• Title/Summary/Keyword: Soft tissue lesion

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Primary Osteolytic Intraosseous Atypical Meningioma with Soft Tissue and Dural Invasion : Report of a Case and Review of Literatures

  • Yun, Jung-Ho;Lee, Sang-Koo
    • Journal of Korean Neurosurgical Society
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    • v.56 no.6
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    • pp.509-512
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    • 2014
  • Primary intraosseous meningioma is a rare tumor, and atypical pathologic components both osteolytic lesion and dura and soft tissue invasion is extremely rare. A 65-year-old woman presented with a 5-month history of a soft mass on the right frontal area. MR imaging revealed a 4 cm sized, multilobulated, strongly-enhancing lesion on the right frontal bone, and CT showed a destructive skull lesion. The mass was adhered tightly to the scalp and dura mater, and it extended to some part of the outer and inner dural layers without brain invasion. The extradural mass and soft tissue mass were totally removed simultaneously and we reconstructed the calvarial defect with artificial bone material. The pathological study revealed an atypical meningioma as World Health Organization grade II. Six months after the operation, brain MR imaging showed that not found recurrence in both cranial and spinal lesion. Here, we report a case of primary osteolytic intraosseous atypical meningioma with soft tissue and dural invasion.

Soft Tissue Infection with Mycobacterium abscessus on the Chin of a Healthy Child: A Case Report (건강한 소아의 턱에 발생한 Mycobacterium abscessus에 의한 연부조직 감염: 증례 보고)

  • Kim, Hong-Ryul;Kim, Deok-Woo
    • Archives of Plastic Surgery
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    • v.37 no.3
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    • pp.289-292
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    • 2010
  • Purpose: Mycobacterium abscessus belongs to the group of rapid-growing atypical mycobacterium. The organism is ubiquitous and is found in soil, dust, and water. Although it rarely causes disease in humans, Mycobacterium abscessus has been associated with soft tissue infection. To the best of our knowledge, this is the first case report of facial soft tissue Mycobacterium abscessus infection in a healthy child in Korea. Methods: A 12-year-old girl presented with an erythematous skin lesion with serous discharge on her chin, which had been present for 3 weeks. On her history, she had a laceration wound on her chin at public bath and the lesion was repaired at emergency department immediately. Although conventional soft tissue infecton treatment, her lesion remains unhealed state and had serous discharge for 2 months. Moreover, we found a 1 cm sized nodular mass on her chin. Therefore we performed excision operation and referred the specimen to the laboratory for microbial and histopathologic study. Results: Pathology report confirmed the mass was enlarged lymph node with chronic necrotizing granulomatous inflammation with central microabscess. Non-Tuberculous mycobacterium identification test through tissue specimen resulted Mycobacterium abscessus. We prescribed clarithromycin for three weeks by oral administration as well as performed wound debridement and mass excision via previous wound. This way, her lesion appeared to be complete healing with minimal scarring. There were no evidence of inflammation sign or palpable mass. Conclusion: Although the prevalence is rare, Mycobacterium abscessus infections of soft tissue should be considered even in a healthy child with a lesion caused by trauma or which fails to respond to conventional treatment.

A CLINICAL STUDY OF METASTATIC CARCINOMA TO ORAL SOFT TISSUE (구강내 연조직 전이암종의 임상적 연구)

  • Park, Joo-Yong;Kim, Hyung-Sup;Ok, Yong-Ju;Song, Jin-A;Lee, Jong-Ho;Kim, Myung-Jin;Choi, Sung-Weon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.27 no.4
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    • pp.346-349
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    • 2005
  • Metastatic tumours to oral soft tissue are uncommon and accounts for approximately 1% of malignant oral neoplasms. Because of its rarity and clinical appearance of benign nature, the diagnosis of a metastatic lesion in the oral soft tissue may be challenging, both to clinicians and pathologists. We analyzed the clinical data of 9 patients who had metastatic carcinoma to oral soft tissues. The metastatic site to oral soft tissue was the gingiva in all cases. The most common primary site was lung (6 cases) followed by liver (2 cases) and breast (1 case). The clinical appearance resembled gingiva hyperplasia, pyogenic granuloma or gingival swelling. In one case, the metastatic gingiva lesion was found before detection of primary cancer. The mean survival time after diagnosis of metastatic lesion was 3 months. Although this metastatic lesion is rare, oral and maxillofacial surgeon should recognized that benign inflammatory lesion may be the metastatic malignant lesion or the first sign of undiagnosed underlying malignancy.

