• Title/Summary/Keyword: 악성 및 침윤성 종양

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Platysma Infiltration on CT or MRI in Parotid Pathology (이하선 병변에서 활경근 침윤의 빈도와 조건)

  • Hie Bum Suh;Hak Jin Kim
    • Journal of the Korean Society of Radiology
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    • v.82 no.1
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    • pp.152-161
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    • 2021
  • Purpose To evaluate the incidence and condition of platysma infiltration in benign tumors, malignant tumors, and inflammatory disease in the parotid gland using CT or MRI. Materials and Methods Patients with benign tumors (n = 314), malignant tumors (n = 52), and inflammatory disease (n = 22) in the parotid gland were included. The incidence of platysma infiltration and the relationship between platysma infiltration and the location, capsular involvement, and focality of the mass were retrospectively evaluated using CT or MRI. Results The incidence of platysma infiltration was 0% in benign tumors,19.2% in malignant tumors (10/52), and 50.0% in inflammation (11/22). Platysma infiltration was positive in 10 of 13 patients with inflammatory lesion with capsular involvement. Platysmal infiltrations in inflammatory lesion showed diffuse lesion in 10 patients and focal lesion in one patient. Malignant tumor with platysmal infiltration showed all capsular involvement, and diffuse lesion in seven and focal lesion in three. Conclusion Platysma infiltration was more common in patients with inflammatory disease than those with malignant tumors or benign tumors. In inflammatory disease, platysma infiltration was more common in patients with capsular involvement or diffuse lesion.

Malignant Proliferating Trichilemmal Tumor - A Case Report - (악성 증식성 모낭 종양 - 증례 보고 -)

  • Hong, Ki-Do;Kim, Jae-Young;Ha, Sung-Sik;Sim, Jae-Chun;Cho, Hye-Jae;Choi, Yoon-Ho
    • The Journal of the Korean bone and joint tumor society
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    • v.15 no.1
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    • pp.65-68
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    • 2009
  • Proliferating trichilemmal tumor(PTT) is a rare neoplasm derived from the outer root sheath of the hair follicle. Malignant transformation is rare, but abrupt enlargement of size, infiltrative growth, and non-scalp location are suggestive of malignant PTT. Histopathologic characteristics of malignant PTT are nuclear atypia, pleomorphism, and mitotic figures. Recurrence and metastasis have been documented in malignant PTT. Wide resection of the tumor with the normal tissue and accurate follow-up is the treatment of choice of the both malignant and benign PTT. We report a 51-year-old man with the mass on right 5th finger distal phalanx for 7 years. The tumor was excised with middle phalangiectomy, and based on the histopathologic findings of the tumor, this case was diagnosed as mailignant PTT. We cannot detect recurrence and metastasis because the patient was lost to follow-up.

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Analysis of Relativity Between Invasiveness on Chest of Tomographic Finding and Histopathologic Invasiveness (종격동 종양의 전산화 단층촬영(CT)소견, 수술소견 및 병리조직학적 침윤도 사이의 상관성 분석)

