The Journal of the Korean bone and joint tumor society
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v.9
no.2
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pp.212-216
/
2003
A Common peroneal nerve palsy caused by ganglionic cyst is very rare condition but well recognised entities. There have been three previous reports describing the magnetic resonance image (MRI) findings of peroneal nerve entrapment due to a ganglionic cyst. Ultrasonography, MRI, and electromyography (EMG), nerve conduction velocity (NCV), and microscopic examination were taken for diagnosis. A tubular structure near the fibular neck extending longitudinally over several slices with an inferior extension towards the superior tibiofibular joint with high T2 signal intensity was characteristic. The peroneal nerve was exposed and the ganglionic cyst was excised. The nerve was paralysed immediately after operation, but at 4 month after operation, started recovery of the function gradually and has recovered completely at 7 month. MRI is helpful to detect the extent, location, and origin of the cyst. Meticulous surgical excision can provide favorable result.
Background: Surgical resection is a standard treatment for pulmonary metastases in patients with osteosarcoma, but the role of performing repeated resections is not clear. This study was designed to clarify the feasibility of performing a repeated pulmonary metastasectomy and the prognostic factors for pulmonary metastases in patients with osteosarcoma. Material and Method: Between January 1990 and July 2005, 62 patients with osteosarcoma were diagnosed with pulmonary metastases and 36 patients underwent pulmonary resection. We reviewed the patients retrospectively. Result: The total number of pulmonary metastasectomies was 62 in 30 patients. Among 36 patients, 18 had a second metastasectomy, 7 had a third metastasectomy, and one patient had a fourth metastasectomy. There was no distinctive difference between the first and second metastatectomy in terms of median survival time, and the 3-year and 5-year survival rate (first resection: 20.5 months, 32.0% and 29,4%; second resection: 11.3 months, 34.9% and 34.%). However, the median survival time (7.1 months) was shorter in patients with a third metastatectomy than in patients with one metastatectomy (p=0.01). In long-term survivors, the number of female patients, patients with a disease free time longer than 12 months, patients with a single metastasis and patients with anatomic resection was larger when compared to non-long term survivors, but showed no statistical significance. Conclusion: Repeated pulmonary metastasectomy is expected to prolong survival time in patients with osteosarcoma, and is expected to increase long-term survival in selected cases. Further studies with a large number of patients are necessary.
Kim, Il-Kyu;Lee, Seong-Ho;Oh, Seong-Sub;Choi, Jin-Ho;Oh, Nam-Sik;Kim, Wang-Sik;Rim, Young-Il;Yang, Dong-Whan
Maxillofacial Plastic and Reconstructive Surgery
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v.23
no.3
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pp.281-288
/
2001
Lymphangiomas are relatively rare benign tumors of the lymphatic system, characterized by congenital lymphatic malformation such as anastomosis or obstuction of the lymphatic channels. There are most frequently diagnosed in children younger than 3years. In contrast to that of the hemangioma, the sex distribution of the lymphangioma is nearly evenly divided. The head and neck lymphangioma represents about $70{\sim}75%$ of all lymphangiomas, and they are difficult to manage. Spontaneous regression is rare, and rapid intermittent enlargement occurs secondary to infection or trauma. Enlargement may cause serious sequelae such as airway obstruction, feeding difficulties, and cosmetic problems. Treatments previously used for lymphangiomas include surgical excision and intralesional injection of sclerosants. Problems associated with surgical excision include the risk of cosmetically unacceptable scarring and the risk of damage to surrounding vital stricture and the high risk of incomplete excision. The sclerosants previously used have numerous other local and systemic side effects. This report describes a case that was successfully treated using OK-432 as a new sclerosant drug and secondary surgical excision for congential cavenous lymphangioma extensively enlarged to tongue, mouth floor and submandibular region.
A 70-year-old female diagnosed with pancreatic ductal adenocarcinoma was treated by pylorus-preserving pancreaticoduodenectomy (PPPD) and adjuvant concurrent chemoradiotherapy with 5-fluorouracil. Pancreatic ductal adenocarcinoma pT3N0 (stage IIA) was pathologically confirmed. Abdominal computed tomography (CT) findings 14 months after PPPD showed 10 mm sized solitary liver metastasis in segment 3. After 12 cycles of gemcitabine and 9 cycles of capecitabine plus oxaliplatin, the metastatic nodule increased in size to 27 mm. Tumorectomy at segment 3 of liver was done. 25 months after tumorectomy, chest CT showed 23 mm sized cavitary nodule in right upper lobe of lung. The result of percutaneous biopsy favored metastatic adenocarcinoma. Two sets of stereotactic body radiation therapy were done and the patient has survived without further disease progression for 6 years after initial diagnosis. This case suggests that selected population of recurrent pancreatic cancer patients with solitary liver or pulmonary metastasis can be treated by resection of metastatic site and ablative therapies.
