• Korean Journal of Head & Neck Oncology
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• v.20 no.2
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• pp.156-160
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• 2004

Background and Objectives: Neck metastasis is one of the most important prognostic factors in treating tonsillar cancer. Incidence and pattern of lymph node metastasis of tonsillar squamous cell carcinoma are the basic knowledge of treatment decision. Occult metastasis rate of tonsillar cancer and pattern of metastasis, failure pattern, survival were retrospectively analyzed. Patients and Methods: Seventy six patients who underwent surgery for tonsillar squamous cell carcinoma as an initial treatment from 1992 to 2004 were evaluated. Charts, imaging studies and pathologic reports were reviewed. Results: At the time of surgery, 78% of patients with tonsillar cancer had neck metastasis and 66% had multiple node metastasis. Occult neck metastasis was in 26%. There was high incidence of neck metastasis even in early stage of primary lesion. Conclusion: High incidence of lymph node metastasis was confirmed histopathologically in tonsillar cancer. All tonsillar cancer patients may need elective treatment of the neck. Tonsillar cancer had relatively good prognosis even though its neck metastasis rate is very high.

• Korean Journal of Head & Neck Oncology
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• v.13 no.1
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• pp.24-29
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• 1997

Background: Supraglottic and hypopharyngeal regions drain into the upper deep cervical lymph nodes. And bilateral neck node metastasis is frequently occured especially, in the early stage. It influences on the prognosis of above diseases. The prognosis for patients wih supraglottic and hypopharyngeal cancers, although usually poor, has improved by modern imaging technique, better application of treatment modalities, increasing assortment of reconstructive procedures and improved application of radiation therapy. Objectives: This study was designed to obtain objective data about the patterns of neck node metastasis and to identify the necessity of elective bilateral neck dissection. Material and Methods: Twenty four patients with supraglottic cancer and twenty six patients with hypopharyngeal cancer were investigated from the chart review. Results: In supraglottic cancer, the most frequent sites of neck metastasis is level II (52.9%) and level III (52.9%) in ipsilateral side, level II (29.4%) in contralateral side, in hypopharyngeal cancer, level II (73.7%) and III (52.6%) in ipsilateral side, level II (10.5%) in contralateral side. In elective neck dissection, the occult metastasis is about 50% in supraglottic cancer, but there is no occult metastasis in hypopharyngeal cancer. Conclusion: In supraglottic cancer, elective bilateral neck dissection is necessary because of early contralateral neck metastasis, but in hypopharyngeal cancer, elective contralateral neck dissection may not be always necessary because of rare occult metastasis and contralateral neck metastasis.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.44 no.6
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• pp.282-288
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• 2018

Objectives: The purpose of this study was to evaluate the neck node metastasis pattern and related clinical factors in oral cavity cancer patients. Materials and Methods: In total, 76 patients (47 males, 29 females) with oral squamous cell carcinoma (OSCC) who had no previous malignancies and were not undergoing neoadjuvant concomitant chemoradiotherapy or radiotherapy were selected for analysis. Results: Occult metastases were found in 8 of 52 patients with clinically negative nodes (cN0, 15.4%). Neck node metastases were found in 17 patients (22.4%). There was a statistically significant relationship between neck node metastasis and T stage (P=0.014) and between neck node metastasis and distant metastasis (Fisher's exact test, P=0.019). Conclusion: Neck node metastasis was significantly related to tumor size and distant metastasis during follow-up.

• Korean Journal of Head & Neck Oncology
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• v.15 no.1
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• pp.18-21
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• 1999

Background and Objectives: Occult neck metastasis rate of laryngeal and hypopharyngeal cancer varies widely depending upon authors. Materials and Methods: Sixty four cases, previously untreated, of N0 laryngeal and hypopharyngeal squamous cell carcinoma patients who underwent surgery as an initial treatment from 1992 to 1997 were evaluated. All had unilateral or bilateral elective neck dissection at the time of surgery for the primary. Occult neck metastasis rate was evaluated with pathologic examination of neck dissection specimen. Results: Occult neck metastasis rate by primary site was as follows. Supraglottis ipsilateral 32%(8/25) contralateral 15%(3/20), glottis ipsilateral 17%(5/30), contralateral 0%(0/22), hypopharynx ipsilateral 78%(7/9), contralateral 25%(2/8). Conclusion: Supraglottic and hypopharyngeal cancer may need elective neck treatment bilaterally. Occult neck metastasis of glottic cancer to opposite site was minimal.

• Korean Journal of Head & Neck Oncology
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• v.7 no.1
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• pp.40-44
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• 1991

Cystic metastasis in the neck from pharyngeal cancer has often been mistaken for either primary squamous cell carcinoma of branchiogenic origin or branchial cleft cyst. The distinctive histological and clinical features of cystic metastasis reviewed after its correct indentification can lead to the discovery of an unsuspected primary lesion and result in specific treatment options. Recendy, the authors experienced three cases of cystic metastasis in the neck from pharyngeal cancer ; one was from nasopharyngeal squamous cell carcinoma and the other two were from tonsillar squamous cell carcinomas. This report summarizes our experiences and review of the literatures.

