• Archives of Plastic Surgery
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• 제35권1호
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• pp.100-103
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• 2008

Purpose: Eccrine porocarcinoma is a very rare, potentially fatal tumor which arises from the intraepidermal portion of the eccrine sweat ductal apparatus. It does not have a characteristic clinical feature but does have a high incidence of metastasis. It may be developed de novo or in a preexisting benign eccrine poroma. It usually affects older people and is located most commonly on lower extremities. We report a rare case of eccrine porocarcinoma which developed on the back without metastasis. Methods: The patient was a 94-year-old woman who showed a painful, ulcerated, dark brown colored polypoid $3.5{\times}3.0cm$ sized mass on the back for 3 years. We totally excised the lesion including normal tissue. Results: After wide excision of the lesion, pathologist reported an eccrine porocarcinoma. Histopathologic findings reveal that the classic type of eccrine gland carcinoma, eccrine porocarcinoma. Immunocytochemical studies showed a positive reactivity to anti-EMA antibody and anti-CEA antibody. Conclusion: Authors experienced a rare case of primary eccrine porocarcinoma on the back. Because of the propensity to develop local recurrence, wide excision of the primary tumor with histologic confirmation of negative margins represents the only curative treatment regimen for eccrine porocarcinoma.

• Archives of Plastic Surgery
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• 제38권4호
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• pp.501-504
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• 2011

Purpose: Epithelial-myoepithelial carcinoma (EMC) represents about the 1% of the malignant neoplasms in the salivary glands and clinically most commonly found localized, well defined and sometimes presents orofacial pain. Treatment of choice is surgical excision. Postoperative radiotherapy can be used when surgical margins are doubtful. We report our experience of EMC of the parotid gland. Methods: A 78-year-old man presented with a three-year history of a localized, painless, $7{\times}6cm$ sized recurred tumor in his right preauricular area. He was diagnosed as EMC of the right parotid gland. So a total parotidectomy was performed. In his old medical history, he had a mass in the same area 5 years ago. The diagnosis of pleomorphic adenoma was made and the mass excision was performed at the local clinic without further evaluation. Results: It was unable to visually discriminate between the tumor and the normal tissue. So a total parotidectomy was performed. The patient was got post-operative radiotherapy and was followed up for 9 months. There was no specific evidence of recurrence. Conclusion: We present a case of EMC of the parotid gland in right preauricular area, which is uncommon. So we report a uncommon case of EMC to discuss about our experience with relevant journal discussion.

• Journal of Korean Neurosurgical Society
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• 제63권6호
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• pp.821-826
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• 2020

Objective : Hyperostosis in meningiomas can be present in 4.5% to 44% of cases. Radical resection should include aggressive removal of invaded bone. It is not clear however to what extent bone removal should be carried to achieve pathologically free margins, especially that in many cases, there is a T2 hyperintense signal that extends beyond the hyperostotic bone. In this study we try to investigate the perimeter of tumour cells outside the visible nidus of hyperostotic bone and to what extent they are present outside this nidus. This would serve as an initial step for setting guidelines on dealing with hyperostosis in meningioma surgery. Methods : This is a prospective case series that included 14 patients with convexity meningiomas and hyperostosis during the period from March 2017 to August 2018 in two university hospitals. Patients demographics, clinical, imaging characteristics, intraoperative and postoperative data were collected and analysed. In all cases, all visible abnormal bone was excised bearing in mind to also include the hyperintense diploe in magnetic resonance imaging (MRI) T2 weighted images after careful preoperative assessment. To examine bony tumour invasion, five marked bone biopsies were taken from the craniotomy flap for histopathological examinations. These include one from the centre of hyperostotic nidus and the other four from the corners at a 2-cm distance from the margin of the nidus. Results : Our study included five males (35.7%) and nine females (64.3%) with a mean age of 43.75 years (33-55). Tumor site was parietal in seven cases (50%), fronto-parietal in three cases (21.4%), parieto-occipital in two cases (14.2%), frontal region in one case and bicoronal (midline) in one case. Tumour pathology revealed a World Health Organization (WHO) grade I in seven cases (50%), atypical meningioma (WHO II) in five cases (35.7%) and anaplastic meningioma (WHO III) in two cases (14.2%). In all grade I and II meningiomas, bone biopsies harvested from the nidus revealed infiltration with tumour cells while all other bone biopsies from the four corners (2 cm from nidus) were free. In cases of anaplastic meningiomas, all five biopsies were positive for tumour cells. Conclusion : Removal of the gross epicentre of hyperostotic bone with the surrounding 2 cm is adequate to ensure radical excision and free bone margins in grade I and II meningiomas. Hyperintense signal change in MRI T2 weighted images, even beyond visible hypersototic areas, doesn't necessarily represent tumour invasion.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제36권2호
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• pp.128-133
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• 2010