  • 김용희;이현우
    • Journal of Chest Surgery
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    • v.30 no.8
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    • pp.780-785
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    • 1997
  • Mediastinal tumor had been fascinated by its location on heart, great vessels, esophagus, and nervous tissue, its convenience of surgical treatment and superiority of its operative result. Between January 1989 and June 1995, eighty-seven patients with mediastinal tumor which were treated surgically in the Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, School of Medicine, University of Ulsan. To provide the appropriate surgical management of mediastinal tumor, the demographic data, diagnostic evaluation, clinical presentation, location, size, operative finding and histopathologic distribution were reviewed and we analyzed relativity between invasiveness in chest computed tomographic finding or invasiveness on operative finding and histopathologic invasiveness. The anterosuperior mediastinum was the most commonly involved site of a mediastinal tumor(57%), followed by the posterior mediastinum(35%) and middle mediastinum(8%). The most frequently encountered tumors were thymic neoplasia(31%), followed by primary cyst(22%), neurogenic tumor(22%) and teratoma(10%) in decreasing order of frequency. Histopathologically invasive tumors were present in 17 patients(20%) and its site included anterosuperior mediastinum(16%) and posterior mediastinum(4%). All patients in this study underwent chest CT. In chest CT's finding, 15 patients(17%) showed invasiveness. A total excision of the tumor was performed 80 patients(92%), subtotal excision 6 patients(7%) and biopsy only 1 patient(2%). In operative finding, 14 patients(16%) were suspected invasiveness. The mean size of the tumor was 6.0$\pm$ 3.2cm. In anterosuperior mediastinum, the mean size was 6.2$\pm$3.1cm, in middle mediastinum, it was 3.9$\pm$1.1cm, in posterior mediastinum, it was 5.8$\pm$2.6cm. In malignant tumors, the mean size was 7.3$\pm$4.6cm, in benign tumor, it was 5.5$\pm$2.6cm(P<0.05). Relativity between histopathological invasiveness(17 patients) and invasiveness in chest CT's finding(15 patients) included sensitivity 35%, specificity 87% and predictability 35%, relativity between histopathological invasiveness(17 patients) and invasiveness on operative finding included sensitivity 52%, specificity 93% and predictability 64%. In conclusion, since it was proved that the compatibility of preoperative chest CT findings or operative findings and histopathological invasiveness is quite low, it is considered that wide excision of the mediastinal tumor except cystic lesion including adjacent tissues would yield better postoperative results.

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Segmental Resection and Replantation for Primary Malignant or Aggressive Tumors of the Upper Limb (상지에 발생한 악성 및 침윤성 종양의 분절절제 및 재접합술)

  • Hahn, Soo-Bong;Lee, Woo-Suk;Shin, Kyoo-Ho
    • The Journal of the Korean bone and joint tumor society
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    • v.6 no.1
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    • pp.10-16
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    • 2000
  • Object : The aim of the current study is to assess the results of segmental resection and replantation for primary malignant or aggressive tumors of the upper limb. Materials and Methods : From 1986 to 1994, ten patients who had primary malignant or aggressive tumors of the upper limb were managed with segmental resection and replantation method. The average duration of follow-up was 7 years and 7 months. Primary indication of this method is stage II B tumors which, because of their extend, could otherwise be adequately treated only by amputation. Three patients had chondrosarcoma, two had osteosarcoma, two had giant cell tumors with pathologic fracture, one had extensive chondroblastoma, one had Ewings sarcoma, and one had leiomyosarcoma. The location of the tumor was humerus in 6 patients, scapula in 3 patients, and soft tissue of forearm in 1 patient. Wide resection margins were achieved in 7 patients and marginal margin in three. Results : One patient died on 40 months after surgery due to systemic metastasis. Nine patients have remained disease free without local recurrence or metastasis. The average overall functional rating was 65% (43~90%) for ten patients on the last follow-up by the functional rating system of Enneking. The mean grasping power and pinching power of operative hand was 75%(28~95%) and 65%(43~90%) of the opposite hand, respectively. Complications associated with this surgical method included three wound dehiscences and one nerve injury that resolved with proper wound care and time. Conclusion : It was concluded that segmental resection and replantation might be used for partial limb salvage in selected cases for the treatment of primary malignant or aggressive tumors of the upper limb.

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A Case of Sclerosing Mucoepidermoid Thyroid Carcinoma with Eosinophilia (SMECE) (Sclerosing Mucoepidermoid Thyroid Carcinoma with Eosinophilia (SMECE) 1예)

  • Chung Woung-Yoon;Yang Woo-Ik;Park Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.17 no.1
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    • pp.48-51
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    • 2001
  • Sclerosing rnucoepidermoid carcinoma with eosinophilia(SMECE)는 1991년 Chan 등이 처음 보고한 이후로 현재까지 전세계적으로 단 17예 만이 보고된 매우 희귀한 갑상선 암종이다. 조직학적으로는 종양 내에 일부 점액성 세포와 증식된 상피성 세포들을 관찰할 수 있고, 조직내 호산구성 세포들이 자주 관찰된다. 대부분의 기질은 밀집된 섬유성 조직으로 구성되어 있으며, 하시모토 갑상선염이 동반되어 있는 것이 특장적이다. 종양의 악성도는 최초 보고인 Chan 등에 의하면 국소 재발 및 원격전이를 거의 하지 않는 예후가 좋은 암종으로 보고되었는데, 이후 여러 문헌에서 국소 침윤, 국소 재발, 원격 전이 및 사망이 발생하여 예후가 매우 불량했던 증례들을 보고한 바 있어 악성도에 대한 시각은 달라지고 있다. 본 저자들은 최근 병리적 진단이 매우 어려웠고, 국소침윤과 림프절 전이 소견을 보였으며, 수술 후 빠른 시일 내에 급속히 재발하였던 악성도가 매우 높은 sclerosing mucoepidermoid thyroid carcinoma with eosinophilia (SMECE) 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

