• 제목/요약/키워드: local recurrence

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Surgery for Pulmonary Sclerosing Hemangioma: Lobectomy versus Limited Resection

  • Park, Joon-Seok;Kim, Kwhan-Mien;Shin, Su-Min;Shim, Hun-Bo;Kim, Hong-Kwan
    • Journal of Chest Surgery
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    • v.44 no.1
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    • pp.39-43
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    • 2011
  • Background: Pulmonary sclerosing hemangioma is a rare thoracic tumor, and pathophysiology or clinical course of this tumor is not yet fully described. Furthermore, there is no consensus on the standard operative procedure for this tumor. Material and Methods: Medical records of thirty-two patients, who underwent surgical resection of pulmonary sclerosing hemangioma from 1996 to 2007, were retrospectively reviewed. Results: Nineteen patients underwent lobectomy and thirteen patients underwent limited resection. Video-assisted thoracoscopic surgery was performed in 9 patients in the latter group. Lymph node dissection was done in 21 patients, and one patient was found to have lymph node metastasis of the tumor. There was no postoperative complication, no early death and no tumor-related late mortality. The mean follow-up duration was 39.3 months (2 months~129 months), and all patients were free of local recurrence and distant metastasis during this period. There was no significant difference in patient's characteristics between the two groups, except that the mean hospital stay was shorter in limited resection group than in lobectomy group (p=0.0031). Conclusion: Pulmonary sclerosing hemangioma usually requires surgical resection for both diagnosis and treatment. Limited resection can decrease hospital stay with a surgical outcome comparable to lobectomy, and may be preferred to lobectomy if sufficient resection margin can be achieved.

Solitary Extramedullary Plasmacytoma of the Head and Neck

  • Park K. R.;Oh W. Y.;Sung J. S.;Suh C. O.;Kim G. E.;Kim B. S.
    • Radiation Oncology Journal
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    • v.3 no.1
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    • pp.35-39
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    • 1985
  • The details of 5 patients with exramedullary plasmacytoma of the head and neck were reviewed for the period from 1970 to 1984. All patients were presented with localized disease at the time of diagnosis. Out of 5 patients the one treated with surgery alone developed local recurrence and disseminated disease. He died at 3 years and 6 months. Rest of the four were alive with no evidence of the disease. Two patients were treated with radiation therapy alone while other two were treated with surgery and postoperative radiation therapy. Curative radiation therapy is recommanded after the diagnosis is established by biopsy examination.

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Patterns of failure after the reduced volume approach for elective nodal irradiation in nasopharyngeal carcinoma

  • Seol, Ki Ho;Lee, Jeong Eun
    • Radiation Oncology Journal
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    • v.34 no.1
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    • pp.10-17
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    • 2016
  • Purpose: To evaluate the patterns of nodal failure after radiotherapy (RT) with the reduced volume approach for elective neck nodal irradiation (ENI) in nasopharyngeal carcinoma (NPC). Materials and Methods: Fifty-six NPC patients who underwent definitive chemoradiotherapy with the reduced volume approach for ENI were reviewed. The ENI included retropharyngeal and level II lymph nodes, and only encompassed the echelon inferior to the involved level to eliminate the entire neck irradiation. Patients received either moderate hypofractionated intensity-modulated RT for a total of 72.6 Gy (49.5 Gy to elective nodal areas) or a conventional fractionated three-dimensional conformal RT for a total of 68.4-72 Gy (39.6-45 Gy to elective nodal areas). Patterns of failure, locoregional control, and survival were analyzed. Results: The median follow-up was 38 months (range, 3 to 80 months). The out-of-field nodal failure when omitting ENI was none. Three patients developed neck recurrences (one in-field recurrence in the 72.6 Gy irradiated nodal area and two in the elective irradiated region of 39.6 Gy). Overall disease failure at any site developed in 11 patients (19.6%). Among these, there were six local failures (10.7%), three regional failures (5.4%), and five distant metastases (8.9%). The 3-year locoregional control rate was 87.1%, and the distant failure-free rate was 90.4%; disease-free survival and overall survival at 3 years was 80% and 86.8%, respectively. Conclusion: No patient developed nodal failure in the omitted ENI site. Our investigation has demonstrated that the reduced volume approach for ENI appears to be a safe treatment approach in NPC.

Primary Conjunctival Mast Cell Tumor in a Korean Native Jindo Dog (진도견에서 발생한 원발성 결막 비만세포종양 1예)

  • Lee, Jae Yeon;Jeong, Seong Mok
    • Journal of Veterinary Clinics
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    • v.30 no.2
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    • pp.131-133
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    • 2013
  • A 9-year-old, intact female Jindo dog weighing 23 kg was presented to the Veterinary Medical Teaching Hospital of Chungnam National University with a history of two months of ocular discharge. Initial ocular examination showed a 2 cm elongated mass arising from the ventral bulbar conjunctiva of the left eye. Ocular ultrasound, performed to rule out any orbital and intraocular involvement, was negative. Thoracic radiographs and abdominal ultrasonography revealed no abnormalities. Fine needle aspiration (FNA) of mass was performed. Aspiration cytology showed the presence of a round cell population mostly characterized. A moderate amount of eosinophils was present among round cells. The mass was excised and identified hitologically as a mast cell tumor. Six months after surgical treatment, thoracic radiographs and abdominal ultrasonography did not reveal any clinical signs of local recurrence or metastatic disease.

