• 대한두경부종양학회지
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• 제11권1호
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• pp.24-29
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• 1995

Melanoma of the mucous membrane is a rare condition and has the worse prognosis than that of any other sites. It is usually asymptomatic in early stage and difficult to find out the primary lesion by visual examination, and these facts lead to delay in diagnosis and reduce the curability. The major factor of failure in treatment of melanoma is local recurrence rather than regional spread. Because the radical procedure is difficult in head and neck lesion due to anatomical limitation, radiation therapy and chemotherapy can be used in the treatment of local recurrence. We experienced two cases of nasopharyngeal melanoma in advanced stage and treated them with radiation therapy and/or chemotherapy. And both patients showed relatively favorable response to these palliative treatments.

• Archives of Plastic Surgery
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• 제36권4호
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• pp.485-488
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• 2009

Purpose: Malignant melanoma of the lower extremity is well known to metastasize to the lymph nodes of the groin. However, in rare cases, the initial site of the nodal disease can be the popliteal fossa. As of yet, there has not been any report on cases with popliteal lymph node metastasis in Koreans. In the following report, authors would like to present two cases of popliteal node metastasis. Methods: A 60 - year - old male patient presented with nodular mass at his left sole. He had popliteal node metastasis detected on preoperative positron emission tomography(PET). Another 67 - year - old man presented with pigmented lesion at his right heel. He also had popliteal node metastasis detected on the MRI. They underwent wide excision of the primary lesion with popliteal node dissection. Results: In the first case, $2.5{\times}2.5cm$ sized metastatic melanoma in popliteal node was pathologically confirmed. There were no postoperative complications, and to date(18 months after the surgery), the patient is alive with no evidence of disease. In the second case, multiple(4) metastatic melanoma in popliteal nodes was confirmed. The patient is alive, but has had interferon therapy for liver metastasis. Conclusion: By increasing the use of lymphoscintigraphy or PET as a preoperative diagnostic work - up for metastasis, even popliteal node metastasis undetectable in a physical exam becomes detectable. When metastatic lymph node is found, node dissection is the standard of care. Therefore, it is essential that we know the anatomy and surgical technique for popliteal lymph node dissection.

• Radiation Oncology Journal
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• 제37권1호
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• pp.51-59
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• 2019

Purpose: We evaluated failure pattern and treatment outcomes of observational approach on regional lymph node (LN) in cutaneous melanoma of extremities and sought to find clinico-pathologic factors related to LN metastases. Material and Methods: We retrospectively reviewed 73 patients with cutaneous melanoma of extremities between 2005 and 2016. If preoperative 18-F-fluorodeoxyglucose (FDG)-positron emission tomography/computed tomography (PET/CT) findings were non-specific for regional LNs, surgical resection of primary tumors with adequate margins was performed without sentinel lymph node biopsy (SLNB) and/or complete lymph node dissection (CLND), irrespective of tumor thickness or size. In patients with suspicious or positive findings on PET/CT or CT, SLNB followed by CLND or CLND was performed at the discretion of the surgeon. We defined LN dissection (LND) as SLNB and/or CLND. Results: With a median follow-up of 38 months (range, 6 to 138 months), the dominant pattern of failure was regional failure (17 of total 23 events, 74%) in the observation group (n = 56). Pathologic LN metastases were significant factor for poor regional failure-free survival (hazard ration [HR] = 3.21; 95% confidence interval [CI], 1.03-10.33; p = 0.044) and overall survival (HR = 3.62; 95% CI, 1.02-12.94; p = 0.047) in multivariate analysis. In subgroup analysis for cN0 patients according to the preoperative PET/CT findings, LND group showed the better trend of LRFFS (log rank test, p = 0.192) and RFFS (p = 0.310), although which is not statistically significant. Conclusion: Observational approach on regional LNs on the basis of the PET/CT in patients with cutaneous melanoma of extremities showed the dominant regional failure pattern compared to upfront LND approach. To reveal regional lymph node status, SLND for cN0 patients may of importance in managing cutaneous melanoma patients.

