• Korean Journal of Head & Neck Oncology
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• v.20 no.1
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• pp.58-61
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• 2004

Lymph node metastasis of thyroid cancer occurs to anterior compartment (level VI) and superior mediastinal lymph node (Level VII). In lateral neck, it occurs commonly in middle and lower jugular lymph node (level III, IV). And it can also metastasis to posterior neck lymph node (level V). Superior mediastinal lymph node metastasis of thyroid cancer requires superior mediastinal dissection with massive removal of peritracheal and periesophageal soft tissue. After superior mediastinal dissection, severe complication may occurs such as innominate artery rupture and tracheal necrosis. We describe a case of tracheal necrosis as a complication of superior mediastinal dissection and total thyroidectomy in thyroid cancer patient.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.33 no.6
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• pp.597-600
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• 2007

PET is one of the most widely used verification methods for evaluation of metastasis on the lymph nodes of the neck in oral cancer patients. The purpose of this study was to assess the correlation between PET findings and histopathologic findings in patients who had been diagnosed as squamous cell carcinoma and performed neck dissection. Thirty-four necks in 25 patients had been evaluated on pathologic lymph nodes and the data were compared with preoperative PET scan. The sensitivity of PET at the level of the neck was 72.7%, specificity was 60%, and accuracy was 79.2%. Since FDG-PET show high false-positive results, it should be used with other diagnostic tools for evaluation of lymph node metastasis.

• Korean Journal of Head & Neck Oncology
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• v.21 no.2
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• pp.115-120
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• 2005

Background and Objectives: Minor salivary gland tumors vary in their primary sites, histopathology and biological behavior. Therefore, various factors are considered in selecting the treatment modality and predicting the prognosis. We performed this study for the purpose of getting further understanding and more supporting ideas for the diagnosis and treatment of minor salivary gland tumor. Materials and Methods: A retrospective analysis of the patients with 52 cases of minor salivary gland tumor who were treated at the Hanyang University Hospital from 1996 to 2003 was performed. We analyzed demography, symptoms, histopathology, treatment and outcomes by the review of medical records. Results: Among 52 cases of minor salivary gland tumor, 46% were classified as benign and 54% were classified as malignant tumors. The most common benign tumor was pleomorphic adenoma. Adenoid cystic carcinoma(15/28) was the most common in malignant tumors. Eight patients were males and sixteen patients were females in benign tumors and 10 patients were males and 18 patients were females in malignant tumors. The most common site of benign tumor was the palate(17/22), whereas malignant tumors were most common in the nasal cavity and paranasal sinus(9/28). Asymptomatic mass was the most common symptom. According to the criteria given by the AJCC on staging, stage III and IV(21/28) were more common than stage I and 11(7/28). All benign tumors were treated with simple excision and had no recurrence. In malignant tumors, 25 patients underwent radical excisional operation and 13 patients of them had postoperative radiation therapy. Three of them were treated with additional chemotherapy. In whom treated with radical operation, 9 patients had recurrence. Three were recurred at the primary site with neck node metastasis, 3 were recurred at the primary site with lung metastasis, 1 was recurred at the primary site with neck node and lung metastasis, 1 was recurred only at neck node. Conclusion: In minor salivary gland tumor, malignant was more common than benign. Malignant tumor originated from minor salivary gland were more frequently diagnosed at advanced stage with high recurrence rate and distant metastasis. Early detection of the disease is needed to improve the prognosis of the patients with malignant tumors of the minor salivary glands.

