• Archives of Plastic Surgery
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• v.37 no.4
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• pp.452-456
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• 2010

Purpose: The schwannoma is a benign peripheral nerve tumor arising from the Schwann cell of the nerve sheath. Only 2-8% of schwannomas arise in the hand and wrist. Misdiagnosis is frequent such as ganglion and neurofibroma. This article documents and clarifies the clinical features of schwannomas arising in the hand and wrist, and emphasizes importance of differential diagnosis and meticulous surgical extirpation under magnification. Methods: The author reviewed clinical features of 15 patients with pathologic final diagnosis of schwannoma developed in hand and wrist during the last 12 years from 1998 through 2009. The review included the sex, age of onset, duration, preoperative diagnosis, location, involved nerve, preoperative symptoms and. Postoperative sequelae after surgical extirpation of the lesion with magnification, or without magnification of the surgical fields. Results: The chief complaints were slow growing firm mass in all patients, and followed by pain in 40%, and paresthesia in 40% respectively. The lesions were developed solitarily in 14 patients (93%). The postoperative pathologic diagnosis and preoperative diagnosis were coincided with only in 6 patients (40%). Other preoperative diagnosis were soft tissue tumor in 4 patient (26.6%), and ganglion in 3 patients (20%), and neurofibroma in 2 patients (13%). In all patients who were undergone surgical excision under the fields of magnification, all symptoms were subsided without any sequelae. Meanwhile muscle weakness, paresthesia, hypoesthesia and /or accidental nerve resection developed after surgical excision with naked eye. Conclusion: Schwannoma in hand most commonly appears as a slow growing solitary mass with pain or paresthesia. The chance of preoperative misdiagnosis was 60% in this series. To provide good prognosis and less sequelae, careful and elaborate diagnostic efforts and meticulous surgical excision under the magnification are necessary in management of schwannoma.

• Korean Journal of Head & Neck Oncology
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• v.13 no.1
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• pp.62-68
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• 1997

The papillary carcinoma is the most common malignant neoplasm of thyroid gland and the prognosis is better than anyother type of thyroid carcinoma. However, the thyroid is closed to the important organs such as esophagus, trachea and larynx, there are some possibilities to invade these organs. In case of advanced disease, not only surrounding structures but also mediastinum and cervical lymphatic chain can be involved or distant metastasis develops frequently. Therefore in these cases the prognosis is worse and the rate of inoperable case is more than those of non-metastatic group. Generally, the treatment modality for papillary thyroid carcinoma consists of surgery, postoperative thyroid hormone and radioiodine therapy. If the tumor invades surrounding structures, cervical lymph node or mediastinum, total thyroidectomy and wide excision of tumor invaded area including mediastinal dissection and neck dissection is necessary. Recently, the authors have experienced a case of locally invasive and recurred papillary thyroid carcinoma without treatment for 7 years. The patient was performed previously thyroid lobectomy and isthmusectomy 13 years ago. We had determinded surgical therapy for this patient and performed mass excision with overlying skin, completion total thyroidectomy, right type I modified radical neck dissection, left lateral neck dissection, thoracotomy with supramediastinal dissection, shaving of diffusely involved trachea and skin defect reconstruction with pectoralis major myocutaneous flap. After operation 2 cycles of radioiodine therapy were taken. Now the patient is following up at the outpatient base and no evidence of disease state for postoperative 16 months. So we report on this case with a brief review of literature.

• Korean Journal of Head & Neck Oncology
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• v.19 no.1
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• pp.3-8
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• 2003

