• Title/Summary/Keyword: adenoma

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Recurrent Pleomorphic Adenomas of the Parotid Gland (재발성 이하선 다형성 선종)

  • Huh H.;Chung Woung-Yoon;Yoon Jong-Ho;Chang Hang-Seok;Park Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.19 no.1
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    • pp.3-8
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    • 2003
  • Background: Surgical management of recurrent pleomorphic adenoma of the parotid gland has a considerable risk of facial nerve injury and a high re-recurrence rate. To obtain more insight into the issue of recurrent pleomorphic adenoma and more specifically to evaluate our experience and results of treatment, a retrospective study was carried out. Materials and Methods: During the period from 1989 to 2002, the medical records of 14 patients who underwent a operation for recurrent pleomorphic adenoma of the parotid gland were reviewed retrospectively. The initial operation for parotid tumor, clinical features of recurrence, reoperation after recurrence, po stop complication were analysed. Results: The male to female ratio was 6 : 9. Median age of the patients at the time of the initial operation was 33 years and at the time of the reoperation was 43 years. The median interval until recurrence was 105 months (6-252 months). The initial operations performed were excision or enucleation in 10 patients, superficial parotidectomy in 3 patients, total parotidectmy in 1 patients. The thirteen patients were underwent reoperation (8 superficial parotidectomies, 3 total parotidectomies, 1 neartotal parotidectomy, 1 wide excision). The facial nerve paralysis after the reoperation occured in 6 patients but all of them were recovered from 3 months to 1 year after surgery. Conclusion: In the management of pleomorphic adenoma of the parotid gland, excision or enucleation is to be avoided due to the higher recurrence rate and superficial or total parotidectomy with preservation of the facial nerve are to be preferred. Because the risk of facial nerve injury during operation for the recurrent tumor was higher than initial surgery, more careful surgical procedure is mandatory for preserving the facial nerve.

Results of Endoscopic Surgery in Patients with Pituitary Adenomas : Association of Tumor Classification Grades with Resection, Remission, and Complication Rates

  • Erkan, Buruc;Barut, Ozan;Akbas, Ahmet;Akpinar, Ebubekir;Akdeniz, Yasemin Sefika;Tanriverdi, Osman;Gunaldi, Omur
    • Journal of Korean Neurosurgical Society
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    • v.64 no.4
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    • pp.608-618
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    • 2021
  • Objective : The endoscopic endonasal transsphenoidal approach is a widely-used method for the surgical treatment of pituitary adenomas. We aimed to evaluate the results of endoscopic surgery by comparing preoperative classification methods and investigating their relationship with postoperative resection and remission rates and complications. Methods : We retrospectively reviewed the medical records of 236 patients (118 males) who underwent surgery for pituitary adenomas. Preoperative Knosp classification, tumor size (TS), suprasellar extension (SSE), postoperative resection and remission rates, and complications were evaluated. Results : The follow-up period was 3 months to 6 years. The patients' ages ranged between 16 and 84 years. Endocrinologically, 114 patients (48.3%) had functional adenoma (FA), and 122 patients (51.7%) had non-functional adenoma (NFA). Among the FA group, 92 (80.7%) showed remission. A statistically significant difference was found between patients with and without remission in terms of the Knosp, TS, and SSE classifications (p<0.01). Knosp, TS, and SSE classification grades were found to be correlated with the resection rates (p<0.01). Meningitis was seen in seven patients (3.0%), diabetes insipidus in 16 (6.9%; permanently in two [0.9%]), and rhinorrhea in 19 (8.1%). Thirty-six patients (15.3%) developed pituitary insufficiency and received hormone replacement therapy. Conclusion : The resection categories and remission rates of FAs were directly proportional to the adenoma sizes and Knosp grades, while the degree of suprasellar growth further complicated resection and remission rates. Adenoma sizes less than 2 cm and SSEs less than 1 cm are associated with favorable remission and resection rates.

A Case of Intra-thyroidal Parathyroid Adenoma Confirmed by Intraoperative Near-infrared Autofluorescence (수술 중 근적외선 자가형광으로 확인된 갑상선 내부의 부갑상선 선종 1예)

  • Dong Gyu Choi;Jun Sang Cha;Yeong Joon Kim;Hyoung Shin Lee;Kang Dae Lee
    • Korean Journal of Head & Neck Oncology
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    • v.39 no.1
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    • pp.53-57
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    • 2023
  • In general, the anatomical location and number of parathyroid glands are well known, but they are often found in a variety of locations, making it difficult to find parathyroid glands during surgery. Besides Intra-thyroidal parathyroid adenoma is extremely rare case, and it is harder to identify in surgery. We encountered a 51-year-old patient with a thyroid nodule. The results of the additional blood test and the Tc-99m MIBI were combined to determine that the left lower lobe parathyroid adenoma was highly likely. This patient was treated with left thyroid lobectomy with parathyroid identification using Near-infrared (NIR) imaging. Afterwards, the biopsy confirmed that it was a parathyroid adenoma, and has since been monitored through outpatient observation without any problem. We present this rare case with a review of related literatures.

