• Title/Summary/Keyword: Soft tissue tumors

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Clinical Experience of Chest Wall Tumors - A Review of Twenty one Cases - (흉벽종양 21례에 대한 임상적 고찰)

  • 김송명
    • Journal of Chest Surgery
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    • v.20 no.4
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    • pp.723-729
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    • 1987
  • A retrospective study of 21 cases of chest wall tumors, 12 benign and 9 malignant, was carried out to review their clinical radiological and pathological features. On age distribution, most cases [80.9%] were found in 4th to 6th decades. The sex ration [M:F] was represented as 2.5:1. Of the 21 lesions, there were 8 cases of soft tissue tumors, 4 cases of bone and cartilage origined tumors and 9 malignant tumors which included 3 metastatic tumors. The overall mortality was 22.2% and all of the deaths were found in the malignant tumors. All of the patients with benign tumors were treated by excision without recurrence. Distinction between benign and malignant chest wall tumors was not possible using radiographic criteria unless cortical destruction and involvement of soft tissue were visualized. On the basis of our analysis, we believe that all tumors of chest wall should be considered malignant until proven otherwise and that wide excision should be carried out. This is necessary not only to obtain as adequate diagnosis but also to provide the best chance for cure in both benign and malignant lesions.

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Diagnosis of Residual Tumors after Unplanned Excision of Soft-Tissue Sarcomas: Conventional MRI Features and Added Value of Diffusion-Weighted Imaging

  • Jin, Kiok;Lee, Min Hee;Yoon, Min A;Kim, Hwa Jung;Kim, Wanlim;Chee, Choong Geun;Chung, Hye Won;Lee, Sang Hoon;Shin, Myung Jin
    • Investigative Magnetic Resonance Imaging
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    • v.26 no.1
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    • pp.20-31
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    • 2022
  • Purpose: To assess conventional MRI features associated with residual soft-tissue sarcomas following unplanned excision (UPE), and to compare the diagnostic performance of conventional MRI only with that of MRI including diffusion-weighted imaging (DWI) for residual tumors after UPE. Materials and Methods: We included 103 consecutive patients who had received UPE of a soft-tissue sarcoma with wide excision of the tumor bed between December 2013 and December 2019 and who also underwent conventional MRI and DWI in this retrospective study. The presence of focal enhancement, soft-tissue edema, fascial enhancement, fluid collections, and hematoma on MRI including DWI was reviewed by two musculoskeletal radiologists. We used classification and regression tree (CART) analysis to identify the most significant MRI features. We compared the diagnostic performances of conventional MRI and added DWI using the McNemar test. Results: Residual tumors were present in 69 (66.9%) of 103 patients, whereas no tumors were found in 34 (33.1%) patients. CART showed focal enhancement to be the most significant predictor of residual tumors and correctly predicted residual tumors in 81.6% (84/103) and 78.6% (81/103) of patients for Reader 1 and Reader 2, respectively. Compared with conventional MRI only, the addition of DWI for Reader 1 improved specificity (32.8% vs. 56%, 33.3% vs. 63.0%, P < 0.05), decreased sensitivity (96.8% vs. 84.1%, 98.7% vs. 76.7%, P < 0.05), without a difference in diagnostic accuracy (76.7% vs. 74.8%, 72.9% vs. 71.4%) in total and in subgroups. For Reader 2, diagnostic performance was not significantly different between the sets of MRI (P > 0.05). Conclusion: After UPE of a soft-tissue sarcoma, the presence or absence of a focal enhancement was the most significant MRI finding predicting residual tumors. MRI provided good diagnostic accuracy for detecting residual tumors, and the addition of DWI to conventional MRI may increase specificity.

