• Archives of Plastic Surgery
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• v.32 no.5
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• pp.635-640
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• 2005

Sentinel lymphnode biopsy is widely performed in the management of malignant melanoma and breast cancer. The sentinel lymphnode is the prime site of draining from the malignant lesion and of metastasis. The aim of this study was to evaluate a usefulness of lymphoscintigraphy in conjunction with a removal of sentinel lymphnodes of skin and soft tissue malignancy. We studied 11 patients selected between January, 2003 and November, 2004. Clinically sentinel lymphnodes free of metastasis were examined with lymphoscintigraphy, gamma detection probe and vital dye staining, and we reviewed histopathologic findings and inert status of the nodes and the results fo treatment. Nine cases were malignant melanoma, one was squamous cell carcinoma on the left hand and another one leiomyosarcoma. Sentinel lymphnodes were identified in all cases. Three cases of malignant melanoma had positive sentinel lymphnodes on histological examination. All patients with positive sentinel lymphnodes were treated with therapeutic regional lymphadectomy, chemotherapy and adjuvant regimen. Four patients underwent PET scanning and followed sentinel lymphnode biopsy. Two had no metastasis signs on PET scanning. Therapeutic lymphnode dissection was carried out upon the patients whose sentinel lymphnode was positive on PET scanning. We contend that lymphoscintigraphy and sentinel lymphnode biopsy are reliable to confirm regional lymphnode metastasis of the skin and soft tissue malignancy, and blind extensive lymphnode dissection can be spared.

• The Journal of the Korean bone and joint tumor society
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• v.5 no.4
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• pp.208-215
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• 1999

The purpose of this study was to identify the independent clinicopathologic prognostic factors of soft tissue sarcoma affecting local recurrence, metastasis and survival. Retrospectively collected data from 130 patients with soft tissue sarcoma were analyzed. Patient, tumor and pathologic factors were analyzed by univariate and multivariate methods for the endpoints of local recurrence, metastasis and survival. In univariate analysis, wide surgical margin, adjuvant radiotherapy and age younger than 40 years reduced local recurrence. Tumor size larger than 5cm was related with a higher rate of metastasis. Patients with metastasis at initial presentation and with a large tumor size had a low survival rate. In multivariate analysis, adjuvant radiotherapy and young age were significantly correlated with a low local recurrence rate. In conclusion, patients with metastasis at initial presentation and a large tumor size had a reduced survival rate. Independent adverse prognostic factors for local recurrence were old age and not undergoing adjuvant therapy.

• Journal of Chest Surgery
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• v.27 no.1
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• pp.63-67
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• 1994

We report two cases of giant soft tissue sarcomas metastatic to the lung from lower extremities. The lung metastasis occurred 2 years later from original diagnosis in 27-year-old woman with hemangiopericytoma and 8 years later in 54-year-old woman with synovial sarcomtt. We had performed pleuropneumonectomies with partial resection of pericardium involved. The postoperative courses were uneventful and postoperative adjuvant therapy was begun.

• The Journal of the Korean bone and joint tumor society
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• v.1 no.2
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• pp.210-219
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• 1995

Many different factors which may affect the prognosis of the soft tissue sarcomas have been reported by many authors ; Generally, tumor size, histologic type, surgical margin, and multi modality therapy therapy as the prognostic factors were reported. The objectives of this retrospective study of soft tissue sarcomas are : 1) to define more clearly prognostic variables that have significant predictive value for disease-free and overall survival ; and 2) to evaluate tumor histologic grade based upon extent of tumor necrosis as a means of stratifying more aggressive soft tissue sarcomas(grade II & III) of the extremities. We treated 94 patients who had soft tissue sarcoma of the extremities and trunk from May 1984 to September 1994(average duration of follow-up was 5 years ranging from 2 months to 10 years) and evaluated the prognostic factors of the soft tissue sarcomas; age, sex, depth, size, location, histologic type and grade, stage, therapy modality, surgical margin, local recurrence and distant metastasis. The results were as follows. 1. The patients with poorer prognosis were over the age of fifty, whose mass was deeply located, size of the mass was over 10cm in diameter, grade III in histology, who had local recurrence, metastasis, and received only surgery. 2. Among these prognostic factors, the most significant prognostic factor was histologic grade base upon extent of tumor necrosis.

• The Korean Journal of Pain
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• v.14 no.2
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• pp.257-260
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• 2001

It is well known that bronchogenic carcinoma frequently metastasize to bony skeleton, although it is unusual for it to metastasize to soft tissue in the form of a musculoskeletal abscess. We report a bronchogenic cancer patient presenting with back pain after undergoing a celiac plexus block. Magnetic resonance imaging (MRI) demonstrated inflammation with an abscess of the paraspinal muscle from T12 to L5; however, it was subsequently diagnosed as a metastatic pleomorphic carcinoma by histopathological study.

