• Title/Summary/Keyword: 관절종양

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Autogenous Low Heat Treated Bone Graft for Bone Reconstruction in Bone and Soft Tissue Tumors (골연부 종양에서 저온 열처리한 자가골을 이용한 재건술)

  • Jeon, Dae-Geun;Lee, Jong-Seok;Kim, Sug-Jun;Cho, Wan-Hyeong;Kwag, Bong-Jun;Lee, Soo-Yong
    • The Journal of the Korean bone and joint tumor society
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    • v.4 no.2
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    • pp.81-87
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    • 1998
  • Although autoclaved autogenous bone reconstruction is one of the established procedures, it may have some problems in bone regeneration and mechanical property. The purpose of this study is to evaluate the efficacy of more biologic and anatomical reconstruction where allograft is not readily available. From Aug.1991 to Feb. 1996 the authors analyzed 32 cases of reconstruction with autogenous low heat treated bone. Autogenous graft sites were humerus 4, tibia 4, pelvis 9, and 15 femur. Average follow-up period was 23(range;12-51) months. There were 49 graft-host junctional sites. Diaphysis was 22, metaphysis 10, and flat bone 17. Average duration of healing for the 38 united sites was 7 months. Average union time for each anatomical area 8 months in 19 diaphysis, 12 months in 7 metaphysis, and 12.7 months in 12 flat bone(pelvis). Eleven nonunion sites consisted of 3 diaphysis(3/22), 3 metaphysis(3/10), and 5 flat bone(5/17). Complications other than nonunion were local recurrence(4), bone resorption(3), graft fracture(2), osteomyelitis(1), metal failure(2), and wound infection(1). Initial bone quality and stable fixation technique was important for union rate. Plate and screw is a good method for diaphyseal lesion. Metaphyseal and flat bone are weak area for rigid fixation and one stage augmentation with iliac bone graft can be a salvage procedure.

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High Grade Surface Osteosarcoma - Case Report - (고등급 표면(High Grade Surface) 골육종 - 증례 보고 -)

  • Lee, Bong-Jin;Lee, Sung-Rak;Yoo, Tae-Yeul;Eom, Ki-Seong;Ha, Chang-Won
    • The Journal of the Korean bone and joint tumor society
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    • v.8 no.1
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    • pp.32-37
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    • 2002
  • High grade surface osteosarcoma is the most rare subtype of osteosarcoma arising on the surface of bone, accounting for less than 1% of the total number of osteosarcomas. Only a few case reports and studies have been reported in the world. In Korea, only one case out of 127 osteosarcomas has been described up to now, but there was no information about the patient, clinicopathologic features and treatment. We experienced a case of high grade surface osteosarcoma in the subtrochanteric area of a 66-year-old female and treated her with neoadjuvant chemotheraphy, wide resection and limb salvage operation with tumor prosthesis and adjuvant chemotheraphy. This tumor is identical to conventional high grade intramedullary osteosarcoma in histology, treatment and prognosis. So, this tumor should be differentiated from other surface osteosarcomas such as parosteal osteosarcoma and periosteal osteosarcoma.

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Diagnostic Strategy of Primary Site in Metastatic Bone Tumor (전이성 골종양에서 원발병소의 진단)

  • Shin, Kyoo-Ho;Suh, Ki-Won;Jahng, Jun-Seop
    • The Journal of the Korean bone and joint tumor society
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    • v.3 no.2
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    • pp.98-104
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    • 1997
  • We carried out a prospective study of the effectiveness of a diagnostic strategy in thirty consecutively seen patients who had skeletal metastasis. The diagnostic strategy consisted of the recording of a medical history, physical examination, routine laboratory analysis, plain radiography of the involved bone and chest, whole-body technetium-99m-phosphonate bone scintigraphy, abdominal ultrasound, computed tomography of the chest, abdomen and pelvis, fiberbronchoscopy and fibergastroscopy. After this evaluation, a biopsy of the most accessible osseous lesion was done in twenty four patients. On the basis of the our diagnostic strategy, we were able to identify the primary site of the malignant tumor in nineteen patients(63%). The laboratory values were non-specific in all patients. The history and physical examination revealed the occult primary site of the malignant tumor in one patient(3.3%) who had carcinoma of the breast. Plain radiographs of the chest established the diagnosis of carcinoma of the lung in three patients(9.9%). Computed tomography of the chest identified an additional three primary carcinoma of the lung(9.9%). Fiberbronchoscopy identified an additional one primary carcinoma of the lung(3.3%). Abdominal ultrasound established the diagnosis in three patients(9.9%). Computed tomography of the abdomen and pelvis established the diagnosis in four patients(13.2%). Fibergastroscopy established the diagnosis in two patients(6.6%). Examination of the biopsy tissue established the diagnosis in one patient(3.3%). So we recommend to perform plain radiographs of chest, abdominal ultrasound, chest C-T, abdomino-pelvic C-T, fiber-bronchoscopy, fibergastroscopy sequentially.

