• Journal of Korean Neurosurgical Society
• /
• 제63권1호
• /
• pp.119-135
• /
• 2020

Objective : To investigate the epidemiology of newly-diagnosed, histologically-confirmed (NDHC) central nervous system (CNS) tumours and its changes over a 21-year period in a regional hospital in Hong Kong. Methods : This is a single-institute retrospective descriptive study of patients undergoing surgery for CNS tumours in a regional hospital of Hong Kong in the period from January 1996 to December 2016. The histological definition of CNS tumours was according to the World Health Organization classification, while the site definition for case ascertainment of CNS tumours was as set out by the Central Brain Tumour Registry of the United States. Patients of any age, who had NDHC CNS tumours, either primary or secondary, were included. The following parameters of the patients were retrieved : age at diagnosis, gender, tumour location, and histological diagnosis. Population data were obtained from sources provided by the Government of Hong Kong. The incident rate, estimated by the annual number of cases per 100000 population, for each histology grouping was calculated. Statistical analyses, both including and excluding brain metastases, were performed. Statistical analysis was performed with Microsoft Excel, 2016 (Microsoft, Redmond, WA, USA). Results : Among the 2134 cases of NDHC CNS tumours, there were 1936 cases of intracranial tumours and 198 cases of spinal tumours. The annual number of cases per 100000 population of combined primary intracranial and spinal CNS tumours was 3.6 in 1996, and 11.1 in 2016. Comparing the 5-year average annual number of cases per 100000 population of primary CNS tumours from the period 1996-2000 to 2011-2015, there was an 88% increase, which represent an increase in the absolute number of cases by 4.52 cases/100000 population. This increase was mainly contributed by benign histologies. In the aforementioned periods, meningiomas increased by 1.45 cases/100000 population; schwannomas by 1.05 cases/100000 population, and pituitary adenomas by 0.91 cases/100000 population. While gliomas had a fluctuating 5-year average annual number of cases per 100000 population, it only had an absolute increase of 0.51 cases/100000 population between the 2 periods, which was mainly accounted for by the change in glioblastomas. Conclusion : This retrospective study of CNS tumour epidemiology revealed increasing trends in the incidences of several common CNS tumour histologies in Hong Kong, which agrees with the findings in large-scale studies in Korea and the United States. It is important for different geographic locations to establish their own CNS tumour registry with well-defined and structured data collection and analysis system to meet the international standards.

• Asian Pacific Journal of Cancer Prevention
• /
• 제14권6호
• /
• pp.3979-3985
• /
• 2013

Background: Although primary malignant CNS tumors are registered in the national cancer registry (NCR) of Iran, there are no available data on the incidence of the primary malignant or benign CNS tumors and their common histopathologies in the country. This study analyzed the 10-year data of the Iranian NCR from March 21, 2000 to March 20, 2010, including a systematic review. Materials and Methods: The international and national scientific databases were searched using the search keywords CNS, tumor, malignancy, brain, spine, neoplasm and Iran. Results: Of the 1,086 primary results, 9 papers were selected and reviewed, along with analysis of 10-year NCR data. The results showed that primary malignant brain tumors have an overall incidence of 2.74 per 100,000 person-years. The analysis of the papers revealed a benign to malignant ratio of 1.07. The most common histopathologies are meningioma, astrocytoma, glioblastoma and ependymoma. These tumors are more common in men (M/F=1.48). Primary malignant spinal cord tumors constitute 7.1% of the primary malignant CNS tumors with incidence of 0.21/100,000. Conclusions: This study shows that CNS tumors in Iran are in compliance with the pattern of CNS tumors in developing countries. The NCR must include benign lesions to understand the definitive epidemiology of primary CNS tumors in Iran.

