• 대한두개안면성형외과학회지
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• 제21권3호
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• pp.202-205
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• 2020

Trichoepithelioma is a benign hair follicle tumor that can undergo malignant transformation into basal cell carcinoma in rare cases. Due to the similar clinical and histological features of trichoepithelioma and basal cell carcinoma, distinguishing between these types of tumors can be a diagnostic challenge. Punch biopsy obtains only a small sample of the entire lesion, and thus inherently involves a risk of misdiagnosis between histologically similar diseases. Therefore, if the possibility of misdiagnosis can reasonably be suspected, clinicians should conduct an excisional biopsy or immunohistochemical staining (e.g., CD10 and Bcl-2) to ensure an exact diagnosis. Although trichoepithelioma is benign, the surgical excision of solitary trichoepithelioma should be considered in order to avoid the possibility of malignant transformation, which has occasionally been documented for multiple familial trichoepitheliomas. Herein, we report a case that was initially misdiagnosed as trichoepithelioma before ultimately being diagnosed as basal cell carcinoma through excision and immunohistochemical staining.

• Archives of Plastic Surgery
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• 제34권4호
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• pp.495-497
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• 2007

Purpose: Malignant peripheral nerve sheath tumors (MPNSTs) are rare neoplasms, usually arising from somatic soft tissues or peripheral nerves. Primary MPNST of the scalp is extremely rare. The case is being reported for its rarity. Methods: A 53-year-old female was presented with a scalp mass on vertex area. The tumor was localized in scalp skin and did not invade underlying periosteum or skull and treated with complete surgical excision followed by adjuvant chemotherapy and radiotherapy. Results: Histologically, the tumor showed malignant spindle cells with focal S-100 positivity on immunohistochemistry and a diagnosis of MPNST was made. Conclusion: Authors experienced a rare case of primary scalp MPNST and report the case.

• 대한두개안면성형외과학회지
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• 제19권4호
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• pp.287-290
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• 2018

Tumoral calcinosis is a condition characterized by deposition of calcium salts in the skin and subcutaneous tissue, commonly found around the joints. However, tumoral calcinosis of the auricle is extremely rare. We present the case of a 13-year-old boy with tumoral calcinosis of the helix of the ear auricle. A 13-year-old boy presented with a 10-year history of an enlarging mass on the left auricle. The mass was hard, non-tender, and non-compressible. The patient had no history of trauma. Complete surgical excision and pathological examination of the specimen was performed. The final diagnosis of the excised mass was tumoral calcinosis. After 9 months of follow-up, there were no signs of recurrence of the tumor and the patient was satisfied with the surgical results. Tumoral calcinosis of the auricle is extremely rare and may be misdiagnosed as other tumors. Pathological examination is essential for definitive diagnosis and complete surgical excision should be considered as the treatment of choice.

• 대한두개안면성형외과학회지
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• 제22권3호
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• pp.135-140
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• 2021

Background: Wide surgical excision is the gold standard for basal cell carcinoma (BCC) treatment. Typically, resection requires a safety margin ≥ 4 mm. We aimed to confirm BCC excisions' cancer recurrence rate and safety on the facial region with new safety margins. Methods: We included patients with primary BCC on the facial region who underwent wide excision with 2- or 3-mm safety margins at our institution between January 2010 and December 2018. Medical records were reviewed to confirm the epidemiology and surgical information. Recurrence was confirmed by physical examination through regular 6-month follow-up. Results: We included 184 out of 233 patients in this study after applying the exclusion criteria. The mean age and follow-up period were 71.2±10.2 years and 29.3±13.5 months, respectively. The predominantly affected area was the nose (95 cases); a V-Y advancement flap was the most commonly used surgical method. There were two cases of recurrence in the 2 mm margin group and one recurrence in the group resected with 3 mm margins. Conclusion: In this large cohort study, we found 2-3 mm excision margins can yield enough safety in facial BCCs. The recurrence rates were found to be comparable with those reported after wider margins.

• Journal of Yeungnam Medical Science
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• 제39권2호
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• pp.168-171
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• 2022

Palisading encapsulated neuroma is a rare, benign, cutaneous nerve sheath tumor. It usually occurs as an asymptomatic solitary skin-colored papule and commonly affects the nose and cheeks. Sometimes, it involves other sites, including the shoulder, upper arm, and trunk, but rarely involves the oral mucosa, including that of the lip. In our case, a 63-year-old female patient complained of a pinkish rubbery nodule on her lower lip. Histopathologic examination demonstrated a well-circumscribed nodule encapsulated by connective tissue stroma in the dermis. The nodule consisted of palisading spindle-shaped tumor cells with wavy and basophilic nuclei. The cells were arranged in streaming fascicles with multiple clefts and were strongly positive for S-100 proteins. To our knowledge, only three cases of palisading encapsulated neuroma on the lower lip have been reported in the Korean literature. Herein, we report a rare case of an oral palisaded encapsulated neuroma.

