• 대한세포병리학회지
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• 제14권1호
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• pp.36-41
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• 2003

Epithelioid hemangioendothelioma is a rare vascular tumor of borderline malignancy which is characterized by the presence of "epithelioid" or "histiocytoid" endothelial cells. Superficial and deep tumors have been recognized in the extremities, head, neck, chest, and mediastinum of adult patients. It may also occur as a primary tumor of liver, bone, and other visceral organs. Few effusion cytologic findings of epithelioid hemangioendothelioma have been reported. We report a case of composite epithelioid hemangioendothelioma with focal epithelioid angiosarcomatous areas of the iliac bone and adjacent soft tissue in a 38-year-old female, which, during its metastatic course, was presented as a pleural effusion. The effusion was cellular with epithelioid cells presenting both singly and in clusters. The tumor cells were round to ovoid shewing cytoplasmic vacuolization, variability in cell size, and prominent nucleoli. The effusion smears and cell block sections revealed strong positive staining for CD31 and vimentin, weak positive for CD34 and Factor VIII-related antigen, and negative for cytokeratin, CEA, and calretinin. The cytologic findings in this case were similar to that of metastatic adenocarcinoma or malignant mesothelioma. Therefore, immunocytochemical staining in smear and cell block is a helpful tool to differentiate malignant 'epithelioid' cells in effusion.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제42권5호
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• pp.307-314
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• 2016

We report a case of retiform hemangioendothelioma (RH) located in the infratemporal fossa and buccal area in a 13-year-old Korean boy. The tumor originated from the sphenoid bone of the infratemporal fossa area and spread into the cavernous sinus, orbital apex, and retro-nasal area with bone destruction of the pterygoid process. Tumor resection was conducted via Le Fort I osteotomy and partial maxillectomy to approach the infratemporal fossa and retro-nasal area. The diagnosis of RH was confirmed after surgery. In the presented patient, surgical excision was incomplete, and close follow-up was performed. There was no evidence of expansion or metastasis of the residual tumor in the 8 years after surgery. In cases of residual RH with low likelihood of expansion and metastasis, even though RH is an intermediate malignancy, close follow-up can be the appropriate treatment choice over additional aggressive therapy. To date, 29 papers and 48 RH cases have been reported, including this case. This case is the second reported RH case presenting as primary bone tumor and the first case originating in the oromaxillofacial area.

• 대한세포병리학회지
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• 제13권2호
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• pp.51-59
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• 2002

To determine the usefulness on fine needle aspiration cytology(FNAC) of bone lesions and the complementary role of FNAC and percutaneous needle biopsy, 75 cases of FNAC taken from bone lesions were analyzed. Correlations with histopathology were possible in 47 cases, including 14 cases of simultaneous core biopsy and 33 cases of subsequent open biopsy due to inadequate aspirates. Among 75 cases, 4 cases were benign tumors and tumor-like lesion, 11 cases were malignant primary bone tumors, 17 cases were metastatic tumors, and 43 cases were nonneoplastic bone lesions. The aspirates were adequate in 35 cases(46.7%), in all of which the discrimination between benignancy and malignancy was possible. The main reason for Inadequate aspirates was due to hypocellularity. In the cases of aspiration and core biopsy simultaneously done, the diagnostic accuracy of aspiration, core biopsy, and both were 57%(8/14), 78.6%(11/14), and 92.9%(13/14), respectively. We conclude that a final diagnosis based on cytology is possible with the adequate aspirates and the clinical and radiological findings. Also we confirm the complementary role between FNAC and core biopsy in bone lesions.

• Imaging Science in Dentistry
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• 제49권3호
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• pp.235-240
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• 2019

Osteosarcoma is the most common primary bone tumor after plasma cell neoplasms. Osteosarcoma has diverse histological features and is characterized by the presence of malignant spindle cells and pluripotent neoplastic mesenchymal cells that produce immature bone, cartilage, and fibrous tissue. Osteosarcoma most frequently develops in the extremities of long bones, but can occur in the jaw in rare cases. The clinical and biological behavior of osteosarcoma of the jaw slightly differs from that of long-bone osteosarcoma. The incidence of jaw osteosarcoma is greater in the third to fourth decades of life, whereas long-bone osteosarcoma mostly occurs in the second decade of life. Osteosarcoma of the jaw has a lower tendency to metastasize and a better prognosis than long-bone osteosarcoma. Radiographically, osteosarcoma can present as a poorly-defined lytic, sclerotic, or mixed-density lesion with periosteal bone reaction response. Multi-detector computed tomography is useful for identifying the extent of bone destruction, as well as soft tissue involvement of the lesion. The current case report presents a fibroblastic osteosarcoma involving the left hemimandible with very unusual radiographic features.

