• Title/Summary/Keyword: 관절종양

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Glomus Tumor in Soft Tissue (연부 조직에 발생한 사구종)

  • Kim, Do-Yeon;Lee, Soo-Hyun;Kim, Min-Ju;Shin, Kyoo-Ho
    • The Journal of the Korean bone and joint tumor society
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    • v.15 no.1
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    • pp.34-43
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    • 2009
  • Purpose: Glomus tumors are rare benign vascular tumors, usually located in the skin or soft tissue of extremities. Approximately 30-50% of glomus tumors occur in subungal area, but glomus tumors have been described in every location even where glomus bodies are not or rarely present. The purpose of this study was to identify clinical, histologic and MRI characteristics of soft tissue glomus tumor. Materials and Methods: Between 1993 and 2008, eight patients underwent surgery of soft tissue Glomus tumor at our institution. Exclusion criteria were patients with Glomus tumors in digits, stomach, trachea and glomus tympanicum. We analyzed medical records, interviews, physical examinations, MR findings and histolocial types retrospectively. Results: There were four men and four women. The mean age was fourty-seven years. The mean prevalence time was eight-point-nine years. In the classic triad of symptoms, all eight patients had pain and tenderness. Two patients complained of cold sensitivity. Two showed skin color changes. After surgery, two showed symptom improvement (VAS $9^{\circ}{\rightarrow}8$, $8^{\circ}{\rightarrow}5$) and?six showed complete disappearance of symptoms. Slightly symptom improvemented (VAS $9^{\circ}{\rightarrow}8$) one had additional surgery two times after first surgery due to relapse/remaining Glomus tumor. The mean size was 13.9 mm. In histology, six were 'solid glomus tumor', one was a mixture of 'solid glomus tumor' and 'lomangioma' and one was 'malignant glomus tumor'. MR findings showed isointense signal on T1 image, high signal on T2 image and strong enhancement on the Gadolinium enhanced image. Conclusion: Glomus tumor has low recurrence rate and malignant change, rapid diagnosis and surgical excision is critical in treatment to prevent unnecessary pain of patient.

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Analysis of Treatment and Prognosis in Malignant Melanoma (악성 흑색종의 치료와 예후에 대한 분석)

  • Kwon, Young-Ho;Kim, Jeong-Ryoul;Lee, Young-Gu;Kim, Jae-Do
    • The Journal of the Korean bone and joint tumor society
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    • v.11 no.2
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    • pp.141-147
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    • 2005
  • Purpose: The most important thing in curing Malignant melanoma is surgical excision, operating method is wide excision. The author et al. studied 5-year survival rate of each stage and appropriate surgical margin after operating wide excision and immuno-chemotherapy. Materials and methods: From March 1995 to August 2003, wide excision and immunochemotherapy were operated to 35 patients (17 males and 18 females) who were diagnosed as malignant melanoma and followed up. Excision was done around 2 cm from edge of tumor regardless of the size or effected degree of the skin, and flap or full thickness skin graft was used for skin deficit that was not covered after excision. As for immuno-chemotherapy, method that prescribes 400 mg of dacarbazine (DTIC) and 3 million IU of interferone-${\alpha}$ in combination was used. Immuno-chemotherapy was operated to patients in over stage III. We used AJCC stage that was revised in 2002. Local recurrence, local metastasis and distant metastasis were investigated for these patients as well as the 5-year survival rate of each stage. Results: Most frequently 15 cases(42.8%) occurred in foot, 5 cases(14.2%) occured in ankle, 2 cases(5.7%) in leg, 2 cases(5.7%) in thigh and 5 cases(14.2%) in hand. The incidence of each stage were 8 cases(22.8%) in IA, 9 cases(25.7 %) in IB, 4 cases(11.4%) in IIA, 2 cases(5.7%) in IIB, 1 cases(2.8%) in IIIA, 2 cases(5.7%) in IIIB, 2 cases(5.7%) in IIIC and 7 cases(20.0%) in stage IV. 5-year survival rate of each stage were 94.1% in stage I, 66.8% in stage II, 40% in stage III and 14.3% in stage IV. Conclusion: 5-year survival rate of stage IV was low in malignant melanoma. In treatment of malignant melanoma, staging before operation is important as operation methods are different from each stage. We recommend wide excision which remove around 1~3 cm from margin of tumor up to each thickness.

