• 대한정형외과 초음파학회지
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• 제4권2호
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• pp.59-65
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• 2011

목적: 신체 검사 및 초음파 검사를 통한 연부조직 종괴의 진단과 수술 후 조직검사를 통한 결과를 상호 비교, 분석하고 초음파 검사의 임상적 유용성에 대하여 고찰하였다. 대상 및 방법: 본원에서 연부조직 종괴에 대해 수술 전 초음파 검사를 시행하였고, 조직학적 생검을 통한 병리학적 검사로 확진을 받은 총 83명의 환자를 대상으로 한 후향적 검사를 시행하였다. 병력 청취와 신체 검사를 바탕으로 한 임상적 진단과 초음파 검사를 이용한 진단의 정확도를 조직학적 생검을 통한 확진을 바탕으로 상호 비교하였다. 결과: 초음파를 이용한 수술 전 진단의 정확도는 86.7%로 신체 검사만을 통한 진단에 비해 높은 정확도를 보였다. 초음파 검사의 경우 표피성 봉입낭종(epidermal inclusion cyst)인 경우 71.4%, 결절종은 85.7%, 지방종은 88.6%의 정확도를 각각 나타내었다. 반면 신체 검사와 병력 청취를 통하여 임상적 진단이 가능했던 경우는 총 54례로, 이 중 33례에서 병리적 진단과 일치하여 61.1%의 민감도를 보였다. 이 경우 종양별 진단 정확도는 결절종이 56.0%, 지방종이 67.9%로 나타났다. 결론: 초음파는 수술 전 연부조직 종괴의 진단에 있어 매우 유용한 진단 수단의 하나로 사료된다.

• Archives of Plastic Surgery
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• 제42권2호
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• pp.201-206
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• 2015

Background Although plastic surgeons daily encounter various facial tumors in the field, reports limited on face are scarce. In our study, we want to provide basic epidemiologic data to help clinicians to decide the proper management for their patients. Methods We retrospectively reviewed the medical records of patients including age and gender, location and size of the tumor, histopathologic result, recurrence, type of anesthesia and any associated disorders who had undergone a surgical removal of their facial tumors and received the histopathologic report in the same institution between January 2009 and October 2012. Results One hundred eighty-nine patients with 203 non-melanocytic benign tumors were included. The most frequent site of tumors was the central subunit of the forehead, followed by the lateral subunit of the cheek and the auricular unit. Of 36 different histopathologic results, the epidermal cyst was most frequent, followed by lipoma, pilomatricoma and osteoma. Statistical analysis showed that males were dominant in the epidermal cyst and lipoma groups. While, females were dominant in the osteoma and pilomatricoma groups. No associations were found between lesions and other diseases. Conclusions Our study is the at most specific and concentrated study on non-melanocytic benign tumors of the face. We expect the epidemiologic data of our study may help plastic surgeons who are confronted with so many facial lesions in the field to decide on the most proper management for their patients.

• 대한족부족관절학회지
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• 제6권2호
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• pp.144-148
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• 2002

Purpose: To evaluate clinical characteristics of soft-tissue masses around the foot Materials and Methods: Sixty seven cases of soft tissue masses around the foot, excised at Kang Dong Sacred Heart hospital from Jan. 1987 to Oct. 2000, were included in the study. The age and sex of the patient, location and size of the lesion, history of trauma, presence or absence of pain and neurological symptoms as wellas final pathological diagnosis were obtained from retrospective analysis. Results: For type of lesion, all lesions were benign. Ganglion was 23 cases, epidermal inclusion cyst was 10 cases, lipoma was 8 cases, hemangioma was 5 cases and fibroma was 4 cases. For age, 63 percent of the patients were either between the ages of twenty and thirty nine or between the ages of fifty and fifty nine. For sex, the male-to-female ratio was 1 to 1.4. For zones of the foot, 18 cases were in Zone 1, 17 in Zone 4, 12 in Zone 2, 12 in Zone 3 and 8 in Zone 5. For clinical finding, 18 cases had pain. Conclusion: Ganglion was the most common lesions, followed in order of frequency by epidermal inclusion cyst, lipoma, hemangioma and fibroma. Lesions occurred frequently at Edward and Michael Zone 1, 4 and pain was the most common symptom.

