• Title/Summary/Keyword: 악성 골 종양

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Quantitative Analysis of Thallium-201 Scintigraphy in Bone Tumor (골종양에서 탈륨 스캔의 정량적 분석)

  • Shin, Duk-Seop;Cho, Ihn-Ho
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.1
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    • pp.45-51
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    • 2003
  • Purpose: This study was designed to know the ability of thallium-201 scintigraphy to discriminate malignant bone tumor from benign by analysing the quantitative thallium uptake ratio. Materials and Methods: We took thallium-201 scintigraphy prospectively with other imaging studies in 82 bone tumor suspecting patients. The results of scintigraphy were read qualitatively and calculated quantitatively, and retention indexes were estimated. For the statistical analysis the patients were divided as four group; high grade malignant bone tumor, benign bone tumor, giant cell tumor and low grade malignant bone tumor. Results: The mean thallium uptake ratio was 4.14 in early phase and 2.26 in delayed phase in high grade malignant bone tumor group, 1.16 and 1.09 in benign bone tumor, 3.15 and 1.94 in giant cell tumor, and 1.41 and 1.31 in low grade malignant bone tumor. Retention indexes were 0.62, 0.97, 0.66, 0.93 in same order. The thallium uptake ratio and retention indexes were statistically correlated in high grade malignant bone tumor and benign bone tumor group(p<0.001). Conclusion: Thallium-201 scintigraphy proved as useful imaging study to discriminate malignant bone tumor from benign, but had exception in giant cell tumor and low grade malignant bone tumors.

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임상가를 위한 특집 3 - 구강악안면영역에서 악성종양의 영상진단 : 상악골의 파괴를 동반한 악성종양의 영상진단

  • Heo, Gyeong-Hoe
    • The Journal of the Korean dental association
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    • v.47 no.10
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    • pp.647-655
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    • 2009
  • 지면의 한계 상 다양한 악성종양을 모두 다룰 수가 없어, 주로 상악에 발생하여 골 파괴를 야기하고 있는 증례들의 영상 소견을 소개하고자 한다. 악성종양의 진단 과정에는 보통 CT, MRI, PET/CT 등의 특수 장치들이 필요하지만, 개원의들이 일반 환자들의 진단과 치료 과정에서 흔히 접하게 되는 파노라마 방사선사진을 중심으로 하여, 악성종양들의 병인이나 기본적인 악성종양에 대한 설명 보다는 실제 임상 증례들을 통해 악성종양의 공통된 영상 소견 특징을 찾아보고자 한다.

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Tumors of the Foot (족부의 종양)

  • Shin, Duk-Seop;Park, Sung-Hyuk;Ahn, Jong-Chul
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.1
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    • pp.69-76
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    • 2003
  • Purpose: This study was designed to provide the data base for the diagnosis and treatment of the foot tumor by investigation of the clinical and pathological characteristics and distribution of the foot tumor. Materials and Methods: 142 foot tumors of 141 patients were studied. All patients were diagnosed with surgical biopsy. We investigated clinical and pathological characteristics and epidemiologic distribution of the foot tumor by reviewing the medical records and imaging materials. The location of the tumors were classified with zone of Kirby et al. Results: 75 patients were female and 66 were male. The average age of the patients was 33.2 years old. Benign soft tissue tumors were the most as 68 cases, and followed by 57 benign bone tumors, 12 malignant soft tissue tumors and 5 malignant bone tumors. Ganglia were the most in benign soft tissue tumors as 36 cases, subungual exostoses in benign bone tumors as 18, squamous cell carcinomas in malignant soft tissue tumors as 7, and metastatic lung cancers in malignant bone tumors as 2. The rate of pain complaints was the highest in malignant bone tumors, the duration of symptom was longest in benign soft tissue tumors, and the size of the tumor was the biggest in malignant bone tumors. Neurological symptoms were found in only 3 benign soft tissue tumors. For the zonal distribution, zone 5 was the most in 59 cases and zone 4 was the least as 10. The most numbers of the benign bone tumors located in zone 5, of benign soft tissue tumors in zone 1, of malignant bone tumors in zone 1 and 2, and of malignant soft tissue tumors in zone 5. The methods of surgical treatment included intralesional or marginal resection, curettage with or without bone graft, toe amputation, below knee amputation and limb salvage. Conclusion: The tumors of the foot were rare and various, and mostly benign (88%), but we can do proper treatment of those tumors without excluding malignant tumors by considering the age of patients, pain, duration of symptom, size of the tumors, and zonal distribution.

