• Title/Summary/Keyword: Cervical lymph node

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Conservative Surgery of Hypopharyngeal Cancer and Intraoperative Radiation Therapy of Neck Recurrence (하인두암의 보존적 수술과 경부 재발의 술중방사선치료 치험 1예)

  • Cho, Woo-Sung;Kim, Yang-Soo;Kim, Moo-Pil;Baek, Seung-Kuk;Jung, Kwang-Yoon
    • Korean Journal of Head & Neck Oncology
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    • v.23 no.2
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    • pp.181-184
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    • 2007
  • Hypopharyngeal cancer usually has invasiveness to adjacent tissue and frequent metastasis to cervical lymph node. In addition, because it often accompanies submucosal extension and second primary malignancy, the sacrifice of larynx and postoperative radiation therapy had been performed in the past. However, it has been reported that conservative surgery of hypopharyngeal cancer show good functional and oncologic outcome according to the development of diagnostic tool and reconstructive technique. We report a case of hypopharyngeal cancer that received conservative surgery followed radiation therapy and intraoperative radiation therapy for neck recurrence.

Respiratory Depression during Oral MS-Contin Administration for Pain Management of Gall Bladder Cancer (말기 담낭암 환자의 통증조절을 위해 MS Contin 투여중 발생한 호흡억제 -증례 보고-)

  • Lee, Chul-Woo;Lee, Byung-Ho;Lee, Yong-Hee
    • The Korean Journal of Pain
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    • v.9 no.1
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    • pp.239-243
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    • 1996
  • MS-Contin is an oral controlled-release preparation of morphine sulfate that has been used widely in the management of advanced cancer pain. It prolongs plasma concentration of morphine with no observable accumulation properties following repeated dosing, thereby promoting uninterrupted sleep and hopefully improving patient's quality of life. The common side effects of MS Contin are nausea, vomiting, drowsiness and constipation. But these symptoms are usually mild and respiratory depression is a rare problem. We experienced respiratory depression during oral administration of MS contin for the pain management of advanced gall bladder cancer of 76 years old male patient with metastasis at liver, intestine and cervical lymph node. After we increased the dosage of MS Contin from 160mg to 220mg per day, due to abdominal pain, we observed morphine reaction of MS Contin overdose such as pinpoint pupil, deeply slow respiration below 8/minute, and drowsiness. After intravenous bolus injection of 0.4 mg naloxone followed by continuous administration of 0.2 mg/hr for 4 hours, the patient regained consciousness. The administered route of morphine was changed to intravenous PCA (patient controlled analgesia). There was no aspiration sign as confirmed by chest x-ray. The patient was comfortable and delayed no signs of respiratory depression until now.

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A Case of Basaloid Squamous Cell Carcinoma of the Palatine Tonsil Presenting as Recurrent Neck Mass (반복적인 경부 종물로 발현된 구개편도의 기저양 편평상피세포암 1예)

  • Kim, Mun-Jun;Youn, Jin;Yang, Yun-Su;Hong, Ki-Hwan
    • Korean Journal of Head & Neck Oncology
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    • v.28 no.1
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    • pp.27-30
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    • 2012
  • Basaloid squamous cell carcinoma(BSCC) is a high-grade variant of squamous cell carcinoma, with a prediction for multifocal involvement of the base of tongue, pyriform sinus, supraglottic larynx, hypopharynx and palatine tonsil. It primary affects men in the seventh decade of life with frequent cervical lymph-node metastasis at presentation. Grossly, these tumors are usually firm to hard, with associated central necrosis, occuring as exophytic to nodular masses. Histologically, the this infiltrating tumor offers a variety of growth patterns, including solid, lobular, cribriform, cords, trabeculae, nests and glands or cyst. We present a 55-year-old female who was treated with surgical excision and radiotherapy. She was firstly presented as a recurrent inflammatory neck mass and finally diagnosed with basaloid squamous cell carcinoma in the palatine tonsil.

Thoracoscopic Radical Esophagectomy in Cervico-Thoracic Esophageal Cancer (경구경계부식도암에서 흉강경을 이용한 근치적 식도암적출술)

  • 박재길;이선희
    • Journal of Chest Surgery
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    • v.29 no.6
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    • pp.681-688
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    • 1996
  • Most patients with carcinoma of the cervico-thoracic esophagus present with locally advanced disease. For this reason, therapeutic efforts have been largely palliative, focused on eradicating locoregional dis- ease, and have been attended by high morbidity rates. A 61 year old man was diagnosed to advanced cervicothoracic esophageal cancer(Type 1) and reli ved concurrent chromo-radiotherapy for 2 months in St. Mary's Hospital. And then he underwent transhiatal subtotal esophagectomy and radical dissection of cervical and superior mediastinal Iymph nodes with thoracoscopy. The histologic diagnosis was early esophageal cancer(Type 0-llb, SM2) and the curability of operation was calculated to highly curative(Clll). And the postoperative course was unevenful.