• Archives of Plastic Surgery
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• 제38권4호
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• pp.523-526
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• 2011

Purpose: The odontogenic sinus and fistulous tracts is the most common draining sinus and fistulous tract of the head and neck region. These are often misdiagnoses by clinicions who are not familiar with cutaneous sinus, since most of patients do not have dental symptoms. Here we present two cases of odontogenic cutaneous sinus tract which have been diagnosed after excision of epidermal cyst. Methods: Two patients who presented with an odontogenic sinus tract draining to the skin at our institusion during the two years were enrolled in this study. We reviewed all the medical records of the patients and literature about odontogenic cutaneous sinus tract. Results: Odontogenic cutaneous sinus tracts of our cases were healed after treatment of periapical odontitis and extraction of the carious tooth. Conclusion: The cutaneous sinus tract of dental origin is well documented condition. But its diagnosis is not always easy unless the clinicians consider the possibility of its dental origin. An understanding of the pathogenesis of odontogenic cutaneous sinus tract will lead to early correct diagnosis and proper treatment without unnecessary surgery.

• Archives of Plastic Surgery
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• 제34권4호
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• pp.508-511
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• 2007

Purpose: Dermoid cysts are almost always caused by congenital events. The most widely accepted pathogenesis is that the cysts are dysembryogenetic lesions that arise from ectodermic elements entrapped during the midline fusion. We report a rare case of dermoid cyst, which occurred not congenitally but newly in the subcutaneous scar tissue secondary to trauma. Methods: A 26-year-old man had a deep submental laceration caused by a car accident and got a primary wound closure 16 months ago. There were 18 cm-long submental hypertrophic scar and newly developed palpable masses inside the subcutaneous layer at the center of the scar. Initial impression was an epidermal cyst or a thyroglossal duct cyst. Ultrasonographic finding showed two cystic masses inside the scars at the submental area, but impressed dermoid cysts. The cystic masses were completely removed with W-plasty and histological examination were followed. Results: The histological diagnosis was dermoid cysts which were mainly composed of keratotic squamous epithelium in their inner surface linings and numerous skin appendages such as sebaceous glands, sweat glands, and hair follicles in their cystic lumens histopathologically. During the follow-up period of 25 months, there was no recurrence of any subcutaneous mass in the site of scar. Conclusion: We report a very unusual case of dermoid cysts developed by an acquired cause, considering that the accidental inclusion of deep skin elements caused by a trauma can be a critical origin of dermoid cysts.

• Archives of Plastic Surgery
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• 제38권3호
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• pp.319-322
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• 2011

Purpose: Glomus tumor is a benign neoplasm of the normal glomus body, occurring as painful subcutaneous nodules, frequently located in the subungual area. There are few cases of facial glomus tumor reported and we report a case of glomus tumor developing on the columella of nose. Methods: A 68-year-old female presented with a mass of the columella grown for 2 years. The nodule was 0.6 cm in diameter, red-colored without any symptoms such as pain, tenderness and cold hypersensitivity. The pathologic result after punch biopsy was hemangiopericytoma. Excision with local anesthesia was executed. Results: The postoperative recovery of the patient was uneventful, Histopathological examination indicated a glomus tumor. Immunostaining revealed positivity for vimentin, actin, and negativity for desmin, CD-34. After 8 months follow up, there is neither complication nor evidence of local recurrence on clinical examination. Conclusion: To accomplish an accurate diagnosis of glomus tumor, the histopathological examination is essential together with immunochemical studies. The differential diagnosis include hemangioma, lipoma, epidermal inclusion cyst, dermoid cyst and arteriovenous malformation in this region. We report a case of glomus tumor on the face with uncommon clinical features.

