• Title/Summary/Keyword: Surgical margin

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TREATMENT OF PLEOMORPHIC ADENOMA ON PALATE A CASE REPORT (구개부에 발생한 다형성선종의 치험례)

  • Lee, Chang-Jin;Kim, Tae-Youl;Kim, Hyo-Eon;Kim, Hee-Kwang;Jeon, In-Seong;Yoon, Kyu-Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.22 no.2
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    • pp.233-237
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    • 2000
  • Pleomorphic adenoma is the most common of all salivary gland tumors, constituting over 50 per cent of all cases of tumors, and approximately 90 per cent of all benign salivary gland tumors. Since the term mixed tumor' was introduced by Broca for its dual origin of epithelial and mesenchymal elements, the term plemorphic adenoma suggested by Willis characterizes closely the unusual histologic pattern of the lesion. The parotid gland is the most common site but it may occur in any of the salivary glands. It is somewhat more frequent in women and in the fourth to sixth decades, but they are also relatively common in young adult and have been known to occur in children. Treatment of choice is surgical excision. Adequate surgery with safe margin reduce its recurrence rate. We represent a case of pleomorphic adenoma with literature review in 65-year old male occured in the palate. The lesion was successfully treated by surgical excision.

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Treatment of Synovial Sarcoma in Popliteal Fossa Adjacent to Tibia - A Case Report - (경골과 접한 슬와부 활막육종의 치료 - 증례 보고 -)

  • Shin, Duk-Seop;Kwack, Byung-Hoon;Ahn, Jong-Chul
    • The Journal of the Korean bone and joint tumor society
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    • v.13 no.2
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    • pp.201-206
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    • 2007
  • It is a well-accepted tenet that wide surgical margins are necessary for the treatment of soft-tissue sarcomas, and it is still true that the rate of recurrence depends on the adequacy of the surgical margins. Sarcomas that rest directly against bone pose a dilemma for the surgeon. A wide margin is not possible in the literal sense without excision of the bone. Whereas reconstruction of skeletal defects is possible, it adds to the complexity of the surgery and increases potential complications. We report the experience of treatment in a case of synovial sarcoma which located at popliteal fossa adjacent to proximal tibia.

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Improvement of Infraorbital Rim contour Using Medpor

  • Hwang, So Min;Park, Seong Hyuk;Lee, Jong Seo;Kim, Hyung Do;Hwang, Min Kyu;Kim, Min Wook
    • Archives of Craniofacial Surgery
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    • v.17 no.2
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    • pp.77-81
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    • 2016
  • Background: Asymmetry of the infraorbital rim can be caused by trauma, congenital or acquired disease, or insufficient reduction during a previous operation. Such asymmetry needs to be corrected because the shape of the infraorbital rim or midfacial skeleton defines the overall midfacial contour. Methods: The study included 5 cases of retruded infraorbital rim. All of the patient underwent restoration of the deficient volume using polyethylene implants between June 2005 and June 2011. The infraorbital rim was accessed through a subciliary approach, and the implants were placed in subperiosteal space. Surgical outcomes were evaluated using preoperative and postoperative computed tomography studies. Results: Implant based augmentation was associated with a mean projection of 4.6 mm enhancement. No postoperative complications were noted during the 30-month follow-up period. Conclusion: Because of the safeness, short recovery time, effectiveness, reliability, and potential application to a wide range of facial disproportion problems, this surgical technique can be applied to midfacial retrusion from a variety of etiologies, such as fracture involving infraorbital rim, congenital midfacial hypoplasia, lid malposition after blepharoplasty, and skeletal changes due to aging.

The Pros and Cons of Computer-Aided Surgery for Segmental Mandibular Reconstruction after Oncological Surgery

  • Han, Hyun Ho;Kim, Hak Young;Lee, Jun Yong
    • Archives of Craniofacial Surgery
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    • v.18 no.3
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    • pp.149-154
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    • 2017
  • Computer-aided surgery (CAS) started being used for head and neck reconstruction in the late 2000s. Its use represented a paradigm shift, changing the concept of head and neck reconstruction as well as mandible reconstruction. Reconstruction using CAS proceeds through 4 phases: planning, modeling, surgery, and evaluation. Thus, it can overcome a number of trial-and-error issues which may occur in the operative field and reduce surgical time. However, if it is used for oncologic surgery, it is difficult to evaluate tumor margins during tumor surgery, thereby restricting pre-surgical planning. Therefore, it is dangerous to predetermine the resection margins during the presurgical phase and the variability of the resection margins must be taken into consideration. However, it allows for the preparation of a prebending plate and planning of an osteotomy site before an operation, which are of great help. If the current problems are resolved, its applications can be greatly extended.

