• Radiation Oncology Journal
• /
• v.26 no.3
• /
• pp.149-159
• /
• 2008

Purpose: To evaluate the results and prognostic factors for postoperative adjuvant radiation therapy in patients at stages I and II of endometrial cancer. Materials and Methods: Between January 1991 and December 2006, 35 patients with FIGO stages I and II disease, who received adjuvant radiation therapy following surgery for endometrial cancer at Ewha Womans University Hospital, were enrolled in this study. A total of 17 patients received postoperative pelvic external beam radiation therapy; whereas, 12 patients received vaginal brachytherapy alone, and 6 patients received both pelvic radiation therapy and vaginal brachytherapy. Results: The median follow-up period for all patients was 54 months. The 5-yr overall survival and disease-free survival rates for all patients were 91.4% and 81.7%, respectively. The 5-yr overall survival rates for low-risk, intermediate-risk, and high-risk groups were 100%, 100% and 55.6%, respectively. In addition, the 5-yr disease-free survival rates were 100%, 70.0%, and 45.7%, respectively. Although no locoregional relapses were identified, distant metastases were observed in 5 patients (14%). The most common site of distant metastases was the lung, followed by bone, liver, adrenal gland, and peritoneum. A univariate analysis revealed a significant correlation between distant metastases and risk-group (p=0.018), pathology type (p=0.001), and grade (p=0.019). A multivariate analysis also revealed that distant metastases were correlated with pathology type (p=0.009). Papillary, serous and clear cell carcinoma cases demonstrated a poor patient survival rate compared to cases of endometrioid adenocarcinoma or adenosquamous carcinoma. The most common complication of pelvic external beam radiation therapy was enteritis (30%), followed by proctitis, leucopenia, and lymphedema. All these complications were of RTOG grades 1 and 2; no grades 3 and 4 were observed. Conclusion: For the low-risk and intermediate-risk groups (stages 1 and 2) endometrial cancer, pelvic control, and overall survival rate was free of severe toxicity when pelvic radiation therapy or vaginal brachytherapy was performed. In the high-risk group, pelvic control rate was excellent, but the survival rate was poor due to distant metastases, in spite of the pelvic radiation therapy. The combined modality of chemotherapy and radiation therapy is recommended for high-risk groups. For the intermediate-risk group, a prospective randomized study is required to compare the efficacy between whole pelvic radiation therapy and vaginal brachytherapy.

• The Journal of the Korean bone and joint tumor society
• /
• v.12 no.1
• /
• pp.71-77
• /
• 2006

Chondrosarcoma is one of the most common types of primary bone sarcoma. With the exception of the mesenchymal subtype, chondrosarcomas are usually low-grade lesions and rarely show multicentricity or distant metastasis. Only rare cases of multicentric chondrosarcomas have been reported in association with Ollier's disease and Maffucci's syndrome. To our knowledge, no report has been issued of a synchronous multicentric chondrosarcoma occurrence across a joint. We experienced a 30-year-old man with a synchronous monomelic juxta-articular multicentric chondrosarcoma across a shoulder joint in the absence of pulmonary and visceral metastases. He was treated by curettage and cement filling with allograft in the acromion and wedge resection with cement filling in the proximal humerus. At the 18-month follow-up, there was no evidence of recurrence, and the patient had full range of motion without pain.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.34 no.5
• /
• pp.550-554
• /
• 2008

