• 제목/요약/키워드: Skin metastasis

검색결과 139건 처리시간 0.031초

동종골 이식술로 치료한 경골 근위부에 발생한 연골 육종 - 증례 보고 - (Chondrosarcoma of Proximal Tibia Trated by Allograft - A Case Report -)

  • 정구희;김재도;정소학;차상원
    • 대한골관절종양학회지
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    • 제12권2호
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    • pp.165-170
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    • 2006
  • 저자들은 근위 경골에 발생한 연골 육종 환자의 동종골 이식술을 이용한 수술적 치료후 만족할 만한 결과를 얻어 보고하고자 한다. 자기 공명 영상에서 종양의 크기는 $3.5{\times}20$ cm 이었고 적절한 수술연을 선택하여 광범위 절제술을 시행하였으며 결손부는 동종 골이식술 및 내측 비복근 회전 피판술 및 부분 층 피부 이식을 통하여 재건하였다. 최종 추시일 까지 국소 재발이나 원격 전이는 관찰 되지 않았으며 이차 감염이나 불유합, 금속물의 해리 등의 합병증도 발생하지 않았다. 또한 적절한 재활 운동을 통해 만족할 만한 슬관절 관절 운동을 얻을 수 있었다.

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Mammary Paget's disease without underlying malignancy of the breast

  • Jang, Nuri;Kang, Suhwan;Bae, Young Kyung
    • Journal of Yeungnam Medical Science
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    • 제35권1호
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    • pp.99-103
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    • 2018
  • Mammary Paget's disease (MPD) is usually accompanied by underlying breast malignancy; however, a few cases have been reported as only skin lesions without any evidence of malignancy of the breast on imaging tests and microscopic examination of surgical specimen. Here, we describe a 47-year-old woman who visited our hospital who had an eczematous lesion on right nipple and areola for over 10 years. The lesion was diagnosed as Paget's disease by punch biopsy; however, imaging studies demonstrated no breast malignancy or lymph node metastasis. The patient underwent surgery of on the nipple and areola including underlying breast tissue. No underlying malignancy was found upon microscopic examination, except for Paget's disease. Immunohistochemical stains revealed that the tumor cells were positive for cytokeratin 7, and negativity for p63, cytokeratin 5/6, estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2. We report a case of MPD without underlying malignancy. To the best of our knowledge, this is the third case reported in Korea.

악성 흑색종의 치료와 예후에 대한 분석 (Analysis of Treatment and Prognosis in Malignant Melanoma)

  • 권영호;김정렬;이영구;김재도
    • 대한골관절종양학회지
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    • 제11권2호
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    • pp.141-147
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    • 2005
  • 목적: 악성 흑색종의 치료 중 가장 중요한 것은 외과적 전절제술이며, 수술시 광범위 절제술을 시행한다. 저자 등은 광범위절제와 면역화학요법을 시행한 후 각 병기별 5년 생존율을 알아보고 예후에 영향을 주는 요인을 주는 요인들을 분석하고자 한다. 대상 및 방법: 1995년 3월부터 2003년 8월까지 악성 흑색종으로 진단 받았던 35명(남자 17명, 여자 18명)을 대상으로 광범위절제술과 면역화학요법을 시행한 후 추시 관찰하였다. 절제술은 종양의 크기나 피부층의 침범정도와 상관없이 종양의 변연으로부터 2 cm으로 하였고, 절제술 후 덮이지 않는 피부 결손부는 피판 이식술이나 전층 피부 이식술을 이용하였다, 면역화학요법으로는 dacarbazine (DTIC) 400 mg과 인터페론-${\alpha}$ 300만 IU를 병용 투여 하는 방법을 사용하였다. 면역화학요법은 III기 이상의 환자에게 시행하였고, 병기는 2002년 개정된 AJCC 병기를 이용하여 판정하였다. 또 이들 환자들에 대해 국소재발과 국소전이, 그리고 원격전이여부를 조사하였고, 각 병기별 5년 생존율을 조사하였다. 결과: 발생부위는 족부가 15명(42.8%)으로 가장 많았고, 족관절부 5명(14.2%), 하퇴부 2명(5.7%), 대퇴부 2명(5.7%), 수부에 5명(14.2%)이었다. 병기별 발생빈도는 IA 8명(22.8%), IB 9명(25.7%), IIA 4명(11.4%), IIB 2명(5.7%), IIIA 1명(2.8%), IIIB 2명(5.7%), IIIC 2명(5.7%) 그리고 IV기는 7명(20.0%) 이었다. 각 병기별 5년 생존율은 I기에서 94.1%, II기에서 66.8%, III기에서 40%, IV기에서 14.3%로 나타났다. 결론: 악성 흑색종은 III기 이상에서는 5년 생존율이 낮았다. 악성 흑색종의 치료는 초기에 진단하여 병기에 따라 치료의 방법을 달리하므로 수술전 병기의 확인이 매우 중요하다. 광범위 절제연에 대해서는 종양 두께에 따라 1~3 cm의 절제연으로 광범위 절제를 권유한다.

