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Primary Malignant Cardiac Tumor (심장에 발생한 원발성 악성종양)

  • 여승동
    • The Korean Journal of Thoracic and Cardiovascular Surgery
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    • v.25 no.11
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    • pp.1265-1268
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    • 1992
  • Primary tumors of the heart are extremely rare, and about 25 per cent of all primary cardiac tumors are malignant. Recently We experinced three cases of primary malignant tumor; malignant fibrous histiwytoma, carcinosarcoma, and synovial sarcoma, These three cases involved 2 men and 1 woman. There was one operative death, and two operative survivors died of metastatic disease at 12 months postoperatively in spite of chemotherapy and radiotherapy. We report these three cases of primary malignant cardiac tumors with review of the literatures.

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A Computer Aided Diagnosis Algorithm for Classification of Malignant Melanoma based on Deep Learning (딥 러닝 기반의 악성흑색종 분류를 위한 컴퓨터 보조진단 알고리즘)

  • Lim, Sangheon;Lee, Myungsuk
    • Journal of the Korea Society of Digital Industry and Information Management
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    • v.14 no.4
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    • pp.69-77
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    • 2018
  • The malignant melanoma accounts for about 1 to 3% of the total malignant tumor in the West, especially in the US, it is a disease that causes more than 9,000 deaths each year. Generally, skin lesions are difficult to detect the features through photography. In this paper, we propose a computer-aided diagnosis algorithm based on deep learning for classification of malignant melanoma and benign skin tumor in RGB channel skin images. The proposed deep learning model configures the tumor lesion segmentation model and a classification model of malignant melanoma. First, U-Net was used to segment a skin lesion area in the dermoscopic image. We could implement algorithms to classify malignant melanoma and benign tumor using skin lesion image and results of expert's labeling in ResNet. The U-Net model obtained a dice similarity coefficient of 83.45% compared with results of expert's labeling. The classification accuracy of malignant melanoma obtained the 83.06%. As the result, it is expected that the proposed artificial intelligence algorithm will utilize as a computer-aided diagnosis algorithm and help to detect malignant melanoma at an early stage.

Malignant Tumor of the Pelvic Bone (골반골의 악성종양)

  • Shin, Kyoo-Ho;Hahn, Soo-Bong;Kung, Yun-Pei
    • The Journal of the Korean bone and joint tumor society
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    • v.1 no.2
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    • pp.181-188
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    • 1995
  • Malignant tumor of the pelvic bone has nonspecific symptom and it is not easily detected by physical examination or by radiologic study in early stage, because of its anatomical characteristics. Associated with their variety of disease entity, the treatment of malignant pelvic bone tumor is a problematic point. We have analysed 36 cases of malignant pelvic bone tumors diagnosed at the Severance hospital from 1968 to 1993 to provide a reference for diagnosis and treatment of the malignant pelvic bone tumors. We found that the chondrosarcoma(27.8%) and the osteogenic sarcoma(27.8%) were the most common type of pelvic bone malignancy, and then, in the order of incidence, there were Ewing's sarcoma(16.7%), malignant fibrous histiocytoma(11.1%). There were differences of the age distribution among each diseases and the average age was Ewing's sarcoma 20.5, osteogenic sarcoma 27.2, chondrosarcoma 40.0, malignant fibrous histiocytoma 64.8, respectively. Three of the 5 patients with low grade tumors survived(60%), whereas 3 of the 17 patients with high grade tumors survived(18%). The survival rate of the low grade malignant group was 60%, the high grade was 18%.

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Malignant Peripheral Nerve Sheath Tumor of Abdomen (복부에 발생한 악성 말초신경초종양)

  • So, Kyu-Sub;Lim, Yeung-Kook;Hong, Yong-Taek;Kim, Hoon-Nam
    • Archives of Plastic Surgery
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    • v.38 no.6
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    • pp.886-889
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    • 2011
  • Purpose: Malignant peripheral nerve sheath tumor without neurofibromatosis type 1 is very rare neoplasm. Development in the superficial soft tissue is exremely rare. Authors experienced one rare case of primary malignant peripheral nerve sheath tumor developed on abdomen. The clinical and histologic findings were described. Methods: An 83-year-old man visited hospital with an $11{\times}6.5{\times}4.5$ cm sized ulcerated and hemorrhagic mass on abdomen. The tumor was localized in abdominal skin and started growing 3 years ago. Results: Wide excision with safety margin of 2 cm and limberg flap was done. The postoperative biopsy revealed a malignant peripheral nerve sheath tumor. There was no evidence of recurrence of tumor for 16 months. Conclusion: Malignant peripheral nerve sheath tumor is an aggressive malignant tumor. An abrupt enlargement of size, ulceration and bleeding are suggestive of malignant chnages of the tumor. We recommand early wide excision with enough safety margin as treatment of malignant peripheral nerve sheath tumor.

