• Title/Summary/Keyword: Radical excision

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Reconstruction of the Maxillary and Cheek Skin Defect with Folded Latissimus Dorsi Free Flap : A Report of One Case (협부피부를 침범한 상악암에서 광범위 절제술 후 광배근 이중도서형 유리피판을 이용한 재건술 1예)

  • Kwon Yun-Hwan;Seo Kyu-Hwan;Lee Seung-Hoon;Dhong Eun-Sang;Kwon Soon-Young
    • Korean Journal of Head & Neck Oncology
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    • v.20 no.1
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    • pp.41-43
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    • 2004
  • An advanced maxillary sinus cancer requires an extensive ablation that results an extensive facial deformity, including a skin defect. Reconstruction has to be considered in a radical maxillectomy, especially with skin defect may be accomplished in one stage with a microsurgical free transfer of a latissimus dorsi flap. A man of right maxillary sinus cancer, squamous cell carcinoma, 47 years old of age, had soft tissue invasion of the cheek region. He underwent a radical maxillectomy with extensive skin excision. The maxillectomy and skin defects were reconstructed with the double skin island latissimus dorsi myocutaneous free flap. The cosmetic result and the functional outcome of the nose were thought to be considerably satisfied.

Treatment of Bone Tumor with Free Vascularized Fibular Graft (유리혈관부착 비골 이식술을 이용한 골종양의 치료)

  • Hahn, Soo-Bong;Choei, Joung-Hyuk;Koh, Young-Gon
    • Archives of Reconstructive Microsurgery
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    • v.4 no.1
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    • pp.43-51
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    • 1995
  • In certain low-grade malignant bone tumors such as chondrosarcoma or frequent recurrent benign bone tumors as ossifying fibroma, radical treatment may provide a good chance for cure. And large bony defect after the radical treatment can be filled with the massive bone graft. Recent advances in clinical microsurgery have made free vascularized bone graft a clinical reality, and Taylor in 1975, first reported the technique of free vascularized fibula graft for the reconstruction of large tibial defect with excellent clinical results. We tried wide excision and free vascularized fibula graft in 5 patients with ossifying fibroma and one patient with chondrosarcoma from January 1984 to December 1994 and followed for more one year. The shortest bony defect was 7cm and the longest bony defect was 20cm and mean bony defect was 13cm. All patients were evaluated clinically and roentgenographycally on basis of functional recovery and bony union. All patients showed satisfactory functional recovery with sound bony union and showed bony hypertrophy. And, local recurrence was not seen.

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Management and treatment of four cases of oral carcinoma cuniculatum

  • Constantinos Mourouzis;Iordanis Toursounidis;Christos Eftychiadis;Georgios Rallis
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.50 no.1
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    • pp.35-40
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    • 2024
  • Objectives: Oral carcinoma cuniculatum (OCC) is a rare variant of squamous cell carcinoma (SCC). It has similar clinicopathological characteristics to SCC and verrucous carcinoma (VC). We present a case series of OCC and analyse its unique features, diagnosis, and management. Patients and Methods: We retrospectively reviewed the medical records of oral cancer patients treated by Oral and Maxillofacial Surgery department from 2009 to 2020 with OCC biopsy findings. The clinicopathological characteristics and management of the OCC cases were analysed. Results: Four patients were identified with histologic findings of OCC, including three on the alveolar ridge mucosa and one on the tongue. Imaging revealed that two of the lesions located in the maxilla had osseous lysis. All four patients were all treated with radical excision, and the histopathology showed findings of SCC cuniculatum. It was decided that no further treatment was necessary. None of the patients has experienced recurrence during follow-up. Conclusion: OCC is a distinct entity that is more locally aggressive than VC but is associated with good prognosis. Radical surgical removal is considered appropriate for OCC. Emphasis should be given on an early diagnosis, as it remains challenging.

The Clinical Outcome of Flap Coverage for the Treatment of Malignant Melanoma (악성 흑색종 치료를 위한 피판술의 임상적 결과)

  • Jeon, Woo-Joo;Kang, Jong-Woo;Kim, Il-Hwan;Son, Gil-Soo;Park, Jong-Woong
    • Archives of Reconstructive Microsurgery
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    • v.19 no.2
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    • pp.81-87
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    • 2010
  • In surgical treatment of the malignant melanoma, radical resection and a sentinel lymph node biopsy are essential procedures to eradicate the tumor and to minimize the risk of local recurrence. For the reconstruction of skin defect after tumor resection, a skin graft has been generally performed procedure. However, if tendon or bone is exposed after tumor resection, simple skin graft is not enough for the coverage of the defect and additional procedure is mandatory. In this study, we reviewed the clinical results of 16 patients, who had been diagnosed with malignant melanoma of the limb and underwent surgical resection and reconstruction of the defect with various methods. The sentinel lymph node dissection was performed in all patients combined with radical excision of the tumor. In 11 cases of positive sentinel lymph nodes, further elective lymph node dissections were performed. The mean tumor invasion depth was 4.54 mm (2~10 mm), and AJCC stage II was most common (9 cases). The pedicled flaps were performed in 10 cases for the reconstruction of defects. All flaps were successfully survived without significant complications until the last follow up. In conclusion, a pedicled flap coverage is very useful reconstruction strategy for the soft tissue defects after radical resection of malignant melanoma.