• Archives of Plastic Surgery
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• 제49권1호
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• pp.39-42
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• 2022

Bilateral pectoralis major myocutaneous (PMMC) flaps are commonly used to reconstruct large chest wall defects. We report a case of large chest wall defect reconstruction using bilateral PMMC flaps augmented with axillary V-Y advancement rotation flaps for additional flap advancement. A 74-year-old male patient was operated on for recurrent glottic squamous cell carcinoma. Excision of the tumor resulted in a 10×10 cm defect in the anterior chest wall. Bilateral PMMC flaps were raised to cover the chest wall defect. For further flap advancement, V-Y rotation advancement flaps from both axillae were added to allow complete closure. All flaps survived completely, and postoperative shoulder abduction was not limited (100° on the right side and 92° on the left). Age-related skin redundancy in the axillae enabled the use of V-Y rotation advancement flaps without limitation of shoulder motion. Bilateral PMMC advancement flaps and the additional use of V-Y rotation advancement flaps from both axillae may be a useful reconstructive option for very large chest wall defects in older patients.

• Journal of Medicine and Life Science
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• 제20권2호
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• pp.89-93
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• 2023

We present three cases of patients with breast cancer and psoriasis who received radiotherapy following breast-conserving surgery. One patient developed an extensive flare-up of psoriasis during chemotherapy. After discontinuing chemotherapy, she received conventional radiotherapy to the ipsilateral whole breast, axillary, and supraclavicular lymph nodes with 50.4 Gy in 28 fractions and boosted with 10 Gy in five fractions to the tumor bed. Two patients received hypofractionated whole-breast radiotherapy at a total dose of 40.05-42.4 Gy in 15-16 fractions. In all three cases, there was no flare-up of psoriatic events at least 6 months after the completion of radiotherapy. We hypothesized that there is a close relationship between psoriatic events and the extent of trauma rather than the daily dose of the fraction. Therefore, we confirmed that the effect of radiotherapy on psoriatic events is minimal if the radiation field size does not exceed that of the whole breast.

• 대한정형외과학회지
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• 제54권1호
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• pp.84-89
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• 2019

신경초종은 Schwann 세포에서 기원하는 양성 종양이다. 총상 신경초종은 총상형이나 다결정성의 성장 형태를 보이는 신경초종의 드문 아형이다. 총상 신경초종은 대부분은 피부와 피하조직에 고립성 병변(solitary lesion)을 보이지만 드물게 심부조직 내에 위치하기도 한다. 저자들은 매우 드물게 후경골 신경 및 원위부 분지 신경에서 발생하였으며, 심부조직에 위치하여 골 변형을 동반한 다발성 총상 신경초종이 재발한 1예를 경험하였기에 이를 보고하고자 한다.

• 대한정형외과학회지
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• 제54권2호
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• pp.197-202
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• 2019

모소낭은 주로 청소년기와 청년기의 남성에서 천미부에 호발하는 질환으로 알려져 있으나 아직 원인이 확실하지 않고 치료 방법 또한 여전히 논란이 있다. 우리나라에서는 서구에 비해 모소낭의 유병률이 낮으며, 단순 농양으로 오진되기 쉽다. 모소낭으로 진단되었을 때, 치료의 원칙은 잔존 모소낭을 남기지 않고 절제를 시행하는 것이다. 이에 저자들은 indigo-carmine 염색 시약을 이용한 모소낭의 광범위 절제술의 과정을 소개하고자 한다.

• 대한두개안면성형외과학회지
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• 제17권2호
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• pp.56-62
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• 2016

Background: The two most common skin cancers are basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). The purpose of this study was to describe the detailed clinical behavior of BCC and SCC in the head and neck region over 19 years at a single institution. Methods: A retrospective analysis was performed for all patients with non-melanoma skin cancer who had undergone surgical resection over an 18-year period. Patient charts were reviewed for demographic information, tumor size, onset-to-diagnosis, anatomic location, clinical subtype, histologic differentiation, method of surgical treatment, and recurrence. Results: The review identified 265 cases of either BCC or SCC in 226 patients. Of the 226 patients, 80 (35.4%) were men and 146 (64.6%) were women. BCC (n=138, 55.9%) was more frequent than SCC (109, 44.1%). The most frequent age group was 70-to-79 year olds (45 patients, 35.2%) for BCC and 80-to-89 year olds (41 patients, 41.8%) for SCC. By aesthetic units of the face, the most common location was the nasal unit (44 cases, 31.9%) for BCC and the buccal unit (23 cases, 21.1%) for SCC. The most common clinical subtype of BCC was the nodular type (80 cases, 58.0%). Local flaps were most commonly used to cover surgical defects (136 cases, 55.1%). Recurrent rates were 2.2% for BCC and 5.5% for SCC. Conclusion: In our study, many characteristics of BCC and SCC were compared to previously published reports were generally similar, except the ratio of BCC to SCC. Further study can help to establish the characteristics of BCC and SCC.