• Archives of Craniofacial Surgery
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• v.21 no.1
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• pp.27-34
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• 2020

Background: Free-flap reconstruction for recurrent head and neck cancer may be challenging depending on the previous treatments, those are, chemotherapy, radiotherapy, and surgery, including neck dissection or free tissue transfer. Specifically, the previous treatment could compromise the neck vessels, thereby making free-flap reconstruction more difficult. This study aimed to investigate the correlation between previous treatments and vascular compromise of the free flap. Methods: In this retrospective study, 124 free-flap reconstructions in 116 patients for recurrent head and neck cancer between 1993 and 2017 were investigated. The demographic characteristics, previous treatments, flap choices, infections, recipient vessels, and vascular crises were evaluated. Results: Of the 124 reconstruction cases, 10 had vascular crises. There were six revisions, totaling six flap failures. The success rate of free-flap reconstruction for recurrent cancer was 95.2%, which significantly differed from that for primary cancer (98.8%, p= 0.006). Moreover, in the recurrent cancer group, no correlation was found between previous treatments and vascular crises (p> 0.05). Increased rates of contralateral or uncommon anastomoses were found following neck dissection (p< 0.05). Conclusion: Previous neck dissection or radiotherapy could lead to scarring and tissue damage, which could in turn make microvascular reconstruction more challenging; however, the effect was not definite in this study. Approximately 60% of patients with previous neck dissection had compromised ipsilateral recipient vessels, which resulted in contralateral or uncommon anastomoses. In this study, free-flap reconstruction seems to be quite safe and preferable in patients with recurrent head and neck cancer based on the overall survival rate.

• Archives of Plastic Surgery
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• v.45 no.6
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• pp.583-587
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• 2018

Kaposiform hemangioendothelioma (KHE) is a very rare, locally aggressive vascular neoplasm. It occurs mostly in children and is rarely observed in adults. It typically originates on the skin, later affecting the deep soft tissue of the extremities, head or neck, and retroperitoneum by infiltrative growth. It is locally aggressive, does not regress spontaneously, and tends to metastasize locally as well as to the regional lymph nodes. In this article, we report a case of adult-onset KHE with neurofibromatosis type 1. The patient presented to our department with a 2-month history of a painful ulceration in her left popliteal area. Since KHE had not previously been reported in patients with neurofibromatosis, the diagnosis was difficult due to the similarity of the skin manifestation to neurofibromatosis-associated lesions. We share our experience of diagnosing and treating this rare case of adult-onset KHE.

• Archives of Craniofacial Surgery
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• v.21 no.1
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• pp.69-72
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• 2020

Hemangioma is a benign vascular tumor that grows by endothelial cell hyperplasia. It occurs most frequently in the head and neck region. Nose reconstruction is tricky because of its unique three-dimensional structure and different tissue components. We report a case of successful reconstruction of near-total nose defect using the paramedian forehead flap combined with a nasolabial flap, immediately after excision of nasal hemangioma. A 49-year-old male patient was presented with a huge mass at the nose. Preoperative magnetic resonance imaging showed prominent vascular channels extending to the forehead and cheek. Complete resection of the mass was performed, which resulted in an eccentric defect. The right paramedian forehead flap and the left nasolabial flap were designed and transferred to the defect. Flap division was performed 1 month later. The patient is satisfied with the overall appearance and did not develop any functional deficit.

• Journal of the Korean Society of Radiology
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• v.82 no.1
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• pp.219-224
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• 2021

Leiomyosarcoma (LMS) is a soft tissue sarcoma that originates from smooth muscle cells. It is commonly found in the uterus but can occur throughout the body, including the retroperitoneal space, abdominal cavity, and any vascular structure. Although there are many case reports of uterine or vascular LMS metastasizing to the heart, cardiac metastasis from nonvisceral lesions has only been reported in two cases. Herein we report a rare case of a patient presenting metastatic LMS from the left flank in the right ventricle observed with echocardiography and enhanced computed tomography.

• Clinical and Experimental Pediatrics
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• v.64 no.11
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• pp.559-572
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• 2021

