• Title/Summary/Keyword: cervical lymph node metastasis

Search Result 155, Processing Time 0.024 seconds

MR Imaging Findings of Uterine Cervical Adenocarcinoma (자궁경부 선암종의 자기공명영상 소견)

  • 김종철
    • Investigative Magnetic Resonance Imaging
    • /
    • v.2 no.1
    • /
    • pp.113-119
    • /
    • 1998
  • Purpose : Because adenocarcinomas of the uterine cervix have lower 5-year survival rate than squamous cell carcinomas due to early lymph node metastasis and local extension, scrutiny of lymph node metastasis and local extension by radiologic examination is necessary in case of clinically diagnosed or suspected adenocarcinomas. The purpose of this study is to evaluate whether there are specific findings of these tumors, compared with squamous cell carcinomas, through the analysis of magnetic resonance (MR) imaging findings. Materials and Methods : Of 21 pathologically proven cervical adenocarcinomas, MR imaging findings of 18 tumors (histologic staging : two Ib, four IIa, two IIb, one IIIa, and one IIIb) were retrospectively analyzed and compared with those of 40 wquamous cell carcinoma in consecutive patients as a control group. T1-wetighted and fast spin echo T2-weighted images were obtained on the axial and sagittal planes, using a 1.5-T MR scanner. The largest diameter, location, signal intensity and degree of contrast enhancement contour, shape and longitudinal extent of the tumor and associated findings on MR image were analyzed. Results : The largest diameters of cervical adenocarcinomas ranged from 0.8 to 4.1 cm(mean, 2.2 cm). Of 18 adenocarcinomas, nine were of endocervical type. All adenocarcinomas were isointense to surrounding cervical stroma on T1-weighted images and hyperintense(homogeneous in ten, inhomogeneous in eight) on fast spin echo T2-weighted images. Adenocarcinomas enhanced on contrast study in all patients (homogeneous in six, inhomogeneous in 12 with hyperintese enhnacing rim in two). Eight adenocarcinomas had smooth contours and ten had irregular ones. The shape of adenocarcinoma was irregular in eight patients, barrel shape in six, papillary/polypod in three, and nodular in one. All adenocarcinomas involved lower half of the uterine cervix and six tumors extended up to the upper half. Pelvic lymph nodes of more than 1.5cm in diameter in two adenocarcinomas pateints and no detectable small pelvic lymph nodes on MR imaging in one patient were pathologically positive. Hydrometra was associated in two adenocarcinomas patients, and hematometra in one patient. Compared with squamous cell carcinomas, more frequent MR findings of endocervical type and barrel shape in cervical adenocarcinomas were statistically significant. Conclusion : Cervical adenocarcinomas had more frequent MR findings of endocervical type and barrel shape, compared with wquamous cell carcinomas. Adenocarcinoma of the uterine cervix may be suspected on MR imaging, when a cervical carcinoma is of barrel shape along the endocervical canal and tends to involve lymth nodes in earlier stages.

  • PDF

Analysis of Treatment Failures in Early Uterine Cervical Cancer (조기 자궁경부 악성종양의 치료실패에 대한 분석)

  • Kim Joo-Young;Lee Kyu-Chan;Choi Hyung-Sun
    • Radiation Oncology Journal
    • /
    • v.9 no.2
    • /
    • pp.285-291
    • /
    • 1991
  • One hundred and twenty six patients with early uterine cervical cancer who had been treated at Departmen of Radiation Oncology of Korea University Hospital from Jan.1981 to Dec.1988 were analysed retrospectively by the treatment result and pattern of of failures. All patients had stage Ia to IIa disease and were grouped whether they had combination of operation and postop irradiation or radiation therapy alone. 1) Sixty six patients belonged to the combination treatment group and 60 patients to the radiation alone group. 2) Combination group consisted of $18.1\%$(12/66) stage Ia, $71.2\%$(47/66) stage Ib and $10.6\%$ (7/66) stage IIa patients. There were no stage Ia, 18.8$\%$(l1/60) stage Ib and 81.6$\%$(49/60) stage IIa patients for RT alone gronp. 3) There were total 23$\%$(29/126) treatment failures,13 patients in combination group and 16 patients in RT alone group. In 66 patients of combination group, they were found to have 5 locoregional failures, 7 distant failures and 1 at both sites. In 60 patients of RT alone group, 9 locoreginal failure and 7 distant failures occured. Eighty six percent (25/29) of total failures appeared within 18 month after completion of treatment. About 60$\%$ of the patients with regional recurrences which were located at pelvic side wall or pelvic lymph nodes paesented their recurrent disease after 1 year of completion of treatment, whereas same percent of distant failures appeared within 6 month. 5) In RT alone group, the first sites of distant failure were mostly para-aortic lymph node and/or left supraclavicular lymph node (71.4$\%$,5/7). In combination group, various sites such as inguinal lymph node, mediastinal lymph node, liver, lung and bone appeared first or at the same time with para-aortic and supraclavicular lymph node metastasis. 6) Logistic regression analysis was done for multivariate analysis of the factors contributing to locoregional and distant failures. In combination group, adequacy of the resection margin and the presence of positive pelvic node were found to be the most significant factors (p=0.0423 & 0.0060 respectively). In RT alone group, less than complete regression of the tumor at the end of treatment was the only significant contributing factor for the treatment failures (p=0.0013) with good liklihood ratio.