• 대한두개안면성형외과학회지
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• 제24권5호
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• pp.244-249
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• 2023

Fibrous dysplasia (FD) is a rare skeletal disorder characterized by abnormal fibro-osseous connective tissue replacing normal bone. Despite its benign behavior, craniofacial FD can cause morphological disfigurement, headache, and even blindness as a result of the produced mass effect. Surgical resection is recommended when the patient shows apparent clinical symptoms or aggravating facial asymmetry. Postoperative complications have been reported, such as hematoma, surgical site infection, abscess formation, resorption of the bone graft used for reconstruction, and recurrence. An aneurysmal bone cyst (ABC) is a rare benign bony lesion that can occur secondary to preexisting bone tumor. Secondary ABCs in craniofacial FD are extremely rare in the literature, accounting for less than 30, all of which are either case reports or series. We report an extremely rare case of symptomatic secondary ABC arising from craniofacial FD that had been misdiagnosed with abscess formation or recurrence and was surgically removed. Notably, 17 years elapsed between the primary surgery and the complication of secondary ABC. The patient underwent total removal of secondary ABC. After surgery, symptoms were relieved, with no recurrence observed during a 6-month follow-up.

• Journal of Gastric Cancer
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• 제6권4호
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• pp.221-226
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• 2006

목적: 암 환자의 골수에서 발견되는 cytokeratin 양성세포와 암의 재발과의 상관관계에 대해서는 알려진 바가 많지 않다. 이에 위암환자의 골수에서 발견되는 cytokeratin 양성세포가 위암 환자의 재발과 생존율을 예측할 수 있는지 알아보고자 하였다. 대상 및 방법: 1998년 6월부터 2000년 7월까지 경북대학교병원 외과에서 원발성 위암으로 수술받은 환자 419명을 대상으로 하였다. 수술 직전 장골능선에서 골수를 흡인하여 단핵구를 분리하고 항 cytokeratin 항체를 이용하여 면역세포화학적 염색을 하였다. 결과: Cytokeratin 양성세포는 219예(52.4%)에서 발견되었고, 위암의 침윤깊이(P=0.021), 병기(P=0.026)에 따라서 통계학적으로 유의한 차이가 있었으나, 암의 위치, 육안형, 림프절전이, 원격전이, 분화도에 따라서는 유의한 차이가 없었다. 골수의 cytokeratin 양성세포 유무에 따른 5년 생존율은 유의한 차이가 없었고(P=0.248), 재발여부, 재발부위도 유의한 차이가 없었다. 결론: 위암 환자의 골수에서 cytokeratin 양성세포 유무는 예후인자로 사용되기 어렵고 재발양상을 예측하기도 어렵다.

• Asian Pacific Journal of Cancer Prevention
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• 제13권3호
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• pp.937-940
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• 2012

Due to lack of sufficient data on characteristics of breast cancer patients and risk factors for developing metastasis in Iran this study was designed to understand clinical aspects impacting on survival. A cross-sectional study on breast cancer patients was conducted in an oncology clinic of the university hospital between 1995 and 2010. Data were retrieved from medical records and included age, menopausal status, tumor diameter, number of involved nodes, histopathological type, estrogen and progesterone receptor expression, c-erbB-2, primary and secondary metastasis sites, overall survival, disease free interval and type of chemotherapy protocol. The results were analyzed with SPSS 13 software. The mean age of the patients was 49.2 (27-89) years. The primary tumors were mainly ER positive (48%) and PR negative (49.3%). The status of lymph nodes dissected and examined in these patients was unknown in 19 patients (25.3%) while 18 patients (24%) had positive lymph nodes with no report on the number of involved nodes. All of the patients had received antracyclin based chemotherapy in an adjuvant or metastatic setting. Adjuvant hormonal therapy was administered to receptor positive patients. In average, overall survival after recurrence was 30 months (95%CI 24.605-35.325) for non-skeletal versus 42 months (95%CI 31.211-52.789) for skeletal metastasis (P= 0.002). The median survival was also greater for receptor positive patients; 39 months (95%CI 33.716-44.284) for PR+ versus 26 months (95%CI 19.210-32.790) for PR- (P=0.047) and 38 months (95%CI 32.908-43.092) for ER+ versus 27 months (95%CI 18.780-35.220) for ER- patients (P=0.016). No relation was found between site of first metastasis and hormone receptor, age, tumor diameter, DFI and menopausal status. Sites of metastasis were independent of age, size of the tumor, menopausal and hormone receptor status in this study. Overall survival provided significant relations with respect to receptor status and bone metastasis.

