• Archives of Plastic Surgery
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• v.48 no.5
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• pp.518-523
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• 2021

Epignathus is a rare congenital orofacial teratoma that arises from the sphenoid region of the palate or the pharynx. It occurs in approximately 1:35,000 to 1:200,000 live births representing 2% to 9% of all teratomas. We present the case of a newborn of 39.4 weeks of gestation with a tumor that occupied the entire oral cavity. The patient was delivered by cesarean section. Oral resection was managed by pediatric surgery. Plastic surgery used virtual 3-dimensional models to establish the extension, and depth of the tumor. Bloc resection and reconstruction of the epignathus were performed. The mass was diagnosed as a mature teratoma associated with cleft lip and palate, nasoethmoidal meningocele that conditions hypertelorism, and a pseudomacrostoma. Tridimensional technology was applied to plan the surgical intervention. It contributed to a better understanding of the relationships between the tumor and the adjacent structures. This optimized the surgical approach and outcome.

• Korean Journal of Bronchoesophagology
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• v.5 no.2
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• pp.212-216
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• 1999

Renal cell carcinoma is the third most common metastatic tumor to the bone and soft tissues of the head and neck. The common sites of metastatic renal cell carcinoma in head and neck region are nasal cavity, paranasal sinuses, oral mucosa, gingiva, tongue, palate, lip as the favored site. The present paper deals with one patient with metachronous oral tongue, nasal cavity and suspicious brain metastases after 2 years of renal cell carcinoma nephrectomy. Also, the patient had history of total thyroidectomy for thyroid follicular carcinoma. Total excision of nasal cavity and tongue mass were performed. Therapeutic aspects are briefly reviewed in literature.

• Archives of Plastic Surgery
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• v.43 no.3
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• pp.265-271
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• 2016

Background Reconstruction of orofacial soft tissue defects is often challenging due to functional and aesthetic demands. Despite advances in orofacial soft tissue defect reconstruction using free flaps, locoregional flaps still remain an important option, especially in health resource-depleted environments. This retrospective study highlights our experiences in oral and maxillofacial soft tissue reconstruction using locoregional flaps. Methods A twenty-three years retrospective analysis of all patients managed in our department was undertaken. Information was sourced from patients' case notes and operating theater records. Data was analyzed using SPSS ver. 16 (SPSS Inc.) and Microsoft Excel 2007 (Microsoft). Results A total of 77 patients underwent orofacial soft tissue defect reconstruction within the years reviewed. Males accounted for 55 (71.4%) cases and trauma was the main etiological factor in 45 (58.4%) of the patients treated. When sites of defect were considered, the lip, 27 (32.1%), was the most frequent site followed by the nose, 17 (20.2%). Forehead flap, 51 (59.3%), was the most commonly used flap. Complications noted were tumor recurrences at the recipient bed in 3 (3.9%) cases, tumor occurrence at the donor site in 1 (1.3%) case and postoperative infection in 11 (14.3%) cases. Conclusions Locoregional flaps still have an important role in the rehabilitation of patients with orofacial soft tissue defects. They remain a vital tool in the armamentarium of the reconstructive surgeon, especially in health resource-depleted environments where advanced reconstructive techniques may not be feasible.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.15 no.2
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• pp.93-98
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• 1993

Pleomorphic adenoma is the most common of all salivary gland tumors, constituting over 50% of all cases of tumors of both major and minor salivary gland origin and approximately 90% of all benign salivary gland tumors. Of the major salivary glands, the parotid gland is the most common site of the pleomorphic adenoma. It may occur, however, in any of the major gland or in the widely distributed intraoral accessory salivary glands. The palatal glands are frequently the site of origin of tumors, and other parts of origins are as follows: upper and lower lip, buccal mucosa, tongue and occasionally other sites. The majority of the lesions are found in patients in the fourth to sixth decades, but they are also relatively common in young adults and have been known to occur in children. It is somewhat more frequent in women than men. The term "mixed tumor" has masquaeraded under a great variety of names throughout the years (e.g., enclavoma, branchioma, endothelioma, enchondroma), but the term "pleomorphic adenoma" suggested by Willis characterizes closely the unusual histologic pattern of the lesion. The accepted treatment for this tumor is surgical excision. The intraoral lesions can be treated somewhat more conservatively by extracapsular excision. In general, Lesions of the hard palate should be excised with the overlying mucosa, while those in lining mucosa, such as the lips, soft palate and buccal mucosa often can be treated successfully by enucleation or extracapsular excision. In our hospital, we experienced two patients who were identified pleomorphic adenoma which occurred at buccal mucosa, submandibular gland. The lesions were successfully treated by surgical excision.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.35 no.1
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• pp.41-44
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• 2009

Lipoma is most common tumor that compromises 4% to 5% of all benign neoplasm, but in oral cavity it is uncommon. In oral cavity, lipoma presents painless, asymptomatic, slow growing, but sometimes it grows to larger size causing deformities, mastication and speech difficulties. While lipoma in commonly affects female patients (68-73%), oral lipoma appears more frequently in male patients. The majority of oral lipoma is seen after the age of forty (uncommon in children). Lipoma of oral cavity and maxillofacial region occurs most commonly in the parotid region, followed by the buccal mucosa, lip, tongue, palate, mouth floor, gingiva in order. A treatment of lesion is surgical excision with recurrence not expected. In this paper we present the case of a patient who has Lipoma in the mouth floor.

