• Archives of Plastic Surgery
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• v.36 no.4
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• pp.417-421
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• 2009

Purpose: Dermatofibrosarcoma protuberans(DFSP) is a moderate - degree malignant tumor of soft tissue from dermis to fat layer with high recurrences(11% to 73%) due to its local infiltrative characteristic. Many debates and controversies in deciding accurate surgical margin were presented before, but references about depth of invasion and appropriate surgical excision level were not properly made out. Therefore, we tried to identify the degree of tissue invasion of DFSP. Methods: Twenty patients, including 8 patients with recurrent lesions, over last 10 years were reviewed retrospectively. Different surgical margins were applied according to the location and based on histopathologic result, we have defined as a 'deep tissue invasion' if there were infiltration of tumor cell into fascia or underlying muscle layer was present. All invaded tissue including dermis, fat, fascia and muscle were excised until no tumor cell was found during intraoperative frozen section biopsy. And comparative analysis of deep tissue invasion according to age, primary site, duration of disease and recurrence was done. Results: Thirteen patients(65%) showed deep tissue invasion and incidence was found to be increasing with age(over 30 years old). All patients with DFSP on head and neck region revealed deep tissue invasion followed by trunk(54%) and lower extremities(50%). There was no relationship between duration of disease and deep tissue invasion. Conclusions: It is clear that many cases of DFSP had a deep tissue invasion. And high prevalence of deep tissue invasion with age, primary site was intimately associated. So, underlying deep tissue must be completely examined and excised sufficiently throughout the operation for clear resection of DFSP with no recurrences, especially when age is over 30s and on head and neck region.

• Radiation Oncology Journal
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• v.25 no.4
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• pp.278-282
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• 2007

Purpose: Diffuse pigmented villonodular synovitis (PVNS) is an uncommon aggressive synovial proliferative disorder of unknown etiology affecting the joint linings. Though a histologically benign inflammatory process, because of its aggressive growth with bone destruction or recurrence, it is frequently suggested to occur as a low malignant neoplasm. Optimal treatment is surgery, but the local recurrence rate after radical synovectomy for diffuse PVNS is relatively high due to the infiltrative growth pattern. External beam radiotherapy with moderate doses or intra-articular instillation of radioactive isotopes may improve the likelihood of local control and long-term function in patients with incompletely resected or recurrent diffuse PVNS. I report one case of diffuse PVNS of the right knee joint treated with arthroscopic synovectomy and external beam radiotherapy is presented.

• Parasites, Hosts and Diseases
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• v.51 no.3
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• pp.335-341
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• 2013

Balamuthia mandrillaris is one of the 4 amebas in fresh water and soil that cause diseases in humans. Granulomatous amebic encephalitis (GAE), caused by B. mandrillaris, is a rare but life-threatening condition. A 4-year-old, previously healthy, Thai girl presented with progressive headache and ataxia for over a month. Neuroimaging studies showed an infiltrative mass at the right cerebellar hemisphere mimicking a malignant cerebellar tumor. The pathological finding after total mass removal revealed severe necrotizing inflammation, with presence of scattered amebic trophozoites. Cerebrospinal fluid (CSF) obtained from lumbar puncture showed evidence of non-specific inflammation without identifiable organisms. A combination of pentamidine, sulfasalazine, fluconazole, and clarithromycin had been initiated promptly before PCR confirmed the diagnosis of Balamuthia amebic encephalitis (BAE). The patient showed initial improvement after the surgery and combined medical treatment, but gradually deteriorated and died of multiple organ failure within 46 days upon admission despite early diagnosis and treatment. In addition to the case, 10 survivors of BAE reported in the PubMed database were briefly reviewed in an attempt to identify the possible factors leading to survival of the patients diagnosed with this rare disease.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.31 no.1
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• pp.1-6
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• 2005

It becomes more concerned that the cell adhesion molecule plays an important role in the process of malignant transformation and tumor behaviors including invasive growth and metastasis. It is postulated if the expression of adhesion molecule is reduced in tumor tissue, the tumor cell will be undifferentiated and lose their cell adhesion ability and polarity. So the tumor cells lost the adhesion of cell to cell and to basement membrane that they became more aggressive. Reduced cadherin expression enhances invasiveness through infiltrative growth and metastasis of tumor cells is well known and mostly accepted in many epithelia tumors. We explored the expression of E-cadherin by immunohistochemical staining in 50 oral squamous cell carcinomas and investigated the correlation between the expression of E-cadherin and clinicopathologic parameters and prognosis. The expression of E-cadherin was reduced in 40/50(80%) of primary tumors, and 21/22(95.5%) of lymph nodes. The reduced expression of the E-cadherin was associated with lymph node metastasis(P=0.029), invasive mode(P=0.030) and marginal status(P=0.038). Survival analysis showed that predictive period of E-cadherin reduced group(37 months) was lower than that of E-cadherin preserved group(60 months), but there was no statistical significant difference.

• Journal of Korean Traditional Oncology
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• v.18 no.1
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• pp.1-7
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• 2013

Objective : This study is purposed to report 2 cases of cancer patient whose symptoms related to radiation pneumonitis had been controlled with Saengmaek-san treatment. Methods : A 56-year-old female rectal cancer patient was prescribed with Saengmaek-san due to the symptoms which had developed 4 weeks after the completion of her radiotherapy session in both lungs. Her chief complaints were shortness of breath, dry cough and fatigue. Another case, 53-year-old male patient with hepatocellular carcinoma, had also developed symptoms of fatigue, weight loss and dry cough after his radiotherapy session in left upper lung zone. Radiological changes of both patients' chest X-ray suggested radiation pneumonitis. Results : Symptoms of the female patient were improved, especially shortness of breath, after Saengmaek-san treatment, without any aggravation in her chest X-ray result. However, infiltrative opacity in the left upper lung zone of the male patient was aggravated despite the improvement of his clinical symptoms. His remaining symptoms and radiological change were effectively controlled after steroid therapy. Conclusion : Seangmaek-san may be considered as a potential treatment for symptoms related to radiation pneumonitis with proper monitoring.

