• Title/Summary/Keyword: axilla

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Treatment of Steatocystoma Multiplex on Whole Body: A Case Report (전신적으로 발생한 다발성 피지 낭종의 치험례)

  • Jang, Pal Young;Shin, Sang Ho;Lee, Kyung Suk;Kim, Nam Gyun;Kim, Jun Sik
    • Archives of Plastic Surgery
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    • v.35 no.3
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    • pp.325-328
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    • 2008
  • Purpose: Steatocystoma multiplex is a rare benign disease that occurred multiply on whole body surface. Many physicians have tried managing steatocystoma in variable methods. However it is hard to define the optimal way to cure steatocystoma. We performed both aspiration and excisional method to study the usefulness of both methods. Methods: A 28-year-old woman has asymptomatic multiple subcutaneous nodules on whole body. Most lesions were aspirated with 26-guage needled 3 cc syringe but large and purulent three nodules were excised. Results: We diagnosed the lesion histologically as steatocystoma multiplex. Aspirated wound healed without scar, excised wound remained scar but esthetically acceptable. Axillary lesion contained so clustered type cysts that was difficult to aspirate whole cyst. Thus additional excisional method was needed. Conclusion: There are many practical methods to cure steatocystoma. However, there is no appropriate method to cure it. Therefore we should select different therapeutic method according to anatomical location and cyst size. Especially at subcutaneous fat-rich lesion like axilla and abdomen, it is better to excise the clustered cyst than to aspirate.

Autologous Fat Graft in the Reconstructed Breast: Fat Absorption Rate and Safety based on Sonographic Identification

  • Kim, Hong Youl;Jung, Bok Ki;Lew, Dae Hyun;Lee, Dong Won
    • Archives of Plastic Surgery
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    • v.41 no.6
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    • pp.740-747
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    • 2014
  • Background Autologous fat graft has become a useful technique for correction of acquired contour deformity in reconstructed breasts. However, there remains controversial regarding the efficacy and safety of the practice for reconstructive breast surgery. Methods A retrospective review was performed on 102 patients who had secondary fat grafting after breast reconstruction. Fat harvest, refinement and injection were done by Coleman's technique. All patients were followed up postoperatively within 1 month and after 6 months including physical examination and ultrasonography. In 38 patients, the reabsorption rate was calculated by serial changes of thickness between skin and pectoral fascia in the ultrasonic finding. Locoregional recurrence rate was compared with control group of 449 patients who had breast reconstruction without fat graft in the same time period. Results Average 49.3 mL fat was injected into each breast. The most common location of fat graft was upper pole, followed by axilla, lower and medial breasts. During 28.7 months of average follow-up period, 2.9% of total patients had symptoms of palpable mass on fat graft side and ultrasonography identified fat necrosis and cyst formation in 17.6% of the patients. Calculated fat reabsorption rate was 32.9%. Locoregional recurrence was occurred in 1 patient (0.9%) and the rate was not different significantly with control group (2%). Conclusions Although further studies are required to provide surgeons with definitive guidelines for the implementation of fat grafting, we propose autologous fat graft is an efficient and safe technique for secondary breast reconstruction.

A Case of Spinal Cord Compression Caused by Rhabdomyosarcoma of the Mediastinum Associated with Type I Neurofibromatosis(NF Type I) - Case Report - (제 I 형 신경섬유종증에 병발하였던 종격동내 횡문근육종에 의한 척수압박 1례 - 증례보고 -)

  • Kim, Sei-Yoon;Whang, Kum;Hong, Soon-Ki;Pyen, Jhin-Soo;Hu, Chul;Kim, Hun-Joo;Han, Young-Pyo;Lee, Myoung-Sup;Lee, Chong-Kook;Cho, Mee-Yon
    • Journal of Korean Neurosurgical Society
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    • v.30 no.5
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    • pp.642-646
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    • 2001
  • A 12-years-old female admitted to the hospital with the complaint of pain on the right upper chest area which persisted about 1 month prior to admission. $Caf{\acute{e}}$-au-lait spots of various size laying on a whole body and freckling on the axilla were found on physical examination. A huge mass was found on the plain chest X-ray and on chest MRI. The mass encroached thoracic spine, posterior rib, back muscles, and then into the neural canal and compressed thoracic spinal cord. On the 5th day of hospitalization, the patient complained tingling on the both legs and 2 days later, monoparesis on the right leg. Open thoracotomy and decompressive laminectomy was done to remove mass. Pathologic reports confirmed rhabdomyosarcoma, embryonal type.

