• Archives of Craniofacial Surgery
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• v.21 no.1
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• pp.58-63
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• 2020

Spindle cell squamous cell carcinoma (SpSCC) is a biphasic tumor composed of squamous cell epithelial and spindle cell mesenchymal components, both of which are malignant. Cutaneous SpSCC can cause diagnostic and therapeutic difficulties because of its rarity, heterogeneity, morphological similarity to other cutaneous spindle cell neoplasms, and uncertain pathogenesis and prognosis, particularly when the squamous cell carcinoma component is minimal or missing. Intransit metastasis and satellite lesion (satellitosis) constitute a spectrum of non-nodal regional metastases. Here the author reports the first known case of cutaneous SpSCC presenting with intransit metastases and a satellite lesion, which were exceptionally aggressive. A 77-year-old female patient presented with a 3×3×0.5 cm mass on her right cheek. Despite wide excision and postoperative radiation, the patient resulted in local recurrence and multiple distant metastases within 3 months. If many high-risk factors-particularly satellitosis and in-transit metastases are observed in a tumor with epithelial to mesenchymal transition, then further wide excision and adjuvant chemoradiation should be considered early in the treatment process. A multidisciplinary approach could be the key to cure the most aggressive malignancies of the skin, as in other organs.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.9 no.2
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• pp.160-163
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• 1998

The glottis consists of two parts : The intermembranous portion or the anterior glottis, and the posterior glottis. The posterior glottis has been described by various inappropriate terms such as posterior commissure and interarytenoid region. The structure surrounding the posterior glottis consists of three portions ; The cartilaginous portion of the vocal fold, the lateral wall of the posterior glottis, and the posterior wall of the glottis. The posterior glottis may be a very rare site for primary squamous cell carcinoma of the larynx because of its embriologic and histologic differences from the anterior glottis. Recently we have experienced a case of a 81-year-old woman who had been presented with throat discomfort and voice change for 10months. She had the smoking history of 40 pack-year. The physical examination revealed poorly demarcated, papillary, whitish-pink colored mass on the posterior glottis. The vocal cord mobility was not affected. Biopsy under the suspension larygoscope showed moderately differentiated squamous cell carcinoma. No regional and distant metastasis was found. She was irradiated with 7000cGy over 7 weeks at a daily dose of 200cGy. No evidence of recurrence was found by the fifteenth month following radiation therapy. We report this case with a review of literature.

• Journal of Chest Surgery
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• v.23 no.4
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• pp.707-714
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• 1990

Despite of mortality and morbidity rates that are higher than other forms of therapy, surgical resection has been mainstay for the treatment of esophageal cancer because of a prompt completeness as well as a high possibility of cure. But a substantial numbers of patients are unsuitable for surgical treatment and those undergoing resection have still poor long term survival rate. With hopes of improving long term survival, we have attempted multimodal approach, composed of preoperative induction chemotherapy utilizing Cisplatin and 5 \ulcornerFU, surgery and postoperative loco-regional radiotherapy for the treatment of esophageal cancer since 1985. During the period of 1967 \ulcorner1985, 27 patients[group A] were treated by surgery only and during recent 5 years 28 patients[group B] by multimodal treatment, Clinical review and comparison between the two groups were as follows: l. Applied surgical procedures were hand-sewn esophagogastrostomy, esophagocologastrostomy and esophagojejunostomy in group A. In group B, only esophagogastrostomy was underwent using stapler mainly. 2. Incidence of peri and postoperative complication showed no remarkable differences between the two groups, but the occurrences of leakage from the anastomotic site were 5[19% ] out of group A and 1[4%] out of group B. 3. The response rate to induction chemotherapy was 36% in group B, 4. The number of local cancer recurrence at the site of anastomosis was 6[22%] out of group A, whereas 2[7%] out of group B. 5. Postoperative I year and 2 year survival were 61%, 15% in group A and 75%, 42% in group B.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.9 no.1
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• pp.86-90
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• 1998

