• 제목/요약/키워드: Soft tissue metastasis

검색결과 148건 처리시간 0.03초

Endoscopic Endonasal Transsphenoidal Resection of Solitary Extramedullary Plasmacytoma in the Sphenoid Sinus with Destruction of Skull Base

  • Park, Sung-Hoon;Kim, Young-Zoon;Lee, Eun-Hee;Kim, Kyu-Hong
    • Journal of Korean Neurosurgical Society
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    • 제46권2호
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    • pp.156-160
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    • 2009
  • Solitary extramedullary plasmacytomas are isolated plasma cell tumors of soft tissue that typically do not metastasize. They are rare and account for 4% of all plasma cell tumors. To our knowledge, only 14 cases of solitary extramedullary plasmacytomas in the sphenoid sinus have been reported. A 32-year-old man presented to our department with complaint of ocular pain in the right eyeball and diplopia. Physical and neurological examinations revealed intact and prompt direct and indirect light reflexes in both pupils and limitation of extraocular muscle movement seen with the lateral gaze of the right eyeball. Magnetic resonance imaging suggested the presence of mucocele or mycetoma, therefore surgical resection was performed with endoscopic endonasal transsphenoidal approach. Histopathology was consistent with plasmacytoma. Systemic work-up did not show any evidence of metastasis and the sphenoid sinus was the sole tumor site, and therefore the diagnosis of solitary extramedullary plasmacytoma was confirmed. We report a rare case of solitary extramedullary plasmacytoma in the sphenoid sinus with successful treatment using the endoscopic endonasal transsphenoidal resection and adjuvant radiotherapy.

Primary Spinal Dumbbell-Shaped Mesenchymal Chondrosarcoma Located Intradurally and Extradurally

  • Bae, Gyu-Seong;Choi, Seung-Won;Youm, Jin-Young;Kim, Seon-Hwan
    • Journal of Korean Neurosurgical Society
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    • 제50권5호
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    • pp.468-471
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    • 2011
  • Mesenchymal chondrosarcomas are rare malignant tumors of the bone and soft tissue. Spinal mesenchymal chondrosarcomas are even rarer and, to the best of our knowledge those that are concomitantly located in the intradural and extradural regions, have never been reported. We report a case of a 25-year-old man with back pain and bilateral progressive weakness of the lower extremities. Magnetic resonance imaging revealed a markedly enhanced dumbbell-shaped mass at the T7 level. The lesion was intradurally located at the left side of the spinal cord, and extended extradurally to the extraforminal space through the T7-8 intervertebral foramen. The tumor was completely excised through a posterior approach. Microscopic examination and immunohistochemical studies confirmed mesenchymal chondrosarcoma. Postoperative radiation therapy and chemotherapy were also performed to prevent local recurrence and metastasis. The patient has been symptom-free for two years after surgery. Herein, we reviewed and discussed the clinical characteristics, treatments, and outcomes of primary intraspinal mesenchymal chondrosarcomas in the literature.

흉쇄유돌근에서 기인한 Low-Grade Myofibroblastic Sarcoma 1예 (Low Grade Myofibroblastic Sarcoma of the Sternocleidomastoid Muscle)

  • 심남석;홍현준;송기재;최성은;서연석;이은정
    • 대한두경부종양학회지
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    • 제30권1호
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    • pp.23-27
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    • 2014
  • Low-grade myofibroblastic sarcoma is a rare disorder of malignant soft tissue tumor and is usually occurred various regions that often manifests in the head and neck region. The most common clinical presentation of this entity is non-tender cervical lymphadenopathy. This disease usually presents high possibility of local recurrence and low possibility of distant metastasis. We report a rare case of low-grade myofibroblastic sarcoma occurring in the sternocleidomastoid muscle and invading to the mastoid tip. A 56-year-old male visited the clinic with a complaint of slowly growing postauricular mass for 6 months. Mass originating from sternomastoid muscle and invasion to mastoid tip was observed by imaging studies. Surgical complete excision with simple mastoidectomy was performed via modified facelift approach. The histopathologic findings revealed malignant spindle cell tumor with positive staining with smooth muscle actin. The patient has no recurrence for 2years without any complication.

하악골에 발생한 양성 섬유성 조직구종의 치험례 (BENIGN FIBROUS HISTIOCYTOMA OF MANDIBLE - A CASE REPORT-)

  • 최소영;김진욱;권대근;신홍인;변기정;김진수
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제30권4호
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    • pp.399-403
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    • 2008
  • Benign fibrous histiocytoma(BFH) is a mesenchymal cell-originated tumor composed of cells with fibroblastic and histiocytic differentiation. BFH occurs predominantly on sun-exposed skin of extremities. Oral BFH lesions are uncommon. The majority of oral lesions includes the soft tissue but not the jaw bones. The lesion appears as well-defined multilocular radiolucencies associated with bony swelling when it occurs on the jaw. The lesion induces the thinning and expansion of the cortex and shows many thin, indistinct septa in the lesion. Surgical excision is the choice of treatment. The recurrence rate is low and metastasis has not been reported. We report the clinical, radiographic and microscopic findings of a BFH case occurred in the mandible with literature reviews.

