• Title/Summary/Keyword: 악성골종양

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Recycling Bone Autotransplantation with Extracorporeal Heat-Treatment for Malignant Bone Tumors of Pelvis (골반골의 악성 골종양의 재건술에서 체외 열처리를 이용한 재활용 자가골 이식술 및 인공 관절 치환술을 시행한 3례 보고)

  • Kim, Sae-Hoon;Lee, Sang-Hoon;Cho, Hwan-Sung;Kim, Han-Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.1
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    • pp.115-123
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    • 2003
  • Study Design: A retrospective clinical and radiographic review. Objectives: The purpose of this study was to suggest recycling bone autotransplantation with extracorporeal heat-treatment as one of favorable reconstruction method for malignant bone tumors of pelvis through 3 cases. Summary of Literature Review: There are many biologic and nonbiologic reconstruction method in pelvic reconstruction. Cases: Case 1- A 20-year-old women had chief complaint of right hip and thigh pain started 3 months ago and done curettage and bone cementing at right ilium at other hospital. She had impression of malignant bone tumor and undergone postoperative radiation therapy for 6 cycles. After that she was referred to our hospital and undergone wide excision of right ilium and recycling bone autotransplantation with extracorporeal heat-treatment at 132 degree celsius for 2 minutes internal fixation with pelvic reconstruction plate and total hip replacement arthroplasty (ABG$^{(R)}$). There was no evidence of distant metastasis and revealed well-differentiated osteosarcoma on postoperative pathology. Neither adjuvant nor neoadjuvant chemotherapy were done. Case 2- A 56-year-old women who suffered right thigh pain for 3 months was detected radiologic abnormality at right pelvis. After incisional biopsy, osteosarcoma was diagnosed. We had undergone wide excision of right ilium and recycling bone autotransplantation with extracorporeal low heat-treatment at 65 degree celsius for 30minutes internal fixation with pelvic reconstruction plate and total hip replacement arthroplasty (ABG$^{(R)}$). There was no evidence of distant metastasis and revealed high-grade osteosacoma which was fibroblastic type on postoperative pathology. Adjuvant chemotherapy (HDMTX, ADR, CDDP) was done immediate after wound healing was completed. Case 3- A 46-year-old women was incidently found mass at left ilium which was suspected chondrosarcoma. We had undergone wide excision of left ilium and recycling bone autotransplantation with extracorporeal low heat-treatment at 65 degree celsius for 30minutes internal fixation with pelvic reconstruction plate and total hip replacement arthroplasty (Protek$^{(R)}$). There was no evidence of distant metastasis and revealed chondrosarcoma which was graded II/III on postoperative pathology. Results: Oncologic and functional outcome at final follow-up were for case 1, final follow-up time was 7 years, is no evidence of disease and functional score is 53% according to Ennecking et al. During follow-up, evidence of radiologic union was at about 1 and 6 months after operation. The case had breakage of pelvic reconstruction plate and some resorption of autotransplated bone, but no symptom present. For case 2, final follow-up was 3 years and 6 months, is no evidence of disease and functional score is 60%. For case 3, final follow-up was 7 months, no evidence of disease and functional score is 63% which is improving state. Discussion: 3 cases which were undergone recycling bone autotransplantation with extracorporeal heat-treatment and total hip replacement arthroplasty had relatively successful oncologic and functional outcome. Taking account that difficulty in using allograft in Korea this method is thoght to be one of the useful way to reconstruct pelvis after resection of primary malignant bone tumor of the pelvis.

