• Title/Summary/Keyword: Distant Metastases

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Polymorphous low-grade adenocarcinoma on hard palate: case report (구개부에 발생한 다형성 저등급 선암종의 치험례)

  • Shin, Young-Min;Choi, So-Young;Kim, Jin-Wook;Byeon, Ki-Jung;Kim, Chin-Soo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.37 no.1
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    • pp.72-76
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    • 2011
  • Polymorphous low-grade adenocarcinomas (PLGA) are distinctive salivary gland neoplasms with a propensity to arise from the minor salivary glands. The most frequent location of PLGA is the palate, even though other locations have been described. Previously used terms for PLGA include lobular carcinoma and terminal duct carcinoma. Although the frequency of the tumor is unknown, the recognition of PLGA as an individual tumor has increased with the establishment of specific histopathological criteria characterizing the PLGA. The first choice of treatment is a wide surgical excision including the subjacent bone if necessary. The prognosis is generally good and the recurrence rate ranges from 17% and 22%. Distant metastases is unusual (9%) but occur mainly in the regional lymph nodes. This is a case report of a 67 year old female patient with PLGA who was treated with a wide excision by layers (2 stage) of the lesion including the surrounding bone. We present this case with a review of the relevant literature.

Thyroid Carcinoma in Children (소아에 발생한 갑상선 악성 종양)

  • Lee, Seung-Joo;Kim, Dae-Yeon;Kim, Seong-Chul;Kim, In-Koo
    • Advances in pediatric surgery
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    • v.6 no.2
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    • pp.95-99
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    • 2000
  • Thyroid carcinoma is relatively rare in children. Eight cases of thyroid carcinoma were among 18 patients operated upon for thyroid tumors at Pediatric Surgery, Asan Medical Center in 11 years' period between 1989 and 2000. Five patients were boys and three were girls. The age distribution ranged from 10 to 14 years with a median age of 11.6 years. We studied clinical presentations, diagnostic workup, pathology, treatment, and follow-up (recurrence, mortality, and survival). All patients presented with anterior neck mass but one with multiple cervical lymph nodes enlargement. Familial history of thyroid cancer was seen in one case. All patients had a cold nodule by 1-131 thyroid scan. Fine needle aspiration (FNA) biopsy was performed in all patients. The right lobe was involved in four patients and the left lobe in two. Two had both lobes involvement. Pathologically, six cases were papillary carcinoma, one was follicular carcinoma, and one insular carcinoma. Four patients underwent unilateral lobectomy and isthmectomy. Total thyroidectomy was performed in three patients. The insular carcinoma case was preoperatively diagnosed as follicular neoplasm by FNA. After confirmation of the pathology by initial right thyroid lobectomy, total thyroidectomy was subsequently done. Cervical lymph node metastases were presented in three cases (37.5%), and lung metastasis in two cases (25%). Three patients received postoperative I-131 ablation. After a median follow-up of 53 months, all patients were alive without evidence of recurrence. In conclusion, thyroid carcinoma in children is frequently associated with lymph nodes involvement and distant metastasis, however, the prognosis is relatively good.

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Multidisciplinary Treatment for Maxillary Cancer (상악암에 대한 집합적 치료)

  • 조재식;김성훈;박은호;이종원
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1993.05a
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    • pp.95-95
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    • 1993
  • Even though maxillary cancer is usually discovered in advanced stage, its regional lymph node or distant metastases are not common comparing to other head and neck cancer. So the result of treatment depends upon local control of the tumor. Because maxillary sinus is anatomically located adjacent to orbit and skull base, it is difficult to remove the tumor completely with sufficient safety margin like in other malignant tumor. Traditionally, surgery including aggressive resection, radiotherapy or both combined therapy have been widely accepted in many institutes, but their results are not still satisfactory. Sixteen cases of maxillary cancer( all squamous cancer, T2 1 case, T3 6 cases, T4 9 cases, mean age 57.2 years) were treated by intraarterial chemotherapy, raditherapy and surgery and followed up retrospectively. 5 year survival rate by Kaplan-Meier method was 51.95%, and orbit, palate or cheek skin could be preserved in many cases and their functional result was good.

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COMPARATIVE IMMUNOHISTOCHEMICAL ASSAYS FOR THE EXPRESSION OF ANGIOGENIC FACTORS IN TUMORS OF HUMAN SALIVARY GLANDS (타액선 종양에서 혈관형성 인자의 발현에 관한 면역조직화학적 비교 연구)

  • In, Yeon-Soo;Kim, Soung-Min;Park, Young-Wook
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.29 no.1
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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.

