• The Journal of the Korean bone and joint tumor society
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• v.9 no.1
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• pp.101-104
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• 2003

Folope et al(1999) reported soft tissue giant cell tumor which was similar to malignant giant cell tumor in clinical, pathologic, and immunohistological aspect but represented low malignancy. We reported a 30-year-old female suffered from pain and palpable mass on the anterolateral aspect of the right knee for one year. Excisional biopsy from the lesion revealed some giant cells and polymorphous cells containing eosinophilic cytoplasm and vacuolated nucleus. Histopathologic findings of the lesion were consistent with soft tissue giant cell tumor of low malignant potential. Hereby, we report a case of soft tissue giant cell tumor of low malignant potential with a review of the literature.

• The Journal of the Korean bone and joint tumor society
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• v.9 no.1
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• pp.52-60
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• 2003

Purpose: To analyse their end results and also to differentiate the single or multiple giant cell tumor(GCT) of tendon sheath in hand. Materials & Methods: Total 21 cases with GCT of tendon sheath in hand were treated surgically and analyzed their end results with clinically, radiologically and pathologically to allowed for average 16 months after surgical excision. Results: The finger flexor tendons, especially on index and ring finger, involving distal interphalangeal joint and mid-phalanges in fourth decades (average age of 47 years old) were frequently involved, and the mass was not exceed than 2 cm in size, fixed on tendon sheath with rubbery hard tenderness but rare bony involvements except 4 cases of bony erosion and cortical perforation. The three cases with multiple GCT of hand was also combined with familial hypercholesterolemia, and are commonly involved the extensor tendons as well as achilles tendons bilaterally, treated with partial excision because of multiplicity. Average 16 months after surgical excision for single GCT cases was followed and showed the recurrence in 3 cases(3/18,16.7%), treated with wide excision. The single and multifocal GCT are similar in pathologic changes but different soft tissue tumors in their pathogenesis, treatment and prognosis. Conclusion: Incomplete excision of GCT of tendon sheath in hand are thought to be the cause of recurrence, especially in cases with incomplete lesional excision, in multilobular and bony involvement etc. So careful wide excision is necessary to prevent the recurrence.

• The Journal of the Korean bone and joint tumor society
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• v.8 no.1
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• pp.12-19
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• 2002

Purpose : Giant cell tumors(GCT) sometimes undergo malignant transformation after the radiotherapy, but very rarely do without radiotherapy. We reviewed the clinical experiences of the malignant transformation of GCT to suggest the guidelines for diagnosis and treatment of them. Materials and Methods : We examined four patients of pathologically proven malignant transformation of GCT, which occurred after the operative treatment alone without radiation, from September 1985 to January 2001. The mean follow-up period after the malignant transformation was 2.4 years(range, 1.3~4 years). Results : The mean time-interval from the initial diagnosis to the malignant transformation was 6.9 years(range, 2.2~13.5 years). The locations of tumors were soft tissues of proximal upper arm, proximal femur, distal femur and proximal tibia. The histology of malignant GCT was osteosarcoma in 3 cases and malignant fibrous histiocytoma in 1 case. Local recurrence developed in 1 patient and the pulmonary metastasis developed in 3 patients which transformed to osteosarcoma. Conclusion : Thorough sampling of the surgical specimen appears to be a very important factor for diagnosing the malignant transformation of GCT. In case of suspicion of malignancy in radiographs, the incisional biopsy should be followed by definite treatment rather than the improper resection.

• Investigative Magnetic Resonance Imaging
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• v.13 no.2
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• pp.199-202
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• 2009

Desmoplastic fibroma of bone is an extremely rare tumor that was first described by Jaffe in 1958. It histologically resembles the desmoid tumor of soft tissue. It is known as locally aggressive tumor but we experienced definitely benign and resembling simple bone cyst radiographically. We report a case of desmoplastic fibroma of bone and it should be included in the differential diagnosis list of any lytic bone lesion. The radiograph, MR imaging features, radiological and pathological differential diagnosis of the case are described, and literatures are reviewed.

