• Title/Summary/Keyword: Excision/curettage

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Treatment of Giant Cell Tumor Around Knee - by Intralesional Excision Using High Speed Burr and Methylmethacrylate - (슬관절 주변에 발생한 거대세포종의 치료 - 고속 바(High-Speed Burr)와 골 시멘트를 이용한 병소 내 절제술 -)

  • Park, Jong-Hoon;Lee, Soo-Yong;Jeon, Dae-Geun;Cho, Wan-Hyung;Song, Won-Seok;Kim, Jin-Wook;Koh, Han-Sang
    • The Journal of the Korean bone and joint tumor society
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    • v.11 no.2
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    • pp.160-167
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    • 2005
  • Purpose : Distal femur and proximal tibia are the common sites affected by giant cell tumor of bone. There are a variety of treatment modality including wide excision and intralesional curettage. We evaluated the local recurrence rates and the post-operative functional scores of giant cell tumors around knee joint and investigated the identification of possible prognostic factors for recurrence. Materials and Methods: We reviewed 41 patients pathologically confirmed as giant cell tumors around knee joint that have undergone intralesional curettage using high-speed burr and methylmethacrylate. We evaluated the recurrence rate and post-surgical functional score and possible prognostic factors for recurrence, such as, gender, age, tumor location, size, subchondral invasion, intra-articular invasion and the Campanacci Grades. Mean follow up period was 50 (12-122) months. Results: The recurrence rate was 17% and mean recurrence onset was 10 months postoperatively. According to Musculoskeletal Tumor Society (MSTS) functional evaluation system, the average score was 27.8(93%) and 78% had excellent function. According to our study, suspected prognostic factors revealed not significant for recurrence. Conclusion: We found no significant recurrence related factors. Intralesional excision with high-sped burring and PMMA provides a low recurrence rate, similar to others in the literature, and good functional scores.

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Treatment Outcomes of Sacral Giant Cell Tumor (천골 거대 세포종의 치료 결과)

  • Kong, Chang-Bae;Lee, Kwang-Youl;Song, Won-Seok;Cho, Wan Hyeong;Koh, Jae-Soo;Jeon, Dae-Geun;Lee, Soo-Yong
    • The Journal of the Korean bone and joint tumor society
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    • v.19 no.2
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    • pp.43-49
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    • 2013
  • Purpose: We analyzed the treatment outcomes of patients with sacral giant cell tumor. Materials and Methods: We retrospectively reviewed 7 patients with giant cell tumor of the sacrum who were treated at out institution between 1990 and 2012. Results: There were 2 men and 5 women with mean age of 23.6 years. The average follow up was 52.3 months (range, 15-73 months). Six patients received surgical treatment. Intralesional curettage was performed for the 5 patients and marginal resection for another one patient. The remaining one patient was received radiation only. The patients who received radiation therapy and marginal excision had no residual or recurrent tumors. Of 5 patients with intra-lesional excision, one patient needs one more operation; two patients need two more operation for local control of the giant cell tumor. The remaining two patients failed to gain local control in spite of additional treatments. Conclusion: For the treatment of sacral giant cell tumor, intralesional resection can be one of the treatments option with minimal neurologic injury. Furthermore, radiation therapy can be recommended when complete excision or curettage is impractical.

ANEURYSAMAL BONE CYST : REPORT OF A CASE (동맥류성 골낭종의 증례보고)

  • Lim, Seok-Kyun;Yeo, Hwan-Ho;Kim, Young-Kyun;Kim, Su-Gwan;Chi, Jae-Hyu
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.20 no.3
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    • pp.237-240
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    • 1998
  • Aneurysmal bone cyst is a benign lesion of bone consisting of a septated, cystic cavity filled with non-endothelium-lined, blood-filled spaces. As it grows, expanding and destroying the affected part of the bone by direct compression, the lesion characteristically produces a prominent bulging of the affected bone, which eventually erodes the overlying cortex. Patients rarely complain of pain unless the cyst affects adjacent nerves or its expasion is great enough to impinge on the surrounding joints and soft tissue. Teeth adjacent to the cyst may be displaced, but usually remain vital. Development of the lesion in the craniofacial region is rare, and the mandible is more often affected than the maxilla. Complete surgical excision is used to treat aneurysmal bone cyst, with either curettage or composite resection. This is a case report of 49 years old female with aneurysmal bone cyst treated with surgical excision & DFDB graft.