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Knee Joint Sparing Tumor Resection in 4years-Old Patient with Osteosarcoma - A Case Report - (4세 소아 대퇴골 골육종의 슬관절 보존형 절제 및 재건술 - 증례 보고 -)

  • Cho, Wan-Hyung;Cho, Sang-Hyun;Won, Ho-Hyun;Jeon, Dae-Geun
    • The Journal of the Korean bone and joint tumor society
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    • v.14 no.2
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    • pp.157-162
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    • 2008
  • Nowadays, most of the malignant bone tumor patient underwent limb salvage operation, however, reconstructive options for skeletally immature group are still controversial. There are three necessary conditions of most ideal reconstructive method in treating the skeletally immature children. As the epiphyseal plate sacrification is usually inevitable in malignant bone tumor around knee joint, ideal reconstructive technique would be as follows; 1)minimal or no damage to theadjacent epiphyseal plate, 2) maintaining mobile joint, 3) index procedure does not disturb subsequent operation such as lengthening. Segmental resection and reconstruction using autogenous pasteurized graft was done for 4 years old meta-diaphyseal osteosarcoma of femur. At 6 months from index operation, plain radiograph showed pasteurized bone resorption and loosening of fixation devise. To overcome the complication, we used allograft reconstruction by impacting the proximal host bone to the fluted portion of allobone. Three months later, proximal bone union was observed and patient showed good functional outcome.

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Functional Outcomes of Internal Pelvectomy without Reconstruction for Periacetabular Maligmant Tumors (비구주변 골반골 악성 골종양에서 재건술을 시행하지 않은 내골반골 절제술의 기능적 결과)

  • Chung, Yang-Guk;Kang, Yong-Koo;Lee, Seung-Koo;Bahk, Won-Jong;Lee, An-Hi;Park, Jung-Mi;Lee, Kyo-Sun;Lee, Hyung-Ju
    • The Journal of the Korean bone and joint tumor society
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    • v.13 no.1
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    • pp.60-66
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    • 2007
  • Purpose: The purpose of this study was to evaluate the functional outcomes of periacetabular malignant bone tumors treated by internal pelvectomy without reconstruction. Materials and methods: Between January 1996 and December 2005, eight patients with primary malignant or metastatic periacetabular bone tumors were treated by internal pelvectomy without reconstruction. There were 6 men and 2 women. Mean age was 42 years old. There were 3 osteosarcomas, 3 chondrosarcomas and 2 metastatic carcinomas. The type of pelvic resections were 6 type I+II+III, 1 type I+II and 1 type II+II resection. The functional outcomes were evaluated with ISOLS revised criteria. The follow up period ranged from 6 to 84 months. Results: At last follow up, 5 patients showed CDF, 2 patients, AWD and the remained 1, DOD. The mean functional score for pain, functional activity, emotional acceptance, use of external support, walking ability and gait were 4.9, 2.9, 2.9, 1.5, 2.3 and 2.5 respectively. The total functional score ranged from 37% to 70%(average: 56%). There were three temporary nerve palsies. Conclusion: The internal pelvectomy without reconstruction for selective difficult periacetabular malignant tumors could be a viable option with fewer complications and fair functional outcomes.

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Malignant Transformation of Giant Cell Tumor Not Associated with Radiotherapy (방사선 조사 없이 속발한 거대 세포종의 악성 전환)

  • Lee, Sang-Hoon;Oh, Joo-Han;Yoo, Kwang-Hyun;Suh, Sung-Wook;Ahn, Jun-Hwan;Kim, Han-Soo;Lim, Soo-Taek
    • The Journal of the Korean bone and joint tumor society
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    • v.8 no.1
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    • pp.12-19
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    • 2002
  • Purpose : Giant cell tumors(GCT) sometimes undergo malignant transformation after the radiotherapy, but very rarely do without radiotherapy. We reviewed the clinical experiences of the malignant transformation of GCT to suggest the guidelines for diagnosis and treatment of them. Materials and Methods : We examined four patients of pathologically proven malignant transformation of GCT, which occurred after the operative treatment alone without radiation, from September 1985 to January 2001. The mean follow-up period after the malignant transformation was 2.4 years(range, 1.3~4 years). Results : The mean time-interval from the initial diagnosis to the malignant transformation was 6.9 years(range, 2.2~13.5 years). The locations of tumors were soft tissues of proximal upper arm, proximal femur, distal femur and proximal tibia. The histology of malignant GCT was osteosarcoma in 3 cases and malignant fibrous histiocytoma in 1 case. Local recurrence developed in 1 patient and the pulmonary metastasis developed in 3 patients which transformed to osteosarcoma. Conclusion : Thorough sampling of the surgical specimen appears to be a very important factor for diagnosing the malignant transformation of GCT. In case of suspicion of malignancy in radiographs, the incisional biopsy should be followed by definite treatment rather than the improper resection.

