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The Clinical Analysis of Parotid Gland Tumors (이하선 종양에 관한 임상적 고찰)

  • Gong Gwun-O.;Kim Jung-Gyu;Choi Kyung-Hyun
    • Korean Journal of Head & Neck Oncology
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    • v.13 no.2
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    • pp.235-240
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    • 1997
  • Parotid tumors constitute about 70 to 80% of all salivary tumors. Two thirds of parotid neoplasms are benign. Women are affected more often than men. Plemorphic adenoma or benign mixed tumor is the most common parotid neoplasm, accounting for 50% of all parotid tumors. The clinical presentation is a discrete, slowly enlarging mass, rarely accompanied by pain or facial paralysis. We reviewed 69 cases of the parotid tumors admitted and treated at Department of Surgery, Kosin University Hospital from Jan, 1970 to June, 1994. The results were as follows: 1) Over all sex ratio was 1 : 1.56(M : F). The sex ratio of benign and malignant tumor was 1 : 1.43(M : F) and 1 : 2.2. 2) The mean duration of symptom was 4.6 years. 3) In the peak incidence of age, Benign tumor was in 4th decade, malignant tumor was in 2nd decade. 4) The chief complaint was painless palpable mass in 65 cases(94%) and pain in 4 cases(6%). 5) The mean size of mass was 2.5cm in diameter and the ratio of lesion site was 37 : 32(Rt : Lt). 6) Superficial parotidectomy was the most common procedure(43%). 7) According to histopathologic findings of 69 cases, Benign tumor was 56 cases(81%) and malignant tumor was 13 cases (19%). In the benign cases, pleomorphic adenoma was the most common(44 cases(65%)). In the malignant, mucoepidermoid ca. was the most common(5 cases (37%)). 8) Postoperative complication occured in 9 cases(13%), facial palsy was in 7 cases, and wound hematoma was 2 cases.

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Treatment of Lymphangioma combined with Facial Bone Deformity (안면골 변형을 동반한 림프관종의 치험례)

  • Cha Sang-Myun;Choi Hee-Youn
    • Korean Journal of Head & Neck Oncology
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    • v.7 no.1
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    • pp.24-34
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    • 1991
  • Lymphangioma is a benign, growth of lymphatic tissue that is present at birth or develops in early childhood, which may cause serious alterations in growth and developmemt. The problems with facial lymphangioma is usually releated directly to their size and to the area of the face which is involved. The lesions themselves may range from small, localized blemishes to huge facial masses involving both soft tissue and underlying bone and causing great distortion and asymmetry. The facial bones are seldom involved, but the natutal evolution of an individual lesion often cannot be accurately predicted when the child is first seen. Any changes in the underlying facial bone could be due either to a direct growth of the lesion into the bone, or secondary to pressure of the lesion growing outside the bone itself. A case of cystic lymphangioma extending from the neck to the tongue is reported. A six-year-old female was admitted because of swelling of the tongue. At that time, the tongue reportedly reached the extraoral size of 7x5x2.5cm and a soft, diffuse swelling of left anterior neck was revealed. The removal of cystic mass including left neck dissection and partial glossectomy were undertaken. The another case of lymphangioma is located on mandibular cheek. A twenty nine-year-old male was admitted because of palpable mass of the left mandibular area and fissure of palate. The radical excision of mass with mandibulectomy of body were undertuken. Thus we reported such a rare case and reviewed the lymphangioma.

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Aspiration Cytology of Insular Carcinoma of Thyroid - A Case Report - (갑상선 미분화 "도암종"의 세침흡인 세포학적 소견 - 1례 보고 -)

  • Yang, Young-Il;Kim, Chan-Hawn;Khang, Shin-Kwang
    • The Korean Journal of Cytopathology
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    • v.5 no.1
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    • pp.46-51
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    • 1994
  • Fine needle aspiration cytologic features of a case of insular carcinoma of the thyroid in a 23-year-old woman who presented a palpable neck mass is described. The aspirate showed cellular smear arranged in trabeculae, solid or loose clusters, and microfillicles in necrotic background. The tumor cells had uniform, small round, hyperchromatic nuclei. The chromatin was finely granular, and nuclear membrane was smooth. Nucleoli were not discernible. Nuclear pleomorphism was minimal. The cytoplasm was usually scanty, pale, poorly outlined, and almostly amphophilic. Sometimes paranuclear cytoplasmic vacuoles were noted. final diagnosis was confirmed by total thyroidectomy as insular carcinoma.

