• Title/Summary/Keyword: Wide surgical excision

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Surgical Treatment of Metastatic Tumor in Proximal Femur with Recycling Autograft Prosthetic Composite after Wide Excision (근위 대퇴골 전이성 종양의 수술적 치료로서 광범위 절제술 후 재활용 자가골을 이용한 복합 고관절 성형술)

  • Kim, Jae-Do;Park, Pil-Jae;Kwon, Young-Ho;Jang, Jae-Ho;Lee, Young-Gu
    • The Journal of the Korean bone and joint tumor society
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    • v.11 no.1
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    • pp.71-81
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    • 2005
  • Purpose: Due to local recurrence of tumor, metal failure usually develops in patients who underwent internal fixation or hip joint arthroplasty after curettage in the case of metastatic tumor of proximal femur. The aim of this study is to find out the appropriateness of reconstruction using recycling autograft after wide excision in the case of metastatic bone tumor by performing recycling autograft and hip joint arthroplasty after wide excision, and through presence or absence of local recurrence, functions of lower limbs and occurrence of complications. Materials and Methods: Five patients, in 6 cases, who had undergone reconstruction using recycling autograft prosthetic composite after wide excision in the metastatic tumor from May 2000 to May 2003 were included in this study. The average age of the patients was 60.8 years of age with male to female ratio of 3:2. Average duration of lives following surgery was 23.3 month (7-57 months). Primary lesion included 2 cases of lung cancer, and 1 each of stomach cancer, renal cancer and multiple myeloma. After wide excision, the hip joint was reconstructed with recycling autograft prosthetic composite ; 4 cases of extracorporeal irradiation and 2 cases of pasteurization. Musculoskeletal Tumor Society (MSTS) score(1993) for 6-month period after surgery, as well as presence of complication and local recurrence during the rest of their lives, were studied. Results: Average Musculoskeletal Tumor Society (MSTS) score over the 6-month period after surgery was 63.3% and 1 case of dislocation of hip joint, as a complication following surgery, was discovered. Local recurrence during the lives of the patients was not observed. Conclusion: In the case of metastatic tumor of proximal femur, in which the life span following surgery is expected to be more than 6 months, undergoing reconstruction using recycling autograft after wide excision, in comparison to internal fixation or hip joint arthroplasty after curettage, is deemed to have better results in prevention of local recurrence, and preservation of the functions of all limbs during the life span of the patient.

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A CASE PRESENTATION OF VERRUCOUS CARCINOMA ORIGINATED FROM VERRRUCOUS LEKOPLAKIA (우췌성 백반증에서 기원한 우췌성 암종의 치험례)

  • Choi, Moon-Gi
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.28 no.4
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    • pp.339-347
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    • 2006
  • Oral leukoplakia is the most common premalignant lesion and malignant transformation has been reported from verrucal lekoplakia. Homogenous, benign leukoplakia develops into a line of squamous cell carcinoma such as verrrucous carcinoma, papillary squamous cell carcinoma and invasive squamous cell carcinoma. Early diagnosis and intervention of premalignant leukoplakia is up-most important to prevent transformation into a oral squamous cell carcinoma. Any change in surface, size and color warrants repeated biopsy. If verrucous carcinoma is evidently derived from the previous leukoplakia, wide surgical excision and periodic follow up is needed. Surgically removed lesion of leukoplakia has the tendency to recur. Follow-up is very important to patient and clinician. Although many therapies have been reported to oral leukoplakia and verrucal carcinoma, accepted treatment principle is not exist so far. But surgical removal is recommended as the treatment of choice.

Intralesional OK-432 Sclerotherapy for Plunging Ranula (OK-432 경화요법으로 치유된 Plunging Ranula)

  • Chung Woung-Youn;Park Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.12 no.1
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    • pp.65-68
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    • 1996
  • The incidence of plunging ranula has been reported as about 10% of all ranula cases. Treatment consists of wide surgical excision or marsupialization. However, it seldom provides a satisfactory result and various modalities of treatment have been proposed in addition to surgical extirpation. We reported our experience using intralesional OK-432 sclerotherapy for a case of plunging ranula in 20 year-old male patient. The OK-432 solution was prepared by dissolving 0.1 KE in 2ml of physiologic saline and was instilled in the same amount of the aspirated cystic fluid. Following two instillations, the lesion completely disappeared. The side effects were mild fever for 3 days and a mild local induration for several days. At present, 9 months after instillation, no recurrence was observed. OK-432 sclerotherapy appears to be simple, safe and effective method for the treatment of plunging ranula.

