• Clinical and Experimental Pediatrics
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• v.58 no.3
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• pp.108-111
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• 2015

DiGeorge syndrome is an immunodeficient disease associated with abnormal development of 3rd and 4th pharyngeal pouches. As a hemizygous deletion of chromosome 22q11.2 occurs, various clinical phenotypes are shown with a broad spectrum. Conotruncal cardiac anomalies, hypoplastic thymus, and hypocalcemia are the classic triad of DiGeorge syndrome. As this syndrome is characterized by hypoplastic or aplastic thymus, there are missing thymic shadow on their plain chest x-ray. Immunodeficient patients are traditionally known to be at an increased risk for malignancy, especially lymphoma. We experienced a 7-year-old DiGeorge syndrome patient with mediastinal mass shadow on her plain chest x-ray. She visited Severance Children's Hospital hospital with recurrent pneumonia, and throughout her repeated chest x-ray, there was a mass like shadow on anterior mediastinal area. We did full evaluation including chest computed tomography, chest ultrasonography, and chest magnetic resonance imaging. To rule out malignancy, video assisted thoracoscopic surgery was done. Final diagnosis of the mass which was thought to be malignancy, was lymphoproliferative lesion.

• Archives of Plastic Surgery
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• v.36 no.1
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• pp.105-108
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• 2009

Purpose: Epidermoid cyst may be congenital or acquired. Acquired cysts are most commonly of traumatic origin and result from an implantation or downward displacement of an epidermal fragment. Traumatic epidermoid cysts are rare tumors occurring on the nasal tip, especially resulting aesthetic procedure. So, we report a rare case of an iatrogenic epidermoid cyst in the nasal tip following rhinoplasty. Methods: A 44 - years old man had undergone rhinoplasty for several times. First time, the previous augmentation rhinoplasty and wedge osteotomy were performed nineteen months ago, lastly implant removal and unknown filler injection were performed one year ago at another local clinic. He had induration and tenderness on nasal tip and dorsum continued for 3 months. We thought that it caused by foreign body reaction with residual alloderm in nose. For removal of residual alloplastic material, open approach using transcolumellar incision was done. But, incidentally we found cystic mass on the nasal tip. Results: The findings were of an $0.8{\times}0.5{\times}0.5cm$ sized round cystic mass containing cream coloured material with a thick cheese - like consistency. The mass was completely excised and submitted for histology. This confirmed the diagnosis of an epidermoid cyst lined by keratinizing squamous epithelium. There was no induration, tenderness and sign of recurrence after excision of the mass. Conclusion: Epidermal cyst of the nasal tip region represents an unusual clinical lesion and it presents as foreign body reaction. And then, our case demonstrates that meticulous surgical approach and suture technique are the keys to prevention against iatrogenic nasal epidermoid cyst, especially in secondary rhinoplasty.

• Journal of Korean Neurosurgical Society
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• v.29 no.7
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• pp.954-958
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• 2000

In the removal of small subcortical lesion in the eloquent area like sensory-motor cortex, the prevention of neurologic deficit is important. We present our technique of identification of M-1, S-1 cortex in a case of subcortical granuloma located in sensorymotor cortex. To accurately localize mass, stereotactic craniotomy was planned. At the beginning of procedure, functional MRI of motor cortex was done with stereotactic headframe in place. Next, the stereotactic craniotomy about 4 cm was done under propofol anesthesia for cortical mapping. After reflection of dura, central sulcus was identified with phase-reversal response of intraoperative SEP(somatosensory evoked potential) of contralateral median nerve. Then the patient was awakened, and direct cortical stimulation was done. We observed the muscle contractions of elbow, hand and fingers and the paresthesia over forearm, hand, fingers on the M-1 and S-1 cortex. Through cortical mapping and stereotactic guidance, we concluded that the mass lie immediately posterior to central sulcus, then the mass was carefully removed through small transsulcal approach, opening about 1 cm of rolandic sulcus.

