• Journal of the Korean Society of Radiology
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• v.82 no.1
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• pp.152-161
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• 2021

Purpose To evaluate the incidence and condition of platysma infiltration in benign tumors, malignant tumors, and inflammatory disease in the parotid gland using CT or MRI. Materials and Methods Patients with benign tumors (n = 314), malignant tumors (n = 52), and inflammatory disease (n = 22) in the parotid gland were included. The incidence of platysma infiltration and the relationship between platysma infiltration and the location, capsular involvement, and focality of the mass were retrospectively evaluated using CT or MRI. Results The incidence of platysma infiltration was 0% in benign tumors,19.2% in malignant tumors (10/52), and 50.0% in inflammation (11/22). Platysma infiltration was positive in 10 of 13 patients with inflammatory lesion with capsular involvement. Platysmal infiltrations in inflammatory lesion showed diffuse lesion in 10 patients and focal lesion in one patient. Malignant tumor with platysmal infiltration showed all capsular involvement, and diffuse lesion in seven and focal lesion in three. Conclusion Platysma infiltration was more common in patients with inflammatory disease than those with malignant tumors or benign tumors. In inflammatory disease, platysma infiltration was more common in patients with capsular involvement or diffuse lesion.

• Childhood Kidney Diseases
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• v.18 no.2
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• pp.116-122
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• 2014

Renal and perinephric abscesses are a rare but potentially fatal complication of urinary tract infection (UTI). Diagnosing renal and perinephric abscesses has been known to be difficult. These abscesses may occur when the appropriate antibiotic treatment for a UTI is delayed, or in cases with a congenital malformation of the urinary system, especially in children. In the present report, we describe 2 cases of renal abscesses with extra-capsular invasion in children with febrile UTI. A 4-month-old male infant with vesicoureteral reflux developed a renal abscess that infiltrated the perinephric area and the left psoas muscle, despite early antibiotic treatment. A 9-year-old boy with prolonged fever also showed a multi-loculated renal abscess that infiltrated the spleen and diaphragm. Both patients were successfully treated with appropriate antibiotics and percutaneous drainage.

• Korean Journal of Head & Neck Oncology
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• v.27 no.1
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• pp.17-21
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• 2011

연구 및 목적 : 이번 연구의 목적은 한국인에서 편도 편평세포암종의 발생에 고위험 인간유두종 바이러스(high risk human pap-illomavirus)의 역할 및 관여 인자에 대해 밝히고자 한다. 재료 및 방법 : 연구는 편도 편평상피세포암종으로 진단받은 54명을 대상으로 하였다. 고위험 인간유두종 바이러스의 감염을 알기위해 in situ hybridization 방법을 이용하였다. 고위험 인간유두종 바이러스의 감염과 나이, 성별, 흡연, 음주, 병기, 병리학적 특징 등과의 관계를 분석하였다. 결 과 : 고위험 인간유두종 바이러스의 양성율은 31.5%(17/54)였다. 고위험 인간유두종 바이러스 감염은 젊은 연령(50세 미만), 비흡연자, 림프절 전이와 유의한 상관관계가 있었다(각각 p=0.008, p=0.042, p=0.027). 하지만 성별, 음주, 원발부위 병기, 종양분화도, 피막외침범, 혈관 및 신경 침범과 고위험 인간유두종 바이러스와의 관계는 통계적으로 유의하지 않았다. 6개월 이상 추적 관찰이 가능한 환자를 대상으로 조사한 5년 전체 생존율 및 질병 특이 생존율은 각각 60%와 62%였다. 고위험 인간유두종 바이러스의 양성율은 질병 특이 생존율과 유의한 상관관계가 있었다(p=0.019). 결 론 : 한국인의 고위험 인간유두종 바이러스 감염은 젊은 연령 및 비흡연자의 편도 편평세포암종의 발생에 관련이 있고 예후 인자로 중요한 역할을 한다.

