• 제목/요약/키워드: mass margins

검색결과 59건 처리시간 0.028초

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
    • /
    • 제29권5호
    • /
    • pp.701-705
    • /
    • 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.

  • PDF

두피에 발생한 혈관 육종의 치험 2례 (Case Report of Angiosarcoma on Scalp (2 cases))

  • 양은진;김정태;김연환;이형중
    • Archives of Plastic Surgery
    • /
    • 제36권1호
    • /
    • pp.96-100
    • /
    • 2009
  • Purpose: Angiosarcoma of the scalp is unusual vascular tumor originating from endothelial cell. Angiosarcoma is an aggressive tumor with high propensity for both local recurrence and distant metastasis. We report 2 cases of angiosarcoma having poor prognosis recently. Methods: Case 1 was a 67 - year - old male patient. He visited the hospital with a $3{\times}5cm$ sized discolored mass in forehead. It began at one month ago from coming to the hospital. Case 2 was a 64 - year - old male patient. He visited for our hospital to remove a $4{\times}5cm$ sized scalp mass. He had a pruritis on scalp from 9 months ago before coming to the hospital. Despite of the conservative treatments, the wound was not healed and advanced necrotic lesion with hemorrhage. Results: Case 1 diagnosed as an angiosarcoma. He underwent a radical operation 5 times. But the tumor expanded multiple area in dura & frontal area of the brain. The patient rejected the treatment any more. And he died one month later. Case 2 diagnosed as an angiosarcoma and metastased to skull in MRI. He got a radical resection including cranium. Three months later, it recurred to ipsilateral Sternocleidomastoideus muscle. He got a additional operation & started radiotherapy. And now he is receiving chemotherapy, but the recurred lesion is expanding. Conclusion: Angiosarcoma is a highly malignant tumor. Especially it arises in vascularized area, it easily metastases. So it is the best to treat angiosarcoma with surgery included wide margins. Despite of the lesion is small, we remember that angiosarcoma is a tumor that consider to metastases.

우측 협부에 발생한 윤활막육종 증례보고 (A Case Report of Synovial Sarcoma of the Face)

  • 허정;이근철;박정민;김석권;노미숙;이진화
    • Archives of Plastic Surgery
    • /
    • 제32권6호
    • /
    • pp.760-762
    • /
    • 2005
  • Synovial Sarcoma is the fourth most common sarcoma, accounting for 8-10 % of all sarcomas. Synovial sarcoma is highly malignant tumor of mesenchymal origin but rarely occurres in head and neck area. Less than 100 cases of synovial sarcoma occurring in head and neck area have been reported all over the world. Pathologically, there is two type of synovial sarcoma: monophasic variant is composed of only one cell type and "classic" (biphasic) synovial sarcoma has two cellular component, a spindle cell(fibrosarcoma-like) component and a pseudoepithelioma component. Recommended treatment is wide resection with negative margins. The role of chemotherapy and radiation therapy is controversial. We experienced a 42-year-old male patient with slowly enlarging, deep seated mass on right cheek. In the first operation, we suggested that the mass maybe benign tumor. But, initial excisional biopsy specimen of the primary lesion was consistent with synovial sarcoma. The final diagnosis was monophasic synovial sarcoma which was composed of spindle cells. Radical resection was performed two months later because remnant tumor was found on follow up MRI. No further treatment was done. There were no recurrence or metastasis on follow up MRI, chest CT and whole body bone scan after 15 months. This is a report of a rare case of synovial sarcoma of the face with a literature review.

R&D 분야의 목표 시그마 수준 설정과 설계 공차의 강건 한계 결정에 대한 연구 (A study on target Sigma Level at R&D stage and robust limits for design margins)

  • 고승곤
    • 응용통계연구
    • /
    • 제29권2호
    • /
    • pp.369-379
    • /
    • 2016
  • 시그마 수준(sigma level)이란 미국 모토롤라사에 의해 소개된 프로세스 능력 지수로서 1970년대 이후 널리 활용되고 있는 다양한 지수들 중의 하나이다. 이는 다른 지수들과 비교할 때 모 프로세스의 확률 분포에 기초한다는 장점을 갖지만 양산 단계를 가정한 것으로 R&D 분야의 시제품 그리고/또는 초도 양산품 단계에 직접 적용하는 것은 적절하지 못할 수 있다. 이에 본 논문은 시그마 수준을 계산할 때 가정하는 치우침에 대한 통계적 고찰을 통하여 양산단계에서 6 시그마 품질 수준을 달성하기 위한 개발 단계의 시제품 그리고/또는 초도 양산품의 목표 시그마 수준 설정 방법을 소개한다. 그리고 이를 기초로 개발과 양산 단계에서 경제성을 달성할 수 있는 설계 공차의 강건 한계 도출 방법을 제시해 보고자 한다.

