• Journal of Veterinary Clinics
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• v.31 no.1
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• pp.46-50
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• 2014

A 7-year-old spayed female Welsh corgi presented with a mass of the skull. The mass was diagnosed as multilobular bone tumor and surgically removed. To treat a large bone defect after the tumor removal, custom-made artificial bone fabricated by a 3-dimensional ink-jet printer was implanted in the defect. Follow-up computed tomography evaluation was performed for 4.3 years. The implant was well integrated with the skull and had covered the large bone defect during the follow-up period. Gradual degradation of the implant began 6 weeks after surgery. It provides an additional option for the treatment of large bone defect.

• Journal of Korean Neurosurgical Society
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• v.30 no.3
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• pp.366-370
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• 2001

Objective : The authors present three cases of brain tumors in which epidural hematomas(EDHs) were developed postoperatively in the remote areas from craniotomy sites. The preventive tactics as well as possible mechanisms of development of remote EDH are discussed. Material and Methods : The magnetic resonance imagings of three patients revealed a left lateral ventricular mass located just aside of foramen Monro in a 27-year-old male, a large cystic mass in the temporal lobe in a 35-year-old male, and a partially calcified pineal mass in a 27-year-old male patient. The surgical removals of these tumors were performed without any noticeable events during surgery via left frontal transcortical transventricular approach for lateral ventricular tumor, left temporal craniotomy for cystic temporal tumor, and right occipital transtentorial approach for pineal tumor. Results : Postoperative EDHs remote from the sites of craniotomy were detected by the immediate postoperative computerized tomographic scans. We obtained good outcomes without any morbidity in all three patients with emergent evacuation of the hematoma. The pathologic diagnoses were lateral ventricular ependymoastrocytoma, temporal craniopharyngioma and mixed germinoma of the pineal region. Conclusion : It is postulated that a sudden reduction of intracranial pressure(ICP) at the time of tumor removal may strip the dura from the inner table of the skull to cause EDH from the remote site of craniotomy. Gradual reduction of ICP with slow drainage of cerebrospinal fluid before tumor removal as well as lowering the head position of patient during surgery might be helpful for preventing this unusual complication.

• Archives of Craniofacial Surgery
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• v.11 no.2
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• pp.95-98
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• 2010

Purpose: CSF (Cerebrospinal fluid) leakage is the most common complication of neurosurgery. Early management with conservative care or surgery must be followed appropriately due to the increased risk of lethal complications, such as meningitis. We report a case of intractable CSF leakage that occurred after a cerebellar tumor resection, which was treated successfully. Methods: A 53-year old male consulted our department for continuous CSF leakage for 3 months after having received conservative care and lumbar drainage. CSF collection was observed in the dead space of the posterior fossa after a cerebellar tumor resection and postoperative radiotherapy. Using a free latissimus dorsi muscle flap, the dead space within the skull was filled and the defects were covered successfully. Results: At 6 weeks after surgery, the follow-up MRI and CT revealed proper coverage and filling in the area where cerebellar tumor had been removed. No CSF leakage was observed at the postoperative 3 month follow-up. Conclusion: Recurrent CSF leakage was treated after cerebellar tumor resection with a relatively satisfactory result. In terms of the patient's treatment, much better results can be achieved by performing dead space filling using a flap with a sufficient size, in addition to coverage of the defects of the dura.

• Archives of Plastic Surgery
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• v.36 no.1
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• pp.96-100
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• 2009

