• Title/Summary/Keyword: Neck node metastasis

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A Case of Soft Tissue Metastasis in Contralateral Submandibular Space by Regional Recurrence of Lower Lip Cancer (하구순암의 구역 재발로 반대편 악하 공간에 발생한 연조직 전이 1예)

  • Hong, Seok Jung;Lim, Sung Hwan;Kim, Eun Ju;Kim, Seung Woo
    • Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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    • v.61 no.12
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    • pp.702-704
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    • 2018
  • The most common cause of treatment failure in oral cavity cancer is when it is found to have local recurrence, usually occurring in the ipsilateral cervical lymph node. On the contrary, it is extremely rare to find local recurrence in soft tissue metastasis (STM) in the contralateral neck. Furthermore, lung cancer and malignant lymphoma are most commonly confined to their primary sites. The poor general condition increases the likelihood of STM, which indicates bad prognosis. A 72-year-old man with a hard and fixed mass on the right submandibular space visited our clinic. He had received a wide excision with local flapreconstruction for squamous cell carcinoma in the left corner of lower lip 18 months ago. We performed the wide excision with bilateral selective neck dissection (I-III), and he was finally diagnosed as STM from contralateral lip cancer. We report this unique and rare disease entity with a literature review.

DIAGNOSTIC ACCURACY OF $^{18}F$-FDG IN NODAL NEGATIVE ORAL SQUAMOUS CELL CARCINOMA (구강암 환자에서 경부 임파절 평가에 대한 $^{18}F$-FDG PET(Fluorine 18-Labelled Deoxyglucose Positron Emission Tomography)의 유용성)

  • Choi, Eun-Joo;Kang, Sang-Hoon;Kim, Ki-Ho;Nam, Woong;Kim, Hyung-Jun;Cha, In-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.33 no.6
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    • pp.597-600
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    • 2007
  • PET is one of the most widely used verification methods for evaluation of metastasis on the lymph nodes of the neck in oral cancer patients. The purpose of this study was to assess the correlation between PET findings and histopathologic findings in patients who had been diagnosed as squamous cell carcinoma and performed neck dissection. Thirty-four necks in 25 patients had been evaluated on pathologic lymph nodes and the data were compared with preoperative PET scan. The sensitivity of PET at the level of the neck was 72.7%, specificity was 60%, and accuracy was 79.2%. Since FDG-PET show high false-positive results, it should be used with other diagnostic tools for evaluation of lymph node metastasis.

An Unusual Metastasis of Posterior Neck and Axillary Lymph Nodes from Nasopharyngeal Carcinoma (비인강암의 후경부 및 액와 림프절 전이)

  • Hong, Yong Tae;Minh, Phan Huu Ngoc;Hong, Ki Hwan
    • Korean Journal of Head & Neck Oncology
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    • v.32 no.2
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    • pp.23-27
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    • 2016
  • 비인강암은 비인강상피에 발생한 암으로 경부전이 및 간, 폐, 뼈 등의 원격전이가 흔히 나타난다. 본 증례에서는 제 4기 병기를 가진 비인강암환자에서 항암 화학요법 및 방사선 치료 후 매우 드물게 후경부 및 액와 림프절 전이를 보인 환자를 보고하는 바이다. 진행된 병기를 보이는 비인강암 환자는 방사선 치료 후 피부전이가 종종 나타나는 현상이나 후경부 림프절 전이는 흔치 않다. 특히 액와 림프절 전이는 비인강암에서 거의 전이를 보이지 않으나 본 증례에서는 매우 드물게 액와 림프절 전이를 보여 보고하는 바이다.

Clinical and Pathologic Characteristics of Papillary Thyroid Carcinoma According to the Size of Primary Tumor (갑상선 유두암의 크기에 따른 임상병리학적 특징)

  • Lee, Joo Hyung;Kim, Hyung-Kyu;Kim, Seok-Mo;Chang, Ho Jin;Kim, Bup-Woo;Lee, Yong Sang;Park, Cheong Soo;Chang, Hang-Seok
    • Korean Journal of Head & Neck Oncology
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    • v.31 no.2
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    • pp.16-20
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    • 2015
  • Background and Objectives : In papillary thyroid carcinoma (PTC), multiplicity and central or lateral lymph node metastases significantly affect the recurrence. This study was carried out to evaluate the clinical and histological characteristics of PTC according to the tumor size. Materials and Method : Between January 1, 2009 and December 31, 2014, 12,269 PTC patients underwent thyroid surgery at the Thyroid Cancer Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Korea. We analyzed pathologic findings and clinical features according to the size of tumor Results : The mean size of tumor was $0.89{\pm}0.70cm$. The Central and lateral compartment metastases were observed 64.7% and 37.6% on the range that the primary tumor size is 1cm. There was a significant association between the PTC primary tumor size and multiplicity and cervical neck metastasis (p<0.001). Conclusion : The PTC primary tumor size for prediction of multiplicity and neck node metastasis can be helpful in optimization of the surgical extent for each patient.