• The Journal of the Korean bone and joint tumor society
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• v.7 no.1
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• pp.20-27
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• 2001

Purpose : The giant cell tumor of tendon sheath is the second most common tumor of the hand, but recurred frequently although excision was performed. Authors analyzed and would report clinical findings and postoperative results of it. Materials and Methods : Between January 1991 and December 1998, 38 patients, 41 cases which the authors had performed excisional biopsy to the mass in the hand and diagnosed with the giant cell tumor of tendon sheath, was analyzed with age, sex, chief complaint, symptom duration, involved finger, involved tendon, frequently developed site in fingers, size, multiplicity, radiologic findings and recurrence. The mean duration of follow-up was 13.1 months (5~40 months). Results : Of 38 patients, twenty-nine were female. It is frequent in the fourth decade and mean age was 40.1 years old. The neurological compression symptom was found in 5 cases. The mean duration of symptom was 23.4 months. Flexor tendon was involved in 24 cases. The distal interphalangeal joint area in digit was involved most frequently in 20 cases. Index finger was the most common involved finger (14 cases), and long finger was the second most common (9 cases). All tumors were unilateral. The majority of patients had solitary lesion but one case had multiple lesion. In the radiologic findings, erosion or pressure indentation of bone was seen in 3 cases. All patients were operated by marginal excision. Recurrence rate was 5.1%. Conclusion : The risk factors in giant cell tumor of tendon sheath were female, forth decade, index finger, flexor tendon, and distal interphalangeal joint area. The recurrence was increased in marginal excision of recurred cases, in cases with multiple developed lesions or in multilobular lesion, so wide surgical excision is necessary to prevent recurrence.

• The Journal of the Korean bone and joint tumor society
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• v.8 no.2
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• pp.58-62
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• 2002

The incidence of giant cell tumors represents only 5% to 10% of all bone tumors. Occurrence on the small bones of the hand and foot are very rare. They typically present with pain and sometimes a pathologic fracture or even soft tissue extension. The radiographic appearance is highly characteristic. An eccentric osteolytic lesion is seen, producing cortical thinning and expansion, and possessing a delicate trabecular pattern. In tarsal bones, poorly or well-defined osteolytic lesions of variable size are encountered. Surgical treatment remains the preferred therapy. Marginal or wide en bloc resection has had far better results in term of local recurrence. Several authors have suggested extended curettage and cement as an alternative to en bloc resection. Follow-up is necessary to monitor for both local recurrence and the infrequent pulmonary metastases.

• Journal of The Korean Ophthalmological Society
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• v.59 no.11
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• pp.1071-1076
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• 2018

Purpose: To report a case of immunoglobulin G4 (IgG4)-related ophthalmic disease associated with adult xanthogranulomatous disease. Case summary: A 38-year-old male with a history of cholecystectomy visited our clinic for bilateral periorbital swelling. Histopathology of the orbital biopsy showed diffuse infiltration of foamy histiocytes with Touton giant cells and lymphoid follicles, with a diagnosis of adult-onset xanthogranuloma. After excisional biopsy, he was treated with azathioprine and prednisolone. Four years after treatment, he again visited the clinic due to bilateral, yellowish eyelid masses. Serological examinations were all nonspecific findings, except for elevation of IgG and IgG4 levels. Magnetic resonance imaging showed bilateral symmetric soft tissue enlargement with slightly heterogeneous T1/T2 isosignal intensity, with contrast enhancement at the superolateral aspect of extraconal spaces. Excisional biopsy and blepharoplasty were performed. Immunohistochemical sections showed that the IgG4+/IgG plasma cell ratio was 10-20% and the IgG4 plasma cell count was 22/high power field (HPF). His past sections of 2013 from the pathology department were again stained and showed that the IgG4+/IgG plasma cell ratio was 40-50% and the IgG4 plasma cell count was 59/HPF. Thus, he was definitely diagnosed with IgG4-related ophthalmic disease. Conclusions: If there is recurrent eyelid swelling, IgG4-related ophthalmic disease should be considered as a differential diagnosis. And the patient with adult xanthogranulomatous disease can be diagnosed with IgG4-related ophthalmic disease.

• 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.