• Title/Summary/Keyword: Tumor resection

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APPLICATION OF RECONSTRUCTION PLATE USING SIMPLE CONDYLAR REPOSITIONING MINIPLATE AFTER SEGMENTAL RESECTION OF MANDIBLE (하악골 절제술후 간단한 과두재위치 소형금속판을 이용한 재건 금속판의 적용: 증례보고)

  • Kim, Young-Kyun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.28 no.3
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    • pp.231-233
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    • 2002
  • Temporary reconstruction of the mandibular continuity defect resulting from the ablative tumor surgery with a reconstruction plate can be used for the preservation of normal facial contour and oral function and for periodic follow up of recurrence. Reconstruction plates are adapted to the bone before the resection and provisionally fixated with some screws. Accurate contouring and adaptation are very important for the prevention of displacement of bony stumps and decubituous skin ulcer. However, if there is large expanding buccal tumor mass in mandible, it is very difficult or even impossible to contour the plate before resection. I, therefore, introduce the reconstruction plate application technique using a simple condylar repositioning miniplate after segmental mandibular resection.

Surgical Experience of Recurrent Immature Teratoma - Report of a case - (연속적 재발성 미성숙 기형종의 외과적 치료)

  • 홍민수
    • Journal of Chest Surgery
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    • v.24 no.8
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    • pp.792-796
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    • 1991
  • Immature teratoma can be viewed as intermediate between mature teratoma and embryonal carcinoma. Unlike the mature teratoma, elements of the three perm cell layers are incompletely differentiated and not arranged in organoid fashion In some area, more mature forms of these tissues may also be seen, Although this tumor is clearly malignant, they may not display clear-cut cytologic features of malignancy. The clinical prognosis is poor. We have experienced one case of recurrent immature teratoma. In first operation[1987, April], tumor of anterior mediastinum was removed with wedge resection of ant. segment of RUL % med. segment of RML. In 2nd operation[1990, June], recurrent teratoma of right inner thoracic wall was resected with partial 5th rib resection and wedge resection of lat. segment of middle lobe. Two months later, the 3rd operation[1990, September] was done, which was a removal of mass on thoracic wall near sup, segment of RLL and partial rib resection of 3rd, 4th & 5th. In November 1990, last operation[4th operation] was made. It was enucleation of walnut sized tumor located between medial segment of RML, and 4th. intercostal space, well encapsulated with endothoracic fascia and invaded into lung parenchyme, Adjuvant chemotherapy was done after each operation, but radiotherapy[5000 Rad] was done only after 1st operation. There was no evidence of recurrence after last operation. The patient is well-being still now.

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Thoracic Fetiform Teratoma: A Case Report of a Very Rare Entity in a Peruvian Hospital

  • Ludwig Caceres-Farfan;Wildor Samir Cubas;Franco Alban;Jorge Mantilla-Vasquez;Johny Mayta-Rodriguez;Karen Mendoza-Guerra
    • Journal of Chest Surgery
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    • v.56 no.4
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    • pp.282-285
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    • 2023
  • Mature fetiform teratoma, or homunculus, is a term coined for a rare variant of teratoma with a prevalence of 0.01% of teratomas. There have been very few cases reported in the world, and its thoracic presentation is extremely unusual. We present the case of a 31-year-old female patient with a history of progressive chest pain in the left hemithorax, associated with dyspnea on moderate exertion and cough. Imaging studies revealed a large intrathoracic tumor visually compatible with a teratoma. Surgical resection by a clamshell approach was successful, and subsequent anatomopathological studies of the operative specimen concluded that the mass was a mature fetiform thoracic teratoma. The treatment of this entity is generally surgical and includes wide resection due to its large adhesive component to surrounding tissues. Thus, the cardiothoracic surgeon must know approaches that allow wide resection, making these cases true surgical challenges.

The Predictors and Clinical Impact of Positive Resection Margins on Frozen Section in Gastric Cancer Surgery

  • Kim, Se-Yeong;Hwang, Yoon-Sun;Sohn, Tae-Sung;Oh, Seung-Jong;Choi, Min-Gew;Noh, Jae-Hyung;Bae, Jae-Moon;Kim, Sung
    • Journal of Gastric Cancer
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    • v.12 no.2
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    • pp.113-119
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    • 2012
  • Purpose: The aim of this study is to compare the characteristics of tumor and prognosis, depending on the status of resection margin involvement, on the frozen section diagnosis in gastric cancer. Materials and Methods: This study was conducted retrospectively, in 83 margin-positive patients on the frozen section diagnosis, who underwent gastrectomy from July 1995 to September 2006. The control group was selected by matching the age, gender, TNM stage and status of adjuvant chemoradiotherapy, among those who had shown clear resection margins. The characteristics of tumor and patient survival are investigated, and they were analyzed between the two groups. Results: The tumor size was significantly larger in the study group than that of the control group (P=0.037). There was significant difference between the two groups in location of the tumors (P=0.003). Multivariate analysis indicated that only the location and Lauren's classification are independent factors, which affected the resection margin involvement. Median survival was $41.0{\pm}11.5$ months in the study group and $93.0{\pm}30.3$ months in the control group (P=0.049). In the survival analysis, it was investigated that TNM stage and the resection margin involvement of the frozen section diagnosis were the critical variables. Conclusions: When the tumor is located at the middle or the upper third, or the Lauren's indeterminate type, they are highly likely to show the resection margin involvement on the frozen section diagnosis, and it can, therefore, have negative effects on the prognosis. It is considered as good to perform more extensive resection as possible, during the initial resection.

