• Maxillofacial Plastic and Reconstructive Surgery
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• 제17권4호
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• pp.389-395
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• 1995

Adenoid cystic carcinoma is malignant neoplasm belonging to a group of tumors of salivary gland origin. It is an aggressive tumor characterized by slow growth and incidious destruction of surrounding tissues. Perineural invasion is a prominent feature. Spread to regional lymph node is rare, other than by direct extension. Distant metastasis are more common. We experienced a 65-year old female with adenoid cystic carcinoma of minor salivary gland in retromolar pad.

• 대한기관식도과학회지
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• 제5권1호
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• pp.96-101
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• 1999

For many years it has been reported that seemingly benign neck cysts may contain carcinoma. Cystic metastases have often mistaken for either branchial cleft cysts or benign mass. Authors experienced two cases which presents cystic cervical metastatic cancer One was a tonsillar carcinoma and the other was a tongue carcinoma. Patients with a cystic squamous carcinoma in the neck likely have a primary in upper aero-digestive system and It is known that the tonsil is most common site. Radiologic examination and fine needle aspiration biopsy of the cyst proved to be non-diagnostic. The development of cervical lymph node metastases before clinical signs of carcinoma of the tonsil is also well recognized. So, in old patients, thorough head If neck examination, panendoscopy and ipsilateral tonsillectomy is mandatory to identify a primary carcinoma prior to cyst excision.

• 대한두경부종양학회지
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• 제33권1호
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• pp.15-19
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• 2017

Background/Objective: The survival and recurrence pattern of the patients with primary cancer of the external auditory canal was evaluated. Materials & Methods: Seventeen patients with primary cancer of the external auditory canal from 2002 to 2013 was analyzed retrospectively. Overall survival, recurrence free survival, local recurrence free survival and distant metastasis free survival was calculated by Kaplan-Meyer's method. Results: Five year overall survival rate, 5 year recurrence free survival rate, 5 year local recurrence free survival rate and 5 year distant metastasis free survival rate were 49.3% 54.9%, 64.7% and 69.6% respectively. The recurrence pattern is different to the pathologic type, squamous cell carcinoma or adenoid cystic carcinoma. The patients with squamous cell carcinoma showed local recurrence and the patients with adenoid cystic carcinoma showed distant metastasis mainly. Conclusion: Primary cancer of external auditory canal showed different clinical course depend on the pathologic diagnosis.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제26권4호
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• pp.427-434
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• 2000

The authors analyzed retrospectively the 36 patients with malignant salivary gland tumors who were treated at Department of Oral and Maxillofacial Surgery, Pusan National University Hospital from February, 1989 to September, 1997. The results obtained were as follows: 1. There were 14 males(38.9%) and 22 females(61.1%). The peak age of patients with major salivary gland tumors was the 6th decade, but with minor salivary gland was the 5th decade. 2. Of all salivary gland tumors, 5 cases arose in the parotid glands, 2 cases in the submanibular glands, 1 case in the sublingual gland and 28 cases in the minor salivary glands. 3. The incidence according to the anatomic primary site for minor salivary glands was 15 cases in the palate, 5 in the floor of mouth and 2 cases each arising in the tongue, lip, retromolar area and buccal mucosa. 4. Of all salivary gland tumors, adenoid cystic carcinoma was 5 cases in the major salivary glands and 8 in the minor salivary glands. mucoepidermoid carcinoma was 2 cases in the major salivary glands and 14 in the minor salivary glands and others were 2 cases of adenocarcinoma, 4 malignant mixed tumors and 1 undifferentiated carcinoma. 5. The incidence of cervical lymph node metastasis was 100%(2/2) in the submandibular glands, 80%(4/5) in the floor of mouth, 50%(1/2) in the tongue and 20%(1/5) in the parotid glands. The highest incidence of lymph node metastasis according to histopathological classfication was found in the high grade of mucoepidermoid carcinoma and tubular type of adenoid cystic carcinoma. 6. Nerve invasion was common in the adenoid cystic carcinoma. 7. The lung was the commonest site for distant metastasis comprising 7 cases among 7 cases in which distant spread occurred.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제29권6호
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• pp.499-508
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• 2007