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Flow Cytometric DNA Analysis of Thyroid Papillary Carcinoma (갑상선 유두상암의 핵산분석)

  • Chu Hyung-Ro;Jung Do-Kwang;Woo Jeong-Su;Choi Jong-Ouck;Kim In-Sun
    • Korean Journal of Head & Neck Oncology
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    • v.10 no.2
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    • pp.102-105
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    • 1994
  • The indolent course of most thyroid papillary carcinomas, even the presence of regional lymph node metastasis, make them unique among human malignant head and neck cancers. Age, sex, extracapsular invasion and anaplastic change are known to be correlated with prognosis. The purpose of this study is to clarify the significance of DNA content analysis as a prognostic factor. Twenty five thyroid papillary carcinomas were possible to be examined by flow cytometric analysis using fresh surgical specimens and three nodular hyperplasias and seven follicular adenomas were included as control group. The results were as follows: l) All of twenty five thyroid papillary carcinomas showed diploidy. 2) S-phase fraction was $1.94{\pm}2.77%$ in normal control group and $2.60{\pm}2.66%$ in papillary carcinoma group. The proliferation index was $8.44{\pm}3.89%$ in normal control and $7.70{\pm}3.63%$ in papillary carcinoma group with even low value. 3) Age, sex, extracapsular spread and lymph node metastasis showed no significant difference. In conclusion, low proliferative activity of thyroid papillary carcinomas are thought to be related with good prognosis.

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Treatment Outcome of Supraglottic Partial Laryngectomy and Neck Dissection for Supraglottic Carcinoma (성문상부암종에서 성문상 후두부분절제술과 경부청소술의 치료성적)

  • Tae, Kyung;Min, Hyun-Jung;Song, Mi-Na;Shin, Kwang-Soo;Lee, Seung-Hwan;Kim, Kyung-Rae;Lee, Hyung-Seok
    • Korean Journal of Head & Neck Oncology
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    • v.23 no.1
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    • pp.15-20
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    • 2007
  • Background and Objectives:Supraglottic partial laryngectomy is oncologically sound surgical procedure for selected cases of laryngeal cancer which maintains physiologic speech and swallowing without permanent tracheostoma. The purpose of this study is to evaluate the oncologic and functional results of supraglottic partial laryngectomy and neck dissection for supraglottic cancer. Materials and Methods:Between 1991-2005, Twenty-three supraglottic cancer patients, underwent supraglottic partial laryngectomy, were studied retrospectively. There were 5 patients with cT1, 14 with cT2, 4 with cT3 and 11 patients with cN0, 1 with cN1, 10 with cN2, 1 with cN3. All patients underwent neck dissection and postoperative radiotherapy was added to twenty patients. They were reviewed with respect to primary subsites, extended subsites, treatment result, survival rate, factors affecting the prognosis, postoperative complication, time of decannulation and oral diet, and postoperative voice. Results:Among eleven patients with clinically negative node, six patients had pathologically positive nodes. So occult metastasis was 54.5%. Two patients recurred at cervical lymph node and one had distant metastasis to lung. Local and regional control were 100% and 91.3%. The overall 3-year and 5-year survival rate were 84%, 78%, respectively. Nineteen cases were squamous cell carcinomas and four were basaloid squamous cell carcinomas. Basaloid subtype was significantly affected to survival. Decannulation and oral feeding were possible in 100%. Conclusions:Supraglottic partial laryngectomy is oncologically safe and functionally good procedure in supraglottic cancers. Elective neck dissection is beneficial in management of occult cervical metastasis.

Value of Postoperative Radiation Therapy for Regional Control after Dissection in Head and Neck Squamous Cell Carcinoma Cases

  • Li, Xiao-Ming;Di, Bin;Shang, Yao-Dong;Tao, Zhen-Feng;Cheng, Ji-Min;He, Zhan-Guo
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.7
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    • pp.4273-4278
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    • 2013
  • Objective: We aimed to define clinicopathologic risk factors associated with regional recurrence (RR) and thus the effectiveness of postoperative radiotherapy (PORT) for neck control for head and neck squamous cell carcinomas (HNSCCs) with differing cervical lymph node status. Methods: A retrospective study was performed in 196 HNSCC patients with pathologically positive neck node (N+) to evaluate the high-risk factors for RR and to define the role of PORT in control after neck dissection and postoperative radiotherapy (PORT). Results: Overall, the RR rate after neck dissection and PORT was 29%. Extracapsular spread (ECS) was confirmed to be the only independent risk factor for RR. There were no significant risk factors associated with RR in the ECS- group. The 5-year disease-specific survival rate was 45%, which descended to 10% with the emergence of RR. Conclusions: ECS remains a determined risk factor for RR after neck dissection and PORT in patients with N+. PORT alone is not adequate for preventing RR in the neck with ECS after neck dissection. More intensive postoperative adjuvant therapies, especially combined chemotherapy and radiotherapy, are needed to prevent regional failure in HNSCC patients with ECS.

