• Title/Summary/Keyword: Primary 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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    • v.40 no.3
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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.

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

  • Yu, Min-Gi;Ryu, Sun-Youl
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.35 no.4
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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.

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

  • Kim, Chang-Nyun;Kim, Sung-Joo;Chung, Jae-Ho;Park, Moo-Suk;Ko, Won-Ki;Lee, Jun-Gu;Kim, Se-Kyu;Kim, Sung-Kyu;Chang, Joon;Shin, Dong-Hwan
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.5
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    • pp.624-629
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    • 2001
  • Metastatic tumors to the eyes are probably the most common type of intraocular malignancies. The most common metastatic tumor is the breast cancer overall and lung cancer in men. An eyeball metastasis from lung cancer has a poor prognosis. Differentiating an eyeball metastasis from the primary malignant melanoma is important. Eyeball metastasis of a lung adenocarcinoma confirmed by pathology has not reported in Korea. Here we report a case of a metastatic lung adenocarcinoma to the eyeball confirmed by enucleation and a transbronchial lung biopsy with a review of the relevant literature.

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A clinical review of reconstructive techniques for patients with multiple skin cancers on the face

  • Kim, Geon Woo;Bae, Yong Chan;Bae, Sung Hwan;Nam, Su Bong;Lee, Dong Min
    • Archives of Craniofacial Surgery
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    • v.19 no.3
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    • pp.194-199
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    • 2018
  • Background: Cases of simultaneous multiple skin cancers in a single patient have become more common. Due to the multiplicity of lesions, reconstruction in such cases is more difficult than after a single lesion is removed. This study presents a series of patients with multiple facial skin cancers, with an analysis of the surgical removal, reconstruction process, and the results observed during follow-up. Methods: We reviewed 12 patients diagnosed with multiple skin cancers on the face between November 2004 and March 2016. The patients' medical records were retrospectively reviewed to identify the type of skin cancer, the site of onset, methods of surgical removal and reconstruction, complications, and recurrence during follow-up. Results: Nine patients had a single type of cancer occurring as multiple lesions, while three patients had different skin cancer types that occurred together. A total of 30 cancer sites were observed in the 12 patients. The most common cancer site was the nose. Thirteen defects were reconstructed with a flap, while 18 were reconstructed with skin grafting. The only complication was one case of recurrence of basal cell carcinoma. Conclusion: Multiple skin cancers are removed by performing Mohs micrographic surgery or wide excision, resulting in multiple defect sites. The authors emphasize the importance of thoroughly evaluating local lesions surrounding the initially-identified lesions or on other sites when reconstructing a large defect which can not be covered by primary closure. Furthermore, satisfactory results can be obtained by using various methods simultaneously regarding the condition of individual patients, the defect site and size, and the surgeon's preference.

Skin Regeneration and Whitening Effects of the Complex Extract of Dendrobii Caulis and Centella asiatica (석곡 및 병풀 복합 추출물의 피부 색소 침착 방지 및 피부재생 효과)

  • Kim, Dong-Myong;Park, Hye-Ryung;Lee, Hyung-Kon;Kwon, Yong-Seong;Choi, Yeon-Mea;Han, In-Suk
    • Korean Journal of Pharmacognosy
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    • v.53 no.2
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    • pp.70-78
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    • 2022
  • The objective of this study was to assess the effect of preventing pigmentation caused by external stimuli, promoting skin regeneration and whitening of the skin composition containing complex extract of Dendrobii Caulis and Centella asiatica (CE). We evaluated cell viability, tyrosinase and melanin inhibition activity, skin irritation test, and skin moisturizing and regenerative effects using CE. As a result of the tyrosinase inhibitory activity, 100 ㎍/mL CE (35.31%) showed higher value than kojic acid (21.32%). The results of melanin synthesis inhibition in B16F10 melanoma cells after treatment with α-melanocyte stimulating hormone showed a similar level of activity to that of arbutin, indicating an excellent whitening effect. In clinical test of the skin composition containing CE, we confirmed that CE is non-irritated in human skin primary irritation test as well as have a high skin moisturizing and regenerative effect. From these results, we suggested the CE not only prevents skin damage and pigmentation caused by external stimuli but has remarkable skin brightening activity and skin regeneration effect.

