• The Journal of the Korean bone and joint tumor society
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• v.11 no.2
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• pp.148-154
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• 2005

Purpose: To evaluate the long term results of surgical treatment for sacral chordoma. Material and Method: We reviewed the records of 4 patients with sacral tumor treated surgical resection. Mean follow-up duration was 8.3 year(3~11). All cases were performed complete resection of tumor mass through posterior approach in 3 cases and anterior-posterior approach in one. The most caudad nerve-roots spared were the second sacral roots in one and the third sacral roots in 3 cases. Functions of voiding and defecation including neurological symptoms of lower extremities, other complications of surgical treatment, and local recurrence or distant metastasis of tumor were evaluated. Result: There was no motor deficit in all cases, but radiating pain was developed in one and wound infection in one. Bladder function was preserved in 2 cases, intermittent incontinence in one, and doing intermittent catheterization in one. Bowel function was preserved in one and 2 cases were suffered from constipation. At the last follow-up, disease-free was in one, local recurrence in one, and local recurrence with distant metastasis in one. Conclusion: The result of surgical resection for sacral chordoma is satisfactory showing average 8 years survival. Early detection and aggressive surgical treatment is the best to prolong survival and to minimize functional deficit with preservation of upper sacral nerves.

• The Journal of the Korean bone and joint tumor society
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• v.10 no.2
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• pp.142-146
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• 2004

Bizzare parosteal osteochondromatous proliferation is a rare lesion, tends to frequently recur. It was first described in 1983, when Nora and his colleagues reported 35 examples of a proliferative lesion involving small bones of the hand and the feet. It was regarded as occurring only in the small bones of the hand and the feet initially, but from then on, other authors have been reported cases including those involving long bones, skull and maxilla. We experienced a case of bizzare parosteal osteochondromatous proliferation which affects the humeral shaft in a 14-year-old male patient. Radiographs showed calcified mass measuring $4{\times}3$ cm in size and attached to the underlying cortex, which had a broad stalk base. Histologically, it showed hypercellular cartilage maturation to the trabecular bone and plump amount of fibrous stroma in the spaces around the bony trabeculae. Bizzare parosteal osteochondromatous proliferation is a relatively rare lesion, but has a recurrent behavior and histologically tends to be mistaken for malignancy. It can be treated by excision.

• The Journal of the Korean bone and joint tumor society
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• v.2 no.1
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• pp.33-37
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• 1996

From January 1994 to August 1995 we performed 270 cases of fine needle aspiration cytology for bone and soft tissue lesions. Among them 137 cases were diagnosed histologically. Sixty-seven cases were benign and 70 cases were malignant. We analysed these on the aspect of sensitivity, specifity, positive predictive value, negative predictive value of the cytologic examination. Malignant cases consisted of bone tumor 29 cases; soft tissue tumor 25 cases; and metastatic tumor 16 cases. The sensitivity and specifity of the aspiration cytology for malignant tumor were 67.8% and 97%, respectively. The positive and negative predictive value of aspiration cytology were 97.4% and 72.7%, respectively. Among them 40 cases were primary bony lesions; 14 benign lesions, 26 malignamt bone tumors. Sensitivity of aspiration cytology for these primary bony lesion was 90%(18/20) and its specifity was 100%(13/13). Three cases showed atypical cells in cytology but with biopsy we could find them as one benign and two malignancies. Two cases of manignancy showed negative result in cytology; one was parosteal sarcoma of proximal femur and the other was osteosarcoma of proximal tibia which was biopsied already at other hospital. Although the overall sensitivity and specifity for malignant bone and soft tissue tumors were relatively low and not so predictable, the fine needle aspiration cytology for primary bony lesion was useful in the differential diagnosis of benign or malignancy.

• The Journal of the Korean bone and joint tumor society
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• v.2 no.1
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• pp.1-7
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• 1996

