A Case of Mediastinal Abscess Requiring Surgical Management / 日本農村医学会雑誌

We report on an apparently healthy woman in her 50s who noticed pain in the left side of her neck anteriorly and was prescribed an antimicrobial agent at a nearby clinic. However, she developed hypotension and hypoxemia and was brought to our hospital. Laboratory investigations revealed evidence of inflammation, and imaging findings showed low-density areas corresponding to the left lobe of the thyroid gland. The low-density areas extended to the superior mediastinum, raising suspicion of a thyroid gland mediastinal abscess. We performed inferior mediastinal drainage with video-assisted thoracoscopic surgery and resection of the left lobe of the thyroid gland. Culture of mediastinal aspirate yielded Streptococcus viridans. Based on these findings, the final diagnosis was descent-related mediastinitis secondary to acute suppurative thyroiditis.

Clinical Statistical Study of 121 Patients with Laryngeal Cancer / 日本農村医学会雑誌

　　Laryngeal cancer is a malignant disease that occurs at a high incidence rate as compared with other forms of cancer of the head and neck, and its treatment is commonly conducted at a regional central hospital from diagnosis to recovery. In this study, we summarized the outcomes of first-line treatment for laryngeal cancer over the past 10 years at our hospital.　　The subjects consisted of 121 patients who received a first-line treatment for squamous cell carcinoma of the larynx between January 2000 and April 2010. Of these, 115 were male and six were female, with a mean age of 67.9 years. There were 56 cases of stage I laryngeal cancer, 30 of stage II, 14 of stage III, and 21 of stage IVa. Cases of stage IVc cancer with distal metastasis were excluded.　　The disease-specific 5-year survival rate was 100% in stage I, 81.8% in stage II, 100% in stage III, and 72.5% in stage IVa, respectively. Moreover, the laryngeal preservation rates was 93.7% in stage I, 69.4% in stage II, 34.2% in stage III, and 42.6% in stage IVa, respectively.　　Although the disease-specific 5-year survival rate in stage III was 100%, the laryngeal preservation rate was the lowest at 34.2%. In cases of stage III cancer, although the survival rate was certainly high when total laryngectomy was performed, we believe that in the future, radiation therapy and partial laryngectomy should be introduced to preserve the larynx.　　There were only three cases of stage II subglottic cancer in which both the laryngeal preservation rate and survival were low.