• Korean Journal of Head & Neck Oncology
• /
• v.13 no.2
• /
• pp.228-234
• /
• 1997

Squamous cell carcinoma originating in the parotid gland has rare occurrence. The primary squamous cell carcinoma of the parotid gland comprise about 0.3% and 9.8% of all parotid malignant tumor. We investigated the clinical behavior and treatment outcome of patients with primary squamous cell carcinoma of the parotid gland. We reviewed all cases of possible primary squamous cell carcinoma of the parotid gland treated at Yonsei Cancer Center, Seoul, Korea, from 1981 through 1995. A total of 128 had primary parotid malignancy. Metastatic squamous cell carcinoma and mucoepidermoid carcinoma were excluded in this study. Ten cases of primary squamous cell carcinoma of the parotid gland were identified. 6 cases of them are men & 4 cases are women. The age of patients ranged from 31 to 68 years with median age of 55 years. On physical examination, 5 cases had palpated cervical neck node and 6 cases had facial nerve palsy. Staging was done according to the current guidelines established by the American Joint Committee on Cancer (1992). Two cases were stage I, 1 in stage III, and 7 in stage IV. Six cases were performed operation and postoperative radiation therapy. Four cases were treated by curative radiation therapy, dose of more than 65 Gy on parotid gland region. The 5 year actual survival rate and the 5 year disease free survival rate were 30.8%, and 40.0%. Initial complete response rate was 70% for all patients. Local failure were occurred 3 of 7 patients with local controlled cases, failure sites were primary site, ipsilateral cervical neck node, contralateral supraclavicular node. Most recurrences developed within 1 year of initial treatment. Distant metastasis was appeared 2 of 3 patients who did not achieved local control. Primary squamous cell carcinoma of the parotid gland occured infrequently. A retrospective study at the Yonsei Cancer Center indicates incidence of 7.8%. At diagnosis, advanced stage, neck node presentation, facial nerve paralysis were associated with a poor prognosis. These results may suggested that radical surgical excision may be treatment of choice and that planned postoperative radiotherapy may be bendicial for reducing locoregional recurrence rates.

• Korean Journal of Head & Neck Oncology
• /
• v.30 no.2
• /
• pp.90-94
• /
• 2014

Salivary duct carcinoma(SDC) is rare malignancy, accounting for approximately 1-3% of all malignant salivary gland tumors. Systemic chemotherapy has been used for stage IV SDC, but there is no consensus on the standard treatment. SDC is histologically similar to ductal carcinoma of breast and often overexpress HER2/neu, hence HER2/neu targeted therapy could be one of treatment options. A 75-year-old Arabian man was diagnosed as SDC of right parotid gland with extensive metastases. He received oral 5-FU as palliative chemotherapy, but he was intolerable to oral chemotherapy due to severe oral mucositis. Considering immunohistochemical stain of tumor tissue showing strong positive for HER2/neu, we decided to administer an anti-HER2/neu antibody, trastuzumab. Follow-up CT scans before the third dose of trastuzumab demonstrated remarkable regression of multiple metastases as well as primary tumor. This case suggests that HER2/neu targeted therapy may be a potential therapeutic option for the SDC patient with overexpression of HER2/neu.

• JOURNAL OF THE KOREAN ACADEMY OF PEDTATRIC DENTISTRY
• /
• v.38 no.1
• /
• pp.88-94
• /
• 2011

Ranula is a mucosal cyst that occurs in the mouth floor. This is a pseudo cyst caused by mucous retention within the tissue due to the rupture of catheter in the salivary gland. Ranula occurs mainly in a unilateral form and is characterized by painless bluish transparent swelling, with a increasing mass size. If the size is large, it can cause discomfort during swallowing, pronounciation, and mastication, but external swelling and infection is rare. Treatments include observation for spontaneous resolution, simple incision and drainage, marsupialization and excision. Marsupialization done by removing parts of the cyst wall and connecting it to the oral mucosa. It is a conservative procedure and recommended for children. It has advantages such as maintaining outline of oral tissue and less risk of damaging anatomic structure. Recurrence is common, mostly occurring within 4 months after surgery. This case is about a eight-year-old girl with ranula on the right mouth floor. This patient was treated with marsupialization that is one of treatment for ranula, and recurrence was not observed.

