• 제목/요약/키워드: Sarcomas

검색결과 136건 처리시간 0.023초

악성 연부조직 종양에 대한 무계획적 절제술 후 잔여 종양의 영상학적 진단의 정확성과 임상적 위험인자 (Diagnostic Accuracy of Imaging Study and the Impact of Clinical Risk Factors on the Presence of Residual Tumor Following Unplanned Excision of Soft Tissue Sarcomas)

  • 오은선;서성욱;정정환
    • 대한정형외과학회지
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    • 제54권2호
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    • pp.150-156
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    • 2019
  • 목적: 악성 연부조직 종양에 대한 무계획적 절제술 후 잔여 종양의 영상학적 진단의 정확성과 임상적 위험인자를 파악하고자 하였다. 대상 및 방법: 2008년부터 2014년까지 무계획적 종양절제술을 시행 후 재절제술을 받은 98명을 대상으로 하여 분석하였다. 재수술 전 모든 환자의 환부를 조영 증강 자기공명영상(magnetic resonance imaging, MRI)을 이용해 영상의학적으로 평가하였으며 54명의 환자는 전신 양전자 방출 단층촬영(positron emission tomography [PET]/computed tomography)을 시행하였다. 모든 환자는 광범위 절제술 후 병리학적 검사를 시행하였다. 각 변수는 일변량 로지스틱 회귀와 다변량 로지스틱 회귀를 이용하여 분석하였다. 결과: 종양이 근막하에 위치한 경우 잔여 종양의 발생률이 높았다(odds ratio: 3.21, p=0.02, 95% confidence interval: 1.25-8.30). MRI는 잔여종양을 발견하는 데 높은 민감도를 보였다(sensitivity 0.79). 결론: 종양이 근막하에 위치한 경우에는 근막 상부에 위치한 경우보다 잔존암이 남을 가능성이 유의하게 높음을 알 수 있었고, MRI 및 PET 검사의 음성예측도가 매우 낮으므로 음성 판정이 나오더라도 이를 근거로 재수술을 시행하지 않는 것은 정당화될 수 없음을 알 수 있었다.

Diagnosis of Residual Tumors after Unplanned Excision of Soft-Tissue Sarcomas: Conventional MRI Features and Added Value of Diffusion-Weighted Imaging

  • Jin, Kiok;Lee, Min Hee;Yoon, Min A;Kim, Hwa Jung;Kim, Wanlim;Chee, Choong Geun;Chung, Hye Won;Lee, Sang Hoon;Shin, Myung Jin
    • Investigative Magnetic Resonance Imaging
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    • 제26권1호
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    • pp.20-31
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    • 2022
  • Purpose: To assess conventional MRI features associated with residual soft-tissue sarcomas following unplanned excision (UPE), and to compare the diagnostic performance of conventional MRI only with that of MRI including diffusion-weighted imaging (DWI) for residual tumors after UPE. Materials and Methods: We included 103 consecutive patients who had received UPE of a soft-tissue sarcoma with wide excision of the tumor bed between December 2013 and December 2019 and who also underwent conventional MRI and DWI in this retrospective study. The presence of focal enhancement, soft-tissue edema, fascial enhancement, fluid collections, and hematoma on MRI including DWI was reviewed by two musculoskeletal radiologists. We used classification and regression tree (CART) analysis to identify the most significant MRI features. We compared the diagnostic performances of conventional MRI and added DWI using the McNemar test. Results: Residual tumors were present in 69 (66.9%) of 103 patients, whereas no tumors were found in 34 (33.1%) patients. CART showed focal enhancement to be the most significant predictor of residual tumors and correctly predicted residual tumors in 81.6% (84/103) and 78.6% (81/103) of patients for Reader 1 and Reader 2, respectively. Compared with conventional MRI only, the addition of DWI for Reader 1 improved specificity (32.8% vs. 56%, 33.3% vs. 63.0%, P < 0.05), decreased sensitivity (96.8% vs. 84.1%, 98.7% vs. 76.7%, P < 0.05), without a difference in diagnostic accuracy (76.7% vs. 74.8%, 72.9% vs. 71.4%) in total and in subgroups. For Reader 2, diagnostic performance was not significantly different between the sets of MRI (P > 0.05). Conclusion: After UPE of a soft-tissue sarcoma, the presence or absence of a focal enhancement was the most significant MRI finding predicting residual tumors. MRI provided good diagnostic accuracy for detecting residual tumors, and the addition of DWI to conventional MRI may increase specificity.

