A Case of Infantile Fibromatosis of Neck / 대한이비인후과학회지

Infantile fibromatosis, which represents the childhood counterpart of musculoaponeurotic fibromatosis (abdominal or extraabdominal desmoid), usually arises as a solitary mass in skeletal muscle or in the adjacent fascia, aponeurosis, or periosteum. It chiefly affects children from birth to 8 years of age and is slightly more common in boys than in girls. Although infantile fibromatosis is a benign tumor, its nature is malignant for an aggressive clinical course with a tendency to recur in high percentage. Complete excision with an ample margin, the choice of treatment, is often extremely difficult and in some cases, may be impossible without disfigurement or dysfuction. In recurred cases, supplemental radiotherapy and chemotherapy can be tried. We present one case of infantile fibromatosis that has appeared at the right neck during first several months of life. The lesion was excised and diagnosis was confirmed by histologic examination. Some reviews with literature were supplemented.

Diagnostic Significance of the Endoscopy-guided Biopsy with Tonsillectomy in Suspected Occult Primary Tumor / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: An occult primary tumor is defined as histologic evidence of malignancy in the cervical lymph nodes with no apparent primary site of origin for the metastatic tumor. MATERIALS AND METHODS: Twenty-three patients who have failed to detect primary tumor on their initial physical examinations, endoscopy and other imaging studies, underwent endoscopy-guided biopsy under the general anesthesia. The histologic examination of frozen sections was done in the operation room. For those failing to give results by the histologic study, we performed the ipsilateral tonsillectomy biopsy. RESULTS: Nine primary lesions were identified: four cases of tonsillar fossa, one case each of nasopharynx, base of tongue, hypopharynx, supraglottis, and esophagus. In the three of the four tonsillar cancer cases, the primary foci were also identified by tonsillectomy biopsy. All the patients whose primary foci were tonsillar fossa showed metastasis of the jugulodigastric lymph node. CONCLUSION: Our results indicate that patients who are considered to have occult primary tumor should be evaluated by endoscopy-guided biopsy under the general anesthesia. Also, this study finds that if the histologic result of the frozen section were negative, ipsilateral tonsillectomy can be justified, especially for patients who show metastasis of jugulodigastric cervical lymph node.