• Brain Tumor Research and Treatment
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• v.6 no.2
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• pp.68-72
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• 2018

We report a rare case of arachnoid granulations mimicking multiple osteolytic bone lesions. A 66-year-old woman was admitted to a local clinic for a regular checkup. Upon admission, brain CT showed multiple osteolytic lesions in the occipital bone. These needed to be differentiated from multiple osteolytic bone tumor. Subsequent brain MRI revealed that the osteolytic lesions were isointense to cerebrospinal fluid, hyperintense on T2-weighted image, hypointense on T1-weighted image, and with subtle capsules around the osteolytic lesions that were visible after gadolinium injection. A bone scan revealed no radiotracer uptake. The lesions were in both the transverse sinuses and the torcular herophili. With typical radiological appearances of the lesions, the osteolytic lesions were diagnosed as multiple arachnoid granulations. No further treatment was planned. A 1-year follow-up brain CT scan revealed no change. We should consider the possibility of arachnoid granulations when multiple osteolytic lesions are observed in the occipital bone.

• Archives of Craniofacial Surgery
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• v.18 no.3
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• pp.191-196
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• 2017

Basal cell carcinoma (BCC) comprising several lesions is not uncommon, but nonsyndromic multiple BCCs with parotid invasion are rare entities. We present two cases of multiple sporadic, nonsyndromic BCCs, and one of these cases is a unique case of parotid invasion associated purely with actinic keratosis. In Case 1, a 79-year-old female presented with multiple skin lesions on the face and left hand. All lesions were completely removed by surgery. The pathologic results showed lesions consistent with BCC and some lesions consistent with actinic keratosis. After 8 months, the patient presented with skin lesions in bilateral temporal areas and left cheek area. Surgical excision of the lesions was performed, and the biopsy results were squamous cell carcinoma in situ and actinic keratosis. In Case 2, a 43-year-old woman presented with multiple skin lesions on the face, scalp, right chest, abdomen and right leg. All lesions were completely removed by surgery. Pathologic evaluation confirmed the diagnosis of BCC. BCC is rarely metastatic, but it can lead to severe disfiguration or destruction. It is important to diagnose and treat BCC at an early stage.

• Journal of Korean Neurosurgical Society
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• v.52 no.4
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• pp.334-338
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• 2012

Objective : We compared the survival time between patients with multiple gamma knife radiosurgery (GKRS) and patients with a single GKRS plus whole brain radiation therapy (WBRT), in patients with multiple metachronous brain metastases from lung cancer. Methods : From May 2006 to July 2010, we analyzed 31 patients out of 112 patients who showed multiple metachronous brain metastases. 20 out of 31 patients underwent multiple GKRS (group A) and 11 patients underwent a single GKRS plus WBRT (group B). We compared the survival time between group A and B. Kaplan-Meier method and Cox proportional hazards were used to analyze relationship between survival and 1) the number of lesions in each patient, 2) the average volume of lesions in each patient, 3) the number of repeated GKRS, and 4) the interval of development of new lesions, respectively. Results : Median survival time was 18 months (range 6-50 months) in group A and 6 months (range 3-18 months) in group B. Only the average volume of individual lesion (over 10 cc) was negatively related with survival time according to Kaplan-Meier method. Cox-proportional hazard ratio of each variable was 1.1559 for the number of lesions, 1.0005 for the average volume of lesions, 0.0894 for the numbers of repeated GKRS, and 0.5970 for the interval of development of new lesions. Conclusion : This study showed extended survival time in group A compared with group B. Our result supports that multiple GKRS is of value in extending the survival time in patients with multiple metachronous brain metastases, and that the number of the lesions and the frequency of development of new lesions are not an obstacle in treating patients with GKRS.