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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자궁경부암: 개정된 2018 FIGO 병기와 자기공명영상을 중심으로 (Uterine Cervical Cancer: Emphasis on Revised FIGO Staging 2018 and MRI)

  • 장원;송지수
    • 대한영상의학회지
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    • 제82권5호
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    • pp.1083-1102
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    • 2021
  • 자궁경부암(uterine cervical cancer)은 발생 빈도가 높은 부인암 중 하나로서 병변의 조기발견과 정확한 병기설정 및 치료가 예후에 큰 영향을 미치며 영상 검사는 병기설정 및 치료계획과 추적 관찰에 있어 중요한 역할을 하고 있다. 특히 자기공명영상은 높은 연부 조직의 대조도를 통해 병변의 크기와 침범 정도를 파악하는 데 유용하다. 2018년 국제 산부인과 학회(International Federation of Gynecology and Obstetrics; 이하 FIGO)에서 병기설정이 개정되었으며, 원발종양의 크기를 세분화하고 림프절 전이를 포함하게 되었다. 본 종설에서는 이전 연구 및 최근 개정된 FIGO 병기를 바탕으로 한 자궁경부암의 병기설정과 여러 가지 치료 후 영상에 대해 자기공명영상 소견을 중심으로 기술하고자 한다.

종격동 악성 말초 신경 초종으로부터 유방 전이의 영상 소견: 증례 보고 (Imaging Findings of Breast Metastasis from Malignant Peripheral Nerve Sheath Tumor of Mediastinum: A Case Report)

  • 박소형;박지연;주미
    • 대한영상의학회지
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    • 제84권3호
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    • pp.770-775
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    • 2023
  • 악성 말초 신경 초종은 드문 연부조직 종양으로, 주로 몸통, 사지, 두경부에 주로 위치하며, 유방에는 드물다. 저자들은 신경섬유종증 1을 가진 27세 여자 환자에서 유방으로 전이된 악성 말초 신경 초종 증례를 보고하고자 한다. 흉부 단층촬영에서 오른쪽 유방에 경계가 분명한 타원형의 약간 조영 증강되는 종괴가 보였다. 초음파에서 혈류와 증등도의 탄성을 가진 경계가 분명한 타원형의 비균질한 에코의 종괴로 보였다. 유방 종괴는 수술로 제거되었고, 악성 말초 신경 초종으로 최종 진단되었다. 드물지만, 악성 말초 신경 초종은 신경섬유종증 1을 가진 환자에서 유방 종괴의 감별진단에 포함되어야 한다.

소아암 환자에서 암의 전이로 오인된 폐결핵 (Pulmonary tuberculosis misdiagnosed as lung Metastasis in childhood cancer patients)

  • 이현재;김동환;이강민;박경덕;이준아;조수연;국윤호;김희연;김동호
    • Clinical and Experimental Pediatrics
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    • 제52권8호
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    • pp.904-909
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    • 2009
  • 목적 : 암환자들은 암의 재발여부를 추적관찰 하기 위해 다양한 영상검사들을 시행하고 있다. 이러한 환자들의 흉부 방사선 추적검사에서 결절이 발견되는 경우에는 종양의 폐전이를 의심하는 것이 일반적이다. 그러나 다른 질환, 특히 우리나라에서 유병률이 높은 폐결핵도 감별해야 한다. 본 연구는 소아암 환자의 흉부 방사선 추적검사 도중 암의 전이로 오인된 폐결핵의 빈도와 그 임상양상을 분석하고자 하였다. 방법 : 2001년 1월부터 2007년 6월까지 원자력병원에서 암으로 진단된 18세 이하의 소아 환자 422명을 대상으로 하였고, 후향적으로 의무기록을 고찰하여 치료 과정 및 치료종결 후 추적관찰 중 암의 폐전이와 폐결핵이 발병한 경우를 찾아내어 그 임상 양상을 분석하였다. 결과 : 수술 후 암으로 오인된 폐결핵은 5례였다. 이들 5명 환자에서 2명은 기침과 가래 등의 호흡기 증상이 있었으며, 나머지는 특별한 소견이 보이지 않았다. 5명 모두 열, 체중 감소, 쇠약감 등의 전신증상은 관찰되지 않았다. 가족 내 결핵의 가족력을 가지고 있었던 경우는 1례 였고, 조직 항산성 염색을 시행하였는데, 이 중 1례가 결핵균 양성으로 드러났고 나머지 4례는 음성이었다. 결핵 피부반응검사 상 양성으로 나온 경우는 2례였으나 객담 검사는 모두 음성이었다. 비정형결핵과의 감별을 위하여 환자들의 폐병변 조직을 얻었으며 이것으로 Tb PCR 시행한 결과, 1례에서 양성소견이 관찰되었다. 5례 중 4례는 폐병변이 모두 폐결핵으로만 드러났으나 1 례는 특이하게도 폐결핵과 폐 전이가 병발하였다. 이 환자는 이후 종양이 재발해 사망하였다. 결론 : 소아암의 기저질환을 가지고 있었던 환자에 있어서 치료 과정 중 또는 추적 관찰 중 새로이 발견된 폐의 종괴를 진단할 때는 결핵의 가능성도 고려하여야 한다.

