• Title/Summary/Keyword: Bone tumors

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Limb Salvage in the Treatment of the Upper Extremity Bone Tumors (상지에 발생한 악성 및 침윤성 양성골종양에 대한 사지 구제술)

  • Hahn, Soo-Bong;Shin, Kyoo-Ho;Kim, Bum-Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.1 no.2
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    • pp.154-163
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    • 1995
  • With the development of anticancer chemotherapy and improved radiographic imaging studies, limb salvage operation became possible in the treatment of malignant and aggressive benign tumors. High grade sarcomas of the shoulder or the upper extremity can be surgically treated with a forequarter amputation, shoulder disarticulation or limb salvage surgery such as Tikhoff-Linberg procedure, segmental resection and replacement with endoprosthesis, segmental resection and replantation, or segmental resection and free vascularized bone graft. Among them the limb salvage surgery showed not only preservation of the remained upper extremity but also the excellent functional results. When comparing amputation and limb salvage operation while performing anticancer chemotherapy in both cases, 5 year survival rate, local recurrence, and distant metastasis did not show much difference. We studied 13 cases of limb salvage for the malignant and aggressive benign bone tumor of the upper extremity from March 1986 to December 1993 at Severance hospital. The summarized results were as follows. 1. There were 21 cases of malignant bone tumors and 5 cases of benign aggressive ones. 2. Of the 26 cases of malignant and benign aggressive bone tumors, limb salvage procedures such as Tikhoff-Linberg operation(8 cases), endoprosthetic replacement(2 cases), segmental resection and replantation(2 cases), and segmental resection and free vascularized fibular graft(l case) were done in 13 cases. 3. In 13 patient on whom the limb salvage procedure was performed, there were 3 osteosarcomas, 4 chondrosarcomas, 3 giant cell tumors, 1 Ewing's sarcoma, 1 leiomyosarcoma and 1 chondroblastoma. 4. In 13 patients, there was no local recurrence nor distant metastasis except one who had a segmental resection of the entire humerus part including glenoid and then postoperative anticancer chemotherapy for the treatment of the Ewing's sarcoma of the entire shaft of the humerus with pathological fracture. Local recurrence occurred 2 years and 6 months postoperatively in this Ewing's sarcoma patient, so forequarter amputation was performed and the irradiation and the anticancer chemontherapy were performed, but multiple bony metastasis developed and died of the disease 22 months after local recurrence. 5. The patients were followed-up for I year to 7 years and 5 months(average 4 years 5 months). 6. In 8 cases in which Tikhoff-Linberg procedure was performed, the function of the hand was almost normal. 7. Segmental resection and endoprosthetic replacement was performed in 2 cases, and the function of the remained upper extremity was good with no evidence of aseptic loosening or nerve palsy. 8. In 1 case of segmental resection and free vascularized fibular graft for the patient of the chon drosarcoma in the humerus, the function of the shoulder, elbow and hand was nearly normal. 9. In I case of leiomyosarcoma which involved both forearm muscles and bone near wrist joint, segmental resection and replantation was performed, and the patient has useful hand function.

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Immediate Reconstruction of Defects Developed After Treatment of Head and Neck Tumors Using Cutaneous and Composite Flaps (두경부종양 치료 후 발생한 결손의 피판 및 복합조직이식을 이용한 재건)

