• 제목/요약/키워드: local recurrence

검색결과 790건 처리시간 0.025초

Novalis Shaped Beam Radiation Treatment for Craniopharyngiomas

  • Yee, Gi-Taek;Han, Seong-Rok;Yoon, Sang-Won;Choi, Chan-Young;Lee, Dong-Joon;Whang, Choong-Jin
    • Journal of Korean Neurosurgical Society
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    • 제40권4호
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    • pp.245-248
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    • 2006
  • Objective : To evaluate the effectiveness of Novalis shaped beam radiation treatment as an adjuvant treatment in patients with craniopharyngiomas. Methods : We reviewed 8 patients with craniopharyngiomas who had recurring tumors during follow-up or had residual lesions after primary surgery. Three of 8 patients were found to have recurrence after gross total excision of the tumor and 5 patents had residual lesions after subtotal resection. All patients were treated with fractionated stereotactic radiation treatment[FSRT] using Novalis system. The mean age of patients was 28 years [range $16{\sim}52$]. The median irradiation dose per fraction was 17Gy [range $1.7{\sim}2.0$]. The median fraction number was 23 [range $15{\sim}25$], and the median total dose was 39.1 Gy [range $25.5{\sim}42.5$]. Follow-up included MR imaging, and ophthalmologic and endocrine examinations. Results : The median follow-up period was 23 months [range $12{\sim}43$]. The local tumor control rate was 87.5%. One patient had a recurring tumor, in which cystic change developed 2 months after FSRT. Four patients showed a decrease in size of their tumor, while 3 patients remained stable. Seven out of 8 patients had hormonal dysfunction that remained unchanged after initial surgery. No further progression of visual impairment was observed. Conclusion : FSRT using Novais system is effective and safe for the treatment of recurring or residual craniopharyngiomas without toxicity like optic neuropathy.

두개골에 발생한 고립성 형질세포종 - 증례보고 - (Solitary Plasmacytoma of the Skull - A Case Report -)

  • 한정훈;박해관;민창기;조정기;박성찬;조경근;이경진;나형균;최창락;강준기
    • Journal of Korean Neurosurgical Society
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    • 제29권5호
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    • pp.701-705
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    • 2000
  • Solitary plasmacytomas are rare and account for 5-10% of all plasma cell disorders. These tumors are categorized as solitary plasmacytomas of bone(osseous) or extramedullary plasmacytomas(non-osseous). About a half of solitary plasmacytomas of bone occur in the spine but rarely in the skull. We report a case of solitary plasmacytoma of the skull presented with a painless palpable left parietal calvarial mass in an otherwise asymptomatic 38- year-old man. Skull radiographs showed a large radiolucent lesion with well defined non-sclerotic margins. Computed tomograph scan demonstrated a markedly enhancing mass extending from the epidural to the subcutaneous space. The patient underwent surgery and tumor was completely excised. Pathological examination showed tumor to be a plasmacytoma synthesizing IgG. Postoperatively, the patient received radiotherapy. There was no evidence of systemic involvement on postoperative laboratory wokups. Our recommended treatment is a complete surgical excision combined with postoperative radiation therapy. The patient should be follwed carefully for more than 10 years because of either local recurrence or possible progression to multiple myeloma.

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근골격계 종양에서 탈륨 스캔의 역할 (The Role of Thallium-201 Scintigraphy in Bone and Soft Tissue Tumor)

  • 신덕섭
    • Journal of Yeungnam Medical Science
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    • 제20권2호
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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.

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The Role of $^{18}F$-Fluorodeoxyglucose Positron Emission Tomography in the Treatment of Brain Abscess

  • Park, Seong-Hyun;Lee, Sang-Woo;Kang, Dong-Hun;Hwang, Jeong-Hyun;Sung, Joo-Kyung;Hwang, Sung-Kyoo
    • Journal of Korean Neurosurgical Society
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    • 제49권5호
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    • pp.278-283
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    • 2011
  • Objective : The purpose of this study was to evaluate whether $^{18}F$-fluorodeoxyglucose positron emission tomography (FOG-PET) can be used to assess the therapeutic response of brain abscess. Methods : A study was conducted on 10 consecutive patients with brain abscess, Magnetic resonance imaging (MRI) with diffuse-weighted imaging (DWI) was performed at 3 and 6 weeks after surgical treatment and intravenous antibiotics therapy and FOG-PET at 6 weeks after treatment. The extent of the abscess, signal changes on MRI, and FOG-PET standardized uptake values were analyzed and correlated with the response to therapy. Results : Aspiration or craniotomy with excision of the abscess followed by intravenous antibiotics for 6-8 weeks resulted in good recovery with no recurrence. In 10 patients, two had low signal intensity on the DWI; one had no uptake on FOG-PET imaging after 6 weeks antibiotics and discontinued intravenous treatment, but the other patient had diffuse, increased uptake on FOG-PET imaging after 6 weeks antibiotics and underwent an additional 2 weeks of intravenous antibiotics. The remaining eight patients had high signals on the DWI. Four had no uptake on FOG-PET imaging and the treatment period varied from 6 to 8 weeks (mean, 6.75 weeks). Among the other four patients, FOG was accumulated in a diffuse or local area corresponding to a high signal area within the DWI and 2 weeks of intravenous antibiotics was added. Conclusion : MRI plus FOG-PET improved the accuracy of assessing therapeutic responses to antibiotics treatment of brain abscess and aided in optimizing therapy.