Malignant transformation of oral lichen planus and related genetic factors

  • Hwang, Eurim C.;Choi, Se-Young;Kim, Jeong Hee
    • International Journal of Oral Biology
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    • v.45 no.1
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    • pp.1-7
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    • 2020
  • Oral lichen planus (OLP) is a chronic inflammatory disease observed in approximately 0.5-2.2% of the population, and it is recognized as a premalignant lesion that can progress into oral squamous cell carcinoma (OSCC). The rate of malignant transformation is approximately 1.09-2.3%, and the risk factors for malignant transformation are age, female, erosive type, and tongue site location. Malignant transformation of OLP is likely related to the low frequency of apoptotic phenomena. Therefore, apoptosis-related genetic factors, like p53, BCL-2, and BAX are reviewed. Increased p53 expression and altered expression of BCL-2 and BAX were observed in OLP patients, and the malignant transformation rate in these patients was relatively higher. The involvement of microRNA (miRNA) in the malignant transformation of OLP is also reviewed. Because autophagy is involved in cell survival and death through the regulation of various cellular processes, autophagy-related genetic factors may function as factors for malignant transformation. In OLP, decreased levels of ATG9B mRNA and a higher expression of IGF1 were observed, suggesting a reduction in cell death and autophagic response. Activated IGF1-PI3K/AKT/mTor cascade may play an important role in a signaling pathway related to the malignant transformation of OLP to OSCC. Recent research has shown that miRNAs, such as miR-199 and miR-122, activate the cascade, increasing the prosurvival and proproliferative signals.

Malignant Transformation of Fibrous Dysplasia on Anterior Skull Base

  • Lee, Chul-Jae;Kim, Seong-Min
    • Journal of Korean Neurosurgical Society
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    • v.37 no.5
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    • pp.383-385
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    • 2005
  • Malignant transformation of fibrous dysplasia is a rare condition and the incidence is estimated at 0.4% for fibrous dysplasia and 4% for Albright's syndrome. The authors did not find a reported case of malignant change at skull base around the orbit in the literature. We experienced a case of fibrous dysplasia, in which neurologic symptoms were aggravated due to malignant change around the orbit, and report its favorable outcome obtained with total surgical removal.

Ventricular Septal Defect Associated with Aortic Insufficiency (대동맥판막 폐쇄부전이 동반된 심실중격결손증의 외과적 치료)

  • 두홍서
    • The Korean Journal of Thoracic and Cardiovascular Surgery
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    • v.21 no.6
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    • pp.1111-1116
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    • 1988
  • Neurofibromatosis is very rare syndrome characterized by abnormal cutaneous pigmentation and numerous skin tumors was described by Smith in 1849, which is inherited as an autosomal dominant trait. Von Recklinghausen reported 2 cases of multiple skin and subcutaneous tumors in 1982. Malignant peripheral nerve tumors, although generally rare, are one of the most characteristic malignant tumors associated with Neurofibromatosis. We have experienced 3 cases of malignant Schwannoma in neurofibroma patients from 1982 to 1988 for 6 years at Thoracic and Cardiovascular surgery department, College of Medicine, Yonsei University, Seoul, Korea. l. One is 62 years old female who was taken total hysterectomy followed by irradiation treatment due to Uterine Carcinoma 21 years ago. She had a large bulging mass on left anterior chest wall and was taken enbloc resection of tumor including rib confirmed malignant Schwannoma. 2. Another is 18 years old female who had large bulging mass on right chest wall and pleural effusion in right thoracic cavity. Thoracentesis revealed a large amount of lymphocytes misdiagnosed of Tbc, pleurisy with Neurofibromatosis. We performed tissue biopsy on bulging mass and the specimen was confirmed malignant Schwannoma 2 months after first diagnosis of Tbc. pleurisy. She was not accessible to radical resection because of far advanced malignant Schwannoma at that time. 3. Third case is 28 years old male who was taken enbloc resection of tumor including rib due to Neurofibroma with Neurofibromatosis at M. hospital 6 months ago. But he had rapid growing mass at operation site again and taken tissue biopsy confirmed of malignant Schwannoma. He was not accessible to enbloc resection due to malignant Schwannoma extending to mediastinal structures.

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A Clinical Study of Surgically Managed Thyroid Nodule (외과적으로 처치한 갑상선 결절)

