• 대한두경부종양학회지
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• 제2권1호
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• pp.49-59
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• 1986

대흉근근피판은 혈액공급이 왕성하며 회전호가 크고 조직량이 층충해 안면부 결손을 기능적 및 미용적으로 잘 재건해 줄 수 있을뿐 아니라 용도에 따라 다양하게 사용할 수 있다. 저자들은 안면 부에 발생한 거대한 기저세포암 l 예와 보존요법으로서는 치료가 불가능한 만성상악골 골수염을 동반한 거대한 섬유성종괴 1 예를 절제하고 이로써 생긴 안면부의 광범한 조직결손을 도서형대흉근근피판으로 대치하여 좋은결과를 얻을 수 있었다.

• 대한두경부종양학회지
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• 제2권1호
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• pp.61-66
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• 1986

저자들은 부갑상선 선종 3 예를 입상고찰과 함께 보고하는 바이다. 부갑상선 기능 항진증이 있는 환자에서 임상증상들이 각각 서로 달랐으며 증상의 다양성과 여러기관의 침범을 볼수 있었다. 제 1 예는 심한 근 쇄약을, 제 2 예는 좌 경골의 낭포성골병변을, 제 3 예는 상복부동통, 관절통 및 정신장애를나타냈다. 전례(全例) 모두에서 骨의 광물질(鑛物質) 소실(消失) (demineralization) 을 보였고 두 예에서는 경부 종괴가 촉지 되었고 나머지 한 예만 전형적인 낭포성 섬유성 골염 (Osteitis fibrosa cystica) 을 보였다. 3 예중 2 예는 주세포 선종 (Chief cell adenoma) 이었으며 나머지 한 예는 혼합성 세포형 (mixed cell type) 이었다. 저자들은 본 질환에 대한 진단기준, 외과적 수술방법 및 수술 성공 여부 판정에 대한 지침을 제시하고저 한다.

• 대한두경부종양학회지
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• 제24권2호
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• pp.174-178
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• 2008

Background and Objectives：Peripheral nerve sheath tumors(PNSTs) are uncommon neoplasm in the head and neck region. The treatment of PNSTs is surgical removal, but excision cause neurologic complications. This study was performed to evaluate the proper diagnosis and treatment of PNSTs with our experiences. Subjects and Method：During the period from October 1994 to July 2007, 58 patients were diagonised with PNSTs in head and neck region. We reviewed medical records and imaging study retrospectively. Result：95%(55/58) of the PNSTs in head and neck were benign；5%(3/58) were malignant peripheralnerve sheath tumors(MPNSTs). 63%(37/58) were neurilemoma, 20%(17/20) were neurofibroma, 2%(1/58) was perineuroma. 55 patients underwent surgery. 80%(45/55) of cases were treated with excision. Enucleation was performed in 7(14%) patients. All cases of benign neurogenic tumors showed no recurrence. Among 3 of MPNSTs 2 patients were Von Recklinghausen’s disease and expired with regional recurrence and lung metastasis. Conclusion：The benign PNSTs can be treated with enucleation if possible and observation can be another choice to minimize neurologic sequele.

• 대한두경부종양학회지
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• 제25권1호
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• pp.8-11
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• 2009

Background and Objectives : In the TNM 6th classification system, extrathyroidal invasion of differentiated thyroid carcinoma has been classified into T3(minimal invasion), T4a(extended invasion), and T4b(more extensive unresectable invasion) according to the degree and it has been recognized as an important prognostic factor. In this study, we investigated the prognostic significances of minimal extrathyroidal invasion in papillary thyroid carcinoma(PTC). Material and Methods : We retrospectively studied 221 patients who are underwent thyroidectomy due to PTC from September 2003 to December 2006. Fifty-four(24.4%) patients had a PTC with minimal extrathyroidal invasion(Group A) and 167(75.6%) patients had a PTC without extrathyroidal invasion(Group B). The existence of minimal extrathyroidal invasion was based on operative and pathological findings. Results : Minimal extrathyroidal invasion in PTC was related to tumor size, lymph node metastasis, and operative method(p<0.001). But, there is no significant difference in age, gender, and multifocality between Group A and B. Hashimoto's thyroiditis was observed more frequently in Group B(p=0.019). Conclusion : These findings suggest that minimal extrathyroidal invasion is related to poor prognostic factors in PTC. Therefore, aggressive surgical approach is required when there is evidence of minimal extrathyroidal invasion in preoperative radiologic examination or operative finding.

• 대한두경부종양학회지
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• 제24권2호
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• pp.189-193
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• 2008

Objectives：The incidence of micropapillary thyroid carcinoma(MPC) which is very good prognosis is increasing due to ultrasonography and accurate fine neede aspiration cytology. MPC defined papillary thyroid carcinoma below 1cm. According to the size, histophaothogic feature is different, lymph node metastasis and capsular invasion occur occasionally. So, we consider different treatment according to the size of MPC. Matrials and Methods：We reviewed and analyzed the record of 216 MPC patients operated at department of general surgery Busan Paik Hospital since 1995 January to 2005 Desember retrospectively. Result：The sex ratio was 1：9.29(male；21, female；195). Total thyroidectomy 20cases(9.3%), subtotal thyroidectomy 141cases(65%), lobectomy 52cases(24%), completion operation 3cases(1.4%) were done. Combined diseases were follicular carcinoma 4cases, follicular adenoma 11cases, thyroiditis 46cases, nodular hyperplasia 44cases. Lymph node metastasis 56cases and capsular invasion 56cases were presented. Group A(<5mm) was 53cases, group B(5-10mm) was 163cases. Group B showed higher lymph node metastasis and capsular invasion(P<0.05). Multiple carcinoma Showed higher capsular invasion than single carcinoma (P<0.05). Complications were post operative bleeding 1case, husky voice 1case, hypocalcemia 1case. Conclusion：We can consider more extensive operation in 5-10mm of MPC patients.

