• 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.

• Archives of Plastic Surgery
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• v.49 no.3
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• pp.397-404
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• 2022

Background Excessive use of corticosteroids therapy along with gross immunocompromised conditions in the novel coronavirus disease 2019 (COVID-19) pandemic has raised the risks of contracting opportunistic fungal infections. Here, we describe our experience with the implementation of a surgical protocol to treat and reconstruct rhino-orbital-cerebral mucormycosis. Methods A retrospective review of our prospectively maintained database was conducted on consecutive patients diagnosed with mucormycosis undergoing immediate reconstruction utilizing our "Mucormycosis Management Protocol." All patients included in this study underwent reconstruction after recovering from COVID-19. Wide local excision was performed in all cases removing all suspected and edematous tissue. Reconstruction was done primarily after clear margins were achieved on clinical assessment under a cover of injectable liposomal amphotericin B. Results Fourteen patients were included. The average age was 43.6 years and follow-up was 24.3 days. Thirteen patients had been admitted for inpatient care of COVID-19. Steroid therapy was implemented for 2 weeks in 11 patients and for 3 weeks in 3 patients. Eight patients (57.1%) had a maxillectomy and mucosal lining resection with/without skin excision, and six patients (42.8%) underwent maxillectomy and wide tissue excision (maxillectomy and partial zygomatic resection, orbital exenteration, orbital floor resection, nose debridement, or skull base debridement). Anterolateral thigh (ALT) flaps were used to cover defects in all patients. All flaps survived. No major or minor complications occurred. No recurrence of mucormycosis was noted. Conclusion The approach presented in this study indicates that immediate reconstruction is safe and reliable in cases when appropriate tissue resection is accomplished. Further studies are required to verify the external validity of these findings.

• Archives of Plastic Surgery
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• v.34 no.3
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• pp.388-391
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• 2007

Purpose: Malignant fibrous histiocytoma (MFH) is mainly a soft tissue sarcoma containing fibroblast-like cells and histiocytic cells. MFH in bone accounts for 5% of all malignant bone tumors. MFH of the maxilla is extremely rare and difficult to diagnose due to its scarcity. Treatment mainstay is a complete surgical excision. Radiation therapy is also available when surgery alone is incomplete. Prognosis is not clear but can be devastating. Authors report one case of MFH developed in the maxilla. Methods: A 24-year-old man firstly diagnosed as fibrous dysplasia based on CT findings. Considering facial contour, partial excision was done. But pathology report confirmed malignant fibrous histiocytoma and secondary wide excision was done including zygoma and grossly all affected area. After surgery, radiation therapy was continued. Results: There are no evidence of tumor recurrence after clinical and radiological treatment. Conclusion: MFH of maxilla is very rare and this can leads to misdiagnosis in many clinicians. Surgeon should differentiate this disease from fibrous dysplasia and pathology and MRI are accurate methods for diagnosis of MFH.

• The Journal of the Korean bone and joint tumor society
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• v.4 no.2
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• pp.103-106
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• 1998

Giant cell tumor was described by Sir Astley Cooper in 1818. This tumor is considered to be a benign tumor but has problems of recurrence and metastatic change after treatment. Methods of operative treatment of this tumor have included currettage, currettage and bone graft, excision, resection, excision and graft and amputation. We experienced a case of giant cell tumor which involved the distal part of right radius and treated by wide excision and fibular graft. The postoperative courses have been satisfactory because of no recurrence or malignant change. After 6 years and 1 month follow up, the patient was able to return to daily life without any problem.

• Archives of Craniofacial Surgery
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• v.15 no.1
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• pp.36-39
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• 2014

Leiomyosarcoma is a rare form of soft tissue neoplasm, with only 1% to 5% occurring in the head and neck region. Current recommended treatment suggests surgical excision with a wide lateral margin, but no definite guidelines regarding excisional margin have been established yet. Recently, complete excision with a narrow surgical margin has been recommended, and the authors present a case of cutaneous leiomyosarcoma on the face that was successfully managed by complete removal with a narrow excisional margin. A 74-year-old woman presented with a 3 cm sized, rapidly growing cutaneous mass on her right preauricular area. Preoperative biopsy of the skin lesion suggested a cutaneous leiomyosarcoma. The authors performed complete surgical excision with a 1 cm lateral margin, and the resulting skin defect was repaired with bilateral V-Y advancement local flaps. Histopathology and immunohistochemistry evaluation confirmed a moderately differentiated cutaneous leiomyosarcoma, with negative margin involvement. The patient refused of any additional treatment, but showed no locoregional recurrence during the 1.5 years of postoperative follow-up period. With a regular postoperative follow-up, cutaneous leiomyosarcomas may be successfully treated with a narrow surgical margin.