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융기성 피부섬유육종의 치료 및 예후 (Dermatofibrosarcoma Protuberans ; Treatment and Prognosis)

  • 이수용;박종훈;전대근;이종석;김석준
    • 대한골관절종양학회지
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    • 제6권1호
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    • pp.17-21
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    • 2000
  • 목적 : 융기성 피부섬유육종은 피부에 생기는 드문 종양으로서 부적절한 절제가 잦은 재발과 예후에 영향을 미치는 것으로 보고되고 있다. 저자들이 경험한 환자를 대상으로 치료와 예후의 관계를 연구하여 적절한 치료법을 제시하고자 하였다. 대상 및 방법 : 1990년 3월부터 본원 정형외과에서 치료한 융기성 피부섬유육종 환자중 추시 기간이 최소 12개월 이상인 14례를 대상으로 치료 방법 및 최종 추시까지의 상태를 점검하였다. 전례 모두 병리학적 진단하에 치료되었으며, 재발 후 전원된 9례를 포함한 13례에서 광범위 절제술이 시행되었다. 1례는 서혜부의 신경, 혈관이 종양과 인접하여 종양내 전절제술을 시행하였고 술후 항암요법을 추가한 경우였다. 결과 : 재발후 전원되었던 9례의 평균 재발 회수는 1.3 (1~2)회였으며, 처음 수술 후 첫번째 재발까지의 기간은 평균 11.8(2~24)개월이었다. 술후 최종 추시까지(평균 추시기간 50.8개월)에서 광범위절제술로 치료한 13례에서는 재발을 볼 수 없었으나, 병소내 전절제술과 항암제치료를 하였던 예에서는 반복된 재발을 보였고, 결국 폐전이로 사망하였다. 결론 : 융기성 피부섬유육종은 반드시 생검을 통한 확진 후 초기에 광범위 절제연 이상으로 절제를 시행하여야 할 것으로 사료된다. 재발은 최소한 2년까지의 추시가 있어야 그 여부를 알 수 있을 것으로 사료된다.

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Proteomic Analysis and the Antimetastatic Effect of N-(4methyl)phenyl-O-(4-methoxy) phenyl-thionocarbamate-Induced Apoptosis in Human Melanoma SK-MEL-28 cells

  • Choi Su-La;Choi Yun-Sil;Kim Young-Kwan;Sung Nack-Do;Kho Chang-Won;Park Byong-Chul;Kim Eun-Mi;Lee Jung-Hyung;Kim Kyung-Mee;Kim Min-Yung;Myung Pyung-Keun
    • Archives of Pharmacal Research
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    • 제29권3호
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    • pp.224-234
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    • 2006
  • We employed human SK-MEL-28 cells as a model system to identify cellular proteins that accompany N-(4-methyl)phenyl-O-(4-methoxy)phenyl-thionocarbamate (MMTC)-induced apoptosis based on a proteomic approach. Cell viability tests revealed that SK-MEL-28 skin cancer cells underwent more cell death than normal HaCaT cells in a dose-dependent manner after treatment with MMTC. Two-dimensional electrophoresis in conjunction with matrixassisted laser desorption/ionization-time of flight (MALDI-TOF) mass spectrometry analysis or computer matching with a protein database further revealed that the MMTC-induced apoptosis is accompanied by increased levels of caspase-1, checkpoint suppressor-1, caspase-4, NF-kB inhibitor, AP-2, c-Jun-N-terminal kinase, melanoma inhibitor, granzyme K, G1/S specific cyclin D3, cystein rich protein, Ras-related protein Rab-37 or Ras-related protein Rab-13, and reduced levels of EMS (oncogene), ATP synthase, tyrosine-phosphatase, Cdc25c, 14-3-3 protein or specific structure of nuclear receptor. The migration suppressing effect of MMTC on SK-MEL-28 cell was tested. MMTC suppressed the metastasis of SK-MEL-8 cells. It was also identified that MMTC had little angiogenic effect because it did not suppress the proliferation of HUVEC cell line. These results suggest that MMTC is a novel chemotherapeutic and metastatic agents against the SK-MEL-28 human melanoma cell line.

