• Title/Summary/Keyword: Soft tissue lesion

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Giant Cell Tumor of Upper Thoracic Spine

  • Lee, Chul Gab;Kim, Sung Hoon;Kim, Dong Min;Kim, Seok Won
    • Journal of Korean Neurosurgical Society
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    • v.55 no.3
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    • pp.167-169
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    • 2014
  • Giant cell tumor (GCT) of the spine is a rare benign tumor, but can be aggressive and can exhibit a high local recurrence rate. Furthermore, GCT of the upper thoracic spine may pose diagnostic and management difficulties. Here, we report a rare case of GCT of the upper thoracic spine with soft tissue extension to the spinal canal. The patient was managed by decompressive laminectomy and posterolateral fusion followed by an injection of polymethylmethacrylate into the vertebral lesion. The patient recovered clinically and showed radiological improvement after surgical treatment without tumor recurrence at his last follow-up of postoperative 7 years. We present this unusual case of GCT and include a review of the literature.

Residual Pain after Operative Treatment for Chronic Ankle Instability (만성 발목 불안정증 수술 후의 지속적인 발목 통증)

  • Cho, Byung-Ki;Ahn, Byung-Hyun
    • Journal of Korean Foot and Ankle Society
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    • v.25 no.1
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    • pp.32-37
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    • 2021
  • Patients with chronic lateral ankle instability often experience a range of associated injuries. The well-known comorbidities include intra-articular pathologies (osteochondral lesion, soft tissue or bony impingement, and loose body), peroneal tendon pathologies, neural injuries, and other extra-articular pathologies. Surgeons should have a high index of suspicion for these associated pathologies before operative intervention, correlate the clinical findings, and plan the treatment. Despite the restoration of ankle stability following ligament repair or reconstruction surgery, a high prevalence (13%~35%) of postoperative residual pain has been reported. This pain can negatively affect the clinical outcomes and patient satisfaction. This study examined the causes of persistent pain after surgical treatments for chronic ankle instability.

Unilateral Chronic Organizing Hematoma after Breast Explantation Mimicking Chest Wall Tumor: a Case Report with Imaging Features

  • Jang, Seon Woong;Lee, Ji Young
    • Investigative Magnetic Resonance Imaging
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    • v.26 no.1
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    • pp.76-81
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    • 2022
  • The number of women undergoing breast augmentation surgery with a prosthesis for cosmetic purposes or reconstruction after a mastectomy is steadily increasing. Hematoma is one of complications associated with breast augmentation surgery. It usually occurs early in the postoperative period. It rarely occurs late (after six months). However, chronic hematomas after prosthesis removal have not yet been reported in the radiological literature. We present a case of unilateral chronic organizing hematoma that developed late and grew persistently over long period after breast explantation, mimicking a soft tissue tumor of the chest wall clinically. Meanwhile, characteristic magnetic resonance imaging features of heterogeneous signal intensities on T1-weighted and T2-weighted images and dark signal intensity with a persistent enhancement of the peripheral wall of the lesion were found. These can be used for a differential diagnosis.

Reconstruction with Anterolateral Thigh Free Flap in Substitute for Radial Forearm Free Flap with Vascular Variation (유리전완피부피판의 혈관변이로 인해 전외측 대퇴유리피판을 대체 적용한 구강 내 재건 증례)

  • Yoon, Sang-Yong;Kim, Sung-Hee;Song, Jae-Min;Lee, Ju-Min;Nam, Su-Bong;Kim, Uk-Kyu
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.35 no.4
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    • pp.248-255
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    • 2013
  • Reconstruction techniques of orofacial defects caused by wide excision of the intraoral malignant lesions are various. Although radial forearm free flap is a common donor site on reconstruction of soft tissue defect, anterolateral thigh (ALT) free flap also has an established site in orofacial soft tissue reconstruction as the favored donor flap with recent progress of the microsurgical technique. A 59-year-old female complained of hyperplastic mass on the right retromolar and buccal cheek, which was diagnosed as a squamous cell carcinoma (SCC) by an incisional biopsy. Before the operation, we planned a wide excision of the SCC lesion, supraomohyoid neck dissection, reconstruction with radial forearm free flap (RFFF), and split thickness skin graft. We accidentally found an arterial variation of the forearm area during elevation of RFFF, and changed the plan of reconstruction operation to reconstruction with ALT free flap. Operative sites was healed well during the post-operative period, and we referred to the department of radiation oncology for post-operative radiotherapy.