Reconstruction of the Pretibial Soft Tissue Lesion after Chronic Tibia Osteomyelitis using Anterolateral Thigh Perforator Flap (전외측 대퇴부 천공지 피판을 이용한 만성 경골 골수염에 동반된 하지 전방 연부조직 병변의 재건)

  • Jung, Heun-Guyn;Choi, Dong-Hyuk;Jeon, Sung-Hoon;Kim, Hee-Dong
    • Archives of Reconstructive Microsurgery
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    • v.18 no.1
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    • pp.16-22
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    • 2009
  • The purpose of this study was to present the clinical result of anterolateral thigh free flap for pretibial soft tissue lesion after chronic tibia osteomyelitis. From December 2006 to September 2008, Five patients were included in our study. 4 of 5 were superficial or localized types of chronic tibia osteomyelitis, based on the classification of Cierny and Mader. Average age at the surgery was 45 years, three were males and two were females. All had a history of chronic tibia osteomyelitis and subsequent pretbial soft tissue lesions coming from previous operations or pus drainage. Pretibial soft tissue defects included small ulcers, fibrotic, bruisable soft tissue and small bony exposures, but not large-sized bony exposures nor active pus discharge. After complete debridement of large sized pretibial soft tissue lesions and decortication of anterior tibial cortical dead bone, anterolateral thigh free flap was applied to cover remained large pretibial soft tissue defect and to prevent the recurrence of infection. All flaps survived and provided satisfactory coverage of soft tissue defect on pretibial region for 16 months' mean follow up period. No patients has had recurrence of osteomyelitis. Anterolateral thigh free flap could be recommend for large sized pretibial soft tissue defect of supreficial or localized types of chronic tibia osteomyelitis after through debridement.

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Diagnostic Efficacy of PET in Soft Tissue Tumors: Comparative Study with Conventional Methods (연부 조직 종양에서 PET의 유용성: 기존의 진단법과의 비교 연구)

  • Seo, Sung-Wook;Park, Sang-Min;Cho, Hwan-Seong
    • The Journal of the Korean bone and joint tumor society
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    • v.11 no.1
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    • pp.32-39
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    • 2005
  • Introduction: Currently, F-18 fluorodeoxyglucose positron emission tomography scans (FDG-PET) has been investigated in soft tissue tumor especially for tumor detection and noninvasive grading. However, the validity and the efficacy of FDG-PET are still unclear in clinical evaluation. The purpose of this study is to determine the efficacy of FDG-PET in compared to conventional diagnostic imaging studies currently used in the soft tissue tumor. Methods: Between March 2001 and March 2002, 29 patients (sixteen males, thirteen females, mean age, 47 years; a range from 4 to 73) diagnosed with soft tissue tumor were evaluated by both conventional diagnostic imaging and FDG-PET. Valid reference test of the local lesion was the histopathologic diagnosis, which was measured in all patients. The suspecting metastasis in the imaging studies was validated by pathology or follow up imaging for at least 6 months. Each imaging diagnosis was made independently. The accuracy of each diagnostic method was evaluated. The incremental cost accuracy ratio was determined in each diagnostic method. Results: For detection of local lesion, sensitivity, specificity, and accuracy for MRI and FDGPET scans were 91%, 57%, 83% and 95%, 43%, 83% respectively. For detection of distant lesion, sensitivity, specificity, accuracy for conventional diagnostic methods and FDG-PET scans were 77%, 89%, 87% and 92%, 94%, 93% respectively. The incremental cost accuracy ratio (ICAR) of FDG-PET for detection of distant lesion was 145,000won/%. According to ICAR for each tumor grade, PET strategy is most cost-effective at high grade tumors. Conclusions: For detection of local lesion such as recurrence or remnant tumor, FDG-PET scan was not more accurate than MRI. However, It was more accurate for detection of metastatic lesion than conventional methods. For detection of high grade tumor, PET was most costeffective than for detection of lower grade tumor.

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Ankle Lesions, Associated with Anterior Soft Tissue Impingement (전방 연부조직 충돌과 동반된 족관절 병변)

  • Sung, Il-Hoon;Kim, Suk-Hwan;Shim, Kyu-Dong;Lee, Jun-Hwan;Kang, Chang-Nam
    • Journal of Korean Foot and Ankle Society
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    • v.14 no.2
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    • pp.115-118
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    • 2010
  • Purpose: To evaluate clinical features of ankle lesions, associated with anterior soft tissue impingement. Materials and Methods: We retrospectively reviewed 21 patients who had chronic anterior ankle pain as initial symptom and associated ankle lesions with anterior soft tissue impingement. Based on preoperative radiologic findings, physical examination intra-operative findings, appropriate procedures were done for lesions by either arthroscopic or minimal open procedure or combined. Clinical evaluation was done using American Orthopedic Foot and Ankle Society, ankle-hind foot score (AOFAS score) and visual analog scale (VAS) on last follow up. Results: Associated lesion(s) to anterior soft tissue impingement of the ankle were 16 cases of osteochondral lesion of talus, 14 cases of bony impingement, 6 cases of ankle lateral instability, 5 cases of loose body, 4 cases of os subfibulare. AOFAS score was $58.9\;{\pm}\;5.1$ preoperatively and $74\;{\pm}\;9.1$ on last follow up. Clinical satisfaction score using VAS showed excellent in 3 cases, good in 11, fair in 3, poor in 4. Conclusion: The patients who had anterior soft tissue impingement would have various associated lesions on their ankle. In such cases, preoperative counseling for variety of postoperative results would be needed.

