• Tuberculosis and Respiratory Diseases
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• v.53 no.1
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• pp.46-51
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• 2002

Numb chin syndrome is a rare clinical manifestation, characterized by focal sensory loss and paresthesia of the chin. It is more often associated with cancer than with benign disorders, and can be the first manifestation of a cancer. A 60-year-old man presented with focal numbness of right chin and gingiva for 10 days. Chest computed tomograghy showed a 3 cm sized mass on the distal left main- stem bronchus. Squamous cell carcinoma was diagnosed on bronchoscopic biopsy. However, bony metastasis of mandible was not evident on reontgenogram, CT scan, bone scintigram and positron emission tomography. Despite the chemotherapy with three cycles of paclitaxel and cisplatinum, the cancer was progressed and pain on the right chin was developed 4 months later. Bone scintigram showed multiple bony metastasis including mandible. Here we report this case with a brief review of the appropriate literature.

• The Journal of the Korean bone and joint tumor society
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• v.14 no.2
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• pp.146-151
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• 2008

Multiple primary malignant neoplasm of the combination of the musculoskeletal system and the gastrointestinal system were very rare. A case of synchronous double primary malignant neoplasm consisted of myxofibrosarcoma of forearm and adenocarcinoma of rectum in a 52 year-old man was found. The patient had pain and swelling on forearm for 1 year. Histologically, the lesion on forearm showed myxofibrosarcoma. In systemic evaluation, the adenocarcinoma of rectum was found by the sigmoidoscopy, and metastasis on lung and intracardiac mass were found by the CT scan. We performed surgical excision and pre and postoperative chemotherapy after pathologic confirmation. He died of pulmonary thromboembolism after postoperative 2 months. We report this case of exceedingly rare combination of the musculoskeletal system and the gastrointestinal system.

• Tuberculosis and Respiratory Diseases
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• v.44 no.6
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• pp.1396-1402
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• 1997

Epithelioid Hemangioendothelioma(EH) is a rare vascular tumor, originating from endothelial cells. The principal locations are lung, soft tissue, bone and liver. This tumor is of borderline malignancy, relatively benign course. In the lung, the tumor is often multifocal, bilateral and frequently lead to the mistaken diagnosis of metastatic carcinoma. Although EH of the lung is relatively slow growing tumor, extensive pulmonary involvement, systemic metastasis, mainly to the liver have been documented. A 26-year-old man with EH involving the lung and liver was reported. Chest X-ray and chest CT showed multiple nodules in both lung fields and Abdominal CT multiple round low densities in liver. Transbronchial lung biopsy was performed. The patient diagnosed as EH by light microscopic finding and immunohistochemical study for Factor VIII-related antigen.

• Journal of the Korean Society of Radiology
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• v.85 no.1
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• pp.240-246
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• 2024

Epithelioid angiosarcoma is a rare variant of angiosarcoma characterized by an epithelioid morphology that mimics carcinoma. Therefore, multicentric epithelioid angiosarcoma is easily misdiagnosed as bone metastasis from carcinoma and has an aggressive clinical course. Here, we present a rare case of a 61-year-old male with multicentric epithelioid angiosarcoma of the bone. Plain radiography, CT, and MRI revealed multiple osteolytic lesions in both femurs; some lesions showed soft tissue extension with cortical bone destruction. Interestingly, PET-CT revealed that the lesions were only distributed along the bones of the lower extremities, including the pelvic bones, femurs, and tibiae. Despite histological analysis initially suggesting metastatic carcinoma, after additional immunohistological staining, including that for vascular markers (CD31 and ERG), the final diagnosis was epithelioid angiosarcoma. A better understanding of the clinicoradiological features of this disease may help eliminate diagnostic confusion and provide better management.

• Tuberculosis and Respiratory Diseases
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• v.57 no.6
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• pp.594-598
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• 2004

Signet ring cell carcinoma of lung is an unique variant of mucin producing adenocarcinoma which is characterized by abundant intracellular mucin accumulation. Only a few cases of primary signet ring cell carcinoma of lung have been reported in the world wide literature. And we have, recently experienced one case of primary signet ring cell carcinoma of lung. A 55 years old man was evaluated for paralysis of lower extremities and was found to have lung cancer in the left upper and lower lobe with pleural, multiple spinal, bone and liver metastases. Signet ring tumor cells were revealed by cytologic examination of pleural fluids. And there were no evidence of signet ring cell carcinoma of other organs. Primary signet ring cell carcinoma of lung seems to have an aggressive behavior and therapeutic modalities could be different from those for signet ring cell carcinomas from other organs. Therefore it is important to separate primary signet ring cell adenocarcinoma of lung from metastatic tumors.

• The Journal of the Korean bone and joint tumor society
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• v.1 no.2
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• pp.164-170
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• 1995

Eight patients with Ewing's sarcoma were treated between September 1983 and September 1992 at medical college, Department of Orthopaedic Surgery, Guro Hospital, Korea University. There were 5 males and 3 femails, with mean age of 28.2 years(ranging from 2-66 years). Three patients with soft tissue Ewing's tumor were excluded from the study. Of the eight patients, two patients presented with multiple metastasis, two cases occurred in the rib, and in the distal femur, mandible, scapular, 3rd, 4th thoracic spine in each patients. Chemotherapy alone was applied in 3 patients, radiotherapy alone in 1 patient, 2 patients were treated with chemotherapy and radiotherapy. Four patients died from the disease itself. Remissions were achieved in the other 4 patients. However, among them two patients relapsed 5 and 36 months later, I patient was not able to be followed, I patient died due to sepsis. The poor prognosis observed for patients with axial lesions should encourage other methods of managing these tumors.

