RESUMEN
PURPOSE: Deciding on treatment carcinoma of the tongue when the tumor has a thickness of 1.5 cm or more is difficult. Surgery often requires wide resection and re-construction, leading to considerable functional impairment. A cesium implant is an attractive option, but according to the Manchester System, a two plane implant is needed. MATERIALS AND METHODS: According to the textbook, a tumor is sandwiched between the needles, which are implanted at the edge of the tumor. This may cause an unnecessarily high dose to the outer surface of the tongue, which sometimes leads to a persistent ulcer. To avoid this complication, we invented a modified implantation method, and applied the method to five consecutive patients. RESULTS: With a minimum follow-up of 2 years, all primary tumors in 5 consecutive patients have been controlled. No complications occurred in soft tissue of the tongue or in the mandible. CONCLUSION: Our modified Manchester System was feasible and effective for tumors that has a thickness of 1.5 cm or more.
RESUMEN
We reported nine cases of metastatic skin carcinoma experienced at the Department of Dermatology, Obihiro Kosei Hospital during the period from April 1991 to March 1993. Lung was the most common primary lesion (four out of nine cases), followed by uterus (two) and stomach, breast, and kidney (one each). The clinical features of the metastases were classified into nodular (five cases), inflammatory (one case) and sclerotic (three cases) types. Peculiar zoster-like inflammation was seen in metastatic gastric cancer. Pathologically, adenocarcinoma was more common than squamous cell carcinoma. The average interval between the diagnosis of the primary cancers and the development of the skin metastases was about 30±25 months. The average life span after the detection of the skin metastases was 6.8±5.6 months. Poor prognosis of skin metastasis was thus reconfirmed.