Reconstruction with Non-vascularized Fibular Graft and Anterolateral Thigh Free Flap after Wide Resection for Unplanned Intralesional Resection of Synovial Sarcoma of the Thenar Muscle - A Case Report - (불완전 절제된 무지구근 활막육종에서 광범위 절제술후 비골 이식술과 전외측 대퇴부 유리 피판 이식술 - 증례 보고 -)

  • Choi, Byung-Wan;Kim, Jung-Ryul
    • The Journal of the Korean bone and joint tumor society
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    • v.13 no.2
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    • pp.124-129
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    • 2007
  • Synovial sarcomas of the hand are rare. It should be treated with wide resection. In the cases of soft tissue sarcomas of the hand, functional reconstruction must be considered. We report 46-year-old male patient with synovial sarcoma of the right thenar muscle which was treated with unplanned intralesional resection at outside hospital, that has been treated with wide resection including trapezium and first metacarapl bone then, reconstructed with nonvascularized fibular graft and anterolateral thigh free flap.

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A Rare Case of Concomitant Intramedullary Gangliocytoma at the Cervicomedullary Junction in Patient with Neuroendocrine Tumor of Lung

  • Aydemir, Fatih;Cekinmez, Melih;Kardes, Ozgur;Kayaselcuk, Fazilet
    • Journal of Korean Neurosurgical Society
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    • v.59 no.2
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    • pp.158-160
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    • 2016
  • Ganglion cell tumors (GCT) are divided into two subtypes : gangliocytoma and ganglioglioma. Intramedullary gangliocytomas are extremely rare. A 20-year-old male patient with pain of neck, who also had a previously known neuroendocrine tumor of lung, was operated for mass found in the cervicomedullary junction with a presumptive diagnosis of metastases. Only partial resection could be performed. Pathological diagnosis had been reported as gangliocytoma. Only ten cases of intramedullary gangliocytoma have been reported in the literature. Although association with scoliosis and Von Recklinghausen;s disease were previously reported in the literature, no gangliocytoma case concomitant with endocrine tumor of lung have been published. Pathological study is the most important diagnostic method for gangliocytomas. Surgical excision is the primary treatment, but difficulty in total surgical tumor resection is the most important problem.

The Preservation of Joint Function in Treatment of Giant Cell Tumor of Bone (거대세포종의 치료시 관절 기능의 보존)

  • Bae, Dae-Kyung;Han, Chung-Soo;Sun, Seung-Deok;Baek, Chang-Hee;Rhee, Jae-Hoon
    • The Journal of the Korean bone and joint tumor society
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    • v.1 no.2
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    • pp.145-153
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    • 1995
  • Giant cell tumor is most frequently found in juxtaarticular region, and difficult to treat because of local recurrence. Although primary resections reduce recurrence, the joint function will be markedly impaired. Techniques involving physical adjuncts(high speed burr and electric cauterization), acrylic cement or en bloc resection with VFG(vascularized fibular graft) have been employed to reduce local recurrence. From October 1984 to April 1994, twenty-nine patients diagnosed as giant cell tumor were treated at department of Orthopaedic Surgery, School of Medicine, Kyung Hee University. There were eleven men and 18 women, ranging in age from 17 to 52 years(mean: 34 years). The average follow-up period was four years and five months. The location of the lesion was around the knee in 15, distal radius in three, femoral head in three, and others in eight patients. Fifteen patients around the knee joint were treated with several modalities; curettage with bone graft in five, curettage with cement filling in three, curettage with bone graft and physical adjuncts in five, en bloc resection with VFG in one and en bloc resection with arthroplasty in one patient. The functional results, according to the Marshall's knee score, were excellent in one, good in two, and fair in two after the curettage with bone graft, good in three after the curettage with bone cement filling, excellent in one, good in four after the curettage with bone graft and physical adjuncts, and good in two after the en bloc resection with VFG or arthroplasty. Three patients had local recurrence among 15 patients with giant cell tumor around knee. Vascularized fibular graft around wrist joint provided good functional restoration without local recurrence in all three patients who had giant cell tumor in distal radius. Although there is no statistical significance, it seems that curettage with bone graft using physical adjuncts or acrylic cement reveals better results than simple curettage with bone graft. Excellent functional result were obtained without local recurrence by using vascularized fibular graft after en bloc resection.