• Archives of Plastic Surgery
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• 제35권3호
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• pp.261-266
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• 2008

Purpose: The incidence of skin cancer is increasing throughout the world including Asian countries such as Korea. Still there are only limited reports of the clinical features of skin cancer in Korea, especially in the fields of plastic surgery. This study is to demonstrate the recent clinical trends of skin cancer and the treatment of skin cancer in Korea by analyzing a single institution's experience. Methods: During a 11-year period, 370 patients visited our department for the excision of skin cancer. Data of the patients such as histopathologic diagnosis, primary site of the tumor, age and sex of the patient, operative methods were reviewed retrospectively. Results: We had 370 patients, 215 men and 155 women. The ages ranged from 10 to 95 years with a mean of 58.8 years. A total of 143 patients were diagnosed as basal cell carcinoma, while 100 were malignant melanoma, 80 were squamous cell carcinoma, 17 were dermatofibrosarcoma protuberans, and 30 were other miscellaneous skin cancers. Local flaps were the most frequently used reconstructive method after wide excision of the cancer, which was followed by primary closure, split-thickness skin graft, free flap and full-thickness skin graft. Conclusion: There was a gradual increase in the incidence of skin cancer after the year 2000. Basal cell carcinoma had the highest incidence which frequently involved the sun-exposed regions in the old ages. Malignant melanoma showed a relatively high incidence compared with other previous studies in Korea. The extremities were the most frequent location for malignant melanoma. Clinical features of other various skin cancers were also reported in this study. The reconstructive method highly depends on the primary site of the cancer, while local flaps were the mostly used operative technique.

• 대한영상의학회지
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• 제84권3호
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• pp.763-769
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• 2023

유방 실질의 원발성 악성 흑색종은 극히 드물며, 대부분 유방 내 만져지는 종괴로 나타난다. 유방 농양으로 나타난 원발성 악성 흑색종은 아직까지 영문 문헌에 보고된 바 없다. 저자들은 반복적으로 재발하는 유방 농양이 있었던 71세 여자 환자에서 진단된 유방 실질의 원발성 악성 흑색종을 보고하고자 한다. 유방 자기공명영상 검사에서 조영증강되는 고형 부분과 낭성 또는 괴사 부분을 동반한 종괴가 있었고, 조영 전 T1 강조 영상에서 높은 신호 강도인 부분과 T2 강조 영상에서 어두운 신호 강도인 테두리가 있었다. 재발성 유방 농양의 임상 소견을 보인 본 증례에서 기저의 악성 질환 가능성을 의심하고 정확한 진단을 얻는 데 MRI 소견이 결정적인 역할을 하였다.

• 대한한의학회지
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• 제35권4호
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• pp.98-103
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• 2014

Objectives: Advanced malignant melanoma (MM) has a poor prognosis, with an expected 2-year survival rate of 10 to 20%. It has long been recognized as an immunogenic tumor, and is worse for elderly patients. Many studies have suggested that herbal treatments improve immune functions, but few clinical studies have reported on this topic. Patients and History: We present two cases of female patients (72 and 77 years old, respectively) with advanced MM. The 72-year-old female patient was, at first, diagnosed with MM with multiple bone metastases. She received resection of the primary lesion, but refused further chemotherapy. The 77-year-old female patient was diagnosed with cutaneous MM of the left heel, with suspicion of sentinel node lymphadenopathy; however, she also refused any conventional treatment due to old age. Course of Therapy and Results: Both patients were exclusively treated with standardized allergen-removed Rhus verniciflua stokes (aRVS) extract combined with Bojungikki-tang (BT, Bu-Zhong-Yi-Qi-Tang in Chinese or Hochu-ekki-to in Japanese). Both patients are still alive and doing well (Feb. 2014), demonstrating that the 72-year-old patient has lived for 27 months and the 77-year-old patient has lived for 31 months without disease progression since the aRVS and BT administration. Conclusion: We suggest that the combination of aRVS extract and BT could be a candidate for overcoming the cancer's immunoediting process especially for elderly MM patients intolerant of conventional treatment.

