Nasal fossae 의 암이란 비강과 부비동들에서 발생하는 것으로서 환자를 가장 괴롭히며 또한 가장 믿을수 없는 악성종양들중의 하나이다. 비록 본 예수병원 암환자 등록부에 의하면 전 암환자의 2.2% 발생빈도로서 주요한 발생빈도를 보이지는 않지만, 이 부위의 암을 치유하는데는 세심하고 철저한 모든 진단적 검사와 과감한 외과 및 치료방사선의 병합치료가 요구된다. 저자들은 지난 22 년간 비강 및 부비동 (Nasal fossae) 에서 발생한 원발성 악성종양중 치유목적의 근치수술을 시행한 68 예를 임상고찰 하였다. 근치수술을 시행했던 68 예중 91% 에서 제 3 병기 또는 4 병기의 진행된 경우 이었다. 외과적 수술은 한예의 사골동 (篩骨洞) 종양적출술 및 부분상악동(上顎洞)절제술 한 예를 제외한 66 예 모두에서 전상악동(全上顎洞)절제술 (total maxillectomy) 또는 확장 전상악동(全上顎洞)절제술 (extended total maxillectomy) 을 시 하였다. 저자들은 역학적(疫學的), 병리학적(病理學的), 병기(病期) 및 치료, 재발율과 생존율들을 분석 고찰하였으며 3가지 치료형태를 서로 비교하였다. 즉 수술만 시행한 군, 수술전 방사선 치료 및 수술병합군, 수술과 수술후 방사선치료 병합 군으로 나눴다. 저자들의 예비적 (preliminary) 관찰 결과는 2 년간 무병생존율 (disease-free 2-year survival) 만을 볼때, 수술만 시행한 군에서 40%로써 통계학적으로는 가장 좋았으나 실제는 수술만 시행한 군에서는 단지 40%만이 제 4 병기(病期)의 진행된 경우였으나 수술전 방사선치료 또는 수술후 방사선치료등의 병합치료에서는 제 4 병기(病期)의 진행된 상태가 무려 60 %나 되었다. 전체적인 재발율 (Overall recurrence rate) 은 68.2%로써 무서울 정도로 높았으며 전체적인 2 년 무병율은 23.7%였다. 저자들은 이 분야에서 실패의 원인분석과 치료방법의 선택등에 대한 지침을 제시하고저 한다.

During the past 14years 267 patients presented with a lump in the neck proven to be metastatic cancer histologically. In most cases the primary site was discovered by thorough physical examination, E.U.A.(examination under anesthesia) and radiodiagnostic studies. However in 31 cases complete diagnostic evaluation failed to reveal the primary site. This paper discusses the characteristics of this group of patients in terms of the frequency of the ultimately discovered primary sites, policies for diagnosis, methods of management, and the ultimate prognosis for such cases in Korea. The male: female ratio was 6.8:1 and 84 % of all cases occurred in the $51{\sim)70$ age group. The majority of these cancers were epidermoid carcinomas(67.7%) and 22 of the 31(71 %) were Stage IV lesinos(17 N3A lesions and 5 N3B lesions). Surgical management was employed in 7 cases only, and in 5 cases this was combined with rediotherapy, chemotherapy, or both. Nevertheless, the only patients who survived disease-free for two years or more (one for over 5 years) were two patients in this management group. None of the patients treated by radiotherapy or chemotherapy of a combination of these two modalities survived. Occult primary sites were eventually discovered in 5 of the 31 cases, two in the nasopharynx, and one each in the base of tongue, pyrifrom sinus, middle ear. Of the 21 cases with epidermoid carcinoma which presented in the neck, 2 are free of disease for 3years or more. Of those who underwent radical surgery two of five survived. This study thus confirms the principle enunciated by MacComb in 1972 that surgical treatment in the form of radical neck dissection is the cornerstone of management whenever feasible.

