• 대한골관절종양학회지
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• 제11권2호
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• pp.126-133
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• 2005

목적: 화상흔, 만성골수염 등의 고위험인자를 동반하는 경우가 많으며 예후가 서구에 비해 나쁜 것으로 알려진 우리나라의 사지에 발생한 편평세포 상피암의 치료 결과를 알아보고자 하였다. 대상 및 방법: 1993년 8월부터 2002년 9월 사이에 본원에 내원당시 원격전이가 없었고, 치료 후 36개월 이상 외래추적 관찰이 가능하였던 20예를 대상으로 광범위 절제술 및 절제연을 얻기 힘든 사지 말단부나 신경, 혈관계를 침범한 경우에는 절단술을 시행하였다. 평균 연령은 57.2세였고, 남자와 여자는 각각 16명과 4명이었다. 병기는 TMN Stage를 이용하여 분류하였고, 절제한 병변의 조직학적 분화도를 측정하였다. 결과: 평균 48.3개월(36~84개월)간의 외래 추적 결과 총 6예(30%)에서 전이가 있었다. 근접 림프절로의 전이가 3예, 원격전이가 3예였으며 원격 전이 장소로는 폐가 3예, 흉추가 1예였다. 최종 추시 상 생존은 18예였고 5년 생존률은 50%였다. 국소재발이 3예에서 있었으며 재발된 평균 시간은 11개월(4~18개월)이었다. 합병증으로 광범위 절제술 시행 후 이식 피부의 부분적인 착상 실패가 2예가 있었다. 광범위 절제술을 시행한 군은 평균 1.9번의 수술을 받았고, 절단술을 시행한 군은 평균 1.3번의 수술을 받았다. 결론: 우리나라에 상대적으로 흔한 사지에 생긴 화상 반흔이나 만성 골수염에 속발한 편평 세포 상피암은 높은 전이율을 보였으며, 광범위한 절제연을 확보할 수 있는 경우 절단술과 비슷한 예후를 보이는 것으로 사료된다.

• Journal of Oral Medicine and Pain
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• 제34권1호
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• pp.49-54
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• 2009

편평태선은 작고 편평한 다각형의 구진을 피부나 점막에 보이는 만성 염증성 질환으로 편평태선을 유발하는 원인은 명확하지는 않으나, 피부나 점막에서의 항원변화가 세포매개성 면역반응을 유도하여 발생하는 것으로 생각되어진다. 구강편평태선은 초기에는 양성 병소로 생각되었으나 세계보건기구에 의해 전암 병소로 분류되었다. 구강편평태선이 악성화되는 단계는 명확하게 밝혀지지 않았으며, 편평태선등의 만성 염증성 질환은 구강암 발생에 있어 일반적인 위험 요인(예: 흡연, 음주)과 관계없이 악성 발현을 보인다. 구강편평태선의 악성전이는 여러 문헌에서 논란을 보이나, 0.5%에서 5%까지 보고되었다. 구강편평태선의 악성 전이는 특정 임상적 양상, 과각화나 미란성에서 더 높은 비율로 발생한다. 구강편평태선의 악성 전이는 예후가 불량하므로 예후의 개선과 조기 진단을 위하여 임상가는 일년에 최소 일회에서 2회까지 추적 조사를 해야 한다. 본 증례 보고에서는 중년의 여성에게서 십수년간 지속된 구강편평태선에서 발생한 편평상피암종을 살펴봄으로써, 임상가가 유념해야 할 구강편평태선의 악성 변이에 대한 고찰 및 진단시와 추적 조사시에 고려사항을 고찰하자고 한다.

• 한국임상수의학회지
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• 제39권2호
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• pp.70-74
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• 2022

A 14-year-old intact male captive leopard (Panthera pardus) first presented with a focal alopecic lesion on the dorsal aspect of the distal one-third of its tail. Although itraconazole was administered, the lesion progressed deeper and became ulcerated due to self-trauma. Due to the wild nature of the leopard, daily dressing of the wound and replacing the bandages without anesthesia became too dangerous, and amputation became necessary. A postoperative tissue sample was submitted for histopathological examination, and tramadol, amoxicillin/clavulanate, and gabapentin were administered. In the days following the amputation, the leopard's appetite significantly decreased, and the patient passed away 18 days later. Histopathological examination of the specimen revealed well-differentiated squamous cell carcinoma (SCC). In hindsight, had more cells been collected by a fine-needle aspirate (FNA) biopsy or had additional FNA biopsies been performed, SCC might have been diagnosed based on its cytological features rather than delayed histopathological findings. The current study highlights the critical reasons why clinicians may often misdiagnose SCC and the importance of being more aware of potential tumors in ulcerative lesions, which are often incorrectly treated as infectious skin diseases. This is also the first report of cutaneous SCC in a leopard.

