• Journal of Chest Surgery
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• 제54권2호
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• pp.158-161
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• 2021

Chordoma is a rare malignant bone tumor originating from the embryonic notochord. Herein, we present a case of thoracic chordoma located at T3-T5 that was misdiagnosed as primary mediastinal adenocarcinoma. The patient underwent neoadjuvant chemoradiation and the disease showed little response. Due to vertebral body invasion, we performed en bloc mass removal and partial corpectomy (T4-5) in collaboration with orthopedic surgeons.

• Imaging Science in Dentistry
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• 제51권4호
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• pp.461-466
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• 2021

Fibro-osseous lesions are a poorly defined category of conditions affecting the jaws and craniofacial bones, and include developmental lesions, reactive or dysplastic lesions, and neoplasms. Fibrous dysplasia and ossifying fibroma are the 2 main types of fibro-osseous lesions affecting the jaw, and ossifying fibroma is a true benign neoplasm of the bone-forming tissues with several well-recognized variants ranging from innocuous to extensively aggressive lesions. However, multiple simultaneous fibro-osseous lesions of the jaw bones involving all quadrants are exceedingly rare. One such case diagnosed by conventional radiography and computed tomography is discussed here.

• Korean Journal of Radiology
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• 제25권4호
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• pp.363-373
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• 2024

Objective: To develop and evaluate a deep learning model for automated segmentation and detection of bone metastasis on spinal MRI. Materials and Methods: We included whole spine MRI scans of adult patients with bone metastasis: 662 MRI series from 302 patients (63.5 ± 11.5 years; male:female, 151:151) from three study centers obtained between January 2015 and August 2021 for training and internal testing (random split into 536 and 126 series, respectively) and 49 MRI series from 20 patients (65.9 ± 11.5 years; male:female, 11:9) from another center obtained between January 2018 and August 2020 for external testing. Three sagittal MRI sequences, including non-contrast T1-weighted image (T1), contrast-enhanced T1-weighted Dixon fat-only image (FO), and contrast-enhanced fat-suppressed T1-weighted image (CE), were used. Seven models trained using the 2D and 3D U-Nets were developed with different combinations (T1, FO, CE, T1 + FO, T1 + CE, FO + CE, and T1 + FO + CE). The segmentation performance was evaluated using Dice coefficient, pixel-wise recall, and pixel-wise precision. The detection performance was analyzed using per-lesion sensitivity and a free-response receiver operating characteristic curve. The performance of the model was compared with that of five radiologists using the external test set. Results: The 2D U-Net T1 + CE model exhibited superior segmentation performance in the external test compared to the other models, with a Dice coefficient of 0.699 and pixel-wise recall of 0.653. The T1 + CE model achieved per-lesion sensitivities of 0.828 (497/600) and 0.857 (150/175) for metastases in the internal and external tests, respectively. The radiologists demonstrated a mean per-lesion sensitivity of 0.746 and a mean per-lesion positive predictive value of 0.701 in the external test. Conclusion: The deep learning models proposed for automated segmentation and detection of bone metastases on spinal MRI demonstrated high diagnostic performance.

• 대한임상검사과학회지
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• 제50권2호
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• pp.197-204
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• 2018

