著者
篠原 尚吾 山本 悦生 田辺 牧人 辻 純 宗田 由紀 坂本 達則 金 泰秀 寺下 健洋
出版者
耳鼻咽喉科臨床学会
雑誌
耳鼻咽喉科臨床 (ISSN:00326313)
巻号頁・発行日
vol.92, no.7, pp.779-783, 1999-07-01 (Released:2011-11-04)
参考文献数
19
被引用文献数
2 1

Papillary microcarcinomas (PMCs) which are 1.0cm or less in diameter are a specific subgroup of thyroid cancer. As the prevalence of these tumors found in autopsy cases was reported to be 10 to 28.4% in Japan, the necessity of surgical treatment of PMCs has been questioned. However, PMCs are often found in conjunction with advanced metastases in cervical lymph nodes, lung, etc..We reviewed eight cases with PMCs revealed by the presence of cervical metastases over the past 10 years. Five cases were revealed by manifest cervical lymph node metastases. Two of the other three cases were operated on for treatment of metastatic lesions subsequent to other diagnoses, notably a parotid tumor and lateral cervical cyst. The PMCs were revealed in a postoperative histological study of these two cases. The remaining case was discovered incidentally during neck dissection for laryngeal cancer. Preoperative ultrasonography was undertaken in seven cases. Two cases showed multif ocal small high echoic spots without tumors and one case showed no abnormal findings in the thyroid.In all cases, total thyroidectomy, unilateral or bilateral neck dissection and postoperative radioiodine scintigraphy were performed. Multifocal tumors in the thyroid were proven histologically in four cases. In one case, the primary lesion was not found even in a postoperative histological study.In accordance with these observations, PMCs revealed by cervical metastases shoul be treated as advanced thyroid carcinomas.
著者
平野 滋 篠原 尚吾 庄司 和彦 児嶋 久剛
出版者
The Society of Practical Otolaryngology
雑誌
耳鼻咽喉科臨床 (ISSN:00326313)
巻号頁・発行日
vol.89, no.1, pp.75-80, 1996-01-01
被引用文献数
14

Intracapsular enucleation is thought to be a suitable method for preserving post-operative function of the original nerve following treatment for cervical neurilemmomas. In previous studies, however, post-operative palsy occurred in most cases and there have been seen several cases in which nerve funtions did not recover. In the present study, we performed a modified method of Intracapsular enucleation for two cervical neurilemmomas, the first case involved the facial nerve, the second the hypoglossal nerve. In these cases, post-operative palsy has not been observed since immediately after surgery. Important points in this procedure include (1) making the incision line at a point on the capsule where few nerve fibers exist, (2)ablating the capsule from the tumor as gently as possible, (3) monitoring nerve function using a nerve stimulator throughout the procedure.