• Title/Summary/Keyword: Wide surgical excision

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Multiple Large Cysts Arising from Nevus Comedonicus

  • Jeong, Hii-Sun;Lee, Hye-Kyung;Lee, Seung-Hyun;Kim, Hyoung-Suk;Yi, Sang-Yeop
    • Archives of Plastic Surgery
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    • v.39 no.1
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    • pp.63-66
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    • 2012
  • Nevus comedonicus is a type of hamartoma that arises from a developmental anomaly of the mesodermal part of the pilosebaceous gland. In most cases of nevus comedonicus, an acne-like skin condition develops. Repeated inflammation can cause a morphological change to the cyst, papule, to abscess. We experienced a case of congenital nevus comedonicus, which led to the formation of large multiple cysts. A 50-year-old man was referred with a $12.5{\times}10cm$ lobulated mass on the posterior neck and upper back. The patient had a widespread presence of nevus comedonicus in the region ranging from the right superior chest to the posterior neck. The patient had a 30-year history of six prior excisions. A magnetic resonance imaging review led to a diagnosis of nevus comedonicus. Surgical treatment consisted of excision of the mass and wide excision for the patch type of nevus comedonicus around the neck. On histopathology, multiple masses were diagnosed as typical cysts containing keratinized tissue. The diffuse comedone lesions were diagnosed as nevus comedonicus. This case shows that large, multiple cysts can occur as a long-term complication of nevus comedonicus, and also highlights the importance of radical resection to prevent its further invagination.

Proximal Humerus Brown Tumor with Primary Hyperparathyroidism in Pregnancy (임신중 발생한 원발성 부갑상선 기능 항진증을 동반한 상완골 근위부의 Brown tumor)

  • Jung, Sung-Taek;Kim, Hyun-Jeong;Lee, Dam-Seon;Park, Gi-Heon
    • The Journal of the Korean bone and joint tumor society
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    • v.13 no.2
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    • pp.173-179
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    • 2007
  • Brown tumor is tumor like lesion resulted from hyperparathyroidism, and it has been rarely reported recently. We evaluated a 29-year-old woman who had brown tumor on proximal humerus caused by primary hyperparathyroidism. She first had presented pain and swelling over the upper arm, and was suspected as giant cell tumor in biopsy combined with hyperparathyroidism. Wide marginal excision and tumor prosthesis were performed. However, it was confirmed as brown tumor resulted from parathyroid adenoma according to laboratory findings and radioactive isotopes image, and surgical excision of adenoma relieved clinical symptoms. We report this case with a review of literatures.

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Giant Cell Tumor of the Rib: A Case Report and Review of the Literature (늑골에서 발생한 거대세포종: 1예 보고 및 문헌 고찰)

  • Kim, Hyun-Soo;Kim, Dae-Hyun;Lim, Sung-Jig;Park, Yong-Koo
    • The Journal of the Korean bone and joint tumor society
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    • v.15 no.1
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    • pp.52-58
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    • 2009
  • Giant cell tumor (GCT) of the rib may present as a posterior mediastinal mass when it involves the posterior arc. Only 4 cases of GCT of the rib presenting as a posterior mediastinal mass have been reported. We report a case of a 38-year-old man with GCT of the rib. Computed tomography revealed a well-defined, multi-lobulated, heterogeneous mass in the right superoposterior mediastinum, which appeared to invade the right third rib and thoracic vertebra. It was thought to be a posterior mediastinal ganglioneuroma or its malignant transformation. Grossly, the tumor mass arose in the posterior arc and showed substantial growth out of the rib. Microscopically, the tumor consisted of interspersed multi-nucleated giant cells and stromal mononuclear cells, compatible with GCT. For GCT, a wide excision with elective radiotherapy should be considered. GCT must be differentiated from posterior mediastinal ganglioneuroma that can be treated by surgical excision alone.

