• Title/Summary/Keyword: Musculoskeletal Tumors

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Giant Cell Tumor of the Patella (슬개골에 발생한 거대세포종 - 증례보고 -)

  • Hahn, Soo-Bong;Kim, Ju-Young;Shin, Kyu-Ho
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.2
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    • pp.217-222
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    • 2003
  • The giant cell tumor comprises approximately 5% of all bone tumors especially in the long tubular bones, particularly in proximity to the epiphysis. A rare case of giant cell tumor involving the patella was recently experienced by authors. Case summary with brief review of reference is presented.

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Expression of c-fos Protein in Fibrous Dysplasia and Osteofibrous Dysplasia (섬유성 이형성증 및 골섬유성 이형성증에서의 c-fos 단백 발현)

  • Park, Hye-Rim;Park, Yong-Koo;Kim, Duck-Whan
    • The Journal of the Korean bone and joint tumor society
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    • v.5 no.4
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    • pp.216-220
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    • 1999
  • The purpose of this study was to evaluate the role of c-fos oncogenes in the development of fibrous dysplasia and osteofibrous dysplasia. The immunohistochemical expression of c-fos protein was evaluated in 15 cases of fibrous dysplasia and 8 cases of osteofibrous dysplasia. Ten cases of fibrous dysplasia were weakly positive with c-fos. Six cases of osteofibrous dysplasia were weakly positive and the remaining two cases were strongly positive. The overall expression of c-fos protein is weaker than high-grade osteosarcoma, thus the implication of c-fos protein is little in the development of these tumors. Fibrous dysplasia and osteofibrous dysplasia share some features of characteristic histology and c-fos expression.

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Autogenous Low Heat Treated Bone Graft for Bone Reconstruction in Bone and Soft Tissue Tumors (골연부 종양에서 저온 열처리한 자가골을 이용한 재건술)

  • Jeon, Dae-Geun;Lee, Jong-Seok;Kim, Sug-Jun;Cho, Wan-Hyeong;Kwag, Bong-Jun;Lee, Soo-Yong
    • The Journal of the Korean bone and joint tumor society
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    • v.4 no.2
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    • pp.81-87
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    • 1998
  • Although autoclaved autogenous bone reconstruction is one of the established procedures, it may have some problems in bone regeneration and mechanical property. The purpose of this study is to evaluate the efficacy of more biologic and anatomical reconstruction where allograft is not readily available. From Aug.1991 to Feb. 1996 the authors analyzed 32 cases of reconstruction with autogenous low heat treated bone. Autogenous graft sites were humerus 4, tibia 4, pelvis 9, and 15 femur. Average follow-up period was 23(range;12-51) months. There were 49 graft-host junctional sites. Diaphysis was 22, metaphysis 10, and flat bone 17. Average duration of healing for the 38 united sites was 7 months. Average union time for each anatomical area 8 months in 19 diaphysis, 12 months in 7 metaphysis, and 12.7 months in 12 flat bone(pelvis). Eleven nonunion sites consisted of 3 diaphysis(3/22), 3 metaphysis(3/10), and 5 flat bone(5/17). Complications other than nonunion were local recurrence(4), bone resorption(3), graft fracture(2), osteomyelitis(1), metal failure(2), and wound infection(1). Initial bone quality and stable fixation technique was important for union rate. Plate and screw is a good method for diaphyseal lesion. Metaphyseal and flat bone are weak area for rigid fixation and one stage augmentation with iliac bone graft can be a salvage procedure.