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The Reconstruction with Extracorporeal Irradiated Autograft for Osteosarcoma of Extremities (사지 골육종에서 체외 방사선 조사를 이용한 재건술)

  • Kim, Jae-Do;Lee, Gun-Woo;Chung, So-Hak
    • The Journal of the Korean bone and joint tumor society
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    • v.16 no.1
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    • pp.1-7
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    • 2010
  • Purpose: With advances in various treatment modalities, limb salvage surgery has been commonly used in osteosarcoma of extremities. An alternative method for skeletal reconstruction is reimplantation of the tumor bearing bone following extracorporeal irradiation (ECI). We report the long-term results of ECI autograft in aspect of the oncological and functional outcomes, and complications. Materials and Methods: We retrospectively reviewed 31 osteosarcoma patients who underwent reconstruction with ECI between July 1995 and January 2006. There were 24 males and 7 females with a mean age of 24 (7-74 years) and a mean follow-up of 117 months (17-177 months). Twenty-five cases were reconstructed with ECI autograft, 6 cases with ECI autograft-prosthesis composite. The pathologic subtypes were conventional in 29 cases, periosteal in 1 case, and parosteal in 1 case. The most common location of tumor was distal femur (15 cases) followed by humerus (3), proximal fibula (3) and proximal tibia (3). Musculoskeletal Tumor Society (MSTS) score was used for functional evaluation. The overall survival rate, local recurrence, complications were analyzed. Results: The overall survival rate was 80.6% and the disease-free survival rate was 64.5%. Five patients died of distant metastasis. One patient required above-knee amputation due to local recurrence. All of them, twenty-three complications occurred, which included nonunion in 7 cases, deep infection in 5 cases, joint instability in 4 cases, metal failure in 2 cases, Limb-length discrepancy (LLD) in 2 cases, periprosthetic fracture in 1 case, epiphyseal collapse in 1, local recurrence in 1 case. The mean MSTS functional score was 62.5%. Conclusion: Extracorporeal irradiated autograft can be achieved relatively good result in aspect of oncological and functional aspect, but is needed to be additional research about occurring many complications. The reconstruction with ECI after intercalary or fragmentary resection is effective reconstruction in aspect of oncological and functional result, complications.

The Findings of $^{99m}Tc$-MDP Bone Scan in Primary Malignant Bone Tumors (원발성 악성 골종양의 $^{99m}Tc$-MDP 골스캔 소견)

  • Hyun, In-Young;Lee, Kung-Han;Lee, Dong-Soo;Chung, June-Key;Lee, Myung-Chul;Koh, Chang-Soon;Kang, Heung-Sik;Lee, Sang-Hoon;Lee, Han-Koo
    • The Korean Journal of Nuclear Medicine
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    • v.29 no.1
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    • pp.73-78
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    • 1995
  • [ $^{99m}Tc$ ]-MDP bone scan was performed in 31 patients with primary malignant bone tumors, 22 patients with osteogenic sarcoma, 5 patients with chondrosarcoma and 4 patients with Ewing's sarcoma. The findings were classified by isotope intensity of accumulation in tumor as grade 1 to 3, overall pattern of isotope distribution in tumor as grade 1 to 3, and distortion of bony outline as grade 1 to 3. Histologic classifications were cor related with scan findings in 22 patients with osteogenic sarcoma. The results were as follows 1) In 22 patients with osteogenic sarcoma, markedly increased isotope intensity higher than sacroiliac joint with patchy areas of decreased intensity and severe bony distortion were found in 16 patients. The correlations between histologic classification and scan findings were not discovered. 2) In 5 patients with chondrosarcoma, mildly increased isotope Intensity with patchy areas of increased intensity and mild bony distortion were found in 4 patients.. 3) In 4 patients with Ewing's sarcoma, markedly increased homogenous intensity with moderate bony distortion were found in 3 patients. Conclusively there were common findings in each 3 primary malignant bone tumors and $^{99m}Tc$-MDP bone scan was complemented with radiologic studies in differentiating primary malignant bone tumors.