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Osteosarcoma Arising from Desmoplastic Fibroma of Proximal Tibia - A Case Report - (근위 경골의 결합조직형성 섬유종 치료 후 발생한 골육종 - 1예 보고 -)

  • Kim, Tai-Seung;Park, Yong-Wook;Park, Moon-Hyang;Jang, Si-Hyong
    • The Journal of the Korean bone and joint tumor society
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    • v.13 no.2
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    • pp.162-166
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    • 2007
  • Desmoplastic fibroma of bone is rare, involves usually long bones, and histologically resemblance to the desmoid tumor of soft tissue. It is benign, but aggressive locally. Recurrence rate is high when treated with simple curettage and bone graft. Moreover, malignant transformation of desmoplastic fibroma with recurrence has been reported very rarely, and then it make us review again whether previous tumor probably was low grade malignant tumor. We report a surgically proven case of osteosarcoma arising from desmoplastic fibroma. A 17 years old male had been treated for a desmoplastic fibroma of the proximal tibia with curettage and bone graft. But after 11 years, the patient showed recurrence accompanying malignant transformation with osteosarcoma. This is very rare case of an osteosarcoma arising in a desmoplatic fibroma of the proximal tibia.

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Double Primary Presentation of Liposarcoma and Ewing's Sarcoma: A Case Report (대퇴부 지방육종 수술 후 발생한 반대측 근위 경골의 유잉육종/원시 신경 외배엽 세포종)

  • Park, Hyeong-Won;Jung, Sung-Taek;Nah, Seon-Yoon
    • The Journal of the Korean bone and joint tumor society
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    • v.17 no.2
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    • pp.95-99
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    • 2011
  • The development of different entities of soft tissue sarcoma in one patient is rare. It usually affects head and neck or abdominal region, whereas those affecting the extremities are much rarer. We describe a patient with double primary presentation of liposarcoma and Ewing's sarcoma in extremity. This case implies that sarcoma patients are at increased risk of a second malignancy, and this implies a need to search for occult tumors during follow up.

Malignancies in children who present with bone pain (뼈의 통증이 있을 때 감별해야 할 악성종양)

  • Lee, Jun Ah
    • Clinical and Experimental Pediatrics
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    • v.51 no.8
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    • pp.792-796
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    • 2008
  • Bone pain in a child could be associated with cancer as an initial manifestation of the disease. The childhood malignancies that frequently present bone pain are leukemia, neuroblastoma, and primary bone tumors such as osteosarcoma and Ewing sarcoma. Persistent bone or joint pain associated with swelling, mass, or limitation of motion implies underlying serious causes. Systemic manifestations such as lymphadenopathy, hepatosplenomegaly, fever, fatigue, night sweat, and laboratory abnormalities are also suggestive of malignancy. The index of suspicion tends to be low since less than 1% of children who complain of bone pain are diagnosed as cancer. Nonetheless, pediatricians should be alert to the possibilities of cancer since early detection and prompt treatment might reduce mortality.

국제학술회의 참관기 - 제46차 미국 정형외과연구학회 연례학술대회

  • Kim, Han-Su
    • The Science & Technology
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    • v.33 no.5 s.372
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    • pp.26-28
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    • 2000
  • 지난 3월 12일부터 나흘간 미국 올란도 오렌지카운티에서 열린 미국 정형외과연구학회 연례학술대회는 25개국에서 1천8백여명이 참석하여 1천1백여편의 논문이 발표되었다. 정형외과의 모든 기초연구 분야의 논문들이 발표되는 이 학술대회에서 필자는 악성골종양에 항암제의 효과를 높이기 위한 방법의 하나로 항암제를 뼈의 약성종양수술에 흔히 사용되는 골시멘트에 혼합하여 약성종양세포 성장이 억제되는 내용의 논문을 발표했다.

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