Verrucous carcinoma is a variant of highly differentiated squamous cell carcinoma and has a predilection for the oral cavity and larynx. It is known to be of good prognosis due to its low regional and distant metastatic potential. Peak incidence is at ages 40-69 while predominantly occuring in males and its association with tobacco smoking has been implicated. The verrucous carcinoma have accordingly been treated by radiotherapy or surgical procedures but there has been considerable controversy regarding the effect of radiotherapy due to the possibility of anaplastic transformation Laser surgery and partial resection are among the commonly used surgical procedures but laser surgery has not yet shown results in improving phonetic abilities. Authors experienced two cases of verrucous carcinoma of the larynx treated by partial laryngectomy and false vocal cord advancement flap who showed no recurrence of disease under stroboscopic examination after two year follow up and when compared to preoperative aerodynamic studies, the expiratory air pressure was decreased and mean air flow rate increased which improved glottal efficiency markedly.

• Korean Journal of Head & Neck Oncology
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• v.19 no.2
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• pp.137-141
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• 2003

Introduction: A routine superficial parotidectomy with facial nerve dissection in parotid tumor surgery often results in facial dysfunction, Frey syndrome and defect in operation site. Formal facial nerve dissection has been a recommended procedure, because pleomorphic adenoma is a commonly recurrent tumor in case of inadequate surgical management, however it can not be always reasonable in aspect of postoperative sequelae. Patients and Methods: Through retrospective review of 245 cases parotidectomies and follow up for more than three years, clinicophathologic factors influencing to the selection of surgical procedure were considered to be age, sex, and preoperative pathology confirmed by preoperative MRI and FNA. Results: Five categories were established as follow for surgical decision in parotid tumor surgery. Category 1. Superficial lobe adenoma -- Superficial parotidectomy -- 124 Category 2. Deep lobe adenoma -- Deep parotidectomy -- 39 Category 3. Non pleomorphic adenoma -- Tumorectomy 1.5cm adenoma in young female -- Tumorectomy -- 25 Category 4. Recurrent multicentric tumor -- Parotidectomy+RT -- 9 Category 5. Parotid cancer; Parotidectomy + UND (RND) + RT -- 48 ; CORE (Composite Regional Ear Resection) -- 2 Conclusion: Surgical morbidity and recurrence rate could be minimized by individualizing the surgical procedure according to the category principle based on the clincopathologic features.

• Korean Journal of Head & Neck Oncology
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• v.35 no.2
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• pp.71-75
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• 2019

Inflammatory myofibrolastic tumor (IMT) is a rare borderline neoplasm. It frequently occurs in the lung but occasionally occurs in extrapulmonary sites such as the genitourinary tract, gastrointestinal tract, breast, salivary glands, sinonasal tract, orbit, and the central nervous system. Laryngeal involvement of IMT is very rare. A 61-year-old woman who complained of hoarseness persisting for 3 months visited our hospital. Laryngoscopy showed an elevated lesion in the right true vocal cord. Incisional biopsy was confirmed as larygeal inflammatory myofibrolastic tumor. We performed a transoral excision with CO₂ LASER under suspension examination. Regional recurrence or distant metastasis was not observed after 9 months of follow-up. Herein we report a case of larygeal inflammatory myofibrolastic tumor that was treated with surgery alone, with a literature review.

• Korean Journal of Bronchoesophagology
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• v.6 no.2
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• pp.172-176
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• 2000

Background and Objectives： The treatment of laryngeal carcinoma is not settled to date and surgeons have used lasers for a variety of benign and malignant lesions in the larynx with good success. The aim of this study is to evaluate the potential role of laser surgery for laryngeal carcinoma. Materials and Methods : Medical records from patients who had undergone laser surgery for laryngeal carcinoma at Seoul National University Hospital between January 1988 3nd December 1998 were reviewed retrospectively. Results : A total of 47 patients were seen during that period and their mean follow-up length was 29 months. Their local control rate was 91％ (94% for glottic T1, 60% for glottic T2, 50% for supraglottic T1 and 100％ for supraglottic T2). The cure rate after laser surgery with or without postoperative radiotherapy was 87％ and 6 of 47 patients showed local or regional recurrences. For those 6 patients, neck dissection, partial or total laryngectomy with or without postoperative RT were conducted and they were all followed up without evidence of disease. All 47 patients who had undergone laser surgery for laryngeal squamous cell carcinoma were followed up with NED and their larynx preservation rate was 96%. Conclusion： This study demonstrates the oncologic validity of laser surgery to the treatment of unadvanced laryngeal carcinoma. However, strict case selection is needed to avoid locoregional recurrences and consequent salvage operations.

