• Archives of Plastic Surgery
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• v.33 no.6
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• pp.764-768
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• 2006

Purpose: Parotid neoplasia are relatively frequent, representing approximately 3% of all tumors in the head and neck regions. But incomplete resection and misdiagnosis of parotid gland is followed by multiple tumor invasion, tumor recurrence, and other iatrogenic tumor formation. In patients undergoing parotidectomy for confirmed or suspected malignancy, the traditional or modified rhytidectomy incision may prove suboptimal because it does not easily lend itself to a continuous neck dissection. Similarly, patients with tumors of the anterior accessory lobe or patients with large anterior tumors may also require the modified Blair incision for adequate surgical exposure. This report serves to revisit the topic of accessory and parotid gland neoplasms to emphasize proper management, particularly the surgical aspects, so that consequences of recurrence are avoided. Methods: This is a retrospective review of our experience with two cases of parotid tumors; one accessory parotid gland neoplasm and one parotid gland neoplasm. We report the case of parotid tumor and epidermal cyst in a 54-year old male patient and the case of case of recurrent parotid tumor with local invasion in 30-year old male patient. Results: All were removed through a modified Blair incision. Pathologic report notified that One was found pleomorphic adenoma and epidermal cyst, and the other one pleomorphic adenoma with subcutenous invasion. The patients recovered well without any complication such as infection, hematoma, facial nerve palsy, and necrosis of skin flap. Patients were discharge POD#7. Patients were followed up to for 1 year and they have no sign of recurrence. Conclusions: A high index of suspicion, prudent diagnostic skills(including fine-needle aspiration biopsy, CT, US), and meticulous surgical approach are the keys to a successful management of these lesions. We experienced two cases of parotid neoplasia, in the treatment of tumor reccurence & iatrogenic tumor arising from the parotid gland and are presented with the review of literatures.

• Archives of Craniofacial Surgery
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• v.10 no.2
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• pp.138-141
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• 2009

Purpose: Squamous cell carcinoma of the scalp sometimes exhibits unusually aggressive behavior. We report a case of extradordinarily aggressive squamous cell carcinoma of the scalp with invasion into the skull and dura mater. Method: The patient is a 38-year-old man with two cystic masses on the occipital area. He was diagnosed as squamous cell carcinoma in that region and have undergone surgical resections including cortical osteotomy of the skull, several years ago. On this occasion, 3-dimensional computed tomographic imaging revealed an erosive lesion on the occipital bone and magnetic resonance imaging showed two cystic masses invasion into the skull and dura mater. Results: He has undergone wide resection of the masses and cranioplasty with dural repair. Histopathologic examination indicated squamous cell carcinoma with moderate differentiation of the masses, bone marrow and dura mater. Conclusion: Squamous cell carcinoma on the scalp can readily penetrate the full thickness of the cranium and invade the dura mater, sagittal sinus and brain. We suggest wide resection of the scalp and split thickness skin graft with sentinel lymph node biopsy, following by postoperative radiation therapy.

• Journal of Chest Surgery
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• v.43 no.6
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• pp.790-792
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• 2010

A 77-year-old man presented with a huge protruding mass on the left anterior chest wall. The tumor was resected and diagnosed as dermatofibrosarcoma protuberans (DFSP). DFSP is an uncommon, intermediate-grade mesenchymal cutaneous tumor which extends deep into subcutaneous tissue and may invade through the fascial planes and into muscle but rarely metastasize. Histologically, DFSP is composed of spindle cells arranged in an irregularly whorled or storiform pattern. The histological diagnosis can be confirmed with immunohistochemical staining for CD34. We report a case of DFSP. The tumor was completely excised and the chest wall was reconstructed using latissimus dorsi muscle flap and skin graft.

• Journal of Acupuncture Research
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• v.26 no.1
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• pp.135-151
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• 2009

Objectives : To survey concept, meaning, and problems of beekeeper's bee sting therapy by reviewing and summarizing outline, indications, and clinical cases of 'Research on Bee Sting Therapy' described in Monthly Yangbonggye. Methods : As a narrative review, literature researches were carried out based on 'Research on Bee Sting Therapy' in Monthly Yangbonggye in the aspects of outline, indications, and clinical cases. In the concrete, outline was just summarized and described, and indications were categorized by recent version of international statistical classification of diseases and related health problems(ICD) of WHO(World health organization), and clinical cases were collected and summarized from the viewpoint of acupoints and methods of therapy. Results : 1. Bee sting therapy is to inject venom into skin by stimulating affected lesions or acupoints on meridian with sting of bee alive for therapeutic purposes. It can be divided into two classes(direct stimulation(直針法) and indirect stimulation(拔針法)) by the differences of methods, and is different from bee venom acupuncture therapy in the aspects of the way of extraction and injection. 2. In this material, bee sting therapy has 83 indications classified into 17 of 22 chapters of ICD. Among clinical cases, cases on neoplasm, goitre, lump, and haemorrhoids by direct stimulation were especially outstanding. 3. The therapeutic acupoints selected in bee sting therapy are mainly Ashi points(阿是穴), and partly acupoints on meridian(經穴), Extra points(經外奇穴), and New points(新穴) with careful consideration of patients' condition. Conclusions : Although bee sting therapy has more or less controversial points of diagnosis, treatment, and management of side effects, it is thought that the accumulated and inherited experiences from old times can be used as meaningful material by further experimental and clinical researches.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.38
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• pp.46.1-46.7
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• 2016

