• The Journal of the Korean bone and joint tumor society
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• v.20 no.2
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• pp.85-88
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• 2014

Localized forms of giant cell tumor are known to arise commonly in the synovial membrane of the finger joints. Multinucleated giant cells are its characteristic pathology finding, giant cell tumor shows a low rate of recurrence after complete excision. When occurring at the knee joints, giant cell tumor manifests a wide form of symptoms, from no symptom at all, to intermittent locking. Complete excision is possible by arthroscopy, but if done incompletely, it is reported to recur in 45% of cases. We present here a case of giant cell tumor that has arisen from the anterior portion of the posterior cruciate ligament, excised by arthroscopy and followed by pathologic confirmation.

• The Journal of the Korean bone and joint tumor society
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• v.14 no.2
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• pp.95-105
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• 2008

Purpose: To identify which is the best procedure in recycling autograft according to the resection & reconstruction type and recycling methods, and so when the recycling autograft is used in limb salvage surgery. Materials and Methods: We have treated fifty-eight patients (34 male, 24 female; age range 5 to 74 years, mean age 36.5 years), who had the malignant musculoskeletal tumors, with recycling autograft (47 patients with extracoporeal irradiation, 11 patients with pasteurization) from December 1995 to February 2006. The resection and reconstruction type was 3 cases with fragmentary, 8 intercalary, 23 rAPC (recycling-Autograft-Prosthesis composite), 18 osteoarticular, 5 total joint and 1 soft tissue (achilles tendon). The result was evaluated by the radiologic union at junctional site, the functional score by musculoskeletal tumor society score and complications according to the resection & reconstruction type and recycling methods. Results: The junctional union was obtained at 15.0 months in extracoporeal irradiation and 12.6 months in pasteurization. Also the mean radiologic union was shown at 6.0 months in fragmentary, 12.8 months in intercalary, 10 months in rAPC, 23.3 months in osteoarticular and 15.6 months in total joint. The functional score was 65.5% in fragmentary, 60.8% in intercalary, 62.8% in APC (except pelvis), 66.0% in osteoarticular and 66.6% in total joint. We have experienced 1 infection, 1 prutrusio acetabuli in pasteurization (18.1%) and other 22 complications (3 deep infections, 8 nonunions, 2 fractures, 2 epiphyseal problems, 5 joint instabilities, 2 local recurrence) in extracoporeal irradiation (46.8%). Also we have experienced 3 complications (3 nonunions) in intercalary (37.5%), 9 complications (4 nonunions, 1 deep infection, 1 periprosthetic fracture, 1 epiphyseal problem, 1 local recurrence, 1 protrusio acetabuli) in rAPC (50.0%), 6 complications (2 deep infections, 2 nonunions, 1 epiphyseal problem, 1 pathologic fracture) in osteoarticular (33.3%), 5 complications (5 joint instabilities) in total joint (100%) and 1 complication(1 local recurrence) in soft tissue (100%). Conclusion: In our experience, according to the resection & reconstruction type fragmentary and intercalary may have several advantages such as good radiologic and functional result and low rate of complication. And it seems that rAPC was available in case which have no sufficient residual bone stock. Also the pasteurization may have more advantages than that of the extracorporeal irradiation.

• The Journal of the Korean bone and joint tumor society
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• v.14 no.1
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• pp.33-43
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• 2008

Purpose: To evaluate the clinical usability of reconstructive methods, and how to select flap after wide excision of malignant soft tissue tumor in ankle and foot. Materials and Methods: The 15 cases shown in the 14 patients (In case of a male patient, reconstruction was performed two times due to local recurrence.) with malignant soft tissue tumor in ankle and foot, who underwent reconstruction after wide excision from March 2000 until March 2007. Oncologic, surgical and functional results were evaluated. Results: The method of reconstruction used were anterolateral thigh perforator flap (5cases), Reversed superficial sural artery flap (4 cases), dorsalis pedis flap (3 cases), local flap (3cases). The defect, mean size was $5.5{\times}5.7\;cm$, was reconstructed with rotation flap or free flap, mean size was $5.9{\times}6.0\;cm$, skin graft for remnant. The mean operation time was 310 minutes (120~540 minutes); it took 256 minutes to reconstruct by rotation flap, and 420 minutes by free flap. As oncologic results, 7 patients were no evidence of disease, 6 patients were alive with disease and 1 patient was expired by pulmonary metastasis at the time of the last follow-up. 4 patients had local recurrence and 4 pateints had distant metastases. As functional results, 14 patients were evaluated with average score of 68.8% using the system of the Musculoskeletal Tumor Society. Conclusion: The dorsalis pedis and reverse superficial sural artery rotation flap which is easy procedure, has less complication and takes short operation time, can be primarily considered to reconstruct a small defect. And the anterolateral thigh perforator flap is suitable for coverage of a large defects after wide excision of malignant soft tissue tumor in ankle and foot.