RECONSTRUCTION WITH A VASCULARIZED FREE ILIAC OSTEOMUSCULAR FLAP AFTER HEMIMANDIBULECTOMY FOR OSTEOSARCOMA OF THE MANDIBULAR CONDYLE REGION : A CASE REPORT (하악과두에서 발생한 악성 골육종 환자에서 외과적 절제 후 유리장골이식을 이용한 재건)

  • Park, Hong-Ju;Yu, Min-Gi;Kook, Min-Suk;Oh, Hee-Kyun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.30 no.4
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    • pp.386-394
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    • 2008
  • Osteosarcoma of the jaw is a rare malignant bone tumor which usually leads to a poor prognosis. It commonly occurs in young patients, especially in male. The tumor can involve mandible or maxilla with same frequency. The swelling in the involved area and facial deformity are common clinical findings. The pain and sensory changes are also complained by the patients. Although radical surgery plays an important role in the management of this tumor, the adjuvant chemotherapy or radiotherapy is used to enhance local control and to prevent distant metastases. We treated a 22-year-old male patient who had osteosarcoma in the left condylar region. The radical surgery which consisted of hemimandibulectomy and total parotidectomy, was done and an immediate mandibular reconstruction was performed with a vascularized free iliac osteomuscular flap. The obtained results, both esthetic and functional, were satisfactory. The patient was received postoperative chemotherapy. This is a case with reviews of the literatures.

Significant Differences in the Clinicopathological Characteristics and Survival of Gastric Cancer Patients from Two Cancer Centers in China and Korea

  • Shen, Zhan Long;Song, Kyo Young;Ye, Ying Jiang;Xie, Qi Wei;Liang, Bin;Jiang, Kewei;Park, Cho Hyun;Wang, Shan
    • Journal of Gastric Cancer
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    • v.15 no.1
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    • pp.19-28
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    • 2015
  • Purpose: To compare the clinicopathological data and long-term survival of gastric cancer patients in China and Korea. Materials and Methods: Patients who had undergone gastrectomy for gastric cancer between 1998 and 2009 in 2 high-volume institutions in both China (n=1,637) and Korea (n=2,231) were retrospectively evaluated. Clinicopathological variables, overall survival (OS), progression-free survival (PFS), and surgery-related complications were assessed for all patients and compared between the 2 institutions. Results: Chinese patients included in the study were significantly older and had a significantly lower body mass index (BMI) than the Korean patients. Esophagogastric junction tumors were more frequent in Chinese patients. However, the number of patients with stage I gastric cancer, the number of harvested lymph nodes, and the number of total gastrectomies were significantly higher in the Korean population. Korean patients also presented with fewer undifferentiated tumors than Chinese patients. Furthermore, Korean patients had prolonged OS and PFS for stage III cancers only. BMI, tumor-node-metastasis (TNM) stage, tumor invasion, number of positive lymph nodes, and distant metastases were all independent factors affecting OS and PFS. Conclusions: Although China and Korea are neighboring Asian countries, the clinicopathological characteristics of Chinese patients are significantly different from those of Korean patients. Korean gastric cancer patients had longer OS and PFS than Chinese patients. Influencing factors included TNM stage, tumor invasion, and lymph node metastasis.

Association between obesity and local control of advanced rectal cancer after combined surgery and radiotherapy

  • Choi, Yunseon;Lee, Yun-Han;Park, Sung Kwang;Cho, Heunglae;Ahn, Ki Jung
    • Radiation Oncology Journal
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    • v.34 no.2
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    • pp.113-120
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    • 2016
  • Purpose: The association between metabolism and cancer has been recently emphasized. This study aimed to find the prognostic significance of obesity in advanced stage rectal cancer patients treated with surgery and radiotherapy (RT). Materials and Methods: We retrospectively reviewed the medical records of 111 patients who were treated with combined surgery and RT for clinical stage 2-3 (T3 or N+) rectal cancer between 2008 and 2014. The prognostic significance of obesity (body mass index [BMI] ${\geq}25kg/m^2$) in local control was evaluated. Results: The median follow-up was 31.2 months (range, 4.1 to 85.7 months). Twenty-five patients (22.5%) were classified as obese. Treatment failure occurred in 33 patients (29.7%), including local failures in 13 patients (11.7%), regional lymph node failures in 5, and distant metastases in 24. The 3-year local control, recurrence-free survival, and overall survival rates were 88.7%, 73.6%, and 87.7%, respectively. Obesity (n = 25) significantly reduced the local control rate (p = 0.045; 3-year local control, 76.2%), especially in women (n = 37, p = 0.021). Segregation of local control was best achieved by BMI of $25.6kg/m^2$ as a cutoff value. Conclusion: Obese rectal cancer patients showed poor local control after combined surgery and RT. More effective local treatment strategies for obese patients are warranted.

