Chun, Young Soo;Baek, Jong Hun;Lee, Seung Hyuk;Lee, Chung Hwan;Han, Chung Soo
The Journal of the Korean bone and joint tumor society
/
v.20
no.1
/
pp.7-13
/
2014
Purpose: As well as patient survival, the restoration of postoperative function such as ambulation is important in limb salvage operations for treatment of malignant bone tumors involving the proximal femur. The authors analyzed clinical outcomes of limb salvage operations using tumor prostheses for metastatic or primary malignant bone tumors in the proximal femur. Materials and Methods: From February 2005 to January 2014, 20 cases (19 patients) with malignant bone tumor involving the proximal femur with pain or complicated pathologic fracture were treated with segmental resection and limb salvage operations with tumor prostheses. Mean age was 63.1 years (range 35-86). Fourteen patients were male and six ones were female. The mean follow-up period was 20 months (1-94 months). There were 15 cases of metastatic bone tumor, 4 cases of osteosarcoma, and 1 case of multiple myeloma. The primary tumors of the metastatic bone tumors included 4 lung cancers, 3 hepatocellular carcinomas, and 3 renal cell carcinomas. Other primary tumors were breast cancer, thyroid cancer, colon cancer, prostate cancer, and malignant spindle cell tumor, each in 1 case. Modular tumor prostheses were used in all cases; (Kotz's$^{(R)}$ Modular Tumor prosthesis (Howmedica, Rutherford, New Jersey) in 3 cases, MUTARS$^{(R)}$ proximal femur system (Implantcast, Munster, Germany) in 17 cases). Perioperative pain was assessed with Visual Analogue Scales (VAS). Postoperative functional outcome was assessed with Musculoskeletal Tumor Society (MSTS) grading system. Results: Out of 20 cases (19 patients), 11 cases (10 patients) survived at the last follow-up. Average postoperative survival of the 9 deceased patients was 10.1 months (1-38 months). VAS score improved from pre-operative average of 8.40 (5-10) to 1.35 (0-3) after operation. Average postoperative MSTS function score was 19.65 (65.50%, 7-28). The associated complications were 2 local recurrences, 3 hematomas, 3 infections, 2 scrotal swellings, and 1 dislocation. There was no case of periprosthetic fracture or loosening. Conclusion: Limb salvage operation with tumor prosthesis is an appropriate treatment for early pain reduction and functional restoration in malignant bone tumors in the proximal femur with pain an/or complicated pathologic fractures.
Kim, Soochan;Kwon, Kyunghun;Choi, Hojung;Lee, Youngwon
Journal of Embryo Transfer
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v.32
no.3
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pp.183-192
/
2017
The mammary gland tumor (MGT) is the most common neoplasia in intact female dogs. Of these, 50% are malignant and metastasis to the other sites are often occurred. Therefore, it is very important for decision of treatment plan and prognosis to differentiate benign tumor from malignancies. Calcification of MGT is a very important imaging finding. The purpose of this study was to investigate the radiological and computed tomographic images of the MGT and the morphology and distribution of calcifications in the MGT using the Breast Imaging Reporting and Data System classification. A total of 42 dogs with MGT were included in this study. The dogs were divided into two groups into benign and malignant groups based upon histologic or cytologic results. The appearance of calcification in the tumor on radiographs and CT images was analyzed for the HU value of pre- and post-contrast injection, margin, surface, and shape of the tumor and the lymph node abnormalities. On radiographs, the positive predictive value of malignant and benign tumors was 72.72 and 85.71%, respectively. On CT examinations, the positive predictive value of malignant and benign tumors was the same value of 83.33%. The maximum diameter of the tumor and the presence of abnormal lymph nodes on CT images showed a strong correlation with malignancies. Therefore, it is thought that radiographs and CT provide useful information for evaluating MGT in dogs.