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Case Report of Recurrent Osteoma at the Grafted Bone (이식된 뼈에서 재발한 뼈종의 치험례)

  • Joo, Chun Seung;Lee, Yoon Ho
    • Archives of Plastic Surgery
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    • v.33 no.3
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    • pp.367-370
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    • 2006
  • Surgical curettage or en bloc excision are the usual choice of treatment for osteoma. Local recurrence of osteoma after surgical treatment is not very common. We report a case of osteoma recurred at the grafted bone. A $5{\times}8cm$ sized osteoma of frontal bone was excised and then the defect was covered with calvarian bone and rib bone. Six years after reconstruction, recurrence from grafted area was noted. We completely removed the osteoma with enough normal tissue around it, after checking that the grafted bone has changed into an osteoma through a bicoronal incision. Then we covered the defect with a rib bone. The tissue was confirmed histologically as an osteoma. The recurrence of the tumor at the bone grafted site after osteoma excision is probably due to the fact that we covered grafted bone with periosteum left over osteoma. Therefore, we can learn that when we excise osteoma, galea should be carefully separated from the periphery of the tumor and that the periosteum should be completely removed, to prevent the osteoma from recurrence.

Surgical Treatment of Metastatic Tumor in Proximal Femur with Recycling Autograft Prosthetic Composite after Wide Excision (근위 대퇴골 전이성 종양의 수술적 치료로서 광범위 절제술 후 재활용 자가골을 이용한 복합 고관절 성형술)

  • Kim, Jae-Do;Park, Pil-Jae;Kwon, Young-Ho;Jang, Jae-Ho;Lee, Young-Gu
    • The Journal of the Korean bone and joint tumor society
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    • v.11 no.1
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    • pp.71-81
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    • 2005
  • Purpose: Due to local recurrence of tumor, metal failure usually develops in patients who underwent internal fixation or hip joint arthroplasty after curettage in the case of metastatic tumor of proximal femur. The aim of this study is to find out the appropriateness of reconstruction using recycling autograft after wide excision in the case of metastatic bone tumor by performing recycling autograft and hip joint arthroplasty after wide excision, and through presence or absence of local recurrence, functions of lower limbs and occurrence of complications. Materials and Methods: Five patients, in 6 cases, who had undergone reconstruction using recycling autograft prosthetic composite after wide excision in the metastatic tumor from May 2000 to May 2003 were included in this study. The average age of the patients was 60.8 years of age with male to female ratio of 3:2. Average duration of lives following surgery was 23.3 month (7-57 months). Primary lesion included 2 cases of lung cancer, and 1 each of stomach cancer, renal cancer and multiple myeloma. After wide excision, the hip joint was reconstructed with recycling autograft prosthetic composite ; 4 cases of extracorporeal irradiation and 2 cases of pasteurization. Musculoskeletal Tumor Society (MSTS) score(1993) for 6-month period after surgery, as well as presence of complication and local recurrence during the rest of their lives, were studied. Results: Average Musculoskeletal Tumor Society (MSTS) score over the 6-month period after surgery was 63.3% and 1 case of dislocation of hip joint, as a complication following surgery, was discovered. Local recurrence during the lives of the patients was not observed. Conclusion: In the case of metastatic tumor of proximal femur, in which the life span following surgery is expected to be more than 6 months, undergoing reconstruction using recycling autograft after wide excision, in comparison to internal fixation or hip joint arthroplasty after curettage, is deemed to have better results in prevention of local recurrence, and preservation of the functions of all limbs during the life span of the patient.

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RECURRENT CHONDROBLASTOMA ON THE RIGHT TEMPORAL AREA : A CASE REPORT (우측 측두골에 재발한 연골아세포종의 증례보고)

  • Seo, Woon-Kyung;Huh, Pil-Woo;Lee, Won;Kim, Seong-Hun;Go, Taek-Su;Heo, Hyun-A;Kim, In-Soo
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.27 no.4
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    • pp.388-393
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    • 2005
  • Chondroblastoma was introduced as a rare benign cartilaginous neoplasm by Codman in 1931. It described by Jaffe and Lichtenstein in 1942 as a benign cartilaginous neoplasm that represents less than 1% of all primary bone tumor. It commonly arises in the epiphysis of long bone but, it occurs very rare in temporal area. Sometimes, microscopic identification of chondroblastoma and giant cell granuloma is difficult. An immunohistochemical studies was performed for S-100 protein which is useful in arriving at the correct diagnosis. Treatment modalities are total curettage, en-bloc excision, irradiation, and radiation combined with surgical excision. But radiation therapy was controversial. We describe a case of chondroblastoma which was arisen in the right temporal area and the recurrence that was treated by surgical excision and radiation therapy with review of literature.