• Tuberculosis and Respiratory Diseases
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• v.43 no.3
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• pp.467-471
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• 1996

We report a case of a 20-year-old woman who presented with fever, dry cough and pulmonary consolidation at the left upper lobe on chest radiograph. Fiberoptic bronchoscopy revealed obstruction of the left upper lobar bronchus with exophytic mass and multiple nodular protruding lesions at the left main bronchus. Endobronchial actinomycosis was confirmed by demonstration of sulfur granule through the bronchoscopic biopsy of nodular lesion. Intravenous administration of penicillin G followed by oral tetracycline therapy for 5 months resulted in complete recovery of symptoms which had been present for 3 months prior to therapy. Infiltrative consolidation on the chest X-ray disappeared and all the lesions shown by bronchoscopy were nearly normalized after 6 months only to remain small nodular remnants at the left main bronchus. Endobronchial actinomycosis should be included in the differential diagnosis of endobronchial mass.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.28 no.5
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• pp.348-352
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• 2002

Ameloblastoma of the maxilla is an unusual epithelial tumor of odontogenic origin. According to many authors and reports, ameloblastoma account for approximately 1% of all tumors of the jaws, but when pseudotumors and cysts are excluded, the ratio rises to 11%. Of these tumors,80% originate in the mandible, while 20% originate in the maxilla. Although it is considered benign histopathologically, it can behave in a slowly growing infiltrative fashion, with multiple recurrences and eventual intracranial, or even distant, spread. We clinically analyzed common site in maxilla, radiographic findings, recurrence rate, duration between treatment and recurrence, the presence and site of distant metastasis in 15 patients who were diagnosed as ameloblastoma of the maxilla and took treatments from 1985 to 1999 in Dept. of Oral and Maxillofacial Surgery, Dental Hospital, Seoul National University. In this paper, treatment outcomes and our clinical experiences of maxillary ameloblastoma are reported with review of literatures.

• Imaging Science in Dentistry
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• v.36 no.3
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• pp.169-175
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• 2006

The Inflammatory myofibroblastic tumor (inflammatory pseudotumor) is a rarely occurring soft tissue lesion of unknown etiology. It can be of any location, but commonly it is found in lungs. It has been considered as a nonneoplastic reactive inflammatory lesion, but nowadays, confusion and dispute about its character is increasing due to its high recurrence rate and metastasis. We present a patient who had been diagnosed with an inflammatory pseudotumor in the right maxilla area, 1 year before visiting our hospital. After that, her pain and swelling did not resolved and she visit our hospital. On radiographic examination, aggressively infiltrative growth of the lesion with destruction of adjacent bony structure was noted. We found unusual aggressiveness of the inflammatory myofibroblastic tumor of the head and neck region. Because the typical behavior of the inflammatory myofibroblastic tumor is not defined yet, we recommend the surgical excision of the lesion and close follow-up.

• The Journal of the Korean bone and joint tumor society
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• v.15 no.1
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• pp.65-68
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• 2009

Proliferating trichilemmal tumor(PTT) is a rare neoplasm derived from the outer root sheath of the hair follicle. Malignant transformation is rare, but abrupt enlargement of size, infiltrative growth, and non-scalp location are suggestive of malignant PTT. Histopathologic characteristics of malignant PTT are nuclear atypia, pleomorphism, and mitotic figures. Recurrence and metastasis have been documented in malignant PTT. Wide resection of the tumor with the normal tissue and accurate follow-up is the treatment of choice of the both malignant and benign PTT. We report a 51-year-old man with the mass on right 5th finger distal phalanx for 7 years. The tumor was excised with middle phalangiectomy, and based on the histopathologic findings of the tumor, this case was diagnosed as mailignant PTT. We cannot detect recurrence and metastasis because the patient was lost to follow-up.

• Journal of Yeungnam Medical Science
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• v.31 no.2
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• pp.131-134
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• 2014

Familial isolated primary hyperparathyroidism(FIPH) is associated with multiple endocrine neoplasia type 1 (MEN1) syndrome, primary hyperparathyroidism accompanied by jaw-tumor syndrome, and familial hypocalciuric hypercalcemia. FIPH may be an early stage of MEN1 or an allelic variant of MEN1. Thymic carcinoid tumor is a rare tumor in MEN1 syndrome. Here, the authors report the case of a 40-year-old man diagnosed with recurrent thymic carcinoid tumor and FIPH. Both the patient and his elder sister had been previously diagnosed to have FIPH with a novel frameshift mutation in the MEN1 gene. Initially, the patient underwent thymectomy because of an incidental finding of a mediastinal mass in his chest X-ray, and had remained asymptomatic over the following 4 years. Pancreas computed tomography conducted to evaluate MEN1 syndrome revealed anterior and middle mediastinal masses, and resultantly, massive mass excision was performed. Histological findings disclosed atypical carcinoids with infiltrative margins. In view of the thymic carcinoid tumor relapse that occurred in this patient, the authors recommend that regular pancreas and pituitary imaging studies be conducted for FIPH associated with a MEN1 gene mutation.