• 대한핵의학회지
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• 제30권3호
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• pp.332-337
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• 1996

기저막 성분인 type IV collagen을 분해하는 type IV collagenase의 농도와 종양의 전이사이에 상관관계가 있다는 동물 실험보고가 있다. 저자들은 유방암환자의 종양조직내 type IV collagenase의 농도와 골스캔상 골전이 소견과 비교하여 그 의의를 알아보고자 하였다. 원발성 및 전이성 유방암 환자의 종양조직에서 92kDa 및 72kDa type IV collagenase에 대한 면역조직화학염색을 각각 57명, 56명 환자에서 시행하여 각 효소 농도를 평가하고 골스캔상 골전이 소견을 관찰하고 등급을 부여하였다. 면역조직화학적으로 평가한 각 효소의 농도는 원발성 유방암과 전이성 유방암 환자 사이에 큰 차이가 있었으며, 골스캔 소견과 효소농도를 상호 비교한 결과 각 효소의 농도가 170이하일 경우에는 골스캔상 활동적인 골전이 소견을 볼 수 없었으나 효소의 농도가 200이상일 경우 골스캔 소견은 정상에서 골전이 소견까지 매우 다양하게 분포하였다. 결론적으로, 면역 조직화학적으로 측정한 92kDa 및 72kDa collagenase의 농도가 170이하일 때는 골스캔상 대부분 정상소견을 보여 골전이의 확률이 낮았다. 반면에 각 효소치의 농도가 200이상일 경우에는 골전이의 확진과 병소의 위치를 확인하고 추적검사를 위해서는 골스캔이 필요하다고 사료된다.

• Clinical and Experimental Pediatrics
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• 제58권4호
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• pp.123-128
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• 2015

Osteosarcoma is the most frequent primary bone tumor. Advances in combination chemotherapy and surgical technique have greatly improved the survival of patients with osteosarcoma. In Korea, improvements in osteosarcoma treatment have been made over the past two decades. The 5-year event-free survival rate of Korean children and adolescents with localized disease is 64.6%, comparable to that of American or European patients. This article provides an overview of current therapies for osteosarcoma in Korea.

• Journal of Chest Surgery
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• 제20권2호
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• pp.399-403
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• 1987

Ewing`s sarcoma is a highly malignant tumor which occurs most frequently in the diaphysis of the long bones, although any bone may be involved. Ewing`s sarcomas occurring in the rib are rare. Recently, we experienced one case of Ewing`s sarcoma which arose in the right second rib in a young female patient. She was treated with three principal treatment modalities-en bloc excision of chest wall followed by radiation therapy and chemotherapy. Clinical course is described with review of related literatures.

• Clinical and Experimental Reproductive Medicine
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• 제49권4호
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• pp.285-288
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• 2022

Mesenchymal chondrosarcoma is a rare tumor that is more common in young people; it is an uncommon type of chondrosarcoma with a poor prognosis. In two-thirds of cases, it affects the bone, especially the spine. However, parts of the body other than the skeletal system are occasionally involved. These rarer types have a worse prognosis, with a high likelihood of metastasis and death. Due to the possible misdiagnosis of mesenchymal chondrosarcoma, the integrated use of imaging, immunohistochemistry, and pathology can be helpful.

• 대한세포병리학회지
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• 제6권2호
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• pp.199-203
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• 1995

Chordoma is relatively uncommon tumor comprising $1\sim4%$ of primary malignant bone tumors, and believed to arise from the remnants of notochordal tissue. Because of its rare occurrence in the thoracic spine, we report a case of chordoma involving the thoracic spine. A 45-year-old male was sufferred from chest pain radiating to the back. Chest CT showed a well marginated, round huge mass with multiseptated enhancement at the thoracic spine from T5 to T8 level. After percutaneous needle aspiration, piecemeal resection of the tumor was done. On cytologic smears, two types of neoplastic cells were arranged in sheets and cords in mucinous background. One type of cells consisted of medium sized cells with pink cytoplasm and round nuclei. The other type had voluminous bubbly or clear cytoplasm divided by intracytoplasmic septae imparting a feathery or basket-like appearance. Histologically, the tumor showed lobulated feature divided by fibrous septae and the tumor cells were pink eosinophilic or physaliphorous in morphology. Immunohistochemically, the tumor cells revealed strong positivity for low(AE1) and high (AE3) molecular weight cytokeratins.

