• 제목/요약/키워드: neck metastasis

검색결과 449건 처리시간 0.041초

5년간 지속된 미만성 폐결절 (Diffuse Pulmonary Nodular Lesions Persisting for 5 Years)

  • 김경규;김병규;정기환;정혜철;김제형;박상면;이신형;신철;조재연;심재정;인광호;강경호;유세화;오유환
    • Tuberculosis and Respiratory Diseases
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    • 제48권5호
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    • pp.802-807
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    • 2000
  • 본 증례는 갑상선암이 폐전이를 일으킨 예로 처음에 목에 작은 림프절이 있었으나 속립성 결핵으로 진단 후 치료한 경우로 갑상선암보다 먼저 폐전이 양상이 뚜렷하게 나타났고 폐결절이 매우 천천히 진행하는 형태를 보여 더욱 진단이 늦어졌다.

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갑상선 미세유두암의 고주파 절제술 후 10년 경과 관찰 (Radiofrequency Ablation of Papillary Thyroid Microcarcinoma: A 10-Year Follow-Up Study)

  • 서유경;조성휘;심정석;양고은;조우진
    • 대한영상의학회지
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    • 제82권4호
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    • pp.914-922
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    • 2021
  • 목적 이 연구는 갑상선 미세유두암을 고주파 절제술로 치료한 후 10년 이상 경과 관찰한 환자들의 결과를 통해 효과와 안전성을 평가하고자 했다. 대상과 방법 2006년 11월부터 2009년 12월까지 갑상선 미세유두암을 고주파 절제술로 치료받은 환자 5명을 대상으로 하였다. 이 환자들은 모두 조직검사를 통해 갑상선 미세유두암으로 진단을 받았고, 병변은 갑상선 내에 국한되어 있었으며, 전이의 증거가 없었고, 수술이나 전신마취가 의학적으로 부적합하거나 수술을 거부한 환자들이었다. 고주파 절제술은 고주파 발생기와 냉각기를 사용하여 한 명의 영상의학과 의사가 시행하였다. 우리는 시술과 연관된 부작용, 소작된 종양의 변화, 재발 여부, 국소 또는 림프절 전이 등에 대해 초음파 영상 소견과 의무 기록을 토대로 분석하였다. 결과 평균 경과 관찰기간은 130.6개월(범위, 121~159개월) 이었다. 세 명의 환자는 한 번의 고주파 절제술을, 두 명의 환자는 두 번의 시술을 받았다. 다섯 명의 환자 모두 시술과 연관된 부작용은 보이지 않았다. 다섯 개 중 세 개의 종양은 시술 후 완전히 사라졌으며 두 개의 종양은 최소한의 흔적으로 남아 평균 16.8개월의 경과 관찰기간 동안 큰 변화가 없었다. 가장 최근의 경과관찰에서 다섯 명의 환자 모두 국소 전이나 림프절 전이는 보이지 않았고 갑상선 글로불린(thyroglobulin)의 수치도 정상 범위였다. 결론 고주파 절제술은 수술에 부적합하거나 수술을 거부하는 저위험 갑상선 미세유두암 환자들에 대해서 효과적이고 안전한 치료법이 될 수 있다.

비인강암의 임상적 고찰과 예후인자 (Clinical Characteristics and Prognostic Factors of Nasopharyngeal Cancer)

