• 제목/요약/키워드: 경부전이

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The indication of neck dissection in treatment of the supraglottic carcinoma (성문상부암 치료에 있어 경부곽청술의 적응)

  • 이병주;백무진;왕수건;전경명
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1993.05a
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    • pp.106-106
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    • 1993
  • Cancer of the larynx is the most common malignant neoplasm of head and neck and has a generally favorable prognosis. But its incidences of lymph node metastasis and recurrence depend on the primary site of lesion. Especially, supraglottic carcinoma tends to involve the cervical lymph node with easy. We have analyzed retrospectively 49 cases of supraglottic carcinoma treated surgically with or without radiotherapy from March 1986 to February 1992 at the department of otolaryngology, Pusan National University Hospital to find out the incidence of ipsilateral and contralateral lymph node metastasis and to establish the indication of neck dissection followed by T stage. The incidence to the ispilateral and contralateral cervical lymph node metastasis in patients with lateral (aryepiglottic fold) lesions is higher than that in those with midline (epiglottis) lesion. And average incidence of isplateral lymph node metastasis was 51.0% regardless of T stage. Therefore routine neck dissection should be considered in surgical treatment of supraglottic carcinoma, especially, over T2 stage.

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A Case of Bilateral Tonsillar Cancer Discovered in Metastatic Carcinoma of Unknown Origin (원발미상의 경부 전이암에서 발견된 양측 편도암 1예)

  • Choi, Jeong-Seok;Lim, Jae-Yol;Han, Chang-Dok;Kim, Young-Mo
    • Korean Journal of Head & Neck Oncology
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    • v.28 no.1
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    • pp.16-18
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    • 2012
  • Ipsilateral tonsillectomy and panendoscopy-guided biopsy following imaging studies are considered a standard procedure in the search for a primary origin in patients with cervical metastatic carcinoma of unknown origin(MUO). However, many authors recommended bilateral tonsillectomy for the determination of the primary site of a MUO, because cervical metastasis may occur contralateral to tonsillar carcinoma. The authors attempted to address the clinical implications of using routine bilateral tonsillectomy to determine the primary site of MUOs based on a case report of cervical MUO that was finally diagnosed as a bilateral synchronous tonsillar carcinoma with cervical metastasis after a diagnostic work-up that included bilateral tonsillectomy.

Langerhans Cell Histiocytosis of Thyroid Gland : A Case Report (갑상선에 생긴 랑게르한스 세포 조직구증 1예)

  • Jang, Chul Soon;Yeon, Je Yeob;Park, Soo Kyoung;Lee, Dong Wook
    • Korean Journal of Head & Neck Oncology
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    • v.29 no.1
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    • pp.18-21
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    • 2013
  • 랑게르한스 세포 조직구증은 골수에서 유래하는 랑게르한스 세포 조직구의 이상 증식에 의해 발병하는 희귀한 질병으로 알려져 있다. 비록 모든 장기에서 발생 할 수 있으나 갑상선을 침범하는 경우는 매우 드물다. 18세 남자가 5달전부터 점점 커지는 갑상선 종괴를 주소로 내원하여 세침흡인 세포검사, 총샘검, 경부 전산화단층촬영을 시행하였다. 세침흡인 세포검사에서 악성신생물이 의심되었고, 총생검에서 랑게르한스 세포 조직구증으로 나타났다. 경부 전산화단층촬영에서는 우측 갑상선에서 윤곽이 잘 구분되는 저음영의 종괴와 우측 기관 주위 림프절의 종대가 관찰되었다. 갑상선 전절제술과 우측 중앙 선택적 경부 림프절 청소술이 시행되었다. 랑게르한스 세포 조직구증이 갑상선을 침범하는 경우는 드물지만 갑상선 비대가 있는 환자가 뇌하수체 기능부전의 증상이나 뼈와 폐의 침범과 관련된 증상을 호소한다면 갑상선의 랑게르한스 세포 조직구증 침범을 고려해야 한다. 또한, 다른 장기의 랑게르한스 세포 조직구증을 치료한 과거력이 있는 경우는 갑상선 종괴를 감별 진단하는데 있어 랑게르한스 세포 조직구증을 고려해야 한다.