• Korean Journal of Head & Neck Oncology
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• v.18 no.1
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• pp.65-70
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• 2002

Background and Objectives: Recently the tenn 'papillary microcarcinoma' has been proposed to designate carcinoma of 10 mm or less in diameter. In some cases, cervical lymph node metastasis preceding the occurrence of the primary tumor may be the first and sole manifestation of the disease. The objective of this study is to assess the clinical features of cervical metastasis in papillary microcarcinoma of thyroid glands. Materials and Methods: 9 cases with papillary microcarcinoma with neck metastasis were analyzed retrospectively. 5 cases are men and 4 are women. All patients complained of painless, movable neck mass. The symptom had been present from 1 month to 36 months. We reviewed clinical history, imaging studies, the results of fine needle aspiration, the surgical method, the pathologic results. Results: In 9 cases, no abnormalities of the thyroid gland were shown by imaging studies and thyroid scan. 3 cases were diagnosed by fine needle aspiration cytology. the others were not. Total thyroidectomy and neck dissection were performed in 9 cases and then pathology reports showed 2 case of multiple, 2 case of contralateral single and 5 cases of unilateral single thyroid microcarcinoma. They have no recurrence during follow-up period. Conclusions: Cervical metastasis from papillary microcarcinoma is variable clinical manifestation. The diagnosis of cervical metastasis from papillary microcarcinoma should be considered in patient with neck mass. We recommend total thyroidectomy with neck dissection and postoperative radioactive iodine ablation therapy in neck metastasis from papillary thyroid microcarcinoma.

• Korean Journal of Head & Neck Oncology
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• v.15 no.1
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• pp.9-17
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• 1999

Objectives: The records of 936 patients with previously untreated carcinoma of the head and neck were reviewed in order to define the incidence and topographical distribution of neck node metastasis on admission. Materials and Methods: The common regions of metastasis are presented for each of the 12th individual head and neck sites selected for study. Results and Conclusion: Knowledge of the preferred areas of spread and those that are almost never involved allows the design of more adequate radiation therapy plans to manage the individual tumors.

• Korean Journal of Head & Neck Oncology
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• v.34 no.2
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• pp.17-21
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• 2018

Background/Objectives: Cancers of the abdominal or pelvic organ rarely metastasize to the cervical lymph nodes. Although it indicates distant metastasis, perceivable prolongation of survival or cure may be possible in selected cases. We sought to identify patients with cervical metastasis from cancers below the diaphragm and identify patients who may benefit from aggressive treatment. Materials & Methods: From 2009 to 2017, patients with pathologically confirmed metastatic cervical lymph nodes originating from below the diaphragm were included for analysis. Patient demographics, cancer characteristics, treatment course, and clinical outcomes were analyzed. Results: 208 patients were identified. Left supraclavicular node (Virchow's node) was the most frequently involved. Irrespective of treatment, survival for uterine cervical and ovarian cancers was significantly longer than that of other primaries. Patients with isolated cervical metastasis (oligometastasis) had significantly longer median survival compared to patients with concomitant bone, lung, brain, and mediastinal metastases. Conclusion: Although cervical metastasis from cancers of the abdominal and pelvic organ represent distant metastasis, patients with uterine cervix and ovary primary and oligometastatic lesions may benefit from aggressive treatment. Prudent patient selection and further investigation is warranted.

• Korean Journal of Head & Neck Oncology
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• v.18 no.2
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• pp.157-162
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• 2002

Background and Objectives: Adenoid cystic carcinoma (ACC) is a unique tumor characterized by frequent and delayed distant metastasis (DM) with uncommon regional lymph node metastasis. We evaluated the factors affecting DM of ACC and survival after appearance of DM. Materials and Methods: Medical records, radiographs and pathologic slides were reviewed for 94 patients from 1979 through 2001. Results: DM of ACC occurred in 46 patients, and developed more frequently in patients with tumors of the solid histologic subtype than in patients with tubular or cribriform subtypes. DM occurred less frequently in the sinonasal tract, and development of DM was not affected by tumor stage. Disease-specific 5- and 10-year survival rates were 88% and 72% for patients without DM, respectively and 76% and 48% for those with DM(p=0.02). Regarding the site of DM and its impact on outcomes, 30 patients had lung metastasis alone, 5 patients bone metastasis alone and 6 patients developed both lung and bone metastasis. Median survivals after appearance of DM among patients with isolated lung metastases and those with bone metastases with or without lung involvement were 54 and 21 months, respectively (p=0.04). Conclusions: Development of DM in ACC is predicted by solid histologic subtype, and major salivary gland or oral/pharyngeal rather than sinonasal primary site. Those patients with bone involvement with our without lung metastases had worse outcomes than those with pulmonary metastasis only.

• Korean Journal of Head & Neck Oncology
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• v.32 no.2
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• pp.61-64
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• 2016

There are various types of malignancy in eyelid, such as squamous cell carcinoma, melanoma, and sarcoma. These malignant tumors have potential of metastasis by regional lymph node drainage. The lymph node around parotid gland has been known as a common site of regional lymph node metastasis. The rarity of malignant tumors in the periorbital area makes it difficult to determine the optimal extent of treatment. We report a case of parotid metastasis after eyelid cancer operation in a 60-year-old man.