• The Journal of the Korean bone and joint tumor society
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• v.19 no.2
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• pp.50-55
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• 2013

Purpose: The purpose of this study is to determine the usefulness of arterial embolization on sacral and pelvic giant cell tumor (GCT). Materials and Methods: We retrospectively reviewed the medical records of 9 patients who had undergone serial arterial embolization between December 1996 and May 2008. We analyzed the clinical outcomes and therapeutic responsiveness of arterial embolization on sacral and pelvic GCT. Results: Six of 9 cases showed progression of disease (PD) status, even if 5 cases showed PD status despite of additional treatments including surgery and radiation, implying that serial arterial embolization on sacral and pelvic GCT is not effective. Three of 9 cases showed stable disease (SD) or continuous disease free (CDF) status and we analyzed associated factors with these good responses for embolization by ${\chi}^2$ test. The number of feeding vessels under six (p=0.048) and the number of collateral arterial supply under three (p=0.048) in the first angiogram showed significant relationships with good response for embolization, while remaining tumor staining by contrast after the first embolization and repeated embolization times were not significant. Conclusion: Although serial arterial embolization is not an effective modality on sacral and pelvic giant cell tumors, it may be a pilot modality under narrow indication of tumors with poor vascularity at first angiogram.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.17 no.1
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• pp.279-286
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• 1987

The authors observed a patient who referred to the Department of Oral Radiology, due to diffuse skeletal pain, muscular weakness and unknown tumor mass on the buccal gingiva of upper right molar region. The patient was found to have peripheral reparative giant cell granuloma and osteomalacia. After removal of the tumor, the clinical, radiologic, and laboratory findings of the patient was rapidly normalized with remarkable improvement of bone pain. The results were as follows: 1. After removal of the tumor, the patient improved. the clinical findings such as bone pain, trismus. muscular weakness and he could walk. 2. In postoperative x-ray findings at 1 and 2 months intervals, the lamina dura of all dentition and bony trabeculae in upper and lower arches were regenerating and the bone density increased. 3. In periodic recall check, no occurrence of osteomalacia was existed and the laboratory findings of the patient showed gradual improvement.

• Journal of Korean Neurosurgical Society
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• v.50 no.1
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• pp.64-67
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• 2011

We present a case report of a 45-year-old woman with spontaneous pneumocephalus accompanied by pneumorrhachis of the thoracic spine, which is a very rare condition generally associated with trauma and thoracic or spinal surgery. The patient had undergone an operation about 10 years earlier to treat a giant cell tumor of the thoracic spine. During the operation, a metallic device was installed, which destroyed the bronchus and caused the formation of a broncho-paraspinal fistula. This is the suspected cause of her pneumocephalus and pneumorrhachis. To our knowledge, this is a very rare case of pneumocephalus accompanied by pneumorrhachis induced by metallic device, and when considering the length of time after surgery these complications presented are also exceptional.

• The Journal of the Korean bone and joint tumor society
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• v.9 no.1
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• pp.124-129
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• 2003

Purpose: To analyze the clinical outcome and radiological features after surgical treatment of stage III giant cell tumor around the knee. Materials and Methods: 21 patients with stage III giant cell tumor around the knee joint, who were operated at our institutes between March 1991 and February 2000, were selected for this study. The average follow-up was 5.7 years (range, 1~9 years). After thorough curettage using high speed burr, cryosurgery and cementing with polymethymethacrylate (PMMA) were performed in 11 patients. 7 patients were treated with PMMA cementing (4 patients) or bone grafting (3 patients) after curettage without cryosurgery. Reconstruction with prosthesis composite allograft and knee fusion with Huckstep nail were performed in 3 patients with huge defect and joint perforation. Results: Local recurrence developed in 1 out of 11 patients who was treated with curettage and cementing with cryosurgery (9.1%) and 3 out of 7 patients who underwent curettage and cementing without cryosurgery (28.6%). Joint space narrowing more than 3mm was noted in 1 patient (9.1%), who treated with cryosurgery and anther patient (14.5%) who treated without cryosurgery. There was no local recurrence in case of wide resection and reconstruction. Conclusion: Thorough curettage and PMMA cementing with cryosurgery as an adjuvant is thought to be effective modalities in the treatment of stage 3 giant cell tumors around the knee. Wide resection and reconstruction can be reserved mainly for the cases of stage 3 giant cell tumor with significant cortical destruction and marked joint destruction, and the cases of local recurrence with poor bone stock.