• 대한두경부종양학회지
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• 제10권2호
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• pp.102-105
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• 1994

The indolent course of most thyroid papillary carcinomas, even the presence of regional lymph node metastasis, make them unique among human malignant head and neck cancers. Age, sex, extracapsular invasion and anaplastic change are known to be correlated with prognosis. The purpose of this study is to clarify the significance of DNA content analysis as a prognostic factor. Twenty five thyroid papillary carcinomas were possible to be examined by flow cytometric analysis using fresh surgical specimens and three nodular hyperplasias and seven follicular adenomas were included as control group. The results were as follows: l) All of twenty five thyroid papillary carcinomas showed diploidy. 2) S-phase fraction was $1.94{\pm}2.77%$ in normal control group and $2.60{\pm}2.66%$ in papillary carcinoma group. The proliferation index was $8.44{\pm}3.89%$ in normal control and $7.70{\pm}3.63%$ in papillary carcinoma group with even low value. 3) Age, sex, extracapsular spread and lymph node metastasis showed no significant difference. In conclusion, low proliferative activity of thyroid papillary carcinomas are thought to be related with good prognosis.

• 대한두경부종양학회지
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• 제10권2호
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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.

• 대한두경부종양학회지
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• 제10권2호
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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.

• 대한두경부종양학회지
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• 제10권2호
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• pp.122-127
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• 1994

One hundred fifty four cases of branchial anomaly treated from January 1987 to July 1993 were analysed to determine clinical features, embryologic and anatomic types of the branchial cleft anomaly, to investigate the differences between adults and pediatrics, and to establish the appropriate treatment plan. The male to female ratio was not signifiacntly different in pediatric and adult patients. The mean symptom duration was 0.5 years(range 0.08-14 years) in pediatric patients and 1.67 years (0.7-7 years) in adult patients. The clinical presentations of these anomalies were lateral neck mass in 112(72.7%), infected discharge in 22(14.3%), non-infected discharge in 6(3.9%), and abscess in 14 cases(9.l%). Sites of the lesions were upper third of the neck in 93(60.3%), infraauricular in 35(22.7%), middle third of the neck in 17(11.0%) and inferior third of the neck in 9 cases(5.8%). The anatomic types were cystic form in 117(75.9%), sinus in 24(15.5%), and fistula in 13 cases(8.4%). Embryologic classification were 124 second branchial cleft anomalies(80.5%), 29 first branchial cleft anomalies(18.8%), and 1 third branchial cleft anomaly(0.6%). Immediate surgery under the uncontrolled infection in 17 cases result in 82.4% recurrent rate(14 cases), and 17.6% cure rate(3 cases). Delayed surgery under the controlled infection in 8 cases recurrent rate(1 case), and 87.5% cure rate(7 cases). In summary, the most common branchial cleft anomaly is second type cyst both in pediatric and adult group, delayed surgical exterpation after infection control with I & D or antibiotics may give a good chance for care and may reduce the recurrence.

• 대한두경부종양학회지
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• 제15권2호
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• pp.222-225
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• 1999

Background and Objectives: Medullary thyroid carcinoma(MTC) is a rare tumor derived from the parafollicular C cells of the thyroid gland accounting for 5-10% of all thyroid malignancies. In Korea, there has been a few case report of medullary thyroid carcinoma(MTC) but their clinical analysis were not exactly studied. So, we made clinical study of 10 patients diagnosed as medullary thyroid carcinoma. Materials and Methods: We reviewed clinical data of 10 patients who were diagnosed as medullary thyroid carcinoma(MTC) from April 1973 to August 1998 at National Medical Center. Results: The incidence of MTC was 2.3% of all thyroid cancer and their mean age were 44.2 years old. Preoperative thyroid scan showed cold nodule in all patients and thyroid function test(TFT) was within normal range. Of the 10 patents, only 4 patients had diagnosis of MTC in preoperative fine needle aspiration biopsy. All the patients underwent total thyroidectomy with central neck dissection. Two patients with cervical lymph node metastasis underwent total thyroidectomy, central neck dissection and modified neck dissection. Two patients (20%) showed recurrence at the site of neck, lung, mediastinum, bone and liver. Conclusion: Most MTC is sporadic form and have peak incidence in the fifth decade and female preponderance. Preoperative fine needle aspiration biopsy is considered to be a clinically useful diagnostic method, but its accuracy is not considered as much high as others. Total thyroidectomy with central neck dissection may be an useful surgical modality in treating medullary thyroid carcinoma.