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.
Journal of the korean academy of Pediatric Dentistry
/
v.31
no.1
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pp.79-84
/
2004
Pilomatricoma is a benign soft tissue tumor of hair follicle origin. They occur most commonly in the head and neck region and are usually found in girls during the first two decades of life. Although malignant transformation has been described, it is exceedingly rare. The clinical presentation is typically that of an asymptomatic, superfical, solitary, firm mass that is often accompanied by a reddish-blue discoloration of the overlying skin. Histopathologically pilomatricoma are seen as epithelial islands embedded in a cellular stroma. The epithelial component consist of two main cell types : basaloid cells and ghost cells. Intracellular and stromal calcification is reported in many cases. Diagnosis is usually suspected based on palpation of a superficial, rock-hard mass and confirmed by histopathologic examination. Surgical excision is both curative and the treatment of choice. Recurrence is rare. In this case, the radiographs showed a dense calcification, measuring about 1cm diameter. So simple excision was peformed intraorally, and resultantly the lesion was proved to be a pilomatricoma by histological examination.
Ha, Eun Sil;Hur, Gyu Young;Jung, Ki Hwan;Lee, Sung Yong;Jo, Won Min;Lee, Sang Yeub;Kim, Je-Hyeong;Lee, Eung Seok;Shin, Chol;Shim, Jae Jeong;In, Kwang Ho;Kang, Kyung Ho;Yoo, Se Hwa
Tuberculosis and Respiratory Diseases
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v.60
no.3
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pp.347-352
/
2006
A teratoma is the most common benign germ cell tumor that develops in the mediastinum. Patients with a mediastinal teratoma are usually asymptomatic. However, a spontaneous rupture of a mediastinal teratoma into the pleural cavity or adjacent organs can cause severe chest pain, hemoptysis, acute dyspnea, etc. Complications such as recurrent pneumonia, pericardial effusion, pleural effusion and great vessel invasion can sometimes occur. We encountered a case of a patient with an abrupt onset of dyspnea after persistent shoulder pain for one month. The X-ray examinations revealed a unilateral mediastinal mass with contralateral pleural effusion. Subsequent evaluations confirmed a spontaneous rupture of the teratoma into the contralateral pleural cavity.
Neck mass as a primary presenting sign is a common problem that physicians and surgeons alike have to face but conclusive diagnosis cna be made only by histopathological examination. During the period of four years from January 1988 to December 1991, three hundred sixteen diagnostic incisional or excisional biopsies of the neck masses were performed at the outpatient department of Surgery, Seoul National University Hospital and tissue diagnoses were confirmed by histopatholotical examination. On which a clinical analysis was performed and its results were compared with the results of one hundred fifteen Fine Needle Aspiration Cytologic examinations on neck masses during the same period. The results were as follows: In the histologic types of neck masses. inflammatory disease was the most common (58.2%), metastatic malignant tumor(22.5%), benign tumor(15.2%). primary malignant tumor(0.4%) in decreasing order. Among the individual lesions. tuberculous lymphadenitis was the most common(29.4%) and nonspecific lymphadenitis was the next. Of overall sexual distribution, female preponderated by a ratio of 1.15:1, but in the primary and metastatic malignancies, male did by a ratio of 1.60:1 and 1.53:1, respectively. The most common age group was third decade(26.8%), and fourth decade was the next(20.9%) but in malignant tumors. sixth decade was the most commom. The duration of symptom between one and three months(33.8%), was the most common and between three and six month was the next but the difference between the individual diseases was not significant. Of the metastatic tumor of seventy one cases, primary site was found in fifty cases(84.2%) and stomach cancer was the most comon primary site. In the result of the Fine Needle Aspiration Cytologic(FNAC) examinations, positive for mlignant cells was the most common(33.1%), following the frequencies with tuberculosis(22.6%), and nonspecific lymphadenitis(16.5%) in decreasing order. Eleven cases of FNAC underwent diagnostic biopsies and the diagnostic accuracy of FNAC was 83.3%. Conclusively, in our study, tuberculous lymphadenitis was the most common histologic type, female was predominant third decade was the most common age group. the duration of symptom between one and three month was the most common and in the metastatic tumors, stomach cancer was the most common primary site.