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Surgical Experience of Infratentorial Meningiomas : Clinical Series at a Single Institution during the 20-Year Period

  • Jung, Min-Ho;Moon, Kyung-Sub;Lee, Kyung-Hwa;Jang, Woo-Youl;Jung, Tae-Young;Jung, Shin
    • Journal of Korean Neurosurgical Society
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    • v.55 no.6
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    • pp.321-330
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    • 2014
  • Objective : Based on surgical outcomes of patients with infratentorial meningiomas surgically treated at our institution, we analyzed the predictors for surgical resection, recurrence, complication, and survival. Methods : Of surgically treated 782 patients with intracranial meningioma, 158 (20.2%) consecutive cases of infratentorial location operated on between April 1993 and May 2013 at out institute were reviewed retrospectively. The patients had a median age of 57.1 years (range, 16-77 years), a female predominance of 79.7%, and a mean follow-up duration of 48.4 months (range, 0.8-242.2 months). Results : Gross total resection (Simpson's grade I & II) was achieved in 81.6% (129/158) of patients. Non-skull base location was an independent factor for complete resection. The recurrence rate was 13.3% (21/158) and the 5-, 10-, and 15-year recurrence rates were 8.2%, 12.0%, and 13.3%, respectively. Benign pathology, postoperative KPS over than 90, low peritumoral edema, and complete resection were significantly associated with longer recurrence-free survival rate. The 5-, 10-, and 15-year survival rates were 96.2%, 94.9%, and 94.9%, respectively. Benign pathology, postoperative KPS over than 90 and complete resection were significantly associated with a longer survival rate. The permanent complication rate was 13% (21/158). Skull base location and postoperative KPS less than 90 were independent factors for the occurrence of permanent complication. Conclusion : Our experience shows that infratentorial meningiomas represent a continuing challenge for contemporary neurosurgeons. Various factors are related with resection degree, complications, recurrence and survival.

Management of Intractable Cerebrospinal Fluid Collection after Cerebellar Tumor Resection: A Case Report (소뇌 종양 적출 후 두개강 내 발생한 난치성 뇌척수액 고임의 치험례)

  • Rha, Eun Young;Oh, Deuk Young;Kim, Hye Young;Lee, Jung Ho;Moon, Suk Ho;Seo, Je Won;Rhie, Jong Won;Ahn, Sang Tae
    • Archives of Craniofacial Surgery
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    • v.11 no.2
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    • pp.95-98
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    • 2010
  • Purpose: CSF (Cerebrospinal fluid) leakage is the most common complication of neurosurgery. Early management with conservative care or surgery must be followed appropriately due to the increased risk of lethal complications, such as meningitis. We report a case of intractable CSF leakage that occurred after a cerebellar tumor resection, which was treated successfully. Methods: A 53-year old male consulted our department for continuous CSF leakage for 3 months after having received conservative care and lumbar drainage. CSF collection was observed in the dead space of the posterior fossa after a cerebellar tumor resection and postoperative radiotherapy. Using a free latissimus dorsi muscle flap, the dead space within the skull was filled and the defects were covered successfully. Results: At 6 weeks after surgery, the follow-up MRI and CT revealed proper coverage and filling in the area where cerebellar tumor had been removed. No CSF leakage was observed at the postoperative 3 month follow-up. Conclusion: Recurrent CSF leakage was treated after cerebellar tumor resection with a relatively satisfactory result. In terms of the patient's treatment, much better results can be achieved by performing dead space filling using a flap with a sufficient size, in addition to coverage of the defects of the dura.

Clinical Importance of the Resection Margin Distance in Gastric Cancer Patients (위암환자에서 위절제술 시 근위부 절제연거리의 임상적 중요성)

  • Ha, Tae-Kyung;Kwon, Sung-Joon
    • Journal of Gastric Cancer
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    • v.6 no.4
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    • pp.277-283
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    • 2006
  • Purpose: The way in which the resection margin distance for gastric cancer patients who undergo a gastric resection influences the recurrence rate, aspects of recurrence, and the prognosis according to the characteristic of the tumor is not known. We aim to find a standard for tailor-made treatment after selecting patients in this point of view who need a more sufficient resection margin. Materials and Methods: A retrospective study was done on 1,472 patients who underwent a gastrectomy due to gastric cancer at our hospital from 1992 to 2005. The median follow-up period was 37 months. Results: There were no significant differences in the recurrence rate, the aspects of recurrence, and the 5-year survival rate between early gastric cancer (EGC) patients with a resection margin distance of less than 2 cm compared with EGC patients with a resection margin distance of greater than 2 cm. However, significant differences in the survival rate were found in advanced gastric cancer (AGC) patients when the patients were classified into groups with resection margin distances less than or greater than 3 cm (P=0.02). Significant differences were noted especially in cases of diffuse histologic-type tumors located in the lower third of the stomach and in cases with Borrmann type-3 and -4 tumors. Conclusion: The distance between the tumor resection margin and the proximal gastric resection margin has no significant influence on the survival rate in EGC patients if the resection margin is negative. However, to improve a patient's survival rate, it is important to guarantee a resection margin of more than 3 cm in AGC patients, especially when the tumor is a diffuse histologic type located in the lower third of the stomach or a Borrmann type 3 and 4.

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