Bisphosphonates (BPs) are a class of agent used to treat patient with osteoporosis or malignant bone metastases. BPs can be categorized into 2 groups: nitrogen-containing and non-nitrogen containing. Nitrogen-containing BPs are considered to have more toxicity. Despite their clinical benefits, bisphosphonate-related osteonecrosis of jaw(BRONJ) is a significant complication to patients receveing these drugs. Since the first description of BRONJ in 2003 by Marx, the number of reports on BRONJ has been rapidly increasing. BRONJ is considered as an emerging problem in oral & maxillofacial surgery. Generally, osteonecrosis in the maxilla is rare, however BRONJ is found both in the maxilla and the mandible. This is an important feature of BRONJ compared to common infectious osteomyelitis of the jaw. Growing number of case reports, suggest that bisphosphonate therapy may cause exposed, necrotic bone. BRONJ has simillar features compared to IORN (infected osteoradionecrosis). BRONJ has meaningful features established through the interestigation on histopathologic and radiographic findings. These features have an impact on treatment plan and prognosis. This presentation contemplates on features of histopathologic and radiographic findings in bisphosphonate-related osteonecrosis of the jaw.

• Asian Pacific Journal of Cancer Prevention
• /
• v.14 no.9
• /
• pp.5293-5299
• /
• 2013

Purpose: High levels of bone morphogenetic protein (BMPs) have been reported in patients with lung cancer. This study was conducted to assess correlations between serum BMP-2 levels and prognostic outcome in patients with non-small-cell lung cancer (NSCLC). Methods: Blood samples from 84 patients with advanced NSCLC and 42 healthy controls were analyzed and quantitated for serum BMP-2 levels before and after two cycles of chemotherapy using a commercially available ELISA kit. Results: The median level of BMP-2 was 146.9 pg/ml in patients with NSCLC vs. 87.7 pg/ml in healthy controls (P<0.01). A significant correlation was observed between pretreatment serum BMP-2 level and ECOG PS, disease stage and number of organs with metastases (P<0.05). Serum BMP-2 level decreased significantly in patients who achieved objective response after two cycles of chemotherapy. Multivariate analysis showed that increased BMP-2 level and advanced clinical stage were significantly correlated with poor prognosis. Conclusion: Thes erum BMP-2 level is positively correlated with clinical stage, ECOG PS and metastatic burden and may serve as an independent negative predictor for prognosis. Decreased BMP-2 after chemotherapy could be a reliable marker for efficacy of treatment.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.37 no.1
• /
• pp.72-76
• /
• 2011

Polymorphous low-grade adenocarcinomas (PLGA) are distinctive salivary gland neoplasms with a propensity to arise from the minor salivary glands. The most frequent location of PLGA is the palate, even though other locations have been described. Previously used terms for PLGA include lobular carcinoma and terminal duct carcinoma. Although the frequency of the tumor is unknown, the recognition of PLGA as an individual tumor has increased with the establishment of specific histopathological criteria characterizing the PLGA. The first choice of treatment is a wide surgical excision including the subjacent bone if necessary. The prognosis is generally good and the recurrence rate ranges from 17% and 22%. Distant metastases is unusual (9%) but occur mainly in the regional lymph nodes. This is a case report of a 67 year old female patient with PLGA who was treated with a wide excision by layers (2 stage) of the lesion including the surrounding bone. We present this case with a review of the relevant literature.

• The Journal of the Korean bone and joint tumor society
• /
• v.8 no.2
• /
• pp.58-62
• /
• 2002

The incidence of giant cell tumors represents only 5% to 10% of all bone tumors. Occurrence on the small bones of the hand and foot are very rare. They typically present with pain and sometimes a pathologic fracture or even soft tissue extension. The radiographic appearance is highly characteristic. An eccentric osteolytic lesion is seen, producing cortical thinning and expansion, and possessing a delicate trabecular pattern. In tarsal bones, poorly or well-defined osteolytic lesions of variable size are encountered. Surgical treatment remains the preferred therapy. Marginal or wide en bloc resection has had far better results in term of local recurrence. Several authors have suggested extended curettage and cement as an alternative to en bloc resection. Follow-up is necessary to monitor for both local recurrence and the infrequent pulmonary metastases.