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Diagnosis of Primary Malignant Lesion Using $^{18}F$ FDG PET/CT in Metastatic Bone Tumor (전이성 골종양에서 $^{18}F$ FDG PET/CT를 이용한 원발성 악성 질환의 진단)

  • Yoon, Hoi-Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.14 no.1
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    • pp.44-50
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    • 2008
  • Purpose: To evaluate usefulness in diagnosing primary malignant lesion of metastatic bone tumor using $^{18}F$ FDG PET/CT. Material & Methods: Retrospective analysis was executed on 5,452 patients who were taken with $^{18}F$ FDG PET/CT between December 2003 and December 2007. 180 patients who had not any history of malignancy and complained musculoskeletal pain and had ill-defined osteolytic lesion in plain X-ray, were included. 96 male and 84 female were enrolled and mean age was 59.1 year old (22~90). We analyzed diagnostic accuracy, age and sex distribution of primary malignant lesion, location of metastatic lesion. Results: We could confirmed primary malignant lesion in 152 cases (84.4%). Most common malignant primary lesion was lung (28.3%), breast (18.9%) and gastrointestinal system (16.7%) and spine was the most common metastatic location of primary malignant lesion. Conclusion: $^{18}F$ FDG PET/CT is a effective molecular imaging detecting primary malignant lesion in patients having metastatic bone lesion without history of malignancy.

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Tumors of the Foot and Ankle (족부 및 족관절에 발생한 종양)

  • Shin, Kyoo-Ho;Park, Hong-Jun;Kim, Jong-Min;Hahn, Soo-Bong;Kang, Eung-Shick
    • The Journal of the Korean bone and joint tumor society
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    • v.6 no.2
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    • pp.69-76
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    • 2000
  • Purpose : Tumors of the foot and ankle are uncommon compared with those arising in the other sites, and the malignant tumors are rare. We analyzed the data of patients who have been diagnosed as having a tumor of the foot and ankle. Materials and Methods : Between 1989 and 1998, we treated 72 patients and analyzed on their clinical characteristics retrospectively. Results : Fifty-three cases were benign. Included are 30 cases of soft tissue tumor and 23 cases of bone tumor. Malignant tumor was in 19 cases (26%), including 17 cases of soft tissue tumor, one cases of metastatic tumor. The most common benign tumor was fibroma in soft tissue and osteochondroma in bone. Malignant melanoma was the most common malignant tumor of the foot (7 cases). The predilection site for benign tumors was around toes while for the malignant tumor mostly arises in the heel. Among 19 malignant tumors, local recurrence developed in 3 cases and the distant metastasis occurred in 8 cases. Conclusion : The ratio of malignant tumor and metastasis was high. Therefore, when we faced with a tumor of the foot and ankle, the histopathologic confirmation is essential through biopsy before the definite initial treatment.

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Rapidly Destructive Coxarthrosis Mimicking a Malignant Bone Tumor - A Case Report - (악성 골 종양으로 오인된 급속 파괴형 고관절증 - 증례 보고 -)

  • Lee, Hyung-Seok;Kim, Jung-Ryul
    • The Journal of the Korean bone and joint tumor society
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    • v.14 no.2
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    • pp.203-207
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    • 2008
  • Rapid destructive hip osteoarthritis is a rare subset of osteoarthritis with rapid destruction of the hip joint within months of the onset of symptoms. The entity simulates rheumatoid arthritis, septic arthritis, neuropathy or malignant bone tumor. We report a case of rapidly destructive coxarthrosis of the right hip joint initially misdiagnosed as a malignant bone tumor at outside hospital in a 80-year-old woman.