Introduction : $^{99m}Tc$-(V)-DMSA is a tumor seeking agent that has been used to image medullary carcinoma of thyroid, soft tissue sarcoma and lung cancer. This study was designed to assess the clinical role of $^{99m}Tc$-(V)-DMSA in the diagnosis of head and neck cancers. We has evaluated the diagnostic efficacy of planar and SPECT imaging using $^{99m}Tc$-(V)-DMSA. Patients and Method : Sixty-eight patients with head and neck mass were included in this study. All subjects were diagnosed by biopsy or surgery. Planar and SPECT images were obtained at 2 or 3 hour after intravenous injection of 740 MBq(20 mCi) $^{99m}Tc$-(V)-DMSA. Seventeen patients also underwent SPECT in aging using dual head camera. Result : The diagnostic sensitivity of $^{99m}Tc$-(V)-DMSA planar and SPECT imaging was 65% and 90%, and specificity was 80% and 66%, respectively. The sensitivity of planar imaging in squamous cell carcinoma was similar to overall sensitivity Six metastatic lesion were first diagnosed by scintigraphy. But benign lesions such as Kikuchi syndrome, tuberculous lymphadenitis also revealed increased uptake. Conclusion : $^{99m}Tc$-(V)-DMSA imaging seems to be a promising method in the evaluation of patients with head and neck mass. We recommend SPECT imaging to delineate anatomic localization of the lesion.
Warthintumor (WT), also known as adenolymphoma or papillary cystadenoma lymphomatosum, was described in 1895 for the first time. It is a common benign tumor of the parotid glands and the second most common neoplasm of the salivary gland, accounting for 5% to 14% of all parotid neoplasm. A 63-year-old man visited our clinic with the complaint of swelling on the right parotid gland. Physical examination showed a 3 cm, firm, well-circumscribed, painless mass on the right mandibular angle. Computed tomography imaging showed a $3.5{\times}2.0{\times}1.6$ cm well-defined cystic mass. WT is histologically characterized by bilayered, oncocystic cell, lymphoid stroma, and cystic space. With these typical cytomorphologic characteristics, the fine-needle aspiration cytology was performed as diagnostic tool before the surgery. The lymphocytes and oncocystic cell were not observed. The lesion was completely excised under general anesthesia. We diagnosed the case as WT, from the surgically excised specimen. We report on the case with a review of the literatures.
Moon, Jin Wook;Kim, Kil Dong;Shin, Dong Hwan;Hahn, Chang Hoon;Jung, Jae;Park, Mu Suk;Jung, Sang Youn;Lee, Jae Hyuk;Kim, Young Sam;Kim, Se Kyu;Kim, Sung Kyu;Chang, Joon
Tuberculosis and Respiratory Diseases
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v.55
no.4
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pp.402-407
/
2003
Mesoblastic nephroma is a neoplasm of the kidney which is characterized by interlacing bundles of spindle mesenchymal cells. It is usually diagnosed during the first six months of life and is mostly benign. Incidence in adults is exceedingly rare. In most cases, only total excision is required without postoperative adjuvant therapy, and the rare cases of local recurrence have usually been related to incomplete removal. However, mesoblastic nephroma may behave aggressively, in contrast to a congenital mesoblastic nephroma. Several cases of metastatic mesoblastic nephroma have been previously described. We report herein a case of a 42-year-old woman with mesoblastic nephroma which recurred as a large metastatic lung mass seven years after the nephrectomy. The patient presented with chest wall discomfort for four days. Seven years previously, total nephrectomy had been performed because of a right renal tumor which had been diagnosed as a mesoblastic nephroma. There had been no evidence of recurrence for five years, after which she discontinued follow-up. On readmission two years later, chest X-ray and CT scan revealed a large lung mass in the left upper lobe. It was completely excised and the pathologic examination was identical with that of the original renal tumor. Synovial sarcoma was excluded because the fusion transcripts of the SYT-SSX fusion gene associated with the t(X;18) translocation were negative. The final diagnosis was a lung metastasis of mesoblastic nephroma and the patient remained free of disease for 7 months postoperatively.
