN) is considered as a gold standard of RLN preservation during thyroid surgery. Intraoperative neuromonitoring (IONM) is classified into the intermittent type and continuous type and helps surgeons identify the functional integrity of RLN and predict the postoperative vocal cord function. RLN injury during thyroid surgery is associated with tumor factors and surgeon factors. Tumor factors mean such as direct tumor invasion, adhesion of RLN to the tumor, and compression by a large thyroid tumor. Surgeon factors include nerve transection, stretching, thermal injury, and ligation injury. A recent meta-analysis reported that the IONM could reduce the RLN injury. Considering various nerve injury mechanism, we suggest that using both I-ONM and C-IONM together is more effective method in preventing nerve damage than using I-IONM alone.

Prognostic value of FDG PET/CT during radiotherapy in head and neck cancer patients

  • Kim, Suzy;Oh, Sowon;Kim, Jin Soo;Kim, Yu Kyeong;Kim, Kwang Hyun;Oh, Do Hoon;Lee, Dong-Han;Jeong, Woo-Jin;Jung, Young Ho
    • Radiation Oncology Journal
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    • v.36 no.2
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    • pp.95-102
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    • 2018
  • Purpose: To evaluate the prognostic value of $^{18}F$-fluorodeoxyglucose positron-emission tomography (FDG PET) with computed tomography (CT) before and during radiotherapy (RT) in patients with head and neck cancer. Methods: Twenty patients with primary head and neck squamous cell carcinoma were enrolled in this study, of whom 6 had oropharyngeal cancer, 10 had hypopharyngeal cancer, and 4 had laryngeal cancer. Fifteen patients received concurrent cisplatin and 2 received concurrent cetuximab chemotherapy. FDG PET/CT was performed before RT and in the 4th week of RT. The parameters of maximum standardized uptake value, metabolic tumor volume, and total lesion glycolysis (TLG) of the primary tumor were measured, and the prognostic significance of each was analyzed with the Cox proportional hazards model. Results: Higher TLG (>19.0) on FDG PET/CT during RT was a poor prognostic factor for overall survival (OS) (p = 0.001) and progression-free survival (PFS) (p = 0.007). In the multivariate analysis, TLG during RT as a continuous variable was significantly associated with OS and PFS rate (p = 0.023 and p = 0.016, respectively). Tumor response worse than partial remission at 1 month after RT was another independent prognostic factor for PFS (p = 0.024). Conclusions: Higher TLG of the primary tumor on FDG PET/CT during RT was a poor prognostic factor for OS and PFS in patients with head and neck cancer.

A Clinical Analysis of Major Salivary Gland Tumors-104 Cases (주타액선종양 104례에 대한 분석)

  • Kim Myung-Sang;Kim Young-Ho;Hong Jung-Pyoe;Choi Eun-Chang;Kim Kwang-Moon;Hong Won-Pyo
    • Korean Journal of Head & Neck Oncology
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    • v.14 no.1
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    • pp.40-45
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    • 1998
  • Backgroud and Objectives: Major salivary gland tumor is a rare disease with a largely unknown origin. And also corresponding to the diversity of histopathologic characteristics is an equally wide distribution of clinical behavior that makes treatment decisions difficult. The aim of this study is to analysis the clinical experience of our major salivary gland tumor and to suggest a guidline of management. Materials and Methods : We studied clinical manifestations and treatment results of 104 patients who were diagnosed as major salivary gland tumors. Tumor site, patient age and sex of the patients were analysed. Histopathologic diagnosis, treatment modality, lymph nodes metastasis, recurrence rate and 5-year survival rate were studied on malignant tumors. Results: 1) 48 patients were male and 56 patients were female. 2) Benign tumors were 79 cases. They consisted of 57 cases(72%) of parotid tumor, 22 cases(27%) of submandibular tumor. And pleomorphic adenoma was the most common benign tumor. 3) Malignant tumors were 25 cases and were consisted of 19 cases(76%) of parotid tumor, 4 cases(l6%) of submandibular tumor and 2 cases(8%) of sublingual gland tumor with high-grade mucoepidermoid carcinoma as the most common cause. 4) In the malignant tumors, the number of stage I, II tumors was 14 and that of stage III, IV tumors was 11. Neck node metastasis was noted in 8 cases. 5) 8 cases of malignant tumor were died and all of them had high-grade malignancy. And they were dead before 17 months from the time of diagnosis. 6) Mean survival duration in the malignant salivary gland tumor was 56 months. 7) High-grade malignancy had a 5-year survival rate of 57.9%. A 5-year survival rate of TI, T2 patients was 92.9% and that of T3, T4 patients was 36.4%. That of patients who had neck node metastasis was 37.5% and that of those who had tree neck was 82.4%. Conclusion: The results of this study suggest that the survival rate is dependent on the tumor size, lymph node matastasis and histologic grade. And also the early diagnosis and radical surgery result in the increased survival rate and are effective for prevention of the tumor recurrance.