• Nuclear Medicine and Molecular Imaging
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• 제40권3호
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• pp.141-147
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• 2006

PET detects only less than 50% of early gastric cancer and 62-98% of advanced gastric cancer. Therefore, mass screening programs are recommended for all adults over the age of 40 for early detection and early treatment of gastric cancer through endoscopy or various radiological tests. The most important step after being diagnosed with gastric cancer is accurate staging, which mainly evaluates tumor resectability to avoid unnecessary surgery. Important factors that affect tumor resectability are whether the tumor can be separated from adjacent organs or important blood vessels, the extent of lymph node metastasis, presence of peritoneal metastasis, or distant organ metastasis. To evaluate the extent of local tumor invasion, anatomical imaging that has superior spatial resolution is essential. There are a few studies on prognostic significance of FDG uptake with inconsistent results between them. In spite of lower sensitivities for lymph node staging, the specificities of CT and PET are very high, and the specificity for PET tends to be higher than that for CT. Limited data published so far show that PET seems less useful in the detection of lung and bone metastasis. In the evaluation of pleural or peritoneal metastasis, PET seems very specific but insensitive as well. When FDG uptake of the primary tumor is low, the distant metastasis is also known to show low FDG uptake reducing its detection. There are only a few data available in the evaluation of recurrence detection and treatment response using FDG PET.

• 대한핵의학회지
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• 제37권5호
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• pp.331-335
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• 2003

원발성골림프종은 매우 드문 질환이기는 하나, 복합항암요법이나 방사선 치료등에 높은 반응율을 보이며, 좋은 예후를 가지는 림프절외 비호지킨 림프종의 일종이다. 그러나, 치료 효과 판정에 있어 골병변의 특이성에 의한 모호한 방사선학적 특징으로 어려움이 있어 왔다. 본 증례는 위와 같은 원발성골림프종 환자에서 PET 스캔을 사용하여 민감하게 완전 반응을 평가할 수 있었던 예로 앞으로 다른 고식적인 방법과 함께 이 질환의 진단과 치료 평가 있어 유용하게 사용 될 수 있을 것으로 전망할 수 있었다.

• 대한골관절종양학회지
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• 제9권1호
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• pp.18-23
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• 2003

목적: 골 육종, 연골 육종은 흔한 질환이 아니므로, 일차 진료 현장에서 명확한 진단이 신속히 이루어지지 않고, 진단의 지연이나 오진으로 인해 문제를 야기할 수 있다. 따라서, 상기 질환에 대한 초기 증상과 임상적 특징을 조사하여 이를 확인하고, 조기 진단에 도움을 주고자한다. 대상 및 방법: 본원에서 진단된 골 육종이나 연골 육종 환자로, 기록 검토와 설문지 조사가 가능한 139명을 대상으로 하였다. 골 육종 환자가 108명, 연골 육종이 31명이었고, 남자가 86명, 여자가 53명이었으며, 평균 연령은 골 육종이 20.2세, 연골 육종이 42.4세이었다. 결과: 병원을 방문하게 된 초기 증상은 두 질병 군 모두에서 동통이 가장 많았는데, 골 육종은 101명(93.5%), 연골 육종은 19명(61.3%)이었다. 이들 중 골 육종의 49명(48.5%), 연골 육종의 1명(5.3%)에서 통증이 외상과 관련되어 시작되었으며, 야간 동통이 골 육종의 77명(76.2%), 연골 육종의 11명(57.8%)에서 있었다. 처음 방문한 진료 기관에서 악성 골 종양으로 진단된 경우는 골 육종에서는 66명(61.1%), 연골 육종에서 20명(64.5%)이었고, 오진된 경우는 골 육종에서는 골절로 본 경우가 18명(16.7%)으로 가장 많았으며, 연골 육종에서는 골 감염으로 본 경우가 6명(19.4%)으로 가장 많았다. 초진 시에 방사선 촬영을 시행한 경우 골 육종과 연골 육종 모두에서 진단율이 유의하게 높았고(p=0.009, p=0.014), 성인 군에서의 진단율이 높았다(p=0.037). 연골 육종에서 골 육종보다 환자와 의사에 의한 지연이 모두 길었다. 진단의 의사 지연을 길게 하는 요소로는 초진 시에 단순 방사선 사진을 촬영하지 않는 것과 골반 등 축성골에 종양이 위치하는 것이었고, 외상과 미성년 환자는 진단의 환자 지연을 단축시킬 수 있는 요소로 파악되었다. 결론: 악성 골 종양의 조기 진단을 위해서는 외상이나 야간 동통 등의 병력 청취를 소홀히 하지 않아야 할 것이며, 초진시의 단순 방사선 촬영과 주기적인 경과 관찰 및 방사선 사진의 비교 등으로 조기 진단의 정확성에 힘써야 할 것이다.

