The Ten Cases of Recurrent Pleomorphic Adenoma of Parotid Gland / 대한이비인후과학회지

BACKGROUND: The main cause of recurrent pleomorphic adenoma of the parotid gland is known to be incomplete surgical excision or accidental rupture of tumor pseudocapsule during surgery, which results in spillage of tumor cells into the wound. Recurrent pleomorphic adenoma of the parotid gland warrants consideration since there is a potential for the risk of malignant conversion. OBJECTIVES: We investigated clinical characteristics of recurrent pleomorphic adenoma of the parotid gland and analyzed the results of the treatment to establish surgical management modalities. MATERIALS AND METHODS: We examined retrospectively 10 cases of recurrent pleomorphic adenoma of the parotid gland and reviewed their clinical features, histopathologic findings, operative findings and postoperative outcomes. Six cases were female and four were male with the mean age of 45.8 years at the time of treatment. The average follow up period was six years and three months. RESULTS: Primary treatments included mass enucleation in seven cases and superficial parotidectomy in three cases. We performed total parotidectomy via anterior approach for all cases and limited neck dissection on level II was performed for six cases in whom the tumor spread was suspected. No patient experienced permanent facial nerve paralysis and tumor recurrence postoperatively except for two patients who died of lung metastasis despite radical tumor extiration and radiotherapy. CONCLUSION: Recurrent pleomorphic adenoma of the parotid gland is largely dependent on primary treatment. Recurrent tumors usually have multiple lesions, therefore total parotidectomy with limited neck dissection should be combined as a treatment modality and always been in mind the possibility of malignant conversion.

Conservation Surgery for Hypopharyngeal Cancer / 대한이비인후과학회지

BACKGROUND: Hypopharyngeal cancer was known to be more aggressive, extensive, and clinically malignant than laryngeal cancer, not generally considered suitable for conservative surgery in the past. Ogura, et al(1960) reported little was gained by sacrificing the entire larynx in many cases of hypopharyngeal cancer. OBJECTIVE: Present study was undertaken to evaluate the complications and results of conservation surgery for hypopharyngeal cancer. MATERIALS AND METHODS: A retrospective review of six patients treated by conservation surgery for early hypopharyngeal cancer was performed. The patients had squamous cell carcinomas at various subsites, including the medial wall of piriform sinus(three patients), posterior hypopharyngeal wall(two patients), and lateral wall of hypopharynx(one patient). Stage of primary tumor showed T1 of 4 patients and T2 of 2 patients. Partial laryngopharyngectomy was performed for three patients with medial wall of piriform sinus, median labiomandibular approach for two patients with posterior wall of hypopharynx and partial pharyngectomy via lateral pharyngotomy for a patient with lateral wall of piriform sinus. Four patients with cervical lymph node metastasis underwent radical neck dissection. Postoperative radiation therapy were done for all patient with 5500 to 6700 cGy. RESULTS: Complications of surgical procedure showed two patients with aspiration and a patient with pharyngocutaneous fistula. Despite of shorterm follow-up period all but one patient showed no evidence of disease. A patient is alive with distant metastasis. CONCLUSION: Conservation surgery seems to be effective surgical method to control the early hypopharyngeal cancer.