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A Case of Soft Tissue Metastasis in Contralateral Submandibular Space by Regional Recurrence of Lower Lip Cancer (하구순암의 구역 재발로 반대편 악하 공간에 발생한 연조직 전이 1예)

  • Hong, Seok Jung;Lim, Sung Hwan;Kim, Eun Ju;Kim, Seung Woo
    • Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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    • v.61 no.12
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    • pp.702-704
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    • 2018
  • The most common cause of treatment failure in oral cavity cancer is when it is found to have local recurrence, usually occurring in the ipsilateral cervical lymph node. On the contrary, it is extremely rare to find local recurrence in soft tissue metastasis (STM) in the contralateral neck. Furthermore, lung cancer and malignant lymphoma are most commonly confined to their primary sites. The poor general condition increases the likelihood of STM, which indicates bad prognosis. A 72-year-old man with a hard and fixed mass on the right submandibular space visited our clinic. He had received a wide excision with local flapreconstruction for squamous cell carcinoma in the left corner of lower lip 18 months ago. We performed the wide excision with bilateral selective neck dissection (I-III), and he was finally diagnosed as STM from contralateral lip cancer. We report this unique and rare disease entity with a literature review.

Management of Hypertension and Proteinuria after Treatment with Lenvatinib for Radioiodine Refractory Papillary Thyroid Carcinoma: a Case Report (렌바티닙 사용과 관련된 고혈압과 단백뇨의 관리: 증례 보고)

  • Song, Eyun;Kim, Won Gu
    • International journal of thyroidology
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    • v.11 no.2
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    • pp.78-81
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    • 2018
  • Lenvatinib, an oral multi-kinase inhibitor, is a valuable treatment option for advanced differentiated thyroid carcinoma. However, severe treatment-related adverse events occur up to 30% of the patients receiving lenvatinib, making it a challenge for clinicians to maintain this drug and therefore affecting the outcome of therapy. Blood vessel related events, such as hypertension or proteinuria, are among the most frequent adverse events. We present a case of 65-year-old man with radioactive iodine refractory papillary thyroid carcinoma with cervical lymph node metastasis and tracheal invasion receiving lenvatinib who developed proteinuria and worsening of hypertension. Management with repeated dose reductions and using supportive medications allowed this patient to continue lenvatinib with his disease stably controlled. Early detection of patients at risk for these adverse events and cautious administration of lenvatinib at appropriate level are crucial in managing patients receiving lenvatinib.

Five-Year Follow-up of an Ovarian Cancer Patient with Brain and Vertebral Metastasis Using Integrative Cancer Treatment: A Case Report (통합암치료를 적용한 난소암 뇌, 척추전이 환자의 5년 추적관찰 증례보고)

  • Hye-ri Bae;Eun-ji Kim;Nam-hun Lee
    • The Journal of Internal Korean Medicine
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    • v.44 no.6
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    • pp.1346-1353
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    • 2023
  • Objectives: This long-term case report presents the case of an ovarian cancer patient with brain, cervical lymph node, and vertebral metastasis suppressed by traditional Korean medicine in combination with cytokine-induced killer (CIK) cell-based immunotherapy. Methods: The patient received acupuncture, moxibustion, GunChil-go, Hangam-dan, and CIK cell-based immunotherapy. The Eastern Cooperative Oncology Group and tumor markers were used to evaluate the treatment effects. Results: Integrative cancer treatment suppressed the progression of cancer, and the patient achieved eight-year survival. The performance status improved, and the tumor marker level was maintained. Conclusions: We suggest that an integrative cancer treatment that includes traditional Korean medicine can be a meaningful treatment option for advanced ovarian cancer.

Atypical presentation of Kawasaki disease resembling a retropharyngeal abscess (인두후부의 농양과 유사하게 표현된 비전형적인 가와사끼병)

  • Kim, Eu Jin;Lim, Young Su;Yoon, Ji Eun;Han, Heon-Seok
    • Clinical and Experimental Pediatrics
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    • v.52 no.2
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    • pp.251-255
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    • 2009
  • Kawasaki disease is an acute systemic inflammatory disorder, the etiology of which has not yet been established. The clinical manifestations are non-specific and are common to many pediatric infectious and immunologic diseases. In 2 cases presenting fever, cervical lymphadenopathy, and retropharyngeal abscess-like lesions on the neck shown in a computerized tomography (CT) scan, the diagnosis of Kawasaki disease was delayed. The patients were not responsive to antibiotic therapy, and fluid collection was not found during retropharyngeal aspiration. They showed typical Kawasaki manifestations over time and atrioventricular valve regurgitation in the echocardiogram. A diagnosis of Kawasaki disease should be considered in similar cases of fever and cervical lymphadenopathy. A CT scan that shows a retropharyngeal abscess-like lesion on the neck can be a false positive finding, and other laboratory exams, including echocardiography, should be performed as early as possible to avoid unnecessary medical and surgical procedures.