• Journal of Yeungnam Medical Science
• /
• 제16권2호
• /
• pp.369-375
• /
• 1999

1988년부터 1999년까지 영남대학교 의과대학 부속병원에서 척삭종으로 진단받은 4례를 대상으로 임상병리학적 특징을 분석하여 다음과 같은 결과를 얻었다. 환자의 연령은 57세에서 75세였고 평균연령은 63.5세였다. 4례 모두 천미골부에서 발생하였다. 종양의 평균 크기는 9.3cm 였다. 종양은 비교적 경계가 비교적 잘 지워지는 섬유성 격벽에 의해 나뉘어지는 분엽성, 점액성, 젤라틴 모습이었고, 조직학적으로 풍부한 점액성 기질과 거품모양의 공포를 갖는 담공포성 세포가 특정적으로 관찰되었다. 4례(100%)에서 종양세포들은 cytokeratin, EMA와 vimentin에 양성반응을 나타내었고, 1례(25.0%)는 S-100 protein에 양성 반응을 나타내었고, CEA에 대하여 모두 음성 반응이었다.

• Tuberculosis and Respiratory Diseases
• /
• 제75권4호
• /
• pp.165-169
• /
• 2013

An inflammatory myofibroblastic tumor (IMT) is a rare disease entity reported to arise in various organs. It is thought to be a neoplastic or reactive inflammatory condition, controversially. The treatment of choice for myofibroblastic tumor is surgery, and recurrence is known to be rare. The optimal treatment method is not well-known for patients ineligible for surgery. We report a 47-year-old patient with aggressive recurrent IMT of the lungs. The patient had been admitted for an evaluation of back-pain two years after a complete resection of pulmonary IMT. Radiation therapy was performed for multiple bone recurrences, and the symptoms were improved. However the patient presented again with aggravated back-pain six months later. High-dose steroid and non-steroidal anti-inflammatory drugs were administered, but the disease progressed aggressively, resulting in spinal cord compression and metastasis to intra-abdominal organs. This is a very rare case of aggressively recurrent pulmonary IMT with multi-organ metastasis.

• 한국임상수의학회지
• /
• 제31권5호
• /
• pp.439-444
• /
• 2014

체중 2.7 kg의 5세령 암컷 말티즈 견이 양측 슬개골 탈구와 후지 파행으로 지역동물병원에 내원하였다. 도르레절제술과 슬개골의 외측 보강 봉합법을 이용하여 슬개골 탈구 정복술을 실시하였으나, 수술 3주 후 등을 굽힌 자세의 보행과 후지의 운동실조, 흉요추부의 압통, 간헐적인 경련증상으로 재 내원하였다. 자기공명영상 촬영 결과, 우측 전두엽의 종괴와 경수에서부터 3번 요수까지의 공동성 변화가 확인되었다. 병리조직학적 소견으로 뇌종양은 느슨한 망상구조 또는 레이스 모양의 수막세포들로 구성되었으며, 세포 외부에 다양한 크기와 형태의 많은 낭포성 공간이 관찰되었다. 면역조직화학염색 결과 종양세포들은 vimentin 양성, 신경원 특이 에놀라제 및 신경교 섬유질 산성 단백질에는 음성을 나타내었다. 경수와 흉수 부위에는 부정형의 확장된 중심관 유사 동공이 관찰되었다. 이 증례는 개에서 특이적인 두개강 내 소낭성 뇌수막종과 연관되어 2차적으로 발생한 척수공동증의 임상소견과 영상학적 및 병리조직학적 특징을 보여주고 있다.