  • PDF

Expression of Vimentin and Ki-67 Proteins in Cervical Squamous Cell Carcinoma and their Relationships with Clinicopathological Features

  • Yu, Jian-Qin;Zhou, Qing;Zheng, Yun-Fei;Bao, Ying
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.16 no.10
    • /
    • pp.4271-4275
    • /
    • 2015
  • Objectives: To investigate the expression of vimentin and Ki-67 proteins in cervical squamous cell carcinoma (CSCC) and their relationships with patient clinicopathological features. Materials and Methods:Fifty-seven CSCC samples archived in Department of Pathology in the First Affiliated Hospital of Wenzhou Medical University were selected. The expression of vimentin and Ki-67 proteins in CSCC tissue were detected using immunohistochemical SP method, and correlations between them and their relationships with clinicopathological features were analyzed. Results: Among 57 CSCC tissues, there were 43 with positive expression of Vimentin, and the positive rate was 75.4%; there were 57 cases with positive expression of Ki-67, and the positive rate came up to 100.0%. The results of Pearson correlation analysis displayed that the expression of vimentin had a significantly-positive correlation with Ki-67 in CSCC tissue (r=0.984, co0.000). The expression of both Ki-67 and vimentin was intimately associated with the presence or absence of local invasion and lymph node metastasis as well as differentiated degrees of the tumor (P=0.003, 0.017, 0.000; P=0.001, 0.008, 0.003) instead of the age, tumor size and clinical staging (P>0.05). Conclusions: Epithelial-mesenchymal transition (EMT) tends to appear in poorly-differentiated CSCC tissue, and the up-regulation of vimentin expression is accompanied by high expression of Ki-67, suggesting that invasion and metastasis readily occur in these tumor cells.

Clinical Features and Prognosis of Patients with Benign Thyroid Disease Accompanied by an Incidental Papillary Carcinoma

  • Wang, Shi-Fu;Zhao, Wen-He;Wang, Wei-Bin;Teng, Xiao-Dong;Teng, Li-Song;Ma, Zhi-Min
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.14 no.2
    • /
    • pp.707-711
    • /
    • 2013
  • Purpose: To investigate the clinical features and prognosis of papillary thyroid carcinoma (PTC) with a background of benign disease. Method: A total of 709 patients with papillary thyroid carcinoma undergoing surgical resection were analyzed retrospectively. In 147 patients who underwent surgery for benign thyroid disease, incidental PTC (IPC group) were identified by intraoperative or postoperative pathological examination of surgical specimens but were not detected by preoperative imaging studies. In the other group, according to the pathological examination with or without co-existing benign thyroid disease, 253 cases were clarified as concomitant PTC and 309 cases were clarified as dominant PTC. Results: Incidental PTC was more common in women, about 85.7%, the mean age was $47.6{\pm}11.3$ years old. Average tumor diameter was $4.4{\pm}2.2$ mm, multiple lesions accounted for 12.9% (19/147), and the cervical lymph node metastasis rate was 6.1% (9/147). After radical resection 8 cases recurred, the median time of recurrence was about 12 months (0.5 to 162), there was no tumor-related death. The tumor-free survival rates were 97.3%, 95.9%, 91.5%, and 79.3% in 1, 5, 10 and 14 year respectively. Conclusion: Incidental PTC with a background of benign lesions is common, and the generally good prognosis can be attributed to tumor early detection and early treatment. On the intraoperative finding of incidental PTC, lobectomy (unilateral) or total thyroidectomy (bilateral) should be the first choice, but with a postoperative pathologic finding of incidental PTC, further treatment, such as completion thyroidectomy or immediate lymph dissection is not necessary. Central lymph node dissection is also not needed unless lymphadenectasis is present.

