• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.31 no.2
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• pp.170-177
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• 2005

The pleomorphic adenoma is well recognized as the most common salivary neoplasm. We examined 49 patients who had received surgical excision of the pleomorphic adenoma from 1989 to 1998 with over 5 years follow-up period. We retrospectively evaluated the patients' age, sex, chief complaints, surgical methods, and recurrence or complication rates after analysis of one's clinical and surgical records. The results are as follows : 1. There were 15 cases in parotid gland, 23 cases in palate, 8 cases in submandibular gland, and 3 cases in cheek. The ratio of male to female was 1 : 1.13. The mean age was 44. The tumor of submandibular gland occurred in more younger age than that of other salivary gland. 2. In 15 patients of parotid pleomorphic adenoma, there was 1 case(6.7%, 1/15) of recurrence. That was transformed into the malignant pleomorphic adenoma after 4 years of first surgery. We performed superficial parotidectomy of 9 cases(56.2%, 9/16), total parotidectomy of 6 cases(37.5%, 6/16), and radical parotidectomy of 1 case(6.3%, 1/16). 3. We used the rotational Sternocleidomastoid muscular flap to cover the exposed facial nerve in 12 cases(75%) after parotidectomy(7 cases of superficial parotidectomy and 5 cases of total parotidectomy). We could see 3 cases(18.7%) of facial nerve palsy and 1 case(6.3%) of Frey's syndrome after parotidectomy. We examined Frey's syndrome in only 1 case which was not used SCM muscular flap after parotidectomy. 4. In 23 patients of palatal pleomorphic adenoma, there were 2 cases(8.7%) of recurrence. In recurrence cases, We performed re-excision after 4 and 5 years of first surgery, respectively. We preserved partial thin overlying palatal mucosa during tumor excision in 5 cases(20%), which were proved as benign mixed tumor in preoperative biopsy. That mucosa-preserved cases had thick palatal mucosa, did not show mucosa ulceration and revealed well encapsulated lesions in preoperative CT. 5. In palatal tumors, we could see the 13 cases(52%) of bony invasion in preoperative CT views and the 4 cases(16%) of oro-nasal fistula after tumor excision. In two cases of recurrence, one(20%, 1/5) was in palatal mucosa-preserved group and the other(5.5%, 1/18) was in palatal mucosa-excised group. 6. We excised tumors with submandibular glands in the all cases of submandibular pleomorphic adenoma. There was no specific complication or recurrence in these cases. 7. After excision of the cheek pleomorphic adenomas, we could not see any complication or recurrence.

• Korean Journal of Head & Neck Oncology
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• v.9 no.1
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• pp.91-97
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• 1993

The salivary gland consists of major and minor glands. The major glands are parotid, submandibular and sublingual glands. The numerous minor salivary glands are located in the mucosa of the upper aerodigestive tracts. Tumors of the salivary gland are relatively uncommon, and the incidence of the salivary gland tumor among the head and neck neoplasm is approximately 3%. Surgery is the primary treatment of choice for the most tumors of the salivary glands. Author reviewed the recent reports of salivary gland neoplasms of Korea and foreign institutes and suggest the guideline of managemnt of salivary gland tumors.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.6
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• pp.545-550
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• 2004

Salivary glands, major and minor, are susceptible to a wide variety of pathologic conditions. Excision of the submandibular gland is a surgical procedure often undertaken. The procedure is the treatment of choice for patients with neoplasm of the submandibular gland and those with non-neoplastic submandibular disorders which are not controlled with conservative medical measures. Extirpation of the submandibular gland may also be undertaken for diagnostic purposes. We evaluated 84 patients who had been admitted to the dept. of oral and maxillofacial surgery of Pusan National University Hospital from January, 1989 to December, 2002 and had been performed submandibular gland excision. The results are as follows : 1. The patients undertaken the excision of the submandibular gland showed an age range of 16 to 71 years. The average was 49.1. 2. They consisted of 60 males(71.4%) and 24 females(28.6%), having 2.5 : 1 of genda ratio. 3. The most common symptom was swelling in 41 cases(48.8%), followed by the pain in 23 cases(27.4%). Other symptoms included mass, dysphagia, facial abnormaly and neck dyscinesia. 4. 42 cases(50.0%) showed sialadenitis and sialodochitis associated with salivary calculus. 5. According to the histopathologic study, all cases consisted of 17 neoplasmatic conditions(20.3%) and 67 non-neoplasmatic(79.7%). The neoplasmatic cases included 13 benign tumors and 4 primary malignant tumors. Sialadenitis and sialodochitis associated with or without salivary calculus were most marked, found in 50 cases(59.3%), in the non-neoplasmatic conditions. Pleoomorphic adenoma showed the highest frequency of the benign tumor.