Differentiating Uterine Sarcoma From Atypical Leiomyoma on Preoperative Magnetic Resonance Imaging Using Logistic Regression Classifier: Added Value of Diffusion-Weighted Imaging-Based Quantitative Parameters

  • Hokun Kim;Sung Eun Rha;Yu Ri Shin;Eu Hyun Kim;Soo Youn Park;Su-Lim Lee;Ahwon Lee;Mee-Ran Kim
    • Korean Journal of Radiology
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    • 제25권1호
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    • pp.43-54
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    • 2024
  • Objective: To evaluate the added value of diffusion-weighted imaging (DWI)-based quantitative parameters to distinguish uterine sarcomas from atypical leiomyomas on preoperative magnetic resonance imaging (MRI). Materials and Methods: A total of 138 patients (age, 43.7 ± 10.3 years) with uterine sarcoma (n = 44) and atypical leiomyoma (n = 94) were retrospectively collected from four institutions. The cohort was randomly divided into training (84/138, 60.0%) and validation (54/138, 40.0%) sets. Two independent readers evaluated six qualitative MRI features and two DWI-based quantitative parameters for each index tumor. Multivariable logistic regression was used to identify the relevant qualitative MRI features. Diagnostic classifiers based on qualitative MRI features alone and in combination with DWI-based quantitative parameters were developed using a logistic regression algorithm. The diagnostic performance of the classifiers was evaluated using a cross-table analysis and calculation of the area under the receiver operating characteristic curve (AUC). Results: Mean apparent diffusion coefficient value of uterine sarcoma was lower than that of atypical leiomyoma (mean ± standard deviation, 0.94 ± 0.30 10-3 mm2/s vs. 1.23 ± 0.25 10-3 mm2/s; P < 0.001), and the relative contrast ratio was higher in the uterine sarcoma (8.16 ± 2.94 vs. 4.19 ± 2.66; P < 0.001). Selected qualitative MRI features included ill-defined margin (adjusted odds ratio [aOR], 17.9; 95% confidence interval [CI], 1.41-503, P = 0.040), intratumoral hemorrhage (aOR, 27.3; 95% CI, 3.74-596, P = 0.006), and absence of T2 dark area (aOR, 83.5; 95% CI, 12.4-1916, P < 0.001). The classifier that combined qualitative MRI features and DWI-based quantitative parameters showed significantly better performance than without DWI-based parameters in the validation set (AUC, 0.92 vs. 0.78; P < 0.001). Conclusion: The addition of DWI-based quantitative parameters to qualitative MRI features improved the diagnostic performance of the logistic regression classifier in differentiating uterine sarcomas from atypical leiomyomas on preoperative MRI.

소아의 흉벽에서 진단된 평활근육종 1례 (Primary leiomyosarcoma of the chest wall in a child : a case report)

  • 최재혁;정찬욱;이미정
    • Clinical and Experimental Pediatrics
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    • 제51권1호
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    • pp.98-101
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    • 2008
  • 평활근육종은 중간엽세포 기원의 평활근 분화를 보이는 연부조직육종으로 소아에서는 전체 연부조직육종의 2% 이하의 발생률을 보이는 매우 드문 질환이다. 특히 흉벽의 평활근육종은 더욱 드물다. 저자들은 우연히 발견된 흉벽 종양을 방사선학적 검사로 골연골종으로 추측하여 완전절제술을 실시하였고, 조직검사 결과 저등급 평활근육종으로 진단된 1례가 있어 보고하는 바이다.

좌심방에 발생한 원발성 미분류 방추세포 육종 1례 (A Case of Primary Unclassified Spindle Cell Sarcoma of the Left Atrium)

  • 조정환;홍그루;송인욱;손창우;정선영;남종호;김미진
    • Journal of Yeungnam Medical Science
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    • 제26권2호
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    • pp.108-113
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    • 2009
  • Primary cardiac tumors are very uncommon. Seventy five percent of them are benign tumors and these are mostly myxomas. The malignant cardiac tumors, the majority of which are undifferentiated sarcomas, comprise up to 25% of all cardiac tumors. A primary malignant sarcoma of the myocardium is exceedingly rare. Thus, there have been very few such cases reported in the literature. We present here a case of a 15 year old man who had complaints of orthopnea and increasing exercise intolerance over a one month period. Transthoracic echocardiography demonstrated a well demarcated huge mass with left ventricular inflow obstruction on the posterior wall of the left atrium. The patient's symptoms were relieved by surgery. The histological diagnosis was an unclassified spindle cell sarcoma.

