• Archives of Plastic Surgery
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• 제39권1호
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• pp.63-66
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• 2012

Nevus comedonicus is a type of hamartoma that arises from a developmental anomaly of the mesodermal part of the pilosebaceous gland. In most cases of nevus comedonicus, an acne-like skin condition develops. Repeated inflammation can cause a morphological change to the cyst, papule, to abscess. We experienced a case of congenital nevus comedonicus, which led to the formation of large multiple cysts. A 50-year-old man was referred with a $12.5{\times}10cm$ lobulated mass on the posterior neck and upper back. The patient had a widespread presence of nevus comedonicus in the region ranging from the right superior chest to the posterior neck. The patient had a 30-year history of six prior excisions. A magnetic resonance imaging review led to a diagnosis of nevus comedonicus. Surgical treatment consisted of excision of the mass and wide excision for the patch type of nevus comedonicus around the neck. On histopathology, multiple masses were diagnosed as typical cysts containing keratinized tissue. The diffuse comedone lesions were diagnosed as nevus comedonicus. This case shows that large, multiple cysts can occur as a long-term complication of nevus comedonicus, and also highlights the importance of radical resection to prevent its further invagination.

• 한국임상수의학회지
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• 제26권6호
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• pp.616-618
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• 2009

5세령의 페키니즈 견이 발생된 지 1년 된 등쪽 종괴의 평가를 위해 내원하였다. 종괴의 세침흡인 도말 표본의 세포학 검사에서 많은 수의 각화 상피세포와 거대 다핵 세포, 소수의 방추 세포가 관찰되었다. 세포학 검사결과 육아종성 표피낭 또는 모낭 종양이 의심되었고, 결절은 외과적으로 절제한 후 병리조직학적 검사를 실시하였다. 피하의 결절은 부분적으로 결합조직에 둘러싸여 있었으며, 주변조직과 경계가 명확하였다. 그 결절은 중심의 큰 낭과 주변의 작은 낭으로 이루어져 있었으며, 그 낭은 중심부에 층판상의 케라틴이 존재하였고 단층 또는 중층의 기저세포와 편평 상피세포로 둘러싸여 있었다. 다소성으로 다수의 대식구와 소수의 다핵거대세포가 관찰되었다. 이에 기초하여 육아종성 염증이 동반된 keratoacanthoma로 진단하였다. 종괴는 수술 제거 후 재발되지 않고 있다.

• BMB Reports
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• 제40권4호
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• pp.467-474
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• 2007

Autosomal recessive polycystic kidney disease (ARPKD) is one of the important genetic disorders in pediatric practice. Mutation of the polycystic kidney and hepatic disease gene 1 (PKHD1) was identified as the cause of ARPKD. The gene encodes a 67-exon transcript for a large protein of 4074 amino acids termed fibrocystin, but its function remains unknown. The neoplastic-like in cystic epithelial proliferation and the epidermal growth factor/epidermal growth factor receptor (EGF/EGFR) axis overactivity are known as the most important characteristics of ARPKD. Since the misregulation of $Ca^{2+}$ signaling may lead to aberrant structure and function of the collecting ducts in kidney of rat with ARPKD, present study aimed to investigate the further mechanisms of abnormal proliferation of cystic cells by inhibition of PKHD1 expression. For this, a stable PKHD1-silenced HEK-293T cell line was established. Then cell proliferation rates, intracellular $Ca^{2+}$ concentration and extracellular signal-regulated kinase 1/2 (ERK1/2) activity were assessed after treatment with EGF, a calcium channel blocker and agonist, verapamil and Bay K8644. It was found that PKHD1-silenced HEK-293T cell lines were hyperproliferative to EGF stimulation. Also PKHD1-silencing lowered the intracellular $Ca^{2+}$ and caused EGF-induced ERK1/2 overactivation in the cells. An increase of intracellular $Ca^{2+}$ in PKHD1-silenced cells repressed the EGF-dependent ERK1/2 activation and the hyperproliferative response to EGF stimulation. Thus, inhibition of PKHD1 can cause EGF-induced excessive proliferation through decreasing intracellular $Ca^{2+}$ resulting in EGF-induced ERK1/2 activation. Our results suggest that the loss of fibrocystin may lead to abnormal proliferation in kidney epithelial cells and cyst formation in ARPKD by modulation of intracellular $Ca^{2+}$.