• Korean Journal of Head & Neck Oncology
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• v.14 no.1
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• pp.40-45
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• 1998

Backgroud and Objectives: Major salivary gland tumor is a rare disease with a largely unknown origin. And also corresponding to the diversity of histopathologic characteristics is an equally wide distribution of clinical behavior that makes treatment decisions difficult. The aim of this study is to analysis the clinical experience of our major salivary gland tumor and to suggest a guidline of management. Materials and Methods : We studied clinical manifestations and treatment results of 104 patients who were diagnosed as major salivary gland tumors. Tumor site, patient age and sex of the patients were analysed. Histopathologic diagnosis, treatment modality, lymph nodes metastasis, recurrence rate and 5-year survival rate were studied on malignant tumors. Results: 1) 48 patients were male and 56 patients were female. 2) Benign tumors were 79 cases. They consisted of 57 cases(72%) of parotid tumor, 22 cases(27%) of submandibular tumor. And pleomorphic adenoma was the most common benign tumor. 3) Malignant tumors were 25 cases and were consisted of 19 cases(76%) of parotid tumor, 4 cases(l6%) of submandibular tumor and 2 cases(8%) of sublingual gland tumor with high-grade mucoepidermoid carcinoma as the most common cause. 4) In the malignant tumors, the number of stage I, II tumors was 14 and that of stage III, IV tumors was 11. Neck node metastasis was noted in 8 cases. 5) 8 cases of malignant tumor were died and all of them had high-grade malignancy. And they were dead before 17 months from the time of diagnosis. 6) Mean survival duration in the malignant salivary gland tumor was 56 months. 7) High-grade malignancy had a 5-year survival rate of 57.9%. A 5-year survival rate of TI, T2 patients was 92.9% and that of T3, T4 patients was 36.4%. That of patients who had neck node metastasis was 37.5% and that of those who had tree neck was 82.4%. Conclusion: The results of this study suggest that the survival rate is dependent on the tumor size, lymph node matastasis and histologic grade. And also the early diagnosis and radical surgery result in the increased survival rate and are effective for prevention of the tumor recurrance.

• Archives of Plastic Surgery
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• v.34 no.2
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• pp.261-264
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• 2007

Purpose: Extranodal marginal zone B cell lymphoma of MALT type represents approximately 8% of non-Hodgkin's lymphomas and this lymphoma is present in extranodal sites. Although the presentation of this lymphomain in stomach is usually associated with H. pylori infection in 95% of cases, MALT lymphoma found in soft tissue has been reported very rarely in the field of plastic surgery. We report a case of MALT lymphoma in the submandibular gland without any involvement of other organs such as the stomach. Methods: A 49-year-old man complained of a huge neck mass sized about $10{\times}12cm$. It started about 2 years ago and grew rapidly for the late 6 months. It was of hard nature with erythematous skin overlying it. Under the diagnosis of possible malignant lymphoma or sarcoma, radical resection was performed and the defect was reconstructed using transverse rectus abdominis musculocutaneous free flap. Results: The mass was well demarcated from the normal tissue, $11{\times}10.5{\times}10cm$ in size and whitish-gray color. Immunohistochemical analysis demonstrated that the tumor cells were LCA(+), CD20(+), CD3(-) and CD5(-). The tumor was diagnosed as extranodal marginal zone B cell lymphoma. The patient was treated with prophylactic radiation therapy after surgery, there was no complication for 1 year. Conclusion: We reported that very rare form of MALT lymphoma in 49-year-old male patient was experienced with clinical characteristics, histologic features and references.

• Imaging Science in Dentistry
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• v.36 no.4
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• pp.217-220
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• 2006

The review of the literature determines that large osteomas of the mandible are relatively rare. We present a case of a 60-year-old man with painless swelling of the left submandibular area and mild difficulty in breathing. The patient complained that the mass have been progressing slowly for at least 20 years. Radiographic studies showed a giant osteoma that attached to the lingual surface of the left mandibular angle and extended from submandibular space to infratemporal space. After the excision of the tumor the patient made a full recovery.

• Journal of Korean Neurosurgical Society
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• v.39 no.3
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• pp.231-233
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• 2006

The C2 level is the transition zone between the cranial and cervical spine. Because of its high position and anatomic relationship to vital structures, exposing C2 is challenging and the surgical approach is controversial. We report a of a recurred chordoma in C2 portion, occupying the osseous intraspinal portion. The patient underwent total corpectomy of C3 and gross total removal of tumor by right submandibular approach 3 years previously. We performed a lateral extrapharyngeal approach from contralateral left side with resection C2 central portion followed by gross total removal of mass and placement of graft bone. Although there was transient hypoglossal nerve palsy postoperatively, the patient had full recovery.