• Journal of Korean Neurosurgical Society
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• v.30 no.5
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• pp.622-626
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• 2001

Acute disseminated encephalomyelitis(ADEM) is an uncommon immune-mediated inflammatory demyelinating disorder that typically affects the white matter of the central nervous system. Radiologic findings of acute disseminated encephalomyelitis are not pathognomomic. The differential diagnosis is always difficult. Occasionally, the clinical features, radiological and histopathological findings of patients with acute disseminated encephalomyelitis mimic the brain tumor or other space occupying lesions. The authors report a 6-year-old girl who presented with right hemiparesis two days after nausea and vomiting. Brain MRI of the patient revealed non-enhanced multiple cystic lesions in subcortical white matter of both cerebral hemisphere with prominent edema. One of the cystic lesions was resected to differentiate with metastatic tumor or inflammatory disease such as abscess and confirmed as the acute disseminated encephalomyelitis via various immunohistochemical stains. Pertinent literature is reviewed with discussion on this uncommon ADEM associated with multiple cystic lesions.

• Korean Journal of Veterinary Service
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• v.24 no.2
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• pp.139-146
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• 2001

To examine the prevalence and types of kidney lesions in Korean cattle, a survey was carried out at a abattoir in september 2000 and January 2001. The collected kidneys were examined grossly and histopathologically and investigated for the patterns of renal diseases with considering season and sex. Of 735 cattle (99 bulls and 246 cows in September and 140 bulls, 3 steers, and 247 cows in January) surveyed, 301 (41%) cattle had various renal lesions. The most common prominent finding was focal or multiple interstitial nephritis (36.2%). Other lesions included focal or multiple renal cyst (9.1%), infarction (0.1%), hemorrhage (0.3%), and renal atrophy (0.3%). Microscopically, main pathological lesions were acute or chronic interstitial nephritis with moderate infiltration of neutrophil or lymphocyte, respectively. Finally, the kidney lesions are more or less correlated with the meat quality, especially in female Korean cattle.

• Imaging Science in Dentistry
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• v.51 no.4
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• pp.461-466
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• 2021

Fibro-osseous lesions are a poorly defined category of conditions affecting the jaws and craniofacial bones, and include developmental lesions, reactive or dysplastic lesions, and neoplasms. Fibrous dysplasia and ossifying fibroma are the 2 main types of fibro-osseous lesions affecting the jaw, and ossifying fibroma is a true benign neoplasm of the bone-forming tissues with several well-recognized variants ranging from innocuous to extensively aggressive lesions. However, multiple simultaneous fibro-osseous lesions of the jaw bones involving all quadrants are exceedingly rare. One such case diagnosed by conventional radiography and computed tomography is discussed here.

• Radiation Oncology Journal
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• v.34 no.1
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• pp.59-63
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• 2016

Purpose: To evaluate the clinical outcomes of symptomatic bone lesions in patients with multiple myeloma (MM) who received local radiotherapy (LRT). Materials and Methods: Fifty-one patients with 87 symptomatic bone lesions treated via LRT were analyzed. LRT was delivered at a median total dose of 21 Gy (range, 12 to 40 Gy) in a median of 7 fractions (range, 4 to 20 fractions). The clinical outcomes of LRT and the factors affecting treatment response were assessed. Results: After a median follow-up time of 66.7 weeks, symptom relief was achieved for 85 of 87 lesions (97.7%). The median time to symptom relief was 7 days from the start of LRT (range, 1 to 67 days). The duration of in-field failure-free survival ranged from 1.1 to 450.9 weeks (median, 66.7 weeks). The radiation dose or use of previous and concurrent chemotherapy was not significantly associated with in-field failure for LRT (p = 0.354, 0.758, and 0.758, respectively). Conclusion: Symptomatic bone lesions in patients with MM can be successfully treated with LRT. A higher radiation dose or the use of concurrent chemotherapy may not influence the in-field disease control. A relatively low radiation dose could achieve remission of symptoms in patients with MM.

