• Korean Journal of Head & Neck Oncology
• /
• v.14 no.1
• /
• pp.40-45
• /
• 1998

Backgroud and Objectives: Major salivary gland tumor is a rare disease with a largely unknown origin. And also corresponding to the diversity of histopathologic characteristics is an equally wide distribution of clinical behavior that makes treatment decisions difficult. The aim of this study is to analysis the clinical experience of our major salivary gland tumor and to suggest a guidline of management. Materials and Methods : We studied clinical manifestations and treatment results of 104 patients who were diagnosed as major salivary gland tumors. Tumor site, patient age and sex of the patients were analysed. Histopathologic diagnosis, treatment modality, lymph nodes metastasis, recurrence rate and 5-year survival rate were studied on malignant tumors. Results: 1) 48 patients were male and 56 patients were female. 2) Benign tumors were 79 cases. They consisted of 57 cases(72%) of parotid tumor, 22 cases(27%) of submandibular tumor. And pleomorphic adenoma was the most common benign tumor. 3) Malignant tumors were 25 cases and were consisted of 19 cases(76%) of parotid tumor, 4 cases(l6%) of submandibular tumor and 2 cases(8%) of sublingual gland tumor with high-grade mucoepidermoid carcinoma as the most common cause. 4) In the malignant tumors, the number of stage I, II tumors was 14 and that of stage III, IV tumors was 11. Neck node metastasis was noted in 8 cases. 5) 8 cases of malignant tumor were died and all of them had high-grade malignancy. And they were dead before 17 months from the time of diagnosis. 6) Mean survival duration in the malignant salivary gland tumor was 56 months. 7) High-grade malignancy had a 5-year survival rate of 57.9%. A 5-year survival rate of TI, T2 patients was 92.9% and that of T3, T4 patients was 36.4%. That of patients who had neck node metastasis was 37.5% and that of those who had tree neck was 82.4%. Conclusion: The results of this study suggest that the survival rate is dependent on the tumor size, lymph node matastasis and histologic grade. And also the early diagnosis and radical surgery result in the increased survival rate and are effective for prevention of the tumor recurrance.

• Korean Journal of Head & Neck Oncology
• /
• v.21 no.2
• /
• pp.115-120
• /
• 2005

Background and Objectives: Minor salivary gland tumors vary in their primary sites, histopathology and biological behavior. Therefore, various factors are considered in selecting the treatment modality and predicting the prognosis. We performed this study for the purpose of getting further understanding and more supporting ideas for the diagnosis and treatment of minor salivary gland tumor. Materials and Methods: A retrospective analysis of the patients with 52 cases of minor salivary gland tumor who were treated at the Hanyang University Hospital from 1996 to 2003 was performed. We analyzed demography, symptoms, histopathology, treatment and outcomes by the review of medical records. Results: Among 52 cases of minor salivary gland tumor, 46% were classified as benign and 54% were classified as malignant tumors. The most common benign tumor was pleomorphic adenoma. Adenoid cystic carcinoma(15/28) was the most common in malignant tumors. Eight patients were males and sixteen patients were females in benign tumors and 10 patients were males and 18 patients were females in malignant tumors. The most common site of benign tumor was the palate(17/22), whereas malignant tumors were most common in the nasal cavity and paranasal sinus(9/28). Asymptomatic mass was the most common symptom. According to the criteria given by the AJCC on staging, stage III and IV(21/28) were more common than stage I and 11(7/28). All benign tumors were treated with simple excision and had no recurrence. In malignant tumors, 25 patients underwent radical excisional operation and 13 patients of them had postoperative radiation therapy. Three of them were treated with additional chemotherapy. In whom treated with radical operation, 9 patients had recurrence. Three were recurred at the primary site with neck node metastasis, 3 were recurred at the primary site with lung metastasis, 1 was recurred at the primary site with neck node and lung metastasis, 1 was recurred only at neck node. Conclusion: In minor salivary gland tumor, malignant was more common than benign. Malignant tumor originated from minor salivary gland were more frequently diagnosed at advanced stage with high recurrence rate and distant metastasis. Early detection of the disease is needed to improve the prognosis of the patients with malignant tumors of the minor salivary glands.

• Korean Journal of Head & Neck Oncology
• /
• v.21 no.2
• /
• pp.201-207
• /
• 2005

Purpose: Submandibular gland tumor is rare, less than 6% of head and neck tumor. The purpose of this article is to analysis the clinical experience and treatment outcomes of malignant submandibular gland tumor, suggesting a guideline of management. Methods: We retrospectively evaluated 26 patients who underwent operation for malignant submandibular gland tumor at Severence hospital between 1986 and 2004. Statistical analysis was performed by Kaplan-Meier method, log rank test, Chi-square test, Fisher's exact test using SPSS v12.0 for Windows. Results: They consisted of 18 males and 8 females whose median age was 47 years(range: 20-71). 10 cases of adenocystic carcinoma, 8 cases of carcinoma ex pleomorphic adenoma, 4 cases of mucoepidermoid carcinoma, 1 case each for acinic cell carcinoma, undifferentiated carcinoma, adeno carcinoma, epithelioid hemangioendothelioma. Sialoadenectomy only was performed in 10 cases(36.5%) and sialoadenectomy with neck node dissection was performed in 16 cases(63.5%). Adjuvant radiotherapy was done in 22 cases(84.6%). 10 year disease free survival rate for malignant submandibular gland tumor was 63.1 % and 10 year overall survival rate for malignant submandibular gland tumor was 70.1%. In univariate analysis, prognostic factors affecting recurrence of malignant submandibular gland tumor was initially papable lateral neck node in physical examination and metastasis of lateral neck node in pathologic confirmation. The prognostic factors affecting survival of malignant submandibular gland tumor was tumor size, TNM stage, recurrence and type of recurrence. Conclusion: In this study, prognostic factors affecting recurrence of malignant submandibular gland tumor was initially papable lateral neck node in physical examination and metastasis of lateral neck node in pathologic confirmation. The prognostic factors affecting survival of malignant submandibular gland tumor was tumor size, TNM stage, recurrence and type of recurrence. To prevent recurrence and to improve survival, early diagnosis and aggressive surgery must be considered.

