Cancers of the upper aerodigestive tract (UADT) constitute 3.5-4% of all malignancies. Since the majority of cases are squamous cell carcinomas which are related with epidemiologic factors, a different pattern of UADT cancer might be present between the Western and Asian populations. We performed a pathology based statistical study on UADT cancers in Korean patients. Cases from Korea Cancer Center Hospital, from January 1, 1988 through December 31, 1998, were subjected to the study. Among 2,842 cases, epithelial malignancies accounted for 87.8%, with squamous cell carcinoma as the major type (76.5%). The larynx was the most commonly affected site (26%), followed by the oral cavity (25.1%), oropharynx (13%), nasopharynx (9%), hypopharynx (8.4%), paranasal sinuses (6.4%), nasal cavity (6%) and salivary glands (6.1%). The percentage of squamous cell carcinoma was highest (98.7%) at the hypopharynx, and lowest at the nasal cavity (42.3%), which showed the most diverse tumor entities. Korean patients with UADT cancers presented with a higher incidence of non-epidermoid malignancy including sarcoma (1.5%) and malignant melanoma (1.4%), and a higher frequency of involvement of the sinonasal tract, compared with the Western patients.
Head and Neck Neoplasms/classification/*pathology ; Humans ; Hypopharyngeal Neoplasms/classification/pathology ; Korea ; Laryngeal Neoplasms/classification/pathology ; Mouth Neoplasms/classification/pathology ; Nasal Cavity ; Nasopharyngeal Neoplasms/classification/pathology ; Oropharyngeal Neoplasms/classification/pathology ; Paranasal Sinus Neoplasms/classification/pathology ; Salivary Gland Neoplasms/classification/pathology

salivary gland tumors. Pleomorphic adenoma accounts for 60% of all parotid gland tumors, 50% of submandibular gland tumors, and only 25% of sublingual gland neoplasms. Fifty percent of all oral minor gland tumors are pleomorphic adenomas of which 55% arise in the palate, 25% in the lip, 10% in the buccal mucosa, and 10% from all other oral and oropharyngeal sites. The presence of tumors within the parapharyngeal space is rare. Some investigators have reported pleomorphic adenomas originating in the deep lobe of the parotid gland advancing to involve this region, as well as primary pleomorphic adenomas of nonparotid origin. We present a case report of pleomorphic adenoma in the parapharyngeal space with literature review. The tumor was completely removed under general anesthesia via submandibular incision with the division of mandible.]]>
Adenoma, Pleomorphic ; Anesthesia, General ; Humans ; Lip ; Mandible ; Mouth Mucosa ; Palate ; Parotid Gland ; Research Personnel ; Salivary Glands ; Sublingual Gland Neoplasms ; Submandibular Gland

As an uncommon, malignant salivary gland tumor with female predominance, hyalinizing clear cell carcinoma (HCCC) is regarded as an indolent tumor. The diagnosis of this rare tumor is challenging, and it depends on microscopic and immunohistochemical (IHC) studies. Although it is regarded as an indolent tumor, there are reports of unconventional forms with aggressive clinical courses. We report an atypical case of this rare tumor, HCCC, in a male patient who had a relatively large-sized mass (3.8x3.0 cm) on the right mouth floor with ipsilateral neck node metastasis. The clinical, radiological, pathological, and IHC features together with the clinical course are described.
Adenocarcinoma ; Diagnosis ; Female ; Head and Neck Neoplasms ; Humans ; Hyalin* ; Male ; Mouth Floor ; Neck ; Neoplasm Metastasis ; Salivary Glands ; Sublingual Gland

OBJECTIVES: The purpose is to provide detailed estimates of population-based incidences of head and neck cancers (HNCs) between 1999 and 2012 in South Korea and to evaluate trends. METHODS: Data was reviewed from the Korea National Cancer Incidence Database regarding the incidence of HNCs between 1999 and 2012. Locations that were surveyed included lip, oral tongue, oral cavity, major salivary gland, nasopharynx, nasal cavity and paranasal sinus, tonsil, hypopharynx, oropharynx, and larynx. Age-standardized incidence rates were calculated and provided with 95% confidence intervals. The increase ratio of HNCs for and male-to-female ratios were also calculated. RESULTS: The incidence of lip (0.07–0.10/100,000 people) and oropharyngeal cancer (0.09–0.12/100,000 people) remained low during the study period while laryngeal cancer (1.17–2.08/100,000 people) occurred most frequently. The incidence of oral tongue, major salivary gland, tonsil, and hypopharynx increased steeply compared to other HNCs between 1999 and 2012. Male-to-female ratio was over 1.0 for all HNCs, especially for those of tonsil, hypopharynx, oropharynx, and larynx cancer which were >5.0. CONCLUSION: The incidence of all the HNCs except for laryngeal cancer has increased yearly in men and women in South Korea since 1998. Rates of oral tongue, major salivary gland, and tonsil cancer have increased the most rapidly during this time period.
Female ; Head and Neck Neoplasms* ; Head* ; Humans ; Hypopharynx ; Incidence ; Korea* ; Laryngeal Neoplasms ; Larynx ; Lip ; Male ; Mouth ; Nasal Cavity ; Nasopharynx ; Neck ; Oropharyngeal Neoplasms ; Oropharynx ; Palatine Tonsil ; Republic of Korea ; Salivary Glands ; Tongue ; Tonsillar Neoplasms