Malignant Fibrous Histiocytoma of the Maxilla - Report of A Case - (상악골의 악성 섬유성 조직구종 - 증례보고 -)

  • Oh, Yoon-Kyeong;Yeo, Hwan-Ho
    • Radiation Oncology Journal
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    • v.13 no.3
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    • pp.225-231
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    • 1995
  • Malignant fibrous histiocytoma(MFH) of the maxilla is a rare malignant bone tumor Seven percents of all MFH occur in the head and neck. Approximately $12{\%}$ of these tumors occur in the maxilla. Local recurrence or distant metastasis was reported in $55{\%}$ of cases of maxillary MFH. The mean survival time of 30 months was reported from a review of 14 MFHs in the maxilla, mandible and oral soft tissues. MFH of the maxilla is best treated surgically but radical neck dissection does not appear to be indicated unless there is clinical evidence of lymph node metastases Although the use of radiation therapy for head and neck MFH has not been studied for a series of cases, individual cases of regression or histological change have been reported. Other authors have reported numbers of cases who received radiation therapy without benefit. Response to combination chemotherapy has been reported in $33{\%}$ of 23 patients with recurrent or metastatic MFH. We report here a case of MFH occurring in the maxilla with a review of literature about the clinical behavior and treatment of these lesions.

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The Clinical Outcome of Flap Coverage for the Treatment of Malignant Melanoma (악성 흑색종 치료를 위한 피판술의 임상적 결과)

  • Jeon, Woo-Joo;Kang, Jong-Woo;Kim, Il-Hwan;Son, Gil-Soo;Park, Jong-Woong
    • Archives of Reconstructive Microsurgery
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    • v.19 no.2
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    • pp.81-87
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    • 2010
  • In surgical treatment of the malignant melanoma, radical resection and a sentinel lymph node biopsy are essential procedures to eradicate the tumor and to minimize the risk of local recurrence. For the reconstruction of skin defect after tumor resection, a skin graft has been generally performed procedure. However, if tendon or bone is exposed after tumor resection, simple skin graft is not enough for the coverage of the defect and additional procedure is mandatory. In this study, we reviewed the clinical results of 16 patients, who had been diagnosed with malignant melanoma of the limb and underwent surgical resection and reconstruction of the defect with various methods. The sentinel lymph node dissection was performed in all patients combined with radical excision of the tumor. In 11 cases of positive sentinel lymph nodes, further elective lymph node dissections were performed. The mean tumor invasion depth was 4.54 mm (2~10 mm), and AJCC stage II was most common (9 cases). The pedicled flaps were performed in 10 cases for the reconstruction of defects. All flaps were successfully survived without significant complications until the last follow up. In conclusion, a pedicled flap coverage is very useful reconstruction strategy for the soft tissue defects after radical resection of malignant melanoma.

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Castleman's Disease of the Neck and Mediastinum (경부와 종격동에 발생한 캐슬만씨 병(Castleman's Disease))

  • Nam Kee-Hyun;Choi Hyun-Ho;Lim Chi-Young;Lee Jan-Dee;Kim Seung-Il;Chang Hang-Seok;Hong Soon-Won;Park Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.21 no.1
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    • pp.48-52
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    • 2005
  • Objectives: Castleman's disease(CD) is a lymphoproliferative disorder of unknown etiology. To elucidate the clinicopathologic characteristics of CD, we retrospectively reviewed our experience. Methods: Fifteen patients with CD of the neck and mediastinum were identified. Patients were divided into two groups: group I had an unicentric CD and group II had multicentric CD. The histology of CD was divided into 3 subtypes: hyaline-vascular(HV), plasma cell(PC), and mixed. Results: The study included 12 cases of group I, 3 cases of group II in the clinical aspect and 10 cases with HV, 3 cases with PC, 2 cases with mixed type in the histologic aspect. Of group I patients who underwent complete surgical excision, all are currently free of disease. The clinical course of group II patients was variable. Of two patients with multicentric plasma cell CD who were treated, one remain free from disease and the other had a local recurrence in the neck. One patient with multicentric mixed CD died of disease after 30 months of presentation. Conclusion: Surgical resection is recommend for patients with the unicentric CD, regardless of histologic subtype. Patients with multicentric disease do not benefit from surgical resection and should be candidates for multimodality therapy.