Mesenchymal chondrosarcoma is very aggressive and represents approximately 1% of all chondrosarcomas. While it affects a very wide age range, the peak frequency is in the second decade of life. It may occur in the head and rib region with a predilection for the maxillofacial skeleton. The small cell undifferentiated component may assume a hemangiopericytoma-like vascular pattern and should be distinguished from hemangiopericytoma. Treatment is en bloc resection, the intended tissue margins of excision should be designed to extend well beyond the actual tumor margin, as mesenchymal chondrosarcomas. Aggressive behavior of mesenchymal chondrosarcoma of the jaw, with a tendency for delayed recurrence and metastasis even many years after treatment. The most frequent site of metastasis was the lung. Here we present 52 years old, female case of mesenchymal chondrosarcoma occurs on Rt. mandible.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제47권4호
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• pp.321-326
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• 2021

Hemangioma is a benign tumor characterized by the proliferation of blood vessels. Although it often appears in soft tissues, its occurrence in bone tissue, particularly the mandible, is extremely rare. A 32-year-old female sought attention at the dental clinic complaining of a painless swelling in the posterior region of the left side of the mandible. A panoramic radiograph and computed axial tomography scan were taken, showing honeycomb and sunburst images, respectively, in the affected area. The patient underwent a biopsy, which led to the diagnosis of intraosseous hemangioma. Having assessed the characteristics of the lesion, it was decided to perform complete excision including safety margins, followed by an iliac crest bone graft to reconstruct the mandible. Awareness of the possible clinical and radiographic presentations of intraosseous hemangioma is considered important, as non-diagnosis could have severe consequences given its possible relation to dental structures.

• 대한두개안면성형외과학회지
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• 제17권3호
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• pp.158-161
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• 2016

Primary cutaneous mucinous carcinoma (PCMC) is a rare malignant tumor of eccrine origin. Clinically, the carcinoma presents as a solitary, slow growing, and painless nodule. For this reason, this tumor is often considered to be a benign mass in the preoperative setting. The lesion is, however, malignant in nature and has a tendency for local recurrence and infrequent metastasis. Wide local excision is the treatment of choice. However, few reports exist with information regarding surgical margins and clinical outcomes. Herein, we report a case of PCMC excised with a narrow surgical margin and review the relevant literature. A 49-year-old man presented with a small cutaneous nodule of the right cheek. The mass was excised without any margin, but pathologic examination revealed histology of mucinous carcinoma. Because of this, the operative site was re-excised with a 5-mm margin, and the wound was closed using a V-Y advancement flap. Systemic work-up did not reveal other potential metastatic primary, for a final diagnosis of PCMC. We report this case of PCMC, treated with relatively narrow margin in a patient with good prognostic factors.

• Archives of Plastic Surgery
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• 제38권4호
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• pp.490-493
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• 2011

Purpose: Basosquamous carcinoma is a rare malignancy, with features of both basal cell carcinoma and squamous cell carcinoma. It is considered as aggressive tumor with a high risk of recurrence and metastases. Authors report a case of basosquamous cell carcinoma. Methods: A 72 year-old man, who had an erythematous ulcer on his left auricle, described a slow growing lesion, starting at the posterior surface of the superior helix with a steady increase in size during the past 10 years. At operation, auricular cartilage was grossly invaded by the tumor and was, therefore, amputated with tumor-free margins. Results: Histopathologic examination was revealed a basosquamous cell carcinoma. On positron emission tomography/computed tomography (PET/CT) and neck CT were negative for signs of further nodal involvement or metastases to other organs. At follow-up 6 months later, his wounds were noted to be well healed, with no evidence of local recurrence or identifiable metastases. Conclusion: Because basosquamous cell carcinoma has a significant potential to recur and metastasize, surgical excision for this type of carcinoma should be more extensive than that performed for conventional basal cell carcinoma or squamous cell carcinoma. In addition, regional lymph nodes should be monitored and close follow-up should be carried out.

• Asian Pacific Journal of Cancer Prevention
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• 제16권14호
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• pp.5709-5714
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• 2015