Thirty-six patients (24 with oral cavity or oropharynx cancers and 12 larynx cancers) were prospectively examined with computed tomography (CT) to determine its value in staging the primary tumor and to compare with the clinical staging. The CT staging agreed with the clinical staging in 50% (12/24) of the oral cavity or oropharynx cancers and in 67% (8/12) of the larynx cancers. The CT upgraded the clinical staging in 29% (7/24) of the oral cavity or oropharynx tumors and in 33% (4/12) of the larynx cancers, whereas the CT downgraded the clinical staging in 21 % (5/24) of the oral cavity or oropharynx cancers. There is no downgrade on CT in larynx cancer. The post-surgical confirmation was not made in most of the cases. The possible causes of disagreement between the CT and the clinical staging, and the diagnostic value of the CT in evaluation of the primary tumor in oral cavity, oropharynx and larynx were discussed.
Head and Neck Neoplasms ; Head ; Humans ; Laryngeal Neoplasms ; Larynx ; Mouth ; Oropharyngeal Neoplasms ; Oropharynx ; Prospective Studies

The salivary gland most frequently involved with secondary cancer is the parotid gland. Metastases are responsible for 21-42% of malignant parotid tumors. Malignant melanoma and squamous cell cancer are the two most common tumors to metastasizing to the parotid gland. Renal cell carcinoma takes up 85% of primary malignant renal tumors. It rarely metastasizes to the head and neck area. When metastasis to head and neck area occurs, it involves the gingiva, tongue, palate, parotid gland, uvlua, mandible, and lip. When tumorous areas arefound in the salivary gland consisting of clear cells, it is important to carry out differential diagnosis of various primary tumors with clear cells and metastatic renal cell carcinoma. In this paper, we report on a case of renal cell carcinoma which had metastasized to the parotid gland after a radical nephrectomy.
Carcinoma, Renal Cell ; Diagnosis, Differential ; Gingiva ; Head ; Lip ; Mandible ; Melanoma ; Neck ; Neoplasm Metastasis ; Neoplasms, Squamous Cell ; Nephrectomy ; Palate ; Parotid Gland ; Salivary Glands ; Tongue

PURPOSE: Radiation therapy in combination with surgery has an important role in the therapy of the head and neck cancer. We conducted a prospective study for patients with head and neck cancer treated with surgery and radiation to evaluate the effect of therapies on the thyroid gland, and to identify the factors that might influence the development of hypothyroidism. MATERIALS AND METHODS: From September 1986 through December 1994, 71 patients with head and cancer treated with surgery and radiation were included in this prospective study. Patients' age ranged from 32 to 73 years with a median age of 58 years. There were 12 women and 59 men. The primary tumor sites were larynx in 34 patients, hypopharynx in 13 patients, oral cavity in 12 patients, unknown primary of the neck in 6 patients, salivary gland in 3 patients, maxillary sinus in 2 patients, and oropharynx in 1 patient. Total laryngectomy with neck dissection was carried out in 45 patients and neck dissection alone in 26 patients. All patients were serially monitored for thyroid function (T3, T4, free T4, TSH, antithyroglobulin antibody and antimicrosomal antibody) before and after radiation therapy. Radiation dose to the thyroid gland ranged from 40.6Gy to 60Gy with a median dose of 50Gy. The follow-up duration was 3 to 80 months. RESULTS: The overall incidence of hypothyroidism was 56.3% (40/71); 7 out of 71 patients (9.9%) developed clinical hypothyroidism and 33 patients (46.4%) developed subclinical hypothyroidism. No thyroid nodules, thyroid cancers, or hyperthyroidism was detected. Hypothyroidism developed earlier in patients who underwent total laryngectomy with neck dissection than in patients with neck dissection alone (P<0.05). The risk factor that significantly influenced the incidence of hypothyroidism was a combination of surgery (total laryngectomy with neck dissection) and radiation therapy (P= 0.0000). Four of 26 patients (15.4%) with neck dissection alone developed hypothyroidism while 36 of 45 patients (80%) with laryngectomy and neck dissection developed hypothyroidism. CONCLUSION: The hypothyroidism following surgery and radiation therapy was a relatively common complication. The factor that significantly influenced the incidence of hypothyroidism was combination of surgery and radiation therapy. Evaluation of thyroid function before and after radiation therapy with periodic thyroid function tests is recommended for an early detection of hypothyroidism and thyroid hormone replacement therapy is recommended whenever hypothyroidism develops.
Female ; Follow-Up Studies ; Head and Neck Neoplasms* ; Head* ; Hormone Replacement Therapy ; Humans ; Hyperthyroidism ; Hypopharynx ; Hypothyroidism* ; Incidence ; Laryngectomy ; Larynx ; Male ; Maxillary Sinus ; Mouth ; Neck ; Neck Dissection ; Oropharynx ; Prospective Studies ; Risk Factors ; Salivary Glands ; Thyroid Function Tests ; Thyroid Gland ; Thyroid Nodule