Bilateral Plunging Ranula Arising from Accessory Submandibular Gland (부악하선에서 유발된 양측성 몰입성 하마종)

  • Choi, Hwan-Jun;Kim, Sun-Joo;Lee, Young-Man
    • Archives of Plastic Surgery
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    • v.37 no.1
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    • pp.75-78
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    • 2010
  • Purpose: Whereas oral ranula is relatively common and presents as a cyst in the mouth, the plunging ranula is rare and manifests itself as a mass in the neck with or without an associated oral lesion. The purpose of this study is to examine the clinical characteristics of rare bilateral plunging ranula arising from accessory submandibular gland in order to provide our experience for its correct diagnosis and treatment. Methods: A 13-year-old girl manifests as a slow growing painless, non-mobile swelling in the anterior neck. She underwent surgery via a cervical approach. A pseudocyst was extirpated and adjacent accessory gland tissue and related lymph node were removed. Results: The histologic appearance is characteristically of a cyst, devoiding of epithelium or endothelium, with a vascular fibro-connective tissue wall containing some chronic inflammatory cells and macrophage stuffed with mucin. Pathologic findings represented a form of myxomatous degeneration and lined by condensed connective tissue and granulation tissue. The nature of the accessory gland tissue was same as subligual gland. Although total submandibular or sublingual gland excision was not performed, no recurrence was observed during 6 months follow-up periods. Conclusion: Usually, unilateral plunging ranula develops commonly because of rupture of sublingual gland duct by trauma and extravasation of salivary secretion to the adjacent tissue. But our case developed because of bilateral congenital accessory submandibular gland. This is thought to be a result from a congenital failure of canalization of the terminal end of the duct. Finally, the correct diagnosis is essential for the most effective treatment, which is excision of the ranula and related accessory salivary gland. We performed excision of accessory submandibular gland and plunging ranula and had a good result without recurrence.

Adjuvant Postoperative Radiation Therapy for Carcinoma of the Uterine Cervix (자궁경부암의 수술 후 방사선치료)

  • Lee Kyung-Ja;Moon Hye Seong;Kim Seung Cheol;Kim Chong Il;Ahn Jung Ja
    • Radiation Oncology Journal
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    • v.21 no.3
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    • pp.199-206
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    • 2003
  • Purpose: This study was undertaken to evaluate the efficacy of postoperative radiotherapy, and to investigate the prognostic factors for FIGO stages IB-IIB cervical cancer patients who were treated with simple hysterectomy, or who had high-risk factors following radical hysterectomy and pelvic lymph node dissection. Materials and Methods: Between March 1986 and December 1998, 58 patients, with FIGO stages IB-IIB cervical cancer were included in this study. The indications for postoperative radiation therapy were based on the pathological findings, including lymph node metastasis, positive surgical margin, parametrial extension, lymphovascular invasion, invasion of more than half the cervical stroma, uterine extension and the incidental finding of cervix cancer fellowing simple hysterectomy. All patients received external pelvic radiotherapy, and 5 patients, received an additional intracavitary radiation therapy. The radiation dose from the external beam to the whole pelvis was $40\~50$ Gy. Vagina cuff Irradiation was peformed, after completion of the external beam irradiation, at a low-dose rate of Cs-137, with the total dose of $4488\~4932$ chy (median: 4500 chy) at 5 mm depth from the vagina surface. The median follow-up period was 44 months ($15\~108$ months). Results: The 5-yr actuarial local control rate, distant free survival and disease-free survival rate were $98\%,\;95\%\;and\;94\%$, respectively. A univariate analysis of the clinical and pathological parameters revealed that the clinical stage (p=0.0145), status of vaginal resection margin (p=0.0002) and parametrial extension (p=0.0001) affected the disease-free survival. From a multivariate analysis, only a parametrial extension independently influenced the disease-free survival. Five patients ($9\%$) experienced Grade 2 late treatment-related complications, such as radiation proctitis (1 patient), cystitis (3 patients) and lymphedema of the leg (1 patient). No patient had grade 3 or 4 complications. Conclusion: Our results indicate that postoperative radiation therapy can achieve good local control and survival rates for patients with stages IB-IIB cervical cancer, treated with a simple hysterectomy, as well as for those treated with a radical hysterectomy, and with unfavorable pathological findings. The prognostic factor for disease-free survival was invasion of the parametrium. The prognosic factor identified in this study for treatment failure can be used as a selection criterion for the combined treatment of radiation and che motherapy.