• Molecules and Cells
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• v.22 no.3
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• pp.360-363
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• 2006

Human endogenous retroviruses (HERVs) contribute to various kinds of genomic instability via rearrangement and retrotransposition events. In the present study the formation of a new human-specific solo-LTR belonging to the HERV-H family (AP001667; chromosome 21q21) was detected by a comparative analysis of human chromosome 21 and chimpanzee chromosome 22. The solo-LTR was formed as a result of an equal homologous recombination excision event. Several evolutionary processes have occurred at this locus during primate evolution, indicating that mammalian-wide interspersed repeat (MIR) and full-length HERV-H elements integrated into hominoid genomes after the divergence of Old World monkeys and hominoids, and that the solo-LTR element was created by recombination excision of the HERV-H only in the human genome.

• Archives of Craniofacial Surgery
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• v.24 no.5
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• pp.236-239
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• 2023

Porocarcinoma (PC) and basal cell carcinoma (BCC) are distinct skin cancers. Few studies have documented the occurrence of two concurrent types of skin cancers, and to the best of our knowledge, this represents the inaugural report of such a coexisting lesion arising from a capillary malformation. Herein, we report a case of concurrent PC and BCC presenting with capillary malformation. A 93-year-old woman visited our hospital with a protruding mass in her right nasal ala that appeared as a capillary malformation. A biopsy was performed on the skin lesion, and BCC was diagnosed. A wide excision was performed. Permanent biopsy revealed that the skin lesion was a PC with basal cells and squamous differentiation. The safety margin of the deep tissue margin was < 0.1 cm; however, considering the advanced age of the patient, further excision was deemed to not possess any benefits. This case illustrates the importance of recognizing the possibility of multiple skin cancers, even in patients with benign lesions such as capillary malformations. The rarity of this presentation highlights the importance of thorough investigation and histopathological examination of skin lesions in guiding appropriate surgical excision.

• Archives of Craniofacial Surgery
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• v.25 no.2
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• pp.90-94
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• 2024

Primary cutaneous mucinous carcinoma (PCMC) is a rare malignancy of the sweat glands that most commonly affects the periorbital area. It is characterized by slow growth over a prolonged period, and its morphology can be easily confused with a benign tumor, such as an epidermal cyst. Consequently, many patients experience recurrence after undergoing multiple resections. However, there are few reports concerning the surgical management of PCMC. We present two cases of PCMC originating in the periorbital area. The first case involved a 76-year-old man with a mass measuring 3.0×1.5 cm that had been increasing in size. The second case was a 61-year-old man with two masses, each measuring 1.0×1.0 cm, that were also growing. Both patients underwent wide excision with a 5-mm safety margin, which was determined based on the widest view of the cross-section of the mass on the magnetic resonance imaging. Subsequently, based on the intraoperative frozen biopsy results, both patients underwent additional excision with a 5-mm safety margin in only one direction. This report shows that, when determining the surgical margin of PCMC in periorbital area, employing imaging modalities and intraoperative frozen biopsies can be helpful for narrowing the surgical margin.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.17 no.2
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• pp.195-201
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• 1995

This is a case report of calcifying aponeurotic fibroma occurred in the right pterygopalatine fossa & ramus area accompanied by adenoid cystic carcinoma of the right sublingual gland of a 44-year-old female. Calcifying aponeurotic fibroma is benign tumor, but it is characterized by poorly marginated, infiltrated growth pattern and a stubborn tendency to local recurrence, but there is no record of malignant transformation or metastasis, and surgical management should be conservative(excision and reexcision). Most cases been reported at the hands and feet, but no reported case occuring in the head region is found in the literature. Adenoid cystic carcinoma is a slow-growing infiltrative tumor with high recurrence rate, and it's treatment requires radical excisin and radiotherapy. Wide surgical excision of tumor, RND and partial resection of mandible were done. And then, immediate mandibular reconstruction was performed by means of reimplantaion technique after autoclaving of the resected bone.

• Journal of Chest Surgery
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• v.20 no.4
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• pp.723-729
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• 1987

A retrospective study of 21 cases of chest wall tumors, 12 benign and 9 malignant, was carried out to review their clinical radiological and pathological features. On age distribution, most cases [80.9%] were found in 4th to 6th decades. The sex ration [M:F] was represented as 2.5:1. Of the 21 lesions, there were 8 cases of soft tissue tumors, 4 cases of bone and cartilage origined tumors and 9 malignant tumors which included 3 metastatic tumors. The overall mortality was 22.2% and all of the deaths were found in the malignant tumors. All of the patients with benign tumors were treated by excision without recurrence. Distinction between benign and malignant chest wall tumors was not possible using radiographic criteria unless cortical destruction and involvement of soft tissue were visualized. On the basis of our analysis, we believe that all tumors of chest wall should be considered malignant until proven otherwise and that wide excision should be carried out. This is necessary not only to obtain as adequate diagnosis but also to provide the best chance for cure in both benign and malignant lesions.