• The Journal of the Korean bone and joint tumor society
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• v.2 no.1
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• pp.94-100
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• 1996

Ossifying fibroma is one of a group of fibro-osseous lesions which arises typically within the jaw bones and only rarely affects the long bones. Ossifying fibroma of the long bones almost involve exclusively the tibia but may also involve the fibula. Ossifying fibroma of the long bones is distinct from fibrous dysplasia, adamantinoma and nonossifying fibroma with regard to age of the patient, site, radiographic appearance, histological features, and clinical course. We are reporting the cases of seven patients with a tumor-like lesion that named osteofibrous dysplasia. It is most commonly found in the tibia and fibula of a child ten years of age or younger. Of the seven cases reported in this study, only one patient was younger than ten years. In all cases, the lesions were usually located in the tibial diaphysis. The average duration of clinical manifestation was 5.2 years. The clinical symptoms were anterior bowing of the tibia in 2 cases, buldging of the tibia in 2 cases, and mass overlying the tibia in 3 cases. On the roentgenography, it shows multiple radiolucent lesion with intervening sclerotic rim of the tibial diaphysis. In seven patients, 6 cases were confirmed with biopsy. We had done curettage and bone graft in three cases, VFG was done in one case. The other three cases underwent conservative management.

• Archives of Plastic Surgery
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• v.36 no.4
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• pp.485-488
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• 2009

Purpose: Malignant melanoma of the lower extremity is well known to metastasize to the lymph nodes of the groin. However, in rare cases, the initial site of the nodal disease can be the popliteal fossa. As of yet, there has not been any report on cases with popliteal lymph node metastasis in Koreans. In the following report, authors would like to present two cases of popliteal node metastasis. Methods: A 60 - year - old male patient presented with nodular mass at his left sole. He had popliteal node metastasis detected on preoperative positron emission tomography(PET). Another 67 - year - old man presented with pigmented lesion at his right heel. He also had popliteal node metastasis detected on the MRI. They underwent wide excision of the primary lesion with popliteal node dissection. Results: In the first case, $2.5{\times}2.5cm$ sized metastatic melanoma in popliteal node was pathologically confirmed. There were no postoperative complications, and to date(18 months after the surgery), the patient is alive with no evidence of disease. In the second case, multiple(4) metastatic melanoma in popliteal nodes was confirmed. The patient is alive, but has had interferon therapy for liver metastasis. Conclusion: By increasing the use of lymphoscintigraphy or PET as a preoperative diagnostic work - up for metastasis, even popliteal node metastasis undetectable in a physical exam becomes detectable. When metastatic lymph node is found, node dissection is the standard of care. Therefore, it is essential that we know the anatomy and surgical technique for popliteal lymph node dissection.

• The Korean Journal of Nuclear Medicine
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• v.28 no.3
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• pp.397-401
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• 1994

A twenty-one-year-old man visited our hospital due to abdominal distension for a month. On the physical examination, there was severe abdominal distension with fluctuation and shifting dullness. The routine laboratory results were within normal range. On the Magnetic Resonace angiography, there wasn't any blood flow within the right and middle hepatic vein. So we concluded that the etiologic disease was Budd-Chiari syndrome. On the liver scan, there was cold area(absence of radiouptake) on entire right lobe of the liver, increased uptake on the bone marrow and showed splenomegaly. This finding was similar to the liver mass occupying right lobe with underlying chronic liver disease. On the previous reports, it is quite uncommon finding that Budd-Chirari syndrome shows lesion like space occupying one on the liver scan. So we report this case with a review of the literature.

