• Journal of Chest Surgery
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• 제25권3호
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• pp.247-257
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• 1992

Bronchial adenoma, firstly described by Muller[1882] had been reported on the subject stressed their benign nature prior to 1940`s, but these tumors including carcinoid tumor, mucoepidermoid carcinoma, adenoid cystic carcinoma, pleomorphic adenoma are now known to possess the various degree of malignant natures from benign course, low grade malignant potential to distant lymphatic or hematogenous metastasis or combination. Although histologically diffeerent, four varieties except carcinoid tumor which is a spectrum of neu-roendocrine tumor originating Kulchitsky cell of the bronchial epithelium and form the part of the APUD tumor spectrum, are morphologically and in many respects clinically similar to the corresponding tumor of the salivary gland is a specific varient of adenocarcinoma that occurs most commonly in the major and minor salivary gland and less frequently tra-cheobronchial tree, esophagus etc. To better understand the clinical characteristics and assess more precisely the malignat nature of bronchial adenoma, we studied 17 cases of bronchial adenoma, which had been experienced at the Department of Thoracic and Cardiovascular surgery of Catholic University Medical College from April 1977 to september 1991. Seventeen cases of bronchial adenoma consist of 2 carcinoid tumors, 6 adenoid cystic carcinomas, 8 mucoepidermoid carcinomas and one pleomorphic adenoma. There is a slight predominace of male patients[10/17] and the age of pt studied varied with a higher incidence occurring between the ages of 40 years and 60 years[mean age, 46.5 years]; the youngest being 15 years and oldest 69 years. Their leading complaints were hemoptysis[4], exertional dyspnea[8], fever & chilness [4], and symptoms mimicking the bronchial asthma[4]. Diagnosis was aided by the radiologic studies such as chest X-ray, polytomography, CT scan, brochography and bronchoscopy. The preferred locations of fumor were in the trachea[4], main stem bronchus[3], bronchus intermedius[3], bronchus of RUL[2], LUL[1], RLL[1], LLL[3] with no peripheral location. Modalities of treatments were single or combination of surgical resection, radiation therapy, chemotherapy. Complete resections were permitted in 12 cases with late recurrences of 4 cases ranging from 6 months to 10 years: pneumonectomy[4], lobectomy[4], bil-obectomy[2], sleeve resection[2]. Gross findings of resected specimens in 14 cases showed that 4 cases were polyp-like pedunculated mass[entirely intraluminal mass] with intact mucosa, 8 cases were broad-bas-ed sessile mass[predominatly intraluminal] and the main portions were located below the mucosa similar to tip of iceburg[predominantly extraluminal] in 2 cases. Follow-up information was availble in all 17 cases ; eight were alive without evidence of disese ranging from 1 month to 13 years. But seven cases died of the causes related to tumor[6 cases within 12 months, one case 10 years after pneumonectomy]. We concluded that 8 cases[47%] of 17 cases were metastasizing bronchial adenoma and precise survival rate cannot be answered by the scanty materials available for study.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제28권1호
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• pp.1-12
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• 2006

Pleomorphic adenoma is the most common benign tumor in salivary glands, and occurred in frequency of 60% in parotid gland tumors, and 50% in submandibular gland tumors, and 25% in sublingual gland tumors. Histopathologically, pleomorphic adenoma is composed of epithelial cells and mesenchymal tissues, and called 'mixed tumor' because of morphological divergency. The cell structures of luminal area are composed of polyhedral and cuboidal secretory epithelial cells and modified myoepithelial cells around it, and mesenchymal tissue is composed of some myoepithelial cells and stromal tissue. In stromal tissue, myxoid change, chondroid change, or hyalinization can be seen even if bone tissue. In many studies, tumor cells of pleomorphic adenoma containing modified myoepithelial cell participate in synthesis of glycosaminoglycans. In this study, tissue sample of pleomorphic adenoma of human salivary gland were obtained from 20 surgical specimens, and all specimens were routinely fixed in 10% formalin and embedded. Serial 4-8${\mu}m$ thick sections were cut from paraffin blocks. The histopathologic evaluation was done with light microscopy. And, with immunohistochemical staining, characteristics of glycosaminoglycan were observed. And, for biochemical analysis of glycosaminoglycan, isolation of crude glycosaminoglycan from tumor tissue and immuno-blot analysis were carried out. With transmission electromicroscopy, tumor cells and biologic behavior of pleomorphic adenoma were observed with distribution and expression of glycosaminoglycan in tumor cells, The results were obtained as follows: 1. In immunohistochemical study, chondroitin 4-sulfate is highly postively stained in myxoid stromal tissue, and chondroitin 6-sulfate is highly positively stained in chondroid mesenchymal tissue, both glycosaminoglycans are positively stained in non-luminal cell of ductal area. 2. Dermatan sulfate and keratan sulfate is positively stained in periductal non-luminal tumor cells. 3. In immunohistochemical study, heparan sulfate is weakly stained in luminal cells and non-luminal cells around duct, and chondroid mesenchymal tissue. 4. In transmission electromicroscopic view, the tumor cells are composed of modified myoepithelial cells, and contain many microfilaments and well developed rough endoplasmic reticulum. 5. In Immuno-Blot analysis, the expression of glycosaminoglycans is expressed mostly in chondroitin 6-sulfate and chondroitin 4-sulfate. From the results obtained in this study, tumor cells of pleomorphic adenoma are composed of modified myoepithelial cells, and glycosaminoglycans of chondroitin 4-sulfate and chondroitin 6-sulfate mostly participate in the development of pleomorphic adenoma, but dermatan sulfate, keratan sulfate and heparan sulfate glycosaminoglycans were expressed variably.