Distribution of Benign Soft Tissue Tumors Occurred in Extremities and Trunk (사지 및 체간에 발생한 양성 연부조직 종양의 발생 분포)

  • Kim, Tai-Seung;Seo, Kyoung-Won;Kim, Tae-Jin
    • The Journal of the Korean bone and joint tumor society
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    • v.5 no.1
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    • pp.35-43
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    • 1999
  • The authors reviewed and analyzed the pathologically confirmed 230 cases of benign soft tissue tumors which had been treated at Department of Orthopaedic Surgery in Seoul Hospital, Hanyang University College of Medicine from February 1984 to November 1997. The following results were obtained. 1. The most common benign soft tissue tumors was ganglion(26.5%) followed by hemangioma(19.6%), lipoma(17.0%), Baker's cyst(13.0%) and neurilemmoma(7.0%) in decreasing order of incidence. 2. Benign soft tissue tumors were found evenly distributed over all age group. Hemangioma and lymphangioma were usually found to occur before 20 years old. 3. Female was affected about 1.3 times more common. But, Baker's cyst and neurilemmoma occurred most frequently in male. 4. In children, the most common benign soft tissue tumors was hemangioma followed by ganglion, lymphangioma, and lipoma. In adult, ganglion, lipoma, Baker's cyst, hemangioma were common. 5. The lower extremity was the predominant site of occurrence(60.0%). 6. Benign soft tissue tumors were taken by excision. Local recurrences were developed in 22(9.6%) out of 230 cases, especially in hemangioma.

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THE STUDY OF THE MALIGNANT TUMORS OF THE MAXILLARY SINUS BY COMPUTED TOMOGRAPHY (전산화 단층 촬영상에 의한 상악동 악성종양에 관한 연구)

  • Dan Jung-Bae;Park Tae-Won
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.19 no.1
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    • pp.137-147
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    • 1989
  • CT findings of proven 25 malignant tumors of the maxillary sinus were retrospectively analyzed to be of help in the diagnosis and treatment. The results were follows: 1. Average age was 54 years old, and eighteen were males and seven were females with a ratio of 2.6:1 2. The most common histopathologic feature was squamous cell carcinoma (19 cases) and others were two cases of adenoid cystic carcinoma, one case of malignant fibrous histiocytoma, mucoepidermoid tumor, histiocytic lymphoma, unidentified malignant tumor. 3. CT findings were sinus opacificaqtion (4%), soft tissue mass (92%), low densities within soft tissue mass (44.%), air densities within soft tissue mass (24%), osteosclerosis (4%), bone destruction (92%), bone displacement (32%), fat plane obliteration (76%). 4. CT in the malignant maxillary sinus tumors approved the value in evaluation of tumor extension to nasal cavity, ethmoid sinus, orbit, infratemporal fossa, pterygopalatine fossa, pterygoid fossa, pterygoid muscle, cheek skin and intracranial cavity. 5. Twenty four cases (96%) were stage Ⅲ, stage Ⅳ according to AJCC TNM classification. 6. Bone findings were destruction, displacement, sclerosis and most frequent site of bone destruction was the medial wall of the antrum(92%). 7. Tumor growth pattern showed destructive pattern in 18 cases(72%), and squamous cell carcinoma showed destructive pattern. (P<0.05)

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Malignant Tumors of the Foot and Ankle (족부 및 족관절의 악성 종양)

  • Kim, Han-Soo;Oh, Joo-Han;Hwang, Chang-Joo;Lee, Han-Koo;Lee, Sang-Hoon
    • Journal of Korean Foot and Ankle Society
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    • v.5 no.1
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    • pp.74-81
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    • 2001
  • Purpose: We analyzed 35 patients of malignant tumors of the foot and ankle to evaluate clinical manifestation. result of treatment and prognosis. Materials and Methods: Thirty five patients who were histologically confirmed for malignant tumors of the foot and ankle from September 1984 to May 1999 were investigated. Results: There were 16 males and 19 females. with an average age 38.3 years. Ten tumors were originated from bone and 25 from soft tissue; osteosarcoma (8) was the most common bone tumor and synovial sarcoma (8) and malignant melanoma (6) were common in soft tissue tumors. Surgical procedures included; marginal resection (2), limb salvage procedure after wide resection (5) for bone tumors, and amputation (12), wide resection (4), marginal resection (5) for soft tissue tumors. In some cases, perioperative chemotherapy and radiotherapy were given. There were 2 local recurrences and 11 metastases; 5 metastases were found at the time of initial diagnosis. Average follow-up was 3.5 years. Conclusion: We conclude that suspicion and early diagnosis are important in malignant tumors of the foot and ankle, and the resection margin must be obtained more thoroughly during surgery with perioperative adjuvant therapy, if necessary.

