Tesu Kim

Implantation metastasis of head and neck cancer after fine needle aspiration biopsy.

One possible complication of the aspiration biopsy of malignant tumors is dissemination of tumor cells along the needle track. However, a search of the literature revealed few definite reports of implantation metastases of head and neck tumors after fine needle aspiration biopsy (FNAB). Here we report two cases of skin metastasis of head and neck cancer after FNAB, including a patient with papillary adenocarcinoma of the thyroid and one with adenoid cystic carcinoma of the submandibular gland. Surgical treatment prevented the spread of the tumor in both cases and there have been no evidence of recurrence to date. This report should alert head and neck surgeons to the possibility of implantation metastasis after FNAB.

Clinical features of sudden hearing loss associated with a high signal in the labyrinth on unenhanced T1-weighted magnetic resonance imaging

Abstract We report on five patients with high signals in the labyrinth on unenhanced magnetic resonance imaging who developed sudden hearing loss and vertigo. Weissman et al. (1992) suggested the possibility that such high signals were caused by hemorrhage. We assessed these patients using audiograms, caloric tests, and auditory brainstem responses to investigate the possibility of inner ear hemorrhage. Most of the patients were found to have severe and irreversible impairment of both cochlear and vestibular function. These findings were consistent with the hypothesis that their symptoms were caused by inner ear hemorrhage.

Clinical Outcome of Therapy for Squamous Cell Carcinoma of the Oropharynx; A Retrospective Study of 50 Cases.

We retrospectively reviewed 50 cases of squamous cell carcinoma of the oropharynx treated at the Department of Otolaryngology, Kobe City General Hospital, between 1987 and 1996. Twenty eight cases underwent radical radiotherapy, and the remaining twenty two were treated mainly by surgery with or without radiotherapy.Multivariate analysis demonstrated that the N stage classification was the only significant parameter affecting the survival rate among the four co-parameters: T stage, N stage, histological differentiation and location of the primary lesion. In the well-differentiated group, the survival rate of the surgically-treated cases was significantly higher than that of cases treated with radical radiotherapy. We conclude that radical radiotherapy is less useful in cases of a high N stage (≥N2a) and in well differentiated types of squamous cell carcinomas.

A Case of Multiple Schwannomas with the Initial Symptoms of a Parotid Tumor.

In 1984, Shishiba et al described 4 cases with multiple cutaneous neurilemmomas as “neurilemmomatosis” which is a systemic disease distinct from neurofibromatosis. Since then, some reports have been published on multiple schwannomas as a systemic disease. In this paper, we report a case of multiple schwannomas with the initial symptoms of a parotid tumor.A 64-year-old man visited our hospital complaining of swelling in the right inf raauricular region. Preoperative CT and MRI examinations revealed a 25×25 mm round tumor in the deep portion of the right parotid gland and two other tumors in the deep right upper neck. A malignant tumor in the parotid gland with lymph node metastasis was suspected. An operation revealed that these tumors originated from the facial nerve, a branch of the accessory nerve and the brachial plexus. There were two independent tumors in the facial nerve. The tumor in the accessory nerve was totally removed, but the others were treated conservatively in consideration of his quality of life. The tumors in the accesory and the facial nerves were examined histologically, and were diagnosed as a mixed type schwannoma.The present case could not be considered to be neurofibromatosis, because the patient did not have dermatological findings, cafe au lait spots, neurofibromas, nor a familial history of neurofibromatosis.