Background and Purpose: Some subtypes of malignant salivary gland tumors such as adenoid cystic carcinoma (ACC) frequently result in distant metastasis of vascular origin, which are main causes of treatment failure. The reasons for the affinity for vascular metastatic potential are unclear. Therefore, molecular characteristics that influence the dissemination of metastatic tumor cells are important for the design of more effective treatment of salivary ACC. Tumor angiogenesis has been known to be essential for the distant metastasis of malignant cells. So, we determined expressions of vascular metastasis related factors in orthotopic (parotid) murine models of parotid ACC and compared with those in ectopic (subcutis) tumors of athymic mice. Experimental Design: Using specimens from murine parotid (orthotopic, experimental group) and subcutaneous (ectopic, control group) tumors, which have developed via transplantation of tumor cells, originated from human parotid ACC, we performed immunohistochemical assays with anti-vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF, FGF2), matrix metalloproteinase (MMP)-9, and interleukin (IL)-8 antibodies. We also performed immunohistochemical assays with VEGF receptor (VEGFR)-1, VEGFR-2, VEGFR-3, and phosphorylated VEGFR-2. Results: Transplantation of human ACC tumor cell $(5{\times}10^5)$ into the parotid and subcutis successfully resulted in orthotopic (parotid) and ectopic (subcutaneous) tumors in athymic mice. Immunohistochemical staining demonstrated higher expression of major angiogenic factors (VEGF, bFGF, MMP-9) in the orthotopic tumors than in ectopic tumors (P<0.05). But the expression level of angiogenic receptors were same in orthotopic and ectopic tumors of parotid ACC. Conclusion: VEGF, bFGF, and MMP-9 could be a good candidates for antiangiogenic therapy for the contol of vascular metastatic lesions of salivary ACC.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제29권1호
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• pp.10-23
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• 2007

Hallmarks of clinical behaviors of adenoid cystic carcinoma(ACC) of salivary glands are the delayed onset of vascular metastasis and poor responses to classical chemotherapeutic agents. Poor prognoses from salivary ACC are caused by lung metastases that are resistant to conventional therapy. Therefore, cellular and molecular characteristics that influence the dissemination of metastatic cells are important for the design of more effective treatment of salivary ACC. Tumor angiogenesis has been known to be essential for the distant metastasis of malignant cells. So, we determined expressions of angiogenic proteins in benign (pleomorphic adenoma) and malignant (ACC, mucoepidermoid carcinoma) tumors of salivary glands and compared each other and to those in oral squamous cell carcinoma. Using surgical specimens, we performed immunohistochemical assays with anti-vascular endothelial growth factor (VEGF), VEGF receptor-2 (VEGFR-2), phosphorylated VEGFR-2 (pVEGFR-2), matrix metalloproteinase (MMP)-9, and interleukin (IL)-8 antibodies. Most angiogenic factors were overexpressed in malignant salivary tumors than in pleomorphic adenoma which is benign nature. Moreover, ACC demonstrated more expression of VEGFR-2 than that of squamous cell carcinoma which used as control. Conclusively, these data show those angiogenic factors produced by salivary gland tumors may affect the propagation and metastasis of malignant cells of salivary tumors, and could be used as biomarkers for the malignant transformation of salivary gland tumors. Prospectively, although further studies will be needed, these biomarkers related to angiogenesis can be molecular targets for the therapy of salivary ACC, which has propensity for delayed vascular metastasis.

• Korean Journal of Radiology
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• 제23권11호
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• pp.1102-1111
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• 2022