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Characterization and predictive value of volume changes of extremity and pelvis soft tissue sarcomas during radiation therapy prior to definitive wide excision

  • Gui, Chengcheng;Morris, Carol D.;Meyer, Christian F.;Levin, Adam S.;Frassica, Deborah A.;Deville, Curtiland;Terezakis, Stephanie A.
    • Radiation Oncology Journal
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    • v.37 no.2
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    • pp.117-126
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    • 2019
  • Purpose: The purpose of this study was to characterize and evaluate the clinical significance of volume changes of soft tissue sarcomas during radiation therapy (RT), prior to definitive surgical resection. Materials and Methods: Patients with extremity or pelvis soft tissue sarcomas treated at our institution from 2013 to 2016 with RT prior to resection were identified retrospectively. Tumor volumes were measured using cone-beam computed tomography obtained daily during RT. Linear regression evaluated the linearity of volume changes. Kruskal-Wallis tests, Mann-Whitney U tests, and linear regression evaluated predictors of volume change. Logistic and Cox regression evaluated volume change as a predictor of resection margin status, histologic treatment response, and tumor recurrence. Results: Thirty-three patients were evaluated. Twenty-nine tumors were high grade. Prior to RT, median tumor volume was 189 mL (range, 7.2 to 4,885 mL). Sixteen tumors demonstrated significant linear volume changes during RT. Of these, 5 tumors increased and 11 decreased in volume. Myxoid liposarcoma (n = 5, 15%) predicted decreasing tumor volume (p = 0.0002). Sequential chemoradiation (n = 4, 12%) predicted increasing tumor volume (p = 0.008) and corresponded to longer times from diagnosis to RT (p = 0.01). Resection margins were positive in three cases. Five patients experienced local recurrence, and 7 experienced distant recurrence, at median 8.9 and 6.9 months post-resection, respectively. Volume changes did not predict resection margin status, local recurrence, or distant recurrence. Conclusion: Volume changes of pelvis and extremity soft tissue sarcomas followed linear trends during RT. Volume changes reflected histologic subtype and treatment characteristics but did not predict margin status or recurrence after resection.

Bilateral Hypertrophy of Abductor Digiti Minimi Simulating a Localized Soft Tissue Mass: A Case Report (연부조직 종양으로 오인한 양측 족부 소지 외전근 비대증: 증례 보고)

  • Jung, Yu-Hun;Song, Woo-Suk;Eun, Dong-Chan
    • Journal of Korean Foot and Ankle Society
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    • v.21 no.4
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    • pp.170-173
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    • 2017
  • Soft tissue tumors of the foot have a low incidence rate, and most of them are symptom free, thus it is difficult to diagnose accurately. Herein, we report a 15-year-old male patient who had swelling without pain on the lateral margin of both feet. We performed excisional biopsy of the abductor digiti minimi via subtotal resection, following radiograph and magnetic resonance imaging. According to the histological analysis, hypertrophy of abductor digiti minimi was positive, and other soft tissue tumors were negative. Six months after the operation, normal appearance of both feet was maintained and the patient was satisfied with the result.

Subungual Osteochondromas of the Toe: Two Case Reports for Diagnosis and Treatment

  • Myung Chul Lee;Chan Eol Seo;Wook Youn Kim;Wan Seop Kim;Jeenam Kim;Donghyeok Shin;Hyungon Choi
    • Archives of Plastic Surgery
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    • v.50 no.1
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    • pp.101-105
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    • 2023
  • Benign cartilaginous tumors, known as chondrogenic tumors, show cartilage components in the microscopic diagnosis. We present two clinical cases with cartilaginous tumors of the toes showing distinctive clinical manifestations. Two juvenile patients visited our outpatient clinic due to tumors with toenail deformities. A 10-year-old girl presented with a palpable mass with a nail deformity on the left third toe. The initial pathology report was soft tissue chondroma until complete resection. Another 15-year-old male patient visited the dermatology department with a toenail deformity and underwent a punch biopsy. The pathology report was fibrosis with myxoid degeneration. Excisional biopsies were performed for both patients. In the operative field, we observed exophytic tumors connected to the distal phalangeal bones. The final pathology reports were subungual osteochondroma on both patients. The specimen exhibited mature bone trabeculae with a focal cartilaginous cap. Benign cartilaginous tumors have a slow, progressive course and do not show significant symptoms. However, tumors in subungual areas are accompanied by toenail deformities and they can cause pain. Their clinical characteristics lead to a delayed diagnosis. Surgeons can be confused between soft tissue and chondrogenic tumors. When they conduct physical examinations, these categories should be considered in the differential diagnosis.