• Archives of Plastic Surgery
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• 제37권1호
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• pp.79-82
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• 2010

Purpose: Carcinosarcomas are rare neoplasms in which both malignant epithelial and mesenchymal elements are identified. We have found only twenty one cases of primary cutaneous carcinosarcoma in the English language literature. Therefore it has been difficult to diagnosis because its unclear etiology and low frequency. Methods: A 31-year-old young man with a protruding mass on his ankle dorsum was examined. The tumor was $7{\times}6{\times}3\;cm$ sized and arose from a burn scar. The mass was wide excised and applied split thickness skin graft. Characteristic pathologic finding was a mixture of squamous cell carcinoma and malignant fibrous histiocytoma. Results: Three months after the operation, the patient died of multiple metastasis to the liver, lung and finally of sepsis despite adjuvant chemotherapy and adjuvant radiotherapy. Conclusion: If a metastatic cutaneous carcinosarcoma is diagnosed, wide excision is required. There should be more aggressive management to minimize the risk of recurrence. Further research into the etiology and pathophysiology of the disease and a more careful differential diagnosis may allow improvement in treatment.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제35권1호
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• pp.45-48
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• 2009

Verrucous carcinoma is a distinctive form of low-grade squamous cell carcinoma. The tumor has an exophytic, cauliflower-like appearance, and usually occurs in males and tends to affect individuals over 60 years of age. It typically involves the oral cavity, larynx, esophagus and skin. Most intraoral cases involve the mandibular vestibule, the buccal mucosa and the hard palate. The cause is unknown, but most verrucous carcinomas arise from the oral mucosa in people who chronically use chewing tobacco or snuff. The treatment of oral verrucous carcinoma remains controversial. Whenever possible, surgically total excision and skin or mucosal grafting is recommended. After total excision of huge verrucous carcinoma,instead of dermal or mucosal grafting, we used artificial dermis silicone membrane. We had a good result without recurrence and present this case.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제27권6호
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• pp.570-574
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• 2005

Keratoacanthoma is a benign, self-limited epithelial lesion that closely resembles Squamous cell carcinoma(SCC). Keratoacanthoma occur primarily exposed skin in male patients over 45 years of ages. although etiology is unknown, sunlight, genetic, and human papillomavirus factor have been considered. in clinical feature, rapid enlargement occurs over 4$\sim$8 weeks, resulting ultimately in a hemispheric, firm, elevated, asymptomatic nodule that contains a central plug of keratin. When fully developed, the keratoacanthoma contains a core of keratin surrounded by a concentric collar of raised skin. Over the next 4$\sim$8 weeks, static lesion persists. Then undergoes spontaneous regression over the next 6$\sim$8weeks period by expulsion of the keratin core with resorption of the mass. In histologic feature, Keratoacanthoma consists of hyperplastic squamous epithelium growing into the underlying connective tissue. The surface is covered by a thickened layer of parakeratin with central plugging. Epithelium cell shows dysplastic features and the margins the normal adjacent epithelium is elevated. The differential diagnosis includes SCC. Keratoacanthoma present as a exophytic lesion with horny keratin occupying a depression on the top of the lesion, persists static period and undergoes rapid growth compared with SCC. Keratoacanthoma is usually treated by surgical excision or curettage of the base, spontaneous regression does not occur in every case. A 60 years old male who present facial lesion visit our hospital and surgical excision was done. Biopsy result was keratoacanthoma. We report case with review of literatures.

• 대한피부과학회지
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• 제56권10호
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• pp.628-630
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• 2018

Disseminated superficial actinic porokeratosis (DSAP) is a rare keratinization disorder. It is histopathologically characterized by the presence of coronoid lamellae and clinically by lesions showing central atrophy with elevated borders. Squamous cell carcinoma originating in the classical Mibelli subtype of porokeratosis is well-documented; however, few reports have described squamous cell carcinoma in DSAP lesions. We report the case of a 76-year-old woman with DSAP who developed Bowen's disease, actinic keratosis, and keratoacanthoma on her face.