Ultrasonographic and Computed Tomographic Appearance of Spontaneous Cutaneous Fistula Resulted from Retained Surgical Gauze in a Dog

  • Hwang, Tae-sung;Huh, Chan;Lee, Hee-chun
    • Journal of Veterinary Clinics
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    • v.36 no.4
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    • pp.238-243
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    • 2019
  • A 6-year-old, spayed female Maltese was presented with the condition of a chronic recurrent abscess formation in the left flank region. Despite the antibiotics and drainage therapy given to the dog, the lesion formed a continued serosanguineous to the point that a purulent discharge was evident. In the meantime, an abdominal ultrasound revealed the presence of a well-defined mass with a hypoechoic outer margin, and a hyperechoic inner rim in the cranial of the kidney. A fistula was noted as being present with a connection between the subcutaneous lesion of the left flank and the abdominal mass. It is emphasized that CT scans revealed the existence of a soft tissue dense mass with low attenuation area, as seen in some internal areas and also a peripheral contrast enhancement was noted within a nonenhancing central region. There was additional nonenhancing fluid found dorsal to the inflammatory tract passing under the epaxial muscles and at the peritoneum. Likewise, the tract exited the skin surface in the left flank. A tentative diagnosis of an abdominal abscess with spontaneous cutaneous fistula was made based on the ultrasonographic and CT appearances. A foreign body such as surgical gauze should always be considered a potential cause of draining tract in small animals, as was considered to be the problem in this case.

Forced orthodontic eruption for augmentation of soft tissue prior to implant placement (임플란트 식립 전 연조직 증대를 위한 교정적 정출술)

  • Park, Chul-Wan
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.29 no.1
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    • pp.54-61
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    • 2020
  • Forced orthodontic eruption(FOE) is a non-surgical treatment approach that allows augmenting both soft- and hard-tissue profiles of potential implant sites, by forced orthodontic extrusion of "hopeless" teeth and their periodontal apparatus. By stretching the gingival and periodontal ligament fibers during extrusion, tension is imparted to the entire alveolar socket, stimulating osseous apposition at the alveolar crest. FOE increases the width of the attached gingiva, and the mucogingival junction remains stable when the gingival margin migrates coronally. Based on these effects, FOE of non-restorable teeth prior to implant placement is a viable alternative to conventional surgical augmentative procedures in implant site development. The aim of this case report is to describes coronal soft-tissue augmentation around fractured teeth, which was achieved by FOE before implant placement.

Surgical Treatment of Cutaneous Angiosarcoma of Scalp:Usefulness of Preoperative Mapping Biopsies (두피에 발생한 혈관육종의 수술시 Mapping Biopsy의 유용성)

  • Kang, Min-Gu;Park, Jong-Lim;Kim, Myung-Good;Minn, Kyung-Won;Koh, Kyung-Suck;Chang, Hak
    • Korean Journal of Head & Neck Oncology
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    • v.23 no.1
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    • pp.37-40
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    • 2007
  • Objectives:Cutaneous angiosarcoma is an infrequent but aggressive neoplasm involving the skin of the face and scalp. Unfamiliarity with the clinical manifestations of cutaneous angiosarcoma frequently leads to misdiagnosis and delay in treatment. Complete surgical resection requires the performance of preoperative staging biopsies to determine the true extent of the neoplasm. Intraoperative frozen section analysis to determine the adequacy of the surgical resection is unreliable due to the high false negative rate. Material and Methods:In five scalp angiosarcoma cases, mapping biopsies were performed at far from the suspected edge of the neoplasm. On permanent pathology, we obtained tumor free margin with occasional focal involvement of the tumor. Results:Frozen-section analysis of the resected margins is inconclusive, for the subtle diagnostic features of angiosarcoma are distorted by the tissue processing required for frozen-section analysis. The characteristic dermal vessels lined by their malignant cells are collapsed by the freezing process. This results in a high rate of false-negative reports and possibly leads to incomplete resection of the neoplasm. Conclusion:Our recommendation is to establish the margins of the tumor by performing preoperative evaluations by mapping biopsies.

