• Title/Summary/Keyword: Soft tissue lesion

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Klebsiella pneumoniae necrotizing fasciitis on the upper lip in a patient with uncontrolled diabetes

  • Kim, Hyeong Seop;Chang, Yong Joon;Chung, Chul Hoon
    • Archives of Craniofacial Surgery
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    • v.21 no.2
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    • pp.127-131
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    • 2020
  • A 60-year-old woman with a history of diabetes mellitus and chronic renal failure was admitted to the hospital with severe pain in the upper lip, which began 4 days prior to admission, accompanied by a bullous lesion and suspected cellulitis in the upper lip. Immediately after admission, as the patient's general condition worsened, tests revealed a non-ST elevated myocardial infarction, septic embolism of the lung, as well as septic shock. Her upper lip suddenly presented a gangrenous and necrotic change, which the tissue and blood culture confirmed to be a Klebsiella pneumoniae infection. After a quick response, the patient's general condition improved. Subsequently, serial debridement was performed to effectively clear away the purulent discharge. While under general anesthesia, the process confirmed full-layer necrosis of the upper lip including the orbicularis oris muscle. Almost half of the entire upper lip sustained a full-layer skin and soft tissue defect, with scar contracture. Six months later, to correct the drooling and lip sealing following the defects, a scar release and an Abbe flap coverage were performed considering both functional and aesthetic aspects. The follow-up revealed a favorable corrective result of the upper lip drooling, and the patient was satisfied from a functional perspective.

A CASE OF SYPHILIS RELATED CERVICAL NECROTIZING FASCIITIS (매독 환자의 경부 괴사성 근막염의 치험례)

  • Myoung, Shin-Won;Lee, Jung-A;Kang, Myoung-Guen;Kim, Kyung-Mok;Park, Je-Uk
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.30 no.6
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    • pp.540-544
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    • 2004
  • The oral lesion of acquired syphilis - primary, secondary, and tertiary - is comparatively rare. Most of the time secondary syphilis manifests itself as a systemic disease with maculopapular eruptions of the skin, generalized lymphadenopathy, fever, and occasional eruptions on the mucous membranes. The lesions of the tertiary stage may occur anywhere in the body, including the oral cavity. Necrotizing faciitis of the head and neck is an uncommon, rapidly spreading soft tissue infection of polymicrobial origin characterized by extensive necrosis and gas formation in the subcutaneous tissue and superficial fascia. This is characterized by its fulminating, devastating, and rapid-progressing course. The mortality rate is high if it is not treated promptly and vigorously. Patients with an impaired immune system and those with small-vessel disease such as diabetes mellitus are more prone to develop this infection.

Osteosarcoma Arising in a Polyostotic Fibrous Dysplasia: A Case Report (다골성섬유형성이상에서 발생한 골육종: 증례 보고)

  • Suh, Kyung-Jin
    • Investigative Magnetic Resonance Imaging
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    • v.11 no.1
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    • pp.49-53
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    • 2007
  • Fibrous dysplasia is a skeletal developmental anomaly of the bone-forming mesenchyme that manifests as a defect in osteoblastic differentiation and maturation. It is a nonhereditary disorder of unknown cause. In fibrous dysplasia, the medullary bone is replaced by fibrous tissue, which appears various imaging findings. It is usually an incidental finding, generally not requiring further investigation. However, fibrous dysplasia may be complicated by pathologic fracture, and rarely by malignant degeneration. We present the image findings of a 44-year-old man who had a chondroblastic osteosarcoma arising from polyostotic fibrous dysplasia in the femur. Evidence of cortical destruction on plain radiography and soft tissue mass in the lesion on MR images suggested a tumor of malignant transformation.

