• 제목/요약/키워드: Primary malignant melanoma

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Surgical Options for Malignant Skin Tumors of the Hand

  • Yun, Min Ji;Park, Ji Ung;Kwon, Sung Tack
    • Archives of Plastic Surgery
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    • 제40권3호
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    • pp.238-243
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    • 2013
  • Background Primary malignant tumors of the hand, although unusual, may present varied and often complex clinical problems. The main treatment modality of skin cancer of the hand has changed. Methods We retrospectively reviewed the medical records of 43 patients who underwent surgery for malignant skin tumors of the hand during an 18-year period, from September 1994 to February 2012. The characteristics of the tumor, methods of reconstruction, and long-term results were reviewed. Results We had 43 patients with 27 melanomas, 14 squamous cell carcinomas, and 2 sarcomas. Their ages ranged from 19 to 74 years (mean, $53.4{\pm}14.5$ years), from 46 to 79 years (mean, $59.7{\pm}9.6$ years), and from 15 to 43 years (mean, $29{\pm}19.8$ years), respectively. Thirty-four cases occurred on the fingertip (16 of those cases on the thumb), 5 cases occurred on the palm, and 4 cases on the dorsum of the hand. Amputation was most frequently used in early cases, but recently, tissue-sparing excision has been performed frequently. The incidence of local recurrence was 3 cases and distant metastasis was 1 case, and the 5-year survival rate was 100%, except in 4 cases due to follow-up loss. Conclusions The principles of treatment-to be curative and to preserve function and appearance-are important points. "Preservative surgery" preserves function and cosmesis of the involved finger or hand dorsum or palm. Preservative surgery not only emphasizes less resection and surgery of a smaller scale, but also optimal reconstruction of the soft tissue defect of the digit.

고형 장기 이식 후 발생하는 피부암과 피부암 전구증으로 최근 22년간 단일 기관을 방문한 환자들에 대한 임상 양상과 인구통계학적 고찰(1995~2017) (Clinical Features and Incidence of Skin Cancer and Precancerous Lesions after Solid Organ Transplantation: A 22-year Single-center Experience in Korea)

  • 박찬성;박지혜;이종희;이동윤;이주흥;양준모
    • 대한피부과학회지
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    • 제56권10호
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    • pp.603-608
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    • 2018
  • Background: It is well known that skin cancer and precancerous disease develop more frequently in patients undergoing solid organ transplantation than normal populations in the normal population in Western countries. However, to date, the clinical and demographic features of skin cancer and precancerous disease after solid organ transplantation are not established in Asian countries. We evaluated the clinical and demographic features of primary skin cancer and precancerous lesions after solid organ transplantation and compared these with the trends observed in Western countries. Methods: We retrospectively reviewed the medical records of patients who underwent kidney, liver, heart, and lung transplantation between January 1995 and April 2017 and who developed skin cancer or precancerous lesions after transplantation. The various lesions observed were squamous and basal cell carcinoma, malignant melanoma, Kaposi sarcoma, Bowen's disease, and actinic keratosis. Results: We identified 4604 patients who received organ transplant. The mean age of patients was 44.8 years (male, 64.6%; female, 35.4%), and the sum of the person-year of observation time was 31,024 person-years. The incidence rate per 100,000 person-years was 29.01 for squamous cell carcinoma, 19.34 for basal cell carcinoma, 6.45 for malignant melanoma 3.22 for Kaposi sarcoma, and 74.17 for Bowen's disease and actinic keratosis. The incidence rate per 100,000 person-years was the highest in patients undergoing heart transplantation (610.50), followed by those who underwent kidney transplantation (136.54) and liver transplantation (90.15). Koreans showed lower incidence rates than those observed in Westerners. Conclusion: The incidence of primary skin cancer and precancerous lesions after solid organ transplantation in Koreans was lower than that in Westerners. Squamous cell carcinoma was the most common skin cancer in patients undergoing solid organ transplantation and the incidence rate of skin cancer and precancerous lesions was the highest in patients undergoing heart transplantation.