Sarcoma Immunotherapy: Confronting Present Hurdles and Unveiling Upcoming Opportunities

  • Sehan Jeong;Sharmin Afroz;Donghyun Kang;Jeonghwan Noh;Jooyeon Suh;June Hyuk Kim;Hye Jin You;Hyun Guy Kang;Yi-Jun Kim;Jin-Hong Kim
    • Molecules and Cells
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    • 제46권10호
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    • pp.579-588
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    • 2023
  • Sarcomas are rare and heterogeneous mesenchymal neoplasms originating from the bone or soft tissues, which pose significant treatment challenges. The current standard treatment for sarcomas consists of surgical resection, often combined with chemo- and radiotherapy; however, local recurrence and metastasis remain significant concerns. Although immunotherapy has demonstrated promise in improving long-term survival rates for certain cancers, sarcomas are generally considered to be relatively less immunogenic than other tumors, presenting substantial challenges for effective immunotherapy. In this review, we examine the possible opportunities for sarcoma immunotherapy, noting cancer testis antigens expressed in sarcomas. We then cover the current status of immunotherapies in sarcomas, including progress in cancer vaccines, immune checkpoint inhibitors, and adoptive cellular therapy and their potential in combating these tumors. Furthermore, we discuss the limitations of immunotherapies in sarcomas, including a low tumor mutation burden and immunosuppressive tumor microenvironment, and explore potential strategies to tackle the immunosuppressive barriers in therapeutic interventions, shedding light on the development of effective and personalized treatments for sarcomas. Overall, this review provides a comprehensive overview of the current status and potential of immunotherapies in sarcoma treatment, highlighting the challenges and opportunities for developing effective therapies to improve the outcomes of patients with these rare malignancies.

비스포스포네이트 관련 악골괴사의 진단 및 치료에 대한 임상적 연구 (Clinical study of diagnosis and treatment of bisphosphonate-related osteonecrosis of the jaws)

  • 김경욱;김범진;이충현
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제37권1호
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    • pp.54-61
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    • 2011
  • Introduction: Bisphosphonates is used widely for the treatment of the Paget's disease, multiple myeloma, bone metastases of malignant tumors with the prevention of pain and their pathological fracture. However, it was recently suggested that bisphosphonates related osteonecrosis of the jaw (BRONJ) is a side effect of bisphosphonate use. Materials and Methods: Twenty-four individuals, who were referred to the Department of Oral and Maxillofacial surgery, Dankook University Dental Hospital, were selected from those who had exposed bone associated with bisphosphonates from January, 2005 to December, 2009 according to the criteria of American Association of Oral and Maxillofacial Surgeons (AAOMS) for BRONJ. The patients group consisted of 7 males and 17 females between the age of 46 to 78 years (average 61.8 years). Each patient had panoramic imaging, computed tomography (CT), whole body bone scanning performed for a diagnosis and biopsy sampling from the necrotizing tissue. C-terminal cross-linking telopeptide of type I collagen (CTX) level of patients who had undergone surgical intervention was measured 7 days before surgery. Results: The main cause of bone exposure was post-extraction (15), chronic periodontitis (4), persistent irritation of the denture (3). Twenty people had undergone BRONJ treatment for two to eight months except for 4 people who had to maintain the bisphosphonates treatment to prevent a metastasis and bone trabecular pain with medical treatment. When the bisphosphonate treatment was suspended at least for 3 months and followed up according to the AAOMS protocols, the exposed necrotizing bones were found to be covered by soft tissue. Conclusion: Prevention therapy, interruption of bisphophonates for at least 3 months and cooperation with the physician for conservative treatment are the essential for treating BRONJ patient with high risk factors. The CTX level of BRONJ patients should be checked before undergoing surgical intervention. Surgical treatments should be delayed in the case of a CTX level <150 pg/mL.