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Fine Needle Aspiration Cytology of Periductal Mastitis (Subareolar Abscess) and its Clinical Significance of Cytological Diagnosis (관주위유방염 (유륜하 농양)의 세침흡인 세포소견 및 세포진단의 중요성)

  • Joo, Mee;Chang, Sun-Hee;Kwak, Ji-Eun;Park, Sung-Hye;Song, Byung-Ju;Kim, Han-Seong
    • The Korean Journal of Cytopathology
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    • v.17 no.1
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    • pp.27-31
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    • 2006
  • Periductal mastitis is a specific clinicopathologic entity, and is referred to by several names: recurrent subareolar abscess, squamous metaplasia of the lactiferous duct, and Zuska's disease. Clinically, the differentiation of periductal mastitis from other benign lesions and carcinomas around the nipple frequently proves a difficult proposition. We reviewed the fine needle aspiration cytology (FNAC) of 14 cases of periductal mastitis, which had been diagnosed either radiologically, histologically, or clinically. The patient group included 13 female patients, and one male. The majority of the patients in this group had presented with subareolar masses. All cases evidenced characteristic anucleated squamous cell clusters within a mixed inflammatory background. A diagnosis of periductal mastitis can be rendered fairly readily on excisional biopsy. However, FNAC is considered to be superior to excisional biopsy as an initial diagnostic procedure for any palpable mass in subareolar lesions of the breast. FNAC can also be a useful diagnostic technique in cases of periductal mastitis, even in the early phases of the disease. A definitive diagnosis of subareolar abscess via FNAC will enable the clinician to select the most appropriate medical or surgical treatment.

Preoperative Diagnostic Value of Fine Needle Aspiration(FNA) Cytology of Palpable Thyroid Nodules (갑상선 결절에 대한 세침흡입 세포검사의 수술전 진단적 가치)

  • Jeon Byeong-Min;Lee Byeong-Wook;Kim Sang-Hyo;Paik Nak-Whan
    • Korean Journal of Head & Neck Oncology
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    • v.10 no.2
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    • pp.192-199
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    • 1994
  • Since 1950s, fine needle aspiration(FNA) cytology has become increasingly popular and numerous reports have demonstrate its accuracy, safety and cost-effectiveness. To evaluate the role of diagnostic FNA cytology in the thyroid nodule, authors compared preoperative cytologic findings with postoperative histologic diagnosis in two hundred two thyroid nodules underwent surgical resection at Department of Surgery, Pusan Paik Hospital. from July 1990 to December 1993. FNA and thyroidectomy was performed primarily by one Head and Neck surgeon and specimen was interpreted by several pathologists. One hundred seventy two FNAs(85%) were interpreted as positive for benign lesion or carcinoma and thirty(15%, cystic in 25, non-cystic lesion in 5 cases) were unsatisfactory specimens for interpretation. The preoperative cytologic diagnosis of 172 cases revealed 'benign' in 112. 'suspicious cancer' in 10 and 'cancer' in 50 cases. Postoperative pathologic diagnosis showed 'nodular goiter' in 64. 'benign tumor' in 43, 'thyroiditis' in 4 and 'cancer' in 61 cases. The value of preoperative FNA diagnosis for thyroid cancer yielded a sensitivity of 85.2%, a specificity of 92.7%, false negative rate 5.2%, false positive rate 4.5% and positive predictive value and overall accuracy were 86.6% and 90.1% respectively. Preoperative rate of malignancy could be increased up to 35.5% by using FNA.

