• Title/Summary/Keyword: 척추종양

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Aneurysmal Bone Cyst of the Rib Misdiagnosed as Soft Tissue Tumor - A Case Report - (연부조직종괴로 오인된 늑골의 동맥류성 골낭종 - 증례 보고 -)

  • Lee, Ah-Won;Lee, Youn-Soo;Jo, Gun-Huyn;Lee, Jung-Dal;Kim, Byung-Kee
    • The Journal of the Korean bone and joint tumor society
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    • v.6 no.4
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    • pp.163-167
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    • 2000
  • Aneurysmal bone cyst(ABC) is a benign lesion and generally occurs in the long bones and vertebral column. ABC of the rib is an uncommon entity. We reported a case of ABC originating in the left first rib. The patient was a 19-year-old woman and presented with palpable mass on the shoulder. Chest X ray and MRI showed a large expansile mass, with multiple cystic areas, arising from the left first rib and bulging out into retroclavicular and paravertebral soft tissue, so the lesion was initially misdiagnosed as a soft tissue malignant tumor destructing adjacent rib. On histological examination, the mass, which was surrounded by a peripheral band of mature trabecular bone, consisted of multiple anastomosing cavernous blood channels separated by fibrous septa that containing osteoid, myxochondroid material and osteoclast-type giant cells.

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A New Technique for Whole Craniospinal Irradiation (WCSI) (새로운 전중추신경 방사선 조사법 ; 방사선속의 발산에 의한 선량의 불균일성을 극복하기 위한 치료 방법)

  • Chang, Hye-Sook
    • Radiation Oncology Journal
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    • v.9 no.1
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    • pp.159-164
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    • 1991
  • To irradiate the entire neuroaxis, bilateral parallel opposed brain fields and direct posterior spinal field have been utilized and radiation dose at the junction between abutting fields has been extensilvely studied. And several workable methods were reported to achieve uniform dose at a desired depth at the juction between abutting fields whose central axis are coplanar. But the dose distribhution at the juction of orthogonal fields has been a persistent problem in radiation oncology. Author describes a new method to solve the junction problem between abutting fields whose central axis are orthogonal. Author utilized split beam/comllimator rotation or collimator/couch rotation to avoid hot or cold spots that may arise from beam divergence. Author achieved accurate and homogeneous dose distribution by mathching the $50\%$ isodose line at the junction between orthogonal central axis beam fields.

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The Clinical Outcomes of Kyphoplasty for the Treatment of Malignant Vertebral Compression Fractures (전이성 척추 종양으로 인한 압박 골절 환자의 척추 후굴 풍선 복원술의 임상 효과)

  • Kim, Da Mi;Seo, Kyung Su;Park, Eun Jung;Han, Kyung Ream;Kim, Chan
    • The Korean Journal of Pain
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    • v.21 no.3
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    • pp.197-201
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    • 2008
  • Background: Kyphoplasty is a minimally invasive procedure that can stabilize osteoporotic and neoplastic vertebral fractures. We retrospectively evaluated the clinical outcomes of kyphoplasty for the treatment of vertebral compression fractures in cancer patients. Methods: We reviewed the clinical data of 27 cancer patients who were treated with kyphoplasty (55 vertebral bodies) between May 2003 and Feb 2008. The clinical parameters, using a visual analog 10 point scale (VAS) and the mobility scores, as well as consumption of analgesic, were evaluated preoperatively and at 1 week after kyphoplasty. Results: A total 55 cases of thoracic and lumbar kyphoplasties were performed without complications. The mean age of the patients was 66 years. All the patients experienced a significant improvement in their subjective pain and mobility immediately after the procedures. The pain scores (VAS), mobility scores and other functional evaluations using the Oswestry disability score and the SF-36 showed significant differences between the pre- and postoperational conditions. Conclusions: Kyphoplasty is an effective, minimally invasive procedure that can relieve the pain of patients with vertebral compression fractures and these fractures are the result of metastasis.

Brown-Sequard Syndrome Produced by Cervical Disc Herniation : Manual and Exercise Therapy after Operation-Case Studies (경추 추간판탈출증에 의한 브라운-시쿼드 증후군 : 수술 후 도수치료와 운동치료 효과-사례연구)