THE POTENTIAL OF SATELLITE REMOTE SENSING ON REDUCTION OF TSUNAMI DISASTER

  • Siripong, Absornsuda
    • 대한원격탐사학회:학술대회논문집
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    • 대한원격탐사학회 2006년도 Proceedings of ISRS 2006 PORSEC Volume I
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    • pp.52-55
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    • 2006
  • It's used to be said that tsunami is a rare event. The recurrence time of tsunami in Sumatra area is approximately 230 years as CalTech Research Group‘s study from paleocoral. However, the tsunami occurred in Indian Ocean on 26 December 2004, 28 March 2005 and 17 July 2006, because the earthquakes still release the energy. To cope with the tsunami disaster, we have to put the much effort on better disaster preparedness. The Tsunami Reduction Of Impacts through three Key Actions (TROIKA) was suggested by Eddie N. Bernard, the director of NOAA/PMEL (Pacific Marine Environmental Laboratory). They are Hazard Assessment, Mitigation and Warning Guidance. The satellite remote sensing has potential on these actions. The medium and high resolution satellite data were used to assess the degree of damage at the six-damaged provinces on the Andaman seacoast of Thailand. Fast and reliable interpretation of the damage by remote sensing method can be used for inundation mapping, rehabilitation and housing plans for the victims. For tsunami mitigation, the satellite data can be used with GIS to construct the evacuation map (evacuation route and refuge site) and coastal zone management. It is also helpful for educational program for local residents and school systems. Tsunami is a kind of ocean wave, therefore any satellite sensors such as SAR, Altimeter, MODIS, Landsat, SPOT, IKONOS can detect the tsunami wave in 2004. The satellite images have shown the characteristics of tsunami wave approaching the coast. For warning, satellite data has potential for early warning to detect the tsunami wave in deep ocean, if there are enough satellite constellation to monitor and detect the first tsunami wave like the pressure gauge, seismograph and tide gauge with the DART buoy can do. Moreover, the new methods should be developed to analyse the satellite data more faster for early warning procedure.

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이하선에 발생한 상피근상피암 (EPITHELIAL-MYOEPITHELIAL CARCINOMA OF THE PAROTID GLAND : A CASE REPORT)

  • 유태민;정영수;김문기;차인호;김진;김형준
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제29권2호
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    • pp.131-134
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    • 2003
  • 상피근상피암은 타액선, 특히 이하선에 호발하는 매우 드문 악성 종양으로 내측의 상피세포와 외측의 투명한 근상피세포의 2열구조로 구성되어 있는 것이 특징이고. 비교적 국소 재발 및 전이를 잘하는 것으로 보고 되었다. 저자들은 드문 타액선 종양인 상피근 상피암을 이하선에서 경험하였기에 문헌 고찰과 함께 보고하였으며, 본 증례의 경우 향후 재발 및 전이 여부 파악 위해 주기적인 경과 관찰이 필요하리라 사료된다.

악하림프절 전이를 동반한 하악골의 법랑모세포종 (MALIGNANT AMELOBLASTOMA OF MANDIBLE WITH LYMPH NODE METASTASIS)

  • 박지현;정재화;윤필영;홍종락;명훈;황순정;서병무;최진영;이종호;정필훈;김명진
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제29권5호
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    • pp.298-300
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    • 2003
  • Ameloblastomas are generally considered to be benign tumors of odontogenic epithelial origin with high local recurrence. Rarely ameloblastomas exhibit malignant behavior with development of metastases. In this report, we present a 19-year-old woman with ameloblastoma in the right ascending ramus and multiple recurrences. Eleven years after first therapy, ameloblastoma metastasized to ipsilateral submandibular lymph node. We also review literature about cause, treatment and work-up of malignant ameloblastoma.