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Treatment of Giant Cell Tumor Around Knee - by Intralesional Excision Using High Speed Burr and Methylmethacrylate - (슬관절 주변에 발생한 거대세포종의 치료 - 고속 바(High-Speed Burr)와 골 시멘트를 이용한 병소 내 절제술 -)

  • Park, Jong-Hoon;Lee, Soo-Yong;Jeon, Dae-Geun;Cho, Wan-Hyung;Song, Won-Seok;Kim, Jin-Wook;Koh, Han-Sang
    • The Journal of the Korean bone and joint tumor society
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    • v.11 no.2
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    • pp.160-167
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    • 2005
  • Purpose : Distal femur and proximal tibia are the common sites affected by giant cell tumor of bone. There are a variety of treatment modality including wide excision and intralesional curettage. We evaluated the local recurrence rates and the post-operative functional scores of giant cell tumors around knee joint and investigated the identification of possible prognostic factors for recurrence. Materials and Methods: We reviewed 41 patients pathologically confirmed as giant cell tumors around knee joint that have undergone intralesional curettage using high-speed burr and methylmethacrylate. We evaluated the recurrence rate and post-surgical functional score and possible prognostic factors for recurrence, such as, gender, age, tumor location, size, subchondral invasion, intra-articular invasion and the Campanacci Grades. Mean follow up period was 50 (12-122) months. Results: The recurrence rate was 17% and mean recurrence onset was 10 months postoperatively. According to Musculoskeletal Tumor Society (MSTS) functional evaluation system, the average score was 27.8(93%) and 78% had excellent function. According to our study, suspected prognostic factors revealed not significant for recurrence. Conclusion: We found no significant recurrence related factors. Intralesional excision with high-sped burring and PMMA provides a low recurrence rate, similar to others in the literature, and good functional scores.

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Reconstruction after Wide Excision of Malignant Soft Tissue Tumor in Ankle and Foot (족관절 및 족부에 발생한 연부 조직 악성 종양의 광범위 절제술 후 재건술)

  • Kwon, Young-Ho;Cho, Yool;Kim, Jae-Do;Chung, So-Hak
    • The Journal of the Korean bone and joint tumor society
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    • v.14 no.1
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    • pp.33-43
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    • 2008
  • Purpose: To evaluate the clinical usability of reconstructive methods, and how to select flap after wide excision of malignant soft tissue tumor in ankle and foot. Materials and Methods: The 15 cases shown in the 14 patients (In case of a male patient, reconstruction was performed two times due to local recurrence.) with malignant soft tissue tumor in ankle and foot, who underwent reconstruction after wide excision from March 2000 until March 2007. Oncologic, surgical and functional results were evaluated. Results: The method of reconstruction used were anterolateral thigh perforator flap (5cases), Reversed superficial sural artery flap (4 cases), dorsalis pedis flap (3 cases), local flap (3cases). The defect, mean size was $5.5{\times}5.7\;cm$, was reconstructed with rotation flap or free flap, mean size was $5.9{\times}6.0\;cm$, skin graft for remnant. The mean operation time was 310 minutes (120~540 minutes); it took 256 minutes to reconstruct by rotation flap, and 420 minutes by free flap. As oncologic results, 7 patients were no evidence of disease, 6 patients were alive with disease and 1 patient was expired by pulmonary metastasis at the time of the last follow-up. 4 patients had local recurrence and 4 pateints had distant metastases. As functional results, 14 patients were evaluated with average score of 68.8% using the system of the Musculoskeletal Tumor Society. Conclusion: The dorsalis pedis and reverse superficial sural artery rotation flap which is easy procedure, has less complication and takes short operation time, can be primarily considered to reconstruct a small defect. And the anterolateral thigh perforator flap is suitable for coverage of a large defects after wide excision of malignant soft tissue tumor in ankle and foot.

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Malignant Schwannomas of the Ethmoid Sinus and the Larynx -Case Report and Review of Literatures- (사골동과 후두에 발생한 악성신경초종)

  • Lee, Kyu-Chan;Choi, Myung-Sun
    • Radiation Oncology Journal
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    • v.10 no.1
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    • pp.77-83
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    • 1992
  • The incidence of malignant schwannoma in the head and neck is extremely rare. Most tumors appear as a rapidly expanding nonpainful mass and the symptoms are usually attributable to local expansion of the mass. About one half occurs in association with von Recklinghausen's disease. Wide surgical excision is generally recommended as a primary treatment. Recently, there has been a trend to include postoperative radiation therapy as a primary modality. Prognosis of head and neck malignant schwannoma has been reported as particularly poor, However, recent authors advocate that prolonged survival is possible after adequate therapy including postoperative radiation therapy. We present our experience with these tumors on very rare locations such as the ethmoid sinus and the larynx, with the review of literatures.