• 대한골관절종양학회지
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• 제17권1호
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• pp.17-22
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• 2011

목적: 저자들은 양성 골종양의 이차적 악성 변화로 인한 속발성 연골육종 환자의 특성 및 종양학적 결과에 대해 알아보고자 하였다. 대상 및 방법: 1986년 4월부터 2009년 4월까지 본원에서 치료받은 183명의 연골육종 환자 중 양성 골종양의 악성 변화로 생긴 속발성 연골육종 환자 18명을 대상으로 후향적 분석을 시행하여 환자의 특성 및 국소재발, 원격전이에 대해 살펴보았다. 결과: 속발성 연골육종 환자 18명을 원발성 병변에 따라 분류하였을 때, 골연골종 4명, 다발성 골연골종 11명, 다발성 내연골종 3명이었다. 추시 기간은 평균 85개월(21-166)이었다. 최종 추시상 5년 무병 생존율은 $85.9{\pm}9.3%$였으며 평균 기능적 점수는 25.2점(84%)으로 비교적 양호하였다. 추시 기간 중 3명의 환자에서 국소 재발이 발생하였으며 원격 전이는 없었다. 질병으로 인하여 사망한 환자는 없었다. 결론: 양성 골종양에서 발생한 속발성 연골 육종의 예후는 비교적 양호하였으며 해부학적 위치와 수술적 절제연이 중요한 예후 인자인 것으로 판단된다.

• Radiation Oncology Journal
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• 제37권3호
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• pp.224-231
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• 2019

Purpose: To investigate the patterns of recurrence in patients with neuroblastoma treated with radiation therapy to the primary tumor site. Materials and Methods: We retrospectively analyzed patients with high-risk neuroblastoma managed with definitive treatment with radiation therapy to the primary tumor site between January 2003 and June 2017. These patients underwent three-dimensional conformal radiation therapy or intensity-modulated radiation therapy. A total of 14-36 Gy was delivered to the planning target volume, which included the primary tumor bed and the selected metastatic site. The disease stage was determined according to the International Neuroblastoma Staging System (INSS). We evaluated the recurrence pattern (i.e., local or systemic), progression-free survival, and overall survival. Results: A total of 40 patients with high-risk neuroblastoma were included in this study. The median patient age was 4 years (range, 1 to 11 years). Thirty patients (75%) had INSS stage 4 neuroblastoma. At the median follow-up of 58 months, there were 6 cases of local recurrence and 10 cases of systemic recurrence. Among the 6 local failure cases, 4 relapsed adjacent to the radiation field. The other 2 relapsed in the radiation field (i.e., para-aortic and retroperitoneal areas). The main sites of distant metastasis were the bone, lymph nodes, and bone marrow. The 5-year progression-free survival was 70.9% and the 5-year overall survival was 74.3%. Conclusion: Radiation therapy directed at the primary tumor site provides good local control. It seems to be adequate for disease control in patients with high-risk neuroblastoma after chemotherapy and surgical resection.

• 대한골관절종양학회지
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• 제13권1호
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• pp.48-54
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• 2007

목적: 대퇴골 근위부의 광범위 골 파괴를 보이는, 전이성 골 종양에 의한 병적 골절 환자들을 대상으로 종양 대치물 삽입술 시행 후 임상 결과를 알아보고자 하였다. 대상 및 방법: 2005년 10월부터 2006년 10월까지 전이성 골 종양에 의한 병적 골절로 진단 받은 환자 중 대퇴골 근위부에 광범위 전이를 보여 근위부 절제술 및 종양 대치물 삽입술을 시행한 6예를 대상으로 하였다. 평균 연령은 61세(범위, 48~77)였으며 평균 추시 기간은 10.5개월(범위, 6~16)이었다. 원발 종양으로는 다발성 골수종이 2예, 폐암이 1예, 유방암이 1예, 신장암이 1예, 원발 종양을 확인할 수 없었던 경우가 1예였다. 6예 모두에서 $MUTARS^{(R)}$ proximal femur system (Implantcast, Munster, Germany)를 이용하여 재건을 시행하였다. 하지 기능평가에는 Musculoskeletal Tumor Society 1993 score를 사용하였으며, 수술 전 후 동통의 정도를 Visual Analogue Scales (VAS)로 평가하였다. 결과: 최종 추시 시에 모든 환자들이 생존하였으며 하지 기능 점수는 평균 17.8(59.3%)점(범위, 12~25)이었다. VAS는 수술 전 평균 8.5에서 수술 후 최종 추시 시 평균 2.5로 호전되었다. 수술 후 가능한 한 조기 보행을 독려하여 수술 후 평균 7.3일(범위, 3~16)에 보행이 가능하였다. 수술 후 삽입물 주위 골절, 치환물의 해리 또는 감염은 없었으며, 1예에서 수술 후 재발성 탈구가 발생하였다. 결론: 전이성 골 종양의 대퇴골 근위부 광범위 침범 소견이 있는 병적 골절 환자에서 종양 대치물 삽입술은 조기에 동통의 경감 및 하지 기능 회복을 기대할 수 있으면서도 수술 후 합병증 발생이 적어 상대적으로 안전한 술식으로 전이성 골 종양의 치료 취지에 부합되는 적절한 치료로 생각된다.