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A Clinical Study of Thyroid Diseases (갑상선 질환에 관한 임상적 관찰)

  • Min Byoung-Sam;Nam Young-Soo;Park Chan-Heun;Pai Soo-Tong
    • Korean Journal of Head & Neck Oncology
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    • v.10 no.2
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    • pp.112-121
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    • 1994
  • During the 7 years period from March 1987 to Febrary 1994, 344 patients with thyroid nodules, were admitted and operated at Department of Surgery, Collage of Medicine, Hallym university. We obtained following results: 1) The thyroid nodules were prevalent in female with ratio 1:17.1, both benign and malignant nodules were prevalent in the forth decade(37.8%:25.8%). 2) The duration of illness within 6 months was most common: 47.1% and within 1 years was 66.6%. 3) The most prominent symptoms & sign were palpable mass in anterior neck(96.8%). 4) The right-sided thyroid nodules were most common. 5) Thyroid scaning and thyroid function test were found to be not much value in differentiating malignancy. 6) Accuracy of the fine needle aspiration cytology was 75.5%. 7) There were 251 cases(73.0%) of benign and 93 cases(27.0%) of malignant nodules: most frequent benign nodule was adenomatous goiter(67.7%) and the most frequent malignant nodule was papillary adenocarcinoma (86.0%). 8) The most commonly performed surgical procedure was unilateral lobectomy with isthmectomy in both benign(41.0%) and malignant(33.3%). 9) Postoperative complications are as follows: transient hypothyroidism 22cases, transient hoaseness 16 cases, hypothyroidism 6 cases, wound infection 4 cases, hematoma 3 cases, permanent hoaseness 2 cases.

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A Way to Avoid Muscular Fibrosis in the First Dorsal Interosseous Muscle after Acupuncture Injection Therapy

  • Wong, Yiu Ming
    • Journal of Pharmacopuncture
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    • v.20 no.3
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    • pp.227-229
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    • 2017
  • Fibrosis of skeletal muscle following acupuncture is an iatrogenic disorder. The present case illustrates a patient with a unilateral fibrotic formation on a thumb muscle after acupuncture injection therapy with red sage. The patient in the present case was a counter-terrorism police officer with right-handedness; he noted a palpable nodule three months after injection therapy at his left first dorsal interosseous in which the acupuncture point LI4 (He Gu) is located. He also found a reduction in the strength of his left pinch grip that noticeably affected his left handgun marksmanship. However, being ambidextrous in single-hand pistol shooting is an essential requirement for counter-terrorism police officers. Based on the patient's medical history and claims, no underlying disease or trauma was found to be associated with his current complaint. During physical examination, a fibrotic formation in his left first dorsal interosseous muscle was visualized by using diagnostic ultrasound; also, as confirmed with dynamometry, the strength of his left pinch grip was significantly lower than that of the right counterpart. Because acupuncture injection therapy has three components, antiseptic practices, the mechanical action of syringe insertion, and the pharmacological effect of the sterile herb extract, any one of the components may have contributed to the present adverse event. The first dorsal interosseous muscle is small in dimension and rather vascular; thus, it is not an ideal site for intramuscular injection. When a clinician needs to treat a patient by performing acupuncture at the LI4 acupoint and injecting a herbal extract simultaneously, the clinician should only mechanically stimulate the LI4 acupoint while injecting the herbal medicine into the LI14 (Bi Noe) acupoint on the same meridian, the LI14 acupoint being located in the distal portion of the deltoid muscle and being fairly close to the universally agreed upon site on the upper arm for safe administration of an injection.

KAPOSI'S SARCOMA OF THE ORAL CAVITY IN RENAL TRANSPLANTED PATIENT; A CASE REPORT (신장 이식 환자에서 발생한 구강내 카포시 육종; 증례 보고)

  • Jeong, Jong-Cheol;Choi, Se-Hoon;Song, Min-Soek;Jun, Chang-Hun;Kim, Hyun-Min;Jeong, Dong-Hae
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.29 no.3
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    • pp.186-190
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    • 2003
  • Kaposi's sarcoma was first descrided by Kaposi in 1872 as an idiopathic multiple hemorrhagic sarcoma. Its clinical features revealed to be erythematous red or purple macule started out, and developing into palpable dome-shaped nodules. Etiology is not defined to detail at present. Kaposi's sarcoma is classified to 4 categories; Classical, African, Epidemic and Transplant type. Epidemic or AIDS categories is found approximately 20 % of all AIDS and has strong predilection for head and neck region. The first case of Kaposi's sarcoma observed in patients with kidney transplants was reported in 1969. Kaposi's sarcoma now accounts for 5% of all tumors associated with transplanted patients and alteration of the immunosuppression may have played a key role in these recipients. The most common site of Kaposi's sarcoma in transplanted patients are extremities but rare in head and neck area. We report a case of Kaposi's sarcoma on the hard palate in the kidney transplantation patient.