• Journal of Korean Neurosurgical Society
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• 제53권1호
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• pp.46-48
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• 2013

Chondrosarcoma is a very uncommon malignant primary bone tumor, especially, it occurs extremely rare in the spine. A 52-year-old man was admitted to the emergency room with sudden paraplegia. Twelve hours prior to a paraplegic event, he visited an outpatient clinic with discomfort and tenderness around the medial border of the right scapular, and his neurologic status was absolutely intact. Magnetic resonance imaging showed a lobulated soft tissue mass from T3 to T5, which extended to the epidural space. Computed tomography scans showed soft tissue mass on the spinal posterior arch and osteolytic change of the adjacent bony structures. Emergent surgery was performed and the lesion was removed. Dark reddish blood and gel-like material were encountered around the dura and posterior arch during the operation. Multiple pulmonary nodules were found on a chest CT scan and a biopsy of one of them had been proven to be a metastasis of chondrosarcoma. The histologic examination showed dedifferentiated chondrosarcoma. The patient's neurologic deficit was improved slowly from ASIA A to ASIA D. Chondrosarcoma in the spine is extremely rare, even more with acute hemorrhage and sudden expansion into the epidural space. We named it chondrosarcoma apoplexy. We should consider the possibility of a hemorrhagic event when the patient's neurologic deficit worsens suddenly with spinal bone tumor.

• 대한두경부종양학회지
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• 제18권2호
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• pp.157-162
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• 2002

Background and Objectives: Adenoid cystic carcinoma (ACC) is a unique tumor characterized by frequent and delayed distant metastasis (DM) with uncommon regional lymph node metastasis. We evaluated the factors affecting DM of ACC and survival after appearance of DM. Materials and Methods: Medical records, radiographs and pathologic slides were reviewed for 94 patients from 1979 through 2001. Results: DM of ACC occurred in 46 patients, and developed more frequently in patients with tumors of the solid histologic subtype than in patients with tubular or cribriform subtypes. DM occurred less frequently in the sinonasal tract, and development of DM was not affected by tumor stage. Disease-specific 5- and 10-year survival rates were 88% and 72% for patients without DM, respectively and 76% and 48% for those with DM(p=0.02). Regarding the site of DM and its impact on outcomes, 30 patients had lung metastasis alone, 5 patients bone metastasis alone and 6 patients developed both lung and bone metastasis. Median survivals after appearance of DM among patients with isolated lung metastases and those with bone metastases with or without lung involvement were 54 and 21 months, respectively (p=0.04). Conclusions: Development of DM in ACC is predicted by solid histologic subtype, and major salivary gland or oral/pharyngeal rather than sinonasal primary site. Those patients with bone involvement with our without lung metastases had worse outcomes than those with pulmonary metastasis only.