• International journal of thyroidology
• /
• v.11 no.2
• /
• pp.117-122
• /
• 2018

Metastases to regional cervical lymph nodes occur frequently in patients with thyroid cancer. The appropriate management of regional lymph node is important to achieve good disease control and to classify risk stratification for adjuvant radioactive iodine. However, there are some occasions that neck dissection is difficult and embarrassing in thyroid cancer. Especially, extensive or unusual nodal metastases bring challenges and makes neck dissection more difficult. Carotid artery management is one of the most difficult procedure in neck dissection. The management of patients who have persistent or recurrent cervical metastasis involving the carotid artery has been controversial and treatment dilemma to the surgeon. Metastasis of well differentiated thyroid cancer to the retropharyngeal lymph nodes is rare but occasionally encountered. The complete surgical excision is usually recommended for retropharyngeal lymph node metastasis of well differentiated thyroid cancer. An extensive mediastinal dissection in advanced differentiated thyroid carcinoma is occasionally required. This paper will review recent reports of management of advanced nodal metastasis of thyroid cancer and share the author's personal experience.

• Korean Journal of Head & Neck Oncology
• /
• v.32 no.2
• /
• pp.23-27
• /
• 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.

• Journal of Gastric Cancer
• /
• v.13 no.3
• /
• pp.192-195
• /
• 2013

Gastrointestinal stromal tumor is a rare tumor which arises from the whole gastrointestinal tracts and most of it is detected in the stomach. It is uncommon with small intestine originated gastrointestinal stromal tumor and more uncommon with lymphatic metastasis. We experienced an unusual case of the small bowel gastrointestinal stromal tumor during experimental autopsy. Two primary tumors with central necrosis were detected in the ileum. The sizes of each tumor were $6.1{\times}3.4{\times}4.0$ cm and $3.7{\times}4.2{\times}3.2$ cm. There was extensive lymphatic metastasis on the greater omentum and mesenteric, iliac lymph nodes were also involved. With histologic findings, the eosinophilic spindle cells were densely distributed. Immunohistochemical findings were CD117 (-), CD34 (+), desmin (-), and S-100 protein (-). Therefore, we diagnosed the tumors as small bowel gastrointestinal stromal tumors with broad lymph node mestasis.

• Journal of Gastric Cancer
• /
• v.14 no.3
• /
• pp.207-210
• /
• 2014

The peritoneum is the most frequent site of recurrence for gastric cancer after gastrectomy, followed by the liver and lymph nodes. In contrast, metastasis to the thymus is rare. Annual surveillance with computed tomography was performed on a 67-year-old man who previously underwent a distal gastrectomy and D2 lymph node dissection for gastric cancer at Tottori University. Five years after the initial operation, an anterior mediastinal tumor was detected by computed tomography. The patient underwent video-assisted thoracic surgery to remove the tumor. Histopathology revealed adenocarcinoma cells similar to those of the gastric cancer resected 5 years previously. Thymic metastasis was considered likely based on the location of the tumor. The recognition that gastric cancer can metastasize to unusual anatomic locations, such as the thymus, can facilitate an accurate, prompt diagnosis and appropriate treatment.

• Korean Journal of Head & Neck Oncology
• /
• v.31 no.2
• /
• pp.39-42
• /
• 2015

Warthin's tumor is the second most common salivary gland benign tumor, typically occurring in the fifth to seventh decades of life which shows an indolent feature. It is usually found in the parotid gland but occasionally in extra-parotid locations such as peri-parotid lymph node. However, Report of solitary Warthin's tumor in cervical lymph node is unusual. We here report a case of 72-year-old male with simultaneous malignant melanoma on eyelid and cervical lymph node enlargement in cervical level II area thus mimicking malignancy metastasis. After excisional biopsy under the local anesthesia, pathology was reported as papillary cystadenoma lymphomatosum, which is a histologically pathognomic finding of Warthin's tumor. However, there was no suspicious tumorous lesion in major or minor salivary glands. This case suggests that Warthin's tumor should be considered as a possible pathology in solitary lymph node lesion of neck.

• Tuberculosis and Respiratory Diseases
• /
• v.42 no.4
• /
• pp.605-609
• /
• 1995

Primary leiomyosarcoma of the lung is very uncommon, and fewer than 50 cases now have been reported. Primary leiomyosarcoma of the lung resembles bronchogenic carcinoma in its clinical presentation and radiologic appearance. However, the former has some differences; younger onset than bronchogenic carcinoma, polypoid endobronchial growth, few positive cytologic examination of sputum and unusual lymph node metastasis. We experienced a case of primary leiomyosarcoma of the lung.

• Journal of Digestive Cancer Research
• /
• v.1 no.1
• /
• pp.48-51
• /
• 2013

We report an unusual case of postoperative early gastric cancer with liver metastasis mimicking pancreaticobiliary carcinoma. A 73-year-old man with early gastric cancer was transferred for endoscopic treatment. The patient underwent endoscopic submucosal dissection for the treatment of the early gastric cancer. The pathological diagnosis was adenocarcinoma with extension to the deep submucosa and some lymphatic invasion. Therefore, subsequent a subtotal gastrectomy was performed. The histological results demonstrated residual adenocarcinoma confined to the mucosa. The resection margin and lymph node metastasis were negative. Thus, he was closely monitored for recurrence every 6 months. After 2 years, he was suddenly suspected of developing liver metastasis and local recurrence. He received a liver biopsy, and the pathological result was poorly differentiated adenocarcinoma. Immunohistochemical staining suggested pancreaticobiliary carcinoma rather than metastatic adenocarcinoma from the stomach or colon, but primary focus was not found. We were sure that the recurrent stomach cancer metastasized to the liver because stomach cancer can show heterogeneous cytokeratin (CK) expression pattern with various histological features. Therefore, no single CK expression pattern has diagnostic value for distinguishing gastric carcinoma. The patient underwent chemotherapy for metastatic stomach cancer.