• Applied Microscopy
• /
• v.35 no.2
• /
• pp.65-72
• /
• 2005

The ultrastructure of submandibular gland was examined in the lesser white-toothed shrew, Crocidura suaveolens. The submandibular gland of C. suaveolens was a mixed gland composed of serous and mucous acinar cells. Secretory granules from the acini were discharged through the salivary ducts into the oral cavity. Serous and mucous acinar cells had well developed rough endoplasmic reticulum and mitochondria and large amount of granules. In case of serous acinar granules, an immature granule was formless and had only dense specks, and a matured granule was a complete round type delimiting by a single membrane and had a homogeneous dense center with dense specks on the border. In case of mucous acinar granules, while an immature granule was a round type and had an only homogeneous matrix and an indistinct limiting membrane, a mature granule was an even round type having a variety of pattern with several dense bands into the homogeneous matrix and had a distinct membrane. Therefore, a mature mucous acinar granule of C. suaveolens was not only distinct from those of the other mammalian species to have a variety of pattern but also from those of C. lasiura to have an even round type. A great serous-like secretory granules and Myelin-like body were observed in the cytoplasm and lumen of granular duct cells. Myelin-like body, a characteristic structure only reported in salivary gland of three shrews, was discharged from secretory cell into lumen by the manner of exocytosis which has little differences from discharging manner of secretory granules.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.34 no.6
• /
• pp.473-479
• /
• 2012

Warthintumor (WT), also known as adenolymphoma or papillary cystadenoma lymphomatosum, was described in 1895 for the first time. It is a common benign tumor of the parotid glands and the second most common neoplasm of the salivary gland, accounting for 5% to 14% of all parotid neoplasm. A 63-year-old man visited our clinic with the complaint of swelling on the right parotid gland. Physical examination showed a 3 cm, firm, well-circumscribed, painless mass on the right mandibular angle. Computed tomography imaging showed a $3.5{\times}2.0{\times}1.6$ cm well-defined cystic mass. WT is histologically characterized by bilayered, oncocystic cell, lymphoid stroma, and cystic space. With these typical cytomorphologic characteristics, the fine-needle aspiration cytology was performed as diagnostic tool before the surgery. The lymphocytes and oncocystic cell were not observed. The lesion was completely excised under general anesthesia. We diagnosed the case as WT, from the surgically excised specimen. We report on the case with a review of the literatures.

• Imaging Science in Dentistry
• /
• v.51 no.2
• /
• pp.129-136
• /
• 2021

Purpose: This study investigated the effects of 1 year of training on imaging diagnosis, using static ultrasonography (US) salivary gland images of Sjögren syndrome patients. Materials and Methods: This study involved 3 inexperienced radiologists with different levels of experience, who received training 1 or 2 days a week under the supervision of experienced radiologists. The training program included collecting patient histories and performing physical and imaging examinations for various maxillofacial diseases. The 3 radiologists (observers A, B, and C) evaluated 400 static US images of salivary glands twice at a 1-year interval. To compare their performance, 2 experienced radiologists evaluated the same images. Diagnostic performance was compared between the 2 evaluations using the area under the receiver operating characteristic curve (AUC). Results: Observer A, who was participating in the training program for the second year, exhibited no significant difference in AUC between the first and second evaluations, with results consistently comparable to those of experienced radiologists. After 1 year of training, observer B showed significantly higher AUCs than before training. The diagnostic performance of observer B reached the level of experienced radiologists for parotid gland assessment, but differed for submandibular gland assessment. For observer C, who did not complete the training, there was no significant difference in the AUC between the first and second evaluations, both of which showed significant differences from those of the experienced radiologists. Conclusion: These preliminary results suggest that the training program effectively helped inexperienced radiologists reach the level of experienced radiologists for US examinations.

• JOURNAL OF THE KOREAN ACADEMY OF PEDTATRIC DENTISTRY
• /
• v.29 no.3
• /
• pp.413-417
• /
• 2002

Mucocele is a mucous retention phenomenon which is caused by a laceration to the duct of minor salivary glands causing extravasation of mucin into the connective tissue forming a cyst-like space. Sialolithiasis of minor salivary glands and chronic obstruction of salivary glands may also cause such a phenomenon. Mucocele is a smooth, rounded sessile mass with diameters varying from 1 to 15mm of sudden appearance. Mucocele tying directly beneath the mucosa may rupture spontaneously and decrease in size, but frequently recurs. Lower lip is most frequently affected, and the mouth floor and buccal vestibule may also be affected. Enucleation of the cyst is needed and removal of minor salivary glands, marsupialization and cryotherapy may also be done. The mucocele frequently recurs after its removal. A 1-year-old female patient visited the hospital with a complaint of a swelling on the lower lip since 4 months before. She had no pain history but 4 months ago, fell and such symptom appeared since then. On her first visit, a bullous solid, opaque lesion of 5mm in diameter was noted. Treatment choice of surgical approach and nonsurgical approach were explained to the guardian. Considering the patient's age, the guardian agreed to a nonsurgical procedure. Treatment was carried out by tieing 3-0 silk to the base of the lesion. One week later, the tie loosened and was re-tied. A week later, the mucocele disappeared. Mucocele on the lower lip may be usually be treated by surgical removal, but this may traumatize the surrounding minor salivary gland causing it to recur. Also, surgicial removal may induce an ischemic change causing sialometaplasia. In case of young patients or children with management problems, non-surgical methods such as this tie method may be used. This tie method does not need any local anesthesia and has no pain, no secondary infection, and low bleeding tendency.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
• /
• v.28 no.1
• /
• pp.245-259
• /
• 1998

