• Title/Summary/Keyword: Residual neoplasm

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Salvage Endoscopic Resection for Residual Lesion after Definitive Chemoradiotherapy in Esophageal Cancer

  • Kim, Seong Jung;Hong, Ran;Lee, Jun
    • Journal of Digestive Cancer Research
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    • v.7 no.2
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    • pp.57-60
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    • 2019
  • Definitive chemoradiotherapy (CRT) with its significant efficacy and safety in esophageal cancer is reserved for patients with unresectable tumor or those who decline surgery. However, the incidence of locoregional failure or recurrence after definitive CRT remains high. Although esophagectomy is the standard treatment for locoregional failure or recurrence, this approach is associated with high mortality and morbidity. A 56-year-old man diagnosed with esophageal squamous cell carcinoma who refused to undergo surgery received definitive CRT. An endoscopy for response assessment performed after 2 months revealed a residual lesion, which was completely resected by salvage endoscopic submucosal dissection. To the best of our knowledge, endoscopic resection in locoregional failure or recurrence after definitive CRT is very rarely reported, and there are no guidelines or consensus to date. Here, we report a case of successful salvage endoscopic resection of residual lesion after definitive CRT.

PROSTHETIC REHABILITATION OF THE PARTIALLY EDENTULOUS PATIENT BY USING OSSEOINTEGRATE IMPLANT AFTER REMOVAL OF AMELOBLASTOMA (법랑아세포종 제거후의 Implant보철수복 증례)

  • Ahn, Sang-Hun;Kim, Jong-Pil;Jo, Byung-Woan;Ahn, Jye-Jynn
    • The Journal of Korean Academy of Prosthodontics
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    • v.35 no.1
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    • pp.95-102
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    • 1997
  • Ameloblastoma is the most agrressive ofht odontogenic tumors and it arises from the dental lamina or the derivatives of lamina. Ameloblastoma is a benign but locally invasive neoplasm consisting of proliferating odontogenic epithelium lying in a fibrous stroma. Usually the ameloblastomas are diagnosed in the forth and fifth decardes. Over 80% of them occur in the mandible, the remainder in the maxilla. The preferred treatment for ameloblastoma is radical excision, conserving(when possible. the inferior border of the mandible. The functional and esthetic rehabilitation of the partially edentulous patient may prevent the remaining structures from supporting conventional prosthetic treatment. Patients with long edentulous spans, malpositioned teeth, residual ridges defects and high muscle attachments may be offered an osseointegrated fixed prosthesis. Osseointegrated dental implants provide a viable alternative of tooth replacement. This is a case report of 16 year old female with ameloblastoma. We treated patient with radical excision, conserving the inferior border of the mandible and allogenous bone graft. The defected residual ridge area was reconstructed implants(Steri-Oss Implant System). the result was satisfactory.

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Huge Size Intracranial Plasmacytoma Treated with Surgery and Fractionated Stereotactic Radiotherapy

  • Choi, Woo-Jin;Yee, Gi-Taek;Choi, Chan-Young;Whang, Choong-Jin
    • Journal of Korean Neurosurgical Society
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    • v.40 no.2
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    • pp.110-113
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    • 2006
  • Surgery and radiotherapy are mainly used for plasma cell neoplasm which constitutes about $1{\sim}2%$ of human malignancy. The authors carried out Fractionated Stereotactic Radiotherapy[FSRT] on the residual tumor after the subtotal removal of Intracranial plasmacytoma. A huge mass lesion was observed on MRI [magnetic resonance image] in the left anterior and middle cranial fossa of a 63-year-old man with left exophthalmus which lasted for a month, and was suspected as a meningioma with strong contrast enhancement. Extramedullary plasmacytoma was diagnosed on histopathological examination. After the surgery, FSRT was also carried out on the residual tumor which invaded the skull base. One-year follow up after FSRT showed contrast enhancement only in the left sphenoid bone on MRI, which indicated significant decrease in the size of the tumor without any abnormal neurologic deficits. We treated intracranial plasmacytoma which invaded left anterior and middle cranial fossa and surrounded cavernous sinus without cranial nerve deficit through subtotal tumor removal and FSRT.