신경섬유종증에 동반된 가성동맥류 파열로 발생한 자연 혈흉 1예 (A Case of Spontaneous Hemothorax Due to Rupture of Pseudoaneurysm in Type 1 Neurofibromatosis)

  • 김순종;정훈;이성순;임채만;이상도;고윤석;김우성;김동순;김원동;심태선
    • Tuberculosis and Respiratory Diseases
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    • 제50권1호
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    • pp.122-126
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    • 2001
  • 저자들은 신경섬유종증 환자에서 우측 내유동맥에 생긴 가성동맥류의 파열로 인한 자연 혈흉을 진단하고 혈관색전술로 치료한 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

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심부하복벽동맥 천공지 유경 피판을 이용한 이영양성 수포성 표피박리증에 합병된 서혜부 편평 세포 상피암의 치료 - 증례 보고 - (Pedicled Deep Inferior Epigastric Perforator Flap for Treatment of Dystrophic Epidermolysis Bullosa-Associated Squamous Cell Carcinoma in the Groin - Case Report -)

  • 김경필;김지훈;김의식;황재하;김광석;이삼용
    • Archives of Reconstructive Microsurgery
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    • 제19권2호
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    • pp.97-100
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    • 2010
  • Purpose: Epidermolysis bullosa is a rare genetic disease, characterized by the presence of extremely fragile skin and formation of recurrent blister resulting from even a minor mechanical injury. Squamous cell carcinoma (SCC) is recognized as a complication of the chronic scarring associated with dystrophic epidermolysis bullosa (DEB). When a soft tissue defect happens in a patient with epidermolysis bullosa, it is difficult to cover it with a skin graft or a flap. We describe the successful use of a pedicled deep inferior epigastric perforator flap for the reconstruction of SCC associated with DEB in the groin. Methods: A 29-year-old man diagnosed with DEB at birth sustained an ulcer increasing in the right groin for the last 7 months. Under general anesthesia, the mass lesion and lymph nodes were removed and the resulting defect was covered with a pedicled deep inferior epigastric perforator flap. Results: The flap survived completely and his postoperative course was uneventful. Histopathological examination revealed a SCC in the right groin and malignant tumor cells in the removed lymph nodes as well. Additional positron emission tomogram showed a malignant lesion in the ileocecal area with regional lymph node metastasis. The patient was referred to an oncologist for chemotheraphy, but the patient refused to take it. During a 4-month follow-up period, there was no recurrence in the right groin. Conclusion: We suggest that perforator flaps can be considered as a reliable alternative for the reconstruction of soft tissue defects in a patient with DEB.

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구강내 악성흑색종에 대한 임상연구 (CLINICAL STUDY ON MALIGNANT MELANOMA IN ORAL CAVITY)

  • 김욱규;허진호;황대석;김용덕;신상훈;김종렬;정인교
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제34권6호
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    • pp.611-615
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    • 2008
  • The prognosis of oral malignant melanoma is poor compared with cutaneous melanoma. It may be related to the difficulty of wide enough resection, the early hematogenous matastases, higher stage at initial diagnosis, and tendency to growth vertically. In the view of histological differences between oral mucosa and skin, it is impossible use Clark's and Breslow's classifications for prognosis. The great problem is that there is still no consensus on the treatment due to rarity. Because data collection from case reports is considered to be the best source of information and should be pooled to analyze key determinants of outcome, We analysed 6 cases of primary malignant melanoma of the oral cavity which were diagnosed and treated in Pusan National University Hospital on recent 7 years and reviewed the literatures. Immunohistochemical study on S 100 Protein, GP 100 (HMB-45) with biopsy was usable to confirm the melanoma. Three patients who were treated by surgery, chemotherapy are alive, but a patients who couldn't received benefit care surgically due to poor condition was died of distant metastasis, and two patients who refused to surgery are still alive. Neck dissection including wide excision is recommended if lymph node involvement is suspected. Additionally, adjuvant chemotherapy could be considered as supporting therapy for malignant melanoma.