• Korean Journal of Head & Neck Oncology
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• v.31 no.2
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• pp.6-10
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• 2015

Background and Objective : Papillary thyroid microcarcinoma(PTMC) is known as slow growing cancer with good prognosis. However, extrathyroidal extension may increase the risk of cervical lymph node metastasis and local invasion to surrounding structures. The aim of this study was to assess the characteristic features of the tumor invading the posterior thyroid capsule. Material and Methods : We made a retrospective review of 123 PTMC patients with thyroid capsule invasion, pathologically staged as T3 or T4. 74 patients (60.2%) had invasion to posterior thyroid capsule (group A) while 49 patients (39.8%) had invasion to-anterior thyroid capsule or anterior wall of trachea (group B). We assessed the clinicopathologic factors of the patients according to the location of capsular invasion of PTMC. Results : There was no difference regarding age, gender, T and N classification and incidence of lymph node metastasis between two groups. Local invasion rate to recurrent laryngeal nerve was 6.8% in patients with posterior thyroid capsule invasion, while the incidence was zero in those with capsular invasion to other locations Conclusion : Increased risk of local invasion to the recurrent laryngeal nerve should be considered in patients with PTMC presenting invasion of the posterior capsule.

• Korean Journal of Head & Neck Oncology
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• v.24 no.2
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• pp.189-193
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• 2008

Objectives：The incidence of micropapillary thyroid carcinoma(MPC) which is very good prognosis is increasing due to ultrasonography and accurate fine neede aspiration cytology. MPC defined papillary thyroid carcinoma below 1cm. According to the size, histophaothogic feature is different, lymph node metastasis and capsular invasion occur occasionally. So, we consider different treatment according to the size of MPC. Matrials and Methods：We reviewed and analyzed the record of 216 MPC patients operated at department of general surgery Busan Paik Hospital since 1995 January to 2005 Desember retrospectively. Result：The sex ratio was 1：9.29(male；21, female；195). Total thyroidectomy 20cases(9.3%), subtotal thyroidectomy 141cases(65%), lobectomy 52cases(24%), completion operation 3cases(1.4%) were done. Combined diseases were follicular carcinoma 4cases, follicular adenoma 11cases, thyroiditis 46cases, nodular hyperplasia 44cases. Lymph node metastasis 56cases and capsular invasion 56cases were presented. Group A(<5mm) was 53cases, group B(5-10mm) was 163cases. Group B showed higher lymph node metastasis and capsular invasion(P<0.05). Multiple carcinoma Showed higher capsular invasion than single carcinoma (P<0.05). Complications were post operative bleeding 1case, husky voice 1case, hypocalcemia 1case. Conclusion：We can consider more extensive operation in 5-10mm of MPC patients.

• Advances in pediatric surgery
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• v.17 no.2
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• pp.188-192
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• 2011

Fitz-Hugh-Curtis 증후군은 골반 내 염증성 질환을 가진 환자의 직접적 간 실질 침범이 없는 간피막 염증에 의한 간주위염으로, 1930년대에 Thomas Fitz-Hugh와 Arthur Curtis에 의해 보고되었다. Neisseria gonorrhea나 Chlamydia trachomatis에 의해 발병하며, 항생제로 치료되는 양성 성교전파질환이다. 대부분 가임기의 젊은 여성에서 발견되지만, 15세의 청소년에서 진단된 증례가 있어 보고하는 바이다. 15세 여자 환자가 1개월 전부터 발생한 간헐적인 우상복부와 하복부의 통증을 주소로 내원하였다. 환자는 한 달 전 남자친구와 첫 성교를 한 이후, 5일 전까지 10여 차례정도 성교를 하였다. 사회력 상 고등학교 1학년 생이고, 월경 주기는 28-30일로 규칙적이었다. 내원 당일 시행한 임신 반응 검사는 음성이었다. 시행한 복부전산화단층촬영에서 우측 간엽의 가쪽 부분이 동맥기 조영증강을 보이며 골반내감염을 동반하고 있었다. 부인과 검진 상 질경부 면봉 검사에서 Chlamydia trachomatis 양성소견을 보였으며, 소변배양검사에서 Neisseria gonorrhea가 동정되었다. Fitz-Hugh-Curtis 증후군 진단 하에 4주간 doxycycline과 metronidazole의 경구용 항생제 복용 후 호전되었다.