  • 배창훈;서영중;예상백;최영호;김용대;송시연
    • Journal of Yeungnam Medical Science
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    • 제22권1호
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    • pp.72-80
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    • 2005
  • 본 연구에서는 1993년 1월부터 2002년 12월까지 10년간 비인강암으로 진단받은 환자 54예를 환자의 의무기록과 전화상담을 통하여 후향적으로 분석하여 비인강암의 임상적인 특징과 생존율에 미치는 인자에 대하여 알아보고자 하였다. 환자의 연령분포는 16~78세로 평균 연령은 46.9세였다. 40대(26.0%)와 50대(27.8%)에서 호발하였으며, 남자가 여자보다 3.5배 많았다. 경부 종물을 주소로 내원한 환자가 30예(55.5%)로 가장 많았으며, 조직학적 유형은 WHO 제 3형이 29예(53.7%)로 가장 많은 분포를 나타내었다. 조직학적 유형에 따른 5년 생존율은 제 1형은 40.0% 제 2형은 45.5% 제 3형은 54.1%였다. 비인강암의 발생위치는 Rosenmuller fossa를 포함한 측벽에서 35예(64.8%)로 가장 많이 발생하였다. 진단 시 III, IV기의 진행된 병기군이 79.6%로 비인강암은 비교적 늦게 발견됨을 알 수 있었다. 전체적인 5년 누적 생존율은 46.5%였으며, 초기 병기군과 진행된 병기군의 5년 누적 생존율은 각각 58.3%, 44.2%로 초기 병기군의 생존율이 높은 것을 알 수 있었으나 통계학적 의의는 없었다. 원격전이의 경우 17예(31.5%)에서 발생하였으며 골, 폐, 뇌, 척추, 간 등의 순서였다. 원발부위의 완전관해 후 6예(11.1%)에서 국소재발하여 다시 방사선치료를 시행하거나 항암화학 요법과 방사선치료를 병행하여 치료하였다. 이상의 결과에서 보면 비인강암은 50대의 남자에서 호발하며, 국내에서는 WHO 제 3형이 가장 빈발한다는 것을 알 수 있었다. 또한 TNM 병기는 비인강암의 생존율을 예측하는데 적절하지 않다고 생각되며, 생존율과 연관된 인자를 찾기 위해 향후 더 많은 연구가 시행되어야 하며 그에 따라 새로운 분류법이 제시되어야 할 것으로 사료된다.

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요추부에 발생한 경막외 유잉육종 - 증례 보고 - (Extraosseous Epidural Ewing's Sarcoma Arising in the Lumbar Area - A Case Report-)

  • 안면환;신덕섭;정광암;하정옥
    • 대한골관절종양학회지
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    • 제5권3호
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    • pp.183-189
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    • 1999
  • Ewing's sarcoma is an uncommon malignant neoplasm of the long bone and it has a poor prognosis due to its early metastasis and aggressive local spread. It is mostly found before the age of 30 and it is rare in extraskeletal sites. Extraskeletal Ewing's sarcoma has been reported to occur in various sites including the larynx, scalp, nasal fossa, neck, chest wall, lung, pelvis, perineum, arm, finger, leg and toe, but it is extremely rare as a primary epidural tumor of the spine. We experienced a case of extraosseous epidural Ewing's sarcoma arising in the lumbar spinal canal at L3-L5 level in a 9-year-old boy. Following total laminectomy from L3 to L5 with a lumbar vertebrae and mass excision, he received chemotherapy with complete remission.

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누액선에 발생한 Adenoid Cytic Carcinoma - 증 례 보 고 - (Lacrimal Gland Adenoid Cystic Carcinoma - A Case Report -)

  • 서대희;백정환;김윤덕;하범준;박익성;남도현;박관;김종현
    • Journal of Korean Neurosurgical Society
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    • 제29권8호
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    • pp.1089-1093
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    • 2000
  • Adenoid cystic carcinoma(ACC) is a rare malignant tumor that occurs in exocrine glands such as major and minor salivary glands, lacrimal glands, ceruminal glands. It has a tendency for delayed distant metastasis and long clinical course. ACC of the lacrimal gland is generally found in adults and is usually managed by radical orbitectomy and supplemental external beam irradiation. The authors present two cases of recurrent lacrimal gland ACC with review of the literature.

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Skull Base Invasion of Adenoid Cystic Carcinoma of the Lacrimal Gland : A Case Report

  • Lee, Jae-Il;Kim, Young-Zoon;Lee, Eun-Hee;Kim, Kyu-Hong
    • Journal of Korean Neurosurgical Society
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    • 제44권4호
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    • pp.273-276
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    • 2008
  • Although adenoid cystic carcinoma (ACC) of the lacrimal gland is a rarely encountered orbital tumor, it invades intracranially more frequently than carcinomas of other glands in the head and neck. A 52-year-old man underwent orbital exenteration and resection of intracranially extended tumor via a fronto-orbito-zygomatic approach in combination with a transfacial approach. Histopathologically, the tumor showed perineural, vascular, and lymphatic invasion. Additionally, he received radiotherapy (60 Gy) and adjuvant systemic cisplatin and 5-fluorouracil chemotherapy due to residual tumor in the orbit and systemic metastases (lung, ribs, and spines). He was free of progression and recurrence at 6 months after treatment. The authors report a case of skull base invasion by an ACC of the lacrimal gland to remind neurosurgeons planning intervention that this disease shows a tendency to invade intracranially.