The International Society for the Study of Vascular Anomalies classifies vascular anomalies into vascular tumors and vascular malformations. Vascular tumors are neoplasms of endothelial cells, among which infantile hemangiomas (IHs) are the most common, occurring in 5%-10% of infants. Glucose transporter-1 protein expression in IHs differs from that of other vascular tumors or vascular malformations. IHs are not present at birth but are usually diagnosed at 1 week to 1 month of age, rapidly proliferate between 1 and 3 months of age, mostly complete proliferation by 5 months of age, and then slowly involute to the adipose or fibrous tissue. Approximately 10% of IH cases require early treatment. The 2019 American Academy of Pediatrics clinical practice guideline for the management of IHs recommends that primary care clinicians frequently monitor infants with IHs, educate the parents about the clinical course, and refer infants with high-risk IH to IH specialists ideally at 1 month of age. High-risk IHs include those with life-threatening complications, functional impairment, ulceration, associated structural anomalies, or disfigurement. In Korea, IHs are usually treated by pediatric hematology-oncologists with the cooperation of pediatric cardiologists, radiologists, dermatologists, and plastic surgeons. Oral propranolol, a nonselective beta-adrenergic antagonist, is the first-line treatment for IHs at a dosage of 2-3 mg/kg/day divided into 2 daily doses maintained for at least 6 months and often continuing until 12 months of age. Topical timolol maleate solution, a topical nonselective beta-blocker, may be used for small superficial type IHs at a dosage of 1-2 drops of 0.5% gel-forming ophthalmic solution applied twice daily. Pulse-dye laser therapy or surgery is useful for the treatment of residual skin changes after IH involution.

• Clinics in Shoulder and Elbow
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• v.24 no.1
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• pp.32-35
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• 2021

Angioleiomyoma is a benign soft tissue tumor originating from vascular smooth muscle. We report a case of a 20-year-old student who presented with pain in the right shoulder of 4 years duration. Shoulder movements were pain-free throughout the range of motion except resisted external rotation. Magnetic resonance imaging visualized a well-circumscribed lesion over the infraspinatus tendon. The lesion was surgically removed and sent for histopathological analysis. Morphology and immunohistochemistry results were suggestive of angioleiomyoma. The most common location for such a lesion is the lower limb, with less than 1% being reported in the upper arm, of which an angioleiomyoma of the shoulder is extremely rare.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.18 no.4
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• pp.280-285
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• 2015

Heterotopic pancreas (HP) is defined as pancreatic tissue lacking anatomic and vascular continuity with the main body of the pancreas. Most are asymptomatic, but can cause ulcer, bleeding, intussusception, and mechanical obstruction. Herein, we presented one case of HP presented as duodenal tumor causing duodenal obstruction. A 7-year-old girl visited the emergency room for abdominal pain with vomiting for 24 hours. Computed tomography and upper gastrointestinal series revealed a polypoid mass with short stalk in the 2nd portion of duodenum. We attempted an endoscopic removal. However, the lumen was nearly obstructed by the mass and the stalk was too broad and hard to excise. The mass was surgically removed via duodenotomy. It was confirmed as a HP with ductal and acini components (type 2 by Heinrich classification). Postoperatively, the patient has been well without any complication and recurrence.

• Korean Journal of Radiology
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• v.1 no.4
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• pp.212-214
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• 2000

Angiolipoma is a rare benign soft tissue tumor, an unusual variant of lipoma, consisting of fatty and vascular components and located in the subcutis, usually in the trunk and extremities. We report a case of posterior mediastinal angiolipoma extending into the spinal canal and showing both fat and angiomatous features on CT scan.

• Korean Journal of Head & Neck Oncology
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• v.39 no.2
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• pp.31-34
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• 2023

Pilomatricoma is characterized by a semi-transparent epidermis, especially pigmented pilomatricoma, containing melanocytes in basaloid cells, which are dark and purple, resembling vessel-derived skin masses. If the vascularity at doppler ultrasound is high before surgery, it may be misdiagnosed. A 10-year-old female patient visited our clinic because of a mass in the right ear triangular fossa. Ultrasonography was performed, and a vascular-origin tumor was suspected because of the high vascularity. The excised mass was diagnosed as pigmented pilomatricoma by a pathologist. Pilomatricoma is mistaken for other masses owing to its various phenotypes. A misdiagnosis can lead to misdirected strategies which can cause delayed treatment and can result in an increase in the size of the pilomatricoma, making the sequalae of surgery more complicated. For proper treatment, careful examination and evaluation are required before surgery.

• Archives of Plastic Surgery
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• v.36 no.4
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• pp.493-496
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• 2009

Purpose: Glomus tumors are neoplasms that are composed of modified smooth muscle cells of the glomus body and multiple glomus tumor comprises 10% of all glomus tumors. We report a case of disseminated multiple glomus tumors. Methods: A 14 - year - old boy presented with multiple subcutaneous purple nodules on the right cheek, back, right arm, right hand dorsum, right fourth finger, and left ankle. Nodules on the back and right fourth finger were completely excised under local anesthesia and histopathologic examination was followed. Results: Histopathologic findings showed numerous dilated, cavernous - like, thin - walled, vascular spaces surrounded by one or a few layers of glomus cells. On immunohistochemical examination, glomus cells stain for smooth muscle actin, and endothelial cells stain for CD31. Those revealed multiple glomangiomas. Conclusion: A review of Korean literature revealed only one reported cases of disseminated multiple glomus tumors, so this is the second case to be reported in the Korean literature. In case of multiple soft tissue tumors, thorough physical examination and preoperative evaluation is needed.