• Title/Summary/Keyword: 관절종양

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Intraosseous Malignant Peripheral Nerve Sheath Tumor of Multiple Bones of the Midfoot: A Case Report (중족부에 발생한 다발성 악성 말초 신경초 종양 1예: 증례 보고)

  • Lee, Hyobeom;Kim, Gab-Lae;Kim, Donghyeon
    • Journal of Korean Foot and Ankle Society
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    • v.24 no.4
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    • pp.156-160
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    • 2020
  • Malignant peripheral nerve sheath tumors (MPNSTs) usually arise in soft tissues; they are rarely found in the bone. This paper reports a case of MPNST in the foot and ankle joint involving the distal tibia, talus, calcaneus, navicular, medial intermediate, and lateral cuneiform, cuboid, and 2nd to 4th metatarsal bone. Palliative treatment was performed. The authors encountered a patient with intraosseous MPNST of the midfoot who presented with nonspecific clinical and radiologic findings. This case shows that a high index of suspicion and a histopathology examination, including immunohistochemistry, will be necessary for an accurate diagnosis.

Treatment of stage 3 giant cell tumor around the knee (슬관절 주위에 발생한 stage 3 거대세포종의 치료)

  • Bank, Won-Jong;Rhee, Seung-Koo;Kang, Yong-Koo;Kwon, Oh-Soo;Chung, Yang-Guk
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.1
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    • pp.124-129
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    • 2003
  • Purpose: To analyze the clinical outcome and radiological features after surgical treatment of stage III giant cell tumor around the knee. Materials and Methods: 21 patients with stage III giant cell tumor around the knee joint, who were operated at our institutes between March 1991 and February 2000, were selected for this study. The average follow-up was 5.7 years (range, 1~9 years). After thorough curettage using high speed burr, cryosurgery and cementing with polymethymethacrylate (PMMA) were performed in 11 patients. 7 patients were treated with PMMA cementing (4 patients) or bone grafting (3 patients) after curettage without cryosurgery. Reconstruction with prosthesis composite allograft and knee fusion with Huckstep nail were performed in 3 patients with huge defect and joint perforation. Results: Local recurrence developed in 1 out of 11 patients who was treated with curettage and cementing with cryosurgery (9.1%) and 3 out of 7 patients who underwent curettage and cementing without cryosurgery (28.6%). Joint space narrowing more than 3mm was noted in 1 patient (9.1%), who treated with cryosurgery and anther patient (14.5%) who treated without cryosurgery. There was no local recurrence in case of wide resection and reconstruction. Conclusion: Thorough curettage and PMMA cementing with cryosurgery as an adjuvant is thought to be effective modalities in the treatment of stage 3 giant cell tumors around the knee. Wide resection and reconstruction can be reserved mainly for the cases of stage 3 giant cell tumor with significant cortical destruction and marked joint destruction, and the cases of local recurrence with poor bone stock.

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Dedifferentiated Parosteal Osteosarcoma of the Femur - A Case Report - (대퇴골에 발생한 역분화성 방골성 골육종 - 증례보고 -)

  • Park, Hye-Rim;Park, Yong-Koo;Jang, Joon-Dong;Nam, Eun-Sook;Sohn, Jin-Hee
    • The Journal of the Korean bone and joint tumor society
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    • v.5 no.1
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    • pp.70-75
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    • 1999
  • We present a case of parosteal osteosarcoma of the femur with secondary dedifferentiation. This 57-year-old woman was radiologically diagnosed as a parosteal osteosarcoma in 1987. In 1992, excisional biopsy revealed a classical parosteal osteosarcoma with diploidy DNA pattern. In 1998, she revisited due to a recurrent tumor with pathologic fracture. The resected specimen showed a classic parosteal osteosarcoma with area of dedifferentiation, showing high-grade spindle cell sarcoma. This dedifferentiated area revealed aneuploidy cell population on DNA flow cytometry. This case reminds us that not all parosteal osteosarcomas are low-grade lesions. Some low-grade lesions may dedifferentiate to become high-grade tumors after inadequate excision.