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Intracranial Invation From Recurrent Angiosarcoma of The Scalp

  • Choi, Kyu-Sun;Chun, Hyung-Joon;Yi, Hyeong-Joong;Kim, Jeong-Tae
    • Journal of Korean Neurosurgical Society
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    • v.43 no.4
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    • pp.201-204
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    • 2008
  • Angiosarcoma of the brain, either primary or metastatic is extremely rare. Moreover, angiosarcoma metastazing to the brain is also highly unlike to occur when comparing with metastases to the other organs. Thus, an ideal treatment strategy has not been established. A 67-year-old man with past surgical history of a scalp angiosarcoma underwent surgical resection of intracranial invasion. Because of wide scalp flap excision and resultant poor vascularity of the scalp flap, additional radiation was not provided. Because adjuvant therapy is impossible due to poor scalp condition, more careful but ample resection of the primary lesion is essential to conduct initial operation.

Two Cases of Sebaceous Carcinoma on Scalp (두피에 발생한 피지선암 2례)

  • Roh, Sang Hoon;Sohn, Hyung Bin;Jung, Young Jin;Hong, In Pyo
    • Archives of Plastic Surgery
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    • v.36 no.3
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    • pp.361-364
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    • 2009
  • Purpose: Sebaceous carcinoma is a rare malignant tumor derived from the adnexal epithelium of sebaceous glands. This tumor usually occurs on the eyelids, but uncommonly it may occur on the extraocular sites. It is characterized by a tendency of local recurrence and occasional metastasis. Surgical excision is appropriate treatment for patients with sebaceous carcinoma. Because this kind of case is rare, we report two cases of sebaceous carcinoma developed on scalp. Methods: Case 1 was a 69 - year - old woman. She visited the hospital with a $1.5{\times}2.5cm$ sized reddish yellow - colored, slowly growing mass on left parietal scalp. The mass began at birth and started growing at 5 years ago. Case 2 was a 67 - year - old woman. She had $2.5{\times}3.0cm$ sized yellow - colored mass on right parietal scalp. It occured at birth and started growing at 3 years ago. And the masses had erythematous ulcer with sanguineous discharge. In the beginning, the masses were miliary nodule. Results: CT scan and fine needle biopsy were done. Case 1 and 2 were diagnosed as sebaceous carcinoma. Wide excision with safety margin of 10 mm and split thickness skin graft was done. Histological examination revealed well demarcated, irregular, variable sized tumor lobules. Each lobule was composed of sebaceous and undifferentiated cells. Postoperatively, the patients did well and the lesion had not recurred. Conclusion: Sebaceous carcinoma is an aggressive malignant tumor. It often can be mistaken for other skin tumors. Authors experienced two rare cases of sebaceous carcinoma developed on scalp. We recommend early wide excision with enough safety margin as treatment of sebaceous carcinoma.

Polymorphous low-grade adenocarcinoma on hard palate: case report (구개부에 발생한 다형성 저등급 선암종의 치험례)

  • Shin, Young-Min;Choi, So-Young;Kim, Jin-Wook;Byeon, Ki-Jung;Kim, Chin-Soo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.37 no.1
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    • pp.72-76
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    • 2011
  • Polymorphous low-grade adenocarcinomas (PLGA) are distinctive salivary gland neoplasms with a propensity to arise from the minor salivary glands. The most frequent location of PLGA is the palate, even though other locations have been described. Previously used terms for PLGA include lobular carcinoma and terminal duct carcinoma. Although the frequency of the tumor is unknown, the recognition of PLGA as an individual tumor has increased with the establishment of specific histopathological criteria characterizing the PLGA. The first choice of treatment is a wide surgical excision including the subjacent bone if necessary. The prognosis is generally good and the recurrence rate ranges from 17% and 22%. Distant metastases is unusual (9%) but occur mainly in the regional lymph nodes. This is a case report of a 67 year old female patient with PLGA who was treated with a wide excision by layers (2 stage) of the lesion including the surrounding bone. We present this case with a review of the relevant literature.

A Case of Locally Invasive and Recurred Papillary Thyroid Carcinoma Metastatizing to Cervical Lymphatic Chains and Mediastinum (광범위한 국소재발 및 경부, 종격동 전이를 동반한 유두상 갑상선암 1례)

  • Choi Hong-Shik;Lee Ju-Hyoung;Kim Jae-Won;Yang Hae-Dong
    • 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.

