• Korean Journal of Head & Neck Oncology
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• v.11 no.2
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• pp.173-177
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• 1995

Multiple primary malignant neoplasms occur relatively frequently today and are important especially in the head and neck area for they usually carry a bad prognosis. Detection of a synchronous primary tumor at the time of initial work-up is crucial both for management and final outcome. The first case was a T1 hypopharyngeal cancer with a mid-esophageal second primary who complained of a huge neck node. The second case was a T3 hypopharyngeal cancer who was initially seen by the chest surgeons for a large lower esophageal tumor. The third case was a patient previously operated for stomach adenocarcinoma three years ago, who had newly developed symptoms like dysphagia and hoarseness, and was diagnosed as hypopharyngeal T3 with oropharyngeal second primary cancer. Three cases were all heavy smokers and had histories of heavy alcohol consumption. They were all treated at the same sitting by en-block resection of the involved organs and postoperative radiation therapy. The authors have recently experienced 3 cases of synchronous second primary cancers in association with hypopharyngeal cancer and a report is made.

• Korean Journal of Head & Neck Oncology
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• v.33 no.2
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• pp.89-93
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• 2017

Background. Ever since the first report of deltopectoral flap in pharyngo-esophageal reconstruction in 1965, various methods of flap reconstruction have been introduced, allowing surgical eradication of tumors that were once thought to be inoperable. Despite these advancement, many literatures emphasize distant metastasis and second primary malignancies as the most important factors that contribute to the low 5-year survival rate of the patients. Specific consensus about defining second primary cancer is still debatable, due to small number of reports regarding second primary tumors arising in flaps used for reconstruction of defects in the head and neck region. Case. We report a case of a 72-year-old male patient who, under the diagnosis of hypopharyngeal cancer, underwent total laryngectomy with partial pharyngectomy, extended right radical neck dissection with extended left lateral neck dissection, right hemithyroidectomy and radial forearm free flap reconstruction on June 16, 2003. After 37 cycles of radiation therapy, the patient exhibited no sign of recurrence. The patient revisited our department on June 14, 2016 with chief complaint of dysphagia that started two months before the visit. Radiologic studies and histology revealed squamous cell carcinoma in neopharynx, one that had been reconstructed with forearm free flap. Conclusion. Until now, only a handful of reports regarding patients with second primary cancer in reconstructed flaps have been described. Despite its rarity, diagnostic criteria for second primary cancer should always kept in consideration for patients with recurred tumor.

• Korean Journal of Bronchoesophagology
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• v.2 no.2
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• pp.222-226
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• 1996

The increasing incidence of multiple primary carcinomas occuring in the upper aerodigestive tract is well documented, with the accepted incidence being as high as 20-30%. The fiberoptic endoscopy has also enabled visualization of areas previously inaccessible without general anesthesia. A prospective panendoscopic examination of the upper aerodigestive tract was peformed on 104 patients with squamous cell carcinoma of head & neck in our hospital between 1989 and 1994. Five second primary cancers (4.8% ：2 stomach, 2 esophagus, 1 lung cancers) were detected endoscopically. These finding should reinforce the belief that head & neck cancer is a panmucosal disease of the aerodigestive tract that silent second primary cancers are not uncommon. So every effort should be done to detect second primary cancers in head & neck squamous cell carcinomas. Panendoscopy has proved valuable in achieving that.

• Korean Journal of Head & Neck Oncology
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• v.34 no.2
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• pp.53-56
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• 2018

Despite adequate diagnostic work-up, unknown primary carcinoma(UPC) of the head and neck cannot be detected in approximately 2- 3% of patients.(1,2) There are several explanations for a cervical metastasis in the absence of a primary tumor. Here in, we report 2 patients, who were diagnosed with nasopharyngeal cancer after treatment of unknown primary cancer of the neck. Both patients had radical neck dissections and chemoradiation therapy, but 1 patient showed nasopharyngeal cancers 4 years after treatment and the other patient at 9 months after treatment for the unknown primary cancer. Therefore, we report 2 cases of nasopharyngeal cancer, which were diagnosed after treatment of unknown head and neck primary site.

• Korean Journal of Head & Neck Oncology
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• v.32 no.2
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• pp.73-77
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• 2016

Simultaneous second primary tumors are not uncommon in patients with oral cavity squamous cell carcinoma. Many studies have previously shown that oral cavity squamous cell carcinoma patients with simultaneous second primary tumor generally have a poor prognosis. Additionally, the choice of the optimal therapeutic modality for oral cavity squamous cell carcinoma patients who present with simultaneous second primary tumor remains problematic. We reported a case of simultaneous squamous cell carcinomas in mouth floor and esophagus, that multidisciplinary team performed resection and reconstruction simultaneously.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.44 no.5
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• pp.220-224
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• 2018