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Computer Simulation Surgery for Mandibular Reconstruction Using a Fibular Osteotomy Guide

  • Jeong, Woo Shik;Choi, Jong Woo;Choi, Seung Ho
    • Archives of Plastic Surgery
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    • v.41 no.5
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    • pp.584-587
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    • 2014
  • In the present study, a fibular osteotomy guide based on a computer simulation was applied to a patient who had undergone mandibular segmental ostectomy due to oncological complications. This patient was a 68-year-old woman who presented to our department with a biopsy-proven squamous cell carcinoma on her left gingival area. This lesion had destroyed the cortical bony structure, and the patient showed attenuation of her soft tissue along the inferior alveolar nerve, indicating perineural spread of the tumor. Prior to surgery, a three-dimensional computed tomography scan of the facial and fibular bones was performed. We then created a virtual computer simulation of the mandibular segmental defect through which we segmented the fibular to reconstruct the proper angulation in the original mandible. Approximately 2-cm segments were created on the basis of this simulation and applied to the virtually simulated mandibular segmental defect. Thus, we obtained a virtual model of the ideal mandibular reconstruction for this patient with a fibular free flap. We could then use this computer simulation for the subsequent surgery and minimize the bony gaps between the multiple fibular bony segments.

Computed Tomographic Characteristics Of Nasal Squamous Cell Carcinoma In a Dog (개의 비강 편평상피세포종의 컴퓨터단층촬영상의 특징)

  • 권정국;송경진;이기창;이희천;최민철
    • Journal of Veterinary Clinics
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    • v.20 no.3
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    • pp.399-402
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    • 2003
  • A female unknown aged Yorkshire terrier, weighing 3.5 kg with nasal discharge, left facial swelling and severe inflammation was referred to Veterinary Medical Teaching Hospital, Seoul National University. Radiographic findings were lytic change and soft tissue swelling of left zygomatic process and increased radiopacity of nasal cavity. In computed tomography, turbinate bone destruction was observed as well as lytic change of left zygomatic process and left maxilla indicating aggressive lesion. Then 3-dimensional reconstruction was also performed. Biopsy of tissue mass revealed it as squamous cell carcinoma. For this patient, euthanasia was performed guarded prognosis. Generally, tumors of the nasal cavity in dogs account for approximately 1 % to 2% of all neoplasms. The prevalence of these tumors increased with age and exposure to the ultraviolet. About two thirds of all nasal tumors are malignant tumors such as squamous cell carcinoma and adenocarcinoma. As these tumors of nasal cavity are locally invasive, and external beam radiotherapy is the current treatment of choice. Unfortunately, diagnosis of these tumors often occurs late in the course of disease, resulting in a poor prognosis for outcome in many patients. It is considered that computed tomography could be used as an aid modality for the exact evaluation of extend and degree of bone lysis of nasal cavity and metastasis.

Meningothelial hamartoma of the scalp

  • Kim, Taeki;Kim, Junhyung;Choi, Jaehoon;Oh, Sangho;Kwon, Sunyoung;Jeong, Woonhyeok
    • Archives of Craniofacial Surgery
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    • v.21 no.3
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    • pp.180-183
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    • 2020
  • Meningothelial hamartoma is a benign tumor composed of ectopic meningothelial elements in the dermis and subcutaneous tissue. It mainly occurs in the scalp; however, the incidence is extremely low. The origin of meningothelial hamartoma has not been elucidated; nevertheless, it has been theorized that it derives from ectopic meningothelial rests displaced during embryologic development. It can be diagnosed histologically as proliferation of connective tissue elements and cells arranged in solid nests, resembling vascular tumors. On immunohistochemistry, it stains positively for epithelial membrane antigen and vimentin. At least 17 cases have been reported, verifying the rarity of the lesion. We present the case of a 16-year-old male patient with a soft scalp mass which was thought to be a lipoma, but turned out to be a meningothelial hamartoma on histology.