Pulmonary Artery Sarcoma - One Case Report - (폐동맥에서 발생한 육종 - 1례보고 -)

  • Kim, Hyeong-Ryul;Kim, Kyung-Hwan;Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.35 no.9
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    • pp.692-696
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    • 2002
  • Pulmonary artery sarcoma is a rare disease and hard to diagnose; therefore, suspicion is very important for the diagnosis and treatment. Surgical resection is almost always needed because of progressive right heart failure. Adjuvant chemotherapy and radiation therapy are still controversial. We report a case of a 42-year-old man who had a right pulmonary arterial tumor Curative resection was impossible because the tumor invaded the left pulmonary artery. Palliative endarterectomy was performed followed by radiation therapy. The patient refused the chemotherapy. Until the postoperative 6th month, the residual tumor was stable. However, 15 months later, follow-up chest computed tomography revealed a metastatic pulmonary nodule at left lower lobe and the increased residual tumor. The patient received chemotherapy with limited tumor response. The metastatic nodule and residual tumor did not increase but bone scan revealed a rib metastasis at postoperative 24 months. He will be receiving additional chemotherapy.

Retiform hemangioendothelioma in the infratemporal fossa and buccal area: a case report and literature review

  • Kim, Il-Kyu;Cho, Hyun-Young;Jung, Bum-Sang;Pae, Sang-Pill;Cho, Hyun-Woo;Seo, Ji-Hoon;Park, Seung-Hoon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.42 no.5
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    • pp.307-314
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    • 2016
  • We report a case of retiform hemangioendothelioma (RH) located in the infratemporal fossa and buccal area in a 13-year-old Korean boy. The tumor originated from the sphenoid bone of the infratemporal fossa area and spread into the cavernous sinus, orbital apex, and retro-nasal area with bone destruction of the pterygoid process. Tumor resection was conducted via Le Fort I osteotomy and partial maxillectomy to approach the infratemporal fossa and retro-nasal area. The diagnosis of RH was confirmed after surgery. In the presented patient, surgical excision was incomplete, and close follow-up was performed. There was no evidence of expansion or metastasis of the residual tumor in the 8 years after surgery. In cases of residual RH with low likelihood of expansion and metastasis, even though RH is an intermediate malignancy, close follow-up can be the appropriate treatment choice over additional aggressive therapy. To date, 29 papers and 48 RH cases have been reported, including this case. This case is the second reported RH case presenting as primary bone tumor and the first case originating in the oromaxillofacial area.

Positional uncertainties of cervical and upper thoracic spine in stereotactic body radiotherapy with thermoplastic mask immobilization

  • Jeon, Seung Hyuck;Kim, Jin Ho
    • Radiation Oncology Journal
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    • v.36 no.2
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    • pp.122-128
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    • 2018
  • Purpose: To investigate positional uncertainty and its correlation with clinical parameters in spine stereotactic body radiotherapy (SBRT) using thermoplastic mask (TM) immobilization. Materials and Methods: A total of 21 patients who underwent spine SBRT for cervical or upper thoracic spinal lesions were retrospectively analyzed. All patients were treated with image guidance using cone beam computed tomography (CBCT) and 4 degrees-of-freedom (DoF) positional correction. Initial, pre-treatment, and post-treatment CBCTs were analyzed. Setup error (SE), pre-treatment residual error (preRE), post-treatment residual error (postRE), intrafraction motion before treatment (IM1), and intrafraction motion during treatment (IM2) were determined from 6 DoF manual rigid registration. Results: The three-dimensional (3D) magnitudes of translational uncertainties (mean ${\pm}$ 2 standard deviation) were $3.7{\pm}3.5mm$ (SE), $0.9{\pm}0.9mm$ (preRE), $1.2{\pm}1.5mm$ (postRE), $1.4{\pm}2.4mm$ (IM1), and $0.9{\pm}1.0mm$ (IM2), and average angular differences were $1.1^{\circ}{\pm}1.2^{\circ}$ (SE), $0.9^{\circ}{\pm}1.1^{\circ}$ (preRE), $0.9^{\circ}{\pm}1.1^{\circ}$ (postRE), $0.6^{\circ}{\pm}0.9^{\circ}$ (IM1), and $0.5^{\circ}{\pm}0.5^{\circ}$ (IM2). The 3D magnitude of SE, preRE, postRE, IM1, and IM2 exceeded 2 mm in 18, 0, 3, 3, and 1 patients, respectively. No association were found between all positional uncertainties and body mass index, pain score, and treatment location (p > 0.05, Mann-Whitney test). There was a tendency of intrafraction motion to increase with overall treatment time; however, the correlation was not statistically significant (p > 0.05, Spearman rank correlation test). Conclusion: In spine SBRT using TM immobilization, CBCT and 4 DoF alignment correction, a minimum residual translational uncertainty was 2 mm. Shortening overall treatment time and 6 DoF positional correction may further reduce positional uncertainties.