다발성 골수종(MM)은 혈액 종양의 주요 사망 원인이다. 최근에 다발성 골수종 진단에 microRNA를 이용한 실험이 보고되고 있다. 이에 우리는 다발성 골수종 진단 마커로 miR-221을 이용 할 수 있는지 확인하고자 하였다. 본 연구는 다른 혈액학적 질환이 없는 다발성 골수종 환자 20명을 대상으로 하였다. MicroRNA 추출은 다발성 골수종 환자의 파라핀 포매 조직을 이용하였다. 우리는 다발성 골수종의 microRNA 표적 유전자로 miR-15a, miR-16, miR-21, miR-181a 그리고 miR-221을 선택하였다. 유의성 검정은 fold change 값을 기준으로 1.5이상 또는 -1.5 미만의 결과를 유의성이 있는 경우로 하였다. Fold change 값은 인간 유전자 SNORD43에 의해 표준화된 데이터를 기준으로 하였다. Fold change 값이 1.5 이상은 "overexpression", -1.5 미만의 값은 "underexpression"으로 정의되었다. miR-221의 65.0% (13/20)에서 "overexpression"으로 유의성이 있음을 확인하였고, 다발성 골수종 환자에서 형질세포가 30% 이상인 그룹과 이하의 그룹은 유의성을 보이지 않았다. MiR-221은 서구인과 같은 결과를 얻었으며, 다발성 골수종 환자에서 miR-221이 다발성 골수종 환자 진단에 매우 중요한 지표가 될 수 있을 것으로 생각된다. 결론적으로 miR-221은 한국인의 다발성 골수종 진단 또는 예후 지표로 활용할 수 있음을 확인하였다.

• 대한골관절종양학회지
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• 제10권2호
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• pp.79-87
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• 2004

목적: 최근 자기공명영상의 개발로 다양한 연조직종양의 영상의학적 진단이 가능해 졌다. 그러나 연조직종양의 다양한 조직구성이나 시간에 따라 구성분의 변화는 자기공명영상 만으로 악성과 양성 종양조차 감별을 어렵게 한다. 이에 본 저자들은 임상과 자기공명영상의 복합적인 소견으로 악성과 양성 연조직종양을 감별해 보고자 하였다. 대상 및 방법: 병리조직학적으로 확진된 82례(중간성종양을 악성종양으로 포함하여 37례와 염증성 종괴를 양성종양으로 포함하여 45례)를 후향적으로, 임상적 소견으로 연령, 크기, 위치, 그리고 자기공명영상 소견으로 종양경계, T2신호강도양상, 조영제T1신호강도양상, 그리고 조영증강 범위를 연관시켜 분석하였다. 자기공명영상으로 진단이 어렵지 않는 많은 전형적인 지방종과 결절종 그리고 농양같은 낭종은 양성종양 분류에서 제외하였다. 결과: 악성연조직종양은 양성에 비하여 연령으로 21~40세와 61~80세, 크기로 3.0 cm 이상, 발생위치로 몸체-골반-하지, 그리고 자기공명영상에서 불규칙한 경계, 50%이상의 조영증강범위 소견들의 빈도가 높았다. 결론: 발생위치로 몸체-골반-하지 와 상지-어깨-척추 로 나눈 임상소견이 악성과 양성 연조직종양을 감별하는데 통계학적으로 유의성있는 차이를 보였으며 나머지 다른 소견들은 특이적이지는 않았지만 부가적으로 악성과 양성을 감별하는데 도움이 되는 소견이었다.

• 대한두개안면성형외과학회지
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• 제11권1호
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• pp.65-68
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• 2010

Purpose: Dermoid cysts are benign neoplasms that are derived from both ectoderm and mesoderm. Approximately 7 percent of all dermoid cysts occur in the head and neck, as most common sites are the lateral ends of the eyebrows, the midline in the nasal root and neck. Rarely they can be found in the frontal sinus, temporal bone, maxilla and the floor of the mouth. Dermoid cysts in the temporal fossa are extremely rare. We experienced a characteristic dermoid cyst that occupied the temporal fossa. Methods: A 16-year-old man had a progressive enlarging mass on the left eyebrow. Computerized tomographic scan showed a bulging mass in the temporal fossa, and it had the density similar to that of fat. The size of the mass was $3{\times}3{\times}2cm$, and it was composed of high density of fat with clear margin. There was no bony invasion, but the mass was fixed on bone. Results: We performed the surgery through coronal incision under general anesthesia. Because the mass was closely connected with temporal fat pads, we removed this mass with some portion of temporal fat pads, avoiding damage to the facial nerve. The postoperative course was ordinary without complication. Conclusion: The reports about dermoid cyst on the temporal fossa is uncommon. However, if there is a mass in the temporal fossa which has the density similar to that of fat in CT scan, we should consider the possibility of dermoid cyst. We suggest that excision through coronal incision with bewaring temporal fat pad can induce good result.