Gastric cancer that mimics a submucosal tumor is rare. This rarity and the normal mucosa covering the protuberant tumor make it difficult to diagnosis with endoscopy. We report two cases of advanced gastric cancer that mimicked malignant gastrointestinal stromal tumors preoperatively. In both cases, the possibility of cancer was not completely ruled out. In the first case, a large tumor was suspected to be cancerous during surgery. Therefore, total gastrectomy with lymph node dissection was performed. In the second case, the first gross endoscopic finding was of a Borrmann type II advanced gastric cancer-like protruding mass with two ulcerous lesions invading the anterior wall of the body. Therefore, subtotal gastrectomy with lymph node dissection was performed. Consequently, delayed treatment of cancer was avoided in both cases. If differential diagnosis between malignant gastrointestinal stromal tumor and cancer is uncertain, a surgical approach should be carefully considered due to the possible risk of adenocarcinoma.
Malignant Sertoli cell tumor was diagnosed in a 5-year-old male Shih Tzu dog. Clinical features of the dog were anorexia, urinary incontinence, constipation, anemia, alopecia, and epistaxis. The dog also had unilateral cryptorchid testis in the abdomen. Several abdominal and thoracic masses were identified on radiography. Grossly, the cryptorchid testicular mass was markedly enlarged to 8 cm in diameter. On cut surface, firm and well demarcated milk-white neoplastic areas were irregularly separated by white fibrous bands. Histologically, the testicular mass was diagnosed as tubular pattern Sertoli cell tumor. In addition, abdominal and mediastinal lymph nodes metastasis were found. Immunohistochemically, the tumor cells were strongly positive for vimentin and neuron specific enolase, but negative for S-100 and cytokeratin.
Kang Gyeong-Beom;Oh Sung-Soo;Park Sung-Gil;Seel David J.;Park Yoon-Kyu
Korean Journal of Head & Neck Oncology
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v.13
no.2
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pp.221-227
/
1997
The authors reviewed 106 cases of parotid gland tumor at Presbyterian Medical Center seen during the past 10 years between January, 1986 and December, 1995. The results were obtained as follows; 1) 86 cases(81.1%) were benign tumors and 20 cases(18.9%) were malignant tumors. 2) Overall male and female sex ratio was 1 : 1.4. 3) For benign tumors, the mean age was 47.9 and for malignant tumors, the mean age was 43.4. 4) Clinical manifestations in benign tumors were palpable mass in 86 cases(100%), pain in 6 cases(6.9%), facial nerve palsy in 2 cases(2.3%), lymphadenopathy in 1 case(1.2%); and in malignant tumors, palpable mass in 20 cases(100%), pain in 7 cases(35%), facial nerve palsy in 2 cases(10%) and lymphadenopathy in 3 cases(15%). Thus, the presence of pain, facial nerve palsy and lymphadenopathy suggest malignant tumors. 5) Operative procedures in benign tumors included superficial parotidectomy in 53 cases(61.6%), total parotidectomy in 10 cases(11.6%), local excision in 23 cases(26.7%); and in malignant tumors, superficial parotidectomy in 3 cases, total parotidectomy in 1 case, local excision in 1 case, superficial parotidectomy with supraomohyoid neck dissection in 6 cases, total parotidectomy with supraomohyoid neck dissection in 8 cases, total parotidectomy with radical neck dissection in 1 case. 6) Postoperative complications in benign tumors were transient facial nerve palsy in 14 cases, Frey's syndrome in 2 cases. In malignant tumors complications included transient facial nerve palsy in 3 cases and permanent facial nerve palsy in 1 case. 7) Pleomorphic adenoma was the most common benign parotid tumor and mucoepidermoid carcinoma was the most common malignant tumor. 8) In our review of 20 patients with malignant parotid tumors, all patients who received supraomohyoid neck dissection and postoperative radiation therapy remain alive from 1986 to 1995 years. Two deaths in this series were adenoid cystic carcinoma patients who failed to receive postoperative radiation therapy. These series of cases have been studied in order to determine whether supraomohyoid neck dissection and postoperative radiation therapy may have further therapeutic effect.