• Radiation Oncology Journal
• /
• 제36권2호
• /
• pp.122-128
• /
• 2018

Purpose: To investigate positional uncertainty and its correlation with clinical parameters in spine stereotactic body radiotherapy (SBRT) using thermoplastic mask (TM) immobilization. Materials and Methods: A total of 21 patients who underwent spine SBRT for cervical or upper thoracic spinal lesions were retrospectively analyzed. All patients were treated with image guidance using cone beam computed tomography (CBCT) and 4 degrees-of-freedom (DoF) positional correction. Initial, pre-treatment, and post-treatment CBCTs were analyzed. Setup error (SE), pre-treatment residual error (preRE), post-treatment residual error (postRE), intrafraction motion before treatment (IM1), and intrafraction motion during treatment (IM2) were determined from 6 DoF manual rigid registration. Results: The three-dimensional (3D) magnitudes of translational uncertainties (mean ${\pm}$ 2 standard deviation) were $3.7{\pm}3.5mm$ (SE), $0.9{\pm}0.9mm$ (preRE), $1.2{\pm}1.5mm$ (postRE), $1.4{\pm}2.4mm$ (IM1), and $0.9{\pm}1.0mm$ (IM2), and average angular differences were $1.1^{\circ}{\pm}1.2^{\circ}$ (SE), $0.9^{\circ}{\pm}1.1^{\circ}$ (preRE), $0.9^{\circ}{\pm}1.1^{\circ}$ (postRE), $0.6^{\circ}{\pm}0.9^{\circ}$ (IM1), and $0.5^{\circ}{\pm}0.5^{\circ}$ (IM2). The 3D magnitude of SE, preRE, postRE, IM1, and IM2 exceeded 2 mm in 18, 0, 3, 3, and 1 patients, respectively. No association were found between all positional uncertainties and body mass index, pain score, and treatment location (p > 0.05, Mann-Whitney test). There was a tendency of intrafraction motion to increase with overall treatment time; however, the correlation was not statistically significant (p > 0.05, Spearman rank correlation test). Conclusion: In spine SBRT using TM immobilization, CBCT and 4 DoF alignment correction, a minimum residual translational uncertainty was 2 mm. Shortening overall treatment time and 6 DoF positional correction may further reduce positional uncertainties.

• Journal of Chest Surgery
• /
• 제38권2호
• /
• pp.175-179
• /
• 2005

흉강입구를 침범한 종양을 근골보존 경흉골병 접근술을 이용하여 수술한 증례를 보고하고자 한다. 우측 상지의 근력 약화를 주소로 69세의 남자 환자가 내원하였다. 단순 흉부 방사선 사진에서 우측 폐 상엽에 기관지 확장증, 만성 결핵과 진균덩이가 관찰되었다. 전산화단층촬영에서 종양이 제 6, 7번 경추와 제 1번 흉추의 척추강내 경막외에 위치하며 우측 흉곽 첨부에까지 연장되어 있었다 신경외과에서 먼저 후궁절제술을 시행하여 척추강 안의 종양을 절제한 후, 흉부외과에서 근골보존 경흉골병 접근술을 통하여 흉강입구를 침범한 종양을 제거하였다. 종양은 혈관외피세포종으로 진단되었으며, 환자는 수술 후 합병증 없이 회복되었다.

• Journal of Korean Neurosurgical Society
• /
• 제38권3호
• /
• pp.184-189
• /
• 2005

Objective : Hemangioblastomas are highly vascular and benign neoplasm of the central nervous system[CNS]. They can often be found as multiple lesions, as is commonly observed in von Hippel-Lindau[VHL] disease. The aim of this study is to determine the proper management for multiple hemangioblastomas. Methods : Since 1990, 78cases of hemangioblastoma have been encountered. Among these, 9cases were multiple hemangioblastomas that were treated with surgical resection with or without radiosurgery. The medical, radiological, surgical and histological records were reviewed retrospectively and analyzed statistically. Results : Nine patients presented with multiple hemangioblastomas and were diagnosed as VHL disease. The mean follow-up duration was 75.7months [$6.6{\sim}159.2months$] after the first surgical treatment. Three patients were treated with surgical resection alone and six patients were treated by both surgical resection and radiosurgery. Twenty-one surgical procedures [13 surgical resections and 8 radiosurgery] were performed. One patient required ventriculoperitoneal shunt and a posterior fossa decompressive craniectomy because of post-radiation brain swelling. Another patient refused additional treatment for the newly developed lesions after the successful treatment of initial lesions. The other patient who presented with numerous lesions in the whole brain and spine underwent cranio-spinal irradiation. Remaining patients showed good results. Conclusion : The surgical outcomes for the patients with a single lesion of the CNS hemangioblastoma are favorable. However. the treatment of multiple hemangioblastoma is more difficult, and should be treated by surgical resection and radiosurgery with careful consideration.