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Treatment of Axillary Osmidrosis Using a Subcutaneous Pulsed Nd-YAG Laser

  • Kim, Dae-Jin;Kim, Jun-Hyung;Yeo, Hyeon-Jung;Kwon, Hyuk-Jun;Son, Dae-Gu;Han, Ki-Hwan
    • Archives of Plastic Surgery
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    • v.39 no.2
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    • pp.143-149
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    • 2012
  • Background : Axillary osmidrosis is characterized by an unpleasant odor, profuse sweating, and in some instances, staining of clothes that may socially and psychologically impair affected individuals. Various types of surgical procedures have been developed for the treatment of axillary osmidrosis. This study was undertaken to evaluate the effectiveness of subcutaneous pulsed neodymium: yttrium-aluminum-garnet (Nd-YAG) laser treatment for the treatment of axillary osmidrosis. Methods : Twenty-nine patients with axillary osmidrosis were included in this study. Patients were categorized according to the results of an axillary malodor grading system, and a subcutaneous pulsed Nd-YAG laser was applied to all patients. The treatment area for the appropriate distribution of laser energy was determined using the iodine starch test (Minor's test) against a grid pattern composed of $2{\times}2cm$ squares. The endpoint of exposure was 300 to 500 J for each grid, depending on the preoperative evaluation results. The results were evaluated by measurement of axillary malodor both pre- and postoperatively using the grading system and iodine starch test. Results : The average follow-up period was 12.8 months. Nineteen patients had a fair-to-good result and ten patients had poor results. The postoperative Minor's test demonstrated that there were remarkable improvements for patients with mild to moderate symptoms. Complications including superficial second degree burns (n=3) were treated in a conservative manner. A deep second degree burn (n=1) was treated by a surgical procedure. Conclusions : Subcutaneous pulsed Nd-YAG laser has many advantages and is an effective noninvasive treatment for mild to moderate axillary osmidrosis.

Cystic Lymphangioma in the Chest Wall of the Child - A case report - (소아의 흉벽에 발생된 림프관종 - 1예 보고 -)

  • Jang In-Seok;Kim Sung-Whan;Yang Jun-Ho;Kim Jong-Woo;Choi Jun-Young;Rhie Sang-Ho
    • Journal of Chest Surgery
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    • v.39 no.8 s.265
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    • pp.652-654
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    • 2006
  • Lymphangioma is a developmental anomaly that is known to occur in the neck and axilla, and only rarely in the mediastinum, retroperitoneum, groin and pelvis. An isolated chest wall lymphangioma is a rare benign neoplasm. In case of large sized lymphangioma, surgical excision is preferably recommended as the treatment of choice. We operated on a three-year old female for excision of chest wall. In pathologic diagnosis, it diagnosed the mass as chest wall lymphangioma.

Fine Needle Aspiration Cytology of Metastatic Small Cell Carcinoma of Lymph Nodes - Comparison to Non-Hodgkin's Lymphoma on 5 Cases - (림프절의 전이성 소세포암종의 세침흡인 세포학적 소견 - 악성 림프종과의 감별을 중심으로 5예 분석 -)

