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Clinical Investigations of Major Salivary Gland Tumors (주타액선 종양의 임상적 고찰)

  • Kim Eun-Seo;Kim Young-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.17 no.2
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    • pp.210-215
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    • 2001
  • Objectives: Salivary gland neoplasms are a diverse group of benign and malignant tumors with a wide range of biologic behaviors. The surgeon must understand the pathologic behavior of each tumor type to develop an appropriate treatment plan. The authors planned this study to evaluate our clinical experiences and establish a new treatment strategy. Materials and Methods: From Sep. 1997 to June 2001, 25 cases of major salivary gland tumors which were underwent surgery were evaluated retrospectively. Results: 20 cases were benign and 5 were malignant. Most(17) of benign cases were pleomorphic adenoma and they showed wide distribution in age. Also we experienced other benign such as warthin's tumor, oncocytoma. In malignant, there were 2 cases of carcinoma ex-pleomorphic adenoma, 2 cases of adenoid cystic carcinoma, and one lymphoma. In carcinoma ex-pleomorphic adenoma, one showed dismal prognosis in spite of multimodality and the other were recurrent to be salvaged. Conclusion: We concluded that salivary gland neoplasms are challenging because of their relative infrequency, inconsistent classification, and highly variable biologic behavior. We need to establish new effective strategies with the regard of factors influencing survival.

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Factors Affecting Psychosocial Adjustment in Patients with Surgical Removal of Benign Breast Tumor (유방 양성종양 절제술 환자의 심리사회적 적응의 영향요인)

  • Kim, Hyunsook;Lee, Myoungha;Kim, Hyeyoung;Nho, Juhee
    • Women's Health Nursing
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    • v.24 no.2
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    • pp.163-173
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    • 2018
  • Purpose: To identify factors influencing psychosocial adjustment in patients with surgical removal of benign breast tumor. Methods: With a survey design, data were collected using the Psychosocial Adjustment to Illness Scale-Self Report (PAIS-SR), Body Image Scale, Physical Discomfort Scale, and Family Support Scale with patients who had had surgical removal of a benign breast tumor from September to November 2017. Data were analysed with descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients, and stepwise multiple regression. Results: The mean scores for physical discomfort, body image, family support, and psychosocial adjustment were $1.57{\pm}0.51$, $0.37{\pm}0.64$, $3.62{\pm}0.67$, and $4.00{\pm}0.45$, respectively. Family support, body image, physical discomfort, number of surgical removal of benign breast tumor (twice), and cancer insurance status (yes) were verified as factors influencing psychosocial adjustment. These factors accounted for 57.4% of psychosocial adjustment. Conclusion: In this study, family support, body image, and physical discomfort were identified as significant predictors of psychosocial adjustment. Therefore, this study can be used as fundamental data to develop nursing intervention strategies in order to increase psychosocial adjustment in patients with surgical removal of a benign breast tumor.

Other Gynecologic Pathology in Endometrial Cancer Patients

  • Khunnarong, Jakkapan;Tangjitgamol, Siriwan;Srijaipracharoen, Sunamchok
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.2
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    • pp.713-717
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    • 2016
  • Background: To evaluate the prevalence and features of other gynecologic or surgical lesions in endometrial cancer (EMC) patients. Materials and Methods: Clinico-pathological data of EMC patients who were treated in the institution from 1995 to 2012 were collected. Data collected were age, stage of disease according to the FIGO 2009 criteria (FIGO), histopathology, tumor grade, adjuvant therapy, other gynecologic or surgical lesions, follow-up period, and living status. Results: The mean age of 396 patients was $56.7{\pm}10.64years$. Abnormal uterine bleeding was the most common presenting symptom (90.1%). Bleeding was accompanied with pelvic mass in 7.7% and 5.4% had only a pelvic mass. Abnormal cervical cytology was found in 3.8%. Approximately 75% had early stage diseases and 86% had endometrioid histology. We found 55.8% of EMC patients had other gynecologic lesions: 89.6% benign and 9.5% malignant. Some 4.5% had pre-invasive cervical/vulva/vagina lesions. The two most common gynecologic lesions were myoma uteri and ovarian tumors. Focusing on the latter, approximately 14% were benign while 8% were malignant. Among 364 patients with available data, surgical lesions were found in 11.8%, 5.7% benign and 9.2% malignant. The most common benign surgical condition was chronic appendicitis while breast and colon cancers were the two most common malignant lesions found. Conclusions: More than half of EMC patients had other gynecologic lesions including benign and malignant tumors. Surgical lesions were also found in more than one-tenth of patients. Careful pre-operative evaluation and intra-operative inspection are advised for proper management and better prognosis.