Purpose: Angiosarcoma of the scalp is unusual vascular tumor originating from endothelial cell. Angiosarcoma is an aggressive tumor with high propensity for both local recurrence and distant metastasis. We report 2 cases of angiosarcoma having poor prognosis recently. Methods: Case 1 was a 67 - year - old male patient. He visited the hospital with a $3{\times}5cm$ sized discolored mass in forehead. It began at one month ago from coming to the hospital. Case 2 was a 64 - year - old male patient. He visited for our hospital to remove a $4{\times}5cm$ sized scalp mass. He had a pruritis on scalp from 9 months ago before coming to the hospital. Despite of the conservative treatments, the wound was not healed and advanced necrotic lesion with hemorrhage. Results: Case 1 diagnosed as an angiosarcoma. He underwent a radical operation 5 times. But the tumor expanded multiple area in dura & frontal area of the brain. The patient rejected the treatment any more. And he died one month later. Case 2 diagnosed as an angiosarcoma and metastased to skull in MRI. He got a radical resection including cranium. Three months later, it recurred to ipsilateral Sternocleidomastoideus muscle. He got a additional operation & started radiotherapy. And now he is receiving chemotherapy, but the recurred lesion is expanding. Conclusion: Angiosarcoma is a highly malignant tumor. Especially it arises in vascularized area, it easily metastases. So it is the best to treat angiosarcoma with surgery included wide margins. Despite of the lesion is small, we remember that angiosarcoma is a tumor that consider to metastases.

• Investigative Magnetic Resonance Imaging
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• v.9 no.1
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• pp.2-8
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• 2005

Purpose : The purpose of this study was to implement a software to visualize tumor and its surrounding fiber tracts simultaneously using diffusion tensor imaging and examine the feasibility of our software for investigating the influence of tumor on its surrounding fiber connectivity. Material and Methods : MR examination including T1-weigted and diffusion tensor images of a patient with brain tumor was performed on a 3.0 T MRI unit. We used the skull-striped brain and segmented tumor images for volume/surface rendering and anatomical information from contrast-enhanced T1-weighted images. Diffusion tensor images for the white matter fiber-tractography were acquired using a SE-EPI with a diffusion scheme of 25 directions. Fiber-tractography was performed using the streamline and tensorline methods. To correct a spatial mismatch between T1-weighted and diffusion tensor images, they were coregistered using a SPM. Our software was implemented under window-based PC system. Results : We successfully implemented the integrated visualization of the fiber tracts with tube-like surfaces, cortical surface and the tumor with volume/surface renderings in a patient with brain tumor. Conclusion : Our result showed the feasibility of the integrated visualization of brain tumor and its surrounding fiber tracts. In addition, our implementation for integrated visualization can be utilized to navigate the brain for the quantitative analysis of fractional anisotropy to assess changes in the white matter tract integrity of edematic and peri-edematic regions in a number of tumor patients.

• Korean Journal of Head & Neck Oncology
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• v.26 no.2
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• pp.243-246
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• 2010

Purpose : Eosinophilic granuloma is a rare benign tumor that is characterized histologically by the presence of destructive granulomas containing numerous Langerhans, cells. The most common presentation of eosinophilic granuloma is a painful, immobile scalp mass in the frontal and parietal bones occurring predominantly in children and adolescents or young adults. We report a representative case of eosinophilic granuloma. Methods : A 16-year-old woman complained of an enlarging fixed scalp mass without pain and tenderness which measured $3{\times}4.5cm$ at the frontal area, which had been found incidentally 2 months before. Plain skull x-ray showed a punched-out bone lesion. Computed tomography and magnetic resonance imaging showed a non-enhancing osteolytic lesion. The tumor and surrounding bony edges were completely removed via a bicoronal approach. The bony defect was reconstructed with bone cement. Results : The tumor was involved frontal bone and dura mater. We confirmed the tumor by the documentation of Birbeck's granules by electron microscopy. There is no evidence of local recurrence during postoperative 1.5 years. Conclusion : The present case shows the characteristic feature of frontal bone involvment of the eosinophilic granuloma. The prognosis of eosinophilic granuloma depend on age at diagnosis and number of bones involved. We consider that best choice of treatment for eosinophilic granuloma is surgical excision.