• The Journal of the Korean bone and joint tumor society
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• v.10 no.2
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• pp.71-78
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• 2004

Purpose: The purpose of this study is to investigate the characteristic of recurred giant cell tumor after bony curettage and cementation, and to review a way to prevent the recurrence. Materials and Methods : Thirty seven cases were analyzed, which were pathologically diagnosed giant cell tumor after diagnostic biopsy or surgical excision, followed by curative curettage, burring and cementation. Location, character, and time interval to recurrence were reviewed. Results: Thirteen out of thirty seven analyzed cases(35%) showed recurrence after primary curettage and cementation. The mean interval to recurrence was sixteen months(5 months to 43 months). Most of recurrence happened within the first two years except two cases. Among the recurred cases, eleven showed recurrence in the vicinity of window area. Two cases recurred in the depth of bone marrow, where cementation was made. The advantage of curettage and cementation is the immediate stability of the operation site, early rehabilitation, and early detection of recurrence. Furthermore, cementation is beneficial in that the cement-producing heat can eradicate the residual tumor burden. In this study, 85% of cases with insufficient curettage (for example, in cases where too small surgical window was made, or where there were anatomical difficulty in approaching the target tumor burden) showed recurrence. Conclusion: Bony curettage, burring and cementation is widely used as the primary curative modality for giant cell tumor. A few other modalities such as chemical cautery using phenol and $H_2O_2$; cryotherapy; and anhydroalcohol have also been introduced, but the benefit of these are still questionable. For some cases that relatively small surgical window was made due to anatomically complicated structures (such as ligament insertion or origin site) over the target tumor burden, unsatisfactory curettage and burring was made. This study showed high chance of recurrence after unsatisfactory curettage, and 85% of recurrence developed in the vicinity of the small window area. Most of the recurrence occurred within the first two years. It is concluded that sufficient window opening, extensive curettage and eradicative burring are key factors to prevent recurrence. Also, it should be reminded that careful and close observation should be made for at least the first two years after initial treatment for early detection of recurrence.

• Journal of the Korean Society of Radiology
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• v.82 no.1
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• pp.250-254
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• 2021

Diffuse-type tenosynovial giant cell tumor (D-TSGCT), previously known as pigmented villonodular synovitis, is a locally aggressive neoplasm that may arise from the synovium, bursa, or tendon sheath. D-TSGCT is usually monoarticular and can be classified into intra- and extra-articular forms, the latter of which is rarer. Here, we report a case of D-TSGCT in a 64-year-old female that involved the entire flexor and extensor tendon sheaths of both wrists. We describe the ultrasonography and MRI findings, as well as review the relevant literature.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.17
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• pp.7689-7694
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• 2015

Background: Bone tumors are neoplasias with a high overall mortality; one of the main factors that reduce survival is their high capacity to develop metastases. It has been reported that finding lung metastases at diagnosis of osteosarcoma (OS), chondrosarcoma (CS) and giant cell tumor of bone (GCTb) is quite common. In this study, we inquire the relationship of metastases caused by these tumors with different clinical and pathological aspects, in order to guide medical personnel in the diagnosis and opportune treatment of metastases or micro metastases. Materials and Methods: We collected data of 384 patients with clinical, radiological and histopathological diagnosis of OS, GCTb and CS that attended the National Rehabilitation Institute (INR) during 2006 to 2014. Chi-square and Fisher's exact tests were performed for data analysis. Results: In the three tumor types, the presence of metastases at diagnosis was variable (p=0.0001). Frequency of metastases was 36.7%, 31.7% and 13.2% for OS, CS and GCTb respectively. The average age had no significant difference (p>0.05) in relation to metastases, even so, patients with OS and GCTb and metastases, were older while patients with CS and metastases were younger, in comparison to patients without metastases. Males had a higher frequency of metastases (68.2%, p = 0.09) in contrast to CS and GCTb, in which the metastases was more frequent in women with 51.9% (p = 0.44) and 57.9% (p = 0.56) respectively. Broadly, metastasis was associated with primary tumors located in the femur (44.4%), followed by the tibia (15.6%); metastases was more frequent when primary tumor of GCTb and OS were in the same bones, but were located in the hip (26.3%) for CS. Conclusions: The frequency of metastases in OS, GCTb and CS is high in our population and is determined by different clinicopathological variables related to the kind of tumor. Further studies are needed in order to evaluate metastases subsequent to diagnosis and associations with survival and clinicopathological factors, as well as to determine the sensitivity and specificity of current methods of detection.