Objective: To evaluate the ultrasonography (US) features for diagnosing metastasis in cervical lymph nodes (LNs) in patients with thyroid cancer and compare the US classification of risk of LN metastasis between European and Korean guidelines. Materials and Methods: From January 2014 to December 2018, US-guided fine-needle aspiration was performed on 836 LNs from 714 patients for the preoperative nodal staging of thyroid cancer. The US features of LNs were retrospectively reviewed for the following features: size, presence of hilum, margin, orientation, cystic change, punctate echogenic foci (PEF), large echogenic foci, eccentric cortical thickening, abnormal vascularity, and cortical hyperechogenicity. A multiple logistic regression analysis was performed to identify the independent US features for the diagnosis of metastatic LNs. The diagnostic performance of independent US features was subsequently evaluated. LNs were categorized according to the Korean Thyroid Imaging Reporting and Data System (K-TIRADS) and European Thyroid Association (ETA) guidelines, and the correlation between the two sets of classifications was assessed. Results: Absence of the hilum, presence of cystic changes, PEF, abnormal vascularity, and cortical hyperechogenicity were independent US features of metastatic LNs. Cystic changes, PEF, abnormal vascularity, and cortical hyperechogenicity showed high specificity (86.8%-99.6%). The absence of the hilum had the highest sensitivity yet low specificity (66.4%). When LNs were classified according to the ETA guidelines and K-TIRADS, they yielded similar categorizations of malignancy risks and were strongly correlated (Spearman coefficient, 0.9766 [95% confidence interval, 0.973-0.979]). According to the ETA guidelines, 9.8% (82/836) of LNs were classified as "not specified." Conclusion: Absence of hilum, cystic changes, PEF, abnormal vascularity, and cortical hyperechogenicity were independent US features suggestive of metastatic LNs in thyroid cancer. Both K-TIRADS and the ETA guidelines provided similar risk stratification for metastatic LNs with a high correlation; however, the ETA guidelines failed to classify 9.8% of LNs into a specific risk stratum. These results may provide a basis for revising LN classification in future guidelines.

• Journal of Chest Surgery
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• 제43권1호
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• pp.113-116
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• 2010

심한 호흡곤란을 주소로 내원한 67세 남자의 영상소견상 종격동의 거대 낭성 종양이 기관을 압박하여 편이시키는 소견이 보여 응급 개흉술을 통해 종양을 절제하였다. 조직 소견상 갑상선의 유두상 암종에 합당하였고 수술 후 시행한 갑상선 초음파 검사와 양성자 단층촬영상 잠재성 갑상선 암종에 합당한 소견을 보였다. 갑상선의 유두상 암종이 초기에 원격 전이를 보이는 경우는 드물며 대부분 단독 결절의 형태를 취하나, 잠재성 암종이 종격동에 거대 낭성 전이를 하는 경우는 극히 드물어 보고하는 바이다.

• 대한기관식도과학회지
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• 제7권1호
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• pp.29-33
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• 2001

Background and Objectives： Adenoid cystic carcinoma (ACC) is an aggressive, often indolent tumor, with a high incidence of distant metastasis (DM). Relatively little has been written about the factor that influence distant spread and subsequent survival because it is uncommon and has protracted clinical course. We attempted to reemphasize the biologic behavior of ACC by investigating the relationship between the clinical features and prognosis. Materials and Methods : We have retrospectively studied 24 determinate patiens who received definitive treatment in our hospital between 1984 and 1995 for ACC in all salivary sites. Inclusion criteria were no prior treatment elsewhere other than excisional biopsy and eligibility for follow-up of at least 5 years. Variables assessed for their impact on distant metastasis included age, gender, size, node status, stage, histologic pattern, locoregional treatment failure. Results : Treatment failure occurred in a total of 16 of 24 determinate Patients (64%), 12 of whom had DM (50%). This was usually associated with locoregional recurrence (8 patients), but DM was the only indication of failure in 4 whose primary tumor was controlled. Of the 12 patients with known DM, the lung was recored as the only involved site in 7 Patients, lung was involved in addition to other sites in 1, bone and liver metastasis occurred in 2 respectively. Disease-free intervals varied from 3 month to 14 years (median 3 years). The only significant factors influencing survival were the size of the primary tumor, locoregional recurrence. Conclusion : The high incidence of DM with locoregional failure confirms the importance of aggressive initial surgery. combined with irradiation, for high-stage tumors or involved surgical margins. Large tumor size and locoregional recurrence, rather than microscopic appearance, were predictive of DM.

• 대한두경부종양학회지
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• 제24권1호
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• pp.76-79
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• 2008

Adenoid cystic carcinoma(ACC) is one of the common malignant tumor of the major and minor salivary glands. ACC arising from the larynx is relatively rare(less than 1% of laryngeal malignant tumors) and only about eighty cases have been reported in the English literature. Definite diagnosis of these lesions is made only from a histological analysis, because findings and symptoms are non-specific. The diagnosis progresses very slowly, therefore it often presents at an advanced stage with regional and distant metastasis. Here, we present one case of ACC of the supraglottic region with a review of literature.