[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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Recently, as Japanese society has aged and radiation therapy technologies have progressed, people are demanding less invasive cancer treatment without deterioration of QOL. Therefore, cancer treatment is witnessing a paradigm shift toward cure without surgery. Radiation therapy has rapidly developed not only by the progress in radiation machine technologies but also the accumulation of knowledge about radiation molecular biology.
This paper discusses the advances in radiation physics and radiation biology.

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Obstructive sleep apnea hypopnea syndrome (OSAHS) in children is now well known to disturb physical and mental development, and therefore children with severe OSAHS should be treated appropriately. Since the efficacy of adenotonsillectomy in children has been widely reported, this surgical procedure is recognized as an effective therapeutic intervention. However, little attention has been paid to its safety, especially in infants and young children, and so surgery for such cases has tended to be avoided. In the present study, we reviewed charts of 147 cases of OSAHS children who had undergone adenotonsillectomy regarding the duration of surgery, the amount of intraoperative bleeding, the incidence of postoperative respiratory complications and postoperative bleeding, and the duration of hospital stay.
As a result, the duration of surgery and the amount of bleeding in the younger group (0-3 years old) were statistically less than those in the older group (4-6 years old) in adenoidectomy (p < 0.01). There was no statistical difference between the two groups in the incidence of postoperative bleeding (8% vs. 4%) or abnormal shadows in the postoperative chest X-ray (18% vs. 11%). No difference was found also in the duration of hospital stay (8.4 days vs. 8.4 days).
In conclusion, adenotonsillectomy in infants and young children can be performed without major perioperative complications, and is considered an appropriate treatment for OSAHS.

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Benign tumors of the esophagus are rare, and most of them are leiomyoma. We present a rare case of cervical esophageal schwannoma. A 69-year-old female with a thyroid tumor suffered from dysphagia. A CT scan revealed two tumors including a thyroid tumor and an esophageal tumor. In the operation we found that the two tumors were separated: one tumor was in the left lobe of the thyroid gland and the other was in the cervical esophagus. Histologically, the esophageal tumor was composed of thin densely cellular spindle-shaped cells arranged in interlacing fascicles and the tumor cells showed positive immunohistochemical staining for S-100 protein. The esophageal tumor was diagnosed as schwannoma. She was discharged from the hospital and has been doing well with no recurrence for 6 months after surgery.
We also summarize the clinical characteristics of patients with esophageal schwannoma reported in the literature.

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Cystic hygroma usually occurs in infants and children, but rarely develops in adults. We report a case of cystic hygroma arising in the right parotid gland region of a 64-year-old man. The patient presented with a soft and painless swelling mass. Ultrasound, CT, and MRI findings suggested a cystic lesion in the right parotid gland. We performed surgical resection on March 12, 2009. Histopathological examination revealed cystic hygroma. Surgical excision is the most effective approach in the treatment of cystic hygroma, however, the complete removal of lympangiomas in children may be difficult in the case of insinuation of the tumor into the adjacent neck structures. In cases with incomplete removal, recurrence is therefore common. In contrast, cystic hygromas in adults are generally encapsulated masses and can usually be excised completely.
After operation in this case, there was no evidence of recurrence.

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Differentiated thyroid cancer, particularly papillary and follicular carcinomas, progresses slowly and the survival rate is high. It is reported that few cases result in death as long as adequate surgery is performed and palliative surgery allows long-term survival even in cases of advanced cancer. However, exclusion of the trachea, larynx and esophagus by tumor invasion may shorten the vital prognosis. Additionally, it may be difficult to maintain the airway during surgery because of stenosis and exclusion of the trachea, so methods to maintain the airway must be thoroughly discussed preoperatively.
Here we report a case who underwent tracheotomy under percutaneous cardiopulmonary support during general anesthesia as well as resection of the tumor following airway management for papillary thyroid carcinoma (T4aN1bM0) due to difficulties caused by airway stenosis. [[[The original English was very unclear. Please check.]]] The patient was successfully saved.

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