A Case of Parotid Metastasis from Sebaceous Carcinoma of the Eyelids (이하선으로 전이된 안검의 피지샘 암종 1예)

  • Chae, Hee Sung;Yang, Hui Joon;Paik, Seung Won;Kim, Ji-Hoon
    • Korean Journal of Head & Neck Oncology
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    • v.36 no.2
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    • pp.21-25
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    • 2020
  • Sebaceous carcinoma is a relatively rare and aggressive malignant tumor. Periocular area (especially eyelid) is the most common lesion to occur, and the most common extraocular lesion is the parotid gland. Because the lesion also mimic other benign inflammatory diseases, this leads to delayed diagnosis or misdiagnosis. Here, we report a 58-year-old male patient who presented with a non-tender painless left parotid mass after wide excision of sebaceous carcinoma in the left eyelid two years ago. When he was diagnosed with sebaceous carcinoma of left eyelid, there was a small left parotid tumor on the computed tomography. But no further examination and treatment were performed. Two years later, physical examination revealed growing parotid tumor and multiple neck nodes on the left side. After radical parotidectomy and neck dissection, histological examination showed a sebaceous carcinoma and neck node metastasis. Considering the aggressiveness of sebaceous carcinoma, further evaluation for parotid glands should be considered when sebaceous carcinoma of the eyelid was discovered. Postoperative chemoradiotherapy was performed for disease control. Follow up after two years, and computed tomography showed no sign of recurrence.

Prognostic value of $^{18}F$-fluorodeoxyglucose positron emission tomography, computed tomography and magnetic resonance imaging in oral cavity squamous cell carcinoma with pathologically positive neck lymph node

  • Jwa, Eunjin;Lee, Sang-Wook;Kim, Jae-Seung;Park, Jin Hong;Kim, Su Ssan;Kim, Young Seok;Yoon, Sang Min;Song, Si Yeol;Kim, Jong Hoon;Choi, Eun Kyung;Ahn, Seung Do
    • Radiation Oncology Journal
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    • v.30 no.4
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    • pp.173-181
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    • 2012
  • Purpose: To evaluate the prognostic value of preoperative neck lymph node (LN) assessment with $^{18}F$-fluorodeoxyglucose positron emission tomography ($^{18}F$-FDG PET), computed tomography (CT), and magnetic resonance imaging (MRI) in oral cavity squamous cell carcinoma (OSCC) patients with pathologically positive LN. Materials and Methods: In total, 47 OSCC patients with pathologically positive LN were retrospectively reviewed with preoperative $^{18}F$-FDG PET and CT/MRI. All patients underwent surgical resection, neck dissection and postoperative adjuvant radiotherapy and/or chemotherapy between March 2002 and October 2010. Histologic correlation was performed for findings of $^{18}F$-FDG PET and CT/MRI. Results: Thirty-six (76.6%) of 47 cases were correctly diagnosed with neck LN metastasis by $^{18}F$-FDG PET and 32 (68.1%) of 47 cases were correctly diagnosed by CT/MRI. Follow-up ranged from 20 to 114 months (median, 56 months). Clinically negative nodal status evaluated by $^{18}F$-FDG PET or CT/MRI revealed a trend toward better clinical outcomes in terms of overall survival, disease-free survival, local recurrence-free survival, regional nodal recurrence-free survival, and distant metastasis-free survival rates even though the trends were not statistically significant. However, there was no impact of neck node standardized uptake value ($SUV_{max}$) on clinical outcomes. Notably, $SUV_{max}$ showed significant correlation with tumor size in LN (p < 0.01, $R^2$ = 0.62). PET and CT/MRI status of LN also had significant correlation with the size of intranodal tumor deposit (p < 0.05, $R^2$ = 0.37 and p < 0.01, $R^2$ = 0.48, respectively). Conclusion: $^{18}F$-FDG PET and CT/MRI at the neck LNs might improve risk stratification in OSCC patients with pathologically positive neck LN in this study, even without significant prognostic value of $SUV_{max}$.

A Case of Papillary Thyroid Carcinoma Arising in Thyroglossal Duct Cyst (갑상설관 낭종에서 발생한 유두상 선암 1예)

  • Lee Kyoung-Keun;Ahn Hae-Sun;Lee Kwang-Man
    • Korean Journal of Head & Neck Oncology
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    • v.16 no.1
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    • pp.83-86
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    • 2000
  • Thyroglossal duct cyst is common midline mass, which is related to hyoid bone and may show signs of inflammation. Carcinoma arising in the thyroglossal duct cyst is rare, occuring in less than 1% of thyroglossal duct cyst. Papillary adenocarcinoma is the most common histologic type(75-85%). The initial treatement of choice is wide excision of the tumor bearing tissue(Sistrunk procedure), resection of associated lymph node alone is enough when they are small and isolated, but a modified neck dissection must be done if regional involvement is more extensive. Its prognosis is excellent(the incidence of regional lymph node metastasis is 7% compare to 89% for papillary cancer of thyroid gland proper).

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