• 제목/요약/키워드: neck metastasis

검색결과 448건 처리시간 0.034초

전이성 유암에서 Woven Dacrorl Y graft를 이용한 상대공정맥 재건술 -치험 III- (A Case of Metastatic breast Cancer and Reconstruction of Superior Vena Cava by Woven Dacron Y Graft)

  • 이원진;신호승
    • Journal of Chest Surgery
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    • 제29권3호
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    • pp.346-349
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    • 1996
  • This 32 year old female patient underwent left radical mastectomy due to ductal carcinoma on May 1990, and treated with FAM (5-fluorouracil, Adriamycin and Mitomycin C) regimen postoperatively. However, right cervical Iymph node enlargement and facial edema progressively developed since December 199). On April 1994, operation was performed, and findings were as followes; x4$\times$5$\times$7 to 1 : 1 $\times$ 1 cm sized multiple enlarged and hyperemic Iymph nodes were scatterred throughout submandibular area to the junction of superior vents cave and pericardium, and partially invaded both anterior segmental lobe, sternum and both distal tip of clavicles. After radical dissection of the nodes of neck and mediastinal nodes, and wedge resection of both anterior segments of lung, and partial resection of both clavicle tips and total sternum. The both innominate veins and superior vena cava were partially obstructed by invaded cancer SVC reconstruction was done with preclotted 10$\times$ 10$\times$ 18mm Y shap d woven Dacron graft, which was anastomosed to the point of the junction of subclavian vein and jugular vein after cross clamping both veins and 2cm above the pericardial junction with one arm clamp. After maintaining blood drainage to the SVC from the right side, left innominate vein was anastomosed with 4-0 Prolene continuous running suture. Bone cement was used for resected sternal portion and clavicular ends were fixed to postal portion with 18 Gauge wires. The patient was treated with radiation and chemotherapy after discharge, and there were no evidence of regrowing of the mass nor obstruction of the graft inspite of no antithrombotic therapy.

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Concurrent Chemoradiotherapy Versus Radiotherapy Alone for Locoregionally Advanced Nasopharyngeal Carcinoma

  • Yu, Hong-Sheng;Wang, Xin;Song, Ai-Qin;Liu, Ning;Zhang, Wei;Yu, Li
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권8호
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    • pp.3961-3965
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    • 2012
  • Objective: To compare the clinical effects of concurrent radiochemotherapy with those of radiotherapy in treating locally advanced nasopharyngeal carcinoma (Stage III~IVa). Methods: A total of 95 patients suffering from nasopharyngeal carcinoma (Stage III~IVa) were divided into two groups: concurrent radiochemotherapy (Group CCRT, n=49) and radiotherapy (Group RT, n=46). The two groups were both delivered conventional fractionated radiotherapy, while Group CCRT also received three cycles of PF (DDP+5-Fu) or PLF (DDP+5-Fu+CF) chemotherapy. Results: The complete remission rate and total remission rate of Group CCRT were higher than those of Group RT ($X^2$=4.72~7.19, P<0.05). The one-year overall survival (OS) rate calculated by the life table method, was also higher than that of Group RT ($X^2$=4.24, P<0.05) as well as the 3-year OS rate, nasopharyngeal control rate and cervical lymph nodes' control rate ($X^2$=4.28~4.40, P<0.05). In addition, the 5-year OS and metastasis-free rates of Group CCRT were higher than those of Group RT and the differences were of statistical importance ($X^2$=3.96~8.26, P<0.05). However, acute toxicity was also obviously higher, the difference in gastrointestinal reactions being statistically significant ($X^2$=11.70, P<0.05). Conclusion: This study demonstrated that concurrent radiochemotherapy could improve the remission rate, overall survival rate and locally control rate. The toxicity of concurrent radiochemotherapy could be tolerated by the patients.

후두골을 침범한 두피의 비전형적 섬유황색종 (Atypical Fibroxanthoma of Scalp Involving Occipital Bone)

  • 조용우;임소영;문구현;현원석;방사익;오갑성
    • Archives of Plastic Surgery
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    • 제33권3호
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    • pp.383-387
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    • 2006
  • Atypical fibroxanthoma is a pleomorphic spindle cell neoplasm characterized by a variable combination of cells with fibroblastic and histiocytic features. It occurs mostly on sun-exposed area of the head and neck of elderly person and is a clinically benign reactive lesion despite apparent malignant histologic features. However, because of its potential for metastasis, it is widely regarded as a low-grade sarcoma. We report a 30-year-old woman with atypical fibroxanthoma developed on the left occipital area. The lesion was $1.5{\times}2cm$ sized papule. There was no skin lesion such as ulcer or eschar. However, mass was involving occipital bone and composed of dense, pleomorphic spindle cells and several bizarre multinucleated giant cells. After wide excision of the scalp and occipital bone, the defect was covered with bone cement, bipedicled local flap and the donor site was covered with STSG. The wound healed completely without complication. It remained free of recurrence for a period of about 1 year follow up.

