두경부 악성종양의 치료 후 재발 병변 ; CT와 MRI소견

Recurrent Lesions in the Malignant Head and Neck Tumors; CT and MRI Evaluation

Background and Objectives: The aim of our study was to describe the appearance of recurrent and residual lesions in the head and neck tumors, and to evaluate the usefullness of CT and MRI. Materials and Methods: CT(n=42) and MRI(n=4) of 44 patients with recurrent head and neck tumors were reviewed retrospectively. Primary tumor sites were larynx/hypopharynx in 15, oral cavity/floor of mouth in 13, base of tongue/tonsil in 5, nasopharynx in 4, palate in 2, and others in 5 patients. Therapeutic modalities included sugery and radiotherapy in 23, radiotherapy in 11, surgery in 5, chemotherapy and radiotherapy in 4, and chemotherapy in 1 patient. Results: The patterns of tumor recurrence were nodal recurrence(n=17), primary tumor bed recurrence combined with nodal recurrence(n=12), primary tumor bed recurrence(n=10) and residual primary tumors(n=5). The most common appearance of residual/recurrent primary tumor on CT was focal or diffuse heterogenous mass with or without surrounding fat or muscle infiltration(25/27). On MRI, the recurrent lesions showed intermediate signal intensity on T1 weighted image and high signal intensity on T2 weighted image with heterogenous enhancement in the most cases(n=3). 38 out of 44 nodal recurrences(86%) which had been pathologically or clinically proved were more than 1 cm in diameter or contained central low density on CT scan. Conclusion: Although CT and MRI findings of recurrent and residual tumors of the head and neck were nonspecific, in the majority the lesions manifested as a mass at primary tumor bed and/or nodal disease including contralateral side of the neck. And CT and MRI are valuable for revealing above lesions.