Value of Contrast-Enhanced Ultrasonography in the Differential Diagnosis of Enlarged Lymph Nodes: a Meta-Analysis of Diagnostic Accuracy Studies

  • Jin, Ya;He, Yu-Shuang;Zhang, Ming-Ming;Parajuly, Shyam Sundar;Chen, Shuang;Zhao, Hai-Na;Peng, Yu-Lan
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.6
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    • pp.2361-2368
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    • 2015
  • Objective: To evaluate the diagnostic accuracy of contrast-enhanced ultrasonography (CEUS) in differentiating between benign and malignant enlarged lymph nodes using meta-analysis. Materials and Methods: Pubmed, Embase, SCI and Cochrane databases were searched for studies (up to September 1, 2014) reporting the diagnostic performance of CEUS in discriminating between benign and malignant lymph nodes. Inclusion criteria were: prospective study; histopathology as the reference standard; and sufficient data to construct $2{\times}2$ contingency tables. Methodological quality was assessed using Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). Patient clinical characteristics, sensitivity and specificity were extracted. The summary receiver operating characteristic curve was used to examine the accuracy of CEUS. A meta-analysis was performed to evaluate the clinical utility in identification of benign and malignant lymph nodes. Sensitivity analysis was performed after omitting outliers identified in a bivariate boxplot and publication bias was assessed with Egger testing. Results: The pooled sensitivity, specificity and AUROC were 0.92 (95%CI, 0.85-0.96), 0.91 (95%CI, 0.82-0.95) and 0.97 (95%CI, 0.95-0.98), respectively. After omitting 3 outlier studies, heterogeneity decreased. Sensitivity analysis demonstrated no disproportionate influences of individual studies. Publication bias was not significant. Conclusions: CEUS is a promising diagnostic modality in differentiating between benign and malignant lymph nodes and can potentially reduce unnecessary fine-needle aspiration biopsies of benign nodes.

Levels of Serum 25-Hydroxy-Vitamin D in Benign and Malignant Breast Masses

  • Alipour, Sadaf;Hadji, Maryam;Hosseini, Ladan;Omranipour, Ramesh;Saberi, Azin;Seifollahi, Akram;Bayani, Leila;Shirzad, Nooshin
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.1
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    • pp.129-132
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    • 2014
  • Background: The true association between breast cancer and vitamin D is currently under investigation. We compared serum 25-hydroxy-vitamin D levels in women with benign and malignant breast masses and controls. Materials and Methods: Levels of vitamin D were measured by electrochemiluminescense. Serum levels >35 ng/ml, 25-35 ng/ml, 12.5-25 ng/ml and <12.5 ng/ml were considered as normal, mild, moderate and severe vitamin D deficiency, respectively. Results: Overall, 364 women were included in the control, 172 in the benign and 136 in the malignant groups. The median serum vitamin D level was significantly lower in breast cancers than controls. Levels were also lower in malignant than benign cases and in benign cases than controls although statistically non-significant. Conclusions: Multinomial logistic regression analysis showed that severe vitamin D deficiency causes a three-fold increase in the risk of breast cancer while this was not the case for moderate and mild deficiency.