Effects of Cervical Stretching Program on Pain, Fatigue and Range of Motion of Nursing College Students Overusing Smartphones (경부스트레칭프로그램이 스마트폰 과다 사용하는 간호대학생의 경부통증, 피로, 관절운동범위에 미치는 효과)

  • Kang, Moon-Jung;Kim, Namsuk
    • The Journal of the Convergence on Culture Technology
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    • v.5 no.3
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    • pp.241-249
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    • 2019
  • The purpose of this study was to evaluate the effect of cervical stretching program on neck pain, fatigue and range of motion caused by overuse of smartphone. Methods: We treated stretching program to measure the pain, fatigue, and range of motion of the neck before and after cervical stretching program for experiment group (n=25), control group(n=27) nursing college students using the smartphone. The general characteristics of the subjects and the range of neck pain, fatigue, and cervical range of motion were analyzed using descriptive statistics. The results of the cervical stretching program for neck pain, fatigue, and range of motion of the neck were analyzed using independent t-test. Results: After cervical stretching program, the pain of the neck(t=2.86, p=.006), fatigue(t=5.44, p<.001). flexion(t=-2.10, p=.041), extension(t=-2.84, p=.006), right lateral flexion(t=-2.4, p=.047), left lateral flexion(t=-2.05, p=0.46) and right rotation(t=-4.48, p<.001), left rotation(t=-3.38, p=.001) range of rotation were improved. Conclusion: The results of this study suggest that a cervical stretching program can be used as an effective intervention for health problems in musculoskeletal disorders due to smartphone overuse.

Association of Bone Mineral Density with Physiological Characteristics and Lifestyles in Premenopausal Working Women (폐경전 성인직장여성의 골밀도와 생리적 특성 및 생활습관과의 관련성)

  • 임화재
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.33 no.2
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    • pp.339-348
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    • 2004
  • This study was peformed to assess the relationships among bone mineral density (BMD), Physiological characteristics and lifestyle factors in 61 premenopausal working women aged 30∼49 y in Busan. The BMDs of the lumbar spines (Ll∼L4), femoral necks (FN), ward's triangles (WT) and trochanters (TC) were measured by dual energy X-ray absorptiometry. Data for physiological characteristics and physical activity was assessed by questionnaire and usual intakes of coffee, green tea, alcohol, Coca cola by food frequency questionnaire. The BMDs of L14, FN, WT and TC were 1.02 g/$\textrm{cm}^2$, 0.76 g/$\textrm{cm}^2$,0.69 g/$\textrm{cm}^2$ and 0.66 g/$\textrm{cm}^2$respectively The BMD of FN was assessed as osteopenia by T-score. The BMD of WT was positively correlated with age of monarch (p<0.05) and the BMD of Ll4 was positively correlated with delivery number (p<0.05). The BMD of Ll4 was positively correlated with hours of outdoor activity per weekend and week (p<0.05, p<0.05). The BMDs of FN and WT (p<0.05, p<0.05) were positively correlated with intake of green tea per month and the BMD of FN (p<0.05) was positively correlated with intake of wine per month. But the BMD of Ll (p<0.05) was negatively correlated with intake of Coca cola per month. So nutritional education for increasing hours of outdoor activity and decreasing intake frequency of beverage contributing to diminishment of bone mineral density is needed for premenopausal working women to prevent osteoporosis.

Neurilemmomas of the Cervical Vagus Nerve (경부 미주 신경에 발생한 신경초종)

  • Park Cheong-Soo;Suh Kwang-Wook;Kim Choon-Kyu
    • Korean Journal of Head & Neck Oncology
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    • v.7 no.1
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    • pp.52-56
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    • 1991
  • 인체에서 발견되는 전체 신경초종중 $25{\sim}40%$가 두경부에서 발견되나 경부미주신경의 신경초종은 매우 희귀하여 1988년까지 영문문헌상 88 예가 보고되어 있다. 임상적으로 경부종괴가 주증상이며 때로는 애성, 종괴촉지시 기침 혹은 방사통, parapharyngeal space 의 종괴성장으로 연하곤란등이 초래되기도 한다. 치료는 종괴의 완전적출과 미주신경의 기능을 보존시키는 것이 주요 목표로 되어 있다. 저자들은 최근 5년간 4 예의 정부미주신경외 신경초종을 경험하였는데, 3 예는 측경부의 상부에, 1예는 측경부의 하부에 발생한 것이었다. 연령은 25세에서 50세까지 성인연령이었고, 성별은 남자 l 예, 여자 3 예이었다. 내원시 주소는 전예가 무통성 경부종괴이었으며, 종괴의 크기는 직경 3cm에서 10cm까지 다양하였다. 전예에서 종괴로 인한 신경학적 증상은 없었으나, 1 예에서 parapharyngeal space 의 거대종괴 때문에 다소간의 연하곤란이 있었다. 2 에에서는 종괴촉지시 기침이 유발됨을 호소하였다. 수술은 경부횡절개로 흉쇄유돌근을 제치고 총경 동맥과 내경정맥을 종괴의 상하부위가 완전히 노출되도록 박리한 후 종괴의 피막을 미주 신경의 주행방향에 따라 절개하여 적출 (enucleation) 하였다. 적출술시 종괴가 유착되어 있는 피막 부위는 동시에 절제하되 미주신경의 신경경로 (neural pathway) 는 유지되도록 하였다. 수술직후 2 예에서 일시적 애성을 호소하였다, 추적은 최단 20 개월에서 최장 80 개월까지 하였는데 일시적 애성은 호전되었고 전예가 재발없이 건강하게 지내고 있었다. 따라서 본 종양수술은 종양적출술시 이환된 미주신경의 절단을 결정하기 전에 신경경로를 유지시킬 수 있는 적출술 (enucleation) 을 먼저 고려하는 것이 바람직하다고 사료되었다.

