• Title/Summary/Keyword: Chest wall pain

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Extraskeletal Ewing Sarcoma of the Chest Wall Manifesting as a Palpable Breast Mass: Ultrasonography, CT, and MRI Findings (만져지는 유방 종괴로 발현된 가슴벽 골외 유잉씨 육종의 초음파, 전산화단층촬영 및 자기공명영상 소견)

  • Mingook Kim;Seung Eun Lee;Joon Hyuk Choi
    • Journal of the Korean Society of Radiology
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    • v.82 no.1
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    • pp.212-218
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    • 2021
  • Ewing sarcomas constitute a group of small, round, blue cell tumors of the bone and soft tissue. Extraskeletal Ewing sarcoma (EES) is a rare malignant neoplasm that arises from soft tissues, and it usually affects children and young adults. EES of the thoracopulmonary region commonly presents with a palpable mass or pain. Although rarely reported, EES affecting the anterior chest wall may present as a breast mass. We report a case of EES arising from the chest wall and manifesting as a palpable breast mass in a 22-year-old woman. The large mass was initially misdiagnosed as a breast origin mass on ultrasonography, but subsequent CT and MRI showed that the mass originated from the chest wall. Radiologists should be aware of the imaging findings of EES, and they should understand that chest wall lesions may be clinically confused as breast lesions.

Synovial Sarcoma of the Anterior Chest Wall: A Case Report (앞가슴벽에 생긴 윤활막육종: 증례 보고)

  • Mingook Kim;Seung Eun Lee;Joon Hyuk Choi
    • Journal of the Korean Society of Radiology
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    • v.81 no.5
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    • pp.1227-1233
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    • 2020
  • Synovial sarcoma is a malignant soft tissue tumor that usually involves the extremities, particularly near the knees; a synovial sarcoma originating in the chest wall is extremely rare. We describe a 26-year-old woman diagnosed with a synovial sarcoma originating in the chest wall, based on CT and MRI findings. Contrast-enhanced CT images revealed a small, well-defined enhancing mass with calcification, in the subpleural area. This lesion was initially diagnosed as a benign tumor; however, the patient developed sudden severe pain with spontaneous bleeding and hemothorax, suggesting the possibility of malignancy. MRI revealed a multilobulated mass with a fluid-fluid level, which characterizes a synovial sarcoma.

Two-ports Technique of VATS in the Primary Spontaneous Pnemothorax (일차성 자연기흉에서 2개의 삽입구를 이용한 흉강경 폐기포절제술)

  • Kim, Keun
    • Journal of Chest Surgery
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    • v.34 no.8
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    • pp.651-652
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    • 2001
  • Usually, Bullectomy with VATS requires three ports on a chest wall for thoracosope, endo lung grasper, and endo auto-suture. However, in some case, the author could successfully accomplish operation using the endo-loop through two ports on a chest wall. The technique reduces postoperative pain and decreases operative wound.

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Nineth Rib Syndrome after 10th Rib Resection

  • Yu, Hyun Jeong;Jeong, Yu Sub;Lee, Dong Hoon;Yim, Kyoung Hoon
    • The Korean Journal of Pain
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    • v.29 no.3
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    • pp.185-188
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    • 2016
  • The $12^{th}$ rib syndrome is a disease that causes pain between the upper abdomen and the lower chest. It is assumed that the impinging on the nerves between the ribs causes pain in the lower chest, upper abdomen, and flank. A 74-year-old female patient visited a pain clinic complaining of pain in her back, and left chest wall at a 7 on the 0-10 Numeric Rating scale (NRS). She had a lateral fixation at T12-L2, 6 years earlier. After the operation, she had multiple osteoporotic compression fractures. When the spine was bent, the patient complained about a sharp pain in the left mid-axillary line and radiating pain toward the abdomen. On physical examination, the $10^{th}$ rib was not felt, and an image of the rib-cage confirmed that the left $10^{th}$ rib was severed. When applying pressure from the legs to the $9^{th}$ rib of the patient, pain was reproduced. Therefore, the patient was diagnosed with $9^{th}$ rib syndrome, and ultrasound-guided $9^{th}$ and $10^{th}$ intercostal nerve blocks were performed around the tips of the severed $10^{th}$ rib. In addition, local anesthetics with triamcinolone were administered into the muscles beneath the $9^{th}$ rib at the point of the greatest tenderness. The patient's pain was reduced to NRS 2 point. In this case, it is suspected that the patient had a partial resection of the left $10^{th}$ rib in the past, and subsequent compression fractures at T8 and T9 led to the deformation of the rib cage, causing the tip of the remaining $10^{th}$ rib to impinge on the $9^{th}$ intercostal nerves, causing pain.