최근 8년간 구강암 환자에 대한 임상통계학적 연구 (A CLINICOSTATISTICAL ANALYSIS OF ORAL CANCER PATIENTS FOR RECENT 8 YEARS)

  • 김명윤;김진수;이상한;김진욱;장현중
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제33권6호
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    • pp.660-668
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    • 2007
  • We investigated 248 patients who were diagnosed as malignant tumor in the department of Oral and maxillofacial Surgery of Kyungpook National University from 1999 to 2006, and following results were obtained. 1. Among 248 patients who have malignant tumor, 164 were men and 84 were women, which made the ratio of male to female 1.95:1. 2. The average age of oral cancer patients was 58.3. 3. As of the primary origin site, lower alveolus and gingiva were the greatest with 70 cases(28.2%), followed by tongue(l6.9%), upper alveolus and gingiva(14.9%), palate(13.7%), mouth floor(9.7%), buccal mucosa(4.8%), retromolar trigone(4.4%), Mx. & Mn. bone(3.2%) and lip(2.8%). 4. As of histologic distribution, squamous cell carcinoma was the greatest with 170 cases(68.6%), followed by sarcoma with 17 cases(6.9%), adenoid cystic carcinoma with 17 cases(6.9%), malignant lymphoma with 15 cases(6.0%), mucoepidermoid carcinoma with 13 cases(5.2%), metastatic carcinoma with 6 cases(2.4%) and malignant melanoma with 4 cases(1.6%). 5. Period between recognition of the symptom and the first visit to hospital was less than 3 months for 58.9% of the patients, and more than 3 months for 41% of the patients. 6. Investigation of whether the patients drink or smoke revealed that the number of non-smoking and non-drinking patients was 63 among 170 patients(37.0%) that were able to investigate. The number of patients who smoke only was 29(17.1%) and both drinking and smoking patients were 78(45.9%). 7. In clinical stage order, Stage IV(61.7%) was found th be the largest, followed by stage I(17.2%), stage II(13%) and stage III(7.8%). 8. The 5-year survival rate of the entire oral cancer patients appeared to be 57.7%. The survival rate was higher in younger group and women had higher survival rate but there was no statistical significance to this. In the aspect of stage, the survival rate was Stage I, Stage II, Stage IV and Stage III in decreasing order. The order according to T classification was the same. In N classification, patients with N0 had the highest survival rate and the survival rate decreased in the order of N1 and N2. Survival rate was especially low in patients with N2.

국내 한의학 암치료 임상연구 논문에 대한 고찰 (Review on Clinical Study of Oriental Medical Treatment for Cancer in Korea)

  • 김종한;박동석;김용석;이재동
    • Journal of Acupuncture Research
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    • 제29권3호
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    • pp.19-28
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    • 2012
  • Objectives : The aim of this study is to evaluate present clinical evidence of oriental medical treatment for cancer in Korea. Method : A search was performed in the Korean Studies Information, Korea Institute of Science and Technology Information, KoreaMed, Oriental Medicine Advanced Searching Integrated System, National Assembly Library, RISS4u, DBPIA, and Oasis using the keyword 'cancer', 'leukemia', 'malignant tumor', 'lymphoma', 'multiple myeloma', 'melanoma'. The search period spanned between Jan 1, 1980~June 30, 2011 and the results were analyzed and evaluated according to the publication date, journal, method of treatment, type of study, and the primary outcome. Randomized clinical trials (RCTs) and Non randomized clinical trial(NRCT) were reviewed separately. Result : The results yielded 133 trials during the period of Jan 1, 1980~June 30, 2011. Most of the trials were concerned with lung cancer and 94 of the trials were simple case studies or case series studies. 61 trials used herbal Formula/herbal medicine as the primary method of treatment. A total of 4 RCTs existed compared to only one NRCT. Conclusion : The use of oriental medicine for the treatment of cancer is gaining popularity in the field of medical scientific research. However most of the studies that have been published up to date are mostly case studies or case series studies, and RCT/NRCT are rare. In order to provide appropriate evidence regarding the effectiveness of oriental medicine in the treatment of cancer, more rigorous and well-designed studies are warranted.

하지에 발생한 악성흑색종 및 편평상피세포암에서 소속 림프절 생검의 의미 (The Significance of Sentinel Node Biopsy in Malignant Melanoma and Squamous Cell Carcinoma of Lower Extremities)

