• Archives of Craniofacial Surgery
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• v.16 no.2
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• pp.67-72
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• 2015

Background: A schwannoma is a benign, slow-growing peripheral nerve sheath tumor that originates from Schwann cells. Orbital schwannomas are rare, accounting for only 1% of all orbital neoplasms. In this study, we retrospectively review orbital schwannomas and characterize clinical, radiologic, and histologic features of this rare entity. Methods: A retrospective review was performed to identify patients with histologically confirmed orbital schwannoma, among a list of 437 patients who had visited our hospital with soft tissue masses within the orbit as the primary presentation between 2010 and 2014. Patient charts and medical records were reviewed for demographic information, relevant medical and family history, physical examination findings relating to ocular and extraocular sensorimotor function, operative details, postoperative complications, pathologic report, and recurrence. Results: Five patients (5/437, 1.1%) were identified as having histologically confirmed orbital schwannoma and underwent complete excision. Both computed tomography (CT) and magnetic resonance imaging (MRI) studies were not consistent in predicting histologic diagnosis. There were no complications, and none of the patients experienced significant scar formation. In two cases, patients exhibited a mild postoperative numbness of the forehead, but the patients demonstrated full recovery of sensation within 3 months after the operation. None of the five patients have experienced recurrence. Conclusion: Orbital schwannomas are relatively rare tumors. Preoperative diagnosis is difficult because of its variable presentation and location. Appropriate early assessment of orbital tumors by CT or MRI and prompt management is warranted to prevent the development of severe complications. Therefore, orbital schwannomas should be considered in the differential diagnosis of slow-growing orbital masses.

• Journal of Yeungnam Medical Science
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• v.28 no.1
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• pp.70-76
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• 2011

Rhabdomyosarcomas are soft tissue sarcomas; while extremely rare in adults, they are one of the most common neoplasms in children and adolescents. Histologically, they can be classified into embryonal (ERMS), alveolar (ARMS), pleomorphic, and undifferentiated types. The ARMS type is very rare, and is associated with a poor prognosis. Common primary sites of ARMS are the trunk and extremities. We report on a case of paraaortic, supraclavicular, and axillary lymph node metastasis from paratesticular ARMS treated with VAC (vincristine, dactinomycin, cyclophosphamide)/ IE(ifosfamide, etoposide) chemotherapy in a young adult. Administration of six cycles of chemotherapy with VAC/IE resulted in complete remission. The patient has maintained complete remission over the past 27 months.

• Archives of Plastic Surgery
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• v.39 no.4
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• pp.376-383
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• 2012

Background No consensus has been reached regarding the outcome of management of local recurrence after transverse rectus abdominis myocutaneous (TRAM) flap breast reconstruction. This study demonstrated the presentation, management, and outcomes of local recurrence after immediate TRAM breast reconstruction. Methods A comparison was conducted among 1,000 consecutive patients who underwent immediate breast reconstruction with a pedicled TRAM flap (TRAM group) and 3,183 consecutive patients who underwent only modified radical mastectomy without reconstruction (MRM group) from January 2001 to December 2009. The presentation, treatment, and outcome including aesthetics and overall survival rate were analyzed. Results Local recurrences occurred in 18 (1.8%) patients (TRAM-LR group) who underwent TRAM breast reconstruction and 38 (1.2%) patients (MRM-LR group) who underwent MRM only (P=0.1712). Wide excision was indicated in almost all the local recurrence cases. Skin graft was required in 4 patients in the MRM-LR group, whereas only one patient required a skin graft to preserve the mound shape in the TRAM-LR group. The breast mound was maintained in all 17 patients that survived in the TRAM-LR group even after wide excision. The overall survival rate was 94.4% in the TRAM-LR group and 65.8% in the MRM-LR group (P=0.276). Conclusions Local recurrence after immediate TRAM flap breast reconstruction could be detected without delay and managed effectively by multiple modalities without reducing overall survival rates. Breast mound reconstruction with soft autologous tissue allowed for primary closure in most of the cases. In all of the patients who survived, the contour of their reconstructed breast remained.

