• Title/Summary/Keyword: Wide surgical excision

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MUCOEPIDERMOID CARCINOMA OF PALATE: REPORT OF A CASE (구개부에 발생한 점액표피양 암종의 치험례)

  • Bae, Jung-Ho;Yoon, Kyu-Ho;Park, Kwan-Soo;Cheong, Jeong-Kwon;Shin, Jae-Myung;Hong, Sung-Chul
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.28 no.1
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    • pp.68-72
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    • 2006
  • Mucoepidermoid carcinoma is one of the most common malignant salivary gland neoplasm. It occurs over a wide age range, and is most common in the parotid gland and usually appears as an asymptomatic swelling. Pain or facial nerve palsy may develop. Minor salivary gland tumors also typically appear as asymptomatic swellings, which are sometimes fluctuant and have blue or red color that can be mistaken clinically for a mucocele. Histopathologically the mucoepidermoid carcinoma is composed of a mixture of mucous-producing cells and squamous (epidermoid) cells. Low-grade tumors show prominent cyst formation, minimal cellular atypia, and relatively high proportion of mucous cells. Mucoepidermoid carcinoma of the minor salivary glands are treated usually by assured surgical excision. For low-grade neoplasm, only a modest margin of surrounding normal tissue may need to be removed, but high-grade or large tumors warrant wider resection. Postoperative radiation therapy also may be used for more aggressive tumors. Mucoepidermoid carcinoma of the oral minor salivary glands generally have a good prognosis, because they are mostly low-to intermediate grade tumors. We present a case of mucoepidermoid carcinoma managed with surgical enucleation and postoperative irradiation and a good clinical result with review of literatures.

Organ-sparing Surgery in Treating Patients with Liposarcoma of the Spermatic Cord: Institutional Experience and Pooled Analysis

  • Cao, Ming-Xin;Chen, Jie;Zhang, Jun-Long;Wei, Xin;Liang, Yue-You
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.8
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    • pp.3419-3423
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    • 2015
  • Background: Liposarcoma of the spermatic cord is rare and frequently misdiagnosed. The standard therapeutic approach has been radical inguinal orchiectomy with wide local resection of surrounding soft tissues. The current trend of organ preservation in the treatment of several cancers has started to evolve. Herein we present our testis-sparing surgery experience in the treatment of spermatic cord liposarcoma and a pooled analysis on this topic. Materials and Methods: Clinical information from patient receiving organ-sparing surgery was described. Clinical studies evaluating this issue were identified by using a predefined search strategy, e.g., Pubmed database with no restriction on date of published papers. The literature search used the following terms: epidemiology, surgery, chemotherapy, radiotherapy, testis sparing surgery, spermatic cord sarcomas/liposarcomas. Results: Patient received a complete excision of the lesion, preserving the spermatic cord and the testis. The final pathological report showed a well differentiated liposarcoma with negative surgical margins and no signs of local invasion. After 2-year of follow-up, there was no evidence of local recurrence. Since the first case reported in 1952, a total of about 200 well-documented spermatic cord liposarcoma cases have been published in English literature. Among these patients, only three instances were reported to have received an organ-sparing surgery in the treatment of spermatic cord liposarcoma. Conclusions: Radical inguinal orchiectomy and resection of the tumor with a negative microscopic margin is the recommended treatment for liposarcoma of the spermatic cord. But for small, especially well-differentiated, lesions, testis-sparing surgery might be a good option if an adequate negative surgical margin is assured.

A clinical review of reconstructive techniques for patients with multiple skin cancers on the face

  • Kim, Geon Woo;Bae, Yong Chan;Bae, Sung Hwan;Nam, Su Bong;Lee, Dong Min
    • Archives of Craniofacial Surgery
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    • v.19 no.3
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    • pp.194-199
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    • 2018
  • Background: Cases of simultaneous multiple skin cancers in a single patient have become more common. Due to the multiplicity of lesions, reconstruction in such cases is more difficult than after a single lesion is removed. This study presents a series of patients with multiple facial skin cancers, with an analysis of the surgical removal, reconstruction process, and the results observed during follow-up. Methods: We reviewed 12 patients diagnosed with multiple skin cancers on the face between November 2004 and March 2016. The patients' medical records were retrospectively reviewed to identify the type of skin cancer, the site of onset, methods of surgical removal and reconstruction, complications, and recurrence during follow-up. Results: Nine patients had a single type of cancer occurring as multiple lesions, while three patients had different skin cancer types that occurred together. A total of 30 cancer sites were observed in the 12 patients. The most common cancer site was the nose. Thirteen defects were reconstructed with a flap, while 18 were reconstructed with skin grafting. The only complication was one case of recurrence of basal cell carcinoma. Conclusion: Multiple skin cancers are removed by performing Mohs micrographic surgery or wide excision, resulting in multiple defect sites. The authors emphasize the importance of thoroughly evaluating local lesions surrounding the initially-identified lesions or on other sites when reconstructing a large defect which can not be covered by primary closure. Furthermore, satisfactory results can be obtained by using various methods simultaneously regarding the condition of individual patients, the defect site and size, and the surgeon's preference.