• The Journal of the Korean bone and joint tumor society
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• v.7 no.4
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• pp.139-143
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• 2001

Purpose : Limb salvage for osteosarcoma of proximal tibia is challenging problem due to difficulties in mobilizing or retracting the main neurovascular structure, inadequate soft tissue coverage, and unsolved problem of patellar tendon reattachment to endoprosthesis. The authors analyzed the functional result of limb salvage using tumor prosthesis with medial gastrocnemius rotation plasty for osteosarcama of the proximal tibia. Materials and Methods : Eleven patients with histologically proven osteosarcoma of the proximal tibia, treated with adjuvant and neoadjuvant chemotherapy and limb salvage operation with tumor prosthesis between January 1992 and December 1998 at our Medical Center, were selected. There were 6 male and 5 female. Age ranged from 15 years to 23.7 years with an average of 23.7 years. Follow-up period ranged from 1 year to 4.5 years with an average of 2.5 years. The final functional result was evaluated using the method by ISOLS, 1993. The factors include pain, functional activities, emotional acceptance, use of external supports, walking ability and gait. Each of the factors has been scored from 0 to 5 depending on the appropriate description or data. The rating score is determined by dividing the individual factor scores into the total score and indicates percentage of normal function. Results : The overall functional result ranged from 53,3% to 86.7% with an average of 68.3% of normal function. In details, the averages were 82.5% for pain, 62.5% for functional activities, 67.5% for emotional acceptance, 77.5% for use of external supports, 62.5% for walking ability, and 57.5% for gait. The average range of motion of the knee joint was $5^{\circ}$ extension and $85^{\circ}$ flexion. Five patients have extension lag ranged from $5^{\circ}$ to $15^{\circ}$ with an average of $10^{\circ}$. Two patients suffered postoperative infection. One was treated with antibiotics injection only, but the other needed removal of the prosthesis and knee fusion. Both of them showed unsatisfactory result. C o n c l u s i o n : The overall functional result after limb salvage using tumor prosthesis with medial gastrocnemius rotational flap for osteosarcoma of the proximal tibia was relatively satisfactory in case of no postoperative infection. The patients were less satisfactory in functional activities, emotional acceptance and gait than pain, use of external supports due to limitation of motion and extension lag. More aggressive postoperative physical therapy and protection with brace for 6~9 months as well as surgical technique is mandatory for more satisfactory result.

• Nuclear Engineering and Technology
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• v.27 no.4
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• pp.635-643
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• 1995

핵의학(nuclear medicine )이 란 방사성 및 안정 핵종의 동위원소표지 화합물을 인체에 투여하여, 관심장기의 형태 및 기능을 평가하여 해부학적 또는 생리학적 상태를 진단, 치료하는 의학의 전문 분야이다. 핵의학에 이용되던 방사성 핵종은 1960년대 까지만 해도 $^{131}$ I이 주였으나 1970년대 부터는 $^{99}$Mo -$^{99m}$ Tc 발생기와 $^{99m}$ TC으로 표지된 방사성의 약품이 활발히 이용되면서 $^{131}$ I을 대신하게 되었다. 원자로-생산핵종들의 특성은 중성자가 과잉이어 붕괴시 배타입자를 방출하는 점으로, 이것이 각종 질병의 치료에 이용되고 있다. 특히 각종 표시 화합물의 성질을 이용하여 원하는 부위에 방사선을 집중시킬 수 있음이 외부조사보다 유리한 점이다. 방사성핵종을 이용한 악성종양의 치료에 가장 성공적인 것은 분화된 갑상선 암환자에서 $^{131}$ I을 사용한 것이며, 갈색세포종 등에 $^{131}$ I-MIBG도 효과적이다. 악성종양의 골전이 치료에 베타선을 방출하는$^{32}$P, $^{186}$ Re, $^{153}$ Sm 등이 이용되었다. 종양의 동맥에 주입하여 세동맥이나 모세혈관에 걸리는 기름, 교진 또는 입자에 의한 치료에 $^{131}$ I-lipiodol, ethiodol, $^{32}$P 또는$^{90}$ Y흡사 ceramic resin 미소구 $^{166}$ Ho 유산중합체 미소구 등이 이용된다. $^{166}$ Ho, $^{198}$ Au, $^{32}$P, $^{90}$ Y, $^{169}$ Er, $^{186}$ Rc, $^{131}$ I, $^{211}$ At 등 의 방사성 핵종의 교질, 미소구 또는 단세포군 항체표지 형태로 직접 종양내 또는 공동이나 체강에 투여하는 치료법이 있다. 류마치스 관절염의 슬관절에 $^{165}$ Dy colloid를 주사하는 $^{166}$ Ho-MAA도 활발히 이용되고 있다.

