• Title/Summary/Keyword: 병소 절제술

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Treatment of Osteoid Osteoma (유골 골종의 치료)

  • Han, Chung-Soo;Cho, Chang-Hyun;Cho, Young-Lin;Cho, Nam-Su;Lim, Chan-Teak
    • The Journal of the Korean bone and joint tumor society
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    • v.6 no.1
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    • pp.22-29
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    • 2000
  • Purpose : The purpose of the current study was to report the results of curettage and en bloc excision as well as to introduce how to excise the nidus percutaneously with Halo-mill. Material and Methods : Twenty patients(14 men and 6 women) were evaluated, who had operative treatments after diagnosed as osteoid osteoma from March 1990 to January 1998. These patients ranged in age from 7 to 42 years(average: 20.8 years). Locations were 9 femurs, 6 tibias, 2 vertebras, 1 ulna, 1 maxilla and 1 skull. Nine femoral lesions included 5 proximal metaphysis, 2 neck and 2 diaphysis, while 5 tibial lesions included 3 diaphysis, 1 proximal metaphysis and 1 distal metaphysis. We used simple radiography, bone scan, CT and MRI for the accurate diagnosis and localization. As for surgical treatments, while excision and curettage had to need open-exposure of lesion, the percutaneous excision of nidus did not need openexposure : guided Halo-mill into K-wire inserted to nidus under image intensifier. Results : Simple radiography showed that 10 cases had typical nidus and others had only cortical sclerosis. Bone scan was performed at 14 cases and all had hot uptake except one case. We used CT in 10 cases and MRI in 4 cases as diagnostic methods, of which 1 case didn't reveal nidus at CT. Surgical treatment consisted of 6 curettages, 11 excisions, 2 percutaneous excisions with halo-mill and 1 total elbow arthroplasty. We used 7mm sized Halo-mill. During the follow-up period, all patient relieved symptoms and there were no recurrences. All had histologically typical findings except one which had hyperostosis without nidus. Conclusion : Complete removal of the nidus is the most important factor in the treatment. We could excise the nidus percutaneously in 2 cases with the minimal injury to surrounding soft tissues. If we could evaluate the precise location, size of nidus and percutaneous acccesibility, the percutaneous excision of nidus with Halo-mill could be an alternative method as a treatment of osteoid osteoma.

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Treatment of Giant Cell Tumor Around Knee - by Intralesional Excision Using High Speed Burr and Methylmethacrylate - (슬관절 주변에 발생한 거대세포종의 치료 - 고속 바(High-Speed Burr)와 골 시멘트를 이용한 병소 내 절제술 -)

  • Park, Jong-Hoon;Lee, Soo-Yong;Jeon, Dae-Geun;Cho, Wan-Hyung;Song, Won-Seok;Kim, Jin-Wook;Koh, Han-Sang
    • The Journal of the Korean bone and joint tumor society
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    • v.11 no.2
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    • pp.160-167
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    • 2005
  • Purpose : Distal femur and proximal tibia are the common sites affected by giant cell tumor of bone. There are a variety of treatment modality including wide excision and intralesional curettage. We evaluated the local recurrence rates and the post-operative functional scores of giant cell tumors around knee joint and investigated the identification of possible prognostic factors for recurrence. Materials and Methods: We reviewed 41 patients pathologically confirmed as giant cell tumors around knee joint that have undergone intralesional curettage using high-speed burr and methylmethacrylate. We evaluated the recurrence rate and post-surgical functional score and possible prognostic factors for recurrence, such as, gender, age, tumor location, size, subchondral invasion, intra-articular invasion and the Campanacci Grades. Mean follow up period was 50 (12-122) months. Results: The recurrence rate was 17% and mean recurrence onset was 10 months postoperatively. According to Musculoskeletal Tumor Society (MSTS) functional evaluation system, the average score was 27.8(93%) and 78% had excellent function. According to our study, suspected prognostic factors revealed not significant for recurrence. Conclusion: We found no significant recurrence related factors. Intralesional excision with high-sped burring and PMMA provides a low recurrence rate, similar to others in the literature, and good functional scores.

