• Advances in pediatric surgery
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• v.7 no.1
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• pp.7-14
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• 2001

Congenital anomalies of the head and neck region such as preauricular sinus and skin tag, thyroglossal duct cyst, branchial anomaly, cystic hygroma and dermoid cyst are common in pediatric population. It is important for pediatricians and pediatric surgeons to be familiar with the embryology and the anatomical characteristic of these lesions in order to diagnose and treat them properly. Three hundred and nineteen patients with congenital head and neck anomalies treated at Hanyang University Hospital between 1980 and 1999 were reviewed to determine the relative frequency of the anomalies and to analyze the method of management. Eight-four (25.1 %) of 335 lesions were preauricular sinus and skin tag, 81 (24.2 %) were thyroglossal duct cyst, 81 (24.2 %) branchial anomaly, 58 (17.3 %) cystic hygroma and 31 were (9.2 %) dermoid cyst. The male-to-female ratio was 1.4:1. Thyroglossal duct cyst most commonly present at 3-5years, however branchial anomalies commonly are diagnosed in children younger than 1 year. Preauricular sinus showed familial tendency in three patients and was bilateral is 33.8 %. Most head and neck anomalies in children have specific clinical and anatomical characterics. A careful history and physical examination is very useful for diagnosis and proper management. Experienced pediatric surgeons should do the initial surgery since the recurrence rate after incomplete surgical excision can be high.

• Advances in pediatric surgery
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• v.3 no.1
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• pp.24-31
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• 1997

Thirty-four consecutive cases of thyroglossal duct lesions in children were reviewed at the Department of Surgery, Chonbuk National University Hospital. Twenty patients were males, and the most prevalent age of discovering was 2 to 4 years (52.9%). Resection was performed within 2 years after discovering the lesions in 19 cases, but was delayed untill 4 to 10 years in 6 cases. Cystic lesions (85.3%) were 5.8 times more common than fistulas. A midline upper neck mass was found in every cystic cases, and a draining sinus at hyoid region was noticed in fistula patients. The location of the lesion was on the hyoid bone in 34 cases, at the midline in 31 cases, slightly to the left in 2 cases, and slightly to the right in 1. Two cases were misdiagnosed as lymphadenopathy, and a single case of ectopic thyroid gland was misinterpreted as a thyroglossal duct cyst. Modified Sistrunk operation was performed in twenty-three cases(67.6%), Sistrunk operation in 9(26.5%), and cyst excision in 2(5.9%). Postoperative complications occurred in 4 cases(11.8%); 2 wound infections and 2 recurrences. One of recurrences was a fistula treated by modified Sistrunk operation, and the other was a cyst treated by cyst excision.

• Journal of Chest Surgery
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• v.44 no.1
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• pp.83-85
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• 2011

The thoracic duct cyst is an extremely rare cystic lesion in the mediastinum. Surgical treatment of the cyst is necessary to confirm histologic diagnosis and prevent potential complications such as spontaneous or traumatic rupture of the cyst and chylothorax.

• The Korean Journal of Nuclear Medicine
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• v.30 no.1
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• pp.126-129
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• 1996

Spontaneous perforation of CBD in infant is a rare but fatal disease. We report a case of bile leakage from common bile duct in 11 months old girl with progressive abdominal distension and vomiting, preoperatively diagnosed by hepatobiliary scan with 99mTc-DISIDA, which was confirmed by surgery, Operative cholangiogram showed a small perforation at the confluence of cystic duct and common bile duct with mild fusiform dilatation, and no definite abnormality in confluence of the common bile duct and pancreatic duct. Simple drainage of the free peritoneal bilous fluid and T-tube drainage were performed without any evidence of the complication. Patient was inevitable for 6 months OPD follow-up examination.

• Korean Journal of Head & Neck Oncology
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• v.38 no.1
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• pp.65-68
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• 2022

Thyroglossal duct cyst (TGDC) is the most common congenital cyst in the neck and usually presents in children. It is most commonly located at the infrahyoid level. However, intrathyroid TGDC in the adult is extremely rare and its pathogenesis remains unclear. Curiously, an intrathyroid TGDC was found on the lateral aspect of the inferior pole of the thyroid gland. Given the unique position of this lesion, and its capacity to stimulate other nodules in the thyroid, it should be differentiated from other lateral neck masses, such as: thymic cysts, branchial cleft cysts, cystic hygroma, lipomas, lymphadenopathies, cervical teratomas, and lymphomas. In this case, a separate cystic mass was found in the right inferior pole of the thyroid gland and extended to the mediastinum. We confirmed it as TGDC by pathology and histological examination.