인중에 발생한 연골모양 땀샘종의 치험례 (A Case Report of Chondroid Syringoma of Philtrum)

  • 차정호;김진우;신한경;정재학;김영환;선욱
    • 대한두개안면성형외과학회지
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    • 제11권2호
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    • pp.107-110
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    • 2010
  • Purpose: Chondroid syringoma is a rare mixed tumor of the skin that was first described by Hirsch and Helwig (1961). Characteristically, it is composed of the proliferation of epithelial cells in a myxoid and chondroid matrix. Most lesions occur on the head and neck region, and their size may range from 0.5~3 cm. Since a chondroid syringoma presents similar characteristics to other masses on the head and neck region, it is significantly important to distinguish with other masses by a surgical biopsy. Methods: A 51-year old woman presented with a painless nodular mass ($0.5{\times}0.5{\times}0.5cm$) on the philtrum, which appeared during the previous year. The mass was treated with a laser without a surgical biopsy. However, the size of the mass showed no changes. Surgical excision under local anesthesia was performed and sent for histopathology. Results: Gross examination showed a mass surrounded by a well developed capsule within the dermal layer. After complete excision without injury to the orbicularis oris muscle, the wound was covered with a local flap. The histology examination revealed numerous cuboid epithelial cells with tuboalveolar structures and keratinous cysts within a chondroid stroma. No recurrence or metastasis was observed at the follow-up visits. Conclusion: Chondroid syringoma is a rare mass on the face. An accurate diagnosis is essential for optimal treatment. This paper reports a case of a chondroid syringoma on the philtrum with a brief review of the relevant literature.

Excellent treatment outcomes in children younger than 18 months with stage 4 MYCN nonamplified neuroblastoma

  • Kim, Chiwoo;Choi, Young Bae;Lee, Ji Won;Yoo, Keon Hee;Sung, Ki Woong;Koo, Hong Hoe
    • Clinical and Experimental Pediatrics
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    • 제61권2호
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    • pp.53-58
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    • 2018
  • Purpose: Although the prognosis is generally good in patients with intermediate-risk neuroblastoma, no consensus has been reached on the ideal treatment regimen. This study analyzed treatment outcomes and toxicities in patients younger than 18 months with stage 4 MYCN nonamplified neuroblastoma. Methods: We retrospectively analyzed 20 patients younger than 18 months newly diagnosed with stage 4 MYCN nonamplified neuroblastoma between January 2009 and December 2015. Patients received 9 cycles of chemotherapy and surgery, with or without local radiotherapy, followed by 12 cycles of differentiation therapy with 13-cis-retinoic acid. Chemotherapy consisted of alternating cycles of cisplatin, etoposide, doxorubicin, and cyclophosphamide (CEDC) and ifosfamide, carboplatin, and etoposide (ICE) regimens. Results: The most common primary tumor site was the abdomen (85%), and the most common metastatic sites were the lymph nodes (65%), followed by the bones (60%), liver (55%), skin (45%), and bone marrow (25%). At the end of induction therapy, 14 patients (70%) achieved complete response, with 1 achieving very good partial response, 4 achieving partial response, and 1 showing mixed response. Nine patients (45%) received local radiotherapy. At a median follow-up of 47 months (range, 17-91 months), none of these patients experienced relapse, progression, or secondary malignancy, or died. Three years after chemotherapy completion, none of the patients had experienced grade ${\geq}3$ late adverse effects. Conclusion: Patients younger than 18 months with stage 4 MYCN nonamplified neuroblastoma showed excellent outcomes, without significant late adverse effects, when treated with alternating cycles of CEDC and ICE, followed by surgery and differentiation therapy.