Song, Won Seok;Cho, Wan Hyeong;Lee, Kwang-Youl;Kong, Chang-Bae;Koh, Jae-Soo;Jeon, Dae-Geun;Lee, Soo-Yong
The Journal of the Korean bone and joint tumor society
/
v.20
no.2
/
pp.47-53
/
2014
Purpose: We analyzed the diagnosis and the treatment outcomes of patients with central low grade osteosarcoma. Materials and Methods: We retrospectively reviewed 16 patients with central low grade osteosarcoma were treated at out institution between 1994 and 2011. Results: There were 4 men and 12 women with mean age of 26 years. Eleven patients were correctly diagnosed but 5 patients were misdiagnosed as osteoid osteoma, non ossifying fibroma, aneurysmal bone cyst, desmoplastic fibroma. 15 patients finally received wide margin en bloc excision and one of them treated under neoadjuvant chemotherapy. Final survival status was continuous disease free in 14 and 1 patient died of renal cell cancer. Remaining 1 with multifocal lesions is alive with disease for 7 years only treated radiation therapy on residual tumors. Nine (56%) of 16 tumors showed extra-osseous extension of tumor (56%) and 1 of them showed extra-compartmental tumors. Conclusion: The diagnosis of central low grade osteosarcoma is challenging, however, considering of the clinical suspicion, the typical findings of radiologic and pathologic features, proper diagnosis is needed. This tumor should be treated with wide excision, even after an intralesional excision, to avoid local recurrence or transformation to higher histologic grade.
The Journal of the Korean bone and joint tumor society
/
v.19
no.1
/
pp.14-19
/
2013
Purpose: We analyzed the oncologic characteristics and outcome of patients with inflammatory myofibroblastic tumor of extremities. Materials and Methods: Among the soft tissue tumor patients who were treated between 1999 and 2012, 5 patients who were pathologically confirmed as the inflammatory myofibroblastic tumor of extremities were analyzed retrospectively. Results: There were 1 man and 4 women with mean age of 44 years (37-55 years). The average follow up was 34.6 months (8-87 months). All patients underwent surgical treatment. Only 1 patient had wide resection margin and remaining 4 had marginal (3) or intralesional (1) resection margin. All of 4 patients without wide resection margin developed local recurrence at 10.3 months (8-19 months). Malignant transformation to fibrosarcoma was occurred in 2 patients who developed local recurrence, and 1 patient developed multiple metastases to lung, liver and lymph nodes and expired at 37 months. Three of 5 patients had tumor location abutted to or invasion to major arteries and 1 patient had tumor invading sciatic nerve. Conclusion: It is observed that inflammatory myofibroblastic tumor of extremities is usually located near the major neurovascular structure. Wide resection should be considered as the initial surgical treatment because this tumor showed a high local recurrence rate and possibility of malignant transformation.
These are two case reports of recurrent ossifying and cemento-ossifying fibroma in a year or 5 months following conservative treatment. Ossifying fibroma or cemento-ossifying is a relatively uncommon benign fibro-osseous tumor of the jaws, and is generally believed to originate from periodontal ligaments. In recent, it is not demanded more differentiation of ossifying, cementifying and cemento-ossifying fibroma due to the thought that these lesions represent a spectrum of the same disease process rather than separate entities. The tumor commonly presents as an asymptomatic mass lesion and is usually well-circumscribed clinically so that conservative surgical excision has been the treatment of choice, but on occasion extended surgical procedures may become necessary, especially for those tumors which demonstrate rapid expansions and are poorly encapsulated (either initially or when recurrent) and when tumor growth is progressed aggressively or recurrent. En-bloc resection of mandible with iliac bone and inferior alveolar nerve graft was performed in case 1, recurrent cemento-ossifying fibroma of 32-year old male patient, and extended surgical enucleation of mass including normal marginal bone was done in case 2, recurrent ossifying fibroma of 72-year old female patient. By follow-up check of the patients, we obtained good result without any sings of recurrence.