• Journal of Genetic Medicine
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• 제6권1호
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• pp.91-94
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• 2009

저자들은 출생당시 특이소견 없었고, 유전질환의 가족력이 없는 20세 남자 환자에서 우측하지에 골전이가 동반된 횡문근 육종을 발견하고, 저신장, 탈모, 백내장, 치열이상, 골다공증, 갑상선기능저하증, 작은 손과 발, 사지는 가늘고 체간이 두터우며, 신체에 비해 큰 머리등 특이한 외모를 가진 워너증후군으로 진단한 1례를 경험하였기에 문헌 고찰과 함께 보고하고자 한다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제37권1호
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• pp.72-76
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• 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.

• Journal of Yeungnam Medical Science
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• 제38권4호
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• pp.289-307
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• 2021

Avulsion injuries result from the application of a tensile force to a musculoskeletal unit or ligament. Although injuries tend to occur more commonly in skeletally immature populations due to the weakness of their apophysis, adults may also be subject to avulsion fractures, particularly those with osteoporotic bones. The most common sites of avulsion injuries in adolescents and children are apophyses of the pelvis and knee. In adults, avulsion injuries commonly occur within the tendon due to underlying degeneration or tendinosis. However, any location can be involved in avulsion injuries. Radiography is the first imaging modality to diagnose avulsion injury, although advanced imaging modalities are occasionally required to identify subtle lesions or to fully delineate the extent of the injury. Ultrasonography has a high spatial resolution with a dynamic assessment potential and allows the comparison of a bone avulsion with the opposite side. Computed tomography is more sensitive for depicting a tiny osseous fragment located adjacent to the expected attachment site of a ligament, tendon, or capsule. Moreover, magnetic resonance imaging is the best imaging modality for the evaluation of soft tissue abnormalities, especially the affected muscles, tendons, and ligaments. Acute avulsion injuries usually manifest as avulsed bone fragments. In contrast, chronic injuries can easily mimic other disease processes, such as infections or neoplasms. Therefore, recognizing the vulnerable sites and characteristic imaging features of avulsion fractures would be helpful in ensuring accurate diagnosis and appropriate patient management. To this end, familiarity with musculoskeletal anatomy and mechanism of injury is necessary.

• Molecules and Cells
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• 제46권10호
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• pp.579-588
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• 2023

Sarcomas are rare and heterogeneous mesenchymal neoplasms originating from the bone or soft tissues, which pose significant treatment challenges. The current standard treatment for sarcomas consists of surgical resection, often combined with chemo- and radiotherapy; however, local recurrence and metastasis remain significant concerns. Although immunotherapy has demonstrated promise in improving long-term survival rates for certain cancers, sarcomas are generally considered to be relatively less immunogenic than other tumors, presenting substantial challenges for effective immunotherapy. In this review, we examine the possible opportunities for sarcoma immunotherapy, noting cancer testis antigens expressed in sarcomas. We then cover the current status of immunotherapies in sarcomas, including progress in cancer vaccines, immune checkpoint inhibitors, and adoptive cellular therapy and their potential in combating these tumors. Furthermore, we discuss the limitations of immunotherapies in sarcomas, including a low tumor mutation burden and immunosuppressive tumor microenvironment, and explore potential strategies to tackle the immunosuppressive barriers in therapeutic interventions, shedding light on the development of effective and personalized treatments for sarcomas. Overall, this review provides a comprehensive overview of the current status and potential of immunotherapies in sarcoma treatment, highlighting the challenges and opportunities for developing effective therapies to improve the outcomes of patients with these rare malignancies.