• Title/Summary/Keyword: Head neck neoplasms

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The Role of CT as a Preoperative Evaluation of Lateral Cervical Lymph Node Metastasis in Papillary Thyroid Carcinoma (갑상선 유두암의 외측 경부림프절 전이에 대한 수술 전 평가로서 CT의 역할)

  • Seok, Jungirl;Kim, Hyung Gu;Kim, Yoonjoong;Han, Kyu-Hee;Ahn, Soon-Hyun
    • Korean Journal of Head & Neck Oncology
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    • v.29 no.2
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    • pp.37-40
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    • 2013
  • Background and Objectives : To assess the usefulness of computed tomography image before papillary thyroid cancer surgery, focus on confirmation of lateral cervical lymph node metastasis not detected by ultrasonography. Material and Methods : From January 2008 to May 2009, total 150 patients who had undergone thyroid surgery and been confirmed papillary thyroid cancer pathologically were enrolled. They had taken neck computed tomography following the ultrasonography. Results : Computed tomography had found suspicious metastatic lateral neck lesion in 13 patients. After the image study, lateral neck lymph node dissection had been included in their surgical plan. Of these, only 7 cases were confirmed pathologically lateral neck lymph node metastasis(positive predictive value=0.54). Taken as whole 150 patients, additionally 4.7% of patients confirmed lateral neck lymph node metastasis by preoperative computed tomography. Conclusion : If preoperative ultrasonography was performed precisely, additional benefits that could be achieved by computed tomography were not much.

Reconstruction of the Head and Neck Region Using Lower Trapezius Musculocutaneous Flaps

  • Yoon, Soo Kwang;Song, Seung Han;Kang, Nakheon;Yoon, Yeo-Hoon;Koo, Bon Seok;Oh, Sang-Ha
    • Archives of Plastic Surgery
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    • v.39 no.6
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    • pp.626-630
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    • 2012
  • Background Recent literature has indicated that free flaps are currently considered the preferred choice for head and neck reconstruction. However, head and neck cancer patients are frequently treated with chemoradiotherapy, which is often associated with a poor general and local condition, and thus, such patients are ineligible for free flap reconstruction. Therefore, other reconstruction modalities should be considered. Methods We used lower trapezius musculocutaneous (LTMC) flap based on the dorsal scapular artery to reconstruct head and neck defects that arose from head and neck cancer in 8 patients. All of the patients had undergone preoperative chemoradiotherapy. Results There were no complications except one case of partial flap necrosis; it was treated with secondary intention. Healing in the remaining patients was uneventful without hematoma, seroma, or infection. The donor sites were closed primarily. Conclusions The LTMC flap is the preferred flap for a simple, reliable, large flap with a wide arc of rotation and minor donor-site morbidity. The authors recommend this versatile island flap as an alternative to microvascular free tissue transfer for the reconstruction of defects in the head and neck region, for patients that have undergone preoperative chemoradiotherapy.

EXPRESSION OF THE EPIDERMAL GROWTH FACTOR RECEPTOR AND CELL CYCLE ANALYSIS IN THE HEAD AND NECK SQUAMOUS CELL CARCINOMAS (두경부 편평세포암종에서 상피성장인자수용체의 발현과 세포주기에 관한 연구)

  • Kim, Kyoung-Won;Kim, Myung-Jin
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.26 no.2
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    • pp.154-163
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    • 2000
  • Growth factors and the receptors play an important role in the regulation of the growth and development of mammalian cells. In particular, epidermal growth factor is a polypeptide with potent mitogenic activity that stimulates proliferation of various normal and neoplastic cells through the interaction with its specific receptor(EGFR). EGFR has been described as a parameter of poor prognosis in many human neoplasms such as breast, bladder, and vulvar cancers. The objectives of this study are the evaluation of the expression of EGFR and cell cycle analysis in the head and neck squamous cell carcinomas(SCC), and the evaluation of the correlation between clinico-patholgic features and expression of EGFR and S-phase fraction. 37 head and neck squamous cell carcinoma specimens were evaluated for expression of EGFR by Western blot analysis and S-phase fraction by cell cycle analysis using the flow cytometry. The obtained results were as follows : 1. The expressions of EGFR were observed in 20 specimens(54%) among 37 head and neck SCC specimens. In case of oral SCC, 15 specimens(56%) out of 27 specimens were observed, and in case of nasopharyngeal SCC 5 specimens(50%) out of 10 specimens. 2. There was no correlation between clinical features(location, stage) of head and neck SCC and expression of EGFR (p>0.05). 3. There was a significant correlation between histo-pathological differentiation of head and neck SCC and expression of EGFR (p<0.02). 4. There was a significant correlation between expression of EGFR and S-phase fraction of cell cycle in the head and neck SCC (p<0.05). The above results suggest that expression of EGFR and S-phase fraction of cell cycle are adjunctive prognostic marker in the head and neck squamous cell carcinomas.

