• 제목/요약/키워드: Tumor bleeding

검색결과 204건 처리시간 0.027초

Intraoperative Monitoring of Motor-Evoked Potentials for Supratentorial Tumor Surgery

  • Lee, Jung Jae;Kim, Young Il;Hong, Jae Taek;Sung, Jae Hoon;Lee, Sang Won;Yang, Seung Ho
    • Journal of Korean Neurosurgical Society
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    • 제56권2호
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    • pp.98-102
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    • 2014
  • Objective : The purpose of this study was to assess the feasibility and clinical efficacy of motor evoked potential (MEP) monitoring for supratentorial tumor surgery. Methods : Between 2010 and 2012, to prevent postoperative motor deterioration, MEP recording after transcranial stimulation was performed in 84 patients with supratentorial brain tumors (45 males, 39 females; age range, 24-80 years; median age, 58 years). MEP monitoring results were correlated with postoperative motor