• The Journal of Korean Medicine
• /
• v.35 no.4
• /
• pp.98-103
• /
• 2014

Objectives: Advanced malignant melanoma (MM) has a poor prognosis, with an expected 2-year survival rate of 10 to 20%. It has long been recognized as an immunogenic tumor, and is worse for elderly patients. Many studies have suggested that herbal treatments improve immune functions, but few clinical studies have reported on this topic. Patients and History: We present two cases of female patients (72 and 77 years old, respectively) with advanced MM. The 72-year-old female patient was, at first, diagnosed with MM with multiple bone metastases. She received resection of the primary lesion, but refused further chemotherapy. The 77-year-old female patient was diagnosed with cutaneous MM of the left heel, with suspicion of sentinel node lymphadenopathy; however, she also refused any conventional treatment due to old age. Course of Therapy and Results: Both patients were exclusively treated with standardized allergen-removed Rhus verniciflua stokes (aRVS) extract combined with Bojungikki-tang (BT, Bu-Zhong-Yi-Qi-Tang in Chinese or Hochu-ekki-to in Japanese). Both patients are still alive and doing well (Feb. 2014), demonstrating that the 72-year-old patient has lived for 27 months and the 77-year-old patient has lived for 31 months without disease progression since the aRVS and BT administration. Conclusion: We suggest that the combination of aRVS extract and BT could be a candidate for overcoming the cancer's immunoediting process especially for elderly MM patients intolerant of conventional treatment.

• Korean Journal of Head & Neck Oncology
• /
• v.18 no.2
• /
• pp.203-206
• /
• 2002

Metastatic carcinomas to the thyroid gland are rare, and thyroid involvement by secondary carcinomas commonly results from direct the extension of malignant cells from adjacent organs such as the larynx or the trachea. The common primary sites of thyroid metastasis are kidney, breast, lung, and lymphoid tissue. Among head and neck cancers, nasopharyngeal carcinoma has a relatively high incidence of distant metastases to other sites and commonly involving sites are bone, lung, and liver. Recently, we experienced a case of a 43-year-old male who had been presented with neck mass for 3 months. He was diagnosed non-keratinizing nasopharyngeal carcinoma in 1993. And, thyroid metastasis of nasopharyngeal carcinoma was confirmed by total thyroidectomy. So we report this rare case with the review of literatures.

• The Journal of the Korean bone and joint tumor society
• /
• v.14 no.2
• /
• pp.172-177
• /
• 2008

The epithelioid sarcoma is a rare high grade soft tissue sarcoma that affects young usually male, adults or adolescents. The most common localization is the hand and the forearm, followed by the leg and the foot. In most cases, the sarcoma grows slowly, involves the dermis, subcutis, or deeper soft tissues in the distal extremities. Epithelioid sarcoma is a slowly growing tumor with a high propensity for local recurrences and lymph node metastases. This neoplasm is likely to be confused with a variety of benign and malignant conditions. The treatment consists of wide surgical excision, chemotherapy and radiotherapy. We report the cases of 16-year-old girl with an epithelioid sarcoma on the lower extremity.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
• /
• v.27 no.1
• /
• pp.263-271
• /
• 1997

The authors diagnosed a 54-year-old male as central mucoepidennoid carcinoma after undergoing clinical, radiological and histopathological examinations. The characteristics were as followed : 1. Clinically, the patient complained of the painless unilateral swelling of the left mandibular molar region and had a pus discharge through the fistula. Painful nodule was palpated on the scalp of the left frontal area and it was regarded as a metastatic lesion. 2. Plain radiographs showed the ill-defined permeative radiolucent lesion. The osteolytic lesions were also detected in the cranial bone, number 9 and 11 ribs, scapula, and vertebral bodies. 3. The mandibular CT and PNS MRI showed the swelling of the left mandible and the enlargement of the several lymph nodes of 1.5 cm in size. 4. Histopathologically, many solid epidermoid type cells were mixed with mucus-secreting cells and they were arranged in duct-like structure. Most of them were epidermoid type, which indicates a high grade tumor. Mucins could be found in mucicamrine staining.