Background: Surgical management of recurrent pleomorphic adenoma of the parotid gland has a considerable risk of facial nerve injury and a high re-recurrence rate. To obtain more insight into the issue of recurrent pleomorphic adenoma and more specifically to evaluate our experience and results of treatment, a retrospective study was carried out. Materials and Methods: During the period from 1989 to 2002, the medical records of 14 patients who underwent a operation for recurrent pleomorphic adenoma of the parotid gland were reviewed retrospectively. The initial operation for parotid tumor, clinical features of recurrence, reoperation after recurrence, po stop complication were analysed. Results: The male to female ratio was 6 : 9. Median age of the patients at the time of the initial operation was 33 years and at the time of the reoperation was 43 years. The median interval until recurrence was 105 months (6-252 months). The initial operations performed were excision or enucleation in 10 patients, superficial parotidectomy in 3 patients, total parotidectmy in 1 patients. The thirteen patients were underwent reoperation (8 superficial parotidectomies, 3 total parotidectomies, 1 neartotal parotidectomy, 1 wide excision). The facial nerve paralysis after the reoperation occured in 6 patients but all of them were recovered from 3 months to 1 year after surgery. Conclusion: In the management of pleomorphic adenoma of the parotid gland, excision or enucleation is to be avoided due to the higher recurrence rate and superficial or total parotidectomy with preservation of the facial nerve are to be preferred. Because the risk of facial nerve injury during operation for the recurrent tumor was higher than initial surgery, more careful surgical procedure is mandatory for preserving the facial nerve.

• The Journal of the Korean bone and joint tumor society
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• v.20 no.2
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• pp.47-53
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• 2014

Purpose: We analyzed the diagnosis and the treatment outcomes of patients with central low grade osteosarcoma. Materials and Methods: We retrospectively reviewed 16 patients with central low grade osteosarcoma were treated at out institution between 1994 and 2011. Results: There were 4 men and 12 women with mean age of 26 years. Eleven patients were correctly diagnosed but 5 patients were misdiagnosed as osteoid osteoma, non ossifying fibroma, aneurysmal bone cyst, desmoplastic fibroma. 15 patients finally received wide margin en bloc excision and one of them treated under neoadjuvant chemotherapy. Final survival status was continuous disease free in 14 and 1 patient died of renal cell cancer. Remaining 1 with multifocal lesions is alive with disease for 7 years only treated radiation therapy on residual tumors. Nine (56%) of 16 tumors showed extra-osseous extension of tumor (56%) and 1 of them showed extra-compartmental tumors. Conclusion: The diagnosis of central low grade osteosarcoma is challenging, however, considering of the clinical suspicion, the typical findings of radiologic and pathologic features, proper diagnosis is needed. This tumor should be treated with wide excision, even after an intralesional excision, to avoid local recurrence or transformation to higher histologic grade.

• The Journal of the Korean bone and joint tumor society
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• v.11 no.2
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• pp.126-133
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• 2005

Purpose: to know the treatment result of squamous cell carcinoma in extremity had poor prognosis with risk factor including burn scar and chronic osteomyelitis. Material and Methods: Between Octorber 1993 and September 2002, 20 patients with squamous cell carcinoma in extremity had no distant metastasis was got operation and followed over 36 months. Amputation was done when it was hard to get enough wide margin or neurovascular structure was involved instead of wide excision. Mean age of patients was 57.2 years old and male to female was 16 to 4. TMN staging and histologic grading were performed. Results: There were 6 metastasis (30%) in 20 cases for mean 48.3 months (36-84 months). 3 metastasis to local lymph node and 3 distant metastasis were happened at lung (in 3 cases) and thorasic vertebra (in 1 case). Survival was 18 cases at last look. 5-year survival rate was 50%. 3 local recurrence was developed at average 11 months (4-18 months). Complication was focal skin defect after wide excision and skin graft in 2 cases. The patients by wide excision got average 1.9 time operation and by amputation got average 1.3 time. Conclusion: Squamous cell carcinoma at extremity in Korea had high metastasis rate due to burn scar and chronic osteomyelitis, and it showed equal treatment result which treated by wide excision compared with amputation.

• The Journal of the Korean bone and joint tumor society
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• v.18 no.2
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• pp.113-117
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• 2012

A 73-year-old male was admitted for unhealed wound. Eight months ago, the patient had been operated for excision of soft tissue mass on left distal thigh area in previous hospital and after 4 months from first operation, had been reoperated because of recurrence. The pathologic diagnosis of previous operation was simple cyst. In operating finding, the mass invaded the vastus lateralis fascia and had irregular margin and adhesion. We carried out simple excision with retaining 5 cm of free margin from the mass. The pathologic diagnosis of our hospital was malignant fibrous histiocytoma, and then the patient was performed radiation therapy. In 1 year follow-up, there was no significant finding either increasing mass size or metastasis. We misdiagnosed as simple cyst and then performed simple excision, however finally pathologic diagnosis confirmed as malignant fibrous histiocytoma. It is considered to operate a mass that preoperative proper evaluation and diagnosis are required.