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Radiotherapy of Neck Node Metastases from an Unknown Primary Cancer (원발병소 불명암의 경부림프절 전이에서 방사선치료의 역할)

  • Lee, Jeong-Eun
    • Radiation Oncology Journal
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    • v.25 no.4
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    • pp.219-226
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    • 2007
  • Purpose: The aim of this retrospective analysis was to analyze the results of radiotherapy administered to patients with neck node metastases from an unknown primary cancer, with or without neck dissection. Materials and Methods: From January 1986 to December 2005, 88 patients with neck node metastases from an unknown primary cancer were treated with curative intent. The age of the patients ranged from 35 to 74 years (median age, 59 years). There were 74 male and 14 female patients. Distribution of patients by N status was as follows: N1, 4 patients; N2a, 10 patients; N2b, 48 patients; N2c, 8 patients; N3, 18 patients. Fifty-one patients underwent neck dissection and 37 patients had only a biopsy (31 patients had fine-needle aspiration and 6 patients had an excisional biopsy). All patients received radiotherapy. The follow-up time ranged from 1 to 154 months, with a median time of 32 months. Results: The overall survival (OS) and disease-free survival (DFS) rate at 5 years were 43.9% and 41.7%, respectively. The factors associated with the OS rate were neck dissection, and a subsequent primary tumor. Factors associated with the DFS rate were N stage, neck dissection, and a subsequent primary tumor. Neck failure was noted in 15 patients, distant metastases in 18 patients, and a subsequent primary tumor in 8 patients. Conclusion: With comprehensive radiotherapy given to the bilateral neck and the potential mucosal sites, good survival rates can be obtained in patients with neck node metastases from an unknown primary cancer. However, considering the side effects, a randomized trial is required to determine the optimal radiotherapy volume.

Neck metastasis of invasive ductal carcinoma of breast causing voice change: a case report (음성변화를 주증상으로 내원한 유방암의 경부연조직 전이환자 1례)

  • Lee, Hyung Min;Park, Ji hoon;Kim, Jin Hwan;Kim, Jung Won;Lee, Dong Jin
    • Korean Journal of Head & Neck Oncology
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    • v.33 no.2
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    • pp.67-70
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    • 2017
  • We present a metastatic carcinoma from the breast to the neck soft tissue around common carotid artery, with a rare finding of voice change. A 60 year-old female patient presented with voice change for 7 months. Neck ultrasound revealed a soft tissue mass between internal jugular vein and common carotid artery. Result of fine needle aspiration biopsy was a metastatic carcinoma. Computed tomography and magnetic resonance image revealed $2.5{\times}3.0cm$ sized irregular marginated soft tissue mass in right lower neck encasing common carotid artery and internal jugular vein. Surgical resection was performed and pathologic result with immunohistochemical analysis confirmed the diagnosis of a metastatic invasive ductal carcinoma originated from breast.

Complete Rupture of Cervical Trachea after Compressed Chest Injury in a Child (소아에서 흉부 압박상 후 발생한 경부기관의 완전 파열)

  • Byun, Joung-Hun;Cho, Sung-Ho;Cho, Sung-Rae
    • Journal of Chest Surgery
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    • v.40 no.4 s.273
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    • pp.309-312
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    • 2007
  • Cervical tracheal rupture is one of the rare injuries after blunt chest trauma, and this can be explained by several mechanisms. Early diagnosis and treatment of tracheal rupture after trauma can reduce the mortality and morbidity. We report here on a surgical experienced case of complete rupture of the cervical tracheal that was due to increased intra-tracheal pressure after a compression injury to the chest of an 8 years old child. We also include a review of the literature.