Bank, Won-Jong;Rhee, Seung-Koo;Kang, Yong-Koo;Kwon, Oh-Soo;Chung, Yang-Guk
The Journal of the Korean bone and joint tumor society
/
v.9
no.1
/
pp.124-129
/
2003
Purpose: To analyze the clinical outcome and radiological features after surgical treatment of stage III giant cell tumor around the knee. Materials and Methods: 21 patients with stage III giant cell tumor around the knee joint, who were operated at our institutes between March 1991 and February 2000, were selected for this study. The average follow-up was 5.7 years (range, 1~9 years). After thorough curettage using high speed burr, cryosurgery and cementing with polymethymethacrylate (PMMA) were performed in 11 patients. 7 patients were treated with PMMA cementing (4 patients) or bone grafting (3 patients) after curettage without cryosurgery. Reconstruction with prosthesis composite allograft and knee fusion with Huckstep nail were performed in 3 patients with huge defect and joint perforation. Results: Local recurrence developed in 1 out of 11 patients who was treated with curettage and cementing with cryosurgery (9.1%) and 3 out of 7 patients who underwent curettage and cementing without cryosurgery (28.6%). Joint space narrowing more than 3mm was noted in 1 patient (9.1%), who treated with cryosurgery and anther patient (14.5%) who treated without cryosurgery. There was no local recurrence in case of wide resection and reconstruction. Conclusion: Thorough curettage and PMMA cementing with cryosurgery as an adjuvant is thought to be effective modalities in the treatment of stage 3 giant cell tumors around the knee. Wide resection and reconstruction can be reserved mainly for the cases of stage 3 giant cell tumor with significant cortical destruction and marked joint destruction, and the cases of local recurrence with poor bone stock.
Kim, Eun-Mi;Kim, Se-Won;Kim, Sang-Woon;Lee, Kyung-Hee;Hyun, Myung-Soo;Park, Won-Kyu;Chang, Jae-Chun;Song, Sun-Kyo
Journal of Gastric Cancer
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v.6
no.4
/
pp.237-243
/
2006
Purpose: This study was conducted to evaluate the treatment outcomes and the prognosis for gastric cancer patients with hepatic metastasis. Materials and Methods: This retrospective study was based on the medical records of 85 gastric cancer patients with hepatic metastasis (62 synchronous and, 23 metachronous) who received chemotherapy with or without resectional therapy from March 1990 to March 2006. The survival rate was analyzed according to clinicopathologic factors and therapeutic factors, such as whether or not a gastrectomy, a hepatic resection, and/or chemotherapy had been performed. Results: The median survival of gastric cancer patients with hepatic metastasis was 11 months (synchronous: 11 months and metachronous: 17 months). The rates of gastrectomies and hepatic resections in the synchronous group were 24.1% and 16.1%, respectively A 23.5% prevalence of extra-hepatic metastasis was observed. The median survivals of patients who underwent a gastrectomy with a hepatic resection, a gastrectomy alone, and non-surgical treatment were 60, 18, and 9 months, respectively (P<0.05). The disease-free median survival of the metachronous group was 8 ($3{\sim}39$) months. There was no difference in initial pathologic stage and frequency of hepatic metastasis after the gastrectomy in the metachronous group. In the synchronous group, extra-hepatic metastasis, a gastrectomy as the operative procedure, a hepatic resection as the operative procedure and the response to chemotherapy were statistically significant in the univariate analysis, and a hepatic resection as the operative procedure, the response to chemotherapy, and extra-hepatic metastasis were independant prognostic factors identified by the multivariate analysis. In the metachronous group, extra-hepatic metastasis, the response to chemotherapy and differentiation were statistically significant in the univariate analysis, and extra-hepatic metastasis was an independent prognostic factor identified by the multivariate analysis. Conclusion: An aggressive surgical therapy and effective chemotherapy are necessary in the treatment of gastric cancer patients with hepatic metastasis. (J Korean Gastric Cancer Assoc 2006;6:237-243)
The Journal of the Korean bone and joint tumor society
/
v.6
no.1
/
pp.17-21
/
2000
Purpose : Dermatofibrosarcoma protuberans(DFSP) is a rare tumor of the skin with a strong tendency of infiltration to surrounding tissues. Inadequate surgical intervention brings about frequent recurrence and poor prognosis. We attempted to find a guideline for adequate treatment for DFSP. Materials and Methods : Fourteen cases who had been treated in our department since Mar. 1993 and followed up for more than 12 months postoperatively were reviewed. Including nine cases who were transferred from other hospital after recurrence, thirteen cases underwent wide resection. One case was treated by intralesional resection followed by chemotherapy (CYVADIC) due to neurovascular abutment to the mass in the inguinal area. Results : The nine cases who were transferred due to recurrences experienced recurrence in average 1.3(1-2) times and the average period until first local recurrence from primary operation was 11.8(2-24) months. The thirteen cases with wide surgical margin showed no recurrence at the final follow up. One case treated by intralesional resection and chemotherapy showed multiple recurrence and died of the disease due to lung metastasis. Conclusions : From these data, we could find that primary wide resection can be the way of reducing recurrence and metastasis, and the follow up period for the detection of recurrence should be at least two years.
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