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Isolated Recurrence of Intracranial Granulocytic Sarcoma Mimicking a Falx Meningioma in Acute Myeloblastic Leukemia

  • Cho, Won-Ho;Choi, Young-Jin;Choi, Byung-Kwan;Cha, Seung-Heon
    • Journal of Korean Neurosurgical Society
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    • 제47권5호
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    • pp.385-388
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    • 2010
  • Intracranial granulocytic sarcomas are rare tumors, which are composed of immature granulocytic cells. Although it has been well known that these tumors are associated with acute myeloblastic leukemia (AML), they have been almost always related to bone marrow relapse. However, isolated recurrence of granulocytic sarcoma following complete remission from prior AML is extremely rare, especially in the central nervous system. A 44-year-old male presented with isolated recurrence of granulocytic sarcoma mimicking a falx meningioma two years after complete remission by allogenic peripheral blood stem cell transfusion (PBSCT) in the acute myelomonoblastic leukemia (FAB, M4). Because of depressed mental state and mass effect, total surgical resection was performed. Pathological findings were compatible with the granulocytic sarcoma. There was no evidence of leukemic relapse in the peripheral blood. We suggest that this phenomenon can be explained by the hypothesis that a certain barrier effect such as blood brain barrier might lead to the proliferation of intracranial leukemic cells which metastasized before PBSCT.

흉부질환을 병발한 Von Recklinghausen's disease -2예 보고- (Von Recklinghausen's disease involving the chest -Two cases report-)

  • 김치경;박재길;이홍균
    • Journal of Chest Surgery
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    • 제13권2호
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    • pp.149-153
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    • 1980
  • Von Recklinghausen's disease is a systemic hereditary disorder with varied manifestations in bone, soft tissue, nervous system, and skin, the most common of which is the developement of multiple, small, cutaneous tumors with a characteristic histologic picture. Tumors develop after birth and before puberty in most cases, and they increase in number until old age. Malignant neoplasms that complicate multiple neurofibromatosis include gliomas of the optic nerve, astrocytomaas of the cerebral and cerebellar hemispheres, and sarcomas of peripheral nerves (femoral, tibial and intercostal nerves) and somatic soft tissues. Little attention has been paid to the presence of cystic lung disease in association with neurofibromatosis. Currently, most think of thoracic involvement in neurofibromatosis in terms of posterior mediastinal neuroma, pheochrocytoma, meningocele or, less commonly parenchymal pulmonary neurofibromas. Author have experienced 2 cases of Von Recklinghausen's disease. One case developed a hyge malignant Schwannoma in the parietal pleura of left 4th intercostal space and multiple benign neurofibromas (two in intercostal spacees and one in the neck) , and the other has several episodes of pneumothorax resulting from diffuse cystic lung disease which required closed thoracotomy drainage.

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이중상 활막육종의 세침흡인 세포학적 소견 -1예 보고- (Fine Needle Aspiration Cytology of Biphasic Synovial Sarcoma - A Case Report -)

  • 김희경;진소영;이동화
    • 대한세포병리학회지
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    • 제14권2호
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    • pp.96-101
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    • 2003
  • Synovial sarcoma is a rare soft tissue tumor accounting for 5-10% of soft tissue sarcomas. Most arise in the extremities and trunk, and a small proportion occur in the abdominal wall, head and neck legion, and mediastinum. It manifests different phenotypic subtypes that render their cytologic evaluation challenging. Moreover, cytomorphologic description of the epithelial component of synovial sarcoma is rare in Korea. We report a case of biphasic synovial sarcoma on the right lower extremity in a 49-year-old woman diagnosed by fine needle aspiration cytology. The aspirate was moderately cellular and composed of a mixture of tissue fragments and dissociated cells with bland chromatin, inconspicuous nucleoli, and oval to spindle-shaped cytoplasm. Mitosis was rare. A monolayer sheet of epithelial component was seen. The cells in this monolayer sheet had more abundant distinct cytoplasm, round nuclei, and prominent micronucleoli. Histologic examination showed a biphasic pattern consisting of mostly sarcomatous stroma and a few small glandular areas at the periphery of the tumor.

Roles of Galectin-7 in Cancer

  • Kaur, Manpreet;Kaur, Tarnjeet;Kamboj, Sukhdev Singh;Singh, Jatinder
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권2호
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    • pp.455-461
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    • 2016
  • Galectins are ${\beta}$-galactoside binding lectins that contain one or more carbohydrate recognition domains. As a consequence of sugar-binding properties, galectins exhibit a variety of interactions with glycoproteins, thus playing important roles in various pathological processes. A number of studies have shown roles of galectins in cancer. Galectin-7 is a prototype member of the galectin family implicated in epithelial stratification and cell migration. It can act as a potent dual regulator in different types of cancer. Galectin-7 may contribute either to neoplastic transformation and tumour progression through regulation of cell growth, cell cycle, angiogenesis, apoptosis and cell migration or may have a protective effect in cancer depending on the tissue type. A perusal of the literature indicates particular roles of galectin-7 in carcinomas and melanomas, while contributions await greater exploration in other types of cancers including sarcomas and leukemia. This review collectively summarizes available literature on expression and roles of galectin-7 in different cancers.