Survival Rate and Prognostic Factors of Liposarcoma (지방 육종의 생존율과 예후 인자)

  • Kim, Jae-Do;Park, Keon;Son, Jeong-Hwan;Hong, Young-Gi;Park, Jeong-Ho
    • The Journal of the Korean bone and joint tumor society
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    • v.2 no.1
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    • pp.54-59
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    • 1996
  • Liposarcoma is second in frequency only to malignant fibous histocytoma among the soft tissue sarcoma. Many different factors which might affect the survival rate of liposarcoma have been reported by many authors. The purpose of this study was to evaluate survival rate of liposarcoma and define the prognostic factors that affected survival rate. The authors analysed retrospectively 17 patients of liposarcoma in extremities from May 1984 to Dec. 1995 who had been treated in department of orthopaedic surgery of Kosin University Medical Center. All cases were resected with marginal or wide margin. There were 9 men and 8 women. The mean age was 48 years. The follow-up period ranged from 15 to 96 months. We compared the prognosis of the patients with several factors; age, sex, surgical staging, size, site, histologic type and treatment modality. At last follow-up, the presence of local recurrence was in 3 cases and the presence of lung metastasis was in 8 cases. The survival rates by Kaplan-Meier product limit method at 2 years and 5 years were 87% and 57% respectively. The statististically significant difference was estimated in histologic type, but was not estimated in age, sex surgical staging, size, site and treatment modality. In conclusion, the histologic type is considered as the most important factor of the prognosis in liposarcoma. Although it was too few patients for the differences to be statistically significant, we consider that surgical staging, site, size, the radio-therapy and chemothrapy in liposarcoma will affect the prognosis.

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Ultrasound Score to Select Subcentimeter-sized Thyroid Nodules Requiring Ultrasound-guided Fine Needle Aspiration Biopsy in Eastern China

  • Cheng, Pu;Chen, En-Dong;Zheng, Hua-Min;He, Qiu-Xiang;Li, Quan
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.8
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    • pp.4689-4692
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    • 2013
  • Ultrasound-guided fine needle aspiration biopsy (FNAB) is a costly diagnostic item with a low yield in identifying the tiny proportion of nodules that actually represent malignant disease. Our aim through this study was to obtain an ultrasound (US) score for selecting subcentimeter-sized thyroid nodules requiring FNAB in eastern China. Some 248 patients for a total of 270 thyroid nodules less than 1 cm in diameter underwent FNAB and subsequent surgery from January 2006 to March 2012 at our hospital. The clinicopathological and US data from all the nodules were analyzed retrospectively. An US score was developed on the basis of independent predictive factors for malignancy. Irregular shape, hypoechogenicity, no well-defined margin, presence of calcifications and ratio between antero-posterior and transversal diameters (AP/TR) ${\geq}1$ were independent predictive factors for malignancy on logistic regression analysis. US score were statistically significant, with ${\leq}2$ favoring benignancy with an 80.3% sensitivity and a 72.7% specificity. US score is useful for differentiating between malignant and benign subcentimeter-sized thyroid nodules. We suggest FNAB for nodules when the US score is higher than 2.

Surgical Outcomes of Patients with Stage IA2 Cervical Cancer Treated with Radical Hysterectomy

  • Mahawerawat, Sukanda;Charoenkwan, Kittipat;Srisomboon, Jatupol;Khunamornpong, Surapan;Suprasert, Prapaporn;Sae-Teng, Charuwan Tantipalakorn
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.9
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    • pp.5375-5378
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    • 2013
  • Background: This study was undertaken to evaluate the surgical outcomes of patients with stage IA2 cervical cancer treated with radical hysterectomy. Data for 58 patients who underwent modified radical hysterectomy or radical hysterectomy with pelvic lymphadenectomy between January 2003 and December 2012 at Chiang Mai University Hospital were retrospectively reviewed. The analysis included clinico-pathological risk factors (nodal metastasis, parametrial involvement), adjuvant treatment, 5-year disease-free survival and 5-year overall survival. All pathologic slides were reviewed by a gynecologic pathologist. Follow-up methods included at least cervical cytology and colposcopy with directed biopsy if indicated. Univariate analysis was performed to identify factors associated with median survival. At the median follow up time of 73 months, the 5-year disease-free survival and the 5-year overall survival were 97.4% and 97.4%, respectively. Two (3.4%) patients had pelvic lymph node metastases. In a univariate analysis, there was no statistically significant association between survival and prognostic factors such as age, histological cell type, lymph-vascular space invasion, vaginal margin status and lymph node status. Surgical and survival outcomes of women with stage IA2 cervical cancer are excellent. No parametrial involvement was detected in our study. Patients with stage IA2 cervical cancer may be treated with simple or less radical hysterectomy with pelvic lymphadenectomy.