• Korean Journal of Head & Neck Oncology
• /
• v.13 no.2
• /
• pp.221-227
• /
• 1997

The authors reviewed 106 cases of parotid gland tumor at Presbyterian Medical Center seen during the past 10 years between January, 1986 and December, 1995. The results were obtained as follows; 1) 86 cases(81.1%) were benign tumors and 20 cases(18.9%) were malignant tumors. 2) Overall male and female sex ratio was 1 : 1.4. 3) For benign tumors, the mean age was 47.9 and for malignant tumors, the mean age was 43.4. 4) Clinical manifestations in benign tumors were palpable mass in 86 cases(100%), pain in 6 cases(6.9%), facial nerve palsy in 2 cases(2.3%), lymphadenopathy in 1 case(1.2%); and in malignant tumors, palpable mass in 20 cases(100%), pain in 7 cases(35%), facial nerve palsy in 2 cases(10%) and lymphadenopathy in 3 cases(15%). Thus, the presence of pain, facial nerve palsy and lymphadenopathy suggest malignant tumors. 5) Operative procedures in benign tumors included superficial parotidectomy in 53 cases(61.6%), total parotidectomy in 10 cases(11.6%), local excision in 23 cases(26.7%); and in malignant tumors, superficial parotidectomy in 3 cases, total parotidectomy in 1 case, local excision in 1 case, superficial parotidectomy with supraomohyoid neck dissection in 6 cases, total parotidectomy with supraomohyoid neck dissection in 8 cases, total parotidectomy with radical neck dissection in 1 case. 6) Postoperative complications in benign tumors were transient facial nerve palsy in 14 cases, Frey's syndrome in 2 cases. In malignant tumors complications included transient facial nerve palsy in 3 cases and permanent facial nerve palsy in 1 case. 7) Pleomorphic adenoma was the most common benign parotid tumor and mucoepidermoid carcinoma was the most common malignant tumor. 8) In our review of 20 patients with malignant parotid tumors, all patients who received supraomohyoid neck dissection and postoperative radiation therapy remain alive from 1986 to 1995 years. Two deaths in this series were adenoid cystic carcinoma patients who failed to receive postoperative radiation therapy. These series of cases have been studied in order to determine whether supraomohyoid neck dissection and postoperative radiation therapy may have further therapeutic effect.

• Korean Journal of Bronchoesophagology
• /
• v.4 no.2
• /
• pp.211-218
• /
• 1998

There have been few large scale surveys of salivary gland tumors, because the salivary gland tumors comprised less than 3 percent of all neoplasms of the head and neck. Also there is a problem that the incidences of specific types of tumors have the variation according to the geographic regions. ]'nother Korean reports about salivary gland tumor, they only treated about 100 cases only. Objectives : The purpose of this study is to identify the frequency and clinical characteristics of salivary gland tumors and to compare with other Korean reports. Materials and Methods : We had performed to analyze 387 cases of salivary gland tumors from 1983 to June 1997, were reviewed in histopathological and clinical aspects. The diagnoses of individual tumors were based on the World Health Organization classification. Tumors were analyzed according to the histologic type site, age and sex. Results : The majority (79.1%) of cases occurred in the major salivary glands and 20.9% in the minor. The parotid gland was the most frequent site with 52.4％ and submandibular glands with 26.3%. Benign tumors were 79.3% of the tumors and malignant tmon were 20.7%. The most frequent tumor was pleomorphic adenoma occupied 63.8% of the total and frequency percent of histologic type of 98 malignant tumors showed 35.7% of mucoepidermoid carcinomas, 24.5% of adenoid cystic carcinomas. Overall gender with female predominance with 1 : 1.4 of male to female ratio. The average age of patients was 42.8 years. The most frequent chief complaint was a palpable mass. The duration of the symptom was shorter in the malignant salivary gland tumors (26.7 months) than in the benign salivary gland tumors (38.2 months). Conclusion : Comparing to the previous Korean reports, the present study confirms that the incidence of salivary gland tumor was lower in the parotid gland, and was higher in the submandibular and minor salivary glands.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.31 no.6
• /
• pp.501-508
• /
• 2005

Generally we use the preauricular incision to access and remove the parotid gland tumor. But the preauricular approach has some complications such as damage of facial nerve and sensory nerve, Frey's syndrome, and postoperative scar. Especially, the postoperative scar can often cause an unesthetic result and mental stress in young patients. Therefore, if we avoid preauricular incision to be performed outside of tragus, the postoperative scar would be hardly remarkable, and patients would be satisfied cosmetically. We performed surgical excision using a modified endaural and neck approach in a 21-year-old female with a pleomorphic adenoma and 15-year-old male with a neurofibroma occured in the parotid gland. A new, modified endaural and neck approach is a combined method of the modified endaural incision by Starck et al and Gutierrez's neck extension. We obtained an adequate access and the cosmetically acceptable postsurgical scar. The postoperative scars were hidden in the external ear and the hairline. Moreover, except the neck dissection can this approach be applied to the surgery of temporomandibular joint as well as the parotid gland tumor.