• 대한골관절종양학회지
• /
• 제8권2호
• /
• pp.63-67
• /
• 2002

진행성 골화성 근염은 매우 드물게 보는 유전성 질환으로서 선천성 족무지 기형과 근막, 건막, 건, 인대 및 골격근육의 간질조직내 결체조직의 부종, 석회화를 거쳐 진행성으로 골화를 일으킴을 특징으로 하는 질환이다. 본 질환은 근본적으로 골격근 자체는 정상이나 근본 병리결함이 결체조직에 발생함으로 종래 사용하던 병명인 '진행성 골화성 근염' 대신 '진행성 골화성 섬유이형성증'이라 칭하는 것이 합당하다고 주장되고 있다. 저자는 최근 일가족 남매에 발생한 진행성 골화성 근염 2예를 경험하였기에 보고하는 바이다.

• 대한골관절종양학회지
• /
• 제8권2호
• /
• pp.48-53
• /
• 2002

상피암의 인접 골격근으로의 직접 전파는 많이 보고되었으나, 골격근으로의 원격전이는 드물고 특히 다발성 전이는 매우 드문 것으로 알려져 있다. 골격근내의 가변적인 혈류량, 근수축이나 난류성 혈류 등과 같은 물리적인 요인, 골격근내의 산성 환경, 젖산, 세포외 기질의 단백분해효소 억제인자 등이 골격근으로의 원격 전이를 억제하는 원인으로 제시되고 있다. 저자들은 최근 다발성 골격근 전이를 동반한 신장암(이행성 상피세포암) 1례를 경험하였기에 이를 보고하는 바이다.

• 대한골관절종양학회지
• /
• 제4권1호
• /
• pp.37-43
• /
• 1998

Between 1992 and 1996, 5 patients with the giant-cell tumor of the spine were treated. Four were female and one was male. The mean age was 34 years old, and the mean follow-up time was 36 months. The locations of the lesions were the cervical spine in 1, the thoracic spine in 3, and the lumbar spine in 1. Pain was the predominant presenting symptom in all cases and four had a neurological deficit. A combined anterior and posterior surgical approach wds as performed in all cases, which were also treated with AIF(anterior interbody fusion) and anterior and/or posterior instrumentation. Adjuvant radiation therapy was performed in 1 case of cervical spine. At the final follow-up, the pain and neurologic symptoms were improved. Radiologic examination showed no evidence of local recurrence and no failure of instrumentation of the spine.

• 대한골관절종양학회지
• /
• 제4권1호
• /
• pp.22-29
• /
• 1998

A limb-sparing operation has a definitive role in the treatment of osteosarcoma in the lower extremity of skeletally-immature patients. After a limb-sparing operation, leg length discrepancy remains as a major disability that should be corrected. This study was designed to suggest methods of tumor resection and proper timing of leg length equalization in skeletally immature osteosarcoma patients. From September 1990 to January 1998, we reviewed eight osteosarcoma patients in an immature skeletal age. There were 4 males and 4 females, and their mean duration of follow-up was 50.37 months (range : 25 to 88 months). Mean skeletal age was 8 years (range : 8 months to 11 years). The patients were classified according to the methods of tumor resection ; intercalary resection in 1 case, transepiphyseal resection in 1, intra-articular resection in 5, and extra-articular resection in 1. The results were as follows ; 1. The leg lengthening was begun when a patient's leg length discrepancy reached 4-5cm. 2. The age of final lengthening with permanent reconstruction was 14 years in males and 12 years in females (about 2 years before skeletal maturity). 3. When reconstruction was performed with a temporary spacer, the site of lengthening Was in the soft tissue, not in bone, and then a permanant reconstruction was done. 4. Reconstruction with a biologic spacer to preserve the joint function was a reasonable method for equalization of leg length. In conclusion, the appropriate choice of reconstructive method and the age at which to correct the leg length discrepancy in a skeletally-immature osteosarcoma patients are important factors for maintaining leg length at full maturity.

• 대한골관절종양학회지
• /
• 제4권1호
• /
• pp.30-36
• /
• 1998

Squamous cell carcinoma is a neglected disease entity in orthopedic oncology. The purpose of this study was to analyze overall survival and the role of surgery on survival and to evaluate the significance of possible prognostic factors. From Oct, 1986 to Aug, 1996, 57 patients were enlisted and 42 patients ere eligible. Inclusion criteria included more than one year follow-up and no distant metastasis at the first visit. Staging and survival followed AJC classification and Kaplan-Meier plot. Stage II included 17 cases and stage III, 25 cases. Thirty-eight patients underwent operations, chemotherapy, and/or radiotherapy, and the remaining four had operations only. The chemotherapeutic regimen was adriamycin-cisplatin. The average follow-up period was 45 months. The ten-year actuarial survival rate of whole patients was 65.4%. Location of primary lesion, stage, pathologic grading, and intensity of chemotherapy in the same stage showed a significant difference in survival. Nine out of 42 patients had local recurrence. Seven patients had inadequate wide margins and two had intralesional margins. Average period of recurrence from operation was 13(4-35)months. The operation itself had no impact on survival but a surgical margin of no less than 3cm from the lesion was important for local control. Pathological grade and staging were significant variables for long term survival. Acral lesion had a significantly higher chance of regional and distant metastasis but actual survival showed no difference. In stage II, aggressive chemotherapy could delay or reduce the chance of regional or distant metastasis.