This is a clinical analysis of 24 cases of parotid gland tumor who were treated in the department of Surgery, Chonnam National University Medical School during the past 10years from January, 1976 to December, 1985. According to this analysis of total 24 cases, we concluded as follows; 1) 21 cases were benign tumors and 3 cases were malignant tumors. As the histopathological findings, benign tumor included 88%and malignant tumor 12%. Majority of benign tumor contained mixed tumor(86.7%), and the malignant tumor contained mucoepidermoid carcinoma (66.7%). 2) The peak age incidence was 40th in benign tumor and 50th in malignant tumor. 3) The chief complaints of patient was a painless mass and the duration of illness was average 5.2 years. 4) The mean size of mass was 4.5cm in diameter. 5) The surgical procedures were performed with excision 6 cases, superficial lobectomy 8 cases, wide excision with partial parotidectomy 4 cases, total parotidectomy 3 cases in benign tumors. In malignant tumors, total parotidectomy 2 cases and wide excision with partial parotidectomy 1 case were performed. 6) Major postoperative complications such as facial nerve palsy 7 cases (temporary ; 5 cases, permanent; 2 cases), Frey syndrome 1 case, seroma 1 case, hematoma 1 case, and wound infection 1 case were developed. The recurrence contained pleomorphic adenoma 1 case and mucoepidermoid carcinoma 1 case.

Tumors of the nasal cavity are rare and are usually classified and reported jointly with tumors of the paranasal sinuses. Neverthless their frequency, diagnostic problems, management, and prognosis differ considerably from the latter and justify their study as a separate entity in order to define clearly and evaluate their characteristics. Males outnumbered females in a ratio of 2 to 1. Regional lymph node metases is infrequent; only 10% of the patients presented nodes on admission. Radiation therapy is more favorable method of treatment for nasal cavity tumor secondary to good cosmetic results and high local control rate. The tumor doses are in the range of 5,000 to 6,000 rads in 5 to 6 weeks and an additional dose of 500 to 1,000 rads were given through reduced field to residual disease area. The results of two cases of nasal cavity tumor treated by radiation alone were reasonably good, and review of literature indicated that the radiation alone can give high local control rate and good cosmetics. Therefore, at present time, we recomend radiation therapy for the nasal cavity tumor.

대흉근근피판은 혈액공급이 왕성하며 회전호가 크고 조직량이 층충해 안면부 결손을 기능적 및 미용적으로 잘 재건해 줄 수 있을뿐 아니라 용도에 따라 다양하게 사용할 수 있다. 저자들은 안면 부에 발생한 거대한 기저세포암 l 예와 보존요법으로서는 치료가 불가능한 만성상악골 골수염을 동반한 거대한 섬유성종괴 1 예를 절제하고 이로써 생긴 안면부의 광범한 조직결손을 도서형대흉근근피판으로 대치하여 좋은결과를 얻을 수 있었다.

저자들은 부갑상선 선종 3 예를 입상고찰과 함께 보고하는 바이다. 부갑상선 기능 항진증이 있는 환자에서 임상증상들이 각각 서로 달랐으며 증상의 다양성과 여러기관의 침범을 볼수 있었다. 제 1 예는 심한 근 쇄약을, 제 2 예는 좌 경골의 낭포성골병변을, 제 3 예는 상복부동통, 관절통 및 정신장애를나타냈다. 전례(全例) 모두에서 骨의 광물질(鑛物質) 소실(消失) (demineralization) 을 보였고 두 예에서는 경부 종괴가 촉지 되었고 나머지 한 예만 전형적인 낭포성 섬유성 골염 (Osteitis fibrosa cystica) 을 보였다. 3 예중 2 예는 주세포 선종 (Chief cell adenoma) 이었으며 나머지 한 예는 혼합성 세포형 (mixed cell type) 이었다. 저자들은 본 질환에 대한 진단기준, 외과적 수술방법 및 수술 성공 여부 판정에 대한 지침을 제시하고저 한다.

An unusual polypoid laryngeal tumor has been studied with light and electron microscopy. In light microscopic section, there were two components: a squamous cell carcinoma and a sarcomatoid spindle cell population. Transitional zone between these two components was found. The electron micrographs demonstrated the presence of slender bundles of tonofilaments in many tumor cells. Desmosomes were present, but few in number and poorly developed. Findings suggest this laryngeal tumor as a spindle cell variant of squamous cell carcinoma.