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Segmental Resection and Rotationplasty of Malignant and Aggressive Bone Tumors Around Knee (슬관절 주위 악성 및 침윤성 골종양의 분절 절제술 후 회전 성형술)

  • Hahn, Soo-Bong;Park, Hong-Jun;Kim, Hyoung-Sik;Kim, Sung-Hun;Shin, Kyoo-Ho
    • The Journal of the Korean bone and joint tumor society
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    • v.7 no.2
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    • pp.51-58
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    • 2001
  • Purpose : In patients having malignant and aggressive bone tumors around knee joint requiring amputation, segmental resection and rotationplasty were performed and the clinical results were analyzed. Materials and Methods : Twenty-six patients underwent segmental resection and rotationplasty between February 1988 and June 1994, because limb salvage with tumor prosthesis after removal of tumor was impossible. The mean follow-up of malignant tumors was 57(6~120) months and the average age of patients was 21.4(5~37) years old. Out of 26 patients, there were 18 osteosarcoma(${\geq}$stage IIB), 2 synovial sarcoma, and 6 giant cell tumor. Results : Clinical results were evaluated by the Shriner's rating system. Four patients were excluded due to death or amputation and remaining 22 patients were included for assessment. Eighteen patients had excellent result, 3 good, and 1 fair. Range of motion of ankle joint was -11(dorsiflexion)~80(plantarflexion) degrees and daily walking activity with prosthesis was possible. Local recurrence developed in 2 patients and distant metastasis in 10. Early complications had 3 thrombosis and 1 sepsis, and late complications had 6 nonunion, 2 malrotation and 1 stiffness of ankle joint. Conclusion : Rotationplasty which is functionally excellent may serve as an effective partial limb salvage procedure, especially in patients less than 10 years old that lower extremity discrepancy or loosening tumor prosthesis due to enlargement of medullary cavity are anticipated or amputation is inevitable for wide resection margin.

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Study on DNA Content and Ki-67 Antibody Expression by Means of Image Analyzer for the Benign and Malignant Lesions of the Larynx (후두 편평상피의 전암성 및 악성병변에서 화상분석기를 이용한 DNA 배수성검사와 Ki-67 항체 양성세포의 분석에 관한 연구)

  • 주형로;이선희;최종욱;김인선
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1993.05a
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    • pp.89-89
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    • 1993
  • The laryngeal epithelial cell kinetics of 26 laryngeal lesions(invasive squamous cell carcinoma 14, epithelial hyperplasia 5, laryngeal nodule 7) were studied by immunehistochemical analysis with the monoclonal antibody Ki-67, which reacts with nuclear antigen in proliferating cells using paraffin embedded tissue. For DNA analysis, touch implint with fresh biopsy specimens were stained with feulgen and analyzed by image analyzer in 22 cases. 1) The proportion of Ki-67-positive cells were 32.65$\pm$ 11.59% in invasive squamous cell ca, 20.14$\pm$3.38% in epithelial hyperplasia lesion and 11.66$\pm$3.02% in laryngeal nodule. 2) DNA aneuploidy was found in 7 cases of 10(70%) invasive squamous cell carcinomas, 2 cases of 5(40%) epithelial hyperplasia lesions and all cases of laryngeal 3) Proliferation index(S phase+G2/M phase) show 23.42$\pm$11.33% in squamous cell carcinoma, 13.09$\pm$ 10.90% in epithelial hyperplasia lesion and 4.50$\pm$1.19% in laryngeal nodule. As the results, measuring the DNA content from touch imprint method together positivity of Ki-67 antibody from the microtissue during the laryngeal microscopic surgery, cell kinetics can be assessed as an effort of deciding the prognosis and provide a key to the management of precancerous lesions.