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Unplanned Excision of Soft Tissue Sarcoma: Patient Profile and Treatment Outcomes (연부 조직 육종에 대한 무계획적 절제술: 환자의 임상적 특징 및 치료 결과)

  • Lee, Jae Hoo;Cho, Yong Jin;Kim, Seung Hyun;Shin, Kyoo Ho
    • The Journal of the Korean bone and joint tumor society
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    • v.18 no.2
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    • pp.72-77
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    • 2012
  • Purpose: Unplanned excision of a soft tissue sarcoma is defined as the operation performed for gross removal of a soft tissue sarcoma without regard for preoperative imaging or the necessity to removal a margin of normal tissue covering the cancer. We report our experience of treating primary soft tissue sarcoma after an unplanned excision. Materials and Methods: We retrospectively reviewed 31 patients referred to our hospital after unplanned excision at other hospitals for treatment of a STS. The clinical information was reviewed with a focus on the patient's age, gender, tumor location, tumor size, tumor depth, presumptive diagnoses at the previous surgery, refer hospital, definitive diagnosis, interval between the initial and additional surgery and local recurrence. Results: There were 19 males and 12 females with a median age of 48 years (range, 17-75 years) at the time of referral. Seventeen patients (54.8%) had tumors in their lower limb, 6 (19.4%) had tumors in their upper limb, and 8 (25.8%) had tumors in their trunk. Tumor depth could be determined for 8 patients (25.8%), with superficial and 22 deep tumors (71%). The medial interval between unplanned excision to re-excision ranged from 2 weeks to 1 year (median, 5 weeks). Local recurrence was detected in 2 patients. All patients were alive without metastasis at last follow up. Conclusion: Even in upper class general hospital, many unplanned excision had been performed, which is considered to be avoided. When the relatively huge mass located in deeper layer it requires enough preoperative imaging studies and biopsy.

Infiltrating Intramuscular Lipoma (침윤성 근육내 지방종)

  • Suh, Jeung-Tak;Kim, Jeung-Il;Cheon, Sang-Jin;Lee, Choon-Key;Ku, Ja-Gyung;Kim, Young-Goun
    • The Journal of the Korean bone and joint tumor society
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    • v.11 no.1
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    • pp.40-45
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    • 2005
  • Purpose: To suggest an accurate diagnosis and treatment of infiltrating intramuscular lipoma by analysis of the clinical, biological, radiological and pathological features. Materials & Methods: 20 patients who treated at our hospital for infiltrating intramuscular lipoma from 1998. to 2001 were selected for this study. Mean age was 45.8 years old. Four were male and eight female. All cases were checked preoperative radiographs, MRI and diagnosed by biopsy. The methods of surgical treatment included excision of tumor and peripheral tissue. We assessed the recurrence by follow up. Results: Tumors located in upper limbs 5 cases, lower limbs 3 cases, abdomen 3 cases, gluteal region 1 case. In preoperative radiographs, infiltrating intramuscular type were 7 cases. In 11 cases, tumors were completely excied with peripheral tissue. 1 cases was incompletely excised because it was very huge mass and infiltrated lung. Encapsulated tumors were 3cases and uncapsulated tumors 9 cases. There were no recurrence excepts 1 case that was infiltrated lung. Conclusion: Infiltrating intramuscular lipoma was wrongly diagnosed as well differentiated liposarcoma. To increase the rate of correct diagnosis, preoperative radiographs, MRI and pathologic diagnosis were performed. Careful wide excision is necessary to prevent the recurrence.

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MRI Evaluation for the Histologic Components of Soft-tissue Tumors: Comparison of MEDIC and Fast SE T2-weighted Imaging (연조직종양의 조직 성분 평가를 위한 자기공명영상: MEDIC 과 지방억제 T2 영상의 비교)

  • Moon, Tae-Yong;Lee, In-Sook;Lee, Jun-Woo;Choi, Kyung-Un;Kim, Jeung-Il;Kim, E. Edmund
    • Investigative Magnetic Resonance Imaging
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    • v.12 no.1
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    • pp.1-7
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    • 2008
  • Purpose : To compare Multi Echo Data Image Combination (MEDIC) and fast SE T2-weighted images with fat saturation (T2FS) to suggest more accurate evaluation of the histologic components of soft-tissue tumors. Materials and Methods : The experimental group included 25 histologic tissues (5 vascular, 4 neural, 4 fibrous, 4 hypercellular, 2 hemorrhagic necroses, 2 cystic, 2 lipoid, 1 myxoid stroma, and 1 thrombus) in 10 patients who had pathologically confirmed schwannoma (n = 3), hemangioma (n = 2), lipoma (n = 1), angiokeratoma (n = 1), synovial sarcoma (n = 1), liposarcoma (n = 1), and malignant fibrous histiocytoma (n = 1). The inhomogeneity values were measured using the standard deviation value (SD) divided by the mean value as SD presents an error amount similar to that of imaging heterogeneity. Results : The inhomogeneity values of 25 histologic components were lower on MEDIC than those on T2FS (p < .001). Conclusion : We conclude that MEDIC is more accurate than T2FS for evaluating the tissue components of soft-tissue tumors using digitalized data because MEDIC images have far lower inhomogeneity.