Pleomorphic Adenoma of the Upper Lip: A Case Report (윗 입술에서 발생한 다형선종: 증례보고)

  • Tae Hyun Kim;Seong Heum Jeong;Chung Hun Kim
    • Korean Journal of Head & Neck Oncology
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    • v.40 no.1
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    • pp.33-36
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    • 2024
  • Pleomorphic adenoma (PA) is a commonly occurring benign tumor originating in the salivary glands. The incidence is mostly in the parotid glands (85%) followed by minor salivary glands (10%). Pleomorphic adenoma from minor salivary glands of the lips is a rare neoplasm. Here, we present a case of a patient with PA in the upper lip, reporting a common neoplasm in a rare site. A 82-year-old male with a slowly progressing swelling that occurred 20years ago on the upper white lip. This tumor is not associated with pain and tenderness. The mass was about 1.5x1.5cm sized, circumscribed, sessile and firm on the external upper lip without oral side bulging (Fig. 1). The tumor was removed completely with a elliptical incision under local anesthesia. The encapsulated mass was measured 0.9x0.9x0.6cm. On histology, a well-circumscribed growth was seen comprising epithelial and stromal components. The epithelial component formed glandular structures lined by round-to oval cells having small nuclei, pink cytoplasm and myoepithelial basal cell layer while the stroma had a fibromyxoid appearance(Fig. 2). Postoperatively wound was well healed without recurrence after 6months. Pleomorphic adenoma of the upper lip is a rare neoplasm, especially not intraoral growth. For aesthetic good result, the mass was removed without hesitation. It is required a high index of suspicion and a long-term follow-up because it could recur and rarely be transformed into malignancy.

The Efficacy of Aspirin in Preventing the Recurrence of Colorectal Adenoma: a Renewed Meta-Analysis of Randomized Trials

  • Zhao, Tai-Yun;Tu, Jing;Wang, Yin;Cheng, Da-Wei;Gao, Xian-Kui;Luo, Hao;Yan, Bi-Chun;Xu, Xiao-Li;Zhang, Hong-Ling;Lu, Xing-Jun;Wang, Yao-Jun
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.5
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    • pp.2711-2717
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    • 2016
  • Background: Through search the possible randomized control trials, we make a renewed meta-analysis in order to assess the impact of aspirin in preventing the recurrence of colorectal adenoma. Materials and Methods: The Medicine/PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Chinese biomedical literature service system (SinoMed) databases were searched for the related randomized controlled trials until to the April 2016. Three different authors respectively evaluated the quality of studies and extracted data, and we used the STATA software to analyze, investigate heterogeneity between the data, using the fixed-effects model to calculate and merge data. Results: 7 papers were included the renewed meta-analysis, among these studies, two pairs were identified as representing the same study population, with the only difference being the duration of follow-up. Thus there were only five papers included our meta-analysis, and one Chinese paper were also included the work. Results were categorized by the length of follow-up, different kinds of people, varied dose of oral aspirin. The relative of adenoma in patients taking aspirin vs placebo were 0.73 (95% CI 0.55-0.98, P=0.039) with 1 year follow up; 0.84 (95% CI 0.72-0.98, P=0.484) with greater than 1 year follow up; for the advanced adenoma, the RR 0.68 (95% CI 0.49-0.94, P=0.582),for one year; RR=0.75 (95% CI 0.52-1.07, P=0.552) for greater one year. Furthermore the white population could divided into two subgroups according to the different length of follow-up time. When the length of follow-up time less than 3-year, The RR of two subgroups respective were RR=0.86 (95% CI 0.76-0.98, P=0.332), $I^2=0%$, RR=0.68 (95% CI 0.47-0.98, P=0.552), $I^2=64.6%$, But with the extension of follow-up time greater than 2-year, with the white, oral aspirin without considering dose had no efficacy on preventing the recurrence of any adenoma, the RR was 0.86 (95% CI 0.71-1.05, P=0.302), $I^2=16.4%$. Conclusions: This meta-analysis indicated that oral aspirin is associated with a remarkable decrease in the recurrence of any adenoma and advanced adenomas in patients follow-up for 1 year without concerning the dose of aspirin, but with the extension of follow-up time for greater than 1 year, oral aspirin can be effective on preventing the recurrence of any adenoma, but for the advanced adenoma, the result indicated that oral aspirin had no efficacy, According to the inclusion of ethnic groups, we also divided relevant papers into two subgroups as the yellow and white group. Then the follow-up time was less than 3 years, oral aspirin without considering the dose, had an significant efficacy on preventing the recurrence of any adenoma. But with the follow-up greater than 2 years, oral aspirin had no effect in the white.