Effects of Preoperative Biopsies on Recurrence in Head and Neck Skin Cancer

  • Jung, Ji Eun;Rah, Dong Kyun;Kim, Yong Oock
    • Archives of Plastic Surgery
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    • 제39권5호
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    • pp.518-521
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    • 2012
  • Background Skin cancer is the most common malignant tumor in humans. Basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) are the two most common types of skin cancers. When skin cancer is clinically suspected, preoperative biopsies are recommended for a definite diagnosis. However, despite a concern over potential increased risk of metastasis associated with mechanical manipulation, there have been few investigations into whether a preoperative biopsy affected the recurrence of BCC and SCC. Methods Primary BCC or SCC patients who underwent standard surgical excision from 1991 to 2010 were reviewed and a retrospective analysis was performed. Ultimately, 45 BCC patients and 54 SCC patients, who did not meet the exclusion criteria, were analyzed. To identify whether a preoperative biopsy affected the recurrence of BCC and SCC, the recurrence rates of each with and without biopsy were compared. Results Preoperative biopsy had no statistically significant effect on recurrence (BCC, P=0.8680; SCC, P=0.7520). Also, there was no statistical significance between the interval from initial biopsy to first operation and recurrence (BCC, P=0.2329; SCC, P=0.7140). Even though there was no statistical significance, the mean interval from the biopsy to the operation among the BCC patients who underwent preoperative biopsy was 9.2 months in those who had recurrence and 2.0 months in those who had no recurrence. Conclusions There was no statistically significant relationship between preoperative biopsy and recurrence of BCC and SCC. However, there was a tendency toward recurrence in patients with a longer interval between the biopsy and the corrective operation in BCC.

안면골 섬유 이형성증이 악성 섬유성 조직구증으로 악성화된 환자의 치험례 (Malignant Transformation of Fibrous Dysplasia: A Case Report of Malignant Fibrous Histiocytoma of Facial Bone)

  • 이상준;임소영;오갑성;방사익;현원석;문구현
    • Archives of Plastic Surgery
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    • 제34권3호
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    • pp.403-405
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    • 2007
  • Purpose: Malignant degeneration of fibrous dysplasia is an uncommon recognized complication of this disease. Especially, degeneration of fibrous dysplasia to malignant fibrous histiocytoma(MFH) in facial bone is rare and the publications had been limited. The purpose of this report is to share our experience. Methods: A 46-year-old patient with facial fibrous dysplasia visited our clinic for recent facial tingling and swelling. Malignant degeneration of fibrous dysplasia was suspected. Results: Total excision of the mass and adjacent facial bone was performed. Defect was immediately reconstructed with bone graft and bone cement. At a month follow up, metastasis was detected at ipsilateral parotid gland. Superficial parotidectomy and neck dissection was performed. The patient is currently taking chemotherapy. Conclusion: Because of the uncommon presentation of this entity, clinical course of treatment was dependent on other histological types of malignant degeneration. We report this case to share our experience.

구강편평세포암종에서 신생혈관화와 기저막침습에 미치는 제니스타인의 효과 (THE EFFECT OF GENISTEIN IN ORAL SQUAMOUS CELL CARCINOMA WITH RESPECT TO THE ANGIOGENESIS AND BASEMENT MEMBRANE INVASION)

  • 김용훈;윤필영;명훈;김명진
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제28권6호
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    • pp.434-439
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    • 2002
  • Oral squamous cell carcinoma (OSCC) is one of the most common head and neck cancers. OSCC generally has a poor prognosis due to its tendency towards a local invasion and subsequent metastasis, which is mediated by multiple proteolytic enzymes and angiogenesis. Soy products contain high levels of isoflavonoids, including the tyrosine kinase inhibitor, genistein, which has been identified as a potent inhibitor of cell proliferation and in vitro angiogenesis. The purpose of this in vitro study is to evaluate the anti-cancer effect of genistein with respect to the angiogenesis and basement membrane invasion in OSCC. The highly invasive OSCC cell line, HSC-3 cells were cultured in the presence of $10{\mu}M$ genistein for 24h. To evaluate the effects of genistein on the invasiveness and the gelatinolytic activity, in vitro invasion assay and zymography were performed. In order to evaluate the effect on the VEGF and bFGF mRNA expression, RT-PCR and northern hybridization reaction, and chemiluminescence detection were applied. The in vitro invasion assay showed that the genistein treatment reduced the cellular invasion through the artificial basement membrane and significant difference between the control group and the genistein treated group was shown in MMP-2 activity. Especially, the 62 kDa activated form of MMP-2 in the control group was 1.8 times higher than that in the genistein treated group. The results of the northern blot analyses indicated that VEGF mRNA expression in the genistein treated group was significantly down regulated. This study showed that genistein inhibits angiogenesis and reduces basement membrane invasion in OSCC. It seems to support the possibility of genistein as an anti-cancer agent.