• Journal of Chest Surgery
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• v.41 no.1
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• pp.141-144
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• 2008

Low grade fibromyxoid sarcoma (LGFM) is a rare, deep soft-tissue malignant tumor. Although its histologic features are benign, the clinical course is malignant. The usual tumor locations are the lower extremity and chest wall. LGFM originating from the visceral pleura is extremely rare. We report here on a 37 year old man with a LGFM of the visceral pleura. Thirty three months after surgery, the patient is alive without any sign of local recurrence or distant metastasis.

• Journal of Chest Surgery
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• v.41 no.2
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• pp.289-291
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• 2008

Pleomorphic hyalinizing angiectatic tumor (PHAT) is a rare, low grade soft tissue neoplasm of an unknown histogenesis. It is characterized by sheets of mitotically inactive oval and pleomorphic cells, mono- and multi-nucleated giant cells, intranuclear cytoplasmic inclusions and prominent clusters of thin-walled ectatic vessels with perivascular hyalinization. We have experienced a 50 years old male patient who had a palpable mass in his right anterior lower chest wall. The mass was excised and it was confirmed as PHAT. He has been well 2 years postoperatively without recurrence.

• Archives of Reconstructive Microsurgery
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• v.18 no.1
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• pp.31-34
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• 2009

Purpose: Merkel cell carcinoma, also called neuroendocrine carcinoma, is a very rare type of skin cancer that develops as Merkel cells grow out of control. Merkel cell carcinoma is reported below 1% of whole skin neoplasms in the United States and is known that the 2-year survival rate is about 50~70%. The principles of treatment are wide excision of primary lesion with radiotherapy and/or chemotherapy that decrease the local recurrent rate. There has been no report of reconstruction with free flap after resection of Merkel cell carcinoma in Korea. Methods: We reconstructed the skin and soft tissue defect after wide excision of Merkel cell carcinoma with anterolateral thigh perforator free flap in two cases. No distant metastasis was found at the preoperative imaging work-up. In one case, preoperative chemotherapy was performed and the size of lesion was decreased. Results: There were no recurrence and significant complications. Functionally and aesthetically satisfactory results were obtained with reconstruction. Conclusion: Wide excision and reconstruction with anterolateral thigh perforator free flap for Merkel cell carcinoma patient is the first report in Korea. We regard this method as the treatment of choice in Merkel cell carcinoma.

• Journal of the korean academy of Pediatric Dentistry
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• v.25 no.2
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• pp.458-466
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• 1998

Non-odontogenic tumors can be classified as malignant or benign. Most oral tumors in children are benign. In the Belfast series only 7.5 percent of soft tissue tumors were malignant and Bhaskar(l963) found only 9 percent of 293 oral tumors of all kinds to be malignant. Benign tumors may be classified as epithelial and mesenchymal. The most common tumor of surface epithelium is the squamous papilloma. These are easily recognized clinically as cauliflower-like lesions. Fibrous lesions are very common in children's mouths. Many of these are not true neoplasms but are related to fibrous hyperplasia. Another common oral tumor in children is angiomatous tumors. Hemangioma occurred more frequently than lymphangioma. Cystic hygroma, a cystic subtype of lymphangioma, is a developmental tumor of lymphatic origin. It is a considered to be a relatively rare lesion. About 50 percent of cystic hygroma are present at birth, and most of the remaining 50 percent appear in the early years of life during the period of active lymphatic growth. The preferred treatment for these lesions, except for hemangioma, is complete surgical excision. With proper surgical techniques, recurrence is not expected.