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Parachordoma of Inguinal Region - A Case Report - (서혜부에 발생한 유척색종 - 증례 보고 -)

  • Moon, Sang-Ho;Kim, Dong-Jun;Kong, Gyu-Min;Lee, Soo-Won;Shim, Jong-Ok;Park, Jean-Kyung;Kim, Sung-Hwan
    • The Journal of the Korean bone and joint tumor society
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    • v.14 no.1
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    • pp.68-72
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    • 2008
  • Parachordoma is an extremely rare tumor that histologically resembles chordoma of axial skeleton but occurs in a peripheral site. It is considered an indolent neoplasm with potential for local recurrence. We present a case of soft tissue parachordoma at inguinal subcutaneous tissue which recurred 2 months after primary simple excision under local anesthesia and was performed revisional wide excision. Bone scan showed no other metastatic lesion. Immunohistochemical findings revealed tumor cells to be reactive to EMA, S-100 protein, vimentin and cytokeratin.

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Adipose Tumor, Fibroblastic/Myofibroblastic Tumors, So-called Fibrohistiocytic Tumors, Smooth Muscle Tumors, Pericytic Tumors and Skeletal Muscle Tumors: An Update Based on the New WHO Soft Tissue Classification (연조직종양의 새로운 WHO 분류를 중심으로: 지방세포종, 섬유모세포성/근육섬유모세포성종, 소위섬유조직구종, 평활근종, 혈관주위종과 근골격종에 대하여)

  • Suh, Kyung-Jin
    • The Journal of the Korean bone and joint tumor society
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    • v.14 no.1
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    • pp.1-9
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    • 2008
  • Soft tissue tumor classifications should be an important part of radiology, oncology and, for clinicians and pathologists, they provide diagnostic instruction and prognostic guidelines. In soft tissue tumor classification systems, the World Health Organization (WHO) classifications have become dominant, enabled by the timely publication of new 'blue books' which included detailed text and numerous good illustrations. The new WHO classification of soft tissue tumors was introduced in 2002. Because the classification represents a broad consensus concept, it has gained widespread acceptance around the globe. This article reviews the changes which were introduced the adipose tumors, fibroblastic/myofibroblastic tumors, so-called fibrohistiocytic tumors, smooth muscle tumors, pericytic tumors and skeletal muscle tumors which have been first recognized or properly classified during the past decade.

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Intradural Schwannoma Associated with Lumbar Spinal Stenosis: A Cese Report (요추부 척추관 협착증과 동반된 경막내 신경초종: 증례 보고)

  • Soh, Jae-Wan;Kim, Tae-Heon;Kwon, Sai-Won
    • The Journal of the Korean bone and joint tumor society
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    • v.17 no.2
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    • pp.106-110
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    • 2011
  • In the patient who has intradural mass associated with spinal stenosis, if the operation for spinal stenosis is performed alone, the symptom may remain. We report with literature review that we achieved the successful outcome after simultaneous decompression of spinal stenosis and space occupying mass removal in the case of intradural and extradural compression. A 71-year-old female patient suffering from low back pain and radiating pain of both lower extremities admitted. In magnetic resonance imaging, spinal stenosis on L4-5 and spondylolisthesis on L5-S1 compressed dural sac and intradural space occupying mass on L4 level compressed. By posterior approach, decompression and interbody fusion were carried out. Then mass was removed with median durotomy. Pathologic diagnosis was schwannoma and the symptom was improved remarkably.

A Case Report : TMJ Osteoarthritis in a Patient with Renal Osteodystrophy (턱관절의 골관절염을 동반한 신성골이영양증 환자 증례보고)