Pulmonary Metastasectomy from Testicular Germ Cell Tumor - A case report- (고환에서 발생한 종자세포암의 폐전이 절제 - 1예 보고 -)

  • Cho, Jun-Woo;Park, Ki-Sung
    • Journal of Chest Surgery
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    • v.43 no.6
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    • pp.833-837
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    • 2010
  • This is a report of successful management for pulmonary metastasis following chemotherapy in patient with testicular germ cell tumor. Postchemotherapy PET-CT was not uptake FDG in metastatic lesion. Pulmonary metastasectomy was performed, which is important to manage a residual postchemotherapy lung mass in testicular germ cell tumor for histological correlation with primary testicular lesion to select the patients who require subsequent chemotherapy. Our patient was well 6 months after operation, not carried out chemotherapy because of no viable tumor.

Light and electron microscopic studies of a gastric xanthoma (위 황색종의 광학 및 전자현미경적 관찰)

  • Kwon Tae-Jung;Kim Chung-Soak;Moon Young-Myung
    • Applied Microscopy
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    • v.11 no.1
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    • pp.21-28
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    • 1981
  • Gastric xanthoma which is not a true neoplasm and clinically insignificant consists of the small yellowish lesion of the gastric mucosa, frequently of multiple occurrence. Histologically the lesion shows chronic superficial gastritis with intestinal metaplasia and occasional collections of foam cells within the lamina propria. Electron microscopically. the xanthoma, cells are composed of. lipid-laden histiocytes with. many autophagocytic Iysosomes surrounding the cytoplasmic lipid vacuoles. Many residual bodies are also noted. The pathogenesis of the gastric xanthoma is obscure, however it is thought that a previous focal lesion of the gastric mucosa may have been a factor. One case of gastric xanthoma is reported here and a brief review of literature is also made.

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Exophagectomy Combined with Resectiion of Invaded Aorta for T4 Esophageal Carcinoma. (대동맥 침습이있었던 식도암의 절제수술)

  • 신화균;이두연;김상진;김부연;이성수;금기창
    • Journal of Chest Surgery
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    • v.33 no.1
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    • pp.103-106
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    • 2000
  • Advanced esophageal carcinoma which invades into adjacent organs are classified as T4 esophageal cancer,. Its complete resection without residual tumor would be difficult. Preoperative chemoradiotherapy and combined modality therapy are being tried to improve survival in patients with T4 esophageal carcinoma. In a 74-year-old man a 6cm squamous cell carcinoma of the esophagus with invasion of the thoracic aorta was detected (T4). After neoadjuvant chemoradiotherapy the patient was operated on using bio-pump with aorto-femoral cannulation. The invased segment of descending aorta was resected and reconstructed with a graft. The tumor was resected and EG anastomosis was done. The postoperative period was uneventful the patient was discharged after good condition and has been well to now.

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A Study on Surgical Treatment of Thymoma -Analysis of 18 Cases- (흉선종의 외과적 치료에 대한 연구 -18례 분석-)

  • 이형렬
    • Journal of Chest Surgery
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    • v.27 no.4
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    • pp.303-309
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    • 1994
  • Eighteen patients with thymoma have undergone surgical treatment at Pusan National university Hospital from 1983 to 1993. The mean age of the patients was 47.3$\pm$13.3 years old and male to female ratio was 1.6 : 1. Eleven of the patients[61.1%] with thymoma had myasthenia gravis; 12 cases[66.7%] were encapsulated and 6[33.3%] invasive. Operation was complete resection in 14[77.8%] of the patients, partial resection with residual tumor in 3[16.7%], and simple biopsy in one[5.5%]. Adjuvant radiotherapy was administered in 5 of 6 invasive thymoma. Postoperatively one patient died for excessive bleeding and sepsis. A tumor relapse was observed in one patient who had invasive thymoma and underwent partial resection followed by postoperative radiotherapy. The overall 5-year survival rate was 88.2$\pm$ 7. 9%.The presence of myasthenia gravis is not considered as an adverse factor for survival but it contributes to early discovery of associated thymoma.

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