Cryoanalgesia vs Bupivacain Intercostal Nerve Block for the Post -thoracotomy Pain (개흉술 후 흉부동통억제를 위한 늑간신경냉동 요법과 약물주입요법에 관한 비교연구)

  • 최영호
    • Journal of Chest Surgery
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    • v.27 no.11
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    • pp.942-947
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    • 1994
  • Post-thoracotomy pain is so severe that lead to postoperative pulmonary complications due to the patient`s inability to cough, deep breathing and chest wall motion. Many authors have been trying to reduce the post-thoracotomy pain, but there is no method of complete satisfaction. In 1990, we reported the result that the cryoanalgesia reduce the immediate postoperative pain significantly. We try to compare the effect of cyroanalgesia with the effect of Bupivacain intercostal nerve block for the post-thoracotomy pain control. Ninety patients, who undergoing thoracotomy in Korea University Medical Center Guro Hospital between the January 1993 and September 1993, were evaluated. The patients were divided into three groups : Group A, control, the patients without pain control procedure [N=30], Group B, the patients with Bupivacain intercostal nerve block [N=30], Group C, the patients with cryoanalgesia [N=30]. Postoperative analgesic effects were evaluated by the scoring system which made arbiturary by author. The results were that the Bupivacain intercostal nerve block markedly reduced the immediate postoperative pain compare with two other groups, the cryoanalgesia reduced the immediate postoperative pain significantly compare with control group, the pain reduction effect of the two groups- cryoanalgesia and Bupivacain intercostal nerve block- were not different at postoperative seventh day, probably due to the action time of Bupivacain and the result that there were no significant complications of the procedures.

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A Case Study of a Patient with Breast Cancer Treated with a Combination of Traditional Korean Medicine and Chemotherapy (유방암에 대한 한양방 병용 치료 증례 보고 1례)

  • Han, Ga-jin;Lee, A-ram;Jung, Jun-suk;Seong, Sin;Kim, Sung-su
    • The Journal of Internal Korean Medicine
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    • v.38 no.5
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    • pp.820-827
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    • 2017
  • The prevalence of breast cancer is very high in Korea. Although the patients receive standard treatments, such as surgery, chemotherapy, or radiotherapy, they frequently experience recurrence or metastasis of their tumors. In addition, many patients with breast cancer also suffer from side effect symptoms induced by these standard treatments. Therefore, increasing numbers of patients now want to undergo treatment with traditional Korean medicine (TKM) in addition to conventional treatment. We present a case of 46-year-old female with recurred breast cancer. She first received two kinds of chemotherapy and then underwent surgery. She then also received 4 cycles of adjuvant chemotherapy. At a follow-up examination, she was informed of recurrent lesions on the right anterior chest wall. She started to receive TKM treatments together with a new chemotherapy. After about one month, the size of the recurred tumor in right chest wall had decreased. Her symptoms, such as shoulder pain, chest pain, and nausea induced by conventional therapy, were also improved. We suggest that a combination of TKM and chemotherapy is a promising treatment for breast cancer.