• Asian Pacific Journal of Cancer Prevention
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• 제17권3호
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• pp.1379-1383
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• 2016

Background: Basal and squamous cell carcinoma (BCC and SCC) are the most common skin cancers worldwide and distinction between the two may sometimes be very difficult in routine histopathology. The present study was aimed to evaluate a reliable diagnostic method for these cancers based on immunohistochemistry (IHC). Materials and Methods: IHC was used with antibodies to Bcl-2, CD10, CEA, and EMA biomarkers, which despite non-specificity are easily available for detection of various types of tumors in pathology sections and can be used as a panel for differentiation. In this descriptive and analytic study, paraffin-embedded blocks of 29 SCC patients and 29 BCC patients were collected and sectioned for IHC staining. The results were analyzed by the STATA (version 8) statistical package using the Chi-square test. Results: BCC patients were 100%, 75.8%, 0% and 0% positive for Bcl-2, CD10, CEA and EMA markers, respectively, and for SCC patients were 3.5%, 0%, 34.5% and 82.7% positive, respectively. Using simultaneously Bcl-2 and CD10 as positive markers, detection of BCC with 88% accuracy and 100% specificity was possible, while application of CEA and EMA positivity could detect SCC with 67% accuracy and 100% specificity. Conclusions: SCC and BCC have different immunostaining profiles; therefore, Bcl-2, CD10, CEA and EMA markers can be helpful to distinguish between them.

• Archives of Plastic Surgery
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• 제38권4호
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• pp.339-344
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• 2011

Purpose: The goal of cancer surgery is complete removal of cancer tissue and prevention of recurrence. Surgeons can change the surgical instruments after total resection of the cancer mass. The purpose of this procedure is to prevent dissemination of the cancer cells attached to the surgical instruments. Authors hypothesize the possibility of local recurrence caused by the cancer cells attached to the surgical instruments in the skin cancer cases. Methods: Skin cancers were induced by using DMBA-TPA two-stage carcinogenesis model in 10 of Balb/c mice. In 2-weeks, skin cancer was developed in all 10 mice. cancer cell attached surgical instruments were made by pinching the removed cancer tissue using Adson tissue forcep 10, 20, 30 times each. To count number of cancer cells in each forcep with different number of pinching was done, the forceps were washed in 30 mL of the normal saline and Cytospin preparation was done. To make recurrence models from cancer cell attached surgical instrument, three incisions were made in normal skin of each mouse, and local seeding was done by pinching subcutaneous tissue in 10, 20, 30 times each by using Adson teeth forceps mentioned above as cancer cell attached surgical instrument. Results: All skin cancers were squamous cell carcinoma. Local recurrences were developed in 7 mice (3 in 10 times forceping site, 2 in 20 times forceping and 3 in 30 times forceping). In the cytospin test, the mean number of squamous cells in 100 microscope was 28.6 in 10 times, 47.2 in 20 times, 93.6 in 30 times, respectively. P value was 0.002 in Wilcoxon-Sign test. Conclusion: The number of cell count was significantly increased as number of pinching was increased. And these cells are able to induce local recurrence by local seeding. Considering this result, authors are able to confirm that the minimal handling in cancer surgery is important factor to prevent local recurrence.

• Archives of Plastic Surgery
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• 제43권6호
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• pp.538-543
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• 2016

Background Cutaneous squamous cell carcinoma (SCC), which occurs in keratinocytes of the epidermis and is the second most common skin cancer, has a more invasive growth pattern and higher potential to metastasize than basal cell carcinoma. Total excision of the primary tumor is the treatment of choice. For clear excision of the tumor, invasion depth is one of the most important factors. This study was conducted to clarify the relationship between the size and the invasion depth of cutaneous SCC. Methods Twenty-six cases were collected for this prospective study. Frozen biopsies were examined after complete resection of the tumor, followed by histological confirmation by pathological examination. The major and minor axis lengths of the tumor, the invasion depth, and the level of invasion were measured. Recurrence or metastasis was recorded through regular follow-up. Results The Pearson correlation coefficient was used for statistical analysis. Significant results were observed for the relationship between the major and minor axis lengths and the invasion depth of the tumor (0.747, 0.773). No cases of recurrence or metastasis were observed. Conclusions In head and neck cutaneous SCC, the invasion depth of the tumor is closely related to the major and minor axis lengths of the tumor. Therefore, the invasion depth of the tumor can be estimated by measuring the size of the tumor, and a standard vertical safety margin for head and neck cutaneous SCC can be established, which could be helpful in the development of a preoperative reconstruction plan.