• Title/Summary/Keyword: local recurrence

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Stromal vascular fraction injection to treat intractable radiation-induced rectovaginal fistula

  • Kim, Mijung;Lew, Dae Hyun;Roh, Tai Suk;Song, Seung Yong
    • Archives of Plastic Surgery
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    • v.48 no.1
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    • pp.127-130
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    • 2021
  • Rectovaginal fistula, which can arise after an injury to the vaginal canal or rectum, is a troublesome obstacle for patients' everyday life. In most cases, it can be covered with a local flap, but previous radiation therapy increases the recurrence rate, making it especially difficult to cure. As the application of stromal vascular fraction (SVF) obtained from enzymatically digested autologous adipose tissue has become increasingly common, several reports have advocated its effectiveness for the treatment of refractory wounds. In light of the angiogenic, regenerative characteristics of SVF, it was incorporated as a treatment option in two cases of rectovaginal fistula discussed here. As described in this report, irradiated rectovaginal fistulas in rectal cancer patients were successfully treated with SVF injection, and we suggest SVF as a feasible treatment option for cases of rectovaginal fistula that would otherwise be very difficult to cure.

A recurrent case of extraocular sebaceous carcinoma with distant organ metastasis

  • Kwon, Byeong Soo;Chung, Eui Han;Kim, Jin Woo
    • Archives of Craniofacial Surgery
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    • v.22 no.1
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    • pp.56-61
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    • 2021
  • Sebaceous carcinoma (SC) is a rare tumor, accounting for approximately 0.7% of skin cancers. SC can be classified as ocular SC (OSC) or extraocular SC (EOSC) depending on its location. Because EOSC accompanied by metastases is rare, there is a paucity of data about EOSC accompanied by metastasis. This study presents a case of an aggressive EOSC of the scalp with lymph node metastases. The patient underwent wide local excision of the primary tumor with a 1 cm safety margin and bilateral radical lymph node dissection. However, recurrence was observed 1 month after surgery. Radiation therapy and resection were performed for the recurrent tumor. However, distant metastases to both lungs eventually occurred. Here, we describe a rare recurrent case of EOSC of the scalp with distant organ metastasis with a review of the literature.

Solitary plasmacytoma in the maxillary sinus: 10-year follow-up

  • Nguyen, Truc Thi Hoang;Eo, Mi Young;Sodnom-Ish, Buyanbileg;Cho, Yun Ju;Kim, Soung Min
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.47 no.6
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    • pp.471-475
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    • 2021
  • Solitary plasmacytoma (SP) is an uncommon form of plasma cell neoplasm occurring intraosseously or in soft tissue and presents as a single mass of monoclonal plasma cells. SP in the maxillary sinus is rare and can be misdiagnosed as other maxillary sinus tumors. The essential examinations in patients with the initial diagnosis of plasmacytoma are bone marrow biopsy, serum and urine electrophoresis, and kappa/lambda ratio (κ:λ ratio) to rule out multiple myeloma (MM). Herein, a rare case of SP in the maxillary sinus treated by surgery and localized radiation is reported. At the 10-year follow-up examination, local recurrence or disseminated development of MM were not evident.

Congenital epulis in a newborn

  • Min-Jun, Kang;Sang-Hoon, Kang
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.48 no.6
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    • pp.382-385
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    • 2022
  • Congenital epulis (CE) is an extremely rare benign tumor of the gingiva that is found on the alveolar ridge of newborns, and the main treatment option is simple excision. Postoperative prognosis is very good, and spontaneous regression may occur despite incomplete excision. This report presented a rare case of CE and its healing process after surgery under local anesthesia. The treatment plan was decided upon through consultation between a medical team and the patient's family, with surgical excision for the main lesion, which benefitted from surgery, and follow-up for a very small-sized lesion, which was thought to be appropriate for a newborn. No recurrence was found after its removal, and favorable healing was observed.

An unusual presentation of peripheral ameloblastoma in the maxilla

  • Rosa Maria Acevedo Ocana;Jorge Cortes-Breton Brinkmann;Carolina Valle Rodriguez;Norberto Quispe Lopez;María Isabel Sanchez Jorge
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.50 no.3
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    • pp.161-165
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    • 2024
  • Peripheral ameloblastoma (PA) is believed to be the rarest variant of ameloblastoma and only has been described in isolated case reports. PA is usually confined to the soft tissues surrounding the supporting tissues of the teeth. Although it manifests nonaggressive behavior and can be treated with complete removal by local surgical excision, long term follow up is mandatory to prevent future recurrence and possible malignant transformation.

The Role of Postoperative Radiotherapy for Ameloblastic Carcinoma of the Mandible: Case Report (사기질모세포 암종에서 수술 후 방사선치료의 역할: 증례보고)

  • Kim Won Taek;Chung In Kyo;Ki Yong Kan;Nam Ji Ho;Gwon Byung Hyun;Kim Dong Won
    • Radiation Oncology Journal
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    • v.23 no.3
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    • pp.194-200
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    • 2005
  • An ameloblastic carcinoma is a very rare odontogenic malignant tumor, which sometimes have a benign clinical nature, but typically have aggressive features, with large ulcerative lesion and extensive local destruction. These clinical characteristics make the complete surgical removal of a tumor difficult. As a consequence, a poor prognosis may result due to local recurrence and distant metastasis. For this reason, it is important to consider adjuvant therapies for high-risk ameloblastic carcinoma patients. Here, the case of a recurrent ameloblastic carcinoma that occurred in the mandible after primary surgery is reported. The lesion was treated with further local excision, followed by postoperative radiotherapy. Also, a few remarks on the role of postoperative radiotherapy in patient with ameloblastic carcinoma have been made from a review of the current literatures on the treatment of this type of lesion.

