• Korean Journal of Head & Neck Oncology
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• v.40 no.1
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• pp.37-41
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• 2024

Carcinoma ex pleomorphic adenoma is an uncommon malignant salivary gland tumor that arises from a long-standing pleomorphic adenoma. The carcinomatous component of carcinoma ex pleomorphic adenoma can possess virtually any histologic subtype of salivary gland cancer. We experienced a case of a 61-year-old patient who presented with a right parotid mass that was initially palpated 20 years ago, with a sudden increase in size in the last few months. Radiological and cytological findings from fine needle aspiration biopsy could not exclude malignancy. Total parotidectomy and selective neck dissection were performed for treatment, and carcinoma ex pleomorphic adenoma with mixed carcinoma components of salivary duct carcinoma and myoepithelial carcinoma was diagnosed. After receiving postoperative radiation of 6000 cGy over 6 weeks, there has been no recurrence up to the 18-month follow-up. We report this rare case of carcinoma ex pleomorphic adenoma with mixed malignancy subtypes, accompanied by a review of literature.

• The Korean Journal of Nuclear Medicine Technology
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• v.13 no.3
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• pp.76-80
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• 2009

Purpose: The uptake of $^{99m}Tc$-MIBI increases in the parathyroid adenoma, hyperplasia, and carcinoma. The purpose of this study is to evaluate and compare the results of the biopsy with quantitative analysis results in the localized parathyroid lesions (adenoma, hyperplasia, and carcinoma). Materials and Methods: From April 2002 to January 2009, double-phase $^{99m}Tc$-MIBI parathyroid scan (early 15 min, delayed 2 hrs) was performed after injection of 750 MBq of $^{99m}Tc$-MIBI in 27 diagnosed parathyroid patients (adenoma:15, hyperplasia:4, carcinoma:8). For quantitative analysis, early, delayed lesion to non-lesion ratios (L/NLs), washout rate (%, WR) and vertical axis were calculated. Results: In early images, lesion to non-lesion ratios were $1.53{\pm}0.41$ (adenoma), $1.38{\pm}0.27$ (hyperplasia) and $1.45{\pm}0.64$ (carcinoma). In delayed images, lesion to non-lesion ratios were $1.56{\pm}0.43$ (adenoma), $1.33{\pm}0.10$ (hyperplasia), $1.83{\pm}0.79$ (carcinoma). In vertical axis, the sizes were $2.11{\pm}0.67$ (adenoma), $2.23{\pm}0.75$ (hyperplasia) and $2.20{\pm}0.97$ (carcinoma). There was no statistical difference between lesion to non-lesion ratios and the size of vertical axis (p>0.05). However, washout rates were $31.59{\pm}13.97$ (adenoma), $37.8{\pm}5.69$ (hyperplasia), $17.73{\pm}11.02$ (carcinoma). As a result, there was a significant difference statistically between and that of carcinoma (p<0.05, p=0.028 by Kruskal-willis statistic, Dunn's Multiple comparison test SPSS Ver 12.0). Conclusions: There was no statistical difference between the lesion to non-lesion ratios and the size of vertical axis. However, there was a significant difference statistically between WR of hyperplasia and that of carcinoma.

• Korean Journal of Head & Neck Oncology
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• v.26 no.1
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• pp.9-13
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• 2010

Background and Objectives : Parathyroid adenoma is a rare disease in Korea, but the incidence of parathyroid adenoma has gradually increased due to generalized measurement of serum calcium and imaging study according to wide spread public health screening program. In previous researches, the analysis of clinical aspects were insufficient due to a few cases. The purpose of this study was to assess the clinical analysis of surgically treated parathyroid adenoma with hyperparathyroidism. Methods : We reviewed the medical records of nineteen cases of parathyroid adenoma with hyperparathyroidism. Initial symptom to visit hospital, hypercalcemia associated medical symptom, surgical outcome and complication were investigated. Serum total calcium, parathyroid hormone, phosphate, alkaline phosphatase were checked before and after surgery. Imaging study was performed with combination of radionuclide parathyroid scan, ultrasonography and neck CT scan. Results : The initial symptoms were no symptom(6/19), pelvic pain(5/19), muscular weakness (3/19), bone pain(3/19) and palpable neck mass(2/19) in order of frequency. Serum total calcium, parathyroid hormone decreased and phosphate increased after surgery than before surgery statistically significantly. Sensitivities of parathyroid scan, neck ultrasonography and neck CT as preoperative localization test were 88.2%, 72.7%, 73.3% each. The most common postoperative complication was transient hypocalcemia(9/19). Conclusion : Similar to previous study, parathyroid adenomas have numerous clinical features and surgical treatment via unilateral approach with preoperatively localized single parathyroid adenoma was successful. In our study, parathyroid adenoma was predominantly detected by elevated serum calcium level with no clinical symptom so we need to evaluate parathyroid adenoma, if serum calcium elevated.

• The Korean Journal of Cytopathology
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• v.7 no.2
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• pp.134-137
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• 1996

Monoclonal antibody(TCM-9) against human thyroid cancers have been studied by screening with human thyroid cancers, normal and benign thyroid tissue, and normal human serum protein. A monoclonal antibody(TCM-9) that is known to have strong specificity for human thyroid cancer but not for Graves' disease, adenoma or normal thyroid does not bind to native or mature human thyroglobulin(Tg). We used to TCM-9 antibody by immunohistochemical staining on 5 follicular cancer, 2 follicular adenoma, 1 follicular neoplasm with suspicious invasion, 2 papillary cancer to ascertain being of help in differentiation between follicular carcinoma and adenoma. Reactivity of TCM-9 was observed in follicular carcinoma and papillary carcinoma but not observed in follicular adenoma. Thus TCM-9 is a novel monoclonal antibody against the thyroid cancer.