Pigmented villonodular synovitis of the temporomandibular joint - computed tomography and magnetic resonance findings: a case report

  • Kim, Il-Kyu;Cho, Hyun-Young;Cho, Hyun-Woo;Seo, Ji-Hoon;Lee, Dong-Hwan;Peng, Wang
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제40권3호
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    • pp.140-146
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    • 2014
  • Pigmented villonodular synovitis (PVNS) is a benign but locally aggressive and destructive disease originating in the synovial membranes. It is a proliferative disorder of unknown etiology. Involvement of the temporomandibular joint (TMJ) is very rare. Computed tomography clearly reveals areas of lytic bone erosion and sclerosis, and also clearly defines the extent of the tumor which is the focal areas of hyperdensity within the soft-tissue mass. Magnetic resonance images invariably show profound hypointensity on both T1- and T2-weighted sequences due to hemosiderin pigmentation. Additionally, high signal intensity on T2-weighted images may indicate cystic loculation of the joint fluid. This case study describes a rare case of PVNS of the TMJ with bone destruction of the mandibular condyle. Complete surgical excision of the lesion was performed through a preauricular approach with temporal extension. During the 10-year follow-up, two more operations were performed due to local recurrence and the fracture of the reconstruction plate. Total joint reconstruction with Biomet was finally performed, and the absence of disease was confirmed with a biopsy report showing fibrosis with hyalinization and mild inflammation of the excised soft tissue from the old lesion.

Verruciform xanthoma in the hard palate: a case report and literature review

  • Garcia, Alexandre Simoes;Pagin, Otavio;da Silva Santos, Paulo Sergio;Oliveira, Denise Tostes
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제42권6호
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    • pp.383-387
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    • 2016
  • Oral verruciform xanthoma (OVX) is an uncommon lesion that appears on the oral mucosa. The aim of this paper was to discuss the probable etiopathogenesis of OVX in the hard palate, reinforcing the importance of including this lesion in the differential diagnosis of verrucous lesions. A 43-year-old male smoker presented with a painless lesion with a verrucous surface and erythematous spots on the hard palate. Excisional biopsy revealed oral mucosa consisting of hyperkeratosis, acanthosis, and elongated rete pegs. Subjacent connective tissue showed numerous foam cells with clear cytoplasm and pyknotic nucleus, negative on periodic acid-Schiff staining. Immunohistochemical analysis revealed foam cells positive for anti-CD68 antibody, while anti-KI-67 antibody was restricted to the basal layer of the oral epithelium. A final diagnosis of OVX was established. The patient showed no signs of recurrence after seven months of follow-up. Physical trauma and smoking habits can be directly related to the etiology of verruciform xanthoma because the lesion is chronic and inflammatory with slow growth, and sites if high trauma are more often affected by such a lesion. The hard palate is the second most commonly affected site, and local trauma caused by smoking can be a cause of this type of lesion.

Lack of Prognostic Value of Blood Parameters in Patients Receiving Adjuvant Radiotherapy for Breast Cancer

  • Cihan, Yasemin Benderli;Arslan, Alaettin;Cetindag, Mehmet Faik;Mutlu, Hasan
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권10호
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    • pp.4225-4231
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    • 2014
  • Aim: To determine prognostic value of blood parameters on overall and progression-free survival in cases received adjuvant radiotherapy and chemotherapy with diagnosis of stage I-III breast cancer. Materials and Methods: We retrospectively reviewed files of 350 patients with non-metastatic breast cancer who were treated in the Radiation Oncology Department of Kayseri Teaching Hospital between 2005 and 2010. Pretreatment white blood cell (WBC), neutrophil, monocyte, basophil and eosinophil counts, and the neutrophil/lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) were recorded. The relationship between clinicopathological findings and blood parameters was assessed. Results: Overall, 344 women and 6 men were recruited. Median age was $55.3{\pm}0.3$ years (range: 22-86). Of the cases, 243 (61.4%) received radiotherapy while 329 (94.3%), received chemotherapy and 215 (61.4%) received hormone therapy. Mean overall survival (OS) and progression-free survival (PFS) was 84.4 and 78.8 months, respectively. During follow-up, 48 patients died due to either disease-related or non-related causes. Local recurrence was detected in 14 cases, while distant metastasis was noted in 45 cases. In univariate analysis, age, pathology, perinodal invasion were significantly associated with overall survival, whereas gender, stage and hormone therapy were significantly associated with progression-free survival. In multivariate analysis, histopathological diagnosis (OR: 0.3; 95%: 0.1-0.7; p=0.006) and perinodal invasion (OR: 0.1; 95% CI: 0.1-1.3; p=0.026) were significantly associated with overall survival, whereas tumor stage (OR: 2.1; 95% CI: 0.0-0.7; p=0.014) and hormone therapy (OR: 2.1; 95%: 1.2-3.8; p=0.010) were significantly associated with progression-free survival. Conclusions: It was found that serum inflammatory markers including WBC, neutrophil, lymphocyte and monocyte counts, and NLR and PLR had no effect on prognosis in patients with breast cancer who underwent surgery and received adjuvant radiotherapy and chemotherapy.