• Journal of Korean Neurosurgical Society
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• v.59 no.6
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• pp.597-603
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• 2016

Introduction : Perioperative irradiation is often combined with spine tumor surgery. Radiation is known to be detrimental to healing process of bone fusion. We tried to investigate bone fusion rate in spine tumor surgery cases with perioperative radiation therapy (RT) and to analyze significant factors affecting successful bone fusion. Methods : Study cohort was 33 patients who underwent spinal tumor resection and bone graft surgery combined with perioperative RT. Their medical records and radiological data were analyzed retrospectively. The analyzed factors were surgical approach, location of bone graft (anterior vs. posterior), kind of graft (autologous graft vs. allograft), timing of RT (preoperative vs. postoperative), interval of RT from operation in cases of postoperative RT (within 1 month vs. after 1 month) radiation dose (above 38 Gy vs. below 38 Gy) and type of radiation therapy (conventional RT vs. stereotactic radiosurgery). The bone fusion was determined on computed tomography images. Result : Bone fusion was identified in 19 cases (57%). The only significant factors to affect bony fusion was the kind of graft (75% in autograft vs. 41 in allograft, p=0.049). Other factors proved to be insignificant relating to postoperative bone fusion. Regarding time interval of RT and operation in cases of postoperative RT, the time interval was not significant (p=0.101). Conclusion : Spinal fusion surgery which was combined with perioperative RT showed relatively low bone fusion rate (57%). For successful bone fusion, the selection of bone graft was the most important.

• The Journal of the Korean bone and joint tumor society
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• v.11 no.2
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• pp.175-182
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• 2005

Purpose: Bone tumor occurred in femur frequently involve proximal intertrochanteric region or distal metaphyseal region. Sometimes, the pathologic fracture can happen according to the size of tumor due to the substantial biomechanical stresses. Therefore, the prognosis can be improved biomechanically by the angled blade plate considering the anatomic configuration after the excision of tumor. Materials and Methods: Between October 1991 and April 2005, there were a total of 16 patients(17 cases) who were treated by the excision of tumor and internal fixation with the angled blade plate for bone tumor occurred in femur. After the excision of tumor, we filled the cavity by bone graft in 11 cases and bone cement in 6 cases. The internal fixation was used by angled blade plate in all cases. Result: The average follow-up time was 55.5 months(6-144 months) in 16 patients(17 cases). No metal failure occurred after the operation. Reoperation was performed in 4 cases due to tumor recurrence, and the internal fixation was firm until that. Conclusion: The angled blade plate can prevent the fracture until grafted bone incorporated to host bone, and protect fragile connection between cement and host bone.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.31 no.1
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• pp.61-66
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• 2009

The brown tumors develop in bone and it develop on various area which in clavicle, rib bone, cervical bone, iliac bone etc. The development on the maxillofacial region is rare, relatively more develop on the mandible. The brown tumor directly develop by the dysfunction of calcium metabolism according to hyperparathyroidism and differential diagnosis with other bone lesion should be difficult if it would diagnose by only radiographic features. The histological feature is that proliferation of spindle cells with extravasated blood and haphazardly arranged, variably sized, multinucleated giant cell is seen. The brown tumor is firm diagnosed by physical examination, because of these histological feature show similar with other giant cell lesions(giant cell granuloma, aneurysmal bone cyst, cherubism). The brown tumors have been described as resulting from an imbalance of osteoclastic and osteoblastic activity. It result in bone resorption and fibrous replacement of the bone. So these lesions represent the terminal stage of hyperparathyroidism-dependent bone pathology. Therefore, it is the extremely rare finding that brown tumor in the facial bone as the first manifestation of an hyperparathyroidism. We experience 1 case of brown tumor(50 years old female) that developed on Maxilla and mandible with no history of hyperparathyroidism. So we report this case with a literature review.

• The Journal of the Korean bone and joint tumor society
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• v.10 no.1
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• pp.39-44
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• 2004

A Giant cell tumor of bone has unusual characteristics of pulmonary metastasis as well as local aggressiveness. Clinical courses of pulmonary metastasis of benign giant cell tumor vary including rapid growth, continuously slow growth or spontaneous regression. We report a case of extensive pulmonary metastasis of giant cell tumor of bone, which regressed spontaneouly.

• The Journal of the Korean bone and joint tumor society
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• v.2 no.1
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• pp.72-77
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• 1996

Metastaic bone tumors are usually accompanied with severe pain. The treatment modalities for this pain are so variable that patients are sometimes afraid of using them. Salmon calcitonin has a function to increase beta-endorphines followed by increasing the blood level of prostaglandin and thromboxan A2, which results in analgesic effect. This drug also has been known to decrease bone resorption. There were a few reports that parenteral use of salmon calcitonin decrease the pain from metastatic bone tumor. We wanted to know the effectiveness and tolerability of nasal spray of salmon calcitonin in relieving bone pain with metastatic tumor. We analyzed the effectiveness in the aspects of pain, sleep, performance status, mobility, supplementary analgesic use. The biologic effect of salmon calcitonin was analysed with CBC, Ca/P, BUN/Cr, uric acid. Simple radiography, alkaline phosphatase, osteocalcin, pyrilink-K were used as parameters for bone change. Eighteen cases of metastatic bone tumors took nasal spray of salmon calcitonin($Miacalcic^{(R)}$, 200IU/day) for 4 weeks, to relieve bone pain. With Wilcoxon Matched-Pairs Signed Ranks Test, we could find pain decreased significantly at 3 week and mobility become improved at 4 week of salmon calcitonin use. Other parameters didn't show any significant changes. We think the analgesic effect is mainly due to effect not on the local bone lesion but on the central nervous system, and that increased dose of salmon calcitonin can induce earlier and stronger analgesic effect.