Infantile Hepatic Hemangioendothelioma: Seventeen Years of Experience at a Single Center (소아 간 혈관내피종 : 17년간의 치료경험)

  • Kwon, Hyung-Joo;Moon, Suk-Bae;Park, Kwi-Won;Jung, Sung-Eun
    • Advances in pediatric surgery
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    • v.14 no.2
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    • pp.134-143
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    • 2008
  • Infantile hepatic hemangioendothelioma (IHHE) is the most common benign vascular hepatic tumor in children. We analyzed the 17-year experience of IHHE. The medical records of 16 patients (M:F=8:8) treated at the Department of Pediatric Surgery and the Department of Pediatrics Seoul National University Children's Hospital between January 1991 and January 2008 were reviewed retrospectively. Mean age at presentation was 87 days (1 day - 551 days). Seventy five percent of patients were diagnosed with imaging study and 25 % with biopsy. Major symptoms were hepatomegaly (N=5), palpable abdominal mass (N=4) and congestive heart failure (N=3). Six patients had no symptoms. Kasabach-Merritt syndrome was combined in one patient. Nine patients (56.3 %) underwent operation and 2 patients (12.5 %) underwent only medical treatment. Clinical observation was tried on 5 patients (31.3 %) without any treatment. Operation was performed on the patient with clinical symptoms or on patients where the differentiation between begin and malignant could not be determined. Patients who had clinical symptoms but tumor was unreresectabile were treated medically. Among the 5 patients who had been observed for their clinical course, 2 patients showed complete regression and the tumors of the remaining 3 patients were regressing. Clinical symptoms, the age at presentation, the size of tumor and ${\alpha}$-FP, all had no significant statistical relationship with the time required for complete tumor regression. There was no relationship between the size change of the tumor and the change of ${\alpha}$-FP level. Only the size of tumor was related with clinical symptoms. One patient died of post-operatvie bleeding. Treatment plan was determined by the extent of the tumor and the presence of clinical symptoms. Observation was enough for the patients without clinical symptoms and complete resection was curative for patients with clinical symptoms. Medical treatment is an alternative for the patient whose tumor is unresectable.

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A Case of Severe Cough-induced Abdominal Wall Hematoma (심한 기침에 의해 발생한 복벽 혈종 1예)

  • Son, Jun-Hyuk;Baik, Jae-Joong;Yang, Keum-Yeoi;Ryu, Kwang-Won;Joo, Young-Jin;Choi, Seung-Min;Kim, Sang-Cheol;Chung, Yeon-Tae
    • Tuberculosis and Respiratory Diseases
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    • v.51 no.5
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    • pp.462-465
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    • 2001
  • Severe cough may contribute to serious complications such as pneumothorax, pneumomediastinum, rib fracture, subconjunctival hemorrhage, subdural hemorrhage and cough syncope. However abdominal wall hematoma is a rare complication. Because it usually presents with abdomianal pain, abdominal wall hematoma needs to be differentiated from the acute surgical abdomen. A 78-year old woman was admitted with right lower quadrant abdominal pain and a palpable mass for several days. She experienced abdominal pain after violent coughing associated with an upper respiratory tract infection. Abdominal computed tomography revealed an approximately $7{\times}4cm$ sized, ill-defined, soft tissue density lesion in the right lower posterolateral abdominal wall. An abdominal wall hematoma was diagnosed. After admission, she had persistent right lower abdominal pain and an increasing mass. The mass was surgically removed and she was discharged without complications. In summary, when a patient complains of abdominal pain after severe coughing, an abdominal wall hematoma as a differential diagnosis must be considered.

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