• Korean Journal of Head & Neck Oncology
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• v.20 no.2
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• pp.189-193
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• 2004

Basaloid squamous carcinoma (BSC) is an uncommon aggressive variant of squamous cell carcinoma with a predilection for hypopharynx, tongue base, and larynx. We present 5 cases of BSC of unusual sites, each from maxillary sinus, external auditory canal, submandibular gland, tonsil, and nasopharynx. Only a few cases arising in these sites have been reported to date. Patients included 3 men and 2 women with the age range of 45-69 years (mean, 56.4 years). Microscopically, the tumors were characterized by solid lobules and nests of ovoid basaloid cells with abundant desmoplastic stroma. Comedonecrosis, peripheral palisading of tumor cells, trabecular pattern, and rosette-like arrangement were commonly observed. Tumor cells had scanty cytoplasm and their nuclei were ovoid, relatively uniform, and hyperchromatic. In two cases, concomitant squamous cell carcinoma in situ was identified. Immunohistochemical stains revealed that tumor cells were strongly positive for pancytokeratin and negative or weakly positive for p63. Being aware of BSC that can arise from unusual sites would help diagnose correctly and treat properly this rare and distinct clinicopathologic entity.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1993.05a
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• pp.96-96
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• 1993

Because of the diversity of tumor types and the relative rarity of salivary gland neoplasm, exact diagnosis and treatment decision have been difficult. Seventy cases of salivary gland tumors which were diagnosed at our hospital from January 1981 to December 1992 were reviewed according to age, sex, site, presenting symptoms, staging, histology, and outcome, retrospectively. The following results were obtained ; 1) Of all salivary gland tumors, 35 cases(50%) arose in the parotid gland, 16 cases(23%) in the submandibular gland, and 19 cases(27%) in the minor salivary glands. 2) There were 55(79%) benign tumors, and 15(21 %) malignant tumors. The most frequent benign tumor was pleomorphic adenoma(89%), and malignant tumor was adenoid cystic carcinoma(40%). 3) The symptoms varied in duration from several weeks to 26 years. 29 cases(41 %) had symptoms for one to five years. 4) Among the parotid and submandibular glands, postoperative facial nerve paralysis was occurred 9 cases(18%). Recurrence was seen in 4 cases(6%).

• Korean Journal of Head & Neck Oncology
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• v.9 no.1
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• pp.74-87
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• 1993

Immunohistochemical studies on S-100 protein and lactoferrin were carried out to evaluate the existence and distribution pattern of S-100 protein and lactoferrin positive cells in salivary gland tumors. The specimens used were 25 cases of pleomorphic adenoma, 2 cases of monomorphic adenoma, 2 cases of mucoepidermoid tumor, 2 cases of acinic cell tumor, 3 cases of adenoid cystic carcinoma and 2 cases of adenocarcinoma occured in parotid and submandibular salivary gland. ABC kits(Dako corp. Copenhagen. Denmark) for S-100 protein and lactoferrin were used. The results obtained were summarized as follows: In the normal salivary gland. positive immunoreaction for S-100 protein was observed in myoepithelial cells of acini and intercalated ducts. Positive immunoreaction for lactoferrin was observed in serous acinic cells, epithelial cells of intercalated ducts, and excretory material in the ductal lumina. In the pleomorphic and monomorphic adenomas. most of tumor cells were positive for S-100 protein, while luminal tumor cells in gland-like or duct-like structures were rarely positive for lactoferrin. In mucoepidermoid tumor, most of squamous cells and a few of intermediate cells were positive for S-100 protein, but all of tumor cells were negative for lactoferrin. In acinic cell tumor, most of tumor cells were positive for lactoferrin, but all of tumor cells were negative for S-100 protein. In adenoid cystic carcinoma, basaloid tumor cells in trabecular structure were focally positive for S-100 protein. and in adenocarcinoma, many of tumor cells were posivive for both S-100 protein and lactoferrin. Thus, according to the embryonic stage of the development of the tumor cell origin, it was possible to classify the salivary gland tumor as followings: mucoepidermoid carcinoma which originated from the earliest stage, acinic cell tumor which originated from the end stage. Between these two extremes, there were pleomorphic adenoma, adenoid cystic carcinoma and adenocarcinoma which originated in the middle stage of the development of .the salivary glands. Based on the above results, it can be stated that S-100 protein is demonstrated in tumor cells orginated from myoepithelial cells and lactoferrin in glandular differentiated tumor cells.