Objectives: The aim of this study was to determine the incidence and characteristics of second primary malignancy (SPM) in patients with head and neck squamous cell carcinoma treated at a tertiary care hospital. Materials and Methods: We retrospectively reviewed the medical records of 221 patients who underwent surgery with or without adjuvant treatment for head and neck cancer from 2000 to 2002. Data of age, sex, risk factors, sites of primary and SPM, TNM stage of primary tumor, incidence of SPM, and survival were collected from medical charts. Results: Eighteen patients developed SPM during a median follow-up of 67 months, with an overall incidence of 8.14%. In addition, 77.7% of SPMs occurred in the oral cavity, followed by 11% in the lungs. The 5-year overall survival after the diagnosis of SPM in the head or neck was 70%, compared to 30% for SPM in other body regions. Conclusion: Considering a high incidence of SPM, i.e., 8.14%, in a mean follow-up period of 67 months suggests the need for long-term follow-up. Since treatment of SPM has shown an acceptable survival rate, early detection and curative therapy should be emphasized.

• Korean Journal of Head & Neck Oncology
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• v.10 no.1
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• pp.31-37
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• 1994

Primary hyperparathyroidism is rare disease entity which secretes parathyroid hormone in excessively resulting in hypercalcemia. It involves skeletal system, urinary tract, gastrointestinal tract, and central nervous system. Recently the determination of the serum calcium and parathyroid hormone level has become a routine laboratory test and the localization of involved gland by neck ultrasonogram and parathyroid gland substraction scan has reduced operative complications. For the purpose of improvement of diagnosis and treatment, the authors analyzed the clinical characteristics of 6 cases of primary hyperparathyroidism(adenoma 5 cases, carcinoma 1 case) during 10 years and report with literatures.

• Korean Journal of Head & Neck Oncology
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• v.25 no.2
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• pp.156-159
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• 2009

Squamous cell carcinoma, which is a common primary head and neck malignant neoplasm that is usually restricted to the mucosal surfaces of the upper aerodigestive tract and skin, is very unusual in the major salivary gland. Among them, few cases are regarded as primary carcinomas. In this article, we present two cases of squamous cell carcinoma in the parotid gland, who first presented with painful mass on infraauricular area.

• Korean Journal of Head & Neck Oncology
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• v.15 no.2
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• pp.166-171
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• 1999

Background and Objectives: The aim of our study was to describe the appearance of recurrent and residual lesions in the head and neck tumors, and to evaluate the usefullness of CT and MRI. Materials and Methods: CT(n=42) and MRI(n=4) of 44 patients with recurrent head and neck tumors were reviewed retrospectively. Primary tumor sites were larynx/hypopharynx in 15, oral cavity/floor of mouth in 13, base of tongue/tonsil in 5, nasopharynx in 4, palate in 2, and others in 5 patients. Therapeutic modalities included sugery and radiotherapy in 23, radiotherapy in 11, surgery in 5, chemotherapy and radiotherapy in 4, and chemotherapy in 1 patient. Results: The patterns of tumor recurrence were nodal recurrence(n=17), primary tumor bed recurrence combined with nodal recurrence(n=12), primary tumor bed recurrence(n=10) and residual primary tumors(n=5). The most common appearance of residual/recurrent primary tumor on CT was focal or diffuse heterogenous mass with or without surrounding fat or muscle infiltration(25/27). On MRI, the recurrent lesions showed intermediate signal intensity on T1 weighted image and high signal intensity on T2 weighted image with heterogenous enhancement in the most cases(n=3). 38 out of 44 nodal recurrences(86%) which had been pathologically or clinically proved were more than 1 cm in diameter or contained central low density on CT scan. Conclusion: Although CT and MRI findings of recurrent and residual tumors of the head and neck were nonspecific, in the majority the lesions manifested as a mass at primary tumor bed and/or nodal disease including contralateral side of the neck. And CT and MRI are valuable for revealing above lesions.

• Korean Journal of Head & Neck Oncology
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• v.31 no.2
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• pp.54-57
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• 2015

Angiosarcoma is a rare and highly malignant neoplasm which develops from the endothelium of blood vessels. A few cases of primary angiosarcoma of the parotid gland have been reported. However, there is no report of primary angiosarcoma of the accessory parotid gland. In this case, we report a primary angiosarcoma of the accessory parotid gland in a 45-year-old man with growing cheek mass. Ultrasonography revealed a $2.0{\times}2.6cm$ sized homogeneous hypoechoic mass and computed tomography showed a contrast enhanced homogeneous mass. Fine needle aspiration biopsy suggested a benign tumor. The mass was completely excised with a minimal vertical incision. The histopathology showed anastomosing vascular channels lined by atypical endothelial cells and many branching vessels with staghorn appearance with positive immunohistochemical staining for CD34, a highly specific endothelial marker. The patient underwent postoperative radiotherapy and was followed for 8 years without recurrence and metastasis.