Upper eyelid reconstruction using a combination of a nasal septal chondromucosal graft and a Fricke flap: a case report

  • Lee, Ju Ho;Woo, Sang Seok;Shin, Se Ho;Kim, Hyeon Jo;Kim, Jae Hyun;Kim, Seong Hwan;Suh, In Suck
    • Archives of Craniofacial Surgery
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    • v.22 no.4
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    • pp.204-208
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    • 2021
  • Sebaceous carcinoma is a malignant neoplasm that usually arises in the sebaceous glands of the eyelids. Its pathogenesis is unknown; however, irradiation history, immunosuppression, and use of diuretics are known risk factors. The mainstay of treatment for sebaceous carcinoma of the eyelid is wide surgical resection with a safety margin of 5 to 6 mm, which often results in full-thickness defects. The reconstruction of a full-thickness defect of the eyelid should be approached using a three-lamella method: a mucosal component replacing the conjunctiva, a cartilage component for the tarsal plate, and a flap or skin graft for the skin of the eyelid. In this case, a full-thickness defect of the upper eyelid was reconstructed after tumor removal using a combination of a nasal septum chondromucosal composite graft and a forehead transposition flap, also known as a "Fricke flap." The flap was designed to include a line of the eyebrow on the lower margin of the flap to replace the eyelash removed during tumor excision. The wound healed completely, without any early or late complications, and the outcome was satisfactory.

Extrapleural Pneumonectomy for the Anterior Mediastinal Liposarcoma with Invasion of Pleura and Lung -1 case report - (흉막 및 폐를 침범한 전종격동 지방육종에서의 흉막외 폐전적출술 - 1예 보고 -)

  • 박천수;김영태;성숙환;김주현
    • Journal of Chest Surgery
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    • v.37 no.3
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    • pp.286-291
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    • 2004
  • Mediastinum is a very rare primary site of liposarcoma. In general, wide surgical excision with adequate resection margin is the treatment of choice for lipesarcoma. We experienced a case of liposarcoma in a 24 year-old male who complained of dyspnea and chest discomfort. Symptoms had been developed a month before admission, and the intensity had been gradually increased. He visited another general hospital, and there he received left closed thoracostomy because hemothorax was suspected. Afterwards, he was transferred to our hospital without a specific diagnosis, on review of outside chest computed tomography film, mass shadow was detected in the mediastinum. For the further evaluation, we checked the chest sonography and chest magnetic resonance imaging. MRI showed 10 cm sized mass contacted with pulmonary artery trunk and left main pulmonary artery. The radiologist strongly suggested sarcoma. On the 4th day after admission, we performed emergent exploratory left thoracotomy for hematoma evacuation because mediastinal shifting progressed and heart rate was increased. Biopsy confirmed that the evacuated materials were extraskeletal myxoid chondresarcoma, so we performed extrapleural left pneumonectomy including diaphragm and a part of the pericardium. The final pathologic diagnosis was myxoid/round cell liposarcoma. He was discharged without complication and systemic chemotherapy was scheduled to begin 2 month later. During chemotherapy, local recurrence and peritoneal metastasis developed, and he died 10 month after the surgical excision. We report this case with reviewal of literature.

Surgical Treatment of Malignant Tumors in Shoulder Girdle (견갑관절 주위 악성종양의 치료경험)

  • Song, Seok-Whan;Chang, Ju-Hai;Kang, Yong-Koo;Kim, Jung-Man;Kim, Hyoung-Min;Rhee, Seung-Koo;Woo, Young-Kyun;Bahk, Won-Jong;Moon, Myung-Sang;Kim, Yang-Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.1 no.1
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    • pp.68-76
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    • 1995
  • To evaluate the clinical result of surgical treatment of malignant tumors in shoulder girdle, nine patients who were treated in Department of Orthopedics, Catholic University Medical College between January 1991 and December 1993, were evaluated. There were 5 men, 4 women. The mean age at operation was 47 years(range from 22 to 64 years). Of 9 patiens, 2 were soft tissue tumors(1 MFH, 1 dermatofibrosarcoma protuberance); one was treated with forequarter amputation, and the other with wide excision, Seven were bone tumor(2 chondrosarcoma, 1 osteosarcoma, 1 MFH, 1 plasmacytoma, 1 thyroid carcinoma metastasis, 1 malignant schwannoma); one patient was treated with segmental excision of proximal humerus, 4 with Malawer type I-A resection and arthroplasty or arthrodesis, 1 with Malawer type V-B resection and arthrodesis. Five patients received adjuvant chemotherapy, with or without local radiation therapy, and one patient received radiation therapy alone. All patients have survived now, but I had local recurrence. Functional results of arthrodesis and arthroplasty were similar.