• 대한지역사회영양학회:학술대회논문집
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• 대한지역사회영양학회 2004년도 추계학술대회
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• pp.74-74
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• 2004

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제31권2호
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• pp.170-177
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• 2005

The pleomorphic adenoma is well recognized as the most common salivary neoplasm. We examined 49 patients who had received surgical excision of the pleomorphic adenoma from 1989 to 1998 with over 5 years follow-up period. We retrospectively evaluated the patients' age, sex, chief complaints, surgical methods, and recurrence or complication rates after analysis of one's clinical and surgical records. The results are as follows : 1. There were 15 cases in parotid gland, 23 cases in palate, 8 cases in submandibular gland, and 3 cases in cheek. The ratio of male to female was 1 : 1.13. The mean age was 44. The tumor of submandibular gland occurred in more younger age than that of other salivary gland. 2. In 15 patients of parotid pleomorphic adenoma, there was 1 case(6.7%, 1/15) of recurrence. That was transformed into the malignant pleomorphic adenoma after 4 years of first surgery. We performed superficial parotidectomy of 9 cases(56.2%, 9/16), total parotidectomy of 6 cases(37.5%, 6/16), and radical parotidectomy of 1 case(6.3%, 1/16). 3. We used the rotational Sternocleidomastoid muscular flap to cover the exposed facial nerve in 12 cases(75%) after parotidectomy(7 cases of superficial parotidectomy and 5 cases of total parotidectomy). We could see 3 cases(18.7%) of facial nerve palsy and 1 case(6.3%) of Frey's syndrome after parotidectomy. We examined Frey's syndrome in only 1 case which was not used SCM muscular flap after parotidectomy. 4. In 23 patients of palatal pleomorphic adenoma, there were 2 cases(8.7%) of recurrence. In recurrence cases, We performed re-excision after 4 and 5 years of first surgery, respectively. We preserved partial thin overlying palatal mucosa during tumor excision in 5 cases(20%), which were proved as benign mixed tumor in preoperative biopsy. That mucosa-preserved cases had thick palatal mucosa, did not show mucosa ulceration and revealed well encapsulated lesions in preoperative CT. 5. In palatal tumors, we could see the 13 cases(52%) of bony invasion in preoperative CT views and the 4 cases(16%) of oro-nasal fistula after tumor excision. In two cases of recurrence, one(20%, 1/5) was in palatal mucosa-preserved group and the other(5.5%, 1/18) was in palatal mucosa-excised group. 6. We excised tumors with submandibular glands in the all cases of submandibular pleomorphic adenoma. There was no specific complication or recurrence in these cases. 7. After excision of the cheek pleomorphic adenomas, we could not see any complication or recurrence.

• 대한세포병리학회지
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• 제1권1호
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• pp.60-67
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• 1990

To evaluate the diagnostic findings of salivary gland tumors, we reexamined aspiration cytology smears of 7 cases of pleomorphic adenoma, 3 cases of adenoid cystic carcinoma, and 3 cases of mucoepidermoid carcinoma, performed during April 1986 to March 1990, which were comfirmed by surgical excision and histologic diagnosis. The results obtained are summarized as follows : 1. All cases of pleomorphic adenoma showed branching cellular clusters of epithelial and myoepithelial cells. Acellular elements including myxomatous and chondroid components were observed. There were no cellular pleomorphism and nucleoli. Keratinizing squamous epithelial cells and keratin pearls were noted. 2. The smears of adenoid cystic carcinoma showed cell bails or cell cords containing a central hyaline core. Nuclear atypism and the nucleoli were frequently observed. There were no keratinizing squamous epithelial cells. 3. The smears of mucoepidermoid carcinoma showed mainly sheets or clusters of intermediate cells and some mucin-producing cells. Some nuclear pleomorphism was observed. Mucinous material and many inflammatory cells were present in the background.