• The Journal of Internal Korean Medicine
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• v.38 no.1
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• pp.72-80
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• 2017

Objective: The purpose of this study is to report the case of a patient with recurring non-small cell lung carcinoma (NSCLC) taking Samchilchoongcho-Jung with Afatinib. Methods: An NSCLC patient diagnosed with multiple bone and pulmonary metastasis was taking Afatinib (20 mg/day) and suffering from stomatitis caused by the Afatinib. The patient was treated with Samchilchoongcho-Jung (1,500 mg/ day) for 3 months. The tumor size was measured with computed tomography, and laboratory findings, including tumor markers (CEA, Cyfra 21-1), were also followed up. Stomatitis was measured by a numeric rating scale, and adverse events were evaluated using the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE), version 4.0. Results: After combined treatment, stable disease was shown on computed tomography. The tumor marker levels of CEA and Cyfra 21-1 were decreased, and the stomatitis significantly improved. NCI-CTCAE 4.0 showed no adverse events. Conclusion: This case study suggests that Samchilchoongcho-Jung may have a synergic effect, in conjunction with Afatinib, on the treatment of patients with recurring NSCLC.

• Journal of Chest Surgery
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• v.29 no.3
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• pp.346-349
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• 1996

This 32 year old female patient underwent left radical mastectomy due to ductal carcinoma on May 1990, and treated with FAM (5-fluorouracil, Adriamycin and Mitomycin C) regimen postoperatively. However, right cervical Iymph node enlargement and facial edema progressively developed since December 199). On April 1994, operation was performed, and findings were as followes; x4$\times$5$\times$7 to 1 : 1 $\times$ 1 cm sized multiple enlarged and hyperemic Iymph nodes were scatterred throughout submandibular area to the junction of superior vents cave and pericardium, and partially invaded both anterior segmental lobe, sternum and both distal tip of clavicles. After radical dissection of the nodes of neck and mediastinal nodes, and wedge resection of both anterior segments of lung, and partial resection of both clavicle tips and total sternum. The both innominate veins and superior vena cava were partially obstructed by invaded cancer SVC reconstruction was done with preclotted 10$\times$ 10$\times$ 18mm Y shap d woven Dacron graft, which was anastomosed to the point of the junction of subclavian vein and jugular vein after cross clamping both veins and 2cm above the pericardial junction with one arm clamp. After maintaining blood drainage to the SVC from the right side, left innominate vein was anastomosed with 4-0 Prolene continuous running suture. Bone cement was used for resected sternal portion and clavicular ends were fixed to postal portion with 18 Gauge wires. The patient was treated with radiation and chemotherapy after discharge, and there were no evidence of regrowing of the mass nor obstruction of the graft inspite of no antithrombotic therapy.

• The Journal of the Korean bone and joint tumor society
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• v.6 no.1
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• pp.17-21
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• 2000

Purpose : Dermatofibrosarcoma protuberans(DFSP) is a rare tumor of the skin with a strong tendency of infiltration to surrounding tissues. Inadequate surgical intervention brings about frequent recurrence and poor prognosis. We attempted to find a guideline for adequate treatment for DFSP. Materials and Methods : Fourteen cases who had been treated in our department since Mar. 1993 and followed up for more than 12 months postoperatively were reviewed. Including nine cases who were transferred from other hospital after recurrence, thirteen cases underwent wide resection. One case was treated by intralesional resection followed by chemotherapy (CYVADIC) due to neurovascular abutment to the mass in the inguinal area. Results : The nine cases who were transferred due to recurrences experienced recurrence in average 1.3(1-2) times and the average period until first local recurrence from primary operation was 11.8(2-24) months. The thirteen cases with wide surgical margin showed no recurrence at the final follow up. One case treated by intralesional resection and chemotherapy showed multiple recurrence and died of the disease due to lung metastasis. Conclusions : From these data, we could find that primary wide resection can be the way of reducing recurrence and metastasis, and the follow up period for the detection of recurrence should be at least two years.

• Radiation Oncology Journal
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• v.15 no.3
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• pp.233-241
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• 1997

Purpose : This study was done to evaluate the survival rate and Prognostic factors of patients with inoperable non-small cell lung cancer(NSCLC) treated with radiation therapy. Materials and Methods A retrospective analysis was undertaken of 62 Patients who had inoperable NSCLC treated with radiation therapy from January 1991 through December 1993. According to AJCC slaging, stage IIIA was 14 patients and stage IIIB was 48 patients. Forty Gy to 70.2Gy to the primary tumor site was delivered with daily fractions of 1.8Gy or 2Gy, 5days per week. Thirty-seven patients received neoadjuvant chemotherapy. Results : Complete, partial and no response to radiation therapy were 3 patients, 34 Patients and 25 patients, respectively The median survival period of all patients was 11 month. One rear survival rate, 2 year survival rateand 5 rear survival rate for all patients were 45.0%, 14.3%, and 6.0% respectively The median survival period was 6.5 months in stage IIIA and 13 months in stage IIIB. One year survival rates were 28.6% in stage IIIA and 50.3% in stage IIIB In univariaite analysis, prognostic factors affecting survival were T-s1aging, AJCC staging, and response after radiation therapy (P<0.05) . Pretreatment peformance status affected survival but was not statistically significant (0.050.1). In multivariate analysis, Pathology and response to radiation therapy are independently significant prognostic factor. T stage was marginally significant (P=0.0809). During follow-up duration, distant metastasis developed in 20 patients-bone metastasis in 10 patients, brain metastasis in 3 patients, liver mentastasis in 3 patients, contralateral lung metastasis in 1 patients and multiple metastases in 3 patients. Conclusion :　Conventional radiotherapy alone or combined chemoradiotherapy are unlikely to achieve long term survival in patients with NSCLC.　Surgery after concurrent chemoradiotherapy is Ivied to improve the local　control in our hospital