Bladder Cancer Metastasis to the Breast in a Male Patient: Imaging Findings on Mammography and Ultrasonography (남자 환자에서 방광암의 유방 전이암: 유방촬영술 및 초음파 영상 소견)

  • In Na Yoon;Eun Suk Cha;Jeoung Hyun Kim;Jee Eun Lee;Jin Chung
    • Journal of the Korean Society of Radiology
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    • v.83 no.3
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    • pp.687-692
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    • 2022
  • Male breast cancer is rare, accounting for approximately 1% of breast cancers. Metastasis from extra-mammary malignancy to the breast in men is extremely rare. The most common primary tumors that metastasize to the breast in male are prostate, lung, stomach, colorectal cancer, melanoma, and sarcoma. To our knowledge, only a few cases of bladder cancer presenting with metastasis to the male breast have been reported, and metastasis with infiltration rather than mass is extremely rare. We report imaging findings on mammography and ultrasonography in a 59-year-old male with bladder cancer metastatic to the breast.

Type I Interferon Increases Inflammasomes Associated Pyroptosis in the Salivary Glands of Patients with Primary Sjögren's Syndrome

  • Seung-Min Hong;Jaeseon Lee;Se Gwang Jang;Jennifer Lee;Mi-La Cho;Seung-Ki Kwok;Sung-Hwan Park
    • IMMUNE NETWORK
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    • v.20 no.5
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    • pp.39.1-39.13
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    • 2020
  • Sjögren's syndrome (SS) is a chronic and systemic autoimmune disease characterized by lymphocytic infiltration in the exocrine glands. In SS, type I IFN has a pathogenic role, and recently, inflammasome activation has been observed in both immune and non-immune cells. However, the relationship between type I IFN and inflammasome-associated pyroptosis in SS has not been studied. We measured IL-18, caspase-1, and IFN-stimulated gene 15 (ISG15) in saliva and serum, and compared whether the expression levels of inflammasome and pyroptosis components, including absent in melanoma 2 (AIM2), NLR family pyrin domain containing 3 (NLRP3), apoptosis-associated speck-like protein (ASC), caspase-1, gasdermin D (GSDMD), and gasdermin E (GSDME), in minor salivary gland (MSG) are related to the expression levels of type I IFN signature genes. Expression of type I IFN signature genes was correlated with mRNA levels of caspase-1 and GSDMD in MSG. In confocal analysis, the expression of caspase-1 and GSDMD was higher in salivary gland epithelial cells (SGECs) from SS patients. In the type I IFN-treated human salivary gland epithelial cell line, the expression of caspase-1 and GSDMD was increased, and pyroptosis was accelerated in a caspase-dependent manner upon inflammasome activation. In conclusion, we demonstrate that type I IFN may contribute to inflammasome-associated pyroptosis of the SGECs of SS patients, suggesting another pathogenic role of type I IFN in SS in terms of target tissue -SGECs destruction.

Gamma Knife Radiosurgery for Metastatic Brain Tumors with Exophytic Hemorrhage

  • Park, Eun Suk;Lee, Eun Jung;Yun, Jung-Ho;Cho, Young Hyun;Kim, Jeong Hoon;Kwon, Do Hoon
    • Journal of Korean Neurosurgical Society
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    • v.61 no.5
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    • pp.592-599
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    • 2018
  • Objective : Metastatic brain tumors (MBTs) often present with intracerebral hemorrhage. Although Gamma Knife surgery (GKS) is a valid treatment option for hemorrhagic MBTs, its efficacy is unclear. To achieve oncologic control and reduce radiation toxicity, we used a radiosurgical targeting technique that confines the tumor core within the hematoma when performing GKS in patients with such tumors. We reviewed our experience in this endeavor, focusing on local tumor control and treatment-associated morbidities. Methods : From 2007 to 2014, 13 patients with hemorrhagic MBTs were treated via GKS using our targeting technique. The median marginal dose prescribed was 23 Gy (range, 20-25). GKS was performed approximately 2 weeks after tumor bleeding to allow the patient's condition to stabilize. Results : The primary sites of the MBTs included the liver (n=7), lung (n=2), kidney (n=1), and stomach (n=1); in two cases, the primary tumor was a melanoma. The mean tumor volume was $4.00cm^3$ (range, 0.74-11.0). The mean overall survival duration after GKS was 12.5 months (range, 3-29), and three patients are still alive at the time of the review. The local tumor control rate was 92% (tumor disappearance 23%, tumor regression 46%, and stable disease 23%). There was one (8%) instance of local recurrence, which occurred 11 months after GKS in the solid portion of the tumor. No GKS-related complications were observed. Conclusion : Our experience shows that GKS performed in conjunction with our targeting technique safely and effectively treats hemorrhagic MBTs. The success of this technique may reflect the presence of scattered metastatic tumor cells in the hematoma that do not proliferate owing to the inadequate microenvironment of the hematoma. We suggest that GKS can be a useful treatment option for patients with hemorrhagic MBTs that are not amenable to surgery.