Spinal Hemangiopericytoma Which Needed Intraoperative Embolization due to Unexpected Bleeding

  • Lee, Chang-Hyun;Kim, Ki-Jeong;Jahng, Tae-Ahn;Kim, Hyun-Jib
    • Journal of Korean Neurosurgical Society
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    • 제54권3호
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    • pp.253-256
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    • 2013
  • Spinal intradural hemangiopericytoma is a very rare tumor and can be characterized by massive bleeding during surgeries, frequent recurrence, and metastasis. However, definite radiologic differential points of hemangiopericytoma are not known. We describe an unexpected hemangiopericytoma case with large bleeding and management of the tumor. A 21-year-old man visited complaining of progressive neck pain and tingling sensation in both hands. Magnetic resonance imaging of his spine revealed C1-2 ventral intradural mass. When the dura was opened, the intradural tumor was placed behind spinal accessary nerves. The tumor was partially exposed only after some accessary nerves had been cut. When internal debulking was performing, unexpected bleeding was noted and it was difficult to control because of narrow surgical field and hypervascularity. Intraoperative spinal angiography and embolization were performed. The tumor was completely removed after embolization. Pathological diagnosis was consistent with hemangiopericytoma. When surgeons meet a flesh-red tumor that bleeds unexpectedly during surgery, hemangiopericytoma may be considered. When feeder control is hard due to reciprocal location of spinal cord, the tumor, and feeders, intraoperative angiography and embolization may be a possible option.

Clear cell odontogenic carcinoma mimicking a cystic lesion: a case of misdiagnosis

  • Kim, Minkyu;Cho, Eunae;Kim, Jae-Young;Kim, Hyun Sil;Nam, Woong
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제40권4호
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    • pp.199-203
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    • 2014
  • Clear cell odontogenic carcinoma (CCOC) is a rare jaw tumor that was classified as a malignant tumor of odontogenic origin in 2005 by the World Health Organization because of its aggressive and destructive growth capacity and metastasis to the lungs and lymph nodes. We report a case of a 66-year-old female who had swelling, incision and drainage history and a well-defined unicystic radiolucent lesion that was comparable to a cystic lesion. At first, the patient received decompression, and the lesion size decreased. Three months after decompression, cyst enucleation was performed. The pathologic result indicated that the lesion was CCOC. In this report we emphasize that patients with painful cystic lesions in addition to jaw enlargement and loosening teeth should be considered for the possibility of malignancy.

경부도상피판을 이용한 구강내 결손부의 재건 - 13증례분석 (RECONSTRUCTION OF INTRAORAL DEFECT WITH CERVICAL ISLAND FLAP)

  • 김종렬;강영기;서종천;성일용
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제23권3호
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    • pp.212-216
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    • 2001
  • The cervical flap, comprising skin, fascia, and platysma muscle, has significant application in the head and neck region after radical ablative surgery for cancer of the oral cavity. The flap may be used for reconstruction of the cheek, floor of the mouth, and lateral side of the tongue. This flap minimizes donor morbidity by use of cervical operation wound and flap size available is adequate for most oral defects and the procedure is relatively simple and time-saving. However the flap is not applicable in patients where there are large tissue defects and metastasis is suspected. We have used the cervical flap for its rapid, simple, and effective closure of oral defects after cancer ablation and found it is very useful for the reconstruction of relatively small oral defects.

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Recombinant Human Bone Morphogenetic Protein-2 in Development and Progression of Oral Squamous Cell Carcinoma

  • Zaid, Khaled Waleed;Chantiri, Mansour;Bassit, Ghassan
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권3호
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    • pp.927-932
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    • 2016
  • Bone morphogenetic proteins (BMPs), belonging to the transforming growth factor-${\beta}$ superfamily, regulate many cellular activities including cell migration, differentiation, adhesion, proliferation and apoptosis. Use of recombinant human bone morphogenic protein-2 (rhBMP-2) in oral and maxillofacial surgery has seen a tremendous increase. Due to its role in many cellular pathways, the influence of this protein on carcinogenesis in different organs has been intensively studied over the past decade. BMPs also have been detected to have a role in the development and progression of many tumors, particularly disease-specific bone metastasis. In oral squamous cell carcinoma - the tumor type accounting for more than 90% of head and neck malignancies- aberrations of both BMP expression and associated signaling pathways have a certain relation with the development and progression of the disease by regulating a range of biological functions in the altered cells. In the current review, we discuss the influence of BMPs -especially rhBMP-2- in the development and progression of oral squamous cell carcinoma.