  • 김재도;이근우;권영호;정소학
    • 대한골관절종양학회지
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    • 제16권2호
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    • pp.69-73
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    • 2010
  • 목적: 사지에 발생된 편평 상피암이나 악성 흑색종에서 술 중 소속 림프절 생검의 의미에 대해 알아보고자 한다. 대상 및 방법: 2005년 9월부터 2009년 1월까지 본원에서 악성 흑색종 또는 편평상피세포암으로 진단된 환자 중, 원발 부위의 광범위 절제술을 시행한 이후 술 후 면역항암화학요법을 시행하고 1년 이상 추시가 가능하였던 악성 흑색종 15예, 편평상피암 10예, 총 25예를 대상으로 하였고, 이 중 소속 림프절 생검을 시행한 군은 10예였다. 평균 연령은 64세였으며, 남자 15예, 여자 10예였다. 결과: 총 25예의 3년 생존율은 100%였고, 3년 무병 생존율는 76%였다. 총 6예에서 전이가 발생하였고, 서혜부 림프절 4예, 슬부 주위 연부조직 1예, 좌측 아킬레스건 1예였다. 소속 림프절 절제술을 시행하지 않았던 15예에서는 평균 생존율은 93.3%였고, 무병 생존율은 73.3%였다. 소속 림프절 절제술을 시행한 10예에서 평균 생존율은 100%였고, 무병 생존율은 90%였다. 술 중 소속 림프절 절제술을 시행한 10예 중 단 1예에서만 조직검사 상 양성 소견을 보였고, 소속 림프절 절제술을 시행하였던 10예 모두에서 추시 상 전이는 없었다. 소속 림프절 절제술 이후 합병증이 발생한 경우는 없었다. 결론: 소속 림프절의 생검 및 절제는 과거의 전 림프절 절제술과 비교하여 간단하고 적은 합병증으로 높은 정확도를 보이며, 종양의 정확한 병기 설정으로 치료 방향을 결정하는 것이 환자의 생존율을 높이는데 도움을 줄 수 있다고 판단된다.

소세포 폐암에서의 위 전이 2예 (Two Cases of Gastric Metastasis from Small Cell Lung Cancer)

  • 유광하;김형중;안철민;이세준;김성규;이원영
    • Tuberculosis and Respiratory Diseases
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    • 제46권2호
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    • pp.273-280
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    • 1999
  • 저자들은 소세포 폐암으로 확진된 환자에서 오심 구토 혈변등 위장관 증상을 호소하여 상부 위 내시경 검사 및 조직 생검을 시행하여 위장으로의 전이를 확인한 2 예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

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Roles of White Blood Cells and Subtypes as Inflammatory Markers in Skin Cancer

  • Baykan, Halit;Cihan, Yasemin Benderli;Ozyurt, Kemal
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권6호
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    • pp.2303-2306
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    • 2015
  • Objective: Skin tumors are the most commonly seen cancer type worldwide. Regarding pathogenesis, it is thought that disruption of kinetics through T lymphocyte-mediated development of chronic inflammation may be involved. The present study was intended to identify role of inflammatory cells such as neutrophils, monocytes and lymphocytes in the determination of risk for skin cancer. Materials and Methods: We retrospectively reviewed charts of 569 cases diagnosed as having primary skin tumors. Data regarding age, gender and histopathological subtype were recorded. Blood parameters studied on the day before surgery including WBCs, neutrophils, and lymphocyte counts, neutrophil:lymphocyte and neutrophil:monocyte ratios were also recorded. Two-hundred and two healthy individuals presented for check-up in an outpatient clinic were selected as the control group. Parameters studied in cases with skin cancer were compared to those healthy individuals. Findings: Of the cases with skin cancer, 401 were basal cell carcinoma (BCC) while 144 were squamous cell carcinoma (SCC) and 13 were malignant melanoma (MM). WBC, neutrophil and monocyte counts and the neutrophil:lymphocyte ratio were found to be lower in the patient group than in the healthy control group (p<0.001) while no significant difference was found in other parameters reviewed (p>0.05). No significant difference was found in WBC, neutrophil, neutrophil: monocyte ratio according to gender (p>0.05). Monocyte count was found to be $0.68{\pm}0.61$ in men and $0.55{\pm}0.25$ in women, indicating strong statistical significance (p<0.001). WBC, neutrophil and monocyte values were highest in control group while lowest in BCC. When BCC and SCC groups were compared to controls, significant differences found (p<0.001). There were no significant differences in lymphocyte counts among groups (p=0.976). Neutrophil:lymphocyte ratios were 3.24 in BCC, 3.59 in SCC, 3.44 in MM and 5.06 in control group (p<0.001). Conclusions: In our study, it was found that there were significant differences in complete blood count, neutrophil, monocyte and neutrophil:lymphocyte levels among groups. Neutrophil: lymphocyte ratio was found to be lowest in BCC among skin cancers.