• Archives of Plastic Surgery
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• v.40 no.4
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• pp.353-358
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• 2013

Background Robots have allowed head and neck surgeons to extirpate oropharyngeal tumors safely without the need for lip-split incision or mandibulotomy. Using robots in oropharyngeal reconstruction is new but essential for oropharyngeal defects that result from robotic tumor excision. We report our experience with robotic free-flap reconstruction of head and neck defects to exemplify the necessity for robotic reconstruction. Methods We investigated head and neck cancer patients who underwent ablation surgery and free-flap reconstruction by robot. Between July 1, 2011 and March 31, 2012, 5 cases were performed and patient demographics, location of tumor, pathologic stage, reconstruction methods, flap size, recipient vessel, necessary pedicle length, and operation time were investigated. Results Among five free-flap reconstructions, four were radial forearm free flaps and one was an anterolateral thigh free-flap. Four flaps used the superior thyroid artery and one flap used a facial artery as the recipient vessel. The average pedicle length was 8.8 cm. Flap insetting and microanastomosis were achieved using a specially manufactured robotic instrument. The total operation time was 1,041.0 minutes (range, 814 to 1,132 minutes), and complications including flap necrosis, hematoma, and wound dehiscence did not occur. Conclusions This study demonstrates the clinically applicable use of robots in oropharyngeal reconstruction, especially using a free flap. A robot can assist the operator in insetting the flap at a deep portion of the oropharynx without the need to perform a traditional mandibulotomy. Robot-assisted reconstruction may substitute for existing surgical methods and is accepted as the most up-to-date method.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.24 no.1
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• pp.173-177
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• 1994

Multiple myeloma is a malignant plasma cell tumor that is thought to originate proliferation of a single clone of abnormal plasma cell resulting production of a whole monoclonal paraprotein. The authors experienced a case of multiple myeloma with severe mandibular osteolytic lesions in 46-year-old female. As a result of careful analysis of clinical, radiological, histopathological features, and laboratory findings, we diagnosed it as multiple myeloma, and the following results were obtained ; 1. Main clinical symptoms were intermittent dull pain on the mandibular body area, abnormal sensation of lip and pain due to the fracture on the right clavicle. 2. Laboratory findings revealed M-spike, reversed serum albumin-globulin ratio, markedly elevated ESR and hypercalcemia. 3. Radiographically, multiple osteolytic punched-out radiolucencies were evident on the skull, zygoma, jaw bones, ribs, clavicle and upper extremities. Enlarged liver and increased uptakes on the lesional sites in RN scan were also observed. 4. Histopathologically, markedly hypercellular marrow with sheets of plasmoblasts and megakaryocytes were also observed.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.31 no.1
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• pp.89-93
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• 2005

Intraosseous neurilemmoma(Schwannoma) is an extremely rare benign neoplasm. The site most commonly involved is the mandible. This occurrence is understandable because of the length of the inferior alveolar canal through the mandible. No other bone contains a canal that transmits a neurovascular bundle of such size and length. We report on a peripheral and central neurilemmoma along pathway of inferior alveolar nerve of the lower lip and mandible in a 28-year old man. A panoramic radiograph of the mandible showed a well-defined bilocular lesion with a thin uniform sclerotic margin located in the ramus and body of the mandible. The CT scan confirmed a well-defined lesion with thinning of the cortex of the body of the left side of the mandible. Histologically, the lesion was a cellular neoplasm with distinct palisading and numerous Verocay bodies. Complete excision was achieved by removing the tumor with the inferior alveolar nerve.

• Archives of Craniofacial Surgery
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• v.20 no.3
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• pp.207-211
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• 2019

Primary cutaneous anaplastic large cell lymphoma (C-ALCL) is a rare subtype of primary cutaneous lymphoma with a favorable prognosis. Primary cutaneous CD30+ lymphoproliferative disorders, which include C-ALCL and lymphomatoid papulosis, are the second most common group of cutaneous T-cell lymphomas. C-ALCL is comprised of large cells with anaplastic, pleomorphic, or immunoblastic cytomorphology, and indeed, more than 75% of the tumor cells express the CD30 antigen. C-ALCL clinically presents with solitary or localized reddish-brown nodules or tumors, and sometimes indurated papules, and they may be with ulceration covering with dark eschar. Multifocal lesions are seen in 20% of the patients. Extracutaneous dissemination, which mainly involves the regional lymph nodes, occurs in 10% of patients. A 69-year-old man noticed a mild elevated cutaneous lesion containing central ulceration covering with brownish black necrotic tissue on the right lower lip, and the lesion was surgically removed. After the first operation, another skin lesion was developed and the histological examination confirmed the diagnosis, C-ALCL. Eight specimens were excised during the 7-month follow-up period. The patient started the treatment with low-dose oral methotrexate (15 mg/wk) and there was no recurrence for 11 months.

• Korean Journal of Head & Neck Oncology
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• v.10 no.1
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• pp.25-30
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• 1994

Minor salivary gland tumors vary in their primary sites, histopathology and bilogical behavior. Therefore various factors are considered in selecting the treatment modality and predicting the prognosis. The prognosis of milignant tumors of minor salivary glands are worse than that of such lesions of major salivary glands. Authors experienced 26 cases of minor salivary gland tumors(10 benign tumors and 16 malignant tumors) during the past 7 years and analyzed their clinical characteristics. 1) The palate was the most common site of origin of minor salivary gland tumors (38.5%). 2) The most common benign tumor was pleomorphic adenoma and majority of them occur red in the palate(60.0%) and the remaining occured in the nasal cavity or the paranasal sinuses (30.0%), and the lip ( 10.0%). 3) In the case of malignant tumors the most frequent sites were the nasal cavity or the paranasal sinuses (31.3%) with the following histopathologic frequencies: adenoid cystic carcinoma(56.3%), malignant pleomorphic adenoma(12.5%), mucoepidermoid carcinoma(12.5%), polymorphic adenocarcinoma (12.5%), epthelial-myoepithelial carcinoma (6.25%). 4) Minor salivary gland tumors have high probability of malignancy and tumor extension is important to their treatment.