• Title/Summary/Keyword: Midline

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Midline dermoid cyst of the upper lip: case report (상순 정중부에 발생한 유표피낭종: 증례보고)

  • Koh, Se-Wook
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.37 no.5
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    • pp.403-405
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    • 2011
  • Midline craniofacial dermoids are rare lesions resulting from the abnormal fusion of embryologic structures. The clinical features of craniofacial dermoid cysts show a range of presentations, including infection, asymptomatic puncti, or seizure secondary to intracranial invasion. Appropriate management involves an accurate diagnosis of the dermoid cyst and a complete resection.

Two Cases of Dermoid Cyst Inducing Dyspnea (호흡곤란을 유발한 유피낭포 2례)

  • 정동학;조정일;김영진;윤정선
    • Korean Journal of Bronchoesophagology
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    • v.3 no.1
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    • pp.181-184
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    • 1997
  • A dermoid cyst is a rare congenital midline neck mass with usually develops in the submental region. It is most often seen in young adults and can become rather large than almost no symptoms. As it increases in size, dysphasia, or dyspnea can develop. The differential diagnosis of the midline lesion includes ranula, thymglossal duct cyst, cystic hygroma, and cystic lymphangioma. The treatment of choice is complete surgical removal. With a review of the literature, we report two cases of a huge dermoid cyst inducing dyspnea.

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Factors Associated Postoperative Hydrocephalus in Patients with Traumatic Acute Subdural Hemorrhage

  • Kim, Han;Lee, Heui Seung;Ahn, Sung Yeol;Park, Sung Chun;Huh, Won
    • Journal of Korean Neurosurgical Society
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    • v.60 no.6
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    • pp.730-737
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    • 2017
  • Objective : Postoperative hydrocephalus is a common complication following craniectomy in patients with traumatic brain injury, and affects patients' long-term outcomes. This study aimed to verify the risk factors associated with the development of hydrocephalus after craniectomy in patients with acute traumatic subdural hemorrhage (tSDH). Methods : Patients with acute traumatic SDH who had received a craniectomy between December 2005 and January 2016 were retrospectively assessed by reviewing the coexistence of other types of hemorrahges, measurable variables on computed tomography (CT) scans, and the development of hydrocephalus during the follow-up period. Results : Data from a total of 63 patients who underwent unilateral craniectomy were analyzed. Postoperative hydrocephalus was identified in 34 patients (54%) via brain CT scans. Preoperative intraventricular hemorrhage (IVH) was associated with the development of hydrocephalus. Furthermore, the thickness of SDH (p=0.006) and the extent of midline shift before craniectomy (p=0.001) were significantly larger in patients with postoperative hydrocephalus. Indeed, multivariate analyses showed that the thickness of SDH (p=0.019), the extent of midline shift (p<0.001) and the coexistence of IVH (p=0.012) were significant risk factors for the development of postoperative hydrocephalus. However, the distance from the midline to the craniectomy margin was not an associated risk factor for postoperative hydrocephalus. Conclusion : In patients with acute traumatic SDH with coexisting IVH, a large amount of SDH, and a larger midline shift, close follow-up is necessary for the early prediction of postoperative hydrocephalus. Furthermore, craniectomy margin need not be limited in acute traumatic SDH patients for the reason of postoperative hydrocephalus.