• 대한골관절종양학회지
• /
• 제4권1호
• /
• pp.65-70
• /
• 1998

Osteosarcoma is the most common primary bone tumor except for multiple myeloma. Hematogenous spread of osteosarcoma presents the t1susal route of dissemination. Lung metastasis is the most common, however the lymph node involvement is quite rare. In addition, according to Mirra, radiologically detectable involvement of lymph node is an extremely rare manifestation of osteosarcoma. The authors had experienced a patient with an osteosarcoma of the right distal femur which spread to the right inguinal lymph node and lung. After preoperative chemotheraphy, a limb salvage operation was performed around the lesion of right distal femur and the right inguinal lymph nodes were dissected. A adjuvant postoperative chemotheraphy was performed. After the treatment, there was no recurrence of osteosarcoma or any other metastatic evidence for two years and 8 months.

• 대한골관절종양학회지
• /
• 제4권1호
• /
• pp.44-52
• /
• 1998

We treated 19 cases of unicameral bone cysts with methylprednisolone acetate (MPA) from January 1988 to December 1995. We evaluated the effect of MPA injections through simple follow-up radiographs according to Oppenheim's, classification and retrospectively reviewed the sites of cyst, age of the patients at diagnosis, the incidence of pathologic fracture, cystic nature, and cystic proximiy to the growth plate, We then analyzed the relationship between these variables with the results of MPA injections. According to Oppenheim's classification, the results with the use of MPA injections were as follows: healed in six cases, improved in seven cases, incomplete obliteration in five cases and recurred in one case, If healed and improved were considered satisfactory results, then 13 cases(68.4%) were satisfactory at the last follow-up. Sites of cyst, age of the patients at diagnosis, incidence of pathologic fracture, cystic nature and cystic proximiy to the growth plate appeared not to influence the results of MPA injections statistically. On these data, we thought that the treatment of unicameral bone cysts with MPA injection was the most effective first choice of treatment before operative options such as curettage and bone graft.

• 대한골관절종양학회지
• /
• 제15권1호
• /
• pp.59-64
• /
• 2009

내혈관 유두내피 증식증 (Masson 혈관종)은 피부나 피하조직에 주로 발생하는 흔하지 않은 양성의 혈관 병변으로 혈관 내피세포의 과도한 증식으로 발생할 수 있다. 이 질환은 정상 또는 기형적인 혈관에서 일차적으로 발생할 수 있으며, 혈관종, 화농성 육아종, 또는 림프관종등과 동반될 수 있다. 혈관내 유두상 내피성 과형성증은 임상적, 조직학적으로 저등급의 혈관육종으로 오인하여 진단, 치료할 수 있으므로 감별하여야 한다. 저자는 27세 환자가 전완부의 종물을 주소로 내원하여 상기 병명으로 진단한 예를 경험하였기에 문헌 고찰과 함께 이를 보고하는 바이다.

• 대한족부족관절학회지
• /
• 제8권2호
• /
• pp.213-217
• /
• 2004

Tumoral calcinosis is rarely encountered disease, and most of reported cases involved large joints such as hip or elbow. We report two patients with tumoral calcinosis in the foot. In the 1st case, the lesion was observed at the 1st MP joint of foot, and in the 2nd case it was found at the DIP joint of 5th toe area with bony erosion which is rare in other tumoral calcinosis. They all needed evaluation with MRI, and eventually surgical excision.

• 한국임상수의학회지
• /
• 제24권1호
• /
• pp.26-28
• /
• 2007

우측 후지가 점진적인 파행을 보이는 11년령의 수컷 시츄견이 내원하였다. 신체검사 결과 부정형의 종괴가 촉진 되었다. 방사선 촬영에서는 균질한 연부 조직성 밀도를 보였으며, 초음파 검사에서는 혼합성 에코를 보이는 경계가 명료한 특징을 갖고 있었다. MRI 검사에서는 주변 근육과 비교한 결과 유사 또는 강한 비균질성 신호강도를 보였다. 종괴는 주로 대퇴부 주변에 형성되어 있었으며, 일부는 골반뼈 폐쇄구멍을 통해 골반강내에서 직장의 변위를 일으키고 있음이 확인할 수 있었다. 병리조직 검사 결과 중간엽 세포와 상피세포로 구성된 활막육종으로 진단되었다. 종괴는 외과적으로 적출하였으나, 지속적인 근위축으로 있었으며 인해 파행은 개선되지 않았다. 적출 후 6개월에 종괴가 형성됨이 확인되었으며 점진적으로 그 크기 비대해져 10개월이 되는 시점에서 견주의 요청으로 안락사 하였다. MRI는 활막육종 형성됨이 확인되었으며 이에 대한 특징적인 소견은 내포하고 있지 않지만 종괴의 수술적 적출과 종괴의 범위를 확인하는데 있어 유용한 정보를 제공함을 알 수 있었다.