Spectrum of Cytological Findings in Fine Needle Aspiration Cytology of Breast Lumps with Histopathology Correlation: Experience in a Tertiary Care Rural Hospital in India

  • Kochhar, Ajay Kumar;Jindal, Umesh;Singh, Karandeep
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.12
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    • pp.7257-7260
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    • 2013
  • To determine the pattern of disease in patients presenting with breast lumps and to determine the sensitivity and specificity of fine needle aspiration cytology of benign and malignant diseases as a diagnostic tool by correlating with histopathology findings. This retrospective study was carried out in the Department of Pathology, Maharaja Agrasen Medical College, Agroha, from Jan 2008 to April 2012. Fine needle aspiration cytology was performed on 370 cases and out of these 52 cases were received in the Department for histopathological examination. Fibroadenoma was the most common disease encountered, in 88 (24%), with a peak incidence in second and third decade of life. Fibrocystic disease was second, being common in the third and fourth decades of life. Peak incidences of duct ectasia, granulomatous and tubercular mastitis were seen in the third decade. Gynaecomastia showed two peak incidences in second and sixth decades of life. Out of total 370 cases undergoing fine needle aspiration, benign cases were 316 (85.4%), malignant and suspicious were 54 (14.6%) and 10 (2.70%) respectively. Out of total 22 histological confirmed malignant lesions 19 were interpreted as malignant cytologically while two as suspicious and one as benign. All thirty histologically confirmed benign cases were diagnosed as benign cytologically. The sensitivity, specificity, positive and negative predictive values were 98%, 100%, 100% and 96.4% respectively. FNA cytology is highly accurate for diagnosis of breast masses. However, the clinician should correlate FNA cytological results with physical examination and imaging findings to prevent false negative and false positive events and to obtain optimal management of their patients.

Significance of HCG to Distinguish Parathyroid Carcinoma from Benign Disease and in Adding Prognostic Information: A Hospital Based Study from Nepal

  • Gupta, Satrudhan Pd.;Mittal, Ankush;Sathian, Brijesh
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.1
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    • pp.325-327
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    • 2013
  • Objective: To differentiate between benign and malignant hyperparathyroidism on the basis of excretion of HCG and its malignant isoforms in urine. Materials and Methods: This hospital based study was carried out using data retrieved from the register maintained in Manipal Teaching Hospital from $1^{st}$ January, 2008 and $31^{st}$ August, 2012. The variables collected were urinary HCG and HCG malignant isoform, calcium and parathyroid hormone. Preceding the study, approval was obtained from the institutional research ethical committee. Analysis was by descriptive statistics and testing of hypothesis. A p-value of <0.05 (two-tailed) was used to establish statistical significance. Results: Out of the 20 cases, 10 were primary hyperparathyroidism and the remainder were parathyroid carcinomas. The urinary HCG $6.1{\pm}0.6$ fmol/mgCr was with in normal range in benign hyperthyroidism but was markedly elevated in three cases of malignant hyperparathyroidism (maximum value of excretion in urine for HCG was 2323 fmol/mgCr). The excretion of malignant isoform of HCG in urine was 0 in benign hyperparathyroidsm and in four cases of malignant hyperparathyroidism which fell into the category of persistantly low HCG. The maximum excretion of the malignant isoform of HCG in urine was 1.8, in the category of very high HCG. Calcium and parathyroid hormone were mildly raised in benign parathyroidism, while parathyroid hormone was markedly elevated in cases of malignant hyperparathyroidism falling into the category of very high HCG. Conclusions: The excretion of urinary HCG in urine has the ability to distinguish between parathyroid adenomas and carcinomas and thus has potential to become a marker of disease progression in malignant parathyroid disease.

Korean Medicine Interventions for Benign Paroxysmal Positional Vertigo: A Systematic Review of Clinical Studies Published in Korea (양성 돌발성 체위성 현훈(Benign Paroxysmal Positional Vertigo)에 관한 임상 문헌 고찰 - 국내에 출판된 한의약 임상 논문을 중심으로 -)

