• Journal of Chest Surgery
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• 제31권6호
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• pp.629-633
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• 1998

폐암의 정확한 진단을 위한 세침 흡입생검에 의한 종양세포의 흉벽전이는 매우 희귀하나 생길 수 있는 합병증 중의 하나이다. 특히 세침 흡입생검에 의한 종양세포의 흉벽전이는 수술적 치료로 완치 가능성이 높은 폐암을 치료가 어려운 치명적인 상태로 전환시킬 수가 있다. 저자등은 세침 흡입생검 후 발생한 폐암의 흉벽전이 2예를 경험하였기에 보고하는 바이다. 55세 남자 환자는 전이된 흉벽의 늑골을 포함하여 전층을 절제하고 결손부위를 광배근을 이용한 근육피부판으로 흉벽 재건술을 시행하였으며 68세 여자 환자는 전이된 흉벽종양의 감염과 괴사성 출혈로 인해 흉벽의 부분절제와 피부이식으로 치료하였다. 두 환자 모두 각각 수술후 2년 7개월, 3개월까지 경과 양호하며 외래 추적관찰중이다.

• 대한두경부종양학회지
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• 제16권2호
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• pp.196-200
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• 2000

Objectives: Submandibular gland tumors is rare. The aim of this study is to get a clinical feature of submandibular gland tumors and to apply a treatment of submandibular gland tumors of future patients. Methods: We analyzed retrospectively the 18 patients with submandibular gland tumors who were treated surgically at Presbyterian Medical Center(PMC), during the period of 8 years from 1992 to 1999. Analysis was performed regarding the incidence, classification, surgical treatment, surgical complication, recurrence and prognosis. Result : 1) Male to female sex ratio was 1:1.25, the most prevalent age group was the 5th decade. 2) Benign tumors were 12 cases(66.7%) and malignant tumors were 6 cases(33.3%). 3) Histopathologically, the most common benign submandibular gland tumor was pleomorphic adenoma, and the most malignant submandibular gland tumor was adenoid cystic carcinoma. 4) In pleomorphic adenoma, excision of submandibular gland was performed in all case(8case). In malignant tumors, excision and supraomohyoid node dissection was performed in 3cases, and modified-radical neck dissection(RND) was performed in 2cases, and than standard RND was performed in 1case. 5) In the malignant tumor, we choose a radiation therapy as adjuvant therapy. 6) In a surgical complication of submandibular gland tumor, we had a facial nerve injury(1case). 7) Recurrence rate of submandibular gland tumor was 22.2%, and than all case were malignant tumor. Overall 5-year survival rate of submandibular gland cancer was 50%. Conclusion: In above results, postoperative recurrence rate is low in benign, but high in malignant tumor of submandibular gland. Surgical procedure should not be aggressive in benign tumor, but should be aggressive in malignant tumor of submandibular gland and an adjuvant radiation therapy should be considered.

• Archives of Plastic Surgery
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• 제39권1호
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• pp.63-66
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• 2012

Nevus comedonicus is a type of hamartoma that arises from a developmental anomaly of the mesodermal part of the pilosebaceous gland. In most cases of nevus comedonicus, an acne-like skin condition develops. Repeated inflammation can cause a morphological change to the cyst, papule, to abscess. We experienced a case of congenital nevus comedonicus, which led to the formation of large multiple cysts. A 50-year-old man was referred with a $12.5{\times}10cm$ lobulated mass on the posterior neck and upper back. The patient had a widespread presence of nevus comedonicus in the region ranging from the right superior chest to the posterior neck. The patient had a 30-year history of six prior excisions. A magnetic resonance imaging review led to a diagnosis of nevus comedonicus. Surgical treatment consisted of excision of the mass and wide excision for the patch type of nevus comedonicus around the neck. On histopathology, multiple masses were diagnosed as typical cysts containing keratinized tissue. The diffuse comedone lesions were diagnosed as nevus comedonicus. This case shows that large, multiple cysts can occur as a long-term complication of nevus comedonicus, and also highlights the importance of radical resection to prevent its further invagination.

• Archives of Plastic Surgery
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• 제39권4호
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• pp.376-383
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• 2012

Background No consensus has been reached regarding the outcome of management of local recurrence after transverse rectus abdominis myocutaneous (TRAM) flap breast reconstruction. This study demonstrated the presentation, management, and outcomes of local recurrence after immediate TRAM breast reconstruction. Methods A comparison was conducted among 1,000 consecutive patients who underwent immediate breast reconstruction with a pedicled TRAM flap (TRAM group) and 3,183 consecutive patients who underwent only modified radical mastectomy without reconstruction (MRM group) from January 2001 to December 2009. The presentation, treatment, and outcome including aesthetics and overall survival rate were analyzed. Results Local recurrences occurred in 18 (1.8%) patients (TRAM-LR group) who underwent TRAM breast reconstruction and 38 (1.2%) patients (MRM-LR group) who underwent MRM only (P=0.1712). Wide excision was indicated in almost all the local recurrence cases. Skin graft was required in 4 patients in the MRM-LR group, whereas only one patient required a skin graft to preserve the mound shape in the TRAM-LR group. The breast mound was maintained in all 17 patients that survived in the TRAM-LR group even after wide excision. The overall survival rate was 94.4% in the TRAM-LR group and 65.8% in the MRM-LR group (P=0.276). Conclusions Local recurrence after immediate TRAM flap breast reconstruction could be detected without delay and managed effectively by multiple modalities without reducing overall survival rates. Breast mound reconstruction with soft autologous tissue allowed for primary closure in most of the cases. In all of the patients who survived, the contour of their reconstructed breast remained.

