• Title/Summary/Keyword: Bloc resection

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One Case of Alveolar Rhabdomyosareoma arising from Intercostal Muscle (늑간근에 발생한 폐포성 횡문 근육종 1례 보고)

  • 김선한
    • Journal of Chest Surgery
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    • v.25 no.6
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    • pp.598-604
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    • 1992
  • Rhabdomyosarcoma is the most common soft tissue sarcoma in childhood and acounts for 6% to 15% of all cases of childhood cancer, Rhabdomyosarcoma in seventh most common form of childhood neoplasms, following acute leukemia, tumors of the central nervous system, lymphoma neuroblastoma, Wilm`s tumor, bone tumor. Rhabdomyosarcoma can arise anywhere in the body, but primary site in the thorax is relatively rare. We experienced a case of aveolar rhabdomyosarcoma arising from intercostal muscle, A 12 year-old woman was suffered from the intermittent left chest pain radiating to the scapular area and dyspnea, On physical examination, pulmonary friction rub was heard on the left upper lobe area. Qn adimission, the chest simple radiography revealed a 7 x 6, 5cm sized radio-opaque mass with pleural effusion in the superior mediastinum and the CT showed a well difined radio-opaque mass including the destructed 2nd rib and pleural effusion. The percutaneous tra-nsthoracic needle aspiration biopsy was likely to show blastoma. After the chemotherapy[vincristine, actinomycin-D, cyclophosphamde] was done to treat blastoma, the pleural effussion was subsided and the mass was slightly decreased by 4.5x 4. 5cm. For treatment and diagnosis, we performed en-bloc resection and the defected chest was reconstucted with Gortex patch. Grossly, the specimen was colored graysh-white and arised in between two ribs The microscopic findings showed that the tumor cells were small round with scant pinkish cytoplasm on the H-E stain and the tumor cell nests were grouped by reticulum fibers and showed alveolar pattern on the silver stain The electromicroscopic finding presented that the cytoplasm contained tangled fibrillar and flocculent materials. The histopathologic findings were compatable with laveolar rhabdomyosarcoma. She was discharged without any complication. After discharge, she has been treated with radiation theraphy and chemotheraphy, and not recurred untill last follow-up We report a case of alveolar rhabdomyosarcoma arising to intercostal muscle, developed in 12 year-old waman, with brief review of literatures.

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OSSIFYING FIBROMA OF THE MAXILLARY SINUS : A CASE REPORT (상악동에 발생한 골화성 섬유종 : 증례보고)

  • Moon, Chul-Woong;Kim, Su-Gwan;Kim, Hak-Kyun;Kim, Moon-Soo;Ha, Jeong-Wan;Choi, Dong-Kook;Kim, Young-Jong;Yoon, Jung-Hoon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.27 no.5
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    • pp.478-481
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    • 2005
  • Ossifying fibroma is a rare, benign, fibro-osseous tumor of mesenchymal origin. It develops mainly in the mandible, where it is usually slow growing and asymptomatic, whereas in the maxilla and paranasal sinus, it is more aggressive. The vast majority are located in the posterior region of the mandible; however, ossifying fibroma involving the maxillary sinus is uncommon. It may reach a very large size and cause facial asymmetry. It shows a female predilection, and most cases are seen in the third and fourth decades of life. Radiographically, ossifying fibroma is radiolucent or radiopaque depending on the amount of calcification. Histologically, the tumor consists of a cementum-like or bony mass. Ossifying fibroma shares many histopathologic features with fibrous dysplasia. Their radiographic features may help to separate these entities when pathological differentiation is uncertain. It is important to differentiate ossifying fibroma from fibrous dysplasia. The treatment of ossifying fibroma involves its complete removal using curettage, enucleation, excision, or en bloc resection. This case report presents an unusual case of ossifying fibroma of the maxillary sinus. We describe a Caldwell-Luc operation with a lateral window approach for excision of an ossifying fibroma of the maxillary sinus.