• Korean Journal of Head & Neck Oncology
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• v.28 no.2
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• pp.118-121
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• 2012

Backgrounds : To evaluated the use of FDG PET/CT for the identification of extracapsular spread(ECS) with histologic correlation in laryngeal cancer. Methods : We reviewed 79 medical records of patients who underwent of FDG PET/CT for laryngeal cancer before surgery. Results : ECS was present in 41.9%(18/43) dissected necks and in 34.5%(20/58) dissected cervical levels. There was a significant difference in the SUVmax between cervical lymph nodes with ECS and without ECS($6.39{\pm}4.53$ vs. $1.19{\pm}1.64$, p<0.001). The cut-off value for the SUVmax for differentiating with ECS from without ECS was 2.8 with the sensitivity of 85.7% and the specificity of 85.6%. Conclusion : The median SUVmax cut-off values of FDG PET/CT higher than 2.8 was associated with greater risk cervical lymph node metastasis with ECS in patients with laryngeal cancer.

• Korean Journal of Head & Neck Oncology
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• v.33 no.2
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• pp.9-15
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• 2017

The recently released the $8^{th}$ edition of the American Joint Committee on Cancer (AJCC) Staging Manual introduces significant modifications from the prior $7^{th}$ edition. In this paper, the contents of the new changes in the decision of cancer of the head and neck is summarized except changes in staging of skin and thyroid cancer. In addition to the 8th edition, 1) Addition of extracapsular involvement in metastatic lymph nodes (N category) 2) Oral cancer T classification change, 3) Staging of the pharyngeal cancer was divided into 3 chapters: high-risk human papilloma virus (HR-HPV) associated oropharyngeal cancer (OPC), non HR-HPV associated OPC and hypopharynx cancer (HPC), and nasopharynx cancer (NPC) 4) Changes in T and N classification in NPC, 5) In the case of cancer of unknown primary, P16-positive case is defined as HR-HPV related OPC, and EBV-positive case is defined as NPC. The process that led to these changes highlights the need to collect high-fidelity cancer registry-level data that can be used to confirm prognostic observations identified in institutional data sets. Clinicians will continue to use the latest information for patient care, including scientific content of the 8th Edition Manual. All newly diagnosed cases through December $31^{st}$ 2017 should be staged with the 7th edition. The time extension will allow all partners to develop and update protocols and guidelines and for software vendors to develop, test, and deploy their products in time for the data collection and implementation of the 8th edition in 2018. The 8th edition strikes a balance between a personalized, complex system and a more general, simpler one that maintains the user-friendliness and worldwide acceptability of the traditional TNM staging paradigm.

• Korean Journal of Head & Neck Oncology
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• v.37 no.2
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• pp.33-41
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• 2021

Background/Objectives: Extra-nodal extension (ENE) is one of the strongest prognosticators in oral cancers. Here we tried to evaluate clinicopathological factors associated with the presence of ENE. Materials & Methods: We retrospectively analyzed clinical information of 120 patients who diagnosed with oral cancer and received curative surgery at our hospital from Mar 2012 to Apr 2020. We comparatively analyzed clinicopathological factors associated with the presence of lymph node (LN) metastasis and ENE, respectively. Results: Variable factors of primary tumor characteristics such as lymphovascular invasion, perineural invasion, largest diameter of tumor, depth of invasion and maximum standardized uptake value were significantly associated with the presence of cervical LN metastasis. The largest diameter of tumor was statistically significant also in multivariate analysis for predicting the LN metastasis. Meanwhile, the association between primary tumor characteristics and the presence of ENE were not statistically significant except the primary tumor size. Importantly, factors associated with LN characteristics including the maximum diameter and number of metastatic LNs were significantly associated with ENE. Conclusion: In this study, several factors affecting cervical LN metastasis and ENE in oral cancer patients were identified. The ENE seems to be influenced by the status of the metastatic LNs, such as the number of metastatic LNs, rather than the characteristics of the primary tumor itself.