  • Kim, Yeon-Mee;Cho, Hye-Je;Ko, Ill-Hyang
    • The Korean Journal of Cytopathology
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    • v.7 no.1
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    • pp.44-50
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    • 1996
  • Small cell carcinoma of the lung is characterized by cells with finely stippled chromatin and scanty cytoplasm as well as a particularly aggressive clinical course and favorable response to the chemotherapy. Recently percutaneous fine needle aspiration (FNA) biopsy has become both widely established and highly respected for the diagnosis of lung cancer. However metastatic small cell carcinoma of lymph node should be cytologically differentiated from the small round cell tumor of particular sites, especially malignant lymphoma, because small ceil carcinoma of classic oat cell type nay simulate small cell non-Hodgkin's lymphoma. We report five cases of metastatic small cell carcinoma of in-termediate cell type diagnosed by FNA of the enlarged lymph nodes of the neck and axilla. The cytologic smears contained diffuse small neoplastic cells larger than lymphocytes with dense, pyknotic nuclei and extremely scanty cytoplasm. Apparently viable large tumor cells have vesicular nuclei with granular, sometimes very coarse chromatin. The characteristic cytologic features of small cell carcinoma as compared to malignant lymphoma were as follows.: 1) small cells with dense pyknotic nuclei are evenly distributed in the background of apparently viable larger tumor cells, admixed with mature lymphocytes and phagocytic macrophages. 2) small loose aggregates of cells with nuclear melding are indicative of small cell carcinoma rather than non-Hodgkin's lymphoma. 3) the cytoplasmic and nuclear fragments of tumor necrosis are more dominant in the smears of small cell carcinoma. 4) nuclear membrane and nucleoli are generally indistinct in small cell carcinoma due to condensation of chromatin.

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A Case of Giant Lymph Node Hyperplasia in the Spermatic Cord (정색을 침범한 거대 림프양 증식증 1례)

  • Shin, Hyun-Chul;Kim, Young-Soo;Park, Tong-Choon;Shim, Young-Ran
    • Journal of Yeungnam Medical Science
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    • v.9 no.1
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    • pp.175-180
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    • 1992
  • Giant lymph node hyperplasia(Castleman's disease) is a rare disease, which represents a peculiar form of lymph node hyperplasia. Generally, it has been considered as benign and localized disease but recently, revealed malignant transformation in some cases of multicenteric form. It usually occurs on the mediastinum and occasionaly neck, lung, axilla, mesentery, broad ligament, retroperitoneum or soft tissue of extremities. Histopathologically, it is divided into hyaline vascular or plasma cell type and the former is characterized with prominent vascular proliferation and hyalinization in the central portion and tight concenteric layering of lymphocytes at the periphery of the fillicles(mantle zone) and the latter is characterized by a diffuse plasma cell proliferation in the interfollicular area. From the point of view of clinical presentation, it has been divided into solitary form, which presents as a localized mass located most commonly in the mediastinum, and multicenteric form, which occurs multiple location and has systemic manifestation arid transformation into malignancy. Herein we report a case of Giant lymph node hyperplasia occuring in the left spermatic cord in a 58-year old male with brief review of literatures.

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A Breast Cancer Nomogram for Prediction of Non-Sentinel Node Metastasis - Validation of Fourteen Existing Models

  • Koca, Bulent;Kuru, Bekir;Ozen, Necati;Yoruker, Savas;Bek, Yuksel
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.3
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    • pp.1481-1488
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    • 2014
  • Background: To avoid performing axillary lymph node dissection (ALND) for non-sentinel lymph node (SLN)-negative patients with-SLN positive axilla, nomograms for predicting the status have been developed in many centers. We created a new nomogram predicting non-SLN metastasis in SLN-positive patients with invasive breast cancer and evaluated 14 existing breast cancer models in our patient group. Materials and Methods: Two hundred and thirty seven invasive breast cancer patients with SLN metastases who underwent ALND were included in the study. Based on independent predictive factors for non-SLN metastasis identified by logistic regression analysis, we developed a new nomogram. Receiver operating characteristics (ROC) curves for the models were created and the areas under the curves (AUC) were computed. Results: In a multivariate analysis, tumor size, presence of lymphovascular invasion, extranodal extension of SLN, large size of metastatic SLN, the number of negative SLNs, and multifocality were found to be independent predictive factors for non-SLN metastasis. The AUC was found to be 0.87, and calibration was good for the present Ondokuz Mayis nomogram. Among the 14 validated models, the MSKCC, Stanford, Turkish, MD Anderson, MOU (Masaryk), Ljubljana, and DEU models yielded excellent AUC values of > 0.80. Conclusions: We present a new model to predict the likelihood of non-SLN metastasis. Each clinic should determine and use the most suitable nomogram or should create their own nomograms for the prediction of non- SLN metastasis.