• Archives of Plastic Surgery
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• 제34권4호
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• pp.504-507
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• 2007

Purpose: Chondroid syringoma, previously known as 'mixed tumor of the skin', is a rare benign tumor. It usually presents an asymptomatic solitary firm intradermal or subcutaneous slowly growing nodule. It occurs frequently in the head and neck region of middle-aged men. We would like to report an uncommon chondroid syringoma about the clinical and histologic presentation. about the clinical and histologic presentation. Methods: We experienced two cases of chondroid syringoma on the nose and the upper lip, each other. Both masses were totally excised with clear margin. Results: On histologic examination, the masses showed a biphasic pattern-an epithelial component exhibiting apocrine/eccrine differentiation and a stromal component exhibiting myxoid/collagenous change-consistent with the diagnosis of chondroid syringoma. There have been no evidence of recurrence and malignant transformation during postoperative follow-up. Conclusion: There is no one distinctive clinical feature that is specific for chondroid syringoma. However, it should be included in the differential diagnosis of a solid nodule in head and neck region with long standing duration, such as epidermal inclusion cyst, pilomatrixoma, dermoid cyst, sebaceous cyst, neurofibroma, and basal cell carcinoma.

• Journal of Korean Neurosurgical Society
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• 제45권3호
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• pp.196-198
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• 2009

Hemifacial spasm (HFS) is almost always induced by vascular compression but in some cases the cause of HFS are tumors at cerebellopontine angle (CPA) or vascular malformations. We present a rare case of hemifacial spasm caused by epidermoid tumors and the possible pathogenesis of HFS is discussed. A 36-year-old female patient presented with a 27-month history of progressive involuntary facial twitching and had been treated with acupuncture and herb medication. On imaging study, a mass lesion was seen at right CPA. Microvascular decompression combined with mass removal was undertaken through retrosigmoid approach. The lesion was avascular mass and diagnosed with an epidermoid tumor pathologically. Eventually, we found a offending vessel (AICA : anterior inferior cerebellar artery) compressing facial nerve root exit zone (REZ). In case of HFS caused by tumor compression on the facial nerve REZ, surgeons should try to find an offending vessel under the mass. This case supports the vascular compression theory as a pathogenesis of HFS.

• 대한세포병리학회지
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• 제2권2호
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• pp.168-171
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• 1991

Pilomatricoma is a well defind and characteristic entity histologically, but this tumor may be encountered during aspiration biopsy of subcutaneous mass, and is, occasionally, confused with other neoplasms, particularly squamous cell carcinoma, basal cell carcinoma, and epidermal inclusion cyst. Recently, we have experienced a case of pilomatricoma diagnosed by aspiration biosy. The smear of the aspirate revealed anucleated "ghost" squamous cells, basaloid or basophilic squamous cells and nucleated squamous cells, which lack nuclear features of malignacy. These findings are consistent with pilomatricoma.

• Archives of Plastic Surgery
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• 제33권6호
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• pp.764-768
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• 2006

Purpose: Parotid neoplasia are relatively frequent, representing approximately 3% of all tumors in the head and neck regions. But incomplete resection and misdiagnosis of parotid gland is followed by multiple tumor invasion, tumor recurrence, and other iatrogenic tumor formation. In patients undergoing parotidectomy for confirmed or suspected malignancy, the traditional or modified rhytidectomy incision may prove suboptimal because it does not easily lend itself to a continuous neck dissection. Similarly, patients with tumors of the anterior accessory lobe or patients with large anterior tumors may also require the modified Blair incision for adequate surgical exposure. This report serves to revisit the topic of accessory and parotid gland neoplasms to emphasize proper management, particularly the surgical aspects, so that consequences of recurrence are avoided. Methods: This is a retrospective review of our experience with two cases of parotid tumors; one accessory parotid gland neoplasm and one parotid gland neoplasm. We report the case of parotid tumor and epidermal cyst in a 54-year old male patient and the case of case of recurrent parotid tumor with local invasion in 30-year old male patient. Results: All were removed through a modified Blair incision. Pathologic report notified that One was found pleomorphic adenoma and epidermal cyst, and the other one pleomorphic adenoma with subcutenous invasion. The patients recovered well without any complication such as infection, hematoma, facial nerve palsy, and necrosis of skin flap. Patients were discharge POD#7. Patients were followed up to for 1 year and they have no sign of recurrence. Conclusions: A high index of suspicion, prudent diagnostic skills(including fine-needle aspiration biopsy, CT, US), and meticulous surgical approach are the keys to a successful management of these lesions. We experienced two cases of parotid neoplasia, in the treatment of tumor reccurence & iatrogenic tumor arising from the parotid gland and are presented with the review of literatures.