• Korean Journal of Head & Neck Oncology
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• v.18 no.2
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• pp.135-141
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• 2002

Backgrounds and Objectives: Metastasis is a complex multistep process that requires sequential interactions between the invasive cell and the extra-cellular matrix. Transforming growth factor-${\beta}1$ ($TGF-{\beta}1$) is a multifunctional regulator of cellular differentiation, motility and growth. Loss of sensitivity to the growth inhibitory effects by $TGF-{\beta}1$ plays important roles in neoplastic progression. The aim of this study was to investigate the role of $TGF-{\beta}1$ in the neoplastic invasion and metastasis through matrix metalloproteinase (MMP) of laryngeal cancer cell lines. Material and Methods: Two laryngeal cancer cell lines, SNU-899 and SNU-1076 were treated with recombinant $TGF-{\beta}1$, and the expression of MMP-2 and MMP-9 was immunohistochemically evaluated and gelatinase activity was studied by gelatin zymogram. Results: The cell growth inhibition was evident on 4th days after 1ng/ml and 10ng/ml $TGF-{\beta}1$ treatment. The expressions of MMP-2 and MMP-9, and their gelatinase activities were increased in dose-dependent manner. Conclusion: $TGF-{\beta}1$ treatment in laryngeal cancer cell lines induces the expression of MMP-2 and MMP-9, thus playing a role in the digestion of extracellular matrix gelatin.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.8
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• pp.4045-4050
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• 2012

Objective: The impact of ablative oral cancer surgery was studied, with particular reference to recurrence and nodal metastasis, to assess survival probability and prognostic indicators and to elucidate if ethnicity influences the survival of patients. Methods: Patients who underwent major ablative surgery of the head and neck region with neck dissection were identified and clinical records were assessed. Inclusion criteria were stage I-IV oral and oropharyngeal malignancies necessitating resection with or without radiotherapy from 2004 to 2009. All individuals had a pre-operative assessment prior to the surgery. The post operative assessment period ranged from 1 year to 5 years. Survival distributions were analyzed using Kaplan-Meier curves. Results: 87 patients (males:38%; females:62%) were included in this study, with an age range of 21-85 years. Some 78% underwent neck dissections while 63% had surgery and radiotherapy. Nodal recurrence was detected in 5.7% while 20.5% had primary site recurrence within the study period. Kaplan-Meier survival analysis revealed that the median survival time was 57 months. One year overall survival (OS) rate was 72.7% and three year overall survival rate dropped to 61.5%. On OS analysis, the log-rank test showed a significant difference of survival between Malay and Chinese patients (Bonferroni correction p=0.033). Recurrence-free survival (RFS) analysis revealed that 25% of the patients have reached the event of recurrence at 46 months. One year RFS rate was 85.2% and the three year survival rate was 76.1%. In the RFS analysis, the log-rank test showed a significant difference in the event of recurrence and nodal metastasis (p<0.001). Conclusion: Conservative neck is effective, in conjunction with postoperative radiotherapy, for control of neck metastases. Ethnicity appears to influence the survival of the patients, but a prospective trial is required to validate this.

• Radiation Oncology Journal
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• v.18 no.4
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• pp.309-313
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• 2000

The metastasis of uterine leiornyosarcorna to the neck node has not been reported previously and the radiotherapy has been rarely used for the metastatic lesion of the other sites. We report a case of neck metastasis from a uterine leiornyosarcorna, which developed 10 months after surgery and postoperative pelvic radiotherapy. It also involved the parapharyngeal space, adjacent spine, and spinal canal. The metastatic neck mass was inoperable, and was treated by neck radiotherapy (6,000 cGy) and chemotherapy including taxol and carboplatin. The mass has regressed progressively to a nearly impalpable state. She has never developed spinal cord compression syndrome, and has maintained good swallowing for eight months since the neck radiotherapy and chemotherapy. Since the extensive metastatic neck mass showed good local response to high dose radiotherapy and chemotherapy, both treatments may be considered for an unresectable metastatic leiornyosarcorna.

• Korean Journal of Bronchoesophagology
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• v.7 no.1
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• pp.29-33
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• 2001