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Mandibular condyle and infratemporal fossa reconstruction using vascularized costochondral and calvarial bone grafts

  • Jang, Hyo Won;Kim, Nam-Kyoo;Lee, Won-Sang;Kim, Hyung Jun;Cha, In-Ho;Nam, Woong
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.40 no.2
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    • pp.83-86
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    • 2014
  • There are some difficulties in approaching and removing the lesion in infratemporal fossa because of its anatomical location. After wide excision of tumor lesion, it is also difficult for reconstruction of mandibular condyle and cranium base on infratemporal fossa. Besides, there are some possibilities of cerebrospinal fluid leakage, intracranial infection and bone resorption. It is also challenging for functional reconstruction that allows normal mandibular movement, preventing mandibular condyle from invaginating into the skull. In this report, we present 14-month follow-up results of a patient who had undergone posterior segmental mandibulectomy including condyle and infratemporal calvarial bone and mandible reconstruction with free vascularized costochondral rib and calvarial bone graft to restoration of the temporomandibular joint area.

Angiosarcoma in a Chronically Lymphedematous Leg - Stewart-Treves Syndrome - (하지의 만성 림프부종에 발생한 혈관육종 - Stewart-Treves 증후군 -)

  • Chun, Young-Soo;Shim, Hee-Seok
    • The Journal of the Korean bone and joint tumor society
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    • v.15 no.2
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    • pp.178-183
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    • 2009
  • Angiosarcoma is a very rare disease of soft tissue sarcoma, and angiosarcoma arising in a region of chronic lymphedema is referred to as Stewart-Treves syndrome. it typically occurs in postmastectomy lymphedema of the arm and sporadically in a lymphedematous leg. The prognosis, even with wide surgical excision and subsequent radiotherapy, is poor. The authors experienced a case of angiosarcoma in a chronically lymphedematous leg which had undergone hysterectomy due to cervical cancer 17 years ago and lymphedema of leg persists for about 16 years. We report a case of angiosarcoma with a brief review of the literature.

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A Case of Primary Hemangiopericytoma of the Lung (폐의 원발성 혈관주위세포종 1예)

  • Kim, Dae-Young;Lee, Dong-Lyeol;Lee, Kyu-Hwan;Jo, Jin-Hoon;Kim, Kang-Hee;Kim, Ho-Kyun;Kim, Hye-Suk;Yoon, Sun-Hee
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.1
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    • pp.111-116
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    • 1999
  • Primary hemangiopericytomas of the lung are uncommon sarcomas that arise from pericytes that surround the basement membrane of capillaries and small venules within the lung parenchyma. The presenting symptoms and signs depend on the location of the tumor and radiologic features are not diagnostic. The behavior of pulmonary hemangiopericytomas is difficult to predict and all tumors should be considered potentially malignant. Wide surgical excision remains the mainstay of treatment. We report a case of primary hemangiopericytoma of the lung with a brief review of literature.

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Reconstructive Considerations in Webster's Modification of Bernard Operation after Wide Excision of Squamous Cell Carcinoma on Lower Lip (하구순 편평세포암의 광범위 절제 후 Bernard씨 술식의 Webster씨 변법을 이용한 재건)

  • Nam, Su Bong;Bae, Yong Chan;Choi, Chi Won
    • Archives of Plastic Surgery
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    • v.32 no.2
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    • pp.168-174
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    • 2005
  • Reconstruction of the lower lip requires consideration of several factors. There should be retained sensation, maintenance of oral sphincter function, and a large enough opening for the mouth. In addition, it is important to achieve an aesthetically acceptable appearance. Webster's modification of Bernard operation is one of good methods which satisfy above mentioned goals. The purpose of this article is to present the results and review the perioperative problems after reconstruction of the lower lip by this operation. We reviewed seven patients after surgical reconstruction by the same method between January of 1996 and December of 2003. Five patients were male and two were female. The mean follow-up period was 15 months. We obtained functionally and cosmetically acceptable appearance after reconstruction. Most of the reconstructed lower lips were large enough for full mouth opening, but one patient required additional commissuroplasty, and one other patient was treated with wound revision for dehiscence resulting from protrusion of mandibular lateral incisor tooth. All other patients accepted their facial appearance. In conclusion, careful planning and consideration for dental problems and proper closure tension may ensure satisfactory outcome & lower lip competence, when using this modified operative method for lower lip reconstruction.