• Archives of Plastic Surgery
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• v.34 no.4
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• pp.520-523
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• 2007

Purpose: Verrucous carcinoma is a rare, low-grade and well-differentiated squamous cell carcinoma, representing as a warty tumor. Estimation of the incidence for cutaneous lesions is not available because they are rare. We describe a case of verrucous carcinoma, a rare type, complication of a chronic pressure ulcer of duration more than 15 years. Methods: A 17-year-old boy presented with a large lesion involving the sacral area, which had been neglected for about 15 years. He had a history of surgical extirpation 2 years ago, but not cured. Examination revealed a cauliflower-like mass arising from an irregularly oval-shaped tumor which was $6.0{\times}4.5cm$ in size with signs of infection and ulcer. The lesion involved the sacrococcygeal area, spreading to both medial gluteal regions. The perianal skin did not appear to be directly affected. Results: A preoperative punch biopsy revealed a extremely well differentiated verrucous carcinoma. There were positive results in immunohistochemistry in the items of p53, p63, Ki-67. An 'en-bloc' excision of the tumor with the clinically normal surrounding tissue was carried out. Reconstruction was achieved by local regional flap. Histopathological findings of the excised area fully confirmed the preoperative biopsy report. It remained free of recurrence for a period of about 8 months. Conclusion: We believe that in patients with buttock involvement, regardless of the extent of such tumors, surgical therapy should be considered as the first-choice of treatment as reconstruction can be performed without excessive impairment for the patient.

• Tuberculosis and Respiratory Diseases
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• v.39 no.1
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• pp.15-23
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• 1992

Background: The prognosis of lung cancer remains poor and early detection and curative surgery is still the most effective treatment for many. In the early detection of lung cancer, sputum cytology and simple chest x-ray are used, but both of these tests are far from being perfect. So we studied the characteristics of patients diagnosed as lung cancer without demonstrable mass lesion on simple chest x-ray to help in the early diagnosis of lung cancer. Methods: We conducted a retrospective study on 11 subjects who were diagnosed as lung cancer at Seoul National University Hospital between August 1986 and June 1989 and had no demonstrable mass lesion on simple chest x-rays. Results: Ten of 11 patients were male, 8 had a history of smoking, most frequent symptoms were sputum, cough, and hemoptysis, and 3 patients either had wheezing or stridor. In 3 of the cases, although there were no mass lesion, there were ill-defined infiltration, major fissure thickening, and fibrostreaky density mimiking tuberculosis where the tumor was eventually found and in one patient tumor was masked by a rib shadow. Also in one case, lateral chest film demonstrated a retrocardiac mass. Both bronchoscopy and computed tomogram were useful in the localization of the tumor. Seven of 11 had relatively early disease (less than StageII). Four of 11 are still alive without any evidence of recurrence between 2 and a half and 4 years after the operation. Conclusion: We conclude that in patients with respiratory symtoms in whom cancer cannot be ruled out, sputum cytology and lateral chest x-rays should be taken and that if necessary further studies like computed tomogram and bronchoscopy should be done to aid in the early diagnosis of lung cancer.

• Tuberculosis and Respiratory Diseases
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• v.39 no.1
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• pp.103-108
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• 1992

Pulmonary paragonimiasis is the infectious disease of lung, due to 'Paragonimus westermani'. The clinical manifestations are various, and the main symptoms are chronic cough and persistent hemoptysis. Radiological findings mainly include thin walled cyst, migrating patch pulmonary infiltration, transient linear shadow, and hydropneumothorax, etc. The differential diagnosis should include pulmonary tuberculosis, pneumonia, other parasitic diseases, and rarely lung malignancy if the mass-like lesion is present. Recently, the incidence of paragonimiasis is very low. But the physicians should suspect paragonimus infection, if the patient has chronic respiratory symptom such as hemoptysis and lives in the endemic area such as Korea. A case of pulmonary paragonimiasis confirmed by histological basis of lung was presented with a review of the literature.

• The Journal of the Korean bone and joint tumor society
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• v.18 no.2
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• pp.89-93
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• 2012

The most common anatomic location of calcific tendinitis is the suprasupinatus muscle of the shoulder joint. However, it is known to develop in any joint including the hip, knee. Infarction of skeletal muscle in the distal areas of the limbs due to vascular occlusion is a well recognized systemic condition in patients who have diabetes. The author experienced mass-like lesion combined muscle infarction and calcification within pure semitendinosus tendon without diabetes in posterosuperior area of distal thigh in old age.