Gingival Squamous Carcinoma with Metastatic Lymph Node Involvement of Papillary Thyroid Carcinoma

  • Kim, Ju-Won;Lee, Chang-Youn;Oh, Seung-Min;Yang, Byung-Eun;Kim, Jwa-Young;Song, Yun-Jung;Ahn, Kang-Min;Park, Joo-Yong
    • Maxillofacial Plastic and Reconstructive Surgery
    • /
    • v.34 no.4
    • /
    • pp.276-279
    • /
    • 2012
  • The development of multiple primary tumors is a problem leading to the treatment of patients diagnosed with gingival squamous cell carcinoma (SCC). The occurrence of multiple primary cancers in patients with SCC of the head and neck is uncommon. Thyroid carcinomas have been found incidentally in the cervical lymph nodes after histopathologic examination. A 72-year-old male with SCC of the lower gingiva at the clinical stage T2N0M0 was treated with partial mandibulectomy and selective neck dissection. Histopathologic examination showed the foci of papillary thyroid carcinoma metastasis. The patient subsequently underwent total thyroidectomy. We report a case of papillary thyroid carcinoma associated with SCC of the oral gingiva along with a review of literatures.

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
    • /
    • v.31 no.2
    • /
    • pp.16-20
    • /
    • 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.

  • PDF

Values of Three Different Preoperative Regimens in Comprehensive Treatment For Young Patients with Stage Ib2 Cervical Cancer

  • Zhao, Yi-Bing;Wang, Jin-Hua;Chen, Xiao-Xiang;Wu, Yu-Zhong;Wu, Qiang
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.13 no.4
    • /
    • pp.1487-1489
    • /
    • 2012
  • Objective: To compare the clinical efficacy of concurrent chemoradiotherapy, neoadjuvant chemotherapy, and intracavity brachytherapy in comprehensive treatment for young patients with stage Ib2 cervical cancer. Methods: One hundred and twelve young patients with stage Ib2 cervical cancer were enrolled retrospectively in our hospital from January 2003 to June 2005. They were categorized into three groups according to preoperative regimens, including the concurrent chemoradiotherapy group (Group 1, n=38), the neoadjuvant chemotherapy (Group 2, n=49), and the intracavity brachytherapy group (Group 3, n=25). Radical hysterectomy was performed following these regimens. Chemotherapy and radiotherapy were given according to pelvic lymph node metastasis, deep cervical stromal invasion, intravascular cancer emboli, histological grading, vaginal stump and positive surgical margin. Results: The cancer disappearance and superficial muscle invasion rates were statistically significantly better in the concurrent chemoradiotherapy group than in the other two groups (P<0.01). No statistically significant difference was noted in the deep muscle invasion rate, surgical time and intraoperative blood loss among three groups, but significantly more postoperative complications occurred in the concurrent chemoradiotherapy group. The 2-year pelvic recurrence was statistically significantly lower in the concurrent chemoradiotherapy group compared to other two groups, while the 5-year survival was higher. Conclusion: Concurrent chemoradiotherapy is efficacious for young patients with stage Ib2 cervical cancer.

A Case of Occult Papillary Carcinoma of Thyroid, Invaded Trachea and Esophagus (기관지 내시경에 의해 진단된 기관과 식도를 침범한 갑상선 잠재성 유두암 1예)

  • Cho, Deok-Su;Ahn, Byung-Yi;Lee, Deok-Su;Han, Dong-Ho;Kim, Sang-Young;Kim, Kwi-Wan
    • Tuberculosis and Respiratory Diseases
    • /
    • v.44 no.5
    • /
    • pp.1125-1131
    • /
    • 1997
  • Occult papillary adenocarcinoma of the thyroid is known to be indolent, slow metastatic, and has a good prognosis. Occult thyroid carcinoma presenting as a blood-borne metastasis without obvious cervical lymph node involvement is extremely rare. A 65-year-old male patient was visited for hoarseness, dysphagia, and shortness of breath. Bronchoscopy with biopsy revealed a papillary carcinoma of thyroid by immunohistochemical staining. Head & neck CT revealed that involving both the upper esophagus and the posterior tracheal wall, extending into the mediastinum along the upper thoracic spine at $T_1-T_2$. We have experienced a rare case of occult papillary carcinoma which invaded the trachea, esophagus and fascia of thoracic spine. Treatment was initiated with radioactive iodine and external bean therapy.

  • PDF

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
    • /
    • v.61 no.12
    • /
    • pp.702-704
    • /
    • 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.