• 대한소아치과학회지
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• 제31권1호
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• pp.79-84
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• 2004

Pilomatricoma(Calcifying epithelioma of Malherbe)는 모낭 세포 기원의 양성 연조직 종양으로, 보통 머리와 목 부위에 나타나며, 20세 이전의 여성들에게서 호발하고, 악성으로의 전이가 보고되기도 하나, 이는 극히 드물다. 임상적으로, 무통성, 표재성, 고형성이며 종종 적청색을 나타내고, 크기는 보통 $0.5{\sim}3.0cm$ 정도로 다양하게 나타난다. 조직학적으로, 세포기질 내에 상피조직이 존재하는 형태이며 상피조직에서는 기저세포(basaloid cell)와 유령세포(ghost cell)가 특징적으로 나타나고, 세포내와 기질내 석회화가 종종 관찰되기도 한다. 진단은, 초진시 고형 물질의 촉진으로 병소를 의심해볼 수 있고, 조직병리학적 검사로 확진할 수 있다. 감별진단으로는 아가미낭(branchial cyst), 혈관종(hemangioma), 횡문근육종(rhabdomyosarcoma), 표피포함낭(epidermal inclusion cyst), 모낭(pilar cyst), 이하선 종양(parotid gland tumor), 피부의 골종(osteomas of the skin), 림프절의 석회화(calcified lymph nodes), 죽종(atheromas) 등이 있다. 치료로는 외과적 절제술이 추천되며 재발은 드물다. 본 증례는 우측 하악각 부위에 결절이 촉진되는 6세 여자 환아에게서 임상 검사와 방사선 검사 후 병소의 외과적 절제술을 시행하였으며, 조직병리학적 검사를 통해 pilomatricoma로 확진되었고, 양호한 치료 결과를 얻었기에 이에 보고하는 바이다.

• 대한세포병리학회지
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• 제6권1호
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• pp.27-35
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• 1995

We reviewed 93 cases of fine needle aspiration of skin/subcutaneous and soft tissue lesions with histologic confirmation. On the basis of the most prominent cytologic features, morphologic classification of the aspirates was done. Skin and subcutaneous lesions included endometriosis, epidermal inclusion cyst, fat necrosis, pilomatrixoma and nodular fasciitis. Neoplastic lesions of soft tissue were categorized as ; round cell, spindle cell, polygonal cell, well-differentiated and myxoid tumor. This classification is convenient to recognize and categorize most soft tissue tumors.

• 대한두개안면성형외과학회지
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• 제21권5호
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• pp.319-322
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• 2020

Angiolymphoid hyperplasia with eosinophilia (ALHE) is a rare benign vascular tumor. The pathogenesis of ALHE is unknown; however, it may be linked to local trauma. ALHE predominantly occurs in areas of the preauricular region, forehead, and scalp; the masseter area is rarely involved. A 49-year-old man was referred for a mass in the right cheek region that was felt 2 months prior. Physical and imaging examination results suggested the presence of a benign tumor. Thus, surgical excision was performed. Pathologic findings confirmed an unexpected diagnosis of ALHE. This case was interesting, since the mass occurred at an unusual site with a misdiagnosis of an epidermal inclusion cyst.