• Radiation Oncology Journal
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• v.11 no.2
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• pp.411-419
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• 1993

A total of 44 patients with extremity soft tissue sarcomas had received conservative surgery and radiation therapy in the Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine between Jan. 1980 and Dec. 1990. Initial surgical treatment consisted of intracapsular excision in 33 patients $(75\%),$ marginal excision in 9 patients, and wide excision in two patients. Total radiation doses were between 40Gy and 65Gy (median 60 Gy). Median follow-up period was 47 months. Overall actuarial 5-year survival rate was $76.9\%$ and 5-year recurrence free survival rate was $39.3\%.$ There was no statistically significant prognostic factors but the 5-year survival rates tended to be decreased in the patients with high grade tumors and treated with narrow surgical extent. Sixteen patients recurred during fellow-up (16/31, $51.6\%).$ The incidence of initial local recurrence was $22.6\%$ (7/31) and distant metastasis was $29\%(9/31).$ Of the 7 who did not have metastasis at diagnosis of local recurrence, 5 were submitted to a salvage treatment. All of them achieved local control and distant metastasis appeared in three of them. In conclusion, conservative surgery and radiation therapy in the patients with extremity soft tissue sarcomas was the effective treatment modality.

• Korean Journal of Head & Neck Oncology
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• v.33 no.2
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• pp.67-70
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• 2017

We present a metastatic carcinoma from the breast to the neck soft tissue around common carotid artery, with a rare finding of voice change. A 60 year-old female patient presented with voice change for 7 months. Neck ultrasound revealed a soft tissue mass between internal jugular vein and common carotid artery. Result of fine needle aspiration biopsy was a metastatic carcinoma. Computed tomography and magnetic resonance image revealed $2.5{\times}3.0cm$ sized irregular marginated soft tissue mass in right lower neck encasing common carotid artery and internal jugular vein. Surgical resection was performed and pathologic result with immunohistochemical analysis confirmed the diagnosis of a metastatic invasive ductal carcinoma originated from breast.

• Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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• v.61 no.12
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• pp.702-704
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• 2018

The most common cause of treatment failure in oral cavity cancer is when it is found to have local recurrence, usually occurring in the ipsilateral cervical lymph node. On the contrary, it is extremely rare to find local recurrence in soft tissue metastasis (STM) in the contralateral neck. Furthermore, lung cancer and malignant lymphoma are most commonly confined to their primary sites. The poor general condition increases the likelihood of STM, which indicates bad prognosis. A 72-year-old man with a hard and fixed mass on the right submandibular space visited our clinic. He had received a wide excision with local flapreconstruction for squamous cell carcinoma in the left corner of lower lip 18 months ago. We performed the wide excision with bilateral selective neck dissection (I-III), and he was finally diagnosed as STM from contralateral lip cancer. We report this unique and rare disease entity with a literature review.

• Archives of Reconstructive Microsurgery
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• v.20 no.2
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• pp.89-95
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• 2011

Purpose: The purpose of this study was to evaluate the clinical results of anterolateral thigh free flap on soft tissue defect following wide excision in malignant soft tissue tumor of lower extremities. Methods: Between February 2005 to April 2010, we followed up 19 cases who were undergoing anterolateral thigh free flap because of soft tissue defect following wide excision of malignant soft tissue tumor in lower extremity, including 9 cases were heel, 5 cases in foot, 3 cases in ankle, 2 cases in knee and leg. We observed that of implanted area's color, peripheral circulation at 3, 5, 7 days after operation and evaluated operating time, amount of hemorrhage, implanted skin necrosis, additional operations, complications. And we also evaluated the oncologic results, including local recurrence, metastasis, and morbidity. Results: Average operation time of wide excision and anterolateral thigh free flap was 7 hour 28 minutes. 18(94.7%) of total 19 cases showed successful engraftment, on the other hand, failure of engraftment due to complete necrosis of flap in 1 case. In 18 cases with successful engraftment, reoperation was performed in 4 cases. Among them, removal of hematoma and engraftment of flap after bleeding control was performed in 3 cases, because of insufficient circulation due to the hematoma. In the remaining 1 case, graft necrosis due to flap infection was checked, and grafted after combination of wound debridement and conservative treatment such as antibiotics therapy, also skin graft was performed at debrided skin defect area. Skin color change was mainly due to congestion with hematoma, flap was not observed global congestion or necrosis except 4 cases which shows partial necrosis on margin that treated with conservative therapy. Conclusions: Anterolateral thigh free flap could be recommended for reconstruction of soft tissue defect following wide excision of malignant soft tissue tumor in lower extremity.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.15
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• pp.6681-6684
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• 2015

Background: Metastatic cancer with invasion of skin, soft tissue and skeletal muscle is not common. Examples presenting as soft tissue masses could sometimes lead to misdiagnosis with delayed or inappropriate management. The purpose of current study was to investigate clinical characteristics in the involvement of metastatic cancer. Materials and Methods: A total of 1,097 patients complaining of skin or soft tissue masses and/or lesions were retrospectively reviewed from January 2012 to June 2013. Tumors involving skin, soft tissue and skeletal muscle of head and neck, chest wall, abdominal wall, pelvic region, back, upper and lower extremities were included in the study. Results: Fifty-seven (5.2%) patients were recognized as having malignancies on histopathological examination. The most common involvement of malignancy was basal cell carcinoma, followed by cutaneous squamous cell carcinoma, sarcoma and melanoma. The most common anatomical location in skin and soft tissue malignancies was head and neck (52.6% of the malignancies). Four (0.36%) of the malignant group were identified as metastatic cancer with the primary cancer source from lung, liver and tonsil and the most common site was upper extremities. One of them unexpectedly expired during the operation of metastatic tumor excision at the scalp. Conclusions: Discrimination between benign and malignant soft tissue tumors is crucial. Performance of imaging study could assist in the differential diagnosis and the pre-operative risk evaluation of metastatic tumors involving skin, soft tissue and skeletal muscle.