ABSTRACT
PURPOSE: Warthin's tumor is a slow growing tumor found exclusively either in the parotid gland or the periparotid lymph nodes. Although surgical resection is the treatment of choice, the extent of surgery which is most beneficial has remained contraversial. We performed a comparative study of the results between enucleation and parotidectomy groups to evaluate the effectiveness of the enucleation procedure for the surgical management of parotid Warthins tumor. METHODS: Between January 1981 and July 2001, 74 patients underwent surgical resection of parotid Warthin's tumor. We reviewed the clinicopathological characteristics retrospectively and compared the operation time, postoperative complication rate, duration of postoperative hospital stay and recurrence between the enucleation group and the parotidectomy group. RESULTS: The mean age was 57.0 years (19~86 years) and the male to female ratio was 5.7: 1. The majority of the tumors were situated in the lower region of the superficial lobe (89.2%). Bilateral simultaneous involvements of the parotid gland was found in 5 patients (6.8%) and therefore a total of 79 parotid glands were involved. Four (5.4%) of the 79 parotid glands featured multifocal tumors of two or three lumps. Tumor sizes varied from 0.5 to 13.0 cm with a mean diameter of 3.5 cm. Of the 74 patients, 51 (68.9%) were diagnosed preoperatively or perioperatively by means of CT scans, ultrasound, 99m-Tc. scan, fine needle aspiration cytology or intraoperative frozen section biopsy. Of the 79 glands, 46 underwent a superficial (n=39), partial (n=2) or total (n=5) parotidectomy, while enucleation was performed for the remaining 33 cases with single Warthin's tumor. Only one case of recurrence was identified during the follow up period. However the operation time, the postoperative complication rate, and the duration of postoperative hospital stay were all significantly reduced in the enucleation group (P<0.05). CONCLUSION: The enucleation procedure may represent a safe and appropriate surgical method for patients with single Warthin's tumor that is diagnosed preoperatively.
Subject(s)
Female , Humans , Male , Biopsy , Biopsy, Fine-Needle , Follow-Up Studies , Frozen Sections , Length of Stay , Lymph Nodes , Parotid Gland , Postoperative Complications , Recurrence , Retrospective Studies , Tomography, X-Ray Computed , UltrasonographyABSTRACT
No abstract available.
ABSTRACT
No abstract available.
ABSTRACT
No abstract available in English.
Subject(s)
Humans , Estrogens , Steroids , Thyroid Gland , Thyroid NeoplasmsABSTRACT
PURPOSE: This study was carried out to investigate the correlation among tumor angiogenetic activity, epithelial membrane antigen (EMA) reactivity and various clinicopathologic parameters. We also evaluated the validity of both as an independent prognostic factor in patients with papillary thyroid carcinoma. MATERIALS & METHODS: We studied 120 patients out of 727 patients with papillary thyroid casrcinoma who underwent thyroidectomy at our institute from January 1986 to December 1994. The age of the patients ranged from 14 to 80 years with a mean of 48.2 years. There were 24 males and 96 females (M:F=1:4). The paraffin embedded tissues of these patients were stained with the monoclonal antibodies against factor VIII related antigen, antigen CD34 to highlight microvessels and against EMA to show immunoreactivity. We measured microvessel density (MVD) in the area of highest vascular density at 200 times of magnification (0.785 mm2 per field). The positive cells for EMA were counted as percentages of the whole cell population and the degree of reaction was rated on a five-point scale. RESULTS: Mean MVDs and EMA reactivities by location of tissue per field were 64.8+/-18.9, 1.97+/-0.74, in the center of the tumor; 41.3+/-15.3, 1.55+/-0.68 in the periphery of tumor; and 22.1+/-14.4, 1.09+/-0.75 in normal thyroid tissue, respectively. In relation to TNM stage, only the MVDs of patients with stage IV disease were higher than those of other disease stages with statistical significance (p<.05). In relation to DeGroot stage, the MVDs of patients with stage IV disease was also higher than others with statistical significance (p<.005). There were no significant differences in MVD and EMA reactivity between the two groups of low risk (n=77) and high risk (n=43) by AMES scale. The MVDs and EMA reactivities of patients with local recurrence (n=23) and death (n=7) during the follow-up period had no statistical significance against those patients without recurrence and living patients. CONCLUSION: Tumor angiogenic activity and EMA reactivity in papillary thyroid carcinoma did not correlate with TNM stage, DeGroot stage, AMES score, local recurrence, and patient death. However, MVD was significantly higher in patients with distant metastasis and may be useful in predicting the distant metastasis in papillary thyroid carcinoma.