For the purpose of evaluation of clinical characteristics and histopathological properties in mediastinal tumor, and to provide the guidelines of surgical management of mediastinal tumor,238 patients with mediastinal tumors treated during the period from January 1983 to December 1991 were reviewed at Seoul National University Hospital. There were 106 males & 132 females, and their ages ranged from 3 months to 73 years, with average 33.6 years. The most frequently encountered tumor site was anterosuperior mediastinum followed by posterior, and middle mediastinum. In the pathological viewpoint, thymoma was the most frequent type followed by neurogenic tumor. 81% of the tumor were benign and 19% were malignant. Half of the malignant tumors were neurogenic tumors. Malignancy rate was high in pediatric patients compared to adults as 40% and 19% respectively. 65% of patients were asymptomatic at diagnosis.There was no operative mortality. Post operative complications were occurred in 35 cases. Most frequent complications were adjacent peripheral nerve injuries. But other usual operative complications, such as bleeding, chylothorax, infection, were relatively rare.
Sacrococcygeal teratoma (SCT) is an extragonadal germ cell tumor (GCT) that develops in the fetal and neonatal periods. SCT is a type I GCT in which only teratoma and yolk sac tumors arise from extragonadal sites. SCT is the most common type I GCT and is believed to originate through epigenetic reprogramming of early primordial germ cells migrating from the yolk sac to the gonadal ridges. Fetal SCT diagnosed in utero presents many obstetrical problems. For high-risk fetuses, fetal interventions (devascularization and debulking) are under development. Most patients with SCT are operated on after birth. Complete surgical resection is the key for tumor control, and the anatomical location of the tumor determines the surgical approaches. Incomplete resection and malignant histology are risk factors for recurrence. Approximately 10-15% of patients have a tumor recurrence, which is frequently of malignant histology. Long-term surveillance with monitoring of serum alpha fetoprotein and magnetic resonance imaging is required. Survivors of SCT may suffer anorectal, urological, and sexual sequelae later in their life, and comprehensive evaluation and care are required.
Background: The DR-$70^{TM}$ immunoassay is a newly developed cancer diagnostic test which quantifies the serum fibrin degradation products (FDP), produced during fibrinolysis, by antibody reaction. The purpose of this study was to evaluate the potential of DR-$70^{TM}$ Immunoassay in screening malignant tumor. Methods: Sample subjects were 4,169 adults, both male and female, who visited the health promotion center of a general hospital from March 2004 to April 2005 and underwent the DR-$70^{TM}$ immunoassay test and other tests for cancer diagnosis. The patient group was defined as 42 adults out of the sample subjects who were newly diagnosed with cancer during the same time period when the DR-$70^{TM}$ immunoassay test was performed. Final confirmation of a malignant tumor was made by pathological analysis. Results: The mean DR-$70^{TM}$ level was $0.83{\pm}0.65{\mu}g/ml$ (range: 0.00 (0.0001)${\sim}7.42{\mu}g/ml)$ in the control group (n=4,127) as opposed to $2.70{\pm}2.33{\mu}g/ml$ (range: $0.12{\sim}9.30{\mu}g/ml)$ in the cancer group (n=42), and statistical significance was established (p<0.0001, Student t-test). When categorized by the type of malignant tumor, all cancer patients with the exception of the subgroups of colon and rectal cancer showed significantly higher mean DR-$70^{TM}$ levels compared with the control group (p<0.0001, Kruscal-Wallis test). The receiver operating characteristic (ROC) curve analysis revealed ${\geq}1.091{\mu}g/ml$ as the best cut-off value. Using this cut-off value, the DR-$70^{TM}$ immunoassay produced a sensitivity of 71.4%, a specificity of 70.1%, a positive predictability of 69.4%, and a negative predictability of 69.2% (1). Conclusion: A significant increase in the mean DR-$70^{TM}$ value was observed in the cancer group (thyroidal, gastric, breast, hepatic and ovarian) com pared with the control group. In particular, the specificity and sensitivity of the DR-$70^{TM}$ immunoassay was relatively high in the subgroups of breast, gastric, and thyroidal cancer patients. There is need for further studies on a large number of malignant tumor patients to see how the DR-$70^{TM}$ level might be changed according to the differentiation grade and postoperative prognosis of the malignant tumor.