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A Case of Pedunculated Localized Nodular Synovitis of the Knee: MR Imaging Findings (유경성 국소성 소결절성 활막염: 자기공명영상소견의 증례 보고)

  • Lee, Jae-Hwan;Lee, Jee-Young;Suh, Kyung-Jin
    • Investigative Magnetic Resonance Imaging
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    • v.11 no.1
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    • pp.54-57
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    • 2007
  • Localized nodular synovitis of the knee joint is a rare benign tumorous condition, and should be differentially diagnosed with pigmented villonodular synovitis. We report a case of localized nodular synovitis in the knee that was noted to have a pedicle and characteristic findings on MR image.

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Treatment of Bone Tumors with a Custom-made Prosthetic Replacement (인공 관절 대치술로 치료한 골 종양)

  • Shin, Hyun-Kug;Suh, Jae-Sung;Ahn, Jong-Chul;Ihn, Joo-Chul
    • Journal of Yeungnam Medical Science
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    • v.8 no.1
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    • pp.206-214
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    • 1991
  • We treated three cases of bone tumors-giant cell tumor, chondroblastoma and malignant fibrous histiocy toma-with a custom-made prosthetic replacement. The patients were followed from 10 months to 18 months, postoperatively. The results of these study are as follows : 1. satisfactory anatomic restoration 2. early ambulation 3. good function 4. biomechanically sound reconstruction.

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A Case of Deep Vein Thrombosis Associated with Myositis due to Streptococcus pyogenes (Streptococcus pyogenes 근염에 심부 정맥 혈전증이 동반한 1례)

  • Lee, Jae Sook;Jang, Tae Young;Ahn, Young Min
    • Pediatric Infection and Vaccine
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    • v.16 no.1
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    • pp.87-91
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    • 2009
  • A 5-year-old boy was admitted to the hospital with a high fever and abnormal gait. Magnetic resonance imaging showed extensive swelling of the quadriceps and adductor muscles around the right hip and anterior thigh. A duplex scan demonstrated a thrombus from the external iliac vein to below the popliteal vein. The blood culture revealed Streptococcus pyogenes. The patient was immediately treated with antibiotics and anticoagulants. Follow-up sonography demonstrated complete disappearance of the venous thrombosis. We report a case of streptococcal myositis complicated by deep vein thrombosis.

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Early Result of Hydroxyapatite in Bone Defect after Operative Treatment of Benign Bone Tumor (양성 골종양의 수술적 치료 후 발생한 골결손에서 시행한 Hydroxyapatite의 조기 결과)

  • Chung, So-Hak;Kwon, Young-Ho;Park, Young-Gyun;Kim, Jae-Do
    • The Journal of the Korean bone and joint tumor society
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    • v.14 no.1
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    • pp.25-32
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    • 2008
  • Purpose: This study was performed to evaluate the efficiency of Hydroxyapatite ($Bongros^{(R)}$-HA) what use for bone defect after operative treatment of benign bone tumor. Materials and Methods: Hydroxyapatite, was used to treat bone defect after operative treatment of benign bone tumor from September, 2006 to December, 2007. A total of 17 benign bone tumor cases (10 males and 7 females) with mean age of 28.5 was observed studied. The diagnoses were fibrous dysplasia in 8 cases, solitary bone cyst in 5 cases, and giant cell tumor in 4 cases. In categorization by location of tumor, there were 6 cases of proximal femur, 3 cases of proximal femur, 3 cases of proximal tibia, 4 cases of proximal humerus, and 1 case of hip bone. Autogenous bone was used with Hydroxyapatite in 4 cases, and only Hydroxyapatite used in 13 cases. Periods of Follow-up were from 3 months to 15 months, and mean period were 7.5 months. Amount of graft resorption and bone formation was observed with compare of post operation radiograph and the difference was shown by percentage. Results: More than 98% bone uptake was observed after mean 4.5 months, and more than 98% bone formation was observed after mean 6.2 months. Lesser bone defect size showed faster bone formation and it was statistically significant result (P=0.012). But other comparative studies on other factors such as sex, age of patients and combination of autogenous bone were no statistically significant differences in graft resorption and bone formation. And there was no significant complications in periods of follow-up. Conclusion: Hydroxyapatite is considered as one of useful method of bone defect after operative treatment of benign bone tumor.