• Journal of Gastric Cancer
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• v.14 no.3
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• pp.204-206
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• 2014

Gastric complications following unintentional foreign body ingestion are extremely rare. Here, we report the case of a 59-year-old healthy woman who presented with nonspecific abdominal pain and an apparent gastric submucosal tumor that was incidentally detected by gastrofiberscopy. The patient underwent laparoscopic surgery, which revealed an intact gastric wall with no tumor invasion, deformity, or evidence of a gastric submucosal lesion. However, an impacted fish bone was found.

• Journal of Korean Neurosurgical Society
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• v.57 no.4
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• pp.292-294
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• 2015

Vestibular schwannoma (VS) usually present the widening of internal auditory canal (IAC), and these bony changes are typically limited to IAC, not extend to temporal bone. Temporal bone invasion by VS is extremely rare. We report 51-year-old man who revealed temporal bone destruction beyond IAC by unilateral VS. The bony destruction extended anteriorly to the carotid canal and inferiorly to the jugular foramen. On histopathologic examination, the tumor showed typical benign schwannoma and did not show any unusual vascularity or malignant feature. Facial nerve was severely compressed and distorted by tumor, which unevenly eroded temporal bone in surgical field. Vestibular schwannoma with atypical invasion of temporal bone can be successfully treated with combined translabyrinthine and lateral suboccipiral approach without facial nerve dysfunction. Early detection and careful dissection of facial nerve with intraoperative monitoring should be considered during operation due to severe adhesion and distortion of facial nerve by tumor and eroded temporal bone.

• Journal of Yeungnam Medical Science
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• v.20 no.2
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• pp.117-128
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• 2003

Thallium-201 scintigraphy is used to discriminate the malignant bone tumor from the benign by qualitatively and quantitatively, and to predict the response of preoperative chemotherapy in osteosarcoma, by comparing the changes of thallium uptake ratio after chemotherapy to the tumor necrosis ratio. Thallium-201 scintigraphy scan should be done prior to surgical biopsy. PICKER Prism 2000 gamma camera with high resolution parallel hole collimator is usually used for scanning. The patient is injected with 2-3mCi of Tl-201 and the early phase is checked in 30 minutes and delayed phase in 3 hours. The scan images are visually evaluated by a blinded nuclear medicine physician. We could evaluate true positive, true negative, false positive and false negative by the comparison of results with those of biopsy, and calculate positive and negative predictive value(%), sensitivity(%), specificity(%) and diagnostic accuracy(%). For the quantitative analysis of thallium uptake, we drew the region of interest on the tumor side and contralateral normal side as mirror image, and calculated the uptake ratio with dividing the amount of gamma count in tumor side by normal side. We could calculate the percent changes of thallium uptake ratio in early and delayed phase, and compare them to the ratio of tumor necrosis. Thallium-201 scintigraphy proved as useful imaging study to discriminate malignant bone tumor from benign, but had exception in giant cell tumor and low grade malignant bone tumors. We can use T1-201 scan to differentiate the benign from the malignant tumor, and to evaluate the response of preoperative chemotherapy or radiotherapy, and to determine the residual tumor or local recurrence. For the better result, we need to have a more detail information about false positive cases and a more objective and quantitative reading technique.

• The Journal of the Korean bone and joint tumor society
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• v.20 no.2
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• pp.104-108
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• 2014

Bizarre parosteal osteochondromatous proliferation (Nora's lesion) is a rare benign tumor and known to be primarily occur in the small tubular bone of the hands and feet. However, it is very unusual to be reported that it occurs in metatarsal bone in Korea. Thus, we report this tumor of metatarsal bone including the literature review because we have experienced this example.

• Archives of Craniofacial Surgery
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• v.11 no.2
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• pp.103-106
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• 2010

Purpose: Giant cell tumors of the bone are rare, locally aggressive lesions that primarily affect the epiphysis of the long bones in young adults. These tumors occur very rarely on the skull, principally in the sphenoid and temporal bones. The occipital bone is an unusual site. We report a rare case of a giant cell tumor of the occipital bone with a review of the relevant literature. Methods: A 7-year-old boy presented with a mass of the right occipital area, which was accompanied by localized tenderness and mild swelling. The mass was first recognized approximately 1 year earlier and grew slowly. There was no significant history of trauma. The physical examination revealed a nonmobile and non-tender bony swelling on the occipital region. The neurological evaluation was normal. The serial skull radiography and CT scan showed focal osteolytic bone destruction with a bulged soft tissue mass in the right occipital bone. The patient underwent a suboccipital craniectomy and a complete resection of the epidural mass. The lesion was firm and cystic. The mass adhered firmly to the dura mater. Results: The postoperative clinical course was uneventful, and the patient was discharged 5 days later. The histopathology report revealed scattered multinucleated giant cells and mononuclear stromal cells at the tumor section, and the giant cells were distributed evenly in the specimen, indicating a giant cell tumor. Conclusion: Giant cell tumors are generally benign, locally aggressive lesions. In our case, the lesion was resected completely but a persistent long term follow up will be needed because of the high recurrence rate and the possible transformation to a malignancy.