A Rare Case of Fat-Forming Variant of Solitary Fibrous Tumor Presenting as a Pleural Mass

  • Kim, Mi-Ae;Lee, Ji-Hyun;Jeong, Hye-Cheol;Koo, Seung-Won;Park, Kyung-Mi;Cho, Sang-Ho;Lee, Hyeon-Jae;Kim, Eun-Kyung
    • Tuberculosis and Respiratory Diseases
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    • v.70 no.6
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    • pp.511-515
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    • 2011
  • The fat-forming variant of solitary fibrous tumors (SFTs) is a rare soft tissue neoplasm that was previously referred to as a lipomatous hemangiopericytoma (L-HPC). The most common affected site is deep soft tissue. Here, we present the first case, worldwide, of a fat-forming variant of SFT of the pleura. A 74-year-old man presented with left lower chest pain. Chest radiographs showed a mass-like lesion at the left lower lung field and chest computed tomography revealed a 12 cm fat-containing enhancing mass that was well-separated, lobulated and inhomogeneous. Radiology findings suggested a liposarcoma. Percutaneous needle biopsy was performed and pathological diagnosis of the mass was a fat-forming variant of SFT. Surgical resection was carried out and there has been no recurrence to date. So, a benign fat-forming variant of SFT must be considered as one of the differential diagnoses of lipomatous tumors of the pleura.

Analysis of prognostic factors affecting poor outcomes in 41 cases of Fournier gangrene

  • Hahn, Hyung Min;Jeong, Kwang Sik;Park, Dong Ha;Park, Myong Chul;Lee, Il Jae
    • Annals of Surgical Treatment and Research
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    • v.95 no.6
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    • pp.324-332
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    • 2018
  • Purpose: We present our experience involving the management of this disease, identifying prognostic factors affecting treatment outcomes. Methods: The patients treated for Fournier gangrene at our institution were retrospectively reviewed. Data collected included demographics, extent of soft tissue necrosis, predisposing factors, etiological factors, laboratory values, and treatment outcomes. The severity index and score were calculated. Multivariate regression analysis was used to determine the association between potential predictors and clinical outcomes. Results: A total of 41 patients (male:female = 33:8) were studied. The mean age was 54.4 years (range, 24-79 years). The most common predisposing factor was diabetes mellitus (n = 19, 46.3%). Sixteen patients (39.0%) were current smokers. Seven patients had chronic kidney disease. The most frequent etiology was urogenital lesion (41.5%). The mortality rate was 22.0% (n = 9). Multivariate regression analyses showed that extension of necrosis beyond perineal/inguinal area and pre-existing chronic kidney disease were significant and independent predictors of mortality. Extension of necrosis beyond perineal/inguinal area was a significant predictor of increased duration in the intensive care unit and hospital stay. In addition, pre-existing chronic kidney disease was a significant predictor of flap reconstruction in the wound. Conclusion: Fournier gangrene with extensive soft tissue necrosis and pre-existing chronic kidney disease was associated with poor prognosis and complexity of patient management. Early recognition of dissemination and premorbid renal function is essential to reduce mortality and establish a management plan for this disease.

Comparison of pain relief in soft tissue tumor excision: anesthetic injection using an automatic digital injector versus conventional injection

  • Hye Gwang Mun;Bo Min Moon;Yu Jin Kim
    • Archives of Craniofacial Surgery
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    • v.25 no.1
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    • pp.17-21
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    • 2024
  • Background: The pain caused by local anesthetic injection can lead to patient anxiety prior to surgery, potentially necessitating sedation or general anesthesia during the excision procedure. In this study, we aim to compare the pain relief efficacy and safety of using a digital automatic anesthetic injector for local anesthesia. Methods: Thirty-three patients undergoing excision of a benign soft tissue tumor under local anesthesia were prospectively enrolled from September 2021 to February 2022. A single-blind, randomized controlled study was conducted. Patients were divided into two groups by randomization: the experimental group with digital automatic anesthetic injector method (I-JECT group) and the control group with conventional injection method. Before surgery, the Amsterdam preoperative anxiety information scale was used to measure the patients' anxiety. After local anesthetic was administered, the Numeric Pain Rating Scale was used to measure the pain. The amount of anesthetic used was divided by the surface area of the lesion was recorded. Results: Seventeen were assigned to the conventional group and 16 to the I-JECT group. The mean Numeric Pain Rating Scale was 1.75 in the I-JECT group and 3.82 in conventional group. The injection pain was lower in the I-JECT group (p< 0.01). The mean Amsterdam preoperative anxiety information scale was 11.00 in the I-JECT group and 9.65 in conventional group. Patient's anxiety did not correlate to injection pain regardless of the method of injection (p= 0.47). The amount of local anesthetic used per 1 cm2 of tumor surface area was 0.74 mL/cm2 in the I-JECT group and 2.31 mL/cm2 in the conventional group. The normalization amount of local anesthetic was less in the I-JECT group (p< 0.01). There was no difference in the incidence of complications. Conclusion: The use of a digital automatic anesthetic injector has shown to reduce pain and the amount of local anesthetics without complication.