A Soft Tissue Myxoma on the Palate: A Case Report

  • Ha, Ji-Woo;Jung, Won;Lee, Kyung-Eun;Suh, Bong-Jik
    • Journal of Oral Medicine and Pain
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    • v.45 no.3
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    • pp.65-70
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    • 2020
  • Myxomas in the orofacial regions are relatively uncommon tumors that occur in two different types: odontogenic myxomas and soft tissue myxomas. Odontogenic myxomas, derived from the mesenchymal cells such as papillae, dental follicles, or periodontal ligament, occur commonly in the maxilla and mandible. However, soft tissue myxomas in the oral cavity are rare and have been previously reported in only about 30 cases of unknown pathogenesis. The aim of this case report is to present a new case of oral soft tissue myxoma in a 37-year-old male patient who presented with a soft, exophytic round mass on the palate.

The Imaging Features of Desmoid Tumors: the Usefulness of Diffusion Weighted Imaging to Differentiate between Desmoid and Malignant Soft Tissue Tumors

  • Lee, Seung Baek;Oh, Soon Nam;Choi, Moon Hyung;Rha, Sung Eun;Jung, Seung Eun;Byun, Jae Young
    • Investigative Magnetic Resonance Imaging
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    • v.21 no.3
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    • pp.162-170
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    • 2017
  • Purpose: To evaluate the imaging findings of desmoid tumors using various imaging modalities and to evaluate whether diffusion-weighted imaging (DWI) can help differentiate between desmoid and malignant tumors. Materials and Methods: The study included 27 patients with pathologically confirmed desmoid tumors. Two radiologists reviewed 23 computed tomography (CT), 12 magnetic resonance imaging (MRI) and 8 positron emission tomography-computed tomography (PET-CT) scans of desmoid tumors and recorded data regarding the shape, multiplicity, size, location, degree of enhancement, and presence or absence of calcification or hemorrhage. The signal intensity of masses on T1- and T2-weighted imaging and the presence or absence of whirling or band-like low signal intensity on T2-weighted imaging were recorded. The apparent diffusion coefficient (ADC) values of the desmoid tumors in nine patients with DWIs were compared with the ADC values of 32 malignant tumors. The maximum standardized uptake value ($SUV_{max}$) on PET-CT images was measured in 8 patients who underwent a PET-CT. Results: The mean size of the 27 tumors was 6.77 cm (range, 2.5-26 cm) and four tumors exhibited multiplicity. The desmoid tumors were classified by shape as either mass forming (n = 18), infiltrative (n = 4), or combined (n = 5). The location of the tumors was either intra-abdominal (n = 15), within the abdominal wall (n = 8) or extra-abdominal (n = 4). Among the 27 tumors, 21 showed moderate to marked enhancement and 22 showed homogeneous enhancement. Two tumors showed calcifications and one displayed hemorrhage. Eleven of the 12 MR T2-weighted images showed whirling or band-like low signal intensity areas in the mass. The mean ADC value of the desmoid tumors ($1493{\times}10^{-6}mm^2/s$) was significantly higher than the mean of the malignant soft tissue tumors ($873{\times}10^{-6}mm^2/s$, P < 0.001). On the PET-CT images, all tumors exhibited an intermediate $SUV_{max}$ (mean, 3.7; range, 2.3-4.5). Conclusion: Desmoids tumors showed homogenous, moderate to marked enhancement on CT and MRI scans and a characteristic whirling or band-like pattern on T2-weighted images. DWI can be useful for the differentiation of desmoid tumors from malignant soft tissue tumors.