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Paraganglioma of the Thoracolumbar Spinal Canal -A Case Report- (흉요추부에 발생한 부신경절종 - 증례 보고 -)

  • Jeong, Soon-Taek;Kim, Dong-Hee;Cho, Se-Hyun;Park, Hyung-Bin;Hwang, Sun-Chul;Lee, Jeong-Hee
    • The Journal of the Korean bone and joint tumor society
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    • v.13 no.2
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    • pp.130-134
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    • 2007
  • Paragangliomas arise from a multicentric system of paraganglion cells derived from the neuroectoderm. Although these tumors are the most common in the head and neck region, they may occur in diverse locations including mediastinum, retroperitoneum and visceral organs. Spinal paragangliomas arising in the intradural space of the thoracolumbar spine have been reported rarely, with the majority located in the cauda equina. Only few cases of thoracic paraganglioma have been previously reported. We present an additional case of thoracolumbar paraganglioma and review the clinical MRI and histopathological features of this unusual tumor.

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Congenital Hemagiopericytoma in the Flexor Digitorium Profundus Muscle of the Distal Forearm - A Case Report - (전완 원위부 심 수지 굴근에 발생한 선천성 혈관 외피세포종 - 증례 보고 -)

  • Kim, Jung-Ryul;Jang, Kyu-Yun;Lee, Sang-Yong
    • The Journal of the Korean bone and joint tumor society
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    • v.13 no.2
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    • pp.146-151
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    • 2007
  • Hemangiopericytoma is a rare malignant vascular tumor that usually occurs in adults. The occurrence of these tumors in infants, known as congenital or infantile hemangiopericytoma, is even rare and their behavior may be more benign than the adult type. Despite of the generally good prognosis associated with this neoplasm, a complete surgical excision has so far been recommended to avoid recurrence, because no definite criteria for determining whether or not the tumor will regress spontaneously have been established to date. We describe a 1-day-old male neonate with congenital hemangiopericytoma, presenting with a left forearm mass at birth. Wide resection was performed at 65 days of age and hemangiopericytoma was diagnosed by histology. There was no tumor recurrence during 32 months of follow-up.

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Giant Cell Tumor of the Rib: A Case Report and Review of the Literature (늑골에서 발생한 거대세포종: 1예 보고 및 문헌 고찰)

  • Kim, Hyun-Soo;Kim, Dae-Hyun;Lim, Sung-Jig;Park, Yong-Koo
    • The Journal of the Korean bone and joint tumor society
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    • v.15 no.1
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    • pp.52-58
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    • 2009
  • Giant cell tumor (GCT) of the rib may present as a posterior mediastinal mass when it involves the posterior arc. Only 4 cases of GCT of the rib presenting as a posterior mediastinal mass have been reported. We report a case of a 38-year-old man with GCT of the rib. Computed tomography revealed a well-defined, multi-lobulated, heterogeneous mass in the right superoposterior mediastinum, which appeared to invade the right third rib and thoracic vertebra. It was thought to be a posterior mediastinal ganglioneuroma or its malignant transformation. Grossly, the tumor mass arose in the posterior arc and showed substantial growth out of the rib. Microscopically, the tumor consisted of interspersed multi-nucleated giant cells and stromal mononuclear cells, compatible with GCT. For GCT, a wide excision with elective radiotherapy should be considered. GCT must be differentiated from posterior mediastinal ganglioneuroma that can be treated by surgical excision alone.

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Tumors in the Foot and Ankle (185 Cases) (족부 및 족근관절에 발생한 종양 (185예))

  • Choi, Woo-Jin;Shin, Kyoo-Ho;Lee, Jin-Woo;Han, Chang-Wook
    • Journal of Korean Foot and Ankle Society
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    • v.11 no.1
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    • pp.1-7
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    • 2007
  • Purpose: Tumors arising in the foot and ankle are uncommon and the malignant tumors are known to be rare compared with those of the other sites. We analyzed the clinical data of patients who have been diagnosed as having a tumor of the foot and ankle. Materials and Methods: From 1989 to 2006, we analyzed 185 patients who have been treated surgically and were pathologically confirmed of having tumors of the foot and ankle. Their clinical characteristics were reviewed retrospectively. Results: One hundred and fifty-seven cases were benign (84.9%) and 28 cases (15.1%) were malignant. 108 cases (58.4%) were benign soft tissue tumors and 49 cases (26.5%) were benign bone tumors. Malignant tumors included 17 cases (9.2%) of soft tissue tumors, 8 cases (4.3%) of primary bone tumors and 3 cases (1.6%) of metastatic bone tumors. The most common benign soft tissue tumor was ganglion (23 cases). Enchondroma (9 cases) was the most common among the benign bone tumors. Malignant peripheral nerve sheath tumor was the most common malignant tumor (4 cases). The predilection site for benign tumors was at the forefoot around toes while for the malignant tumor was around the ankle. 4.6% of benign soft tissue tumors and 8.2% of benign bone tumors had locally recurred and 14 cases (50%) of malignant tumor were confirmed as having distant metastasis. Conclusion: The ratio of malignant tumor and its metastasis rate was high. Therefore, the histopathologic confirmation is essential when treating tumors of the foot and ankle.