• 대한두경부종양학회지
• /
• 제34권1호
• /
• pp.21-27
• /
• 2018

Background/Objectives: This study aimed to evaluate the changes of uptake around the sternoclavicular joint (SCJ) according to 18F-FDG PET images in patients with head and neck cancer who underwent neck dissection. Materials & Methods: Retrospectively, the medical records of patients who received selective or comprehensive neck dissection were reviewed. Preoperative and 1-year postoperative 18F-FDG PET images, if available, were analyzed by nuclear medicine physicians in both qualitative and quantitative manners. Correlation between the changes of uptake around SCJ and perioperative data were statistically analyzed. Results: Thirty-seven patients satisfying the inclusion criteria were enrolled. Seven patients with increased uptake around SCJ on 1-year postoperative 18F-FDG PET showed a correlation with radical or comprehensive neck dissection, accessory nerve sacrifice, and high postoperative SUVmax. When 20 patients with increased uptake around SCJ according to quantitative measurement were compared with other patients without increased uptake, no parameter was significantly different, except postoperative SUVmax. Bivariate logistic regression analysis revealed that the clinical symptom (shoulder or sternal pain) was significantly correlated with the extent of neck dissection (OR 0.227, CI 0.053-0.966, p=0.045) and spinal accessory nerve sacrifice (OR 13.500, CI 1.189-153.331, p=0.036). Conclusions: Increased uptake around SCJ on 1-year postoperative 18 F-FDG PET was correlated with either the radical or comprehensive procedure, as well as with accessory nerve sacrifice. This suggests that subjective analysis of 18F-FDG PET can be used to detect subclinical shoulder instability.

• Journal of Korean Neurosurgical Society
• /
• 제62권1호
• /
• pp.106-113
• /
• 2019

Objective : The efficacy of preoperative embolization for hypervascular metastatic spine disease (MSD) such as renal cell and thyroid cancers has been reported. However, the debate on the efficacy of preoperative embolization for non-hypervascular MSD still remains unsettled. The purpose of this study is to determine whether preoperative embolization for non-hypervascular MSD decreases perioperative blood loss. Methods : A total of 79 patients (36 cases of preoperative embolization and 43 cases of non-embolization) who underwent surgery for metastatic spine lesions were included. Representative hypervascular tumors such as renal cell and thyroid cancers were excluded. Intraoperative and perioperative estimated blood losses (EBL), total number of transfusion and calibrated EBL were recorded in the embolization and non-embolization groups. The differences in EBL were also compared along with the type of surgery. In addition, the incidence of Adamkiewicz artery and complications of embolization were assessed. Results : The average age of 50 males and 29 females was $57.6{\pm}13.5$ years. Lung (30), hepatocellular (14), gastrointestinal (nine) and others (26) were the primary cancers. The demographic data was not significantly different between the embolization and the non-embolization groups. There were no significant differences in intraoperative EBL, perioperative EBL, total transfusion and calibrated EBL between two groups. However, intraoperative EBL and total transfusion in patients with preoperative embolization were significantly lower than in non-embolization in the corpectomy group (1645.5 vs. 892.6 mL, p=0.017 for intraoperative EBL and 6.1 vs. 3.9, p=0.018 for number of transfusion). In addition, the presence of Adamkiewicz artery at the index level was noted in two patients. Disruption of this major feeder artery resulted in significant changes in intraoperative neuromonitoring. Conclusion : Preoperative embolization for non-hypervascular MSD did not reduce perioperative blood loss. However, the embolization significantly reduced intraoperative bleeding and total transfusion in corpectomy group. Moreover, the procedure provided insights into the anatomy of tumor and spinal cord vasculature.