• Archives of Plastic Surgery
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• v.35 no.5
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• pp.607-610
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• 2008

Purpose: Salivary duct carcinoma(SDC) is uncommon but high grade adenocarcinoma arising in the ductal epithelium of salivary glands. SDC is characterized by distinctive clinical and pathologic features. The most important histologic aspect of this neoplasm is its resemblance to ductal carcinoma of the breast. Clinically SDC is defined by cervical lymph node involvement and distant metastasis with a high rate of recurrence and mortality. We described some of the clinical and pathological features of SDC and the management using case report for our patient. Methods: We present a case of a 40-year-old male with 2-year history of a swelling arising in his left preauricular region. There was a single painless, firm and solid $2{\times}1.5cm$ mass in the left parotid area. Facial nerve function was intact and no cervical lymph node were palpable. In August 2005, we found out $1.7{\times}1.8cm$ sized cystic, nodular lesions that were located in the superficial lobe of left parotid gland through Computed tomography. And then superficial parotidectomy and postoperative radiation therapy were performed in Jan 2007. Results: Pathologically, the specimen were consisted of homogeneous, chondoid to myxoid type of tissues. It was yellow mass that has multiloculated cystic lesions. In postoperative PET(Positiron emission tomography) CT, there was no evidence of uptaking FDG(Fluorodeoxyglucose) into the deep layers of parotid gland and distant metastasis were not seen. Conclusion: Salivary duct carcinoma(SDC) is a rare but high grade adenocarcinoma related to pleomorphic adenocarcinoma. The prognosis of SDC can be different according to the type of tumor such as mucoepidermoid adenocarcinoma, adenoid duct carcinoma and acinar cell carcinoma. So we need to study more carefully for accurate diagnosis in early stage of diagnosis. Although radiotherapy has not yet proven to be a significant factor in overall survival, the combination of parotidectomy and postoperative radiation therapy can lead to more favorable results in treating of SDC.

• Korean Journal of Bronchoesophagology
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• v.3 no.1
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• pp.181-184
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• 1997

A dermoid cyst is a rare congenital midline neck mass with usually develops in the submental region. It is most often seen in young adults and can become rather large than almost no symptoms. As it increases in size, dysphasia, or dyspnea can develop. The differential diagnosis of the midline lesion includes ranula, thymglossal duct cyst, cystic hygroma, and cystic lymphangioma. The treatment of choice is complete surgical removal. With a review of the literature, we report two cases of a huge dermoid cyst inducing dyspnea.

• Archives of Plastic Surgery
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• v.32 no.2
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• pp.255-258
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• 2005

The nasopalatine duct cyst, known as the incisive canal cyst, is the most common nonodontogenic cyst in the maxillofacial area. It is believed to arise from epithelial remnants of the embryonic nasopalatine duct. Nasopalatine duct cysts are most often detected in patients between forties and sixties. The trauma, bacterial infection, or mucous retention has been suggested as etiological factors. The cysts often present as asymptomatic swelling of the palate but can present with painful swelling or drainage. Radiologic findings include a well demarcated cystic structure in a round, ovoid or heart shape presenting with a well-defined bone defect in the anterior midline of the palate between and posterior to the central incisors. Most of them are less than 2cm in size. On MRI, the cyst is identified as a high-intensity, well-marginated lesion, which indicates that it contains proteinaceous material. We experienced a case of a 61-year-old female patient who had a $2.3{\times}2.6{\times}1.7cm$ sized nasopalatine duct cyst. The bony defect after a surgical extirpation was restored with hydroxyapatite. So we report a good results with some reviews of the literatures.

• Korean Journal of Head & Neck Oncology
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• v.25 no.2
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• pp.123-127
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• 2009

Objectives : The aim of this study was to investigate immunohistochemical expression of CK7, CK19, CK20, SMA and Ki-67 in Adenoid cystic carcinoma(ACC) of the Head and Neck. Material and Methods : Sixteen patients who were treated in Chungbuk National University Hospital from 1992 to 2004, were included in this study. Ten ACCs, 3 MECs, 1 Salivary duct carcinoma, 1 Adenocarcinoma(NOS), and 1 cacinoma ex pleomorphic adenoma were analyzed immunohistochemically for CK7, CK19, CK20, SMA, and Ki-67. Results : CK7 was expressed in 100% of the adenoid cystic carcinoma and 75% of the other tumors. CK19 was expressed in 75% of the adenoid cystic carcinoma and 100% of the other tumors. CK20 was not expressed in all tumors. SMA was expressed in 88.9% of the adenoid cystic carcinoma and not expressed in the other tumors. Ki-67 was expressed in low level in the adenoid cystic carcinoma. Conclusion : The Ki-67 index could explain the natural course of tumor. Immunohistochemistry of CK7, CK19, CK20, SMA and Ki-67 expression in Adenoid cystic carcinoma may provide useful information to diagnosis.

• Advances in pediatric surgery
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• v.2 no.2
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• pp.143-147
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• 1996

Spontaneous perforation of the bile duct in children is a very rare disorder. We experienced a 6 year-old girl with spontaneous perforation of the right hepatic duct. The patient was initially misdiagnosed as hepatitis because of elevation of liver enzyme and then as appendicitis because of fluid collection in the pelvic cavity demonstrated by ultrasonogram. A laparoscopic exploration was done and no abnormal findings were detected except bile-stained ascites. Peritoneal drainage was performed and the patients seemed to improve clinically. Abdominal pain, distention and high fever developed after removal of the drains. DISIDA scan showed a possible of bile leak into the peritoneal cavity. ERCP demonstrated free spill of dye from the right hepatic duct. At laparotomy, the leak was seen in the anterior wall of the right hepatic duct 2cm above the junction of the cystic duct and common hepatic duct. The perforation was linear in shape and 0.8cm in size. The patient underwent cholecystectomy, primary closure of the perforation and T-tube choedochostomy. We could not identify the cause of the perforation; however, the T-tube cholangiography taken on the 42nd postoperative day showed a little more dilatation of the proximal common bile duct compared with the cholangiography taken on the 14th day. Long-term follow-up of the patient will be necessary because of the possibility for further change of the duct.