Treatment and Rehabilitation of Repetitively Recurrent Langerhans Cell Histiocytosis: A Case Report

  • Yoo, Hee Young;Park, Kyung Soo;Lee, Baek Soo;Kwon, Yong Dae;Choi, Byung Joon;Ohe, Joo Young;Lee, Jung Woo
    • Journal of Korean Dental Science
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    • v.9 no.1
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    • pp.35-41
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    • 2016
  • Langerhans cell histiocytosis (LCH) is characterized by proliferation of histiocyte-like cells (Langerhans cell histiocytes) with characteristic Birbeck granules, accompanied by other inflammatory cells. Treatments of LCH include surgery, chemotherapy, and radiotherapy. One of the representative forms of chemotherapy is intralesional injection of steroids. Surgical treatment in the form of simple excision, curettage, or even ostectomy can be performed depending on the extent of involvement. Radiotherapy is suggested in case of local recurrence, or a widespread lesion. This article shows the case of repetitively recurrent LCH of a 56-year-old man who had been through surgical excision and had to have marginal mandibulectomy and radiotherapy when the disease recurred. After the first recurrence occurred, lesions involved the extensive part of the mandible causing pathologic fracture, so partial mandibular bone resection was performed from the right molar area to the left molar area followed by the excision of the surrounding infected soft tissues. The resected mandibular bone was reconstructed with a segment of fibula osteomyocutaneous free flap and overdenture prosthesis supported by osseointegrated implants.

KERATOACANTHOMA ON FACIAL SKIN : CASE REPORT (안면부에 발생한 각화극세포종의 치험례)

  • Kang, Hee-In;Lee, Won-Hak;Oh, Hae-Soo;Kim, Dong-Suk;Kim, Sang-Joong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.27 no.6
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    • pp.570-574
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    • 2005
  • Keratoacanthoma is a benign, self-limited epithelial lesion that closely resembles Squamous cell carcinoma(SCC). Keratoacanthoma occur primarily exposed skin in male patients over 45 years of ages. although etiology is unknown, sunlight, genetic, and human papillomavirus factor have been considered. in clinical feature, rapid enlargement occurs over 4$\sim$8 weeks, resulting ultimately in a hemispheric, firm, elevated, asymptomatic nodule that contains a central plug of keratin. When fully developed, the keratoacanthoma contains a core of keratin surrounded by a concentric collar of raised skin. Over the next 4$\sim$8 weeks, static lesion persists. Then undergoes spontaneous regression over the next 6$\sim$8weeks period by expulsion of the keratin core with resorption of the mass. In histologic feature, Keratoacanthoma consists of hyperplastic squamous epithelium growing into the underlying connective tissue. The surface is covered by a thickened layer of parakeratin with central plugging. Epithelium cell shows dysplastic features and the margins the normal adjacent epithelium is elevated. The differential diagnosis includes SCC. Keratoacanthoma present as a exophytic lesion with horny keratin occupying a depression on the top of the lesion, persists static period and undergoes rapid growth compared with SCC. Keratoacanthoma is usually treated by surgical excision or curettage of the base, spontaneous regression does not occur in every case. A 60 years old male who present facial lesion visit our hospital and surgical excision was done. Biopsy result was keratoacanthoma. We report case with review of literatures.

Surgical treatment of Giant Cell Tumor in Knee Joint (슬관절 주위 거대세포종의 치료)

  • Bae, Dae-Kyung
    • The Journal of the Korean bone and joint tumor society
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    • v.1 no.1
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    • pp.1-6
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    • 1995
  • Giant cell tumors are primary bone tumors originating from non-osteoblastic connective tissue. The sites of involvement were commonly distal femur, proximal tibia, proximal humerus, distal radius and others (including os calcis, ilium and sacrum). Giant cell tumor located around knee joint has been difficult to treat because of local recurrence following curettage with or without bone graft. Although primary resections reduce recurrence of the lesion, the joint function will be markedly impaired. Marginal excision was very often complicated by a loss of joint integrity since all the giant cell tumors occupy juxtaarticular positions. Techniques involving physical adjuncts(high speed burr and electric cauterization) have been used in the hope of decreasing the rate of local recurrence and avoiding the morbidity of primary resection. A meticulous clinical, radiological and histological evaluation is needed to choose the correct treatment, keeping in mind the possibility of recurrence after each treatment modality.

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Fine Needle Aspiration Cytology of Unusual Epidermoid Cyst with Diffuse Parakeratosis and Aggressive Growth - A Case Report - (미만성 이상각화증을 동반한 침습성 표피양 낭의 세침흡인 세포학적 소견 - 1예 보고 -)

  • Nam, Hae-Joo
    • The Korean Journal of Cytopathology
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    • v.10 no.1
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    • pp.85-89
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    • 1999
  • An extremely unusual case of epidermoid cyst showing diffuse parakeratosis and aggressive clinical behavior is presented. A destructive bone lesion with surrounding ill-defined soft tissue lesion was found by computed tomography in a 63 year-old man complaining of painful swelling of the right buttock. He had a history of surgical excision twice for epidermoid cysts of soft tissue of the right hip during recent one year On aspiration cytology, the aspirate was highly cellular and mostly composed of desquamated nucleated squamous cells. Operation finding revealed that the iliac bone was Irregularly destroyed and filled with gray-white cheesy material and necrotic bone bedris. Adjacent gluteus muscle showed scattered gray-white lesions. The curettage specimen showed bone necrosis and desquamated squamous cells filling the marrow spaces. The lesion within muscle revealed epidermoid cyst with diffuse parakeratosis.

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