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Malignant Fibrous Histiocytoma of the Maxilla - Report of A Case - (상악골의 악성 섬유성 조직구종 - 증례보고 -)

  • Oh, Yoon-Kyeong;Yeo, Hwan-Ho
    • Radiation Oncology Journal
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    • v.13 no.3
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    • pp.225-231
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    • 1995
  • Malignant fibrous histiocytoma(MFH) of the maxilla is a rare malignant bone tumor Seven percents of all MFH occur in the head and neck. Approximately $12{\%}$ of these tumors occur in the maxilla. Local recurrence or distant metastasis was reported in $55{\%}$ of cases of maxillary MFH. The mean survival time of 30 months was reported from a review of 14 MFHs in the maxilla, mandible and oral soft tissues. MFH of the maxilla is best treated surgically but radical neck dissection does not appear to be indicated unless there is clinical evidence of lymph node metastases Although the use of radiation therapy for head and neck MFH has not been studied for a series of cases, individual cases of regression or histological change have been reported. Other authors have reported numbers of cases who received radiation therapy without benefit. Response to combination chemotherapy has been reported in $33{\%}$ of 23 patients with recurrent or metastatic MFH. We report here a case of MFH occurring in the maxilla with a review of literature about the clinical behavior and treatment of these lesions.

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Limb Salvage Surgery with Tumor Prosthesis for the Malignant Bone Tumors Involving the Proximal Femur (대퇴골 근위부 악성 골종양 환자에서 종양 대치물을 이용한 사지 구제술)

  • Chun, Young Soo;Baek, Jong Hun;Lee, Seung Hyuk;Lee, Chung Hwan;Han, Chung Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.20 no.1
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    • pp.7-13
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    • 2014
  • Purpose: As well as patient survival, the restoration of postoperative function such as ambulation is important in limb salvage operations for treatment of malignant bone tumors involving the proximal femur. The authors analyzed clinical outcomes of limb salvage operations using tumor prostheses for metastatic or primary malignant bone tumors in the proximal femur. Materials and Methods: From February 2005 to January 2014, 20 cases (19 patients) with malignant bone tumor involving the proximal femur with pain or complicated pathologic fracture were treated with segmental resection and limb salvage operations with tumor prostheses. Mean age was 63.1 years (range 35-86). Fourteen patients were male and six ones were female. The mean follow-up period was 20 months (1-94 months). There were 15 cases of metastatic bone tumor, 4 cases of osteosarcoma, and 1 case of multiple myeloma. The primary tumors of the metastatic bone tumors included 4 lung cancers, 3 hepatocellular carcinomas, and 3 renal cell carcinomas. Other primary tumors were breast cancer, thyroid cancer, colon cancer, prostate cancer, and malignant spindle cell tumor, each in 1 case. Modular tumor prostheses were used in all cases; (Kotz's$^{(R)}$ Modular Tumor prosthesis (Howmedica, Rutherford, New Jersey) in 3 cases, MUTARS$^{(R)}$ proximal femur system (Implantcast, Munster, Germany) in 17 cases). Perioperative pain was assessed with Visual Analogue Scales (VAS). Postoperative functional outcome was assessed with Musculoskeletal Tumor Society (MSTS) grading system. Results: Out of 20 cases (19 patients), 11 cases (10 patients) survived at the last follow-up. Average postoperative survival of the 9 deceased patients was 10.1 months (1-38 months). VAS score improved from pre-operative average of 8.40 (5-10) to 1.35 (0-3) after operation. Average postoperative MSTS function score was 19.65 (65.50%, 7-28). The associated complications were 2 local recurrences, 3 hematomas, 3 infections, 2 scrotal swellings, and 1 dislocation. There was no case of periprosthetic fracture or loosening. Conclusion: Limb salvage operation with tumor prosthesis is an appropriate treatment for early pain reduction and functional restoration in malignant bone tumors in the proximal femur with pain an/or complicated pathologic fractures.