• The Journal of the Korean bone and joint tumor society
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• v.8 no.3
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• pp.106-110
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• 2002

Ganglion cysts occurring within sheaths of peripheral nerves have been documented, but are relatively rare entities. The peroneal nerve at the level of the knee and proximal tibiofibular joint is most commonly involved. We report a case of the intraneural ganglion cyst in the peroneal nerve without neurologic deficit, which was excised sucessfully.

• Radiation Oncology Journal
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• v.25 no.4
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• pp.278-282
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• 2007

Purpose: Diffuse pigmented villonodular synovitis (PVNS) is an uncommon aggressive synovial proliferative disorder of unknown etiology affecting the joint linings. Though a histologically benign inflammatory process, because of its aggressive growth with bone destruction or recurrence, it is frequently suggested to occur as a low malignant neoplasm. Optimal treatment is surgery, but the local recurrence rate after radical synovectomy for diffuse PVNS is relatively high due to the infiltrative growth pattern. External beam radiotherapy with moderate doses or intra-articular instillation of radioactive isotopes may improve the likelihood of local control and long-term function in patients with incompletely resected or recurrent diffuse PVNS. I report one case of diffuse PVNS of the right knee joint treated with arthroscopic synovectomy and external beam radiotherapy is presented.

• 대한미세수술학회:학술대회논문집
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• 1994.11a
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• pp.107.2-108
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• 1994

• The Journal of the Korean bone and joint tumor society
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• v.19 no.1
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• pp.1-8
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• 2013

Purpose: Primary bone tumors of hindfoot are uncommon compared with other locations, and there have been few large-group studies. This study was designed to analyze the characteristics and the clinical results of the primary bone tumors of hindfoot. Materials and Methods: Forty five cases in 44 patients who have been diagnosed from 1989 to 2011 were reviewed. The minimum follow-up period was 1 year. We retrospectively reviewed the medical records and images. Results: Twenty six cases were male and 18 cases were female. Mean follow-up period was 33.1 months and mean age was 25.1 years. Forty four cases were benign and 1 case was malignant. Thirty six cases occurred in calcaneus and 9 cases were in talus. The most common benign bone tumor was simple bone cyst (20 cases), followed by intraosseous lipoma (12 cases), and chondroblastoma (4 cases). In calcaneus, there were 18 cases of simple bone cyst, and 12 cases of intrasosseous lipoma. In talus, there were 3 cases of chondroblastoma, 2 cases of simple bone cyst, and 2 cases of intraossesous ganglion. Many patients with hindfoot bone tumors presented with pain, but some were found accidentally. Patients received surgical procedures, such as curettage and bone graft, open reduction and internal fixation, tumor resection, and below knee amputation. Conclusion: Primary bone tumors of hindfoot are rare and can be misdiagnosed as ankle sprain or contusion. Although most are benign, malignant tumors cannot be ruled out, so early diagnosis and appropriate treatment is important.

• The Journal of the Korean bone and joint tumor society
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• v.12 no.1
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• pp.71-77
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• 2006

Chondrosarcoma is one of the most common types of primary bone sarcoma. With the exception of the mesenchymal subtype, chondrosarcomas are usually low-grade lesions and rarely show multicentricity or distant metastasis. Only rare cases of multicentric chondrosarcomas have been reported in association with Ollier's disease and Maffucci's syndrome. To our knowledge, no report has been issued of a synchronous multicentric chondrosarcoma occurrence across a joint. We experienced a 30-year-old man with a synchronous monomelic juxta-articular multicentric chondrosarcoma across a shoulder joint in the absence of pulmonary and visceral metastases. He was treated by curettage and cement filling with allograft in the acromion and wedge resection with cement filling in the proximal humerus. At the 18-month follow-up, there was no evidence of recurrence, and the patient had full range of motion without pain.