H$\"{u}$rthle cell neoplasm of the thyroid gland is an uncommon, but potentially malignant lesion. However, in many instances, the malignant potential of the H$\"{u}$rthle cell neoplasm is very difficult to judge histologically. For this reason, the biologic behavior of this tumor and its optimal treatment have come under considerable debate in recent years. In order to review the clinicopathologic features of the H$\"{u}$rthle cell neoplasm and to determine its optimal treatment modalities, we studied 26 patients with path logical proof of H$\"{u}$rthle cell tumor from January 1987 to September 1997. We also performed an immunohistochemical study using the monoclonal antibodies against antigen CD34 for the angiogenic activity of this tumor and evaluated the differences of microvessel density(MVD) between benign and malignant tumors. The age of the patients ranged from 1 to 71 years with a mean of 44.2 years. There were 6 males and 20 females(M : F= 1 : 3.3). The accuracies of fine needle aspiration biopsy and frozen section were very low; 6.3% and 34.8%, respectively. There were 20 benign tumors and 6 malignant tumors(23.1%). All the malignant tumors were microinvasive(intermediate) type which had minimal capsular invasion and most of them(5 cases) were diagnosed postoperatively. Any specific clinicopathologic differences were not seen between benign and intermediate groups. Most of the cases had conservative surgeries(15 ipsilateral lobectomy-isthmusectomy, 7 subtotal thyroidectomy) while total thyroidectomy was performed in 4 cases. Of the cases with malignant tumor, 2 had ipsilateral lobectomy-isthmusectomy, 3 had subtotal thyroidectomy and the remaining 1 had total thyroidectomy. Mean size of the tumors was 3.0 cm(0.1- 8.5 cm) in the greatest diameter and multiple tumors were seen in 6 cases(23.1 %). During the follow-up period, only one recurrence(3.8%) of benign tumor occurred but distant metastasis or cause-specific death was seen in the benign or intermediate groups. Mean MVDs of the benign(n=13) and intermediate(n=6) groups were $121.7{\pm}35.3$ and $114.3{\pm}31.7$, respectively and there was no statistical significance between them. In conclusion, because of the low accuracies of fine needle aspiration biopsy and frozen section for the H$\"{u}$rthle cell neoplasm, the extent of surgery could be individualized based on permanent pathologic examination; Conservative surgery would be adequate for patients with benign or intermediate H$\"{u}$rthle cell neoplasm and total or near-total thyroidectomy for those with definite malignancy.
Journal of Physiology & Pathology in Korean Medicine
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v.27
no.1
/
pp.136-138
/
2013
Carcinosarcoma of gallbladder is a rare malignant tumor characterized by malignant epithelial and malignant mesenchymal components. Its pathogenesis is unknown and most of carcinosarcomas of gallbladder are associated with poor survival because the disease presents at an advanced stage. A 69-year-old man presented with right upper quadrant pain. The preoperative diagnosis was gallbladder cancer, and thus, curative radical cholecystectomy was performed. Pathologic examination of the surgical specimen revealed that the tumor was composed of carcinomatous components with adenocarcinoma and squamous cell carcinoma, and sarcomatous components with spindle cell sarcoma and chondrosarcoma, which was consistent with a diagnosis of primary carcinosarcoma of the gallbladder. The tumor was found to extend to the pericholecystic fat and no metastasis in regional lymph nodes.
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