OBJECTIVE: To investigate the value of diffusion-weighted magnetic resonance imaging (DW-MRI) as a noninvasive tool to assess salivary gland function for follow-up of patients with radiation-induced xerostomia. MATERIALS AND METHODS: This study included 23 patients with nasopharyngeal carcinoma who had been treated with parotid-sparing radiotherapy (RT). Salivary function was assessed by DW-MRI pre-treatment and one week and one year post-RT, respectively. The maximum apparent diffusion coefficient (ADC) of parotid glands (pADCmax) and the time to peak ADC of parotid glands (pTmax) during stimulation were obtained. Multivariate analysis was used to analyze factors correlated with the severity of radiation-induced xerostomia. RESULTS: The ADCs of parotid and submandibular glands (1.26 ± 0.10 × 10−3 mm2/s and 1.32 ± 0.07 × 10−3 mm2/s pre-RT, respectively) both showed an increase in all patients at one week post-RT (1.75 ± 0.16 × 10−3 mm2/s, p < 0.001 and 1.70 ± 0.16 × 10−3 mm2/s, p < 0.001, respectively), followed by a decrease in parotid glands at one year post-RT(1.57 ± 0.15 × 10−3 mm2/s, p < 0.001) but not in submandibular glands (1.69 ± 0.18 × 10−3 mm2/s, p = 0.581). An improvement in xerostomia was found in 13 patients at one year post-RT. Multivariate analysis revealed 4 significant predictors for the improvement of xerostomia, including dose to parotid glands (p = 0.009, odds ratio [OR] = 0.639), the ADC of submandibular glands (p = 0.013, OR = 3.295), pADCmax (p = 0.024, OR = 0.474), and pTmax (p = 0.017, OR = 0.729) at one week post-RT. CONCLUSION: The ADC value is a sensitive indicator for salivary gland dysfunction. DW-MRI is potentially useful for noninvasively predicting the severity of radiation-induced xerostomia.
Diffusion ; Follow-Up Studies* ; Head and Neck Neoplasms ; Humans ; Magnetic Resonance Imaging* ; Multivariate Analysis ; Odds Ratio ; Parotid Gland ; Radiotherapy ; Salivary Glands* ; Submandibular Gland ; Xerostomia*

Synovial sarcoma is a malignant soft tissue with unknown origin. Although head and neck region is the second common site of involvement, rare cases have been reported in Para nasal sinus and larynx. We presented two cases of synovial sarcoma, one of which arised from maxillary sinus and the other from laryx, and re- view the literature to sum up the diagnosis and treatment strategies. The conclusion is that synovial sarcoma in the head and neck still raises diagnostic and therapeutic issues. Surgical excision with wide margins is essential and necessary, usually associated radiotherapy. The effect of chemotherapy remains to explored.
Head and Neck Neoplasms ; pathology ; Humans ; Larynx ; Maxillary Sinus ; Paranasal Sinuses ; Sarcoma, Synovial ; pathology

Sinonasal cancers account for less than 1% of all malignancies and comprise 3% of all head and neck malignancies. The most common malignant neoplasm in the sinuses and nose is squamous cell carcinoma, which accounts for 70% of these neoplasms. Most of these arise in the maxillary antrum, and only 10% to 30% occur in the nasal cavity or ethmoid sinus. It is well known the surgery is primary treatment for sinonasal malignancies. Adjunctive irradiation and/or chemoradiatioin has resulted in improved locoregional control and increased survival rates. The goal of surgical resection is to remove the cancer en bloc, with clear margin devoid of neoplastic cells. For maxillary sinus neoplasms, maxillectomy is a standard surgical procedure. Neoplasms involving the ethmoid, frontal, or sphenoid sinuses may require a craniofacial approach because of frequent invasion into the skull base. The proximity of the nasal cavity and paranasal sinuses to the adjacent structures including the orbit, dura, brain, cranial nerves, and carotid arteries mandates careful radiologic and neurologic evaluations throughout the course of the disease. Surgical advances now permit complex tumor removal and reconstruction surrounding these structures resulting in functional and cosmetic improvements when compared to earlier techniques.
Brain ; Carcinoma, Squamous Cell ; Carotid Arteries ; Cranial Nerves ; Ethmoid Sinus ; Head ; Maxillary Sinus ; Maxillary Sinus Neoplasms ; Methods ; Nasal Cavity ; Neck ; Nose ; Orbit ; Paranasal Sinuses ; Skull Base ; Sphenoid Sinus ; Survival Rate