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Mutations in the tyrosine kinase domain of the EGFR gene are rare in the Korean Oral Squamous Cell Carcinoma

  • Lee, Eun-Ju
    • Journal of the Korea Society of Computer and Information
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    • v.21 no.9
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    • pp.101-106
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    • 2016
  • The epidermal growth factor receptor(EGFR) protein kinase signaling is an important pathway in cancer development and recently reported that EGFR and its kinase domain molecules are mutated in various of cancers including head and neck cancer. Functional deregulation of EGFR due to mutations in coding exons and copy number amplification is the most common event in cancers, especially among receptor tyrosine kinases(TK). We have analyzed Korean oral squamous cell carcinomas (OSCC) cell lines for mutations in EGFRTK. Exons encoding the hot-spot regions in the TK domain of EGFR (exons 17 to 23) were amplified by using polymerase chain reaction(PCR) and sequenced directly. EGFR expression was also analyzed in 8 OSCC cell lines using western blotting. Data analysis of the EGFR exons 17 to 23 coding sequences did not show any mutations in the 8 OSCC cell lines that were analyzed. The absence of mutations indicate that protein overexpression might be responsible for activation rather than mutation.

A Case of Epithelial-Myoepithelial Carcinoma of Parotid Gland and Analysis of 33 Cases Reported in Korea (이하선의 상피-근상피 암종 1례와 국내에 보고된 33건의 증례 분석)

  • Kim, Ji Won;Kim, Min Soo;Kim, Bo Sung;Kim, Seong Dong
    • Korean Journal of Head & Neck Oncology
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    • v.37 no.2
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    • pp.61-65
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    • 2021
  • Epithelial-myoepithelial carcinoma is rare, low-grade malignant neoplasm that compromises approximately 1% of all salivary gland neoplasms. We reported a 68-year-old woman with epithelial-myoepithelial carcinoma in the parotid gland. We analyzed demographic and clinicopathological characteristics of salivary gland epithelial-myoepithelial carcinoma which has been reported in 33 cases in Korea from 1992 to 2017, and compared this result to overseas retrospective cohort studies. There was no significance in terms of mean age at diagnosis, the predominance of females, low frequency in regional lymph nodes, and distant metastasis between the two groups. However, T classification and AJCC stage at diagnosis in domestic cases are more advanced than those of overseas cases. Although the recurrence rate in domestic cases has been reported lower than that of overseas, further study may be needed considering that the follow-up period after treatment is short in domestic cases.

A Case of Intra-thyroidal Schwannoma Diagnosed by Preoperative Core Needle Biopsy (수술 전 중심부바늘생검을 통해 진단된 갑상선에 발생한 신경초종 1예)

  • Dong Gyu Choi;Young-Ok Kim;Min Jung Jung;Hyoung Shin Lee
    • Korean Journal of Head & Neck Oncology
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    • v.39 no.1
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    • pp.37-40
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    • 2023
  • Schwannoma is a slow growing benign tumor that can occur anywhere in our body. About 25~45% cases of schwannomas occur in the head and neck, but intra-thyroidal schwannomas are very rare, and mostly are diagnosed by post-thyroidectomy pathologic study. In this article, we present a case of intra-thyroidal schwannoma diagnosed preoperatively with core needle biopsy. The patient underwent enucleation of the thyroid tumor, and the pathology of the tumor was confirmed as schwannoma. Few cases of intra-thyroidal schwannomas have been reported in the literature, but none of them have been diagnosed through core needle biopsy preoperatively. Preoperative diagnosis of intra-thyroidal schwannoma can be helpful when determining appropriate surgical extent and avoid unnecessary thyroidectomy.

A Case of Hemangioma of Nasal Cavity in Von Hippel-Lindau Syndrome (Von Hippel-Lindau 증후군 환자에서 발생한 비강내 혈관종)

  • Hyun Seok Kang;Soo Jin Jung;Seoung Wan Chae;Seok Jin Hong
    • Korean Journal of Head & Neck Oncology
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    • v.39 no.2
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    • pp.65-69
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    • 2023
  • We report a unique case of hemangioma of the nasal cavity in von Hippel-Lindau (VHL) syndrome. A 26-year-old female with VHL syndrome who had previously undergone surgery for pancreatic and adrenal mass presented with a 4-month history of left-sided nasal obstruction. The patient had an expansile mass lesion in the left nasal cavity and an imaging test demonstrated the mass in the left maxillary sinus extending to the nasal cavity. The tumor was removed with an endoscopic prelacrimal recess approach considering the possibility of not only a benign tumor such as hemangioma but also a malignant tumor of the maxillary sinus and histopathologic examination confirmed cavernous hemangioma. This case is the rarely reported manifestation of the paranasal sinus in VHL disease.