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A CASE OF AGGRESSIVE FIBROMATOSIS INVADED MANDIBULAR BODY ON THE PAROTID REGION (이하부에 발생한 침습성 섬유종증이 하악체에 침범한 증례 보고)

  • Kim, Young-Jo;Lee, Dong-Keun;Um, In-Woong;Min, Seung-Ki;Chung, Chang-Joo;Kim, Eun-Cheol
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.16 no.2
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    • pp.186-195
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    • 1994
  • Fibromatosis is benign fibroblastic proliferative lesion with abundant collagenous neo-formation located principally in the abdominal wall and in the upper and lower extremities (Masson & Soule, 1966). Wilkins and Waldron, in 1975, suggested that the title aggressive fibromatosis was a more appropriate term, reflecting the invasive characteristics of the disease. Synonyms listed were extra-abdominal desmoid, juvenile fibromatosis, aggressive infantile fibromatosis and congenital fibrosarcoma. A total of 12% of all fibromatosis arise in head and neck. Fibromatosis of the oral cavity is uncommon and is even more rare when in involve the mandibule. It is a locally aggressive fibrous tissue tumor, generally does not metastasize, but may cause considerable morbility and even death due to local infiltration. The degree of microscopic cellularity is variable, not only from tumor to tumor but also from area to area in the same tumor. Some tumors present with proliferation of mature fibroblasts and a dominating collagenous component : others may show a lack of the tumor in both types. The common histologic denominator appears to be cellular interlacing bundles of elongated fibroblasts, showing little or no mitotic activity and no pleomorphism. Mitosis are not a consistent index of malignancy when found in younger age groups. Fibromatosis still posses difficult problems of diagnosis and treatment. It is frequently recurrent and infliltrates neighbouring tissues. These lesion infliltrate widely and replace muscle, fat, and even bone with fibrous tissue of varying cellularity. Lesion representing fibromatosis in the oral cavity must be carefully evaulated by both surgeon and pathologists to ensure proper diagnosis and treatment planning. When these lesions involve bone, surgeon must be aware of the lesion's potential to perforate the cortex and expand while remaining hidden from the surgeon's view. Careful and precise clinical correlation with histologic appearance is essential to preclude misdiagnosis of fibrosarcoma yet provide surgical treatment plan that provides adequate local excision and long-term follow up. As regards cause, little is known. It is attributed to trauma or alteration in the sex hormone(Carlos, et al, 1986). Clinially, the lesion is reported to be not painful in most cases, but capable of rapid growth. The treatment is essentially surgical excision with wide margin of adjacent uninvolved tissue. Radiotherapy, hormone treatment or chemotherapy are of no use (WIkins et al, 1975 ; Majumudar and Winiarkl, 1978). We report a case of aggressive fibromatosis of 15-year-old with a lesion in the soft tissue of the parotid area that invaded the underlying bone of the mandibular body.

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CLINICAL STUDY OF AMELOBLASTOMA ON THE JAW (악골에 발생한 법랑아세포종의 임상적 연구)

  • Kim, Hyun-Syeob;Ryu, Jae-Young;Yu, Min-Gi;Seo, Il-Young;Shet, Uttom Kumar;Kook, Min-Suk;Park, Hong-Ju;Ryu, Sun-Youl;Choi, Hong-Ran;Oh, Hee-Kyun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.33 no.5
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    • pp.535-542
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    • 2007
  • Ameloblastoma, a benign tumor of odontogenic type, represents 10% of all tumors of the jaw. It is localized in the mandible(80%) and in the maxilla(20%). In every case, the selection of the surgical treatment must consider some fundamental elements, including the age and general state of health the clinicopathological variant, and the localization and extent of the tumor. This study was invested the clinicopathological findings of 23 patients with ameloblastoma which had been diagnosed by biopsy during the period of 1987 to 2005 at Chonnam National University Hospital. And it contained the statistical analysis according to the treatment methods and the clinicopathological findings such as sex, age, location, chief complaints, duration, radiographic findings, histologic findings, treatment methods. The results obtained are were follows. The age of patient ranged from 10 to 91 years(means, 35.9 years) at biopsy. Thirteen(57%) of the 23 subjects were males, and 10(43%) were females. Twenty(87%) of the 23 ameloblastomas were located in the mandible. Swelling was the most common symptom and was experienced by 20(87%) patients. Radiographically, 11(48%) of the 23 tumors were unilocular with a well-demarcated border and 12(52%) were multilocular. The most common histologic pattern was plexiform and acanthomatous rather then follicular. Conservative treatment was performed 7 cases(30%), radical treatment 11 cases(48%), and combined treatment 5 cases(22%). Follow-up period ranged from 2.1 years to 22 years(mean 5.1 years). Based on the above results, surgical excision after marsupialization was found to be useful as a preliminary treatment of the large cystic ameloblastoma in children and adolescents. On the contrary, the lesion with a soap bubble appearance, the one with ineffective marsupialization was subjected to extensive excision of the tumor with a wide margin of normal bone.