구강암 환자에서 $^{18}F$ FDG-PET/CT의 경부 림프절 전이 평가 유용성 (USEFULNESS OF $^{18}F$-FDG PET/CT IN THE EVALUATION OF CERVICAL LYMPH NODE METASTASIS IN PATIENTS WITH ORAL CANCER)

  • 유민기;유선열
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제35권4호
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    • pp.213-220
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    • 2009
  • Purpose: The present study was aimed to examine the usefulness of 18F-FDG PET/CT in the evaluation of cervical lymph node metastasis in patients with oral cancer. Materials and methods: Twenty-two patients who underwent neck dissection to treat oral cancer were subjected for examination. The cervical node metastasis was evaluated by means of clinical examination, CT scan, PET, and histologic examination. By comparing the results of each examination modality with those of histologic examination, it's sensitivity, specificity, positive predictive value, and negative predictive value were determined. Results: The oral cancer was more frequent in males with a ratio of 2.14:1. The sixth decade showed the highest incidence in age distribution with mean of $56{\pm}16$. Histologic findings showed that squamous cell carcinoma was the most common (15 patients), and mucoepidermoid carcinoma (3), malignant melanoma (2), and adenoid cystic carcinoma and ghost cell odontogenic carcinoma (1 each), in order. In most cases, wide surgical excision of the primary cancer and neck dissection was performed, followed by reconstruction with free flaps when necessary. When comparing the results of each examination modality with those of the histologic examination, clinical examination showed sensitivity, specificity, positive predictive value, and negative predictive value at 11%, 85%, 33%, and 58%, respectively. CT scans showed at 67%, 77%, 67%, and 77%, while $^{18}F$-FDG PET/CT at 78%, 77%, 70%, and 83%, respectively. Conclusions: These results suggest that PET is more useful, compared with clinical examination and CT scans, in the evaluation of cervical lymph node metastasis in patients with oral cancer.

안구 적출술로 확진된 폐 선암의 안구 전이 1예 (A Case of Eyeball Metastasis of Lung Adenocarcinoma Confirmed by Enucleation)

  • 김창년;김성주;정재호;박무석;고원기;이준구;김세규;김성규;장준;신동한
    • Tuberculosis and Respiratory Diseases
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    • 제50권5호
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    • pp.624-629
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    • 2001
  • 우안 시력 장애와 안구종괴를 주소로 내원한 환자에서 폐종괴가 관찰되어 경기관지 폐생검과 안구 적출술을 시행하여 폐선암의 우안구 전이를 진단한 1예를 경험하여 보고하는 바이다.

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뇌전이암 진단을 위한 제한적 뇌 자기공명영상의 유용성에 관한 연구 (Detection of Brain Metastatses Using Limited Brain MR Imaging : Usefulness of Limited Contrast-Enhanced MR Imaging in Brain Metastasis)

  • 권선중;이연선;안진영;박희선;정성수;김주옥;김진환;송창준;김선영
    • Tuberculosis and Respiratory Diseases
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    • 제55권5호
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    • pp.499-505
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    • 2003
  • 연구배경 : 본 논문에서는 뇌 전이 병소의 발견에 있어서 고식적 조영증강 자기공명영상 기법과 비교하여 제한적 조영증강 자기공명영상의 유용성을 알아보고자 하였다. 방 법 : 1998년 4월부터 2002년 9월까지 뇌 전이의 여부를 알아보기 위해 고식적 뇌 자기공명영상올 시행한 폐암 및 기타 암으로 진단을 받은 47명의 환자를 대상으로 하였다. 47명의 환자에서 축상면 T1 강조영상, 축상면 조영증강 T1강조영상, 관상면 조영증강 Tl 강조영상을 포함하는 제한적 뇌 자기공명영상을 선정하여 뇌 전이 결절의 영상판독을 시도하고 이를 고식적 뇌 자기공명영상의 영상소견과 비교하여 뇌 전이 발견의 민감도, 특이도와 일치율을 알아보았다. 결 과 : 47명의 환자 중 고식적 조영증강 자기공명영상에서 43명이 뇌 전이가 있었고, 제한적 자기공명영상에서는 42명에서 뇌 전이를 발견하였다.(민감도=97.67%). 고식적 뇌 자기공명영상에서 뇌 전이가 없었던 4명의 환자는 제한적 뇌 자기공명영상에서도 모두 뇌 전이가 없었다.(특이도=100%) 제한적 뇌 자기공명영상과 고식적 뇌 자기공명영상은 Pearson correlation이 0.884(Confidence Interval: 99%)로 높은 일치율올 보였다. 결 론 : 제한적 뇌 자기공명영상은 적은 비용으로 뇌 전이 여부를 판정할 수 있는 방법으로 제한적 자기공명 영상은 고식적 자기공명영상에 비해 손색없는 진단율을 보이므로 증상이 있는 환자에서만 시행되어 왔던 뇌영상 조영을 무증상 환자에서도 뇌 전이의 여부를 알아보기 위해 시행할 수 있을 것이다.