  • Kim, Myung-Joon
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.15 no.1
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    • pp.79-85
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    • 2009
  • 목적 : 브라운시쿼드는 대부분 척추손상과 수질외 척추 종양에서 주로 나타난다. 드물게 경추 디스크가 브라운시쿼드의 원인이 된다. 경추디스크에 의한 브라운시쿼드 증세의 수술후 물리치료 및 도수치료 결과를 보고하기 위함이다. 방법 : 50세 남자로써 브라운시쿼드 증세로 진단을 받고 수술후 좌측 팔과 다리에 운동신경에 의한 마비증세가 있었으며(팔>다리), 우측으로 감각과 온도감각이 저하된 경우이다(팔>다리). 측정방법은 통증지수(VAS), 근력(Distal PowerTracII$^{TM}$ test), 지구력(Ergometer) 측정과 심리상태(설문)를 치료전과 후를 비교하였다. 물리치료에서는 기능적 전기자극 치료와 도수치료 및 운동치료 방법을 실시하였다. 도수치료는 통증완화와 근력강화를 위한 MET, MFR, Mobilization 등을 실시하였으며, 운동은 슬링시스템 등을 이용한 운동과 견관절의 불안정을 위해 안정화운동을 실시하였다. 결과 : 이 케이스는 수술후 이상 징후가 척수압박으로 인하여 보다 넓게 통증이 나타났으며, 운동 및 감각신경이 둔해지고 온도에 대한 감각이 반대편 결손으로 나타났으며, 좌측 어깨, 팔 견갑부의 근육 마비와 우측의 감각이 떨어진 현상이 나타났다. 물리치료 후 단기목표와 장기목표에 있어서 통증과 운동 및 감각 기능이 회복되어 각각 팔 통증에서는 VAS 8 ${\rightarrow}$ 1, 상지 하지의 운동기능은 Trace ${\rightarrow}$ Good 로 평가 회복되었으며, 근력측정에서 모두 유의한 차이를 보였다. 모든 치료과정 결과에서 심리적 상태의 설문에서도 높은 점수를 얻어 긍정적 신뢰가 높아 진 것으로 나타났다. 검사결과 다리의 근력이 증가는 걷기 운동 및 에르고메터의 지구력 및 균형이 레벨1의 10분 수행능력이 레벨 20에서 30분 수행능력으로 향상되어 일상적인 활동이 가능해졌다. 결론 : 예상하지 못했던 수술 후유증(side effects)에 대한 치료과정이 환자의 심리에 심각한 부정적인 생각이 신체의 기능과 감정의 손상에 영향을 미치기 때문에 체계적이고 장기적인 치료 과정에서 기능적 향상과 더불어 정신적인 심리의 정서 안정이 매우 필요하다고 사료된다.

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Spinal Intraosseous Hibernoma: A Case Report and Review of Literature (척추에서 발생한 골 내 동면종: 증례 보고와 문헌 고찰)

  • Mi-Kyung Um;Eugene Lee;Joon Woo Lee;Kyu Sang Lee;Yusuhn Kang;Joong Mo Ahn;Heung Sik Kang
    • Journal of the Korean Society of Radiology
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    • v.81 no.4
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    • pp.965-971
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    • 2020
  • Hibernoma is a rare benign tumor that arises from vestiges of brown fat. Spinal intraosseous hibernoma has only recently been described in the literature, and only 12 cases have been reported to date due to its extreme rarity. Here, we report the case of a patient who was incidentally diagnosed with an intraosseous hibernoma in the thoracic spine, following a diverse imaging work-up and pathologic confirmation. We correlate the clinical presentation and imaging features of our case with those of previously reported cases during our review of the literature.

Radiotherapy of Pineal and Ectopic Pineal Tumors (송과선종 및 이소성 송과선종의 방사선 치료)

  • Cho, Heung-Lae;Sohn, Seung-Chang
    • Radiation Oncology Journal
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    • v.9 no.2
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    • pp.177-184
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    • 1991
  • From December 1984 to February 1990, 16 patients with tumors of pineal and suprasellar location were treated with radiation therapy. Tissue diagnoses were obtained before radiation therapy in 5 patients and 11 were irradiated without histologic confirmation. Initial treatments for these patients were craniospinal plus boost primary irradiation(six), whole brain plus boost primary irradiation(nine), primary tumor site irradiation(one). The 5 year actuarial survival rate is $71\%$. Three cases with elevated beta-human chorionic gonadotropin(HCG) responded favorably to radiation, but pineal tumors with elevated alpha-fetoprotein(AFP) did not respond well. Spinal metastasis developed in 2 cases(2/15) with elevated AFP : one received prophylactic spinal irradiation, another did not. Our studies suggest that more aggressive treatment would be necessary in patient with elevated AFP and in this patient, radiation therapy may be initiated without pathologic confirmation. From the result of our study, routine use of prophylactic spinal irrdiation for all patients with pineal region tumor is not indicated and use of prophylactic spinal irradiation is considered for the patients with positive craniospinal fluid cytology, meningeal seeding, disease extension along the ventricular wall and biopsy proven germinoma.