Absent or Faint Renal Uptake in Bone Scan: Etiology and Significance in Metastatic Bone Disease (골 신티그라피에서 신장 영상 비출현의 원인 질환 및 전이성 골질환에서의 의의)

  • Kim, Sang-Eun;Kim, Deog-Yoon;Lee, Dong-Soo;Chung, June-Key;Lee, Myung-Chul;Koh, Chang-Soon;Koong, Sung-Soo
    • The Korean Journal of Nuclear Medicine
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    • v.24 no.2
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    • pp.299-306
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    • 1990
  • 골 신티그라피에서 신장이 희미하게 보이거나 전혀 안보이게 되는(이하 신장 영상 비출현이라 함) 원인 질환을 파악하고, 또 골 신티그라피에서 골전이가 발견된 여러 악성종양에서 신장 영상 비출현의 빈도 및 신장 영상 비출현의 소견을 보이는 여러 악성종양의 골전이 범위를 관찰하기 위하여, 서울대학교 병원에서 최근 6년간 시행한 골 신티그람 중 신장 영상 비출현의 소견을 보이는 889개를 재검토하였다. 신장영상 비출현의 원인 질환으로는 신부전이 대부분을 차지하였으나(816/889 : 91.8%), 신장 질환이 없는 경우에서는 광범위한 골전이가 가장 많았으며 (53/889 : 6.0%), 그 원발부위는 전립선암 (19/53 : 35.8%), 위암(14/53 : 26.4%), 유방암(5/53 : 9.4%), 폐암(4/53 : 7.5%) 신세포암(2/53 : 3.8%), 방광암(1/53 : 1.9%), 원발부위 미상(8/53 : 15.1%)으로 전립선암과 위암이 가장 많았다. 특히 강직성 척추염 4예, 류마토이드 관절염 3예, 성인형의 골화석증 1예에서 신장 영상 비출현의 소견을 보여 이채로왔으며, 이 밖에 원발성 부갑상선 기능항진증 및 그레이브스병이 각 1예씩 있었으며 원인을 알 수 없는 경우가 10예 있었다. 전립선암 140예중 골 신티그라피에서 골전이가 발견된 예는 108예(77.1%), 이중 신장 영상 비출현의 소견을 보이는 예는 19예(19/108, 17 6%)이었으며, 위암에서는 각각 328예, 162예(49.4%), 14예 (8.6%), 유방암에서는 각각 1754예, 730예 (41.6%), 5예(0.7%), 폐암에서는 각각 1105예, 596예(53.9%), 4예(0.7%), 방광암에서는 각각 247예, 110예(44.5%), 1예(0.9%)로 전립선암에서 신장 영상 비출현의 빈도가 가장 높았으며, 특히 위암에서 골전이 및 신장 영상 비출현의 빈도가 높아 주목되었다. 골전이 및 신장 영상 비출현의 소견을 보이는 악성종양 환자의 골 신티그람 53개중 44개 (83.0%)에서 척추 및 늑골에 미만성, 또는 다발성 침습이 관찰되었다. 또 골전이 부위를 두개골, 척추, 견대부, 늑골, 골반, 사지의 근위부 장골의 6개 부위로 나누어 분석할 경우 49개(92.5%)에서 3부위 이상에 전이가 발견되었고, 35개(66.0%)에서 4부위 이상에 전이가 발견되었으며, 5부위 이상, 6개 부위에 모두 전이가 발견된 것은 각각 20개 (37 7%), 11개(20.8%)이었다. 이상의 성적으로 보아 악성종양 환자의 골 신피그라피에서 신장 영상의 비출현은 종양의 광범위한 골전이를 간접적으로 시사하는 소견으로 생각된다. 여러 악성종양중 전립선암에서 신장 영상 비출현의 빈도가 가장 높았으며, 특히 위암에서 골전이 및 신장 영상 비출현의 빈도가 높음은 주목할 만한 것이라 하겠다.

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Post Traumatic Osteolysis of the Pubic Bone Simulating Malignancy or Osteomyelitis - A Case Report - (악성 골종양이나 골수염으로 오인된 치골부위의 외상 후 골 용해 - 증례 보고 -)

  • Song, Kyeong-Seop;Kim, Hyung-Gyu;Park, Byeong-Mun;Kim, Jong-Min;Jung, Sung-Hoon;Yang, Bong-Seok
    • The Journal of the Korean bone and joint tumor society
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    • v.13 no.2
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    • pp.180-184
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    • 2007
  • The etiology of post-traumatic, and presumably post-fracture, osteolysis of the pubic bone is unknown, although the pathological process is similar to bony destruction related to bone tumor or osteomyelitis. We have seen and wish to report one patient in whom destruction of the pubic bone was a prominent feature of the healing process following trauma.

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