Minimal Subdermal Shaving by Means of Sclerotherapy Using Absolute Ethanol: A New Method for the Treatment of Axillary Osmidrosis

  • Shim, Hyung-Sup;Min, Sung-Kee;Lim, Jin-Soo;Han, Ki-Taik;Kim, Min-Cheol
    • Archives of Plastic Surgery
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    • v.40 no.4
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    • pp.440-444
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    • 2013
  • Background Axillary osmidrosis is characterized by unpleasant odors originating from the axillary apocrine glands, resulting in psychosocial stress. The main treatment modality is apocrine gland removal. Until now, of the various surgical techniques have sometimes caused serious complications. We describe herein the favorable outcomes of a new method for ablating apocrine glands by minimal subdermal shaving using sclerotherapy with absolute ethanol. Methods A total of 12 patients underwent the procedure. The severity of osmidrosis was evaluated before surgery. Conventional subdermal shaving was performed on one side (control group) and ablation by means of minimal subdermal shaving and absolute ethanol on the other side (study group). Postoperative outcomes were compared between the study and control groups. Results The length of time to removal of the drain was 1 day shorter in the study group than in the control group. There were no serious complications, such as hematoma or seroma, in either group, but flap margin necrosis and flap desquamation occurred in the control group, and were successfully managed with conservative treatment. Six months after surgery, we and our patients were satisfied with the outcomes. Conclusions Sclerotherapy using absolute ethanol combined with minimal subdermal shaving may be useful for the treatment of axillary osmidrosis. It can reduce the incidence of seroma and hematoma and allow the skin flap to adhere to its recipient site. It can degrade and ablate the remaining apocrine glands and eliminate causative organisms. Furthermore, since this technique is relatively simple, it takes less time than the conventional method.

Analysis of Sasang Constitutional Deviation of Health Condition according to the Tendency of Perspiration (발한양상에 따른 건강상태의 체질별 편차에 대한 분석)

  • Kim, Hyo-Jung;Lee, Hae-Jung;Jin, Hee-Jeong;Kim, Myoung-Geun
    • Journal of Sasang Constitutional Medicine
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    • v.21 no.3
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    • pp.89-106
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    • 2009
  • 1. Objectives: The aim of this study was to survey the tendency of perspiration and health condition of Sasang Constitution and to analysis the relationship between health condition and perspiration. 2. Methods: We recruited 1565 subjects in multi-oriental hospitals and researched their perspiration and health condition. Subjects were diagnosed by the Sasang Constitutional specialists in oriental hospitals, and had remarkable improvement in their chief complains after Sasang Constitutional Medication. All subjects answered the questionnaire about the tendency of perspiration including the amount and region of sweating, and the health condition such as meal, appetite, tiredness, health degree, and warm-cold preference. Based on these clinical data, we analyzed the Sasang Constitutional deviation of health condition according to the tendency of perspiration. We found the differences of answering using Chi-square test between-group comparison. We analyzed using SPSS 14.0 for Korean. 3. Results: The amount of sweating was related with degree of health condition such as tiredness, health degree, meal, appetite, and warm-cold preference. However there was no significant differences between Sasang Constitutional groups. 4. Conclusions: According the region of sweating, there was some deviation of health conditions between Sasang Constitution. Especially sweating of head and neck meant good symptom for SE type but not for SY type. And the sweating on the chest and axilla meant bad symptoms for all Sasang Constitutional types.

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