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Diagnosis and Treatment of Brown Tumor (Brown 종양의 진단 및 치료)

  • Cho, Yong Jin;Cho, Yung Min;Na, Seung Min;Jung, Sung-Taek
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.1
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    • pp.54-61
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    • 2020
  • Purpose: Brown tumor is a tumor-like disease that can occur as a linked disease of hyperparathyroidism which can causes osteoporosis, osteitis fibrosa cystica, pathologic fractures. Brown tumor has been reported as a case report, but there is no comprehensive report on the exact diagnosis and principle of management for osseous lesion. The purpose of this study is to report the treatment and results of osseous lesions through 5 cases. Materials and Methods: From February 2004 to May 2015, five cases of Brown tumor were diagnosed in Chosun University Hospital and Chonnam National University Hospital orthopedic department. Medical records and radiographs were reviewed retrospectively. Parathyroid tumors were surgically removed, and surgical treatment and observation were performed for orthopedic osseous lesions. Results: The mean length of the long axis of the symptomatic osseous lesion was 6.2 cm (4.5-9.0 cm). An average of 7.6 (range, 3 to 14) of high uptake osseous lesion showed in whole body bone scan. The absolute value, T-score and Z-score of the vertebrae and proximal femur were adequate for diagnosis of osteoporosis using dual energy X-ray absorptiometry bone mineral density at diagnosis and recovered to normal at the last follow-up. In laboratory tests, serum concentrations of total calcium, ionized calcium, inorganic phosphorus, serum alkaline phosphatase, and parathyroid hormone were helpful to diagnosis and normalized upon successful removal of parathyroid adenoma or cancer. Conclusion: For accurate diagnosis of Brown tumor, it should be accompanied by systemic examination as well as clinical symptoms, laboratory tests and radiologic examination for osseous lesions. And a good prognosis can be expected if the hyperparathyroidism is treated together with the comprehensive treatment of osseous lesions.

Extraskeletal Ewing's Sarcoma Arising in the Chest Wall (흉벽에 발생한 골외 Ewing's Sarcoma)

  • Kim, Hyung-Woo;Sohn, Hong-Ju;Joo, Mee;Kang, Yun-Kyung;Jeon, Woo-Ki;Lee, Hyuk-Pyo;Kim, Joo-In;Choi, Soo-Jeon;Yum, Ho-Kee
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.5
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    • pp.1158-1165
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    • 1997
  • Extraskeletal Ewing's sarcoma is a very rare tumor which was first reported by Angervall and Enzinger in 1975. The common sites of extraskeletal Ewing's sarcoma are bony structures of lower extremities, paravertebral region, and pelvis, but rarely chest wall. Microscopically, extraskeletal Ewing's sarcoma is indistinguishable from the Ewing's sarcoma of bone. We present here a case of extraskeletal Ewing's sarcoma of the left lateral chest wall in a 19-year-old male. Wide extirpation and postoperative combined chemotherapy were done, and we discuss the clinical picture, histopathology, therapeutic management, and prognosis with review of the literature.

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Surgical Treatment of the Giant Cell Tumors in the Spine (척추에 발생한 거대세포종의 수술적 치료)

  • Kang, Yong-Koo;Lee, In-Ju;Chang, Han;Kwon, Soon-Yong;Rhyu, Kee-Won;Yi, Sang-Hoon
    • The Journal of the Korean bone and joint tumor society
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    • v.4 no.1
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    • pp.37-43
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    • 1998
  • Between 1992 and 1996, 5 patients with the giant-cell tumor of the spine were treated. Four were female and one was male. The mean age was 34 years old, and the mean follow-up time was 36 months. The locations of the lesions were the cervical spine in 1, the thoracic spine in 3, and the lumbar spine in 1. Pain was the predominant presenting symptom in all cases and four had a neurological deficit. A combined anterior and posterior surgical approach wds as performed in all cases, which were also treated with AIF(anterior interbody fusion) and anterior and/or posterior instrumentation. Adjuvant radiation therapy was performed in 1 case of cervical spine. At the final follow-up, the pain and neurologic symptoms were improved. Radiologic examination showed no evidence of local recurrence and no failure of instrumentation of the spine.

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Sporadic Intradural Extramedullary Hemangioblastoma Not Associated with von Hippel-Lindau Syndrome: A Case Report and Literature Review (폰 히펠린다우 증후군과 관련 없는 특발성 경막 내 수외 혈관모세포종: 증례 보고와 문헌 고찰)

  • Mi-Kyung Um;Eugene Lee;Joon Woo Lee;Kyu Sang Lee;Yusuhn Kang;Joong Mo Ahn;Heung Sik Kang
    • Journal of the Korean Society of Radiology
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    • v.82 no.3
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    • pp.700-707
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    • 2021
  • Hemangioblastomas are low-grade, highly vascular tumors that are usually associated with von Hippel-Lindau syndrome. Hemangioblastomas most commonly occur in the cerebellum, and intradural extramedullary hemangioblastoma of the cauda equina is very rare, especially in patients without von Hippel-Lindau syndrome. Herein, we report a case of intradural extramedullary hemangioblastoma of the cauda equina that was not associated with von Hippel-Lindau syndrome, with a focus on its imaging characteristics and differential diagnoses. We compared the clinical presentation and imaging features of our case with those of previously reported cases in the review of the literature.