Midline Involvement as a Risk Factor for Vulvar Cancer Recurrence

  • Stankevica, Jekaterina;Macuks, Ronalds;Baidekalna, Ieva;Donina, Simona
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.10
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    • pp.5237-5240
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    • 2012
  • Objective: This observational study was to identify risk factors for vulvar cancer recurrence. Materials and Methods: In the study 107 patients with primary vulvar cancer were analyzed. Surgical treatment consisted of radical excision of the primary tumor in combination with unilateral or bilateral superficial and deep inguinofemoral lymphadenectomy through separate incisions. Patients with deeper tumor invasion >1 mm or wider than 2 cm and/or groin lymphnode metastases were referred for adjuvant radiotherapy. Those with large privary vulvar tumors received neoadjuvant radiotherapy of 30Gy followed by surgical treatment and adjuvant radiotherapy. Results: Most of patients had only primary radiotherapy to the vulva and inguinal lymph nodes and only 34.5% of patients were eligible for surgical treatment. In 5 year follow-up period 25.2% (27) patients were alive without the disease, 15.0% (16) were alive with the disease and 59.8% (64) were dead. 60.7% (65) patients experienced local recurrence and 2.8% (3) patients had distant metastases. Median survival for patients without recurrent disease was $38.9{\pm}3.2$ months and $36.0{\pm}2.6$ months with no statistically significant difference. Patients with early stage vulvar cancer had longer mean survival rates-for stage I $53.1{\pm}3.4$ months, $38.4{\pm}4.4$ months for stage II and $33.4{\pm}2.6$ and $15.6{\pm}5.2$ months for patients with stage III and stage IV vulvar cancer, respectively. The only signifficant prognostic factor predicting vulvar cancer recurrence was involvement of the midline. Conclusions: Patients having midline involvement of vulvar cancer has lower recurrence risk, probably because of receiving more aggressive treatment. There is a tendency for lower vulvar cancer recurrence risk for patients over 70 years of age and patients who are receiving radiotherapy as an only treatment without surgery, but tendency for higher risk of recurrence in patients with multifocal vulvar cancer.

Three-dimensional evaluation of the mandibular symphyseal region in block graft harvesting for dental implants using cone-beam computed tomography

  • Gandhi, Vaibhav;Lowney, Arianna;Cardarelli, Lauren;Yadav, Sumit;Tadinada, Aditya
    • Imaging Science in Dentistry
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    • v.50 no.3
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    • pp.217-226
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    • 2020
  • Purpose: The purpose of this study was to analyze the quantity and quality of the mandibular anterior alveolar bone in terms of alveolar width, density, and total alveolar height (TAH) based on dental status, gender, and age. Additionally, this study aimed to quantitatively evaluate the available alveolar height for graft harvesting (AHGH) and examine its variability based on the aforementioned factors. Materials and Methods: This retrospective cone-beam computed tomographic study included a total of 100 subjects. On the basis of gender, dental status, and age, the scans were divided into 3 primary groups and 8 subgroups. The mandibular alveolar width and density were measured 5 mm mesial to the mental foramen bilaterally and at the midline. The TAH was measured at the midline, and the AHGH was measured as the midline distance between 5 mm apical to the root of the canines and 5 mm superior to the lower border. Results: The mandibular alveolar width was statistically similar between dentulous and edentulous patients (P>0.05). A significantly greater density was observed at the midline in edentulous patients (P<0.05). The TAH was significantly greater in edentulous male patients than in edentulous female patients (P<0.05). Dentulous and male patients had significantly greater AHGH than edentulous and female patients, respectively (P<0.05). Conclusion: Based on the data evaluated in this study, it can be concluded that the mandibular symphyseal area has adequate bone quality and quantity for bone graft harvesting for dental implant therapy.

Leptomeningeal Metastasis in Gliomas : Clinical Characteristics and Risk Factors

  • Jeyul Yang;Ji-Woong Kwon;Sang Hoon Shin;Heon Yoo;Kyu-Chang Wang;Sang Heyon Lee;Ho-Shin Gwak
    • Journal of Korean Neurosurgical Society
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    • v.66 no.4
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    • pp.465-475
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    • 2023
  • Objective : Our objective is to analyze the occurrence, clinical course and risk factors for glioma patients with leptomeningeal metastasis (LM) according to different metastasis patterns and clinical variables. Methods : We retrospectively reviewed data from 376 World Health Organization (WHO) grade II-IV adult glioma patients who were treated in the National Cancer Center from 2001 to 2020. Patients who underwent surgery at other institutions, those without initial images or those with pathologically unconfirmed cases were excluded. LM was diagnosed based on magnetic resonance imaging (MRI) findings or cerebrospinal fluid (CSF) cytology. The metastasis pattern was categorized as nodular or linear according to the enhancement pattern. Tumor proximity to the CSF space was classified as involved or separated, whereas location of the tumor was dichotomized as midline, for tumors residing in the thalamus, basal ganglia and brainstem, or lateral, for tumors residing in the cerebral and cerebellar hemispheres. Results : A total of 138 patients were enrolled in the study. A total of 44 patients (38%) were diagnosed with LM during a median follow-up of 9 months (range, 0-60). Among the clinical variables, tumor proximity to CSF space, the location of the tumor and the WHO grade were significant factors for LM development in univariate analysis. In multivariate analysis, the midline location of the tumor and WHO grade IV gliomas were the most significant factor for LM development. The hazard ratio was 2.624 for midline located gliomas (95% confidence interval [CI], 1.384-4.974; p=0.003) and 3.008 for WHO grade IV gliomas (95% CI, 1.379-6.561; p=0.006). Conclusion : Midline location and histological grading are an important factor for LM in glioma patients. The proximity to the CSF circulation pathway is also an important factor for WHO grade IV glioma LM. Patients carrying high risks should be followed up more thoroughly.