Traumatic Funnel Chest due to Blunt Trauma -A Case Report- (둔상에 의한 외상형 누두흉 -1례 보고-)

  • 조규석
    • Journal of Chest Surgery
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    • v.28 no.2
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    • pp.218-220
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    • 1995
  • This 51 years old male patient was admitted to the department of thoracic and cardiovascular surgery via OPD because of anterior chest pain. 7days before admission, He got the chest trauma after traffic accidents,the lateral chest roentgenogram showed complete transverse sternal fracture. He also complained of mild dyspnea. We also noticed that he had depressed anterior chest wall. It looks like funnel chest. The operative findings revealed dislocated & callus formations at the both 4th and 5th costochondral junction and transverse fracture of sternal body between 4th and 5th costochondral junction, the upper end of sternal fracture was situated below the lower end of sternal fracture. The two ends of sternal fracture were situated at the same level and reapproximated the two ends by two-interrupted wire sutures. The patient is well on the road to recovery after the operation.

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Hibernoma of Lower Chest Wall, Left -One Case Report (좌측 흉벽에 발생한 동면선종 -1례보고-)

  • 전용선;전찬규
    • Journal of Chest Surgery
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    • v.30 no.4
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    • pp.467-470
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    • 1997
  • Hibernoma is a rare, benign soft tissue tumor that is derived from the remnants of fetal brown tissue. The term hibernoma was proposed in 1914 by Cery because of its morphologic similarity to the cel s of the so-called hibernating gland of animals. The most common site of hibernomas is the subcutaneous tissue of the back, especially the interscapular area. These tumors are considered benign and malignant transformation has not been reported. We experienced a case of hibernoma, 60-year-old woman had suffered from the palpable mass without pain or tenderness on posterolateral lower chest wall, left. The tumor was extirpated under the impression of angiolipoma, but was confirmed hibernoma. She was discharged without complication.

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Infective Costochondritis after Augmentation Mammoplasty: A Rare Case Report and Review of the Literature

  • Sally Min;Jinil Choi;Kwon Joong Na;Ki Yong Hong
    • Archives of Plastic Surgery
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    • v.50 no.5
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    • pp.488-491
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    • 2023
  • Silicone breast implant insertion is a commonly performed surgical procedure for breast augmentation or reconstruction. Among various postoperative complications, infection is one of the main causes of patient readmission and may ultimately require explantation. We report a case of infective costochondritis after augmentation mammoplasty, which has rarely been reported and is therefore difficult to diagnose. A 36-year-old female visited the clinic for persistent redness, pain, and purulent discharge around the left anteromedial chest, even after breast implant explantation. Magnetic resonance imaging showed abscess formation encircling the left fourth rib and intracartilaginous and bone marrow signal alteration at the left body of the sternum and left fourth rib. En bloc resection of partial rib and adjacent sternum were done and biopsy results confirmed infective costochondritis. Ten months postoperatively, the patient underwent chest wall reconstruction with an artificial bone graft and acellular dermal matrix. As shown in this case, early and aggressive surgical debridement of the infected costal cartilage and sternum should be performed for infective costochondritis. Furthermore, delayed chest wall reconstruction could significantly contribute to the quality of life.

T-cell Non-Hodgkin`s Lymphoma originating in the wall of Chronic Tuberculous Empyema - One Case Report - (결핵성 만성 농흉벽에 원발한 T 세포형 악성 임피종;1례 보고)

  • 송우철
    • Journal of Chest Surgery
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    • v.25 no.10
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    • pp.1102-1106
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    • 1992
  • A 66-year-old male patient was admitted due to chest pain and dyspnea of 1 year duration, He had history of treatment for tuberculosis and pleurisy, about 40 years ago. At another hospital the patient underwnt closed thoracostomy drainage for six months, and thereafter the symptom gradually aggrevated. Under the diagnosis of chronic tuberculous empyema, decortication was performed. The peel attached to the posterolateral aspect of chest wall, there was an area of soft tissues with pale-brown discoloration, extending to intercostal muscles, but sparing overlying muscles. The biopsy specimen of the lesion was pathologically diagnosed as diffuse, large T-cell non-Hodgkin`s lymphoma. A review of the literature showed that malignant lymphoma of this type have been reported exclusively from Japan but never from other countries including Korea. After 1 year of followup period, the patient is well and stable.

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