• Journal of Korean Neurosurgical Society
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• v.30 no.4
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• pp.518-521
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• 2001

We present a rare case of a pituitary adenoma revealing a sedimentation level on MRI, which has not been previously documented. This 55-year-old woman was referred with the diagnosis of craniopharyngioma. She presented with four-month history of progressive headache and visual dimness. Neurological examination revealed a bitemporal hemianopsia and decreased visual acuity. Laboratory data including endocrine examination were unremarkable. An additional three-dimensional MRI was taken for further evaluation, and demonstrated a sedimentation level within the tumor. The patient underwent transcranial removal of the tumor. About 12cc of dark-red blood was aspirated from the tumor. Histological examination revealed a pituitary adenoma with hemorrhage. Postoperatively, the patient showed gradual improvement of visual function. Considering that the pituitary adenoma is one of more common tumors that cause tumoral bleeding, a cystic sellar tumor that has a sedimentation level should be sought first for a pituitary adenoma rather than a craniopharyngioma. This may have an important impact when deciding surgical approach.

• Korean Journal of Head & Neck Oncology
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• v.26 no.2
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• pp.216-220
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• 2010

Carcinoma ex pleomorphic adenoma is rare, aggressive, poorly understood malignancy that occurs in the salivary glands. The patient was 70-year-old male presenting ovoid elevated submandibular mass that has been present for 30 years and rapid growing for 6 months. The initial cytologic finding by fine needle aspiration biopsy showed highly malignant cells and the radiologic finding revealed a $3.6{\times}3.7{\times}4.8cm$ sized mass with cervical lymphadenopathy. After wide excision of submandibular gland and modified radical neck dissection, the histologic examination revealed that tumor was composed partly of a benign pleomorphic adenoma and partly of an adenocarcinoma component with areas of calcification and frequent angiolymphatic invasion. We present a rare case of adenocarcinoma ex pleomorphic adenoma with tumor thrombus in the submandibular gland.

• Nutrition Research and Practice
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• v.5 no.5
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• pp.464-470
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• 2011

Growing evidence suggests an elevated risk for colorectal neoplasia among individuals with low levels of vitamin D, the biological actions of which are mediated by the vitamin D receptor (VDR). To investigate the association among vitamin D status, VDR polymorphisms (FokI, and BsmI), and colorectal adenoma, we conducted a meta-analysis of nine studies of circulating levels of 25-hydroxyvitamin D (25(OH)D) and five studies of FokI or BsmI polymorphisms in relation to colorectal adenomas. Study-specific relative risks (RRs) and 95% confidence intervals (CIs) were pooled using a random-effects model. A total of 3398 coloreetal adenomas for 25(OH)D and 1754 colorectal adenomas for VDR were included in the meta-analysis. We identified a significant inverse association between colorectal adenoma (combined RR, 0.93; 95% CI, 0.87-0.98 per 10 ng/mL increase in 25(OH)D levels). When we examined FokI and BsmI polymorphisms in the meta-analysis, we found no association for either FokI (combined RR, 1.00; 95% CI, 0.95-1.06) or BsmI (combined RR, 0.99; 95% CI, 0.93-1.05) in the additive model. These data suggest an inverse association between circulating 25(OH)D levels and colorectal adenoma risk.

• Korean Journal of Head & Neck Oncology
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• v.36 no.1
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• pp.15-19
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• 2020

Basal cell adenocarcinoma is 1 ~ 2 % of salivary gland carcinoma. It was recently classified as low grade malignancy. It is low grade malignant counterpart of basal cell adenoma. It has similar morphologic attributes with basal cell adenoma, but it has distinctive malignant potential including infiltrative growth into surrounding tissues and distant metastasis. Recently, we have experienced a case of basal cell adenocarcinoma arising from the bilateral parotid gland in a 38-year old woman who was previously operated on superficial parotidectomy due to pleomorphic adenoma. We report this rare case with a review of literature.

• The Korean Journal of Nuclear Medicine
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• v.25 no.1
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• pp.110-116
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• 1991

To elucidate alteration of peripheral T cell subsets in thyroid tumors, the author enumerated T cell subsets in periphral blood by indirect immunofluorescent method, using monoclonal antibodies (CD3, CD4 and CD8) in 17 cases of thyroid cancer, 12 cases of thyroid adenoma, and 16 cases of adult healthy subjects as controls. Diagnoses were confirmed histopatologically in thyroid cancer and adenoma, and were established on the basis of commonly accepted clinical and biochemical criteria in Hashimoto's thyroiditis. The blood was drawn from veins of the patients and control subjects in Pusan National University Hospital during the period of January to October 1990. The results obtained were summarized as follow: 1) The percentage of CD3+ cells was significantly decreased in thyroid cancer as compared with healthy subjects. 2) The percentage of CD4+ cells was not different among thyroid cancer, thyroid adenoma, Hashimoto's thyroiditis and control subjects each other. 3) The percentage of CD8+ cells was significantly decreased in thyroid cancer as compared with adult healthy subjects, and tended to be decreased as compared with thyroid adenoma and Ha-shimoto's thyroiditis. 4) The CD/CD8 ratio was significantly increased in thyroid cancer as compared with control subjects, and tended to be increased as compared with thyroid adenoma and Hashimoto's thyroiditis. On the basis of the results, it can be suggested that the immunodysfunction may be due to decreased soppressor/cytotoxic T cells in thyroid cancer.

• 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.