Background: Osteoradionecrosis is the most dreadful complication after head and neck irradiation. Orocutaneous fistula makes patients difficult to eat food. Fibular free flap is the choice of the flap for mandibular reconstruction. Osteocutaneous flap can reconstruct both hard and soft tissues simultaneously. This study was to investigate the success rate and results of the free fibular flap for osteoradionecrosis of the mandible and which side of the flap should be harvested for better reconstruction. Methods: A total of eight consecutive patients who underwent fibula reconstruction due to jaw necrosis from March 2008 to December 2015 were included in this study. Patients were classified according to stages, primary sites, radiation dose, survival, and quality of life. Results: Five male and three female patients underwent operation. The mean age of the patients was 60.1 years old. Two male patients died of recurred disease of oral squamous cell carcinoma. The mean dose of radiation was 70.5 Gy. All fibular free flaps were survived. Five patients could eat normal diet after operation; however, three patients could eat only soft diet due to loss of teeth. Five patients reported no change of speech after operation, two reported worse speech ability, and one patient reported improved speech after operation. The ipsilateral side of the fibular flap was used when intraoral soft tissue defect with proximal side of the vascular pedicle is required. The contralateral side of the fibular flap was used when extraoral skin defect with proximal side of the vascular pedicle is required. Conclusions: Osteonecrosis of the jaw is hard to treat because of poor healing process and lack of vascularity. Free fibular flap is the choice of the surgery for jaw bone reconstruction and soft tissue fistula repair. The design and selection of the right or left fibular is dependent on the available vascular pedicle and soft tissue defect sites.

• Tuberculosis and Respiratory Diseases
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• v.70 no.2
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• pp.139-142
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• 2011

Background: Lung cancer is responsible for substantial proportions of cutaneous metastasis from internal malignancies. The aim of this study was to evaluate the clinical manifestations and outcomes of cutaneous metastasis in Korean lung cancer patients. Methods: On a retrospective basis, we analyzed medical records of all patients diagnosed with lung cancer from 2000 to 2006. Results: Cutaneous metastases were found in 10 of 4,385 patients. The number of cases was highest for squamous cell carcinoma. However, there was no metastasis from 754 cases of small cell carcinomas. Cutaneous metastasis was detected during staging work-up in 4 patients and it was the presenting sign of recurrence post-operative in 2 patients. Average time from the diagnosis to discovery of cutaneous metastasis was 16.3 months and median survival was 8.5 months (range, 1.8~19.1 months). Conclusion: Physicians should be acquainted with clinical manifestations and outcomes of cutaneous metastasis from lung cancer to detect new, recurrent cancer, or disease progression, and to administer appropriate and prompt management.

• Journal of Chest Surgery
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• v.31 no.8
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• pp.816-819
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• 1998

Myxomas are the most common form of intracardiac tumors and are found primarily in the left atrium. In rare cases, Carney and associates have described a syndrome called "the complex of myxoma" consisting of cardiac myxoma, which characteristically is familial, in assocation with two or more of the follow conditions: myxomatous masses (cardiac myxoma, cutaneous myxosma, and mammary myxoid fibroademoma), spotty pigmented lesions of the skin, and endocrine disorders. We report a case of familial atrial myxoma with Carney's complex in a 19-year old woman who has spotty pigmentations on her face, and left atrial myxomas, and myxoma on the right nipple. Her mother and sister share the left atrial myxoma. The myxomas originated in the septum of the left atrium and the anterior leaflet of the mitral valve were successfully excised. In conclusion, family members of affected patients should be screened periodically with echocardiography in an attempt to identify asymptomatic cardiac myxomas. Complete excision and postoperative follow up are necessary to rule out the muticentricity and high rate of recurrent lesions.

• Clinical and Experimental Pediatrics
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• v.61 no.2
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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.

• Journal of Gastric Cancer
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• v.6 no.3
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• pp.193-197
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• 2006

Melanoma is a malignant neoplasm of melanocytes most frequently arising from the skin, but primary melanoma can also arise from the mucosa of the gastrointestinal tract. Gastrointestinal melanomas are most commonly metastases from a cutaneous melanoma. Primary melanoma of the stomach is rare and carries a poor prognosis. Reported here is the case of a 75-year-old man with a primary gastric melanoma who presented with a melena, abdominal pain, and weight loss. Most cases of melanoma are treated by excision of the primary tumor. Patients with melanoma have been treated with adjuvant chemotherapy, radiation therapy, and immunotherapy. None of these modalities has been demonstrated to prolong the survival rate. To improve long-term disease-free survival, early diagnosis and surgical intervention are very important.

• Journal of Genetic Medicine
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• v.6 no.1
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• pp.91-94
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• 2009

Werner syndrome (WRN), or adult progeria, is a very rare, autosomal recessive disorder characterized by the appearance of accelerated aging, including cataracts, gray hair, skin atrophy, and atherosclerosis. This syndrome is caused by mutations in the WRN gene and had a high risk of a spectrum of rare neoplasms including: i) non-epithelial malignant or pre-malignant tumors/conditions, osteosarcomas and soft tissue sarcomas, malignant melanomas, myeloid leukemia and myelodysplastic syndrome; ii) an epithelial neoplasm, thyroid carcinoma, and iii) meningiomas. Recently, authors experienced a case of Werner syndrome complicated by bone metastasis of rhabdomyosarcoma in a 20-year old Korean man. The patient revealed a painful mass on his right knee and progeroid features, short stature, scalp alopecia, abnormal dentition, craniofacial disproportion, hypothyroidsm, cataracts and osteoporosis. The onset of symptoms of Werner syndrome generally precedes any later symptoms of associated conditions, such as malignant tumor. Therefore, early recognition of Werner syndrome is important to assist identification of malignant tumors at an early stage in this patient group.