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Effect and Tolerability of Nasal Spray of Salmon Calcitonin in the Relief of Pain due to Bone Metastasis (전이성골암에 의한 통증에 대한 Salmon Calcitonin($Miacalcic^{(R)}$) 비강분무의 효능 및 안정성)

  • Lee, Soo-Yong;Jeon, Dae-Geun;Lee, Jong-Seok;Kim, Sug-Jun;Hong, Seok-Il;Choi, Soo-Yong;Jang, Jin-Dae
    • The Journal of the Korean bone and joint tumor society
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    • v.2 no.1
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    • pp.72-77
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    • 1996
  • Metastaic bone tumors are usually accompanied with severe pain. The treatment modalities for this pain are so variable that patients are sometimes afraid of using them. Salmon calcitonin has a function to increase beta-endorphines followed by increasing the blood level of prostaglandin and thromboxan A2, which results in analgesic effect. This drug also has been known to decrease bone resorption. There were a few reports that parenteral use of salmon calcitonin decrease the pain from metastatic bone tumor. We wanted to know the effectiveness and tolerability of nasal spray of salmon calcitonin in relieving bone pain with metastatic tumor. We analyzed the effectiveness in the aspects of pain, sleep, performance status, mobility, supplementary analgesic use. The biologic effect of salmon calcitonin was analysed with CBC, Ca/P, BUN/Cr, uric acid. Simple radiography, alkaline phosphatase, osteocalcin, pyrilink-K were used as parameters for bone change. Eighteen cases of metastatic bone tumors took nasal spray of salmon calcitonin($Miacalcic^{(R)}$, 200IU/day) for 4 weeks, to relieve bone pain. With Wilcoxon Matched-Pairs Signed Ranks Test, we could find pain decreased significantly at 3 week and mobility become improved at 4 week of salmon calcitonin use. Other parameters didn't show any significant changes. We think the analgesic effect is mainly due to effect not on the local bone lesion but on the central nervous system, and that increased dose of salmon calcitonin can induce earlier and stronger analgesic effect.

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Ganglion-like Lesions of the Foot on the Ultrasonography (초음파에서 족부 결절종으로 오인한 유사 병변)

  • Chun, Kyung-Ah;Shin, Dong-Hwan;Seo, Dong-Hyun;Singh, Kanwarjot;Suh, Jin-Soo
    • Journal of Korean Foot and Ankle Society
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    • v.14 no.2
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    • pp.169-172
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    • 2010
  • Purpose: The authors have experienced various lesions that simulate ganglion of the foot on the ultrasonography. The purpose of this study is to evaluate ultrasonographic findings of soft tissue lesions, which were interpreted as ganglion but confirmed as different lesions in the foot. Materials and Methods: We reviewed a database of patients with ganglion on the ultrasonography from two different institutions. There were 109 patients who underwent both ultrasonography and surgical confirmation. Twenty one lesions were identified, of which initial interpretation on the ultrasonography included ganglion which pathology revealed to be different lesions. All images were evaluated by one musculoskeletal radiologist, regarding size, margins, internal echogenicity of lesions, and presence of posterior enhancement. Results: Of 21 lesions, there were 6 fibrous tumors including fibroma, giant cell tumor of tendon sheath, and fibromatosis, 3 hemangiomas, 2 epidermal inclusion cysts, 2 chondromas, 2 angioleiomyomas, 1 trichilemal cyst, 1 neurofibroma, 1 granular cell tumor, 1 neurilemmoma, 1 neuromyxoma, and 1 nodular hidradenoma. Mean size of the lesion was 1.1 cm. Margins were smooth in 10, mild lobulation in 8 and marked lobulation in 3 lesions. Lesions were hypoechoic in 16, anechoic in 4 and isoechoic in 1 case. Posterior acoustic enhancement was definitely present in 5 lesions. Conclusion: On the ultrasonography, various soft tissue lesions of the foot may be confused with ganglion. During surgical resection care should be given even to a simple ganglion as it might turn up to be a solid lesions such as fibrous tumors.