Preoperative Extrapontine Myelinolysis with Good Outcome in a Patient with Pituitary Adenoma

  • Zhou, Ying;Zhu, Yicheng;Wang, Wenze;Xing, Bing
    • Journal of Korean Neurosurgical Society
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    • v.59 no.2
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    • pp.161-164
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    • 2016
  • Few preoperative extrapontine myelinolysis (EPM) cases with pituitary adenoma have been reported. No such case had long follow-up to see the outcome of EPM. We reported a 38-year-old man complaining of nausea, malaise and transient loss of consciousness who was found to have severe hyponatremia. Neurologic deficits including altered mental status, behavioral disturbances, dysarthria and dysphagia developed despite slow correction of hyponatremia. Endocrine and imaging studies revealed hypopituitarism, nonfunctional pituitary macroadenoma and extrapontine myelinolysis. Transsphenoidal surgery was performed after three weeks of supportive therapy, when neurological symptoms improved significantly. The patient recovered function completely 3 months after surgery. Our case indicates that outcome of EPM can be good even with prolonged periods of severe neurologic impairment.

Adenocarcinoma with Pleomorphic adenoma of the Parotid gland - A case report - (혼합종과 병존한 이하선의 악성 선암 그예)

  • Yoon Jung-Han;JeGal Young-Jong
    • Korean Journal of Head & Neck Oncology
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    • v.5 no.1
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    • pp.21-25
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    • 1989
  • It is frequently difficult to assess the presence of malignancy in patients with parotid tumor, because of unreliable diagnostic tools and riskful preoperative biopsy, In our case, a parotid adenocarcinoma and pleomorphic adenoma was revealed on permanent histologic section, which was made a impression as pleomorphic adenoma on preoperative Tru-Cut biopsy and intraoperative frozen section, So, the most accurate diagnosis of the parotid malignancy is a complete removal of tumor tissue, accompanied with permanent histologic section.

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A Case of NRRL(Non-Recurrent Recurrent Laryngeal Nerve) in a Patient with the Parathyroid Adenoma (부갑상선 선종 수술시 관찰된 비회귀성 반회후두신경 (Non-Recurrent Recurrent Laryngeal Nerve) 1례)

  • 한수진;임재열;박헌이;최홍식
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.11 no.2
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    • pp.188-191
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    • 2000
  • In thyroid and parathyroid surgery, damage to the recurrent laryngeal nerve(RLN) is the most common iatrogenic cause of vocal cord paralysis. Identification and preservation of the BLNs and meticulous technique can siginificantly decrease the incidence of this complication. We experienced one case of NRRLN in a patient with the parathyroid adenoma. During the dissection, there was no branch to be considered as RLN in tracheoesophageal groove. While searching for the RLN, We found a white structure coursing horizontally at the level of cricoid cartilage directly arising from the vagus nerve in the carotid sheath. That structure was nonrecurrent recurrent laryngeal nerve(NRRLN) and NRRLNs are exceedingly rare. Awareness of the possibility of NRRLN will prevent the surgeon from accidentally severing one if it is encountered during surgery.

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Histopathological observation on the uterus and ovary of rats and mice treated with Ivermectin (Ivermectin을 투여한 rat와 mouse의 자궁 및 난소에 대한 병리조직학적 관찰)

  • Cho, Yoo-joung;Lee, Cha-soo
    • Korean Journal of Veterinary Research
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    • v.36 no.2
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    • pp.429-440
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    • 1996
  • In order to know morphological changes on the female genital organs by Ivermectin(IVM) administration, the histopathological observation was carried out in the organs of rat and mouse treated with the overdose of IVM. In the microscopical findings of the uterus, there were many mitotic figures, epithelial hyperplasia and papillary foldings in the endometrial surface. The increased prevalance of uterine glands, uterine epithelia and glands hyperplasia were markedly presented on diverse patterns adenoma-like structure and single nodular or multiple polyp-like adenoma. In ovary, primary and mature follicles were decreased in number, and hypoplasia of ovarian follicles, atretic follicles, follicular cysts and ovarian atropy were observed. It was considered that IVM administration resulted in follicular hypoplasia and atropy of ovary, and hyperplasia of uterine gland and endometrial surface epithelium might be transformed to neoplasia of glandular structures.

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Incidental Superior Hypophygeal Artery Aneurysm Embedded within Pituitary Adenoma

  • Choi, Hong-Seok;Kim, Min-Su;Jung, Young-Jin;Kim, Oh-Lyong
    • Journal of Korean Neurosurgical Society
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    • v.54 no.3
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    • pp.250-252
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    • 2013
  • Intra-cranial aneurysm can be incidental findings in patients with pituitary adenomas, and are usually located outside the pituitary region. However, the coexistence of intrasellar (not intracranial) aneurysms with pituitary adenomas is extremely rare. We report a patient with an incidental superior hypophygeal aneurysm embedded within a non-functional pituitary adenoma which was treated by transsphenoidal surgery after endovascular coil embolization.