Aim: To assess the treatment outcome in patients with malignant skin melanoma and prognostic factors for distant metastases (DM), disease-free survival (DFS) and overall survival (OS). Materials and Methods: A retrospective analysis was conducted on 113 patients with malignant skin melanoma (60 females, 53 males, average age-55 years) who were treated surgically. Primary treatment consisted of local excision. In 12 cases, it was accompanied by lymph node excision. In 93 (82%) cases, radicalization was necessary, which was either local only (19 cases) or accompanied by lymph node surgery/biopsy (74 cases). Possible prognostic factors such as Clark's stage and Breslow's depth of invasion, ulceration, average tumor dimensions, lymph nodes metastases (pN+), gender, tumor location and primary excision margins were considered. Results: In 51 (45%) cases, treatment failure occurred. The 5-year DM rate was 47%, the 5-year DFS was 38%, and the 5-year OS was 56%. In the univariate analysis, the important factors with respect to at least one endpoint included Clark's stage, Breslow's depth of invasion, ulceration, average tumor dimensions, lymph nodes metastases, gender and primary tumor localization. The presence of metastasic nodes was the most important prognostic factor, with a 5-year DM rates of 30% for pN(-) and 76% for pN(+) and a 5-year DFS and OS of 56% and 76% for pN(-) and 13% and 24% for pN(+), respectively. The average tumor dimension was independently significant for DFS and OS, with 5-year rates of 69% and 80% for ${\leq}1cm$, 28% and 53% for 1-2 cm, and 18% and 30% for >2 cm, respectively. Tumor location was also significant for DM and OS, with 5-year rates of 69% vs 33% and 41% vs 66% for trunk vs other locations, respectively. Conclusions: The natural course of a malignant skin melanoma treated radically is disadvantageous, with unsuccessful outcome in nearly half of the cases. Common clinical factors, such as Clark's tumor stage, Breslow's depth of invasion and the presence of metastatic nodes, have high prognostic significance. The size and location of the primary lesion may be considered independent prognostic factors. The most important negative prognostic factor is the presence of metastatic regional lymph nodes. Only one quarter of patients with metastases in lymph nodes survive 5 years from primary surgery.

• Journal of Chest Surgery
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• 제36권3호
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• pp.175-181
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• 2003

원발성 흉벽종양은 흉부의 연조직이나 뼈 또는 연골에서 다양하게 발생할 수 있는 종양으로서 전체 원발성 종양의 약 l∼2%를 차지한다. 수술적 절제술은 만성 궤양이나 심한 통증이 있는 환자에서 효과적인 치료법이며 조직학적 진단 및 수술방법에 따라서 장기생존이 가능할 수 있다. 대상 및 방법: 1976년 9월부터 2001년 3월까지 원발성 흉벽종양을 가진 125명(양성종양 86명, 악성종양 39명) 의 환자에서 수술적 절제술을 시행하여 수술결과와 예후에 영향을 미치는 요소들을 해석하고자 하였다. 결과: 양성종양은 수술적 치료로 재발 없이 완전 치료가 되었으며 악성종양은 대부분 광범위 절제술을 시행하였으며 환자에 따라 수술 후 보조요법을 병행하였다. 양성종양 중 신경초종이 가장 많았으며 악성종양은 악성섬유성조직구종이 가장 많은 빈도를 보였다. 악성종양의 경우 3년 생존율이 76.0%, 10년 생존율이 60.5%이었다. 수술과 관련된 사망은 없었으며 외래 추적 중 사망한 환자의 원인은 원격 전이에 의한 장기부전 이었으며 11명에서 재발하였다. 안전거리 절제면을 4 cm 이상과 미만으로 구분하였을 때 두 군간의 생존율에 차이가 없었다. 결론: 양성종양의 경우 수술적 치료로 재발 없이 완치가 가능하였으며 악성종양도 비교적 좋은 장기생존율을 나타내었다. 안전거리 4 cm는 예후에 미치는 영향은 발견할 수 없었으나 재발 시에는 예후가 좋지 않았다.

• 대한영상의학회지
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• 제84권2호
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• pp.398-408
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• 2023

목적 유방의 양성 선근상피종의 영상 소견에 대해 기술하고자 한다. 대상과 방법 최근 20년 동안, 본원에서 조직 확진된 120명의 환자의 유방에서의 선근상피종을 대상으로 하였다. 43명의 환자는 유방암으로 유방 전 절제술을 시행하면서 우연히 발견되어 제외하였으며, 28명의 환자는 절제생검을 하지 않고 경피적 생검만 시행하여 제외하였고, 8명의 환자는 생검에서 양성 선근상피종으로 확인되었으나 완전 절제술 후 다른 질환으로 확진되어 제외하였다. 결과적으로, 완전 절제술 후 조직 확진된 41명 환자의 양성 선근상피종에 대해 후향적으로 임상 정보와 영상 소견을 분석하였다. 결과 유방촬영술에서 병변은 원형 또는 타원형의 모양(56%), 경계가 좋지 않음(62%), 고밀도음영(53%), 종괴형(89%)을 보였으며, 미세석회회가 없었다(95%). 유방초음파에서 병변은 의심스러운 종괴(98%), 경계가 좋지 않음(66%), 저에코(43%), 그리고 종양내 혈관성(63%)을 보였다. 유방자기공명영상에서 의심스러운 종괴(100%), 불분명한 경계(61%) 그리고 조영증강 시 지연기 소실(84%)을 보였다. 양성 선근상피종의 41개 병변 중 16개 병변은 처음 중심바늘생검에서 다른 질환으로 오진되었으며 2명의 환자는 유방암으로 오진되었다. 결론 유방의 양성 선근상피종은 유방촬영술, 유방초음파, 유방자기공명영상에서 악성 종양과 유사한 의심스러운 특징을 보인다. 양성 선근상피종을 다른 질환과 감별하는 것은 중심바늘생검만으로는 어려우며, 올바른 진단을 위해서는 완전절제술이 필요하다.