  • Hong Kwan-Uye;Lee Myung-Bok;Moon Chul;Kim Ik-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.10 no.2
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    • pp.91-101
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    • 1994
  • Nodular thyroid disease is a common clinical problem. The problem in clinical practice is to distinguish malignant or potentially malignant tumor from harmless nodules. The cases of thyroid nodule surgically managed at Department of General Surgery, Soon Chun Hyang Univ. Hospital during the period Jan. 1985 to July. 1992 were reviewed retrospectively. To assess method of distinguishing malignant from benign lesions of the thyroid gland, we reviewed 162 patients with thyroid nodule. There were 61(37.7%) malignant nodules and 101(62.3%) benign nodules. According to the review, distinguishing the benign from the malignant nodule with history, physical examination, clinical manifestation, and duration of illness was not suggested sufficiently. In ultrasonogram of 73 cases, 57.5% of nodules were solid, 20.6% were cystic, 21.9% were mixed solid and cystic. Of these, 28.5% of the operated solid lesions, 12.5% of the mixed lesions, and only 6.7% of the cystic lesions were malignant. Thyroid scanning of 82 cases revealed cold nodules in 60 patients(73.2%), of which 26 cases were malignant(36.6%) 137 patients underwent fine needle aspiration cytology(FNAC), and these results were as follow: sensitiviey was 70.6%, specificity was 93.0%, false-positive rate was 14.3%, and false-negative rate was 15.8%. 41 patients underwent frozen biopsy, and the results as follow: sensitivity was 80.0%, specificity was 89.7%. Neither scintigraphy nor ultrasonogram has sufficient specificity to distinguish benign from malignant nodule. But FNAC and frozen biopsy have sufficient accuracy to differentiate benign from malignant nodule. In the benign nodules, the most common type of operation was total lobectomy (60.4%). Of the malignant nodules, total thyroidectomy with or without modified radical neck dissection was performed in 30 cases(49.2%). We conclude that the single technique used to determine the differential diagnosis of a thyroid nodule are unrealiable. It is therefore essential to combine all avaiable clinical and laboratory information.

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Fibroblast Growth Factor 4 (FGF4) Expression in Malignant Skin Cancers (악성 피부 종양에서의 Fibroblast Growth Factor 4 (FGF4) 발현)

  • Cho, Moon-Kyun;Song, Woo-Jin;Kim, Chul-Han
    • Archives of Plastic Surgery
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    • v.38 no.3
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    • pp.217-221
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    • 2011
  • Purpose: FGF4 (fibroblast growth factor 4) is a newly characterized gene which was found to be a transforming gene in several cancerous cells. FGF4 expression and amplification has been subsequently observed in several human cancers including stomach cancer, breast cancer, head and neck squamous cell carcinoma, lung cancer and bladder cancer. This study was designed to measure the protein expression of FGF4 in malignant skin cancers. Methods: We examined 8 normal skin tissues and 24 malignant skin tumor tissues which were 8 malignant melanomas, 8 squamous cell carcinomas and 8 basal cell carcinomas. The specimens were analyzed for the protein expression of FGF4 using immunohistochemical staining. To evaluate the amount of expression of FGF4, the histochemical score (HSCORE) was used. Results: FGF4 was expressed more intensely in malignant melanoma, followed by SCC and BCC in immunohistochemistry. The average HSCORE was 0.01 for normal skin, 2.02 for malignant melanoma, 1.28 for squamous cell carcinoma, and 0.27 for basal cell carcinoma, respectively. The expression of FGF4 in malignant melanoma and squamous cell carcinoma was increased in comparison with normal tissues and basal cell cancer, and the difference was statistically significant (p<0.05). The difference between malignant melanoma and squamous cell carcinoma was not statistically significant. Conclusion: These findings provide evidences that the expression of FGF4 plays an important role in malignant melanoma and squamous cell carcinoma progressions. This article demonstrates expression of FGF4 in human skin malignant tumors, and suggests that FGF4 is more expressed in highly aggressive skin tumors.

MALIGNANT HYPERTHERMIA (악교정 수술 중 발생한 지연성 악성 고열증의 치료)

  • Oh, Sung-Hwan;Min, Seung-Ki;Kwon, Kyung-Hwan;Jo, Pil-Kwy;Song, Yun-Kang
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.27 no.4
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    • pp.381-387
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    • 2005
  • Malignant hyperthermia is a catastrophic, hypermetabolic syndrome that arises in susceptible individuals when they are exposed to certain inhalational anesthetics or muscle relaxants. It is characterized by hyperthermia, tachycardia, acidosis, and muscle rigidity. It has been noted that the majority of cases of malignant hyperthermia are fatal unless early diagnosis and treatment are performed. We experienced a 24 year old male Malignant hyperthermia presented for orthognathic surgery under $O_2-N_2O$-sevoflurane anesthesia without succinylcholine. Two half hours after induction, tachycardia developed and was followed by unstable blood pressure and hyperpyrexia. Anesthesia was terminated and vigorous emergency treatment was attempted. The patient was treated by the intravenous administration of dantrolene sodium. The diagnosis of an acute malignant hyperthermia reaction by clinical criteria can be difficult because of the nonspecific nature and variable incidence of many of the clinical signs and laboratory findings. So the malignant hyperthermia clinical grading scale is recommended for use as an aid to the objective definition of this disease. This clinical grading system provides a new and comprehensive clinical case definition for the malignant hyperthermia syndrome. We recently encountered a case of delayed malignant hyperthermia during sevoflurane anesthesia that was successfully treated by the intravenous administration of dantrolene sodium. In conclusion, exposure to sevoflurane should be avoided in patients thought to be susceprible to malignant hyperthermia.