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Reconstruction with Non-vascularized Fibular Graft and Anterolateral Thigh Free Flap after Wide Resection for Unplanned Intralesional Resection of Synovial Sarcoma of the Thenar Muscle - A Case Report - (불완전 절제된 무지구근 활막육종에서 광범위 절제술후 비골 이식술과 전외측 대퇴부 유리 피판 이식술 - 증례 보고 -)

  • Choi, Byung-Wan;Kim, Jung-Ryul
    • The Journal of the Korean bone and joint tumor society
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    • v.13 no.2
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    • pp.124-129
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    • 2007
  • Synovial sarcomas of the hand are rare. It should be treated with wide resection. In the cases of soft tissue sarcomas of the hand, functional reconstruction must be considered. We report 46-year-old male patient with synovial sarcoma of the right thenar muscle which was treated with unplanned intralesional resection at outside hospital, that has been treated with wide resection including trapezium and first metacarapl bone then, reconstructed with nonvascularized fibular graft and anterolateral thigh free flap.

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Pulmonary Resection for Multidrug-Resistant Tuberculosis (다제내성 폐결핵의 폐절제술에 관한 연구)

  • 박승규;윤후식;이창민;허진필;권은수
    • Journal of Chest Surgery
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    • v.34 no.1
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    • pp.72-79
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    • 2001
  • 배경: 일반적으로 다제내성 폐결핵의 경우 화학요법만으로는 치료성적이 만족스럽지 못하였다. 이에 수술적 치료와 항결핵 화학요법의 병합사용이 높은 균음전율과 장기 생존율을 보여주고 있으므로 이러한 치료전략이 다제내성 폐결핵환자의 일반적인 치료방법으로 정립되리라는 전망을 갖게 하고 있다. 대상 및 방법: 1995년 1월부터 1999년 12월까지 국립마산결핵병원에서 폐결핵에 대한 수술을 시행받은 130례 중 다제내성 폐결핵으로 폐절제수술을 받은 49례를 대상으로 의무기록 및 검사기록 등을 근거로 후향적 조사를 실시하였다. 결과: 대상환자들의 평균연령은 35세였고, 내성약제의 수는 평균 4.5였다. 43례(87.8%)의 환자에서 공동성 병소를 보였으며 31례(63.3%)의 환자에서 술전 객담내 균양성 소견을 보였다. 수술술식은 12례에서 전폐적출술을, 28례에서 폐엽절제술을, 7례에서는 폐엽절제술과 구역절제술 혹은 설상절제술 등을, 그리고 설상절제술과 공동성형술을 각각 1례에서 시행하였다. 술후 지속적인 내과적 약물치료를 병합하여 장기적인 균음전율은 93.5%였고 술후 사망환자는 없었다. 술후 합병증으로는 1주일 이상 지속되는 공기유출 6례와 술후 출혈, 창상분열이 각각 1례씩 있었다. 결론: 다제내성 폐결핵환자에서 폐절제 수술에 대해서는 적절한 적응증, 수술후 처방, 그리고 술후 치료기간 등에 대한 이견이 있지만 적극적으로 고려되어야 하며 술후 내과적 치료와 병행함으로 좋은 치료효과를 얻을 수 있었다.

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Short Term Result of Total en Bloc Spondylectomy in Spine Tumor (원발성 및 전이성 척추종양에 대한 전 척추 절제술의 단기 추시 결과)