Treatment of intramuscular lipoma of tongue with enveloped mucosal flap design: a case report and review of the literature

  • Hur, Sung-Hwi;Lim, Jae-Seok;Choi, Sun-Gyu;Kang, Ji-Yeon;Jung, Ji-Hye;Lee, Eun-Young
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.42
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    • pp.38.1-38.7
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    • 2020
  • Background: Lipomas are benign soft tissue neoplasms of mature adipose tissue commonly occurring in the trunk or extremities. But, intraoral lipomas are rare entities which may be only noticed during routine dental examinations. Especially intramuscular lipomas on the tongue have been reported very rarely. In this study, we report a case of intramuscular lipoma on tongue, with a review of the literature from 1978 to 2019, providing data on age, gender, location, presenting symptoms, size, surgical methods, and recurrence. Case presentation: A case of intramuscular lipoma occurring in tongue region in a 65-year-old male is reported. Surgical excision is the mainstay of treatment for the lesion. In order to decrease the deformity and discomfort after the excision, we tried to modify surgical technique using enveloped mucosal flap. This technique provided more comfortable healing procedure on the operative site without recurrence. Conclusion: This is a rare case of large intramuscular lipoma on tongue. Surgical excision with enveloped mucosal flap design was performed to diminish postoperative raw surface and discomfort and a 24-month follow-up showed excellent healing without any recurrence. A case of intramuscular lipoma on tongue and relevant literature reviews are presented in this study.

Spontaneous Rupture of Proximal Rectus Femoris: A case report (근위부 대퇴직근의 자연 파열 - 증례보고 -)

  • Jeon, In-Ho;Kyung, Hee-Soo;Lee, Sang-Won;Kim, Poong-Taek
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.5 no.1
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    • pp.81-84
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    • 2006
  • Rupture of the rectus femoris at the musculotendinous junction is very rarely reported in the literature, especially which is caused by chronic repetitive stimulation. A 21 year old soldier complained of progressing right thigh pain and mass for 8 weeks after military training. MRI of the right thigh showed inhomogenous mass lesion suspecting soft tissue tumor. However ultrasonographic examination showed torn retracted rectus femoris tendon at musculotendinous junction. One year after primary repair of ruptured tendon, the patient is free from symptoms and returned to full previous activities. Knowledge of this sonographic and MRI finding will help the surgeon to diagnose and treat this rare injury.

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A Case Report of Malignant Mixed Mammary Tumor in Left Caudal Thoracic Mammary Gland of a Dog (개의 좌측후흉측 유선에 발생한 악성혼합유선종양의 발생례)

  • 정순욱;박수현;박남용
    • Journal of Veterinary Clinics
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    • v.16 no.1
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    • pp.199-202
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    • 1999
  • In a 10-year old mixed dog, a $10{\times}10{\times}4$ cm mass was palpated around the left caudal thoracic mammary gland with abdomen expension. In hormonal assay, serum concentrate of progesterone was 0 pg/ml and serum concentrate of estradiol was 66.7 pg/ml. Radiological finding of the mammary gland showed higher density than that of soft tissue and ultrasonographic finding showed inhomogeneous in echogenicity. Light microscopic view of mammary gland showed neoplastic hyperplasia of epithelial and myoepithelial cells and showed some metaplastic lesion of these cells to cartilage or bone tissues with metastasis to the lung. This case was diagnosed as malignant mixed mammary tumor.

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Tuberculous chest wall abscess (결핵성 흉벽농양)

  • Jo, Gyu-Seok;U, Se-Yeong
    • Journal of Chest Surgery
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    • v.17 no.1
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    • pp.140-143
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    • 1984
  • We have experienced 30 patients of tuberculous chest wall abscess which was surgically treated at Kyung Hee University hospital during 6 years from Jan, 1978 to Dec, 1983. We analyze 30 cases of clinical findings and surgically treated, and 20 cases of chest X-rays are available. The results of this sturdy are as follows: 1.Sex ratio ; Male: Female = 1:1.72. 2.Chief complaints are fluctuated mass with or without tenderness or pain and pus from wound. 3.Out of 20 cases of chest x-rays revealed 8 cases of osteolytic lesion, 11 cases of soft tissue swelling, 5 cases of pleural changes and 4 cases of negative findings. 4.We resected partially 43 ribs of 30 patients [average: 1.43 resected] in tuberculous chest wall abscess. 5.Operative methods of tuberculous chest wall abscess were partial resection of destructed or denuded periosteum of ribs and curettage of its surrounding tissues in operative field.

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