Malignant Fibrous Histocytoma Originating from the Chest Wall (흉부에서 발생한 악성 섬유성 조직구종)

  • Lee, Chul-Burm;Chung, Tae-Yul;Halm, Shee-Young;Kim, Hyuk;Jung, Won-Sang;Kim, Young-Hak;Kang, Jung-Ho;Jee, Heng-Ok;Park, Yong-Wook
    • Journal of Chest Surgery
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    • v.33 no.4
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    • pp.333-337
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    • 2000
  • Malignant fibrous histiocytoma(MFH) is a deep-seated pleomorphic sarcoma, which occurs principally as a mass of the extremities, abdominal cavity, or retroperitoneum in adults. However, it only rarely occurs in the chest wall. An 85-year-old man had undeergone excision of a small mass on the right posterior chest wall under local anesthesia 14 months age. However, the lesion did not heal and the mass recurred. He was referred to our hospital after the mass had grown to a size of 10.5$\times$8$\times$4cm with a 3$\times$3cm skin defect. Intraoperative frozen biopsy revealed MFH. An en-bloc wide resection and thin-thickness skin graft from his thigh were performed. Although distant metastasis to the lund developed 14 months later and the patient died 2 months later, there was no local recurrence. Thin-thickness skin graft is a simple method for a wide range skin defect, especially in the old age. He recovered in good condition without any physical disabilities.

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Aneurysmal Bone Cyst in a Pomeranian (포메라이언견에서 발생한 동맥류성 골낭종 1례)

  • Shin, Beom-Jun;Lee, Jae-Yeon;Kim, Soo-Hyun;Park, Ji-Young;Lee, Young-Won;Cho, Sung-Whan;Kim, Myung-Cheol;Jeong, Seong-Mok
    • Journal of Veterinary Clinics
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    • v.27 no.1
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    • pp.117-120
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    • 2010
  • A 5-years-old 3.7 kg intact female Pomeranian dog was presented with the history of swelling and pain in the distal part of the right forelimb. The swollen lesion was firm as bony material on palpation. On radiographic examination, there was a well-marginated, radiolucent, and expansile bone lesion in the distal metaphysis of the right ulna. Because of very narrow zone of transition, well-defined margins and absence of any periosteal reactivity, benign bone cyst was strongly suspected. The lesion was removed by en bloc resection and packed the space with $Gelfoam^{(R)}$ and aneurysmal bone cyst was finally diagnosed according to histopathological examination. Normal gait was showed on postoperative day 9 and there have been no pain and complication for 1 year since then.

An Unusual Case of Superior Vena Cava Syndrome Caused by the Intravascular Invasion of an Invasive Thymoma

  • Kim, Hyung Joon;Cho, Sun Young;Cho, Woo Hee;Lee, Do Hyun;Lim, Do Hyoung;Seo, Pil Won;Park, Mi-Hyun;Lee, Wonae;Lee, Jai Hyuen;Kim, Doh Hyung
    • Tuberculosis and Respiratory Diseases
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    • v.75 no.5
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    • pp.210-213
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    • 2013
  • Superior vena cava syndrome (SVCS) is usually caused by extrinsic compression or invasion of the superior vena cava (SVC) by malignant tumors involving mediastinal structures. Although thymomas are well-known causes of SVCS, cases of SVCS caused by malignant thymomas protruding into adjacent vessels draining the SVC with thrombosis have been very rarely reported worldwide. We experienced a 39-year-old female patient with SVCS that developed after the direct invasion of the left brachiocephalic vein (LBCV) and SVC by an anterior mediastinal mass with a high maximum standardized uptake value on the chest computed tomography (CT) and positron emission tomography-CT. Based on these results, she underwent en bloc resection of the tumor, including removal of the involved vessels, and was eventually diagnosed as having a type B2 thymoma permeating into the LBCV and SVC. We present this case as a very rare form of SVCS caused by an invasive thymoma.