Treatment of Squamous Cell Carcinoma in Extremity & Trunk (사지와 체부에 발생한 편평상피 세포암의 치료)

  • Shin, Duk-Seop;Kim, Beom-Jung
    • The Journal of the Korean bone and joint tumor society
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    • v.18 no.1
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    • pp.7-13
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    • 2012
  • Purpose: The purpose of this study is to compare general survival rate and survival rate according to expectable prognostic factors by analyzing the result of treating a patient of squamous cell carcinoma. Materials and Methods: From Mar. 1999 to Feb. 2011, 151 patients were pathologically confirmed as squamous cell carcinoma of limbs and body in our hospital, and among those patients, 51 patients underwent the surgical treatment. This study included 41 patients who underwent the surgical treatment and were followed-up for more than 12 months. The mean age of population was 64.4 years. 31 males and 10 females were included. Wide excision with following skin grafts or flaps for reconstruction (29 cases) was mostly performed, but amputation (12 cases) was also performed for cases with extremities where resection margin was difficult to obtain and cases with neural or vascular invasion. 8 patients underwent chemotherapy or radiotherapy after resection, and 33 underwent the operation only. Stages were classified by AJCC Classification, survival rate was calculated by Kaplan-Meier method and survival rate of groups was compared by Log-rank test. For the expectable prognostic factors related to survival rate, location of primary lesion, cause of disease, pathologic grade, staging, surgical method, additional anticancer therapy were examined and each survival rate was compared. Results: The average follow-up period was 65.2 (12-132) months. Thirty patients survived out of 41 patients till last follow up. The overall survival rate in 5 years was 77%. Three cases (7.3%) had local recurrence, and 7 cases (17.0%) had metastasis. The average period of recurrence from operation was 27 (18-43) months. Possible prognostic factors such as location of primary lesion, cause of disease, pathologic grade, staging, additional anticancer therapy showed no significant difference in survival rates. However, patients with amputation showed significantly lower survival rate than those with wide excision. Conclusion: In analysis the results of treating 41 cases of squamous cell carcinoma, the overall 5-year survival rate was 77%. And, among the several prognostic factors, only the surgical method was significant statistically.

Surgical Treatment of Recalcitrant Wart (난치성 사마귀의 수술적 치료)

  • Kim, Ka-Ram;Choi, Jai-Koo;Hur, Gi-Yeun;Ko, Jang-Hyu;Seo, Dong-Kook;Lee, Jong-Wook;Jang, Young-Chul
    • Archives of Plastic Surgery
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    • v.38 no.6
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    • pp.798-802
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    • 2011
  • Purpose: A wart is caused by epidermal infection with the human papilloma virus. Although wart naturally disappears in some cases, it require treatment because of pain, aesthetic problem, and the possibility of malignant change. Conventional non-surgical treatment cannot be a fundamental solution for the pain and has such disadvantages as frequent recurrence and difficulties in achieving a satisfactory outcome. A surgical procedure was performed on patients with wart and the procedure had a good outcome. Methods: We investigated the gender, age, lesion site, mean treatment duration, and presence or absence of recurrence in 21 patients with a wart within the period of January 2007 to July 2011. For local lesions, primary closure, including subcuticular suture after the excision, was performed. If the defect size was too big to do primary closure, we performed rotation flap. For wide multiple lesions, a split thickness skin graft was performed. Results: Among the 21 patients, 12 patients were male and 9 patients were female, and their mean age was 42 years (SD=17.38, range: 11~75 years). The lesion site was the foot in 10 patients, the hand in 8 patients, the face in 2 patients, and the scalp in 1 patient. The mean treatment duration was 13.5 days (SD=4.36, range: 6~15 days) for the primary closure or rotation flap, and 18.5 days (SD=2.12, range: 17~20 days) for the skin graft. 20 patients were cured without recurrence. No recurrence was observed in the patients who underwent primary closure or rotation flap. One of the two patients who underwent a skin graft of their wart that had covered their entire palm had local recurrence in part of her finger tips. Conclusion: We performed surgical procedure on recalcitrant wart. As a results, we can treat it with short treatment duration, low recurrence rate and less scarring and get high patient satisfaction.