Intravascular Papillary Endothelial Hyperplasia (Masson tumor) of the Skull : Case Report and Literature Review

  • Park, Keuk-Kyu;Won, Yu-Sam;Yang, Jae-Young;Choi, Chun-Sik;Han, Ki-Young
    • Journal of Korean Neurosurgical Society
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    • v.52 no.1
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    • pp.52-54
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    • 2012
  • A 10-year-old female patient presented with a rapidly growing nodular mass lesion on her right frontal area. On skull radiography and computed tomography (CT) imaging, this mass had a well-demarcated punch-out lesion with a transdiploic, exophytic soft tissue mass nodule on the frontal scalp. Magnetic resonance (MR) imaging revealed the presence of a $1.5{\times}1.2{\times}1$ cm sized calvarial lesion. This lesion was hypointense on T1 and heterogenous hyperintense on T2 weighted MR images, and exhibited heterogeneous enhancement of the soft tissue filling the punch-out lesion after intravenous administration of gadolinium. En block removal of the tumor with resection of the rim of the normal bone was performed. The pathological diagnosis was intravascular papillary endothelial hyperplasia (IPEH). After surgery, no recurrence was found for 8 months. IPEH is a rare and benign reactive lesion usually found in thrombosed subcutaneous blood vessels. Involvement of skull bone is rare. In this article, we present a case of IPEH involving the calvarium, in a 10-year-old woman.

FIBROMA ON THE PALATE : A CASE REPORT (구개의 섬유종 : 증례보고)

  • Kim, Young-Jae;Jang, Ki-Taeg;Hahn, Se-Hyun;Kim, Chong-Chul;Lee, Sang-Hoon;Kim, Jung-Wook
    • Journal of the korean academy of Pediatric Dentistry
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    • v.30 no.2
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    • pp.286-290
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    • 2003
  • The fibroma is the most common benign soft-tissue tumor found in the oral cavity and most commonly occurrs in sites predisposed to irritation or trauma. Treatment is conservative surgical excision. Seldom does the lesion recur. A 14-year old girl was referred to the Department of Pediatric Dentistry for evaluation and management of a mass on the palate. The patient's parents reported the slow growth of this soft tissue lesion over a 6-month period. A history of trauma or irritable habits was denied. Clinical examination revealed an asymptomatic, soft, pedunculated elevation of mucosa, measuring 3cm in diameter. Excisional biopsy of the lesion supported a diagnosis of fibroma. There have been no signs of recurrence during follow up of 4 years after surgical intervention. The clinical picture, pathology and management of the case are described, and the differential diagnosis and treatment are discussed.

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Fine Needle Aspiration Cytology of Unusual Epidermoid Cyst with Diffuse Parakeratosis and Aggressive Growth - A Case Report - (미만성 이상각화증을 동반한 침습성 표피양 낭의 세침흡인 세포학적 소견 - 1예 보고 -)

  • Nam, Hae-Joo
    • The Korean Journal of Cytopathology
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    • v.10 no.1
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    • pp.85-89
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    • 1999
  • An extremely unusual case of epidermoid cyst showing diffuse parakeratosis and aggressive clinical behavior is presented. A destructive bone lesion with surrounding ill-defined soft tissue lesion was found by computed tomography in a 63 year-old man complaining of painful swelling of the right buttock. He had a history of surgical excision twice for epidermoid cysts of soft tissue of the right hip during recent one year On aspiration cytology, the aspirate was highly cellular and mostly composed of desquamated nucleated squamous cells. Operation finding revealed that the iliac bone was Irregularly destroyed and filled with gray-white cheesy material and necrotic bone bedris. Adjacent gluteus muscle showed scattered gray-white lesions. The curettage specimen showed bone necrosis and desquamated squamous cells filling the marrow spaces. The lesion within muscle revealed epidermoid cyst with diffuse parakeratosis.

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Angioleiomyoma masquerading as shoulder pain

  • Ravi, Surekh;Chandy, Lazar J;Kumar, Gautam;Jacob, Biju;Emmanuel, Ami M
    • Clinics in Shoulder and Elbow
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    • v.24 no.1
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    • pp.32-35
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    • 2021
  • Angioleiomyoma is a benign soft tissue tumor originating from vascular smooth muscle. We report a case of a 20-year-old student who presented with pain in the right shoulder of 4 years duration. Shoulder movements were pain-free throughout the range of motion except resisted external rotation. Magnetic resonance imaging visualized a well-circumscribed lesion over the infraspinatus tendon. The lesion was surgically removed and sent for histopathological analysis. Morphology and immunohistochemistry results were suggestive of angioleiomyoma. The most common location for such a lesion is the lower limb, with less than 1% being reported in the upper arm, of which an angioleiomyoma of the shoulder is extremely rare.