• The Journal of the Korean bone and joint tumor society
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• v.7 no.1
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• pp.20-27
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• 2001

Purpose : The giant cell tumor of tendon sheath is the second most common tumor of the hand, but recurred frequently although excision was performed. Authors analyzed and would report clinical findings and postoperative results of it. Materials and Methods : Between January 1991 and December 1998, 38 patients, 41 cases which the authors had performed excisional biopsy to the mass in the hand and diagnosed with the giant cell tumor of tendon sheath, was analyzed with age, sex, chief complaint, symptom duration, involved finger, involved tendon, frequently developed site in fingers, size, multiplicity, radiologic findings and recurrence. The mean duration of follow-up was 13.1 months (5~40 months). Results : Of 38 patients, twenty-nine were female. It is frequent in the fourth decade and mean age was 40.1 years old. The neurological compression symptom was found in 5 cases. The mean duration of symptom was 23.4 months. Flexor tendon was involved in 24 cases. The distal interphalangeal joint area in digit was involved most frequently in 20 cases. Index finger was the most common involved finger (14 cases), and long finger was the second most common (9 cases). All tumors were unilateral. The majority of patients had solitary lesion but one case had multiple lesion. In the radiologic findings, erosion or pressure indentation of bone was seen in 3 cases. All patients were operated by marginal excision. Recurrence rate was 5.1%. Conclusion : The risk factors in giant cell tumor of tendon sheath were female, forth decade, index finger, flexor tendon, and distal interphalangeal joint area. The recurrence was increased in marginal excision of recurred cases, in cases with multiple developed lesions or in multilobular lesion, so wide surgical excision is necessary to prevent recurrence.

• BMB Reports
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• v.46 no.10
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• pp.507-512
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• 2013

Invasion of trophoblasts into maternal uterine tissue is essential for establishing mature feto-maternal circulation. The trophoblast invasion associated with placentation is similar to tumor invasion. In this study, we investigated the role of KAI1, an anti-metastasis factor, at the maternal-fetal interface during placentation. Mouse embryos were obtained from gestational days 5.5 (E5.5) to E13.5. Immunohistochemical analysis revealed that KAI1 was expressed on decidual cells around the track made when a fertilized ovum invaded the endometrium, at days E5.5 and E7.5, and on trophoblast giant cells, along the central maternal artery of the placenta at E9.5. KAI1 in trophoblast giant cells was increased at E11.5, and then decreased at E13.5. Furthermore, KAI1 was upregulated during the forskolin-mediated trophoblastic differentiation of BeWo cells. Collectively, these results indicate that KAI1 is differentially expressed in decidual cells and trophoblasts at the maternal-fetal interface, suggesting that KAI1 prevents trophoblast invasion during placentation.

• The Journal of the Korean bone and joint tumor society
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• v.3 no.1
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• pp.47-55
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• 1997

During the last decade, the use of primary amputation has decreased, and a larger number of patients are being treated with resection and reconstruction with limb preservation. The advantage of chemotherapy, improvements in diagnostic imaging methods and newer techniques for reconstruction have made limb salvage an alternative to amputation for most patients with malignant bone tumor. Clinical results and functional results of the limb salvage operation of bone tumors treated at the Department of Orthopaedic Surgery, Guro Hospital, Korea university was reviewed. Eighteen bone tumors(seven giant cell tumors and eleven malignant bone tumors.) were studied over a period of five years. The limb salvage group included fourteen endoprothesis, two pasteurized autograft, one near total scapulectomy and one rotationplasty. Functional evaluation was performed according to the Enneking's modified system. The results were as followed; 1. At a mean follow-up of thirty two months (15-77 months), fourteen(83%) of the eighteen patients with limb salvage procedures had been continuously disease free. 2. There are no local recurrence but deep infection developed in two patients and three patients with distant metastasis. 3. Thirteen(87%) of the fifteen patients showed above 60% of functional results. 4. Fourteen(93%) of the fifteen patients were satisfied with the limb salvage procedures.