Gutter Splint for Ingrown Toe Nail in Young Patients (어린 환자에서 내향성 조갑증에 대한 조갑홈통 부목을 이용한 치료)

  • Shin, Yong-Woon;Bae, Su-Young;Ahn, Sang Jun
    • Journal of Korean Foot and Ankle Society
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    • v.22 no.3
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    • pp.111-115
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    • 2018
  • Purpose: Ingrown toenails are a common disease in the adolescent period and the treatments could be more conservative for this early stage of the disease. This study is a case series on the results of a gutter splint for an adolescent ingrown toe nail as a simple, comfortable treatment method. Materials and Methods: From 2011 to 2018, 22 patients (mean age, 12.2 years; range, 8~15 years) with ingrown toenails were treated with a gutter splint. There were 16 boys and 6 girls with 7 patients on both great toes, and additional 4 both corners of a nail, giving a total of 33 splints. Flat, plastic straws and glue or suture were used to protect the nail corners under local anesthesia. The medical records were reviewed retrospectively and phone calls were made to obtain the long-term results. Results: Fifteen splints were fixed with a suture and the other 18 splints were fixed with glue. There were 9 cases of recurrence out of 33 gutter splints, 8 out of 15 sutured splints and 1 out of 18 glued splints (p=0.010). There was no gender (p=0.383) or age (p=0.305) difference in the number of recurrences. Conclusion: For growing people, ingrown nails can be cured easily by conservative treatment for a transiently shortened or broken toenail. The glued gutter splint had a reasonable success rate as a first line treatment.

Sequential reconstruction for recurrent head and neck cancer: A 10-year experience

  • Chung, Soon Won;Byun, Il Hwan;Lee, Won Jai
    • Archives of Plastic Surgery
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    • v.46 no.5
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    • pp.449-454
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    • 2019
  • Background Most patients with head and neck cancer successfully undergo oncologic resection followed by free or local flap reconstruction, depending on the tumor's size and location. Despite effective curative resection and reconstruction, head and neck cancer patients still face a high risk of recurrence and the possibility of a second primary cancer. Moreover, surgeons hesitate to perform sequential reconstruction following curative resection for several reasons. Few large-scale studies on this subject are available. Therefore, we retrospectively evaluated the outcome of sequential head and neck reconstruction to determine the possible risks. Methods In total, 467 patients underwent head and neck reconstruction following cancer resection at our center from 2008 to 2017. Of these cases, we retrospectively reviewed the demographic and clinical features of 58 who had sequential head and neck reconstruction following resection of recurrent cancer. Results Our study included 43 males (74.1%) and 15 females (25.9%). The mean age at the initial operation was $55.4{\pm}15.3years$, while the mean age at the most recent operation was $59.0{\pm}14.3years$. The interval between the first and second operations was $49.2{\pm}62.4months$. Twelve patients (20.7%) underwent surgery on the tongue, and 12 (20.7%) had procedures on the oropharynx. Thirty-four patients (58.6%) received a sequential free flap reconstruction, and 24 patients (41.4%) were treated using locoregional flaps. No cases of flap failure occurred. Conclusions Our findings suggest that patients who need additional operations with recurrent head and neck cancer could optimally benefit from sequential curative resections and reconstructions.

Endoscopic Submucosal Dissection for Superficial Barrett's Neoplasia in Korea: a Single-Center Experience

  • Joo, Dong Chan;Kim, Gwang Ha;Lee, Bong Eun;Lee, Moon Won;Baek, Dong Hoon;Song, Geun Am;Lee, Sojeong;Park, Do Youn
    • Journal of Gastric Cancer
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    • v.21 no.4
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    • pp.426-438
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    • 2021
  • Purpose: While the incidence of Barrett's neoplasia has been increasing in Western countries, the disease remains rare in Asian countries. Therefore, very few studies have investigated the endoscopic treatment for Barrett's neoplasia in Korea. Endoscopic submucosal dissection (ESD) enables en bloc and complete resection of gastrointestinal neoplastic lesions. This study aimed to evaluate the therapeutic outcomes of ESD for Barrett's neoplasia in a single center in Korea and to examine the predictive factors for incomplete resection. Materials and Methods: We conducted a retrospective observational study of 18 patients who underwent ESD for superficial Barrett's neoplasia (dysplasia and early cancer) between January 2010 and December 2019 at Pusan National University Hospital. The therapeutic outcomes of ESD and procedure-related complications were analyzed. Results: En bloc resection, complete resection, and curative resection were performed in 94%, 72%, and 61% of patients, respectively. Histopathology (submucosal or deeper invasion of the tumor) was a significant predictive factor for incomplete resection (P=0.047). Procedure-related bleeding and stenosis were not observed, whereas perforation occurred in one case. During the median follow-up period of 12 months (range, 6-74 months), local recurrence occurred in 2 patients with incomplete resection, one patient underwent repeat ESD, and the other patient received concurrent chemoradiotherapy. The 3-year overall and disease-specific survival rates were 73% and 93%, respectively. Conclusions: ESD seems to be an effective and safe treatment for superficial Barrett's neoplasia in Korea. Nevertheless, the suitability of ESD for Barrett's cancer cases should be determined considering the high risk of deep submucosal invasion.