  • Kim, Jae-Do;Jang, Jae-Ho;Park, Chan-Jae;Chung, Jae-Yoon
    • The Journal of the Korean bone and joint tumor society
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    • v.13 no.1
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    • pp.37-42
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    • 2007
  • Purpose: Because of the anatomical characteristics, it is difficult to perform radical operation in spinal tumor. Numerous operations on primary and metastatic spinal tumor have been performed and among those total en bloc spondylectomy has produced decent clinical result. Clinical and radiological results have been analyzed based on five total en bloc spondylectomy on primary and metastatic spinal tumor. Materials and Methods: Patients included in this study were one with primary and four with metastatic spinal tumors, from June 1997 to January 2006. Two of the four were originated form kidney. One was from breast and the other one was not identified. McAfee's 4 point scale, VAS and Frankel's classification have been used as clinical assessment of pain and neurological symptoms. Clinical assessment have been conducted for every 3 months after operation including local recurrence, bone union and complications. Results: Assessment of pain decreased from average of 3 before operation to 1.6 after operation in McAfee's scale and VAS decreased from average of 9.2 to 1.6. Neurological deficit after operation improved from C to D in Frankel's category. Local recurrence has been detected on metastatic adenocarcinoma of L4 during follow up. Conclusion: Total en bloc spondylectomy is evidently useful operational method for primary and metastatic spinal tumor since it completely decompresses spinal nerves, decreases axial pain immediately and improves the quality of remaining life.

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Treatment Outcomes of Sacral Giant Cell Tumor (천골 거대 세포종의 치료 결과)

  • Kong, Chang-Bae;Lee, Kwang-Youl;Song, Won-Seok;Cho, Wan Hyeong;Koh, Jae-Soo;Jeon, Dae-Geun;Lee, Soo-Yong
    • 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.

Multiple Periosteal Chondroma of the Fourth Toe (제4족지의 다발성 골막 연골종)

  • Kim, Jong-Kil;Park, Yeong-Cheol
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.4
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    • pp.338-342
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    • 2020
  • Periosteal chondroma is a rare, slow-growing, benign cartilaginous tumor that develops between the periosteum and cortex, but there are no reports of multiple periosteal chondroma of the toes. A 19-year-old male presented with a palpable mass of the right fourth toe with tenderness for one year. A radiology examination revealed multiple, radio-lucent lesions with mild cortical irregularity. The magnetic resonance imaging findings were chondrogenic tumors with multiple, well-defined T1-low and T2-high signal enhanced lesions involved in the fourth proximal, middle, and distal phalanges. The tumors were removed by a surgical resection and curettage. Histologically, the tumors were proven to be periosteal chondroma.

Recurred Fibrous Dysplasia in the Vascularized Fibular Graft -A Case Report- (이식한 생비골에서 재발한 섬유성 골이형성증 -1례 보고-)

  • Chung, Duke-Whan;Han, Chung-Soo;Rhee, Yong-Girl;Han, Soo-Hong;Lee, Chong-Won
    • Archives of Reconstructive Microsurgery
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    • v.5 no.1
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    • pp.147-150
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    • 1996
  • In the benign bone tumor such a fibrous dysplasia, destructive lesion is generally treated by curettage and simple bone graft. Such lesions are unlikely to recur if treated local curettage with bone graft or simple excision of the lesion. When it is impossible to cure only with simple bone graft due to wide extent of tumor, vascularized fibular graft have been introduced for functional loss and appearance. The recurrence of the primary tumor in the grafted fibula is rare in benign bone lesion. We experienced a case of fibrous dysplasia which was recurred in the grafted fibula following the initial treatment with vascularized fibular graft. So we report a case of our experience.

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Diagnosis & Surgical Treatment of Neurilemmoma (신경초종의 진단과 수술적 치료)

  • Suh, Jeung-Tak;Park, Byung-Guk;Yoo, Chong-Il
    • The Journal of the Korean bone and joint tumor society
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    • v.5 no.1
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    • pp.44-50
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    • 1999
  • Neurilemmoma is a benign encapsulated nerve sheath tumor originated from peripheral nerve. Previously its preoperative diagnosis had mainly depended on the history, physical examination, electrodiagnostic test, ultrasonography, bone scan. But only with these diagnostic modalities, exact preoperative diagnosis was nearly impossible. Therefore operation was performed under the impression of lipoma or just simple soft tissue tumor. Recently, the advent of magnetic resonance imaging(MRI) has made it easier to diagnose neurilemoma before surgery. MRI also helps to determine the extent of lesion and operative procedures. We performed marginal excision in 24 cases, evaluated those cases with respect to the sex, age, location, chief complaint, duration of illness, preoperative diagnosis, involved nerve, imaging studies, size of mass, complication, duration of follow-up and report with review of the literature.

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