• Archives of Craniofacial Surgery
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• v.14 no.1
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• pp.61-64
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• 2013

Schwannomas are well-differentiated solitary benign tumors that originate from the schwann cells of the nerve sheath. They can readily occur in the head and neck regions, but the schwannoma originating from the infraorbital nerve is extremely rare and usually painless, slow-growing, and without specific symptoms. The author experienced a rare case of infraorbital schwannoma, which was completely removed through the intraoral approach. A 20-year-old woman was admitted to our hospital for a painless, solid and circular mass located on the right infraorbital region. The eyeball movement and visual field were normal. There was no globe displacement or proptosis. Preoperative computed tomography demonstrated $13{\times}10{\times}5mm$-sized soft tissue mass. On March 2011, the mass was removed through an intraoral approach. On histopathological examination, the gross specimen consisted of a smooth, well-encapsulated and light yellowish solid mass, measuring $12{\times}7{\times}5mm$. Microscopically, it presented a typical manifestation of schwannoma with Antoni A area with Verocay body, and Antoni B area on H&E stain. The result of the immunohistochemical staining was positive for the S-100 protein. The patient had hypoesthesia of the nasal septum and vestibule in the postoperative period, and this finding confirmed that the internal nasal branch of infraorbital nerve was the nerve in which the schwannoma originated. Infraorbital schwannomas are very rare and must be included in the differential diagnosis of the orbital masses inferior to the eyeball. In the case of early diagnosis, the small-sized infraorbital schwannomas can be completely removed without any scar through an intraoral approach.

• Journal of Yeungnam Medical Science
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• v.38 no.4
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• pp.289-307
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• 2021

Avulsion injuries result from the application of a tensile force to a musculoskeletal unit or ligament. Although injuries tend to occur more commonly in skeletally immature populations due to the weakness of their apophysis, adults may also be subject to avulsion fractures, particularly those with osteoporotic bones. The most common sites of avulsion injuries in adolescents and children are apophyses of the pelvis and knee. In adults, avulsion injuries commonly occur within the tendon due to underlying degeneration or tendinosis. However, any location can be involved in avulsion injuries. Radiography is the first imaging modality to diagnose avulsion injury, although advanced imaging modalities are occasionally required to identify subtle lesions or to fully delineate the extent of the injury. Ultrasonography has a high spatial resolution with a dynamic assessment potential and allows the comparison of a bone avulsion with the opposite side. Computed tomography is more sensitive for depicting a tiny osseous fragment located adjacent to the expected attachment site of a ligament, tendon, or capsule. Moreover, magnetic resonance imaging is the best imaging modality for the evaluation of soft tissue abnormalities, especially the affected muscles, tendons, and ligaments. Acute avulsion injuries usually manifest as avulsed bone fragments. In contrast, chronic injuries can easily mimic other disease processes, such as infections or neoplasms. Therefore, recognizing the vulnerable sites and characteristic imaging features of avulsion fractures would be helpful in ensuring accurate diagnosis and appropriate patient management. To this end, familiarity with musculoskeletal anatomy and mechanism of injury is necessary.

• Korean Journal of Head & Neck Oncology
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• v.38 no.2
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• pp.29-32
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• 2022

Lipoma is one of the most common benign soft tissue tumors. However, giant lipomas compressing and deforming the neurovascular structure rarely occur in the lateral neck. A 70-year-old man visited our outpatient clinic for treatment of a visible painless neck mass that had been identified 2 years prior. Neck magnetic resonance imaging revealed that a 10 × 9 × 4 cm fatty mass located between the sternocleidomastoid and sternohyoid muscles invaded the carotid sheath. Under general anesthesia, the mass was excised without damage to the adjacent neurovascular structures. Upon histopathological examination, the mass was identified as a lipoma. During the surgery, enlargement of the internal jugular vein was observed under the resected mass. However, on ultrasound examination, the function of the internal jugular vein was evaluated as good. No recurrence or neurological and vascular complications were reported during a 6-month follow-up after the surgery. As a giant lipoma located in the deep layer of the lateral neck can deform important cervical structures, its impact on the surrounding structures should be carefully assessed preoperatively to minimize the rate of possible complications.