Features of Malignancy Prevalence among Children in the Aral Sea Region

  • Mamyrbayev, Arstan;Dyussembayeva, Nailya;Ibrayeva, Lyazzat;Satenova, Zhanna;Tulyayeva, Anara;Kireyeva, Nurgul;Zholmukhamedova, Dinara;Rybalkina, Dina;Yeleuov, Galymzhan;Yeleuov, Almasbek
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.12
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    • pp.5217-5221
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    • 2016
  • Objective: A study of primary cancer morbidity among children and subsequent calculation of average annual incidence were carried out for boys and girls, and young men and women in Kazakhstan. Methods: The investigated population lived in three areas of the Aral Sea region: designated catastrophe (Aral, Kazalt, Shalkar regions), crisis (Zhalagash, Karmakshy, Shiely regions), pre-crisis (Irgiz, Arys, Ulytau regions). Zhanaarka region of Karaganda oblast was applied as a control. Parameters were retrospective analyzed for the 10 years from 2004 to 2013. Result: The results indicate that indices of children cancer morbidity were slightly higher in the Aral Sea region than in the control district, but they were comparable with similar data from studies in other regions. In all areas of the Aral Sea region, except for Ulytau, primary cancer morbidity exceeded the control level by 1.3-2.7 times (4.7%000). Hematological malignancies, including solid tumors - tumors of musculoskeletal system and skin, digestive system, brain and central nervous system predominated. Stress levels in zones of the Aral Sea region were slightly higher in the crisis zone than in the catastrophe zone that can be explained by the phenomenon of wave-like dynamics of disease growth risk. Gender differences in characteristics of malignancy formation were not more pronounced in the studied region. Conclusion: Indices of children cancer are slightly higher in the Aral Sea region than in the control area of Kazakhstan, but they are comparable to results for other regions.

Surgical Treatment of the Neurilemoma in Extremities (사지 말초신경에 발생한 신경초종의 수술적 치료)

  • Pyun, Young-Sik;Kim, Seong-Ryeol;Joh, Young-Rok
    • The Journal of the Korean bone and joint tumor society
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    • v.4 no.2
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    • pp.88-93
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    • 1998
  • Neurilemoma usually discovered incidentally, is a benign nerve-sheath tumor which has been described as a painless mass. In most cases, the size of the mass was smaller than 5cm. However, it was reported that there were masses, sometimes associated with local tenderness and pain, whose size was over 6cm. Then, we have found there is a relationship between mass size and neurologic symptoms, as well as with, postoperative complications. It is important to diagnose early and to treat it. Twenty neurilemoma patients, who were treated at Keimyung University Dongsan Medical Center were analyzed using their clinical symptoms, pathologic findings, radiologic findings and complications. There was no sexual difference in tumor incidence. The anatomical locations of tumors were as follows. ; upper extremities in 15 cases(69%), axilla in 1 case(4%) and lower extremities in 6 cases(27%). Symptoms were palpable mass in 22 cases, local tenderness in 8 cases(36%), radiating pain in 6 cases(27%) and paresthesia in 6 cases(27%), Median nerve was involved most frequently(33%). There were 2 patients(10%) with multiple symptoms. Tumor enucleation was done in all cases. The size of tumors in longest axis was smaller than 2cm in 2 cases, between 2 and 4cm in 11 cases and more than 5cm in 9 cases. There was no case of malignant transformation or recurrence. In conclusion, incidence of clinical symptom and postoperative complications are increased with the size of the tumor especially over the 5cm. Preoperative MRI finding was the most accurate method of diagnosis and most helpful in determining surgical resection margin.

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