• 대한골관절종양학회지
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• 제1권1호
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• pp.84-90
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• 1995

To evaluate the role of radiation and chemotherapy after limb-saving operation in the management of soft tissue sarcoma, the authors analysed retrospectively 33 patients treated in department of Orthoaepdic Surgery and Radiation Therapy, Catholic University Medical College, in terms of survival rate, local recurrence rate and prognostic factors. There were 16 males and 17 females. The age distribution ranged from 16 to 81 years with mean age of 48. The follow-up period ranged from 2 to 10 years with average of 5.5 years. The histologic diagnoses were 9 liposarcoma(27.2%), 8 malignant fibrohistiocytoma(24.2%), 7 unclassifiable(21.2%), 3 rhabdomyosarcoma(9.1%), 2 malignant schwannoma, 2 synovral sarcoma, and 2 fibrosarcoma(6.1%) in orders. While marginal and intralesional margins were gained in 24 patients(72.7%), wide and radical margins were obtained only in 9 patients(27.3%). On postoperative 3 weeks, local irradiation of 5000-7000 cGy was delivered to all patients by shrinking field technique for 5-8 weeks. Of 33 patients, 16(45.5%) patients were received adjuvant chemotherapy in combination of adriamycin, cyclophosphamide & vicristine, or VP16 & ifosfamide based on histologic type and obtained surgical margin. The survival rates by direct method at 2 years and 5 years were 58% and 37% respectively. Local recurrences occured in 15 patients(45.5%) at average 16 months after operation. Survival rates at 2 years and 5 years were 37% and 22% in case of intralesional and manginal excision, 75% and 47% in case of wide and radical excision respectively with statistical significance(p<0.05). They were 25% and 17% in the presence of local recurrence, 67% and 42% in the absence of local recurrence respectively with statistical significance(p<0.05). Even though there was no statistical correlation between survival rate and tumor size(p>0.05), the authors considered tumor size as a significant prognostic factors as well as surgical margin and the presence of local recurrence.

• 대한두경부종양학회지
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• 제10권1호
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• pp.46-52
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• 1994

This review is based on the 52 cases of salivary gland tumors treated at the department of surgerym Hallym University Kangdong Sacred Heart hospital during the period from March 1987 to May 1992. There were 43 benign and 9 malignant tumors. Twenty eight(54%) of these cases were located in the parotid gland, 14(27%) in the submandibular gland, the rest of 10 cases(19%) in the minor salivary glands. Female outnumbered male by the ratio 1.6:1. Pleomorphic adenoma was the most common tumor followed by carcinoma and adenolymphoma(Warthin's tumor). The most common presenting symptom in both benign and malignant tumors was palpable mass. However, some patients with malignancy presented symptoms such as pain, facial palsy and dysphagia. Among 9 cases with malignancies 3 cases were found to have metastasis in the regional lymphnodes and two cases had distant metastasis. In majority of benign parotid tumors, superficial parotidectomy was carried out. In three cases of carcinoma of parotid gland with lymphnode metastasis, total parotidectomy with radical neck dissection was done. One case out of two cases of carcinoma of submandibular gland was treated with total excision of the gland with radical neck dissection. There were no postoperative mortalies. Two cases each of facial palsies and wound infections were observed as complication.

• Archives of Plastic Surgery
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• 제33권5호
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• pp.627-631
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• 2006

Purpose: Ischial region is common site of pressure sore as well as greater trochanteric area. In general, ischial pressure sore associated with a large subcutaneous bursa often requires radical surgical treatment. The authors performed sclerotherapy using absolute ethanol which was considered as an alternative in treating recurrent ischial pressure sore. Methods: From may 2005 to February 2006, 11 ischial pressure sore patients were treated sclerotherapy using absolute ethanol. The authors performed sclerotherapy using absolute ethanol in 11 patients in whom the ischial sore has recurred despite of multiple radical surgical treatment. The patients' original disorders were spinal cord injury in 9 patients, cerebral palsy in 1 patient and giant cell tumor in thoracic vertebrae 1 patient. Results: Recurrence of pressure sore was not found in any patient during the follow-up period. The swap of the bursa taken before the surgery was germ cultured and compared with the discharge from an end of the inserted drain tube. The germ cultured results after the surgery were tested negative in all patients. Conclusion: This method involves causing the bursa to become scarred and closing it up by sterilizing, fixing, and denaturing by the pharmacologic effect of absolute ethanol instead of surgical excision of the bursa. We felt that aforementioned treatment modality may be considered as an alternative in treating recurrent ischial pressure sore.