• Korean Journal of Head & Neck Oncology
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• v.39 no.1
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• pp.23-26
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• 2023

Basal cell carcinoma (BCC) is the most common skin cancer. Ultraviolet radiation exposure and genetic predisposition are known to be the most important etiological factors. Multiple BCC is often associated with genetic familial conditions such as BCC syndrome, basal cell nevus syndrome. We present a case of 54-year-old female who had multiple BCC that had reoccurred. She was completely cured after receiving radio-chemotherapy for leukemia 16 years ago. She had multiple lesions (scalp, left thigh, right popliteal fossa, and right buttock), and had underwent wide excisions of all lesions. All biopsies revealed BCC. Six years later, she had also multiple lesions; left forehead, frontal vertex scalp, parietal vertex scalp, right occipital scalp, and lower abdomen. We performed wide excision. Histopathological examination revealed BCC. She had no signs of any BCC associated syndrome. We report a rare case of nonsyndromic multiple BCC that reoccurred at the new site.

• Archives of Craniofacial Surgery
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• v.19 no.3
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• pp.194-199
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• 2018

Background: Cases of simultaneous multiple skin cancers in a single patient have become more common. Due to the multiplicity of lesions, reconstruction in such cases is more difficult than after a single lesion is removed. This study presents a series of patients with multiple facial skin cancers, with an analysis of the surgical removal, reconstruction process, and the results observed during follow-up. Methods: We reviewed 12 patients diagnosed with multiple skin cancers on the face between November 2004 and March 2016. The patients' medical records were retrospectively reviewed to identify the type of skin cancer, the site of onset, methods of surgical removal and reconstruction, complications, and recurrence during follow-up. Results: Nine patients had a single type of cancer occurring as multiple lesions, while three patients had different skin cancer types that occurred together. A total of 30 cancer sites were observed in the 12 patients. The most common cancer site was the nose. Thirteen defects were reconstructed with a flap, while 18 were reconstructed with skin grafting. The only complication was one case of recurrence of basal cell carcinoma. Conclusion: Multiple skin cancers are removed by performing Mohs micrographic surgery or wide excision, resulting in multiple defect sites. The authors emphasize the importance of thoroughly evaluating local lesions surrounding the initially-identified lesions or on other sites when reconstructing a large defect which can not be covered by primary closure. Furthermore, satisfactory results can be obtained by using various methods simultaneously regarding the condition of individual patients, the defect site and size, and the surgeon's preference.

• Journal of Korean Neurosurgical Society
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• v.38 no.3
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• pp.184-189
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• 2005

Objective : Hemangioblastomas are highly vascular and benign neoplasm of the central nervous system[CNS]. They can often be found as multiple lesions, as is commonly observed in von Hippel-Lindau[VHL] disease. The aim of this study is to determine the proper management for multiple hemangioblastomas. Methods : Since 1990, 78cases of hemangioblastoma have been encountered. Among these, 9cases were multiple hemangioblastomas that were treated with surgical resection with or without radiosurgery. The medical, radiological, surgical and histological records were reviewed retrospectively and analyzed statistically. Results : Nine patients presented with multiple hemangioblastomas and were diagnosed as VHL disease. The mean follow-up duration was 75.7months [$6.6{\sim}159.2months$] after the first surgical treatment. Three patients were treated with surgical resection alone and six patients were treated by both surgical resection and radiosurgery. Twenty-one surgical procedures [13 surgical resections and 8 radiosurgery] were performed. One patient required ventriculoperitoneal shunt and a posterior fossa decompressive craniectomy because of post-radiation brain swelling. Another patient refused additional treatment for the newly developed lesions after the successful treatment of initial lesions. The other patient who presented with numerous lesions in the whole brain and spine underwent cranio-spinal irradiation. Remaining patients showed good results. Conclusion : The surgical outcomes for the patients with a single lesion of the CNS hemangioblastoma are favorable. However. the treatment of multiple hemangioblastoma is more difficult, and should be treated by surgical resection and radiosurgery with careful consideration.