A Case of Co-Existence of Diffuse Large B cell Lymphoma in Parotid Gland and Follicular Lymphoma in Upper Neck (동측의 이하선과 상경부에 공존하여 발생한 미만성 거대 B세포 및 여포성 림프종 1예)

  • Hong, Seok Jung;Kim, Eun Ju;Kim, Seung Woo
    • Korean Journal of Head & Neck Oncology
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    • v.34 no.1
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    • pp.49-53
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    • 2018
  • Primary non-Hodgkin's lymphoma (NHL) rarely involves the parotid gland and its incidence is only 1.7% to 3.1% of all salivary gland neoplasms. The mucosa associated lymphoid tissue (MALT) is the most common subtype of NHL, followed by follicular lymphoma (FL) and diffuse large B cell lymphoma (DLBCL). However, two distinct types of lymphomas occurring synchronously in the parotid gland and cervical lymph node have not been reported earlier. A 72-year-old man with rubbery-hard and fixed mass on the left parotid area came to our clinic. We performed the left total parotidectomy with ipsilateral excision of lymph node (level II), and he was finally diagnosed as DLBCL in parotid gland and FL in upper neck. It is presumed that the DLBCL appeared to be a transformation from FL. We report the unique and rare disease entity with brief literature review.

Validity of Needle Aspiration Cytology and Frozen Section in Thyroid Tumor (갑상선 결절에서 세침흡인검사와 동결조직검사의 의의)

  • Kim Jae-Won;Lee Jang-Won;Bae Sung-Ho;Ko Kook-Jin;Yoon Suk-Young;Kim Young-Mo
    • Korean Journal of Head & Neck Oncology
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    • v.20 no.2
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    • pp.143-146
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    • 2004
  • Background and Object: The role of fine needle aspiration cytology (FNAC) and frozen section (FS) in management of thyroid neoplasms continues to generate considerable controversy. We reviewed our current experience to determine the clinical utility of FNAC and FS in our surgical management and investigated reliability of FNAC and FS in planning the extent of thyroid resection. Material and Method: 212 patients who had operations for thyroid disease from May 1996 to November 2003 were included our retrospective study. FNAC was undertaken in 175 patients and FS was done in 148 patients. Result: The sensitivity and specificity of FNAC were 72.1% and 100%, respectively, and those of FS were 67.2% and 100%. The results of FNAC were benign (n=72) , malignancy (n=31), indeterminate (n=9), and nondiagnostic (n=63). The results of FS were benign (n=95), and malignancy (n=53). The 9 indeterminate cases on FNAC were benign (n=6) and malignancy (n=3) on final pathology, and benign (n=7) and malignancy (n=2) on FS. The false negative of FNAC were micro papillary carcinoma (n=6) and follicular carcinoma (n=6). The false negative of FS were micropapillary carcinoma (n=10) and follicular carcinoma (n=2). Conclusion: When results of FNAC are interpreted as indeterminate, FS is a valuable tool. FS is helpful in determining the extent of thyroidectomy when results of FNAC were follicular neoplasm. However we always concerned about micropapillary carcinoma and follicular carcinoma although FNAC and FS were benign.

Prognostic value of FDG PET/CT during radiotherapy in head and neck cancer patients

  • Kim, Suzy;Oh, Sowon;Kim, Jin Soo;Kim, Yu Kyeong;Kim, Kwang Hyun;Oh, Do Hoon;Lee, Dong-Han;Jeong, Woo-Jin;Jung, Young Ho
    • Radiation Oncology Journal
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    • v.36 no.2
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    • pp.95-102
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    • 2018
  • Purpose: To evaluate the prognostic value of $^{18}F$-fluorodeoxyglucose positron-emission tomography (FDG PET) with computed tomography (CT) before and during radiotherapy (RT) in patients with head and neck cancer. Methods: Twenty patients with primary head and neck squamous cell carcinoma were enrolled in this study, of whom 6 had oropharyngeal cancer, 10 had hypopharyngeal cancer, and 4 had laryngeal cancer. Fifteen patients received concurrent cisplatin and 2 received concurrent cetuximab chemotherapy. FDG PET/CT was performed before RT and in the 4th week of RT. The parameters of maximum standardized uptake value, metabolic tumor volume, and total lesion glycolysis (TLG) of the primary tumor were measured, and the prognostic significance of each was analyzed with the Cox proportional hazards model. Results: Higher TLG (>19.0) on FDG PET/CT during RT was a poor prognostic factor for overall survival (OS) (p = 0.001) and progression-free survival (PFS) (p = 0.007). In the multivariate analysis, TLG during RT as a continuous variable was significantly associated with OS and PFS rate (p = 0.023 and p = 0.016, respectively). Tumor response worse than partial remission at 1 month after RT was another independent prognostic factor for PFS (p = 0.024). Conclusions: Higher TLG of the primary tumor on FDG PET/CT during RT was a poor prognostic factor for OS and PFS in patients with head and neck cancer.