  • Jung, Jun-su;Jung, Sung-heon;Kim, Min-joo;Park, Jang-kyung;Bae, Kwang-ho;Kong, Kyung-hwan;Ko, Ho-yeon
    • The Journal of Internal Korean Medicine
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    • v.38 no.4
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    • pp.479-490
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    • 2017
  • Objectives: This study provides evidence for clinical practices by analyzing present clinical Korean medicine articles about benign paroxysmal positional vertigo (BPPV). Methods: Articles published up to July, 2017 were found by searching "BPPV", "Benign positions", and "Vertigo" as keywords in three domestic electric databases (i.e., OASIS, NDSL, RISS). Results: The initial search resulted in 228 articles; however, only 20 articles satisfied the selection criteria and were analyzed. Of these, 40% were published in the Journal of Korean Oriental Internal Medicine, and 35% were published in 2003. When diagnosing BPPV patients, VAS scores are primarily used for clinical assessments rather than objective diagnostic tools. Banhabaekchulcheonmatang was the most frequent herbal medicine used to treat BPPV, and the most commonly used therapeutic acupuncture point was Jok-samni (ST36). The most common diagnosis of BPPV was dam-eum according to nine studies. Conclusions: Systematic and large-scale research for the standardization of BPPV treatment is needed.

Validity of Needle Aspiration Cytology and Frozen Section in Thyroid Tumor (갑상선 결절에서 세침흡인검사와 동결조직검사의 의의)

  • Kim Jae-Won;Lee Jang-Won;Bae Sung-Ho;Ko Kook-Jin;Yoon Suk-Young;Kim Young-Mo
    • Korean Journal of Head & Neck Oncology
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    • v.20 no.2
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    • pp.143-146
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    • 2004
  • Background and Object: The role of fine needle aspiration cytology (FNAC) and frozen section (FS) in management of thyroid neoplasms continues to generate considerable controversy. We reviewed our current experience to determine the clinical utility of FNAC and FS in our surgical management and investigated reliability of FNAC and FS in planning the extent of thyroid resection. Material and Method: 212 patients who had operations for thyroid disease from May 1996 to November 2003 were included our retrospective study. FNAC was undertaken in 175 patients and FS was done in 148 patients. Result: The sensitivity and specificity of FNAC were 72.1% and 100%, respectively, and those of FS were 67.2% and 100%. The results of FNAC were benign (n=72) , malignancy (n=31), indeterminate (n=9), and nondiagnostic (n=63). The results of FS were benign (n=95), and malignancy (n=53). The 9 indeterminate cases on FNAC were benign (n=6) and malignancy (n=3) on final pathology, and benign (n=7) and malignancy (n=2) on FS. The false negative of FNAC were micro papillary carcinoma (n=6) and follicular carcinoma (n=6). The false negative of FS were micropapillary carcinoma (n=10) and follicular carcinoma (n=2). Conclusion: When results of FNAC are interpreted as indeterminate, FS is a valuable tool. FS is helpful in determining the extent of thyroidectomy when results of FNAC were follicular neoplasm. However we always concerned about micropapillary carcinoma and follicular carcinoma although FNAC and FS were benign.

Differential Diagnosis of Malignant Biliary Tract Cancer from Benign Tissues using Apparent Diffusion Coefficient Measurements with Diffusion Weighted Imaging in Asians

  • Zhao, Xu-Ya;Zhou, Shi;Wang, Da-Zhi;He, Wei;Li, Jun-Xiang;Zhang, Shuai
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.14
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    • pp.6135-6140
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    • 2015
  • Background: The aim of this meta-analysis was to assess the efficacy of the apparent diffusion coefficient (ADC) value of diffusion-weighted MRI (DWI) for differentiating biliary tract cancer (BTC) from benign biliary tract diseases in Asians. Materials and Methods: We systematically searched Embase and PubMed prior to December 2014. Eight studies conducted in Asians met our predetermined inclusion criteria. Results: Our meta-analysis results showed that ADC values in BTC tissues were significantly lower than in benign biliary tract tissues (SMD = -1.54, 95%CI: -1.75~-1.33, P<0.001). Subgroup analysis based on the MRI machine type showed that the ADC values were consistent, accurate and reliable in the diagnosis of BTC when comparing cancer tissue vs. benign tissue under the Siemens 1.5 T/3.0 T, Philips 1.5 T/3.0 T, GE 1.5 T, and Toshiba 1.5 T types, respectively (all P<0.05). Further, ADC values were still consistent and accurate in the differential diagnosis of BTC under the b value of 800 and $1000s/mm^2$ (all P<0.05). Conclusions: Our findings supported potential clinical applications of DWI ADC values in differentiating BTC from benign biliary tract diseases in Asians.