Radiologic Manifestations of Pulmonary Nuclear Protein in Testis Midline Carcinoma: A Case Report (폐에 발생한 고환 핵단백질 정중선 암의 영상의학적 소견: 증례 보고)

  • Jung A Kim;Mi-jin Kang;Jung Yeon Kim;Ji-Young Kim;Soung Hee Kim;Myeong Ja Jeong;Ji Hae Lee
    • Journal of the Korean Society of Radiology
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    • v.84 no.2
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    • pp.498-503
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    • 2023
  • Nuclear portein in testis (NUT) midline carcinoma is a very rare and low-differentiating malignant epithelial tumor that differentiates very aggressively and has poor prognosis. NUT midline carcinoma occurring in the lungs in particular can be confused with other cancers because few cases have been reported in Korea to date and can show various histological forms. Reports of radiology findings are very rare worldwide. Here we report the imaging findings of pulmonary NUT midline carcinoma in a 25-year-old female along with pathological findings.

Eosinophilic Granuloma Presenting as an Epidural Hematoma and Cyst

  • Lee, Young-Suk;Kwon, Jeong-Taik;Park, Yong-Sook
    • Journal of Korean Neurosurgical Society
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    • v.43 no.6
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    • pp.304-306
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    • 2008
  • Langerhans' cell histiocytosis (LCH) is a rare immunologic disorder characterized by histiocyte proliferation in multiple organ systems. Eosinophilic granuloma, a benign bone lesion, represents a focal form of LCH. We experienced a case of Langerhans' cell histiocytosis in a patient who presented with intracranial epidural hematoma and cyst on the midline of the frontal skull. A 10-year-old boy presented with a rapidly growing large scalp mass on the midline frontal area after mild head trauma. The scalp mass was painless and immobile. Plain skull x-ray showed a punched-out bone lesion. Computed tomography and magnetic resonance imaging showed a non-enhancing osteolytic lesion presenting with an epidural hematoma and cyst on the midline of the frontal skull. The lesion of the skull was completely resected and the patient's recovery was uneventful. The acute presentation of a solitary eosinophilic granuloma of skull with an epidural hematoma has been described in only five cases in the literature and we report the first case of LCH presenting as an intracranial epidural hematoma on frontal area.

Surgery of a Solid Hemangioblastoma at the Cervicomedullary Junction

  • Kim, Tae-Won;Jung, Shin;Jung, Tae-Young;Kang, Sam-Suk
    • Journal of Korean Neurosurgical Society
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    • v.40 no.2
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    • pp.117-121
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    • 2006
  • The surgical removal of solid deep-seated hemangioblastomas remains challenging, because treatment of these lesions is often complicated by severe bleeding associated with the rich vascularity of this tumor, and by severe neural tissue injury associated with the difficulty of en bloc resection, especially when the tumor is located at the cervicomedullary junction. Therefore, preoperative embolization of deep-seated solid hemangioblastomas may play an important role in successful surgical removal by reducing major bleeding and neural tissue damage. A 24-year-old woman, 28-weeks pregnant, was admitted to our hospital for the evaluation of quadriparesis, and brain magnetic resonance imaging[MRI] revealed intra-axial mass lesion in the cervicomedullary junction. After delivery, her neurologic symptoms became aggravated, and we decided to operate. Preoperative angiography revealed a hypervascular tumor in the posterior fossa, and embolization of the main feeding artery using gelfoam and microcoil, resulted in marked reduction of tumor vascularity. She underwent a midline suboccipital craniotomy involving the removal of the arch of C-1. The tumor was totally removed through a midline myelotomy, and at her 6-month follow-up she walked independently. We report on the combined use of the preoperative embolization of feeding vessels and subsequent operative resection in a patient with a solid hemangioblastoma at the cervicomedullary junction immediately after delivery.