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Malignant Tumors of the Foot and Ankle (족부 및 족관절의 악성 종양)

  • Kim, Han-Soo;Oh, Joo-Han;Hwang, Chang-Joo;Lee, Han-Koo;Lee, Sang-Hoon
    • Journal of Korean Foot and Ankle Society
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    • v.5 no.1
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    • pp.74-81
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    • 2001
  • Purpose: We analyzed 35 patients of malignant tumors of the foot and ankle to evaluate clinical manifestation. result of treatment and prognosis. Materials and Methods: Thirty five patients who were histologically confirmed for malignant tumors of the foot and ankle from September 1984 to May 1999 were investigated. Results: There were 16 males and 19 females. with an average age 38.3 years. Ten tumors were originated from bone and 25 from soft tissue; osteosarcoma (8) was the most common bone tumor and synovial sarcoma (8) and malignant melanoma (6) were common in soft tissue tumors. Surgical procedures included; marginal resection (2), limb salvage procedure after wide resection (5) for bone tumors, and amputation (12), wide resection (4), marginal resection (5) for soft tissue tumors. In some cases, perioperative chemotherapy and radiotherapy were given. There were 2 local recurrences and 11 metastases; 5 metastases were found at the time of initial diagnosis. Average follow-up was 3.5 years. Conclusion: We conclude that suspicion and early diagnosis are important in malignant tumors of the foot and ankle, and the resection margin must be obtained more thoroughly during surgery with perioperative adjuvant therapy, if necessary.

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Diffuse-Type Tenosynovial Giant Cell Tumor of the Tendon Sheath in Both Wrists (양측 손목의 힘줄에 생긴 미만형의 건활막거대세포종)

  • Sunah Heo;Sun-Young Park;Jinwon Seo;Sung Hye Koh;In Jae Lee
    • Journal of the Korean Society of Radiology
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    • v.82 no.1
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    • pp.250-254
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    • 2021
  • Diffuse-type tenosynovial giant cell tumor (D-TSGCT), previously known as pigmented villonodular synovitis, is a locally aggressive neoplasm that may arise from the synovium, bursa, or tendon sheath. D-TSGCT is usually monoarticular and can be classified into intra- and extra-articular forms, the latter of which is rarer. Here, we report a case of D-TSGCT in a 64-year-old female that involved the entire flexor and extensor tendon sheaths of both wrists. We describe the ultrasonography and MRI findings, as well as review the relevant literature.

Segmental Resection and Replantation for Primary Malignant or Aggressive Tumors of the Upper Limb (상지에 발생한 악성 및 침윤성 종양의 분절절제 및 재접합술)

  • Hahn, Soo-Bong;Lee, Woo-Suk;Shin, Kyoo-Ho
    • The Journal of the Korean bone and joint tumor society
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    • v.6 no.1
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    • pp.10-16
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    • 2000
  • Object : The aim of the current study is to assess the results of segmental resection and replantation for primary malignant or aggressive tumors of the upper limb. Materials and Methods : From 1986 to 1994, ten patients who had primary malignant or aggressive tumors of the upper limb were managed with segmental resection and replantation method. The average duration of follow-up was 7 years and 7 months. Primary indication of this method is stage II B tumors which, because of their extend, could otherwise be adequately treated only by amputation. Three patients had chondrosarcoma, two had osteosarcoma, two had giant cell tumors with pathologic fracture, one had extensive chondroblastoma, one had Ewings sarcoma, and one had leiomyosarcoma. The location of the tumor was humerus in 6 patients, scapula in 3 patients, and soft tissue of forearm in 1 patient. Wide resection margins were achieved in 7 patients and marginal margin in three. Results : One patient died on 40 months after surgery due to systemic metastasis. Nine patients have remained disease free without local recurrence or metastasis. The average overall functional rating was 65% (43~90%) for ten patients on the last follow-up by the functional rating system of Enneking. The mean grasping power and pinching power of operative hand was 75%(28~95%) and 65%(43~90%) of the opposite hand, respectively. Complications associated with this surgical method included three wound dehiscences and one nerve injury that resolved with proper wound care and time. Conclusion : It was concluded that segmental resection and replantation might be used for partial limb salvage in selected cases for the treatment of primary malignant or aggressive tumors of the upper limb.

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