Malignant Fibrous Histiocytoma of the Maxilla - Report of A Case - (상악골의 악성 섬유성 조직구종 - 증례보고 -)

  • Oh, Yoon-Kyeong;Yeo, Hwan-Ho
    • Radiation Oncology Journal
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    • v.13 no.3
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    • pp.225-231
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    • 1995
  • Malignant fibrous histiocytoma(MFH) of the maxilla is a rare malignant bone tumor Seven percents of all MFH occur in the head and neck. Approximately $12{\%}$ of these tumors occur in the maxilla. Local recurrence or distant metastasis was reported in $55{\%}$ of cases of maxillary MFH. The mean survival time of 30 months was reported from a review of 14 MFHs in the maxilla, mandible and oral soft tissues. MFH of the maxilla is best treated surgically but radical neck dissection does not appear to be indicated unless there is clinical evidence of lymph node metastases Although the use of radiation therapy for head and neck MFH has not been studied for a series of cases, individual cases of regression or histological change have been reported. Other authors have reported numbers of cases who received radiation therapy without benefit. Response to combination chemotherapy has been reported in $33{\%}$ of 23 patients with recurrent or metastatic MFH. We report here a case of MFH occurring in the maxilla with a review of literature about the clinical behavior and treatment of these lesions.

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A Single-Center Experience of Endoscopic Resection for Early Gastric Cancer with Lymphoid Stroma

  • Lim, Hyun;Lee, Jeong Hoon;Park, Young Soo;Na, Hee Kyong;Ahn, Ji Yong;Kim, Do Hoon;Choi, Kee Don;Song, Ho June;Lee, Gin Hyug;Jung, Hwoon-Yong
    • Journal of Gastric Cancer
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    • v.18 no.4
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    • pp.400-408
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    • 2018
  • Purpose: This study aimed to evaluate immediate outcomes and clinical courses of patients with early gastric carcinoma with lymphoid stroma (GCLS) who underwent endoscopic resection. Materials and Methods: We retrospectively reviewed the medical records of 40 patients (mean age, 56.9 years; 90.0% male) who underwent endoscopic resection and were pathologically diagnosed with GCLS confined to the mucosa or to the submucosa between March 1998 and December 2017. Results: Forty GCLS lesions in 40 patients were treated using endoscopic resection. Only 4 (10%) patients received diagnosis of GCLS before endoscopic resection. Fourteen (35.0%) lesions were intramucosal cancers and 26 (65.0%) exhibited submucosal invasion. En bloc resection (97.5%) was achieved for all lesions except one, with no significant complications. The complete resection rate was 85.0% (34 of 40 lesions). After endoscopic resection, 17 patients were referred for surgery and underwent gastrectomy with lymph node (LN) dissection because of deep submucosal invasion (n=16) and misclassification as undifferentiated cancer (n=1). No LN metastasis was determined in the specimens obtained during surgery. During a mean follow-up period of 49.7 months for 23 patients without surgical treatment, no regional LN enlargements, distant metastases, or gastric cancer-related deaths were found, although 1 metachronous lesion (undifferentiated adenocarcinoma, follow-up duration: 7 months) was observed. Conclusions: In patients with early GCLS, endoscopic resection is technically feasible and has favorable clinical outcomes. Therefore, endoscopic resection might represent an alternative treatment modality in patients with early GCLS with a low likelihood of LN metastasis.

Application of Radiofrequency Ablation to Thyroid Cancer: Past, Present, and Future (갑상선암에 대한 고주파 절제 적용의 과거, 현재, 그리고 미래)

  • Ji-hoon Kim
    • Journal of the Korean Society of Radiology
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    • v.84 no.5
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    • pp.999-1008
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    • 2023
  • Thyroid cancer, characterized by high incidence rates, good prognosis, and frequent recurrence, is typically treated surgically. However, since the early 2000s, radiofrequency ablation, which is commonly utilized in liver, lung, and kidney cancers, is being performed for management of primary and recurrent thyroid cancers. Many studies have focused on inoperable cases of low-risk papillary microcarcinoma (≤ 1 cm) and some have investigated its role in larger lesions (up to 4 cm). Overall, these studies have reported positive results. Radiofrequency ablation for recurrent cancer has primarily been performed for locally recurrent cervical cancer, and this therapeutic approach has been attempted for treatment of distant metastases in lungs and bones, with encouraging outcomes. A growing global trend, particularly in South Korea, the United States, and Europe supports radiofrequency ablation for thyroid cancer. However, this therapy is currently not recognized as a treatment option recommended by universally accepted clinical guidelines such as those established by the National Comprehensive Cancer Network. Based on past efforts and future research, radiofrequency ablation is expected to play a key role in thyroid cancer treatment in the near future.