염증성 근섬유모세포종의 증례보고 (Inflammatory myofibroblastic tumor : A case report)

  • 은상아;박혁연;차인호;김현실;정호걸;김기덕;박창서
    • Imaging Science in Dentistry
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    • 제36권3호
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    • pp.169-175
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    • 2006
  • The Inflammatory myofibroblastic tumor (inflammatory pseudotumor) is a rarely occurring soft tissue lesion of unknown etiology. It can be of any location, but commonly it is found in lungs. It has been considered as a nonneoplastic reactive inflammatory lesion, but nowadays, confusion and dispute about its character is increasing due to its high recurrence rate and metastasis. We present a patient who had been diagnosed with an inflammatory pseudotumor in the right maxilla area, 1 year before visiting our hospital. After that, her pain and swelling did not resolved and she visit our hospital. On radiographic examination, aggressively infiltrative growth of the lesion with destruction of adjacent bony structure was noted. We found unusual aggressiveness of the inflammatory myofibroblastic tumor of the head and neck region. Because the typical behavior of the inflammatory myofibroblastic tumor is not defined yet, we recommend the surgical excision of the lesion and close follow-up.

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횡경막에 발생한 악성 섬유종 조직구종 1예 (A case of Primary Malignant Fibrous Histiocytoma of the Diaphragm)

  • 심재준;조용선;김현숙;최혜숙;최천웅;유지홍;강홍모;양문호
    • Tuberculosis and Respiratory Diseases
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    • 제54권6호
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    • pp.645-650
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    • 2003
  • 저자들은 우측 흉부 불편감을 주소로 내원한 25세 여자 환자를 개흉 조직 검사를 시행하여 원발성 횡격막 기원 악성 섬유성 조직구종을 진단하였고 ifosfamide, doxorubicin으로 항암 화학 요법 시행 후 부분 관해가 있었으나 진단 후 12개월째 외래 추적 검사 중 뇌전이로 사망한 젊은 여성 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

갑상선암 환자에서 I-131의 진단적 전신스캔과 치료후 전신스캔의 비교 (Comparision of I-131 Diagnostic Scan and Therapeutic Scan in Thyroid Carcinoma)

  • 이범우;이동수;문대혁;정준기;이명철;조보연;고창순
    • 대한핵의학회지
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    • 제24권1호
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    • pp.80-86
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    • 1990
  • Fifty seven patients with differentiated thyroid carcinoma were performed radioactive iodine-131 whole body scans after administration of diagnostic dose $(2\sim10\;mCi)$ and therapeutic dose $(30\sim150\;mCi)$ within three months. We evaluated the state of radioactive iodine-131 uptakes in whole body scan to detect correct metastasis of thyroid carcinoma. The results are as follows: 1) In 20 of the 57 patients (35%), the therapeutic scan showed the additional uptakes that were not seen in the diagnostic scan. 2) In 9 (64.2%) of the 14 patients who had been received the thyroid ablation theraphy with I-131 previously, new additional lesions were found in the therapeutic scan but only 11 (25%) of the 32 patients who had not been received the thyroid ablation theraphy disclosed new uptake lesions (p < 0.01). 3) The additional uptake lesions of therapeutic scan were significantly more common in the bony metastatic foci (55.7%) than other areas (p < 0.01). In 11 (55%) of 20 patients, additional uptake regions were anterior neck areas (thyroid bed or regional lymph node). We conclude that diagnostic scan with $2\sim5$ mCi I-131 is inadequate in evaluating residual iodine avid tissues of patients with thyroid carcinoma. Also post-theraphy I-131 whole body scan would be important to evaluate the correct staging and prognosis of thyroid carcinoma, and to follow-up patients.

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A systematic review of therapeutic outcomes following treatment of squamous cell carcinoma of the retromolar trigone

  • Kim, Hye-Won;Kim, Moon-Young;Kim, Chul-Hwan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제47권4호
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    • pp.291-314
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    • 2021
  • Squamous cell carcinoma (SCC) of the retromolar trigone (RMT) is a rare but potentially fatal disease that carries a poor prognosis due to its unique anatomic position. RMT SCCs tend to spread to vital nearby structures, including the tonsillar pillar, masticatory muscles, and underlying mandibular bone, even in their early stages, and aggressive treatment is often warranted. This systematic review appraises and qualitatively analyzes all available literature regarding the survival outcomes and prognosis of RMT SCC. Four databases were searched to identify all eligible articles published since January 1980. Of the 1,248 studies, a total of 15 studies representing 4,838 cases met the inclusion criteria. The evaluated patients had a high rate of advanced tumor stage (T3 or T4: 61.4%), lymph node metastasis (38.8%), and mandibular bone invasion (24%) at the time of diagnosis. Aggressive surgical treatments such as lip-splitting (92%), segmental mandibulectomy (61.1%), radical neck dissection (44.1%), and reconstruction using free flaps (49.5%) was undertaken for 92% of the pooled patient population. The mean rates for local, regional, and systemic recurrence were 23.40%, 8.40%, and 8.50%, respectively. The mean 5-year overall survival rate was 38.90%. Osteonecrosis was noted in 11.6% of the 328 patients who received radiotherapy. In conclusion, RMT SCC is generally associated with high recurrence, low survival, and high postoperative complication rates. Early diagnosis and aggressive treatment are thus warranted. However, significant methodological problems hamper current knowledge. Future studies of this topic that use randomized or cohort designs are thus needed.