  • Tark, Kwan-Chul;Lee, Young-Ho;Lew, Jae-Duk
    • Korean Journal of Head & Neck Oncology
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    • v.1 no.1
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    • pp.35-61
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    • 1985
  • The surgical treatment of advanced carcinomas and some benign tumors having clinically malignant behaviors of the head and neck region often require extensive resection, necessitating large flaps for reconstruction. Since the original upper arm flap was described by Tagliacozzi in 1597, a variety of technique such as random pattern local flap, axial flap, distant flap, scalping flap, myocutaneous flap, free flap etc. have been proposed for reconstruction of head, face and neck defects. Reconstruction of the facial defects usually require the use of distant tissue. Traditionally, nasal reconstruction has been carried out with a variety of forehead flaps. In recent years, there has been more acceptance of immediate repairs following the removal of these tumors. As a result, patients are more willing to undergo these extensive resections to improve their chances of cure, with the reasonable expectation that an immediate reconstruction will provide an adequate cosmetic result. Authors experienced 13 cases of head and neck tumor during last three and half years that required wide excision and immediate reconstruction with various flaps, not with primary closure or simple skin graft. We present our experience with varied flaps for reconstruction after wide resection of head and neck tumors 3 cases of defect of dorsum of nose or medial canthus with island forehead flaps, lower eyelid defect with cheek flap, cheek defect with Limberg flap, orbital floor defect with Temporalis muscle flap, lateral neck defects with Pectoralis major myocutaneous flap or Latissimus dorsi myocutaneous free flap, subtotal nose defect with scalping flap, wide forehead defect with Dorsalis pedis free flap and 3 cases of mandibular defect or mandibular defect combined with lower lip defect were reconstructed with free vascularized iliac bone graft or free vascularized iliac bone graft concomitantly combined with free groin flap pedicled on deep circumflex iliac vessels We obtained satisfactory results coincided wi th goal of treatment of head and neck tumors, MAXIMAL CURE RATE with MINIMAL MORBIDITY, OPTIMAL FUNCTION, and an APPEARANCE as close to normal as possible.

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Giant Cell-Rich Osteosarcoma of the Proximal Tibia - A Case Report - (경골 근위부에 발생한 거대세포형 골육종 - 증례 보고 -)

  • Kim, Jung-Ryul;Jang, Kyu-Yun;Lee, Sang-Yong;Sohn, Kyung-Rak
    • The Journal of the Korean bone and joint tumor society
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    • v.12 no.2
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    • pp.155-160
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    • 2006
  • Giant cell-rich osteosarcoma is a rare tumor that is hard to distinguish from giant cell tumors of bone. The location and radiographic aspect of these tumors can be identical. The histologic differentiation between a giant cell-rich osteosarcoma and a giant cell tumor can be difficult. Due to the different prognosis and treatment strategies of these tumors it is essential to make the right diagnosis at presentation. This article reports a case of a giant cell-rich osteosarcoma of the proximal tibia that initially was diagnosed histologically as a giant cell tumor by needle biopsy.

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The Differentiation of Malignant and Benign Musculoskeletal Tumors by F-18 FDG PET/CT Studies - Determination of maxSUV by Analysis of ROC Curve (F-18 FDG PET/CT에서 양성과 악성 근골격 종양의 감별진단 - 수신자 판단특성곡선을 이용한 maxSUV의 절단값 결정)

  • Kong, Eun-Jung;Cho, Ihn-Ho;Chun, Kyung-Ah;Won, Kyu-Chang;Lee, Hyung-Woo;Choi, Jun-Heok;Shin, Duk-Seop
    • Nuclear Medicine and Molecular Imaging
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    • v.41 no.6
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    • pp.553-560
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    • 2007
  • Purpose: We evaluated the standard uptake value (SUV) of F-18 FDG at PET/CT for differentiation of benign from malignant tumor in primary musculoskeletal tumors. Materials and Methods: Forty-six tumors (11 benign and 12 malignant soft tissue tumors, 9 benign and 14 malignant bone tumors) were examined with F-18 FDG PET/CT (Discovery ST, GE) prior to tissue diagnosis. The maxSUV(maximum value of SUV) were calculated and compared between benign and malignant lesions. The lesion analysis was based on the transverse whole body image. The maxSUV with cutoff of 4.1 was used in distinguishing benign from malignant soft tissue tumor and 3.05 was used in bone tumor by ROC curve. Results: There was a statistically significant difference in maxSUV between benign (n=11; maxSUV $3.4{\pm}3.2$) and malignant (n=12; maxSUV $14.8{\pm}12.2$) lesions in soft tissue tumor (p=0.001). Between benign bone tumor (n=9; maxSUV $5.4{\pm}4.0$) and malignant bone tumor (n=14; maxSUV $7.3{\pm}3.2$), there was not a significant difference in maxSUV. The sensitivity and specificity for differentiating malignant from benign soft tissue tumor was 83% and 91%, respectively. There were four false positive malignant bone tumor cases to include fibrous dysplasia, Langerhans-cell histiocytosis (n=2) and osteoid osteoma. Also, one false positive case of malignant soft tissue tumor was nodular fasciitis. Conclusion: The maxSUV was useful for differentiation of benign from malignant lesion in primary soft tissue tumors. In bone tumor, the low maxSUV correlated well with benign lesions but high maxSUV did not always mean malignancy.