Background and Objectives： Adenoid cystic carcinoma (ACC) is an aggressive, often indolent tumor, with a high incidence of distant metastasis (DM). Relatively little has been written about the factor that influence distant spread and subsequent survival because it is uncommon and has protracted clinical course. We attempted to reemphasize the biologic behavior of ACC by investigating the relationship between the clinical features and prognosis. Materials and Methods : We have retrospectively studied 24 determinate patiens who received definitive treatment in our hospital between 1984 and 1995 for ACC in all salivary sites. Inclusion criteria were no prior treatment elsewhere other than excisional biopsy and eligibility for follow-up of at least 5 years. Variables assessed for their impact on distant metastasis included age, gender, size, node status, stage, histologic pattern, locoregional treatment failure. Results : Treatment failure occurred in a total of 16 of 24 determinate Patients (64%), 12 of whom had DM (50%). This was usually associated with locoregional recurrence (8 patients), but DM was the only indication of failure in 4 whose primary tumor was controlled. Of the 12 patients with known DM, the lung was recored as the only involved site in 7 Patients, lung was involved in addition to other sites in 1, bone and liver metastasis occurred in 2 respectively. Disease-free intervals varied from 3 month to 14 years (median 3 years). The only significant factors influencing survival were the size of the primary tumor, locoregional recurrence. Conclusion : The high incidence of DM with locoregional failure confirms the importance of aggressive initial surgery. combined with irradiation, for high-stage tumors or involved surgical margins. Large tumor size and locoregional recurrence, rather than microscopic appearance, were predictive of DM.

• Korean Journal of Head & Neck Oncology
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• v.20 no.1
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• pp.7-12
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• 2004

Background and Objectives: Brain metastasis from well-differentiated thyroid carcinoma is uncommon, and the treatment remains controversial. In this study, we analyzed cases of brain metastasis from well differentiated thyroid carcinoma to determine optimal treatment. Material and Methods: From March 1986 to May 2003, we experienced 13 cases of brain metastases from well-differentiated thyroid carcinomas. There were 6 men and 7 women with a mean age of 62.3 years. The time interval detecting the brain metastasis, treatment methods, outcomes, and the prognostic factors were analyzed. Results: In 11 patients, brain metastasis was found at a mean of 96 months after thyroid surgery (range, 1-204months). In 1 patient, brain metastasis was found simultaneously with the thyroid cancer. In the remaining one, brain metastasis was presented as the first sign. Treatment included gamma knife therapy in 2, external radiation therapy (ExRT) in 2, resection and ExRT in 2, gamma knife therapy and ExRT in 2 and intracranial holmium injection in 1. Three patients received no treatment. The mean survival was 20.5months (1-119 months). Only 2 patients with early detection remained alive after treatment (23months and 119months). The age, sex, primary tumor size, combined organs of distant metastasis and treatment methods did not affect the prognosis. There were noticeable symptomatic improvements in patients who received any kind of treatment for brain metastasis. Conclusion: Early detection and treatment of brain metastasis appears to bring symptomatic relief and improve survival. Therefore, early screening for brain metastasis is recommended for patients with symptoms. However, further study is needed to determine the optimal method of treatment.

• 대한두경부종양학회:학술대회논문집
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• 1989.11a
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• pp.16.1-16.1
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• 1989

• Korean Journal of Head & Neck Oncology
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• v.21 no.2
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• pp.174-177
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• 2005

Skin metastasis from papillary thyroid carcinoma is extremely rare. Due to similar histopathologic features, it is difficult to differentiate skin metastatic papillary thyroid carcinoma and some primary skin neoplasms without a clinical history. However, most of metastatic skin lesions showed a strong reactivity to the antithyroglobulin antibodies unlike primary skin neoplasms. Metastatic skin lesions must be completely removed and radiotherapy can be added. Investigators reported that prognosis of skin metastases from thyroid carcinoma is dismal and the average survival after it's diagnosis was only 19 months because distant metastases were often discovered at diagnosis of skin metastasis or during follow-up period. We report a case of skin metastasis from tall cell variant of papillary thyroid carcinoma. In our case, the anti thyroglobulin antibodies measured from cystic fluid from a skin lesion was more than 2000 IU/ml. Skin metastasis was diagnosed at 20 months after primary surgery for thyroid cancer and brain metastasis at 12 months after diagnosis of skin metastasis. Although skin metastasis is an ominous prognostic indicator in patients with thyroid carcinoma, a radical treatment for skin lesions and early diagnosis of distant metastasis could provide a chance to the patients to improve their survival.