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Limb Salvage in the Treatment of the Upper Extremity Bone Tumors (상지에 발생한 악성 및 침윤성 양성골종양에 대한 사지 구제술)

  • Hahn, Soo-Bong;Shin, Kyoo-Ho;Kim, Bum-Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.1 no.2
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    • pp.154-163
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    • 1995
  • With the development of anticancer chemotherapy and improved radiographic imaging studies, limb salvage operation became possible in the treatment of malignant and aggressive benign tumors. High grade sarcomas of the shoulder or the upper extremity can be surgically treated with a forequarter amputation, shoulder disarticulation or limb salvage surgery such as Tikhoff-Linberg procedure, segmental resection and replacement with endoprosthesis, segmental resection and replantation, or segmental resection and free vascularized bone graft. Among them the limb salvage surgery showed not only preservation of the remained upper extremity but also the excellent functional results. When comparing amputation and limb salvage operation while performing anticancer chemotherapy in both cases, 5 year survival rate, local recurrence, and distant metastasis did not show much difference. We studied 13 cases of limb salvage for the malignant and aggressive benign bone tumor of the upper extremity from March 1986 to December 1993 at Severance hospital. The summarized results were as follows. 1. There were 21 cases of malignant bone tumors and 5 cases of benign aggressive ones. 2. Of the 26 cases of malignant and benign aggressive bone tumors, limb salvage procedures such as Tikhoff-Linberg operation(8 cases), endoprosthetic replacement(2 cases), segmental resection and replantation(2 cases), and segmental resection and free vascularized fibular graft(l case) were done in 13 cases. 3. In 13 patient on whom the limb salvage procedure was performed, there were 3 osteosarcomas, 4 chondrosarcomas, 3 giant cell tumors, 1 Ewing's sarcoma, 1 leiomyosarcoma and 1 chondroblastoma. 4. In 13 patients, there was no local recurrence nor distant metastasis except one who had a segmental resection of the entire humerus part including glenoid and then postoperative anticancer chemotherapy for the treatment of the Ewing's sarcoma of the entire shaft of the humerus with pathological fracture. Local recurrence occurred 2 years and 6 months postoperatively in this Ewing's sarcoma patient, so forequarter amputation was performed and the irradiation and the anticancer chemontherapy were performed, but multiple bony metastasis developed and died of the disease 22 months after local recurrence. 5. The patients were followed-up for I year to 7 years and 5 months(average 4 years 5 months). 6. In 8 cases in which Tikhoff-Linberg procedure was performed, the function of the hand was almost normal. 7. Segmental resection and endoprosthetic replacement was performed in 2 cases, and the function of the remained upper extremity was good with no evidence of aseptic loosening or nerve palsy. 8. In 1 case of segmental resection and free vascularized fibular graft for the patient of the chon drosarcoma in the humerus, the function of the shoulder, elbow and hand was nearly normal. 9. In I case of leiomyosarcoma which involved both forearm muscles and bone near wrist joint, segmental resection and replantation was performed, and the patient has useful hand function.

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Malignant Solitary Fibrous Tumor of the Pleura A case report (흉막에 발생한 악성 고립성 섬유성 종양 1예 보고)

  • 박승일;양경무
    • Journal of Chest Surgery
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    • v.29 no.12
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    • pp.1385-1391
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    • 1996
  • Solitary fibrous tumor of the pleura has been classified as a type of mesothelioma. This tumor have been recently described and distinguished from the mesothelioma, immunohistochemically and elect r om ic ro scop ical 1 y Thls 65 years female was admitted with right chest pain, coughing and dysnea. Chest X-ray and C-T scan showed a huge mass in the right thorax. Right thoracotomy was done and a 12$\times$12$\times$6cm(400gm) sized mass was excised, and the tumor had metastasized to the diaphragm, parietal pleura and lung parenchyma. Microscopically, the tumor Is composed of oval-round and plump spindle cells with diffuse pattern. There are occasional mitoses (311 OHPFS) and invasion to lung parenchyma. The immunohistochemical and electromicroscopical findings are consistent with malignant solitary fibrous tumor of the pleura. We experienced a case of pleural malignant solitary fibrous tumor and report this case with the review of literature.

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