• Journal of Korean Neurosurgical Society
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• 제57권6호
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• pp.473-477
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• 2015

A 69-year-old man was referred with left exophthalmos. Computed tomographic (CT) findings detected a well-circumscribed mass in the left side of the intraorbital cavity. At that time, he refused the further evaluation and treatment. About three years later, the size of the mass had enlarged, and the patient's symptoms were getting worse. The mass was completely removed with frontotemporal craniotomy and superolateral orbitotomy. In operative findings, the mass had originated in the lacrimal gland and was well-encapsulated without invasion to the surrounding tissue. In the pathologic findings, the tumor consisted of pleomorphic adenoma with osteosarcomatous change of stromal components. Postoperatively, the adjuvant radiotherapy was done four weeks later. The patient's symptoms were improved. The pleomorphic adenoma with osteosarcomatous change is extremely rare and appropriate treatment is not clearly established. We would like to report this rare case with a review of the literature.

• 한국임상수의학회지
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• 제35권2호
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• pp.53-56
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• 2018

Computed tomography (CT) findings of hepatic adenoma in veterinary medicine are variable and unlike in human medicine, not defined clearly. A 12-year-old neutered male Shih Tzu presented after a seizure, with weight loss, salivation, and cachexia. An abdominal mass was identified on radiography, and ultrasonographic images showed a mixed echo pattern with marked vascularity. CT showed that the mass originated from caudate lobe, was heterogeneously hypoattenuated compared with the hepatic parenchyma, and had irregular margins. Contrast enhanced CT showed that the mass enhanced like the surrounding liver parenchyma. However, it contained unenhanced areas and enhanced vessels were observed in the arterial phase at the periphery of the mass. The margins of mass were more enhanced in the venous phase than the arterial phase and the hypoattenuating regions within the mass were not enhanced. Greater enhancing in the venous phase is seen with adenomas; however, the heterogeneous enhancement pattern, especially the marginal vascular enhancement and internal hypoattenuating regions, is seen with malignancy. Although this is a single case of hepatic adenoma, the atypical enhanced pattern of this case can provide useful information to predict the malignancy of primary liver tumor.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제22권2호
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• pp.233-237
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• 2000

Pleomorphic adenoma is the most common of all salivary gland tumors, constituting over 50 per cent of all cases of tumors, and approximately 90 per cent of all benign salivary gland tumors. Since the term mixed tumor' was introduced by Broca for its dual origin of epithelial and mesenchymal elements, the term plemorphic adenoma suggested by Willis characterizes closely the unusual histologic pattern of the lesion. The parotid gland is the most common site but it may occur in any of the salivary glands. It is somewhat more frequent in women and in the fourth to sixth decades, but they are also relatively common in young adult and have been known to occur in children. Treatment of choice is surgical excision. Adequate surgery with safe margin reduce its recurrence rate. We represent a case of pleomorphic adenoma with literature review in 65-year old male occured in the palate. The lesion was successfully treated by surgical excision.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제33권6호
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• pp.520-524
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• 2011

A 27-year-old female presented to our hospital with a slow growing, hard and soft palate mass on the right that had been present for the several months. Physical examination showed a 2 cm, firm, well-circumscribed, painless mass on the right side of the palate. PNS computer tomographic imaging showed a $1.5{\times}1.3{\times}2$ cm well-defined cystic mass on the right side of both the hard and soft palate without any underlying bone change. The lesion was completely excised under general anesthesia. In order to preserve the palatal mucosa, trapdoor approach for removal of the pleomorphic adenoma was done. This technique provided more comfortable healing of the operative site. Three years after surgery, there was no evidence of recurrence. If pleomorphic adenoma without bony and mucosal destruction exists, we suggest consideration of the trapdoor approach to protect the palatal mucosa. In view of the potential for tumour recurrence, long-term follow-up and careful examination are necessary.

• 대한두경부종양학회지
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• 제36권1호
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• pp.49-52
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• 2020

The most common cause of primary hyperparathyroidism is a single adenoma accounts for more than 85% and about 1-2% in multiple occurrence. The adenoma arises mainly in the neck and rarely in the mediastinum. The simultaneous occurrence is extremely rare. A 73-year-old man came to our clinic complained about sense of falling forward during last eight months. The brain MRI and vestibular function test showed non-specific findings but total calcium and intact parathyroid hormone levels were markedly elevated. Radiologic studies and sesta-MIBI scan revealed multiple masses in lower paratracheal area and superior mediastinum. We performed mass excision with transcervical approach and all of them were diagnosed as parathyroid adenoma. After surgery, intact PTH and calcium levels returned to the normal range and his symptoms were dramatically improved. We report the unique and rare disease entity with a brief literature review.