• Journal of Yeungnam Medical Science
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• v.2 no.1
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• pp.259-264
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• 1985

Neuroblastoma is the most common extracranial solid tumor of childhood which presents various clinical symptoms depending on the primary and metastatic sites. However, it has been rarely reported that sudden onset of blindness was the chief complaint of neuroblastoma. A four years old boy was admitted to the Yeungnam University Hospital with the chief complaint of a sudden onset of blindness due to a distant metastasis of abdominal neuroblastoma to the sphenoid sinus. On admission, both side pupils were dilated without light reflex, fundoscopy showed pale optic disk, electroretinogram was subnormal and visual evoked potential showed no response. The liver was palpable in $3{\frac{1}{2}}$ finger breadth from the right costal margin and adult fist sized mass was palpable in the right flank. Skull X-ray showed destructed sphenoid bone and clinoid process and brain CT scan showed tumor mass in the sphenoid sinus and left orbit. Ultrasonogram and CT scan of the abdomen showed large tumor masses around the right kidney and para-aortic and retropancreatic lymph node. IVP showed displaced right calyceal system with preserved contour. Left supraclavicular lymph node which appeared after admission was biopsied and it showed poorly differentiated neuroblasts. He was treated according to the multiagent chemotherapy schedule for stage IV neuroblastoma patient of children's cancer study group. Abdominal tumor masses and sphenoid sinus mass were markedly reduced after 2 courses of the combination chemotherapy of cyclophosphamide, vincristine, DTIC, adriamycin and VM-26. Eventhough the blindness was not improved, the patient has been in good clinical condition.

• Radiation Oncology Journal
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• v.2 no.1
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• pp.139-148
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• 1984

The CT findings of 46 cases of nasopharyngeal cancer were analyzed and compared with clinical tumor staging. They are composed of 28 cases $(61\%)$ of squamous cell carcinoma, 13cases $(28\%)$ of undifferentiated carcinoma, 4 cases $(9\%)$of lymphoma and 1 case $(2\%)$ of adenoid cystic carcinoma. The results were as follows : 1. The most common CT findings of nasopharyngeal cancers are air·way asymmetry including obliteration of Rosenmuller fossa, orifice of Eustachian tube and asymmetric obliteration of parapharyngeal fat. 2. Other involved anatomic sites are carotid sheath area, oropharynx, paranasal sinuses especially sphenoid sinus, cervical lymph nodes, nasal cavity and skull base or middle cranial fossa. 3. CT does significantly influence on the tumor staging of the nasopharynx cancers, but has a definite value in evaluating deep tissue invasion of the cancers especially to parapharyngeal space or carotid sheath area. 4. CT seems to be essential for staging work-up, estimating the prognosis, and assessing the effect of radiotherapy of the nasopharyngeal cancer because it clearly shows the whole extent of the tumors including deep tissue invasion.

• Annals of Clinical Neurophysiology
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• v.4 no.1
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• pp.74-77
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• 2002

Collet-Sicard Syndrome is one of the variant of the jugular foramen syndromes in which the last four cranial nerves are involved whereas the sympathetic plexus is spared. The possible causes of these multiple lower cranial nerve palsy are variable, including metastasis of systemic malignancy to the base of skull, primary tumor of head and neck, vascular complication, trauma and so on. We experienced two men visited to our clinic with symptoms of headache, hoarsness, swallowing difficulty and showed the evidence of cranial nerve palsy on neurologic examination. Magnetic resonance imaging and computed tomography demonstrated oropharyngeal and hypopharyngeal tumor and electrodiagnostic study supported the diagnosis.

• Journal of Oral Medicine and Pain
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• v.35 no.2
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• pp.149-154
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• 2010

In benign exophytic lesion in TMJ such as osteoma, chondroma, osteochondroma, synovial chondromatosis etc, symptom such as pain, mouth opening limitation, Most case of condylar exophytic lesion manifest with facial asymmetry, malocclusion, mandibular midline deviation. An osteochondroma and synovial chondromatosis are most commom benign condylar tumor. However this tumor is most frequently found on long bone and flat bone and is unusual on the skull. We report cases of osteochondroma, synovial chondromatosis of TMJ and review literatures.