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.

Invasion of the great vessels or atrium predicts worse prognosis in thymic carcinoma

  • Eom, Keun-Yong;Kim, Hak Jae;Wu, Hong-Gyun;Kim, Young Tae;Heo, Dae Seog;Kim, Young Whan
    • Radiation Oncology Journal
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    • v.31 no.3
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    • pp.131-137
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    • 2013
  • Purpose: We evaluated treatment outcomes of thymic carcinomas to determine prognostic factors for survival. Materials and Methods: Between May 1988 and May 2009, 41 patients had pathologic diagnosis of thymic carcinoma in Seoul National University Hospital, Seoul, Korea. Of these, 40 patients were followed up to 188 months after treatment. The mean age of all patients was 58.3 years and male to female ratio was 23 to 17. Results: Among 30 patients who underwent surgical resection, 26 achieved R0 resection and postoperative radiotherapy (PORT) was performed in 22 patients (73%). Various chemotherapeutic regimens were given with local treatment modalities, surgery and/or radiotherapy, in 12 patients. The 5-year locoregional control (LRC), distant metastasis-free survival, progression-free survival (PFS), and overall survival were 79.4%, 53.0%, 42.6%, and 63.6%, respectively. Patients with Masaoka stage I or II showed excellent prognosis of 5-year PFS around 90%. In advanced stages, invasion of the great vessels or atrium by thymic carcinomas was negative prognostic factor for PFS in univariate analysis. Lymph node involvement was statistically significant factor for LRC and PFS. Local or regional recurrence was infrequent after surgical resection followed by PORT, while distant metastasis was the major component of treatment failure. Conclusion: Complete resection followed by PORT provided remarkable local control without severe acute toxicities in patients with stage II and favorable stage III thymic carcinoma. Invasion of the great vessels or atrium was statistically significant prognostic factor for PFS.

Concurrent Chemoradiotherapy in Nasopharyngeal Carcinoma (비인강암의 동시 항암화학방사선치료)

  • Chung, Eun-Ji;Kim, Yong-Tai;Hong, Hyun-Jun;Hong, Won-Pyo
    • Korean Journal of Head & Neck Oncology
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    • v.24 no.2
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    • pp.169-173
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    • 2008
  • Purpose:This is a retrospective study to evaluate the results of concurrent chemoradiotherapy in nasopharyngeal carcinoma. Material and Methods:From Mar 2000 to June 2005, 18 patients with nasopharyngeal carcinoma completed planned concurrent chemoradiotherapy. Stages were I in 1 patients, II in 2 patients, III in 7 patients and IV in 8 patients. Pathologic type was squamous cell carcinoma(WHO type 1) in 2 patients, non-keratinizing type(WHO type 2) in 8 patients and undifferetiated carcinoma(WHO type 3) in 8 patients. The follow up period ranged from 30 months to 95 months with a median of 56 months. Follow up was possible in all patients. Results:Response to concurrent chemoradiation therapy was a complete response in all patients. Patterns of failure were as follows:local recurrence in only one patient(5.6%) and distant metastases in three patients with N3 diseases(16.7%). The overall 5 year survival rates were 88.5%, the 5 year disease free survival rate was 77% and these were very good results. There were no significant differences in the local control and survival rates between the clinical stages and pathologic types. Conclusion:The outcome of the nasopharyngeal carcinoma treated with concurrent chemoradiotherapy was very good, even though most of the patients(15/18=83.3%) were in stage III and IV diseases. We concluded that concurrrent chemoradiotherapy in nasopharyngeal carcinoma showed the good local control and survival rates without significant complications. In the patients with N3 disease, we have to consider the more effective and strong chemotherapeutic regimens to prevent distant metastases.

Maximum standardized uptake value at pre-treatment PET in estimating lung cancer progression after stereotactic body radiotherapy

  • Park, Jisun;Choi, Yunseon;Ahn, Ki Jung;Park, Sung Kwang;Cho, Heunglae;Lee, Ji Young
    • Radiation Oncology Journal
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    • v.37 no.1
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    • pp.30-36
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    • 2019
  • Purpose: This study aimed to identify the feasibility of the maximum standardized uptake value (SUVmax) on baseline 18F-fluorodeoxyglucose positron emission tomography-computed tomography (FDG PET/CT) as a predictive factor for prognosis in early stage primary lung cancer treated with stereotactic body radiotherapy (SBRT). Materials and Methods: Twenty-seven T1-3N0M0 primary lung cancer patients treated with curative SBRT between 2010 and 2018 were retrospectively evaluated. Four patients (14.8%) treated with SBRT to address residual tumor after wedge resection and one patient (3.7%) with local recurrence after resection were included. The SUVmax at baseline PET/CT was assessed to determine its relationship with prognosis after SBRT. Patients were divided into two groups based on maximum SUVmax on pre-treatment FDG PET/CT, estimated by receiver operating characteristic curve. Results: The median follow-up period was 17.7 months (range, 2.3 to 60.0 months). The actuarial 2-year local control, progression-free survival (PFS), and overall survival were 80.4%, 66.0%, and 78.2%, respectively. With regard to failure patterns, 5 patients exhibited local failure (in-field failure, 18.5%), 1 (3.7%) experienced regional nodal relapse, and other 2 (7.4%) developed distant failure. SUVmax was significantly correlated with progression (p = 0.08, optimal cut-off point SUVmax > 5.1). PFS was significantly influenced by pretreatment SUVmax (SUVmax > 5.1 vs. SUVmax ≤ 5.1; p = 0.012) and T stage (T1 vs. T2-3; p = 0.012). Conclusion: SUVmax at pre-treatment FDG PET/CT demonstrated a predictive value for PFS after SBRT for lung cancer.