A two-year audit of non-vascularized iliac crest bone graft for mandibular reconstruction: technique, experience and challenges

  • Omeje, Kelvin;Efunkoya, Akinwale;Amole, Ibiyinka;Akhiwu, Benjamin;Osunde, Daniel
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.40 no.6
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    • pp.272-277
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    • 2014
  • Objectives: Non-vascularized iliac crest bone graft (NVIBG) is a known treatment option in mandibular reconstruction following jaw resection, but no documented review of patients treated with NVIBG exists for northern Nigeria. The experience and technique from a Nigerian tertiary hospital may serve as baseline data for comparison and improvement of practice for other institutions. Materials and Methods: A retrospective review of medical records and patient case files from January 2012 to December 2013 was undertaken. All case files and other medical records of patients who had reconstruction with NVIBG for benign or malignant lesions with immediate or delayed reconstruction were selected for review. Results: Twenty patients had mandibular reconstruction with NVIBG during the study period. Two patients were excluded because of incomplete medical records. Eighteen patients' (male=14, female=4) records were reviewed. Their ages ranged from 13 to 62 years (mean $26.0{\pm}10.6years$). Indications for NVIBG included jaw tumors (n=16; 88.3%), jaw cyst (n=1; 5.6%) and gunshot injury (n=1; 5.6%). Jaw tumors seen were ameloblastoma (n=15; 83.3%) and osteosarcoma (n=1; 5.6%). Treatments done were mandibular resection with condylar resection (n=7; 38.9%), mandibular segmental resection (n=10; 55.6%) and subtotal mandibulectomy (n=1; 5.6%). Patients' postoperative reviews and radiographs revealed good facial profile and continued bone stability up to 1 year following NVIBG. Conclusion: NVIBGs provide an acceptable alternative to vascularized bone grafts, genetically engineered bone, and distraction osteogenesis for mandibular reconstruction in resource-limited centers.

Central odontogenic fibroma (simple type) in a four-year-old boy: atypical cone-beam computed tomographic appearance with periosteal reaction

  • Anbiaee, Najme;Ebrahimnejad, Hamed;Sanaei, Alireza
    • Imaging Science in Dentistry
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    • v.45 no.2
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    • pp.109-115
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    • 2015
  • Central odontogenic fibroma (COF) is a rare benign tumor that accounts for 0.1% of all odontogenic tumors. A case of COF (simple type) of the mandible in a four-year-old boy is described in this report. The patient showed asymptomatic swelling in the right inferior border of the lower jaw for one week. A panoramic radiograph showed a poorly-defined destructive unilocular radiolucent area. Cone-beam computed tomography showed expansion and perforation of the adjacent cortical bone plates. A periosteal reaction with the Codman triangle pattern was clearly visible in the buccal cortex. Since the tumor had destroyed a considerable amount of bone, surgical resection was performed. No recurrence was noted.