• Journal of Chest Surgery
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• 제30권10호
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• pp.1001-1004
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• 1997

흉부 교감신경절제술은 수장부 다한증의 근치적이고 확실한 치료법이다. 영동세브란스병원 흉부외과에서 는 1992년 1월부터 1997년 3월까지 4명의 재발성 다한증 환자에서 흉강경을 이용한 재교감신경절제술을 시행하였다. 그 중 남자가 2명, 여자가 각각 2명씩이었으며 평균연령은 20세이었다. 수술시 모든 환자에서 이전에 교감신경을 절제한 부위에 중등도에서 심한정도의 유착이 있었으나 개흉술 로의 전환이나 수술 중 및 수술 후 합병증은 없었다. 수술 후 모든 환자에게 손바닥 발한은 관찰되지 않았으며, 수술결과에 대해 크게 만족스러워 하였다. 결론적으로 재발성 다한증은 흉강경을 이용한 재교감신경절제술로 성공적으로 치료되었으며 재발을 방지 하고 수술후 합병증을 최소화하기 위해서는 제2교감신경절의 정확한 위치선정. Knd fibers를 포함한 해부학 적인 변이에 대한 확실한 제거가 필요하다.

• Asian Pacific Journal of Cancer Prevention
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• 제16권8호
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• pp.3419-3423
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• 2015

Background: Liposarcoma of the spermatic cord is rare and frequently misdiagnosed. The standard therapeutic approach has been radical inguinal orchiectomy with wide local resection of surrounding soft tissues. The current trend of organ preservation in the treatment of several cancers has started to evolve. Herein we present our testis-sparing surgery experience in the treatment of spermatic cord liposarcoma and a pooled analysis on this topic. Materials and Methods: Clinical information from patient receiving organ-sparing surgery was described. Clinical studies evaluating this issue were identified by using a predefined search strategy, e.g., Pubmed database with no restriction on date of published papers. The literature search used the following terms: epidemiology, surgery, chemotherapy, radiotherapy, testis sparing surgery, spermatic cord sarcomas/liposarcomas. Results: Patient received a complete excision of the lesion, preserving the spermatic cord and the testis. The final pathological report showed a well differentiated liposarcoma with negative surgical margins and no signs of local invasion. After 2-year of follow-up, there was no evidence of local recurrence. Since the first case reported in 1952, a total of about 200 well-documented spermatic cord liposarcoma cases have been published in English literature. Among these patients, only three instances were reported to have received an organ-sparing surgery in the treatment of spermatic cord liposarcoma. Conclusions: Radical inguinal orchiectomy and resection of the tumor with a negative microscopic margin is the recommended treatment for liposarcoma of the spermatic cord. But for small, especially well-differentiated, lesions, testis-sparing surgery might be a good option if an adequate negative surgical margin is assured.

• Journal of Chest Surgery
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• 제18권4호
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• pp.849-854
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• 1985

We have experienced 50 cases of mediastinal tumors and cysts from March, 1979 to August, 1985 at Kyung Hee University Hospital. The results of this cases analysis were as followings; 1. Of all 50 mediastinal tumors and cysts, 26 patients were male and 24 patients were female. There was no sex preference. The age distribution was from 27 months to 64 years, and mean age was 33.5 years old, and also no age preference. 2. The most common mediastinal tumor was benign cysts [12 cases], which comprise 24% of all mediastinal tumors and cysts. The second common mediastinal tumor was teratoma [9 cases-18%], and followed by thymic tumors and tuberculous granuloma [7 cases-14% each], neurogenic tumors [5 cases-10%], and other tumors [10 cases-20%]. 3. The anterior mediastinum was most common tumor location, and followed by middle, superior, and posterior. 4. All 9 teratomas were developed at anterior mediastinum, and 4 of 5 neurogenic tumors were developed at posterior mediastinum. Thymomas were developed at anterior and superior mediastinum. The bronchogenic cysts had no predilection of location. 5. The most common chief complaint at admission was chest pain or discomfort [23 cases-46%], and followed by cough with or without sputum, and exertional dyspnea. Asymptomatic patients were only 7 patients [24%]. 6. Of all 50 cases, 38 cases [76%] received radical tumor resection, 7 mediastinoscopic biopsy, 3 explo thoracotomy and biopsy, and 1 neck mass biopsy. 7. There were 2 hospital deaths, one of which was a patient who suffered malignant thymoma and Myasthenia Gravis. The patient received radical tumor excision, but died at 7th POD. The other patient was a patient with malignant transformation of the benign cystic teratoma. The operative mortality was 4%.