PURPOSE : The purpose of this study is to know the ability of detecting malignant tumor tissue by Tl-201 scan, and to compare with that of Tc-99m-MIBI and Tc-99m-MDP scan. MATERIAL AND METHODS : Between February 1994 and December 1995,38 unselected patients with various bone pathologies were studied prospectively. Eighteen had malignant bone and soft tissue pathologies, while twenty had benign. All patients were studied with Tl-201, Tc-99mMIBI and Tc-99m-MDP scan prior to surgical biopsy. PICKER Prism 2000 gamma camera with high resolution parallel hole collimator was used for scanning. To avoid the interaction of isotope, the early(30min.) and delayed phase(3hrs.) of Tl-20l scan was performed first and Tc-99m-MIBI scan was performed after 30 minutes, and then Tc-99m-MDP scan 48 hours later. The scan images were visually evaluated by a blinded nuclear medicine physician. We could find true positive, true negative, false positive and false negative by the comparison of results with those of biopsy. We calculated positive and negative predictive value(%), sensitivity(%), specificity(%) and diagnostic accuracy(%) of each scan. RESULT : The results of each scan were 85.7, 100, 100, 85, 92.1% in Tl-201, 81, 94.1, 94.4, 80, 86.8% in Tc-99m-MIBI and 50, 66.7, 88.9, 20, 52.6% in Tc-99m-MDP scan. As a conclusion, Tl-201 scan was the most specific and accurate method for detecting malignant tumor tissue. Tc-99m-MIBI scan was also good for malignant tumor searching. CONCLUSION : With our results, we can use Tl-201 scan to differentiate benign from malignant tumor, and to evaluate the response of preoperative chemotherapy or radiotherapy, and to determine the residual tumor or local recurrence. For the better result, we need to have a more detail information about false positive cases and a more objective and quantitative reading technique.

• The Journal of the Korean bone and joint tumor society
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• v.14 no.2
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• pp.106-118
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• 2008

Purpose: Disturbed cell cycle regulatory proteins are key events underlying the development and/or progression of human malignancies. The aim of this study is to evaluate the protein expression status involved in G1/S cell cycle in human soft tissue sarcoma. Materials and Methods: We simultaneously evaluated the expression of Cyclin D1, Cyclin E, CDK4, CDK2, p16, p27, Rb, E2F1, p53 and Ki-67 by immunohistochemistry in 43 cases of soft tissue sarcoma Results: The Cyclin D1, Cyclin E, CDK4, CDK2, E2F1, and p53 were expressed in 25 (58.1%), 18 (41.9%), 13 (30.2%), 33 (76.7%), 20 (46.5%), and 18 cases (41.9%). The p16, p27, and Rb expressions were decreased in 26 (60.5%), 22 (51.2%) and 19 cases (44.2%). All of the cases showed alterations of more than one out of the above proteins. The increased Cyclin E expression and Ki-67 labeling index (LI) were significantly associated with histologic grade. The Cyclin E and E2F-1 expressions were increased in relapsed cases and the CDK4 expression was increased in cases of metastasis. Conclusion: Alterations of G1/S cell cycle regulatory proteins may play an important role in the tumoriogensis of soft tissue sarcomas. Our results suggest that increased expressions of Cyclin E, E2F1, and CDK4 were associated with tumor relapse or metastasis and could be considered as parameters of prognosis of soft tissue sarcoma.

• The Journal of the Korean bone and joint tumor society
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• v.17 no.1
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• pp.30-35
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• 2011

Purpose: This study was designed to evaluate the treatment results of malignant melanoma and to analyze the factors influencing prognosis. Materials and Methods: Thirty one cases of malignant melanoma were included in this study. They were treated in our hospital surgically, medically and immunologically from January 1996 to December 2005, and were followed more than 5 years. We compared 5 year survival rate (5YSR) according to the age, gender, anatomical site, depth of tumor, TNM stage, involvement of lymph node and immuno-chemotherapy. Results: Overall 5YSR was 80.6%. 5YSR of the age group below 65 years was 89.7% and 66.7% for the age group over 65 (p=0.033). 5YSR for men was 75% and 90.9% for women. 5YSR according to the site of occurrence showed 66.7% in upper extremities, 89.5% in lower extremities, and 66.7% in other site. 5YSR was 100% for the Clark level below III and 62.5% for the level above IV (p=0.032). 5YSR was 53.8% for lymph node metastasis group and 100% for non-lymph node metastasis group (p=0.021). Conclusion: We concluded that early diagnosis and wide excision was the most important in treatment of malignant melanoma. The prognostic fractors of malignant melanoma were age, depth of tumor (Clark's stage) and metastasis of lymph node.