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IgG4 Related Disease Misdiagnosed to Carotid Body Tumor (경동맥소체종양으로 오인된 IgG4 연관 질환)

  • Lee, Gun Hyuk;Song, Ji-Sun;Yoon, So Yeon;Cho, Youn Jin;Hong, Hyun Jun
    • Korean Journal of Head & Neck Oncology
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    • v.36 no.2
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    • pp.27-31
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    • 2020
  • Neck mass has various etiologies, including inflammatory, congenital, neoplastic causes. The IgG4-related disease can cause symptoms in the head and neck areas with an inflammatory neck mass. It also shows clinical and pathological findings from inflammation caused by immune reactions, such as lymphocyte and plasma cell infiltration, storiform fibrosis, obliteration phlebitis, and invigorated serum IgG4 levels. The treatment guideline has not been established and still under debate, but systemic glucocorticoid seems to be effective in the most cases. In this brief report, a 48-year-old male patient presented with voice change for 3 weeks. Left side paramedian vocal fold palsy was observed in the flexible laryngoscopy. About 2.5×2.0×1.2cm size, heterogeneously enhanced neck mass with irregular margin encasing left carotid artery was noted on preoperative contrast enhanced neck CT scan, and it was suspicious of left carotid body tumor. The pathology shows IgG4-related disease rather than carotid body tumors. We report this case of IgG4-related disease, which can be misdiagnosed to carotid body tumors.

Lymphoepithelial Carcinoma of the Parotid Gland, Mimicking Malignancy of Unknown Origin(MUO) in the Head and Neck (원발미상암으로 오인된 이하선 림프상피암종)

  • Park, Jun Oh;Jang, Jeon Yeob;Ko, Young-Hyeh;Jeong, Han-Sin
    • Korean Journal of Head & Neck Oncology
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    • v.29 no.2
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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.

A Case of Intravenous Pyogenic Granuloma Found as a Neck Mass (경부 종물로 발견된 정맥 내 화농성 육아종 1례)

  • Lee, Dong Won;Kim, Jeong Kyu
    • Korean Journal of Head & Neck Oncology
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    • v.36 no.2
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    • pp.61-64
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    • 2020
  • Intravenous pyogenic granuloma, commonly known as intravenous lobular capillary hemangioma, is a rare benign tumor of the vein. It rarely occurs in the neck, and its character is not enough to diagnosis clinically. It could be diagnosed with preoperative radiologic examinations such as ultrasound and computed tomography and typical pathologic findings that demonstrate lobules of multiple capillaries lined with flattened endothelial cells admixed with fibromyxoid stroma. The authors report a case of a 32-year-old male who presented with a palpable neck mass for one month with a review of the literature. He was successfully treated with resection, including the tumor and normal external jugular vein, without any complications.

A Case of Neurilemmoma of the Larynx (후두에 발생한 신경초종 1예)

  • Lee, Sung-Su;Lee, Dong-Wook;Shim, Woo-Sub;Moon, Young-Eun
    • Korean Journal of Head & Neck Oncology
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    • v.25 no.2
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    • pp.171-173
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    • 2009
  • Neurilemmoma is a relatively rare benign tumor which may be derived from nerve sheath of the peripheral, sympathetic and cranial nerve except the optic nerve and olfactory nerve. And it is a characteristically solitary and well-encapsulated mass. About 25% of neurilemmoma occurs in the head and neck region and the acoustic nerve is most frequently involved, but neurilemmoma of the larynx is rare. Recently, we experienced a case of neurilemmoma occurred in the right aryepiglottic fold of the larynx. The tumor was successfully removed by transoral approach under direct laryngoscope. So we report this case with literature review.

A Case of Recurrent Spindle Cell Epithelial Tumor of Thymus-Like Differentiation (SETTLE) in the Glottis (성문에서 발생한 재발성 흉선상 방추상 상피세포 종양(Spindle Epithelial Tumor with Thymus-Like Differentiation, SETTLE) 1예)

  • Park, Woori;Choi, Nayeon;Chung, Man Ki
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.26 no.2
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    • pp.133-136
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    • 2015
  • Spindle epithelial tumor with thymus-like differentiation (SETTLE) is an extremely rare type of thyroid tumor, with spares reports on its clinical course. SETTLE is derived from branchial pouch or thymic remnants, and classified as a low grade, malignant neoplasm due to its indolent growth and tendency to develop delayed metastasis. Therefore, stringent initial workups and long-term follow-up are required to prevent misdiagnosis. We present a case of recurrent spindle epithelial tumor with thymus-like differentiation (SETTLE) in the glottis of 57 year-old male patient, who had a history of surgical excision for the SETTLE from the thyroid gland 5 years ago. Transoral CO2 laser surgery was performed to remove the glottic tumor and there was no evidence of local recurrence at 11 months postoperatively.

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A Case of Neurogenic Tumor-like Cervical Arteriovenous Malformation (신경인성 종양과 유사한 양상의 경부 동정맥 기형 1예)

  • Lim, Sung Hwan;Kim, Min A;Kim, Seung Woo
    • Korean Journal of Head & Neck Oncology
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    • v.34 no.2
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    • pp.85-87
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    • 2018
  • The arteriovenous malformation (AVM) is an anomaly of capillary development that results from direct connection between branches of artery and vein without intervening capillary bed. The neurogenic tumors have a tendency to various types of degeneration. Recently, we experienced a 73-year old man with a mass in left supraclavicular area. The intraoperative findings showed severe adhesions with cervical plexus, like a neurogenic tumor. Finally, the mass was revealed as AVM. We report a unique disease pattern with a literature review.