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Heparin-induced Thrombocytopenia Type II after Free Flap Operation

  • Baek, Jiwoong;Park, Jung Hyun;Cha, In-Ho;Kim, Hyung Jun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.35 no.6
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    • pp.408-411
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    • 2013
  • After radical excision of a tumor in the maxillofacial area, functional and esthetic reconstruction is needed, including flap surgery. Among the many etiologies of flap failure, venous thrombosis is one of the most frequent. Heparin is used routinely in the effort to avoid development of venous thrombosis. In rare cases, heparin-induced thrombocytopenia (HIT) type II occurs due to exposure to heparin. Heparin attached to platelet factor 4 forms a PF4/heparin-immunoglobulin G immune complex on platelet surfaces. This complex activates platelets, which leads to multiple coagulation in venous and arterial blood. We report here on a rare occurrence of HIT type II following fibula free flap surgery.

Epithelioid sarcoma associated with neurofibromatosis type I

  • Hwang, Sung Oh;Lee, Soo Hyang;Lee, Han Byul
    • Archives of Craniofacial Surgery
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    • v.21 no.1
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    • pp.41-44
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    • 2020
  • In general, patients with neurofibromatosis type I have a higher risk than those with other types of neurofibromatosis of developing soft-tissue sarcomas related to the nervous system. We here present a 42-year-old man with neurofibromatosis type I who developed a protruding mass over only 2 weeks. The histopathological diagnosis was epithelioid sarcoma. Epithelioid sarcomas are rare and, to the best of our knowledge, no epithelioid sarcomas have been reported in patients with neurofibromatosis type I. Radical excision of the primary lesion was performed and postoperative radiotherapy and chemotherapy administered, as is recommended for epithelioid sarcoma. Our case emphasizes that patients with neurofibromatosis type I may develop malignant tumors.

A Case of Multiple Symmetrical Lipomatosis Causing Upper Airway Obstruction (상기도 폐쇄를 일으킨 다발성 대칭성 지방종증 1예)

  • Kim, Jeong-Kyu;Kim, Kyung-Chan
    • Tuberculosis and Respiratory Diseases
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    • v.70 no.1
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    • pp.63-68
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    • 2011
  • Multiple symmetrical lipomatosis (MSL), also called Madelung's disease, is a rare disorder of unknown etiology and characterized by abnormal accumulation of large subcutaneous fatty masses in neck, shoulder, and upper trunk. MSL has known to predominantly affect middle-aged men with a history of alcoholism. Although the clinical course of MSL is considered to be slowly progressive, in advanced stage, fatty masses in the neck may compress the upper aerodigestive tract, resulting in dyspnea and dysphagia. The treatment of MSL is surgical resection, but radical excision is very difficult and recurrence after surgery is frequent. We report the case of 55-year-old man with long lasting MSL, which caused severe airway obstruction. This patient was admitted with progressive dyspnea and massive accumulation of fat around the vocal cord that was detected on a neck CT scan. This abnormal fatty infiltration in supraglottic region caused upper airway obstruction.

Huge Immature Teratoma of Mediastinum - A case report - (종격동에 발생한 거대 미성숙기형종 -1례 보고-)

  • 강재걸
    • Journal of Chest Surgery
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    • v.22 no.5
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    • pp.867-872
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    • 1989
  • Primary mediastinal immature teratoma is a rare germinal tumor which includes various elements of mature teratoma, choriocarcinoma, yolk sac carcinoma, embryonal carcinoma, and seminoma in some proportions. The tumor is virtually restricted to young man and the response to surgery and radiotherapy are poor. Recently, we experienced a case of primary mediastinal immature teratoma with elevated serum [-HCG and [-fetoprotein in 18 years old man. The well-encapsulated mass, weighing 4.5 kg, was completely resected and then adjuvant combination chemotherapy was tried with Vincristine, Bleomycin, and Cisplatin. Radical excision of tumor and adjuvant chemotherapy would appear to produce better result than have been reported in other cases. The postoperative course was uneventful and the tumor markers were returned to normal range.

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Squamous Cell Carcinoma of the External Ear Canal (외이도의 편평상피암)

  • 이상도;홍래복
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1976.06a
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    • pp.86.3-86
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    • 1976
  • The external ear canal is a rare site for development of squamous cell carcinoma which is usually in the advanced state of invasion by the time the diagnosis is made. Recently the authors experienced squamous cell carcinoma of the external ear canal which was treated with wide excision of the external ear canal and radical mastoidectomy followed by post-operative radiotherapy.

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A recurrent case of extraocular sebaceous carcinoma with distant organ metastasis

  • Kwon, Byeong Soo;Chung, Eui Han;Kim, Jin Woo
    • Archives of Craniofacial Surgery
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    • v.22 no.1
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    • pp.56-61
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    • 2021
  • Sebaceous carcinoma (SC) is a rare tumor, accounting for approximately 0.7% of skin cancers. SC can be classified as ocular SC (OSC) or extraocular SC (EOSC) depending on its location. Because EOSC accompanied by metastases is rare, there is a paucity of data about EOSC accompanied by metastasis. This study presents a case of an aggressive EOSC of the scalp with lymph node metastases. The patient underwent wide local excision of the primary tumor with a 1 cm safety margin and bilateral radical lymph node dissection. However, recurrence was observed 1 month after surgery. Radiation therapy and resection were performed for the recurrent tumor. However, distant metastases to both lungs eventually occurred. Here, we describe a rare recurrent case of EOSC of the scalp with distant organ metastasis with a review of the literature.