A Clinical Study of Medial Maxillectomy (내측상악부분절제술의 임상적 고찰)

  • Cho Seung-Ho;Kim Hyung-Tae;Kim Min-Sik;Sun Dong-Il;Park Young-Hak;Jung Min-Kyo
    • Korean Journal of Head & Neck Oncology
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    • v.13 no.1
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    • pp.40-44
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    • 1997
  • Background: Lateral rhinotomy and medial maxillectomy, an en bloc resection of the medial maxillary sinus, ethmoid sinus with the lamina papyracea, medial orbital floor, and lacrimal fossa-duct, have been advocated for lateral nasal wall neoplasms as a standard approach method. Objective: This report was conducted to investigate the clinical efficacy of lateral rhinotomy and medial maxillectomy for lateral nasal wall neoplasms. Materials and Methods: We retrospectively analyzed clinical data of 31 patients who were treated at department of otolaryngology-head and neck surgery, Catholic university of Korea, school of medicine between 1990 and 1996. Results: Twenty five patients had benign lesions(80.6%). By far, the largest percentage was inverted papillomas(80%, 20/25). Of the six malignant lesions(19.4%), 33.3%(2/6) was squamous cell carcinoma and other lesions were metastatic renal cell carcinoma, adecarcinoma, transitional cell cacinoma, and hemangiopericytoma. There were a 4% recurrence for benign tumors(1/25), 5% especially for inverted papilloma(1/20), and 50% for malignant neoplasms(3/6). The overall complication rate was 9.7%. Conclusion: Despite the various approach for treatment of lateral nasal wall neoplasms including inverted papilloma, we continue to advocate a lateral rhinotomy and medial maxillectomy as the treatment of choice.

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A novel subdermal anchoring technique for the effective treatment of congenital melanocytic nevus using de-epithelialized dermal flaps

  • Han, Jin Woo;Sun, Hook;Kim, Jin Woo;Yun, Ji Young;Chung, Eui Han;Oh, Min Jun
    • Archives of Plastic Surgery
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    • v.48 no.1
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    • pp.55-60
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    • 2021
  • Background In patients with congenital melanocytic nevus (CMN), single-stage removal of large lesions can be difficult because the high tension created by excising and repairing a large lesion may result in scar widening. Herein, we introduce a method to effectively excise lesions while minimizing scarring and compare its outcomes to those of existing surgical methods. Methods We compared patients who underwent surgery using the anchoring technique (n=42) or the conventional elliptical technique (n=36). One side of the lesion was removed via en bloc resection up to the superficial fascia. The other side of the lesion was removed via de-epithelialization. The de-epithelialized dermal flap was then fixed by suturing it to the superficial fascia on the opposite side. The length of the lesion's long axis and amount of scar widening were measured immediately after surgery and at 2, 6, and 12 months postoperatively. At 12 months, patients were assessed using the Patient and Observer Scar Assessment Scale. Results The lesion locations included the face, arms, legs, back, and abdomen. The anchoring method resulted in shorter and smaller scars than the conventional method. There were no cases of postoperative hematoma or wound dehiscence. Significant differences in postoperative scar widening were found in the arm and leg areas (P<0.05). Conclusions The anchoring method introduced in this study can provide much better outcomes than the conventional method. The anchoring method is particularly useful for the removal of CMN around the joints or extremities, where the surgical site is subjected to high tension.

Efficacy and Safety of ClearCutTM Knife H-type in Endoscopic Submucosal Dissection for Gastric Neoplasms: A Multicenter, Randomized Trial

  • Eun Jeong Gong;Hyun Lim;Sang Jin Lee;Do Hoon Kim
    • Journal of Gastric Cancer
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    • v.23 no.3
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    • pp.451-461
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    • 2023
  • Purpose: Endoscopic submucosal dissection (ESD) is an effective treatment for early gastrointestinal neoplasms. However, this is a time-consuming procedure requiring various devices. This study aimed to evaluate the efficacy and safety of the ClearCutTM Knife H-type, which is an integrated needle-tipped and insulated-tipped (IT) knife. Materials and Methods: Between July 2020 and September 2021, 99 patients with gastric epithelial neoplasms scheduled for ESD at three tertiary care hospitals were randomly assigned to H-knife (ClearCutTM Knife H-type) or IT-knife (conventional IT knife) groups. Procedure times, therapeutic outcomes, and adverse events were analyzed. Results: A total of 98 patients (50 in the H-knife group and 48 in the IT-knife group) were analyzed. The median total procedure time was 11.9 minutes (range, 4.4-47.2 minutes) in the H-knife group and 12.7 minutes (range, 5.2-137.7 minutes) in the IT-knife group (P=0.209). Unlike the IT-knife group, which required additional devices in all cases, no additional devices were used in the H-knife group (P<0.001). En-bloc resection was performed for all lesions in both groups. The incidence of adverse events was not significantly different between groups (4.0% in the H-knife group vs. 8.3% in the IT-knife group; P=0.431). Conclusions: The newly developed hybrid device, the ClearCutTM Knife H-type, had comparable efficacy to the conventional IT knife for gastric ESD.