  • Lee, Gi-Ho
    • Journal of Oral Medicine and Pain
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    • v.38 no.3
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    • pp.247-253
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    • 2013
  • Renal osteodystrophy(RO) is characterized by skeletal changes in patients with renal disease and developed as a result of alterations in the metabolism of calcium, phosphate and secondary hyperparathyroidism. Bony changes in the craniofacial region include decreased bone density, radiolucent lesions(brown tumors), depletion of cortical bone and loss of lamina dura, but such changes rarely occur in the temporomandibular joint(TMJ). We report an uncommon case of bony changes and pain of both TMJs in a patient with RO. A 41-year-old man with RO came to our clinic due to TMJ pain and sounds. Occlusal change was also reported. Radiographs revealed degenerative changes of the both condyles. The patient had medical history of renal cancer therapy and hemodialysis. The patient was diagnosed with TMJ arthritis of RO and referred for systemic management through medication of calcium and vitamin D and parathyroidectomy. At 15-month follow-up, most of TMD symptoms disappeared and second radiographs revealed that bone density and cortical thickness of the mandible increased and the skeletal outline of the both condyles became relatively clear. As bony changes may begin in the early stage of the renal disease, dentists should be alert to detect the sign of the disease. In addition, it is important to differentiate TMJ arthritis of systemic cause because the treatment protocol is quite different.

Femur Fractures Associated with Benign Bone Tumors in Children (양성 골종양을 동반한 소아 대퇴골의 병적 골절)

  • Jung, Sung-Taek;Kim, Byung-Soo;Moon, Eun-Sun;Lee, Keun-Bae;Seo, Hyoung-Yeon
    • The Journal of the Korean bone and joint tumor society
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    • v.11 no.2
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    • pp.111-117
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    • 2005
  • Purpose: We evaluate the results of treatment of pathologic femur fractures secondary to bone tumors in children. Materials and Methods: Between January 1995 and June 2004, 18 patients(20 cases) were evaluated. Their mean age of the first episode of fracture was 10.2 years and mean follow-up period is 42.5 months. Primary bone tumors, the location of fracture, time to union and complications were evauated. Results: Fractures occurred at proximal portion in 14 cases, shaft 3 cases and distal portion 3 cases. The bone tumors causing pathologic fracture were fibrous dysplasia(9 c ases), simple bone cyst(4 cases), aneurysmal bone cyst(4 cases), nonossifying fibroma(2 cases) and eosinophilic granuloma(1 case). In the treatment for fractures, cast was in 11 cases, internal fixation 8 cases and external fixation in 1 case. In the treatment for tumors, observation was in 11 cases, curettage & bone graft in 8 cases and resection in 1 case. In polyostotic fibrous dysplasia, all cases were treated by cast initially but deformity developed in all cases. Fracture prevention and deformity correction were obtained with intramedullary nailing. Conclusion: Adequate choice of treatment of bone tumor and fracture will result in good prognosis.

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Short Term Result of Total en Bloc Spondylectomy in Spine Tumor (원발성 및 전이성 척추종양에 대한 전 척추 절제술의 단기 추시 결과)

  • Kim, Jae-Do;Jang, Jae-Ho;Park, Chan-Jae;Chung, Jae-Yoon
    • The Journal of the Korean bone and joint tumor society
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    • v.13 no.1
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    • pp.37-42
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    • 2007
  • Purpose: Because of the anatomical characteristics, it is difficult to perform radical operation in spinal tumor. Numerous operations on primary and metastatic spinal tumor have been performed and among those total en bloc spondylectomy has produced decent clinical result. Clinical and radiological results have been analyzed based on five total en bloc spondylectomy on primary and metastatic spinal tumor. Materials and Methods: Patients included in this study were one with primary and four with metastatic spinal tumors, from June 1997 to January 2006. Two of the four were originated form kidney. One was from breast and the other one was not identified. McAfee's 4 point scale, VAS and Frankel's classification have been used as clinical assessment of pain and neurological symptoms. Clinical assessment have been conducted for every 3 months after operation including local recurrence, bone union and complications. Results: Assessment of pain decreased from average of 3 before operation to 1.6 after operation in McAfee's scale and VAS decreased from average of 9.2 to 1.6. Neurological deficit after operation improved from C to D in Frankel's category. Local recurrence has been detected on metastatic adenocarcinoma of L4 during follow up. Conclusion: Total en bloc spondylectomy is evidently useful operational method for primary and metastatic spinal tumor since it completely decompresses spinal nerves, decreases axial pain immediately and improves the quality of remaining life.

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