• 대한두개안면성형외과학회지
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• 제22권3호
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• pp.157-160
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• 2021

Head and neck cutaneous metastasis of advanced gastric cancer is uncommon, and scalp metastasis is particularly rare. We present the case of a 60-year-old man who was diagnosed with cutaneous metastasis on the scalp originating from advanced gastric cancer. The patient was referred to the plastic surgery department for a scalp mass near the hairline. He had been diagnosed with advanced gastric cancer and undergone total gastrectomy and Roux esophagojejunostomy 3 years previously. The differential diagnosis for a single flesh-colored nodule on the scalp included benign tumors such as epidermal cyst or lipoma; therefore, the patient underwent excision and biopsy. In the operative field, the mass was found to be located in the frontalis muscle. The biopsy result showed that the mass was a metastatic lesion of advanced gastric cancer. Whole-body computed tomography revealed a gastric tumor with blood vessel infiltration, peritoneal carcinomatosis, liver metastasis, and multiple disseminated subcutaneous metastases. Although scalp metastasis originating from an internal organ is extremely rare, plastic surgeons should always consider a metastatic lesion in the differential diagnosis if a patient with a scalp lesion has a history of malignant cancer.

• Archives of Plastic Surgery
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• 제48권2호
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• pp.175-178
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• 2021

The umbilicus is an important aesthetic component of the abdomen; therefore, its absence is both cosmetically and psychologically distressing to the patient. However, loss of the umbilicus during abdominal surgical procedures is often unavoidable. Umbilical reconstruction is aimed at obtaining a natural, three-dimensional appearance. We propose a simple method for immediate umbilical reconstruction with good long-term results. This technique was used successfully on a patient who underwent tumor excision. A 49-year-old woman presented with a large mass, measuring 5.8×4.0 cm, on her umbilicus. The mass, an epidermal cyst, developed after laparoscopic uterine myomectomy 5 years earlier. Complete excision of the mass resulted in a large defect, and immediate umbilical reconstruction was planned. Our procedure involved apposing and anchoring two opposing flaps onto the abdominal wall, so that the umbilicus would retain its depth over a long period of time. Negative-pressure wound therapy was applied for 72 hours as a mild compressive dressing. No complications were encountered. The healing process was uneventful and the aesthetic outcome was pleasing; a natural-appearing navel was created. The patient was satisfied with the end result. This technique provides a permanent and sufficient depression for the umbilicus.

• 대한두경부종양학회지
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• 제39권1호
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• pp.41-44
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• 2023

Mucinous Eccrine carcinoma (MEC) is a rare malignant tumor related to the eccrine sweat gland and is commonly located on the face, especially around the eyelids and scalp. Most of these tumors are diagnosed at age 40's to 60's and exhibit a wide variety of patterns in addition to the general appearance previously reported. MEC is difficult to diagnose clinically, but can be diagnosed by accompanying biopsy. We present the case of a 75-year-old man who complained of a gradually growing Left lower lid tumor of duration one year. Initially, the tumor was mistaken for an epidermal cyst and treated by surgical resection. However, biopsy findings resulted in a diagnosis of Mucinous Eccrine carcinoma. Therefore, we performed wide excision and flap reconstruction surgery. In a one year follow-up examination, the patient achieved successful functional and aesthetic results without regional or distant metastasis and recurrence.

• 대한두개안면성형외과학회지
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• 제25권2호
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• pp.90-94
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• 2024

Primary cutaneous mucinous carcinoma (PCMC) is a rare malignancy of the sweat glands that most commonly affects the periorbital area. It is characterized by slow growth over a prolonged period, and its morphology can be easily confused with a benign tumor, such as an epidermal cyst. Consequently, many patients experience recurrence after undergoing multiple resections. However, there are few reports concerning the surgical management of PCMC. We present two cases of PCMC originating in the periorbital area. The first case involved a 76-year-old man with a mass measuring 3.0×1.5 cm that had been increasing in size. The second case was a 61-year-old man with two masses, each measuring 1.0×1.0 cm, that were also growing. Both patients underwent wide excision with a 5-mm safety margin, which was determined based on the widest view of the cross-section of the mass on the magnetic resonance imaging. Subsequently, based on the intraoperative frozen biopsy results, both patients underwent additional excision with a 5-mm safety margin in only one direction. This report shows that, when determining the surgical margin of PCMC in periorbital area, employing imaging modalities and intraoperative frozen biopsies can be helpful for narrowing the surgical margin.