Histologic Change of Extracorporeal Irradiated Autogenous Joint Transplantation in Rabbit's Knee (가토에서 체외 방사선 조사후 재이식한 자가관절의 조직학적 변화)

  • Kim, Jae-Do;Cho, Myung-Rae;Yoo, Kyung-Sik;Kim, Young-Chang
    • The Journal of the Korean bone and joint tumor society
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    • v.5 no.1
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    • pp.9-16
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    • 1999
  • A new method of limb sparing by resection, extracorporeal irradiation and reimplantation has several theoretical advantages. This method preserves the mobility of a joint and avoids the problem of loosening or breakage of tumor prosthesis. This study involved using extracorporeal irradiated autogenous joint transplantation for reconstruction after en bloc resection, and observed the periods of functional union and histological changes in irradiated tissue of the knee joint. This study also aimed to clarify whether the degeneration of articular cartilage is induced in rabbits by a single 50Gy dose of irradiation at the knee joint. Twenty New Zealand rabbits about three kilograms were randomized into two groups of 10 rabbits each. In group 1, as control, we resected the knee joint followed by reimplantation without irradiation. Group 2 received extracorporeal irradiation on the resected knee joint followed by reimplantation. Following are the results of these observations. The osteotomy site showed external callus formation in the roentgenographic finding eight weeks after reimplantation. There was marked degenerative changes in the collagen fiber of the irradiated anterior cruciate ligament and meniscus during the fourth week, but new blood-vessel formation was observed in the vicinity. There was degenerative changes in the collagen fiber of articular cartilage treated extracorporeal irradiation at four and eight weeks in the scanning electron micrographic findings. These findings was in contrast to those of subchondral bone which showed decreased cellularity and empty lacuna at four and eight weeks. Autoradiography demonstrated active [$^3H$]uridine incorporation by irradiated chondrocyte at eight weeks after reimplantation. These results indicate that when destruction of the articular cartilage and soft tissue of the knee joint is not severe, extracorporeal irradiation and reimplantation can be used with several advantage in maintaining movement of the joint while avoiding problems of tumor prosthesis and rejection, and therefore extracorporeal irradiated autogenous joint transplantation can be used as a limb-sparing procedure for temporary biological spacer in the childhood bone tumor around the knee.

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Do the Rotating Hinge-Flexible Intramedullary Nail Composites Alleviate Junctional Osteolysis in Megaprothesis Reconstruction for Bone Tumor? (탄력성 있는 골수강 내고정물과 회전경첩형 슬관절 전치환물을 조합한 종양인공관절로 자가골의 골 용해를 감소시킬 수 있는가?)

  • Song, Won-Seok;Cho, Wan-Hyeong;Cho, Sang-Hyun;Jeon, Dae-Geun
    • The Journal of the Korean bone and joint tumor society
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    • v.13 no.2
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    • pp.96-104
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    • 2007
  • Purpose: The authors investigated whether 35 flexible nail-rotating hinge composite reconstructions around knee joint minimize junctional osteolysis of host bone. Material and Method: The reconstructive technique was as follows: 1) en bloc tumor resection, 2) filling of the host bone marrow cavity with multiple Ender nails, 3) assembling the Ender nails and an Endo-Link type total knee component with wire and bone cement. Result: Mean follow-up was 53 months (ranged 30~79). At final follow-up, 29 patients retained a mobile joint. Resection of more than 40% of bone showed a positive relationship with junctional hypertrophy (p=0.028). Eight patients showed nail breakage and eight prostheses were removed due to early or late infection. The cumulative prosthetic survival rate was 33% at 6 year. Average functional score according to the MSTS criteria was 26.8. Conclusion: Mid-term evaluations showed that results were fair. The revision process was straightforward. Junctional hypertrophy observed appears to give some clues as to how to minimize osteolysis at the prosthesis-host junction after modular prosthesis fixation.

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