Adipose Tumor, Fibroblastic/Myofibroblastic Tumors, So-called Fibrohistiocytic Tumors, Smooth Muscle Tumors, Pericytic Tumors and Skeletal Muscle Tumors: An Update Based on the New WHO Soft Tissue Classification (연조직종양의 새로운 WHO 분류를 중심으로: 지방세포종, 섬유모세포성/근육섬유모세포성종, 소위섬유조직구종, 평활근종, 혈관주위종과 근골격종에 대하여)

  • Suh, Kyung-Jin
    • The Journal of the Korean bone and joint tumor society
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    • v.14 no.1
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    • pp.1-9
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    • 2008
  • Soft tissue tumor classifications should be an important part of radiology, oncology and, for clinicians and pathologists, they provide diagnostic instruction and prognostic guidelines. In soft tissue tumor classification systems, the World Health Organization (WHO) classifications have become dominant, enabled by the timely publication of new 'blue books' which included detailed text and numerous good illustrations. The new WHO classification of soft tissue tumors was introduced in 2002. Because the classification represents a broad consensus concept, it has gained widespread acceptance around the globe. This article reviews the changes which were introduced the adipose tumors, fibroblastic/myofibroblastic tumors, so-called fibrohistiocytic tumors, smooth muscle tumors, pericytic tumors and skeletal muscle tumors which have been first recognized or properly classified during the past decade.

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Clinical Analysis of the Mediatinal Neurogenic Tumor -18 case report- (종격동에 빈발하는 신경종에 대한고찰 -18례 임상 경험-)

  • 최영호
    • Journal of Chest Surgery
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    • v.27 no.11
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    • pp.938-941
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    • 1994
  • Neurogenic tumors of the mediastinum may have an intraspinal component connected by a narrowed segment of tumor in the intervertebral foramen, then have symptoms of back pain,lower extremity tingling sensation. CT scan or MRI demonstrated a Dumbbell-shaped mass density compressing spinal canal, enlargement of the foramen, erosion of bone, and intervertebral widening. We report the analysis of the 18 cases of neurogenic tumors on posterior mediastinum and Dumbbell type tumors are 3 cases among the 18 cases. The neurilemmomas were 12 cases[67%], the ganglioneuroma were 5 cases[28%], and neuroblastoma was one case[5%]. The successful removal was done in all cases, a standard thoracotomy and laminectomy was done in Dumbbell type tumors.There was no postoperative neurological complications.

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Post-Traumatic Peripheral Giant Osteoma in the Frontal Bone

  • Kim, Seong Hwan;Lim, Dong Seob;Lee, Do Hun;Kim, Kyung Pil;Hwang, Jae Ha;Kim, Kwang Seog;Lee, Sam Yong
    • Archives of Craniofacial Surgery
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    • v.18 no.4
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    • pp.273-276
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    • 2017
  • Osteomas are benign, slow-growing tumors that most frequently occur in the craniomaxillofacial region. These tumors are mostly asymptomatic and are generally found incidentally. A giant osteoma is generally considered to be greater than 30 mm in diameter or 110 g in weight. A 35-year-old female presented to us with complaints of a firm mass that showed continuous growth on the forehead following trauma. A hairline incision was made to expose the osteoma. Biopsy of the tumor confirmed a osteoma. There were no complications after surgery. Postoperative computed tomography revealed that the tumor was completely removed. Because a peripheral giant osteoma of the frontal bone with a history of trauma is a rare finding, thorough history-taking, physical examination, and preoperative imaging tests are needed for patients with a history of trauma to rule out a giant osteoma.

Primary Benign Rib Tumors: 3 cases (늑골에 발생한 원발성 양성 종양[3 치험예])

  • Lee, Nam-Soo;Baek, In-Gi;Sohn, Kwang-Hyun
    • Journal of Chest Surgery
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    • v.14 no.4
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    • pp.359-363
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    • 1981
  • From Aug. 1975 to Aug. 1981,3 patients with primary benign rib tumors have been treated at the department of thoracic surgery, Paik Hospital, Seoul, Korea. Of these, one was aneurysmal bone cyst and two were fibrous dysplasia. Complete excision of the benign tumor including rib resection was performed in all patients and resulted in long term cure.

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