• Archives of Craniofacial Surgery
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• v.20 no.6
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• pp.354-360
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• 2019

Background: Keloids are benign fibro-proliferative lesion, related to excessive inflammatory reactions in certain anatomical areas, including the auricles. Their specific etiology remains unclear; nonetheless they exhibit tumor-like characteristics of significant recurrence and cause emotional distress, even with various treatment strategies. We applied intermittent magnetic pressure therapy on ear keloids in combination with surgical excision, and present its effectiveness herein. Methods: Ear keloid patients were treated with surgical excision followed by magnetic pressure therapy. The keloid tissues underwent excision and keloid marginal flaps were utilized for wound closure. Intermittent magnetic pressure therapy was applied 2 weeks after the surgical procedure. The pressure therapy consisted of a 3-hour application and 2-hour resting protocol (9 hr/day), and lasted for 6 months. The results were analyzed 6 months after the therapeutic procedures, using the scar assessment scale. Results: Twenty-two ear keloids from 20 patients were finally reviewed. Among the keloids that completed the therapeutic course, 20 ear keloids out of 22 in total (90.9%) were successfully eradicated. Two patients (2 keloids) exhibited slight under-correction. Postoperative complications such as wound dehiscence or surgical site infection were not noted. The scar assessment scale demonstrated a significant improvement in each index. The intermittent pressure therapy led to patient compliance, and avoided pressure-related pain and discomfort. Conclusion: Excision followed by intermittent pressure application using a magnet successfully reduced the burden of fibro-proliferative keloids, and had good patient compliance. The role of intermittent pressure application and resting should be studied with regard to keloid tissue remodeling.

• Korean Journal of Head & Neck Oncology
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• v.29 no.2
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• pp.54-57
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• 2013

Malignant triton tumor(MTT) is a rare type of malignant peripheral nerve sheath tumor(MPNST) with focal rhabdomyoblastic differentiation. MTT constitutes about 5% of all MPNSTs and described the first case of a MTT in a patient with Von Recklinghausen disease by Masson in 1932. MTT is commonly seen in the head, neck, extremities and trunk. It can occur in sporadic form or over a setting of neurofibromatosis-1(NF-1). The diagnosis can be confirmed based on morphologic grounds supported by an immunostain such as S-100 protein. Desmin, myo-D1 and myogenin are immunostains positive for rhabdomyoblasts. MTT has an aggressive biological behavior so prognosis of this rare and highly malignant tumor is poor and optimal treatment remains unclear. But modern treatment consisted of radical excision and postoperative radiotherapy has improved the prognosis of such cases.

• The Journal of the Korean bone and joint tumor society
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• v.20 no.2
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• pp.80-84
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• 2014

Inclusion body fibromatosis is a rare benign soft tissue neoplasm typically involving fingers and toes of children in mostly less than one year old. Histologic findings include spindle-shaped fibroblasts surrounded by dense stroma and small perinuclear eosinophilic inclusions in the cytoplasm. Although the tumor typically undergoes spontaneous regression, surgery is considered when functional impairment or deformity develops with the lesion. Unfortunately, recurrence rate was reported to be as high as 60 % following tumor excision. Authors would like to present our case where the tumor occurred in relatively older child and kissing lesion was found a few months after the surgery.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.32 no.4
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• pp.374-379
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• 2006

Central granular cell odontogenic tumor(CGCOT) is a very rare lesion that consists of densely packed granular cells with numerous scattered strands of odontogenic epithelium interspersed throughout the tissue. CGCOT was initially reported in 1962 by Cough et al as central granular cell ameloblastic fibroma. But, recently, this term is inappropriate because of histologic and chronologic differences. CGCOT is usually present as painless swellings. Radiographs show a well-demarcated radiolucent or mixed radiopaque-radiolucent lesion. The average age on presentation of CGCOT is 47.3 and women are 75% more likely to develop this lesion than men. The tumor only occur in tooth bearing areas of the jaw with 88% of cases occurring in the mandible and 12% involving the maxilla, usually in an equal distribution between the caninepremolar-molar areas. This tumor is benign, and care is effected by localized surgical excision. We report an additional case of CGCOT that occurred in the Rt. Maxillar premolar/molar region of a 32-year old man with literature review.