CT Finding of Tuberculous Cervical Lymphadenitis and Management / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: There are controversies in the management of tuberculous cervical lymphadenitis in spite of high prevalence. This study was performed to investigate clinical findings of the patients indicated for surgery and to analyze clinical efficacies of surgery and antituberculous chemotherapy. Materials and METHODS: Fourty patients who had been pathologically confirmed to have cervical tuberculous lymphadenitis were analyzed retrospectively. We classified them into 4 groups according to CT findings and checked their clinical and laborotary findings, as well as efficacies of treatment used. RESULTS: The Type 4 was the most common. All patients were treated with antituberculous medication. In Type 1 and 2, 11 patients among 13 patients were treated with antituberculous medication alone, whereas in Type 3 and 4, 21 patients among 27 patients were treated with the combined method of surgery and antituberculous medication. Most complicated cases were Type 3 and 4, where two cases had recurrence, but most of the cases had local wound problems. All of these complicated cases had recovered to nearly normal state. Two recurrent cases were treated with the combined methods completely. CONCLUSION: For cases that fall into type 1 and 2 tuberculous cervical lymphadenopathys, Antituberculous medication can serve as the first line of treatment. For cases that fall into type 3 and 4 tuberculous cervical lymphadenopathy, the combined method of surgery and antituberculous medication can be the first choice of treatment. For the initial treatment of type 3, 4, applying antituberculous medication for a period of 1-2 months before surgical intervention would be a more effective treatment.

Multiple Nonfunctioning Parathyroid Carcinoma Secondary to Chronic Renal Failure / 대한이비인후과학회지

Parathyroid carcinoma is a rare entity accounting for only 0.5% to 5% of all cases of parathyroid neoplasm. Most of these malignancies present themselves as functional hormone-producing masses with elevated serum levels of parathormone and calcium. These tumors may also be nonfunctional, which is even rarer. Clinical detection of nonfunctioning parathyroid carcinoma prior to operation is primarily based on symptoms of an expanding neck mass and voice change. These condition may allow it to escape clinical attention until it has achieved an advanced state. So, the prognosis is relatively too bad. Most of these tumors often arise from preexisting parathyroid hyperplasia or adenoma. En bloc resection of primary lesion, ipsilateral thyroid lobe and isthmus together with a neck dissection only in case of lymph node involvement is recommended as the standard treatment. In this paper, we will introduce a case report of a bilateral nonfunctioning parathyroid carcinoma secondary to chronic renal failure.

Epidemiologic Survey of Head and Neck Cancers in Korea

Head and neck cancers have never been systematically studied for clinical purposes yet in Korea. This epidemiological survey on head and neck cancer patients was undertaken from January to December 2001 in 79 otorhinolaryngology resident-training hospitals nationwide. The number of head and neck cancer patients was 1,063 cases in the year. The largest proportion of cases arose in the larynx, as many as 488 cases, which accounted for 45.9%. It was followed by, in order of frequency, oral cavity (16.5%), oropharynx (10.0%), and hypopharynx (9.5%). The male:female ratio was 5:1, and the mean age was 60.3 yr. Surgery was the predominant treatment modality in head and neck cancers: 204 (21.5%) cases were treated with only surgery, 198 (20.8%) cases were treated with surgery and radiotherapy, 207 cases (21.8%) were treated with combined therapy of surgery, radiotherapy, and chemotherapy. Larynx and hypopharynx cancers had a stronger relationship with smoking and alcohol drinking than other primary site cancers. Of them, 21 cases were found to be metastasized at the time of diagnosis into the lung, gastrointestinal tract, bone, or brain. Coexisting second primary malignancies were found in 23 cases. At the time of diagnosis, a total of 354 cases had cervical lymph node metastasis accounting for 42.0%.