Soft Rot on Citrus unshiu Caused by Rhizopus oryzae in Korea (Rhizopus oryzae에 의한 감귤 무름병)

  • Kwon, Jin-Hyeuk;Kim, Jin-Woo;Hyun, Jae-Wook;Lee, Yong-Hwan;Shim, Hong-Sik
    • Research in Plant Disease
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    • v.17 no.1
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    • pp.78-81
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    • 2011
  • Soft rot caused by Rhizopus oryzae occurred on unshiu orange (Citrus unshiu Marc.) sampled from commercial markets in Jinju, Korea, 2010. The first symptom of soft rot on orange is a water-soaked appearance of the affected tissue. The infected parts later disintegrated into a mushy mass of disorganized cells followed by rapid softening of the diseased tissue. The lesion on orange was rapidly softened and rotted, then became brown or dark brown. Optimum temperature for mycelial growth of the causal fungus on potato dextrose agar was $30^{\circ}C$ and growth was still apparent at $37^{\circ}C$. Sporangiophores were $6{\sim}20\;{\mu}m$ in diameter. Sporangia were globose and $40{\sim}200\;{\mu}m$ in size. The color of sporangia was brownish-grey to blackish-grey at maturity. Sporangiospores were sub-globose, brownish- black streaked and $4{\sim}10\;{\mu}m$ in size. Columella were globose to sub-globose and $85{\sim}120\;{\mu}m$ in size. On the basis of mycological characteristics, pathogenicity test, and the ITS sequence analysis, the causal fungus was identified as Rhizopus oryzae. To our knowledge, this is the first report of soft rot caused by R. oryzae on unshiu orange in Korea.

Soft Rot on Peach Caused by Rhizopus oryzae in Korea (Rhizopus oryzae에 의한 복숭아 무름병)

  • Kwon, Jin-Hyeuk;Kang, Dong-Wan;Ha, Jeong-Seok;Kim, Jin-Woo;Kwak, Youn-Sig
    • The Korean Journal of Mycology
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    • v.40 no.1
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    • pp.65-68
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    • 2012
  • In July and August 2011, a disease suspected to be Rhizopus soft rot was observed on peach (Prunus persica var. vulgaris) at the Wholesale Market for Agricultural Products, Jinju, Korea. The first symptom of soft rot on peach is a water-soaked appearance of the affected tissue. The infected parts later disintegrated into a mushy mass of disorganized cells followed by rapid softening of the diseased tissue. The lesion on peach was rapidly softened and rotted, then became brown or dark brown. Optimum temperature for mycelial growth of the causal fungus on PDA was $30^{\circ}C$and growth was still apparent at $37^{\circ}C$Sporangiophores were 6~20 ${\mu}m$ in diameter. Sporangia were globose and 35~200 ${\mu}m$ in size. The color of sporangia was brownish-grey to blackish-grey at maturity. Sporangiospores were sub-globose, brownish- black streaked and 5~10 ${\mu}m$ in size. Columella were globose to sub-globose and 85~120 ${\mu}m$ in size. On the basis of mycological characteristics, pathogenicity test, and molecular identification, the causal fungus was identified as Rhizopus oryzae Went & Prinsen Geerligs. To our knowledge, this is the first report of soft rot caused by R. oryzae on peach in Korea.

Two Cases of Giant Cell Tumor of the Bone Diagnosed by Fine Needle Aspiration Cytology (골 거대세포종의 2예 세침 천자 세포학적 소견)

  • Myong, Na-Hye;Ha, Chang-Won;Cho, Kyung-Ja;Jang, Ja-June;Baek, Goo-Hyun;Lee, Soo-Yong
    • The Korean Journal of Cytopathology
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    • v.1 no.1
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    • pp.93-97
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    • 1990
  • Two cases of giant cell tumor of bone diagnosed by fine needle aspiration cytology are described. Case 1 was a 28-year-old male who had pain sense for one year at the right distal thigh. His radiologic finding revealed a destructive cortical lesion with soft tissue extension at medial side of epiphysis of the distal femur. Case 2 was a 21-year-old female complaining pain at left distal forearm for eight months and showed a well-demarcated expansile osteolytic lesion with multiseptation, and cortical destruction at epiphysis and metaphysis of the left distal radius on the X-ray. Fine needle aspiration of each lesion was performed. The aspirate of the case 1 revealed moderate cellularity, which was composed of scattered giant cells of osteoclastic type and small round to oval monotonous stromal cells in large areas. Giant cells were evenly distributed in single or small groups and had irregular but abundant cytoplasms with 10 to 20 nuclei in the center. The nuclei showed ovoid shape, fine granular chromatin, and a small but conspicuous nucleolus. Stromal cells were dispersed in isolated pattern or sometimes aggregated in clusters and showed the same nuclei as those of giant cells and scanty cytoplasms. Comparing to case 1, case 2 had a more translucent abundant cytoplasm in the giant cells and more spindled stromal cells. All two cases revealed neither nuclear atypism nor increased abnormal mitoses In both giant and stromal cells, suggesting no evidence of malignancy. Thereafter the lesions were treated with excision and curettage, and histologically confirmed as giant cell tumors of the bone.

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