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Treatment of Synovial Sarcoma in Popliteal Fossa Adjacent to Tibia - A Case Report - (경골과 접한 슬와부 활막육종의 치료 - 증례 보고 -)

  • Shin, Duk-Seop;Kwack, Byung-Hoon;Ahn, Jong-Chul
    • The Journal of the Korean bone and joint tumor society
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    • v.13 no.2
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    • pp.201-206
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    • 2007
  • It is a well-accepted tenet that wide surgical margins are necessary for the treatment of soft-tissue sarcomas, and it is still true that the rate of recurrence depends on the adequacy of the surgical margins. Sarcomas that rest directly against bone pose a dilemma for the surgeon. A wide margin is not possible in the literal sense without excision of the bone. Whereas reconstruction of skeletal defects is possible, it adds to the complexity of the surgery and increases potential complications. We report the experience of treatment in a case of synovial sarcoma which located at popliteal fossa adjacent to proximal tibia.

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Concordant Surgical Treatment: Non-melanocytic Skin Cancer of the Head and Neck

  • Ryu, Wan Cheol;Koh, In Chang;Lee, Yong Hae;Cha, Jong Hyun;Kim, Sang Il;Kim, Chang Gyun
    • Archives of Craniofacial Surgery
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    • v.18 no.1
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    • pp.37-43
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    • 2017
  • Background: Skin cancer is the most common type of cancer. Of the 4 million skin lesions excised annually worldwide, approximately 2 million are considered cancerous. In this study, we aimed to describe a regional experience with skin cancers treated by a single senior surgeon and to provide a treatment algorithm. Methods: The medical records of 176 patients with head and neck non-melanocytic skin cancer (NMSC) who were treated by a single surgeon at our institution between January 2010 and May 2016 were retrospectively reviewed, and their data (age, sex, pathological type, tumor location/size, treatment modality) were analyzed. Patients with cutaneous squamous cell carcinoma (cSCC) who were classified as a high-risk group for nodal metastasis underwent sentinel node mapping according to the National Comprehensive Cancer Network guidelines. Results: Among the patients with NMSC who were treated during this period, basal cell carcinoma (BCC; n=102, 57.9%) was the most common pathological type, followed by cSCC (n=66, 37.5%). Most lesions were treated by complete excision, with tumor-free surgical margins determined via frozen section pathology. Thirty-one patients with high-metastasis-risk cSCC underwent sentinel node mapping, and 17 (54.8%) exhibited radiologically positive sentinel nodes. Although these nodes were pathologically negative for metastasis, 2 patients (6.5%) later developed lymph node metastases. Conclusion: In our experience, BCC treatment should comprise wide excision with tumor-free surgical margins and proper reconstruction. In contrast, patients with cSCC should undergo lymphoscintigraphy, as nodal metastases are a possibility. Proper diagnosis and treatment could reduce the undesirably high morbidity and mortality rates.

Clinical Evaluation of Chest Wall Tumors -Review of 33 Cases- (흉벽종양 33례에 대한 임상적 고찰)

  • Lee, Mun-Geum;O, Tae-Yun;Jang, Un-Ha
    • Journal of Chest Surgery
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    • v.28 no.8
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    • pp.778-783
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    • 1995
  • The incidence of chest wall tumor is rare than those of other portions of the body. The chest wall tumors need special attention about their diagnosis and management than other tumors. From March, 1985 to September, 1994, 33 patients with chest wall tumor underwent surgical treatment, and those were consisted of 28 benign tumors and 5 malignant tumors arising from soft tissue, rib and sternum.Benign tumors were included 11 lipoma, 4 cysticercosis, 2 chondroma and 1 each of fibroma, dermatofibroma, osteochondroma, fibrous dysplasia and hemangioma,and 6 other cases. Malignant chest wall tumors were included 2 metastatic carcinoma,1 each of giant cell tumor, chondrosarcoma and epithelioid sarcoma.Sex ratio of male to female was 1.5:1, and the range of age was 16 to 72 years,and the mean age was about 40 years. Clinical manifestations of chest wall tumor were palpable mass[55% , pain[21% ,tender mass[9% , growing mass[9% and asymptomatic[9% .The all cases were treated surgically, the results were as follows:Local excision 16 cases, wide resection 12 cases, wide resection with chemotherapy 3 cases, each one case of wide resection with radiotherapy and wide resection with chest wall reconstruction.

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