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Early Result of Demineralized Bone Matrix (DBM, Genesis$^{(R)}$) in Bone Defect after Operative Treatment of Benign Bone Tumor (양성 골 종양의 수술적 치료 후 발생한 골 결손에서 탈무기화 골 기질(DBM, Genesis$^{(R)}$)의 단기 결과)

  • Seo, Hyun Je;Chung, So Hak
    • The Journal of the Korean bone and joint tumor society
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    • v.19 no.2
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    • pp.56-63
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    • 2013
  • Purpose: This study was performed to evaluate the efficiency of demineralized bone matrix (DBM, Genesis$^{(R)}$) used for bone defect after operative traetment of benign bone tumors by clinical and radiological methods. Materials and Methods: DBM was used to treat bone defect after operative treatment of benign tumor from February 2012 to May 2013. Total 25 benign bone tumor cases (15 males, and 10 females) with mean age of 30.3 were studied. The diagnoses were solitary bone cyst in 9 cases, non ossifying fibroma in 5, fibrous dysplasia in 5, aneurysmal bone cyst in 3 and enchondroma in 3. In categorization by location of tumor, there were 5 cases of distal femur, 4 of proximal tibia, 3 of proximal femur, 3 of proximal humerus, 3 of phalanx, 2 of distal radius, 2 of hip bone, 2 of calcaneus, and 1 of scapula. Autogenous bone was used with DBM in 6 cases, and only DBM used in 19 cases. Mean periods of follow up were 8.7 months (range: 6 to 14 months). Amount of graft resorption and bone formation was observed with compare of post operation radiograph and the difference was shown by percentage. Resorption level was measured by DBM level which could be observed from simple x-ray, and bone formation level by bone trabecular formation level at impaired site. Results: Twenty three cases of total 25 cases showed bone union. In the 23 cases, more than 98% DBM resorption was observed after mean 4.3 months, and more than 98% bone formation was observed after mean 6.9 months. Lesser bone defect sizes showed faster bone formation and it was statistically significant (p=0.036). But other comparative studies on other factors such as, sex, age of patients and combination of autogenous bone were no statistically significant differences in graft resorption and bone formation. And there was no significant complication in periods of follow-up. Conclusion: Demineralized Bone Matrix (Genesis$^{(R)}$) is thought to be useful treatment for bone defect after operative treatment of benign bone tumor, however longer follow-up periods appears to be needed.

Surgical Treatment of Metastatic Tumor in Proximal Femur with Recycling Autograft Prosthetic Composite after Wide Excision (근위 대퇴골 전이성 종양의 수술적 치료로서 광범위 절제술 후 재활용 자가골을 이용한 복합 고관절 성형술)

  • Kim, Jae-Do;Park, Pil-Jae;Kwon, Young-Ho;Jang, Jae-Ho;Lee, Young-Gu
    • The Journal of the Korean bone and joint tumor society
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    • v.11 no.1
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    • pp.71-81
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    • 2005
  • Purpose: Due to local recurrence of tumor, metal failure usually develops in patients who underwent internal fixation or hip joint arthroplasty after curettage in the case of metastatic tumor of proximal femur. The aim of this study is to find out the appropriateness of reconstruction using recycling autograft after wide excision in the case of metastatic bone tumor by performing recycling autograft and hip joint arthroplasty after wide excision, and through presence or absence of local recurrence, functions of lower limbs and occurrence of complications. Materials and Methods: Five patients, in 6 cases, who had undergone reconstruction using recycling autograft prosthetic composite after wide excision in the metastatic tumor from May 2000 to May 2003 were included in this study. The average age of the patients was 60.8 years of age with male to female ratio of 3:2. Average duration of lives following surgery was 23.3 month (7-57 months). Primary lesion included 2 cases of lung cancer, and 1 each of stomach cancer, renal cancer and multiple myeloma. After wide excision, the hip joint was reconstructed with recycling autograft prosthetic composite ; 4 cases of extracorporeal irradiation and 2 cases of pasteurization. Musculoskeletal Tumor Society (MSTS) score(1993) for 6-month period after surgery, as well as presence of complication and local recurrence during the rest of their lives, were studied. Results: Average Musculoskeletal Tumor Society (MSTS) score over the 6-month period after surgery was 63.3% and 1 case of dislocation of hip joint, as a complication following surgery, was discovered. Local recurrence during the lives of the patients was not observed. Conclusion: In the case of metastatic tumor of proximal femur, in which the life span following surgery is expected to be more than 6 months, undergoing reconstruction using recycling autograft after wide excision, in comparison to internal fixation or hip joint arthroplasty after curettage, is deemed to have better results in prevention of local recurrence, and preservation of the functions of all limbs during the life span of the patient.

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