The Comparative Effects of Yugmijihwangtang in Donguibogam and Experiment Research Results -Focusing on the Korean Medicine and Traditional Chinese Medicine- (육미지황탕 효능의 동의보감과 실험연구결과의 비교고찰 -한의학과 중의학을 중심으로-)

  • Han, Yoochang;Kim, Myung Dong;Lee, Sundong
    • Herbal Formula Science
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    • v.25 no.2
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    • pp.223-251
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    • 2017
  • Objectives : A lot of experiment results of Yugmijihwangtang(YM) are reported in various kinds of journals. Many of them report on the new effects that are not recorded in the traditional medical texts. So it is necessary to take it into consideration that newly reported effects could be of help to clinical practice, because this process of comparison of Donguibogam and scientific experiment results will have basis to lead into the evidence based medicine. Methods : We compared the effects of in Donguibogam and the experiment results of YM. Results : The effects of YM in Donguibogam are to replenish essence and marrow, and to treat red wen, fatigue, treat hypouresis, urinary sediment, urinary urgency, hematuria, hydrocephalus, speech and movement retardation, yin-deficiency, diabetes mellitus, nonalcoholic fatty liver, melanoma, disability to see near and far sight, tinnitus, hearing loss, alopecia, angiogenesis, cough, cough at night, trachyphonia, and, infantile convulsion. The experiment results of YM since 2000 in both Korea and China are to inhibit atopic dermatitis, renal interstitial fibrosis, anti-oxidant, emphysema, stress, glomerulosclerosis, diabetic nephropathy, chronic glomerulonephritis, hemorrhage, plantar sweating, dermal aging, kidney aging, bone loss, breast cancer, pathological myocardial cell, primary liver cancer, thrombosis, osteoporosis, intrauterine growth retardation, chronic renal failure, IgA nepropathy, slow cerebral development, and hippocampal tissue lesions on the one hand, and to help bone formation, renin-angiotensin- aldosterone system, cerebral recovery, cognitive function and expression, osteoblast proliferation and differentiation, learning and memory, cold-tolerance and oxygen deficit-tolerance and anti-fatigue, endometrial formation, humoral and cell-mediated immunity, immune regulation effect, Hypothalamus-Pituitary-Ovary Axis, and spermatogenesis, on the other hand. Conclusion : When we compared the effects of YM with the experiment results of YM, there existed a considerable gap between them. So, from now on, it is expected that a great effort and consideration are needed to solve these gaps from an academic and clinical point of view.

Gamma Knife Radiosurgery for Brainstem Metastasis

  • Yoo, Tae-Won;Park, Eun-Suk;Kwon, Do-Hoon;Kim, Chang-Jin
    • Journal of Korean Neurosurgical Society
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    • v.50 no.4
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    • pp.299-303
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    • 2011
  • Objective : Brainstem metastases are rarely operable and generally unresponsive to conventional radiation therapy or chemotherapy. Recently, Gamma Knife Radiosurgery (GKRS) was used as feasible treatment option for brainstem metastasis. The present study evaluated our experience of brainstem metastasis which was treated with GKRS. Methods : Between November 1992 and June 2010, 32 patients (23 men and 9 women, mean age 56.1 years, range 39-73) were treated with GKRS for brainstem metastases. There were metastatic lesions in pons in 23, the midbrain in 6, and the medulla oblongata in 3 patients, respectively. The primary tumor site was lung in 21, breast in 3, kidney in 2 and other locations in 6 patients. The mean tumor volume was $1,517mm^3$ (range, 9-6,000), and the mean marginal dose was 15.9 Gy (range, 6-23). Magnetic Resonance Imaging (MRI) was obtained every 2-3 months following GKRS. Follow-up MRI was possible in 24 patients at a mean follow-up duration of 12.0 months (range, 1-45). Kaplan-Meier survival analysis was used to evaluate the prognostic factors. Results : Follow-up MRI showed tumor disappearance in 6, tumor shrinkage in 14, no change in tumor size in 1, and tumor growth in 3 patients, which translated into a local tumor control rate of 87.5% (21 of 24 tumors). The mean progression free survival was 12.2 months (range, 2-45) after GKRS. Nine patients were alive at the completion of the study, and the overall mean survival time after GKRS was 7.7 months (range, 1-22). One patient with metastatic melanoma experienced intratumoral hemorrhage during the follow-up period. Survival was found to be associated with score of more than 70 on Karnofsky performance status and low recursive partitioning analysis class (class 1 or 2), in terms of favorable prognostic factors. Conclusion : GKRS was found to be safe and effective for management of brainstem metastasis. The integral clinical status of patient seems to be important in determining the overall survival time.