• Archives of Plastic Surgery
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• v.47 no.1
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• pp.88-91
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• 2020

Cutaneous squamous cell carcinoma (SCC) is the second most common skin malignancy. This report describes the case of an unusual extensive SCC involving the whole hemiface, which required reconstruction with a combination of a dual vascular free transverse rectus abdominis muscle (TRAM) flap and a skin graft. A 79-year-old woman visited our hospital with multiple large ulcerated erythematous patches on her right hemiface, including the parieto-temporal scalp, bulbar and palpebral conjunctiva, cheek, and lip. A preliminary multifocal biopsy was performed in order to determine the resection margin, and the lesion was resected en bloc. Orbital exenteration was also performed. A free TRAM flap was harvested with preserved bilateral pedicles and was anastomosed with a single superior thyroidal vessel. The entire TRAM flap survived. The final pathological examination of the resected specimen confirmed that there was no regional nodal metastasis, perineural invasion, or lymphovascular involvement. The patient was observed for 6 months, and there was no evidence of local recurrence. Usage of a TRAM flap is appropriate for hemifacial reconstruction because the skin of the abdomen matches the color and pliability of the face. Furthermore, we found that the independent attachment of two extra-flap anastomoses to a single recipient vessel can safely result in survival of the flap.

• Korean Journal of Head & Neck Oncology
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• v.35 no.1
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• pp.33-36
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• 2019

Mucosa-associated lymphoid tissue (MALT) lymphoma has specific clinical and pathologic features. The most common site MALT lymphomas is the stomach; however, it can also occur in other organs, such as the salivary glands. MALT lymphoma is rare, but its prognosis is good. A 32-year-old man visited Konyang university hospital with parotid mass. Superficial partial parotidectomy was performed to exclude lymphoid neoplasms. IgH gene rearrangement analysis of the surgical specimen led to the diagnosis of MALT lymphoma. The patient underwent esophagogastroduodenoscopy, positron emission tomography-computed tomography, and whole-body bone scan. Regional or distant metastasis was not observed on staging workup. The patient underwent postoperative radiation therapy, there has been no recurrence of MALT lymphoma to date. Here, we report this rare case of parotid MALT lymphoma that was treated with surgery and postoperative radiation therapy.

• International Journal of Oral Biology
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• v.44 no.3
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• pp.77-80
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• 2019

Clear cell odontogenic carcinoma (CCOC), a very rare neoplasm located mostly in the mandible, has been regarded as a benign tumor. However, due to the accumulation of case reports, CCOC has been reclassified as a malignant entity by the World Health Organization. Patients with CCOC present with regional swelling and periodontal indications with variable pain, often remaining misdiagnosed for a long period. CCOC has slow growth but aggressive behavior, requiring radical resection. Histologic analysis revealed the monophasic, biphasic, and ameloblastic types of CCOC with clear cells and a mixed combination of polygonal and palisading cells. At the molecular level, CCOC shows the expression of cytokeratin and epithelial membrane antigen, along with markers that assign CCOC to the sarcoma family. At the genetic level, Ewing sarcoma breakpoint region 1-activating transcription factor 1 fusion is regarded as the key feature for identification. Nevertheless, the scarcity of cases and dependence on histological data delay the development of an efficient therapy. Regarding the high recurrence rate and the potential of distant metastasis, further characterization of CCOC is necessary for an early and accurate diagnosis.