• The Journal of the Korean bone and joint tumor society
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• v.19 no.2
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• pp.43-49
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• 2013

Purpose: We analyzed the treatment outcomes of patients with sacral giant cell tumor. Materials and Methods: We retrospectively reviewed 7 patients with giant cell tumor of the sacrum who were treated at out institution between 1990 and 2012. Results: There were 2 men and 5 women with mean age of 23.6 years. The average follow up was 52.3 months (range, 15-73 months). Six patients received surgical treatment. Intralesional curettage was performed for the 5 patients and marginal resection for another one patient. The remaining one patient was received radiation only. The patients who received radiation therapy and marginal excision had no residual or recurrent tumors. Of 5 patients with intra-lesional excision, one patient needs one more operation; two patients need two more operation for local control of the giant cell tumor. The remaining two patients failed to gain local control in spite of additional treatments. Conclusion: For the treatment of sacral giant cell tumor, intralesional resection can be one of the treatments option with minimal neurologic injury. Furthermore, radiation therapy can be recommended when complete excision or curettage is impractical.

• The Journal of the Korean bone and joint tumor society
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• v.7 no.2
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• pp.41-50
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• 2001

Purpose : To investigate biochemical markers for osteosarcoma, activities of deoxyribocuclease(DNase), ribonuclease(RNase), 5'-nucleotidase, alkaline phosphatase and amylase were determined in the osteosarcoma tissue and serum of patients with osteosarcoma. Also studied were DNase, RNase in osteosarcoma tissue, isolating the enzymes from the sarcoma tissue and investigating the sarcoma specific enzymes. Materials and Methods : The experimental tissue and serum were obtained from twelve patients with osteosarcoma. The control group were obtained from the normal healthy tissue of the same patients. The tissue were centrifugalized to obtain extracts. The extracts were analized for the estimation of nucleic acid, protein contents and enzyme activities. And then each enzymes were isolated and analized by DEAE-cellulose chromatography and estimated for activities. Result : Activities of acid DNase, RNase, 5'-nucleotidase and alkaline phosphatase were significantly increased in osteosarcoma tissue. Neutral RNase in osteosarcoma tissue was shown to bo highly active, exhibiting secretory form of RNase inhibitor associated with the RNase was also increased. In the serum of patients with osteosarcoma, RNase activity was significantly increased. DEAE-cellulose column chromatographical analysis revealed that acid DNase was isolated as a single enzyme and neutral RNase as five isozymes in osteosarcoma tissue. Conclusion : The results indicated that combination of these enzymes could be used as markers for osteosarcoma. The results indicated that acid DNase and neutral RNase might play a role in genesis of sarcoma and suppression of sarcoma.

• The Journal of the Korean bone and joint tumor society
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• v.18 no.2
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• pp.113-117
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• 2012

A 73-year-old male was admitted for unhealed wound. Eight months ago, the patient had been operated for excision of soft tissue mass on left distal thigh area in previous hospital and after 4 months from first operation, had been reoperated because of recurrence. The pathologic diagnosis of previous operation was simple cyst. In operating finding, the mass invaded the vastus lateralis fascia and had irregular margin and adhesion. We carried out simple excision with retaining 5 cm of free margin from the mass. The pathologic diagnosis of our hospital was malignant fibrous histiocytoma, and then the patient was performed radiation therapy. In 1 year follow-up, there was no significant finding either increasing mass size or metastasis. We misdiagnosed as simple cyst and then performed simple excision, however finally pathologic diagnosis confirmed as malignant fibrous histiocytoma. It is considered to operate a mass that preoperative proper evaluation and diagnosis are required.

• The Journal of the Korean bone and joint tumor society
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• v.9 no.2
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• pp.169-177
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• 2003

Purpose: The purpose of the current study is to evaluate the correlation between the expressions of p21 and p27 in osteosarcoma, and prognostic impact such as local recurrence, distant metastasis and survival rate. Materials and methods: Between 1988 and 2001, forty patients who underwent surgery, followed more than 12 months, and whose pathologic blocks were available, were evaluated retrospectively. Their formalin-fixed and paraffin-embedded tumor specimens were investigated. The correlation between expressions of p21, p27, local recurrence, distant metastasis and survival rate was statistically evaluated. Results: p21 protein was expressed in 38 (95%) patients. p27 protein was expressed in 14 (35%) patients. Patients with high expression of p21 had more frequent metastasis and poorer results (p=0.024). In contrast with these findings, patients with positive staining of the p27 had the significant lower distant metastasis (p=0.028). Conclusion: The prognosis of the osteosarcoma according to the expression level of p21 and p27 had inverse relationship which had unknown mechanism. Further work will be needed to define the relationship between p21 and p27.