Cellular transforming genes have been identified in a number of different tumor cell lines and tumor types. A significant number of these oncogenes belong to the ras gene family. The ras gene family consists of three closely related genes:H-ras, K-ras and N-ras which code for a related 21 kDa protein. Mutations in codon 12, 13 and 61 of one of the three ras genes convert these genes into acute oncogenes. The presence of H-ras gene mutations has important prognostic implications in various tumors. Each genomic DNA was isolated from tumors induced by implantation with DMBA, or by treatment with DMBA -implantation/irradiation. When genome DNA was transfected into NIH 3T3 cells and investigated by two-step PCR-RFLP, the fOllowing results were concluded: 1. Transformation foci developed in two groups when the genome DNA of two experimental groups were transfected into NIH 3T3 cells. 2. Transformation efficiency was 0.01-0.02 foci/㎍DNA in the experimental group with the DMBA-implantation, 0.01-0.03 foci/㎍lgDNA in the experimental group with the DMBA-implantation/irradiation according to results of transfection assay. 3. When the point mutation of H-ras gene was investigated by a two-step PCR-RFLP, there was 13.9％ (5/36) in the experimental group with the DMBA implantation, 15.4 ％ (6/39) in the experimental group with the DMBA -implantation/irradiation. 4. The point mutation in codon 12 and 61 of H-ras was 5.6％(2/36) and 8.3％(3/36) in the experimental group with the DMBA implantation. 5. The point mutation in codon 12 and 61 of H-ras gene was 7.7％(3/39) in the experimental group with the DMBA -implantation/irradiation.

• Korean Journal of Head & Neck Oncology
• /
• v.19 no.1
• /
• pp.9-15
• /
• 2003

Purpose: To introduce our early experience with intensity-modulated radiotherapy (IMRT) in the treatment of nasopharyngeal carcinoma. Methods and Materials: Eight patients who underwent IMRT for no disseminated nasopharyngeal carcinoma at the Asan Medical Center between September 2001 and November 2002 were evaluate by prospective analysis. According to the 1997 American Joint Committee on Cancer staging classification, 5 had Stage III, and 3 had Stage IVB disease. The IMRT plans were designed to be delivered as a 'Simultaneous Modulated Accelerated Radiation Therapy' (SMART) using the 'step and shoot' technique with a MLC (multileaf collimator). Daily fractions of 2.2-2.5Gy and 1.9-2Gy were prescribed and delivered to the GTV and CTV and clinically negative neck node, respectively. The prescribed dose was 70A-79.0Gy to the gross tumor volume (GTV), 60Gy to the clinical target volume (CTV) and metastatic nodal station, and 46Gy to the clinically negative neck. All patients also received weekly cisplatin during radiotherapy. Acute and late normal tissue effects were graded according to the Radiation Therapy Oncology Group (RTOG) radiation morbidity scoring criteria. Results: Follow-up period was ranging from 5 to 18 months. All patients showed complete response and loco-regional control rate was 100% but one patient died of malnutrition due to treatment related toxicity. There were no Grade 3 or 4 xerostomia and all patients had experienced improvement of salivary gland function. Conclusion: 'Simultaneous Modulated Accelerated Radiation Therapy' (SMART) boost intensity-modulated radiotherapy technique allows parotid sparing as evidenced both clinically and by dosimetry. Initial tumor response and loco-regional control was promising. It is clinically feasible. A larger population of patients and a long-term follow-up are needed to evaluate ultimate tumor control and late toxicity.

• Journal of the Korean Society of Radiology
• /
• v.10 no.5
• /
• pp.291-298
• /
• 2016

Recently, the interest in the orthodontic treatment for children is increased by a rise in national income level. The number of cephalometric radiography that could diagnose a malocclusion and malposition between teeth and jawbone increased. It required attention to radiation exposure, because the subject of dental examination is children which are more sensitive to radiation and the head and neck, the object of that include radiation sensitive organ such as the thyroid, bone marrow, eyes, salivary gland, and so on. In this study, we measured two-dimensional dose distribution in cephalometric radiography system (VATEC Pax-400C) using Agfa CP-G Plus film and MagicMax Dosimeter, and calculated radiation organ dose of head and neck through MCNPX simulation. And then we designed a radiation protective device to decrease radiation dose. The dose distribution of the cephalometric radiography system irradiated the head and neck overall as well as the oral and maxillofacial parts. The radiation organ dose calculated that thyroid, oesophagus and eyes are irradiated high, and the radiation organ dose decreased about 70 ~ 80% by the application of the radiation protective device. The results of this study will be used construction of database for dental radiation exposure and research of reducing radiation dose.