• Interdisciplinary Bio Central
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• 제3권1호
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• pp.5.1-5.5
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• 2011

Introduction: Many signal transduction pathways mediate cell's behavior by regulating expression level of involved genes. Abnormal behavior indicates loss of regulatory potential of pathways, and this can be attributed to loss of expression regulation of downstream genes. Therefore, function of pathways should be assessed by activity of a pathway itself and relative activity between a pathway and downstream genes, simultaneously. Results and Discussion: In this study, we suggested a new method to assess pathway's function by introducing concept of 'responsiveness'. The responsiveness was defined as a relative activity between a pathway itself and its downstream genes. The expression level of a downstream gene as a function of an upstream pathway activation characterizes disease status. In this aspect, by using the responsiveness we predicted potential progress in cancer development. We applied our method to predict primary and metastatic status of melanoma cancer. The result shows that the responsiveness-based approach achieves better performance than using gene or pathway information alone. The mean of ROC scores in the responsiveness-based approach was 0.90 for GSE7553 data set, increased more than 40% compared to a gene-based method. Moreover, identifying the abnormal regulatory patterns between pathway and its downstream genes provided more biologically interpretable information compared to gene or pathway based approaches.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제47권2호
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• pp.76-81
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• 2021

Objectives: We aimed to collect and report data from all patients who have been diagnosed with mucosal malignant melanoma to obtain the epidemiology and principles of current treatments. Materials and Methods: Between January 2008 and December 2018, 20 patients underwent surgery or follow-up observations at Yonsei University Dental Hospital. The patients' clinical information was reviewed retrospectively. Results: Seventeen of 20 patients had undergone definitive surgery, while only 6 patients received adjuvant radiotherapy or systemic therapy. Eight of 20 patients, including those that had recurrent lesions, were provided immunotherapy. The 3-year survival for all stages was 50%, with a local recurrence rate of 75% and a metastasis rate of 65%. Conclusion: The overall survival of patients receiving surgical treatment was longer than that of patients who did not undergo surgical resection. Eight of 20 patients received immunotherapy as the first-line regimen at our clinic, and those patients exhibited longer overall survival compared to patients in reported keynote studies.

• Journal of Chest Surgery
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• 제25권10호
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• pp.1030-1034
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• 1992

There are follow-up data according to thirteen patients recieved the surgical resection for metastatic lung cancer arising from different primary tumor. The patients were received the surgical resection at Korean Cancer Center Hospital from July 1987 to Setember 1991 and followed-up to August 1992. There were 9 men and 4 women, ranging in age from 16 to 70 years[mean age, 42.8 years]. The primary tumors were 2 synovial sarcoma, 2 sarcoma, 2 osteosarcoma, 3 laryngeal ca, 1 melanoma, 1 ovarian ca and 1 bladder ca. The operative procedures were 5 wedge resections, 1 segmental resection, 5 lobectomies, 1 bil-obectomy and 1 pneumonectomy. There was no operative and hospital death. There were 3 deaths[each survival period: 2, 9 and 20 months, average 10.3 months]and 5 tumor recurrence during follow-up. At now, the average survival period of aliving patients is 29.1 months.

• Journal of Photoscience
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• 제9권2호
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• pp.197-200
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• 2002

UVR-induced immunosuppression contributes to skin cancer. The aim was to construct accurate dose response curves for primary and secondary contact sensitivity for solar-simulated UVR (ssUVR; 290-400nm), UVA and UVB as the role of UVA in immunosuppression is controversial. We used a xenon arc source. The mice were immobilised, enabling accurate dosing. C57BL/6 mice were immunosuppressed at half the dose of ssUVR required to cause sunburn but not by higher doses (up to the sunburn dose). Thus, ssUVR causes systemic immunosuppression only over a narrow, low dose range. UVA caused suppression at low but not high doses whereas UVB induced immunosuppression at all doses tested. 8 weeks later the mice were resensitised to assess tolerance. Mice exposed to the minimum immunosuppressive dose of ssUVR prior to primary sensitisation were tolerant to re-sensitisation. However, at higher doses of ssUVR, these mice were protected from tolerance. Interestingly, while low doses of UV A caused immunosuppression, even lower doses enhanced the response to the second sensitisation. Higher doses of UVA had no affect. UVB induced tolerance in a dose related manner. Thus, ssUVR only induces immunosuppression and tolerance over a narrow dose range. Both UVA and UVB are immunosuppressive at this dose, while higher doses of UVA protect from the suppressive effects of UVB. Surprisingly very low doses of UVA enhanced memory development. Thus UVR has complex effects on the immune system depending on dose and spectrum.