Lee, Wonchul;Choi, Se Young;Lee, Chanwoo;Yoo, Sangjun;You, Dalsan;Jeong, In Gab;Song, Cheryn;Kim, Kun Suk;Hong, Bumsik;Hong, Jun Hyuk;Ahn, Hanjong;Kim, Choung-Soo
Investigative and Clinical Urology
/
v.59
no.6
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pp.357-362
/
2018
Purpose: Classic angiomyolipoma (AML) is common benign kidney tumor. However, some studies have claimed that epithelioid angiomyolipoma (EAML) has malignant potential. We compared the patient characteristics and prognosis of EAML and classic AML to demonstrate predicting factors and poorer prognosis of EAML. Materials and Methods: The medical records of 231 patients who were diagnosed with EAML (n=27, 11.7%) or classic AML (n=204, 88.3%), were reviewed. All patients underwent computed tomography (CT) scans before operation or needle biopsy. We assessed the age, sex, tumor size, body mass index, comorbidities, and Hounsfield unit (HU) according to each CT phase. We defined the unfavorable group as patients with recurrence, metastasis and death due to tumor progression. Logistic regression analysis was used to predict EAML. Results: EAML patients were younger (41.2 years vs. 49.1 years, p=0.001), predominantly male (55.6% vs. 28.4%, p=0.005), and had a larger tumor (7.5 cm vs. 4.2 cm, p<0.001). The median pre-contrast HU was not significantly different between EAML and classic AML ($29.9{\pm}23.7$ vs. $14.7{\pm}41.0$, p=0.071). In multivariable analysis, younger age (odds ratio [OR], 0.96; p=0.032), male sex (OR, 3.33; p=0.013), and tumor larger than 4 cm (OR, 3.8; p=0.009) were significant predictive factors. Five patients (18.5%) had unfavorable outcomes, two patients had lymph node metastasis, and three patients had lung metastasis. Conclusions: Patient and tumor characteristics can be helpful in determining the type of AML preoperatively. Younger age, male sex, and larger tumor mass may increase the possibility of diagnosing EAML. EAML has malignant potential and requires careful follow-up.
This study aimed to investigate the performance of the S-detect method in breast ultrasonography and to determine how to reduce unnecessary biopsy by comparing the results of the S-detect method and biopsy. Thirty patients who had undergone breast ultrasonography between August and October 2018 and were scheduled to undergo biopsy because of the presence of breast nodules were retrospectively analyzed. The McNemar test was performed to determine whether detection of a malignant breast mass significantly differed between the S-detect method and biopsy. The following results were obtained from the analysis of the S-detect method: sensitivity, 90.9%; specificity, 84.21%; validity, 86.66%; positive predictive value, 76.92%; and negative predictive value, 94.11%. Analysis of the degree of agreement between the S-detect method and biopsy revealed a kappa value as high as 0.724 (p < 0.05), exhibiting good agreement between the two methods. The S-detect method in breast ultrasonography is diagnostically valuable in terms of distinguishing between malignant and benign breast masses, and if used properly before breast biopsy, unnecessary biopsy can be reduced.
Background : Bronchioloalveolar carcinoma (BAC) has been reported to diveres spectrum of chinical presentations and radiologic patterns. The three representative radiologic patterns are followings ; 1) a solitary nodule or mass, 2) a localized consolidation, and 3) multicentric or diffuse disease. While, the localized consolidation and solitary nodular patterns has favorable prognosis, the multicentric of diffuse pattern has worse prognosis regardless of treatment. BAC presenting as a solitary pulmonary nodule is often misdiagnosed as other benign disease such as tuberculoma. Therefore it is very important to make proper diagnosis of BAC with solitary nodular pattern, since this pattern of BAC is usually curable with a surgical resection. Methods : We reviewed the clinical and radiologic features of patients with pathologically-proven BAC with solitary nodular pattern from January 1995 to September 1996 at Samsung Medical Center. Results : Total 11 patients were identified. 6 were men and 5 were women. Age ranged from 37 to 69. Median age was 60. Most patients with BAC with solitary nodular pattern were asymptomatic and were detected by incidental radiologic abnormality. The chest radiograph showed poorly defined opacity or nodule and computed tomography showed consolidation, ground glass appearance, internal bubble-like lucencies, air bronchogram, open bronchus sign, spiculated margin or pleural tag in most patients. The initial diagnosis on chest X-ray were pulmonary tuberculosis in 4 patients, benign nodule in 2 patients and malignant nodule in 5 patients. The FDG-positron emission tomogram was performed in eight patients. The FDG-PET revealed suggestive findings of malignancy in only 3 patients. The pathologic diagnosis was obtained by transbronchial lung biopsy in 1 patient, by CT guided percutaneous needle aspiration in 2 patients, and by lung biopsy via video-assited thoracocopy in 8 patients. Lobectomy was performed in all patients and postoperative pathologic staging were $T_1N_0N_0$ in 8 patients and $T_2N_0M_0$ in 3 patients. Conclusion : Patients of BAC presenting with solitary nodular pattern were most often asymptomatic and incidentally detected by radiologic abnormality. The chest X-ray showed poorly defined nodule or opacity and these findings were often regarded as benign lesion. If poorly nodule or opacity does not disappear on follow up chest X-ray, computed tomography should be performed. If consolidation, ground glass appearance, open bronchus sign, air bronchogram, internal bubble like lucency, pleural tag or spiculated margin are found on computed tomography, further diagnostic procedures, including open thoracotomy, should be performed to exclude the possiblity of BAC with solitary nodular pattern.
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