귀밑샘의 상피세포-근상피세포 암종 치험례 (Epithelial-Myoepithelial Carcinoma of the Parotid Gland: A Case Report)

  • 배우식;노시균;이내호;양경무;강명재
    • Archives of Plastic Surgery
    • /
    • 제38권4호
    • /
    • pp.501-504
    • /
    • 2011
  • Purpose: Epithelial-myoepithelial carcinoma (EMC) represents about the 1% of the malignant neoplasms in the salivary glands and clinically most commonly found localized, well defined and sometimes presents orofacial pain. Treatment of choice is surgical excision. Postoperative radiotherapy can be used when surgical margins are doubtful. We report our experience of EMC of the parotid gland. Methods: A 78-year-old man presented with a three-year history of a localized, painless, $7{\times}6cm$ sized recurred tumor in his right preauricular area. He was diagnosed as EMC of the right parotid gland. So a total parotidectomy was performed. In his old medical history, he had a mass in the same area 5 years ago. The diagnosis of pleomorphic adenoma was made and the mass excision was performed at the local clinic without further evaluation. Results: It was unable to visually discriminate between the tumor and the normal tissue. So a total parotidectomy was performed. The patient was got post-operative radiotherapy and was followed up for 9 months. There was no specific evidence of recurrence. Conclusion: We present a case of EMC of the parotid gland in right preauricular area, which is uncommon. So we report a uncommon case of EMC to discuss about our experience with relevant journal discussion.

Recurrent thymic carcinoid tumor in familial isolated primary hyperparathyroidism

  • Song, Jeong Eun;Shon, Mu Hyun;Kim, Ga Young;Lee, Da Young;Lee, Jung Hun;Kim, Jong Ho;Shon, Ho Sang;Lee, Ji Hyun;Jeon, Eon Ju;Jung, Eui Dal
    • Journal of Yeungnam Medical Science
    • /
    • 제31권2호
    • /
    • pp.131-134
    • /
    • 2014
  • Familial isolated primary hyperparathyroidism(FIPH) is associated with multiple endocrine neoplasia type 1 (MEN1) syndrome, primary hyperparathyroidism accompanied by jaw-tumor syndrome, and familial hypocalciuric hypercalcemia. FIPH may be an early stage of MEN1 or an allelic variant of MEN1. Thymic carcinoid tumor is a rare tumor in MEN1 syndrome. Here, the authors report the case of a 40-year-old man diagnosed with recurrent thymic carcinoid tumor and FIPH. Both the patient and his elder sister had been previously diagnosed to have FIPH with a novel frameshift mutation in the MEN1 gene. Initially, the patient underwent thymectomy because of an incidental finding of a mediastinal mass in his chest X-ray, and had remained asymptomatic over the following 4 years. Pancreas computed tomography conducted to evaluate MEN1 syndrome revealed anterior and middle mediastinal masses, and resultantly, massive mass excision was performed. Histological findings disclosed atypical carcinoids with infiltrative margins. In view of the thymic carcinoid tumor relapse that occurred in this patient, the authors recommend that regular pancreas and pituitary imaging studies be conducted for FIPH associated with a MEN1 gene mutation.

개에서 발생한 요추 혈관종성수막종 증례 (Lumbar Angiomatous Meningioma in a Dog)

  • 손정민;김보은;정선영;지서연;윤대영;권오경;김대용;최민철;윤정희
    • 한국임상수의학회지
    • /
    • 제31권2호
    • /
    • pp.152-155
    • /
    • 2014
  • 11년령의 중성화된 수컷 Schnauzer 가 후지마비 증상으로 내원하였다. 6개월 전부터 후지의 운동실조를 보이다가 3개월 전부터는 좌측 후지의 불완전마비를 보였으며, 2주 전부터는 양측 후지의 완전마비 증상을 나타내었다. 신경계 검사에서 양측 후지의 완전마비와 자세반사 및 심부통 소실이 확인되었으며, 척수반사는 항진되어 있었고 자발배뇨는 불가능한 상태였다. 흉요추 부위의 MR (0.3 Tesla) 영상 검사가 실시되었다. 척수를 심하게 압박하는 하나의 종괴가 요추 2번 수준에서 확인되었으며, 종괴는 좌측 및 등쪽으로 경질막과 넓게 접하고 있었다. 종괴는 T1 강조 영상에서 척수와 비슷한 신호 강도를 보였으며, T2 강조 영상에서는 고신호를 보였다. 조영 후 T1 강조 영상에서는 고도의 균일한 조영 증강을 보였으며, 경계는 명확하고 "dural tail sign" 을 동반하고 있었다. 이러한 영상학적 특징으로 부터 경질막내 척수외 종양이 고려되었으며, 그 중에서도 수막종이 가장 우선적으로 고려되었다. 좌측 편측후궁절제술 및 등쪽 후궁절제술이 실시되었다. 부분적으로 경질막과 유착되어 있는 하나의 경질막내 종괴가 척수를 압박하고 있는 것이 확인되었고, 종괴는 유착된 경질막 부분과 함께 완전히 제거되었다. 조직병리학적 검사를 통해 혈관종성수막 종으로 진단되었다.

The Importance of Interface Irregularity between the Tumor and Brain Parenchyma in Differentiating between Typical and Atypical Meningiomas: Correlation with Pathology

  • Lee, Jeongmin;Lee, Yeon Soo;Ahn, Kook-Jin;Lee, Song;Jang, Jinhee;Choi, Hyun Seok;Jung, So-Lyung;Kim, Bum-soo;Jeun, Sinsoo;Hong, Yongkil
    • Investigative Magnetic Resonance Imaging
    • /
    • 제20권3호
    • /
    • pp.158-166
    • /
    • 2016
  • Purpose: To understand clinical significance of irregular interface between meningioma and adjacent brain parenchyma in predicting histological grading of tumor, focusing on brain parenchymal invasion. Materials and Methods: Pathologically confirmed 79 cases with meningiomas with pathological reports about the presence of parenchymal invasion were included. We defined the presence of interface irregularity as either spiculations or fuzzy margins between the tumor and brain parenchyma. We counted number of spiculations and measured ratio of fuzzy margin length to whole length of mass with consensus of two neuroradiologists. We classified the patients into Present group and Absent group, and the two groups were compared by using the Mann-Whitney U test. Statistical correlations between the presence of an interface irregularity and brain parenchymal invasion by the tumor as well as meningioma histological grade were tested with chi-square test. The optimal cutoff values of spiculation numbers and the ratio of fuzzy margins were determined. The sensitivity and specificity of number of spiculations, ratio of fuzzy margin and the presence of irregular interface as combined parameters for predicting the parenchymal invasion were calculated using ROC curve analysis. Results: Statistically significant differences were noted between the Present and Absent groups for number of spiculations and ratio of fuzzy margin (P = 0.038 and P = 0.028, respectively). The optimal cutoff value for number of spiculations (> 4.5 with 61.1% sensitivity and 68.9% specificity) and the ratio of fuzzy margin (> 0.24 with 66.7% sensitivity and 65.6% specificity) were determined. The sensitivity and specificity of interface irregularity as the combined parameters were 72% and 59%, respectively. The interface irregularity between tumor and brain parenchyma significantly correlated with not only brain parenchymal invasion (P = 0.001) and but also histological grade (P < 0.001). Conclusion: The interface irregularity between tumor and brain parenchyma in MRI can be a strong predictive factor for brain parenchymal invasion and high grade meningioma.

KSLV-III를 이용한 한국형 화성 탐사 임무의 설계 (KOREAN MARS MISSION DESIGN USING KSLV-III)

  • 송영주;유성문;박은서;박상영;최규홍;윤재철;임조령;최준민;김병교
    • Journal of Astronomy and Space Sciences
    • /
    • 제23권4호
    • /
    • pp.355-372
    • /
    • 2006
  • 이 논문에서는 KSLV-III(Korea Space Launch Vehicle-III)를 이용한 향후 우리나라의 화성 탐사 임무 설계를 제시한다. 우리나라 최초의 발사장인 '나로 우주센터(NARO Space Center)'를 발사장으로 가정하였으며, 현재 개발중인 KSLV 시리즈와 건설중인 우주센터의 완공기간 그리고 안정성 수립 기간을 고려하여 임무 수행 가능 기간을 약 2033년경으로 선정하였다. 화성 탐사 임무 수행시 각 단계에 따라 차별화 되어 요구되는 각종 기동(maneuver)의양 즉, 화성 천이(Trans Mars Injection, TMI)기동, 궤적 보정 기동(Trajectory Correction Maneuver, TCM), 화성 궤도 진입(Mars Orbit Insertion, MOI)기동 및 임무 수행 궤도를 이룩하기 위한 기동(Orbit Trim Maneuver, OTM)은 NPSOL 소프트웨어 이용하여 비선형 최적화 문제를 풀어 직접 산출하였다. 이렇게 산출된 최적 기동의 양을 바탕으로 KSLV-III를 이용하여 화성 탐사 임무를 수행할 경우에 대비, 구체적인 발사체 상단부(Upper stage)와 최대 탑재 가능한 탐사선의 질량에 대한 설계가 이루어졌다. 임무 설계 결과 향후 우리나라는 2033년 4월 16일 12시 17분 26초(UTC)부터 약 27분간 나로 우주센터에서 화성 탐사선을 발사 할 수 있다. 이때 최적의 기동량을 바탕으로 계산된 최대 가능 탐사선의 총 질량은 탑재되는 추력기의 비추력을 290초로 가정하였을 때 약 206kg(추진제: 109kg + 구조체: 97kg)이며, 발사체 상단부는 비추력 및 구조비를 290초와 0.15로 가정하였을 때 약 1293kg(추진제: 1099kg +구조체: 194kg)으로 나타났다. 하지만 최적의 기동량에 10%의 여유분을 고려한다면 탐사선은 약 148kg, 발사체 상단부는 약 1352kg의 질량을 갖는 것으로 나타났다. 이 연구를 통하여 제시된 각종 자료들은 향후 우리나라의 독자적인 화성 탐사선 개발을 위하여 많은 사전 정보를 제공해 줄 것이다.

유건종(類腱腫)의 임상적 고찰 (Clinical Investigation of Desmoid Tumors)

  • 이승구;김정만;김형민;강용구;김용식;권순용;이경태;김인
    • 대한골관절종양학회지
    • /
    • 제1권2호
    • /
    • pp.205-209
    • /
    • 1995
  • A desmoid tumor is a locally aggressive growth of connective tissue origin which infiltrates the surrounding tissue and has a marked tendency for recurrence. And so it was also called as an aggressive fibromatosis, musculofascial fibromatosis or fibrosarcoma etc. Thirteen cases of desmoid tumor was treated since 1980, and their retrospective study was done with 79 months of follow-up after initial surgical excision. The female was involved in 12 cases(one male) with the age ranged from 7-50 years, average 28 years, and seven patients in third decade. A slowly growing mass was excised on average 4 months after first notice of the mass, but their margins are not demarcated clearly in most cases. Wide excision in 12 cases was done, but wide excision and saphenous vein graft was performed in one case because of invasion of posterior tibial artery by tumor mass. The tumor was found on extraabdominal region in 8 cases(61.5%) but 5 cases in abdominal wall(38.5%). The recurrence rate was high(6/13, 46.2%), and 11 times in 6 patients were recurred(average 1.8 times), within 27 months of initial excision. Six cases of recurrence were treated with wide excision again in 3 cases, wide excision combined with radiotherapy(4,000-6,000cGy) in 4 cases and wide excision with chemotherapy in one case. During the follow-up for average 21 months after treatment, no recurrences are found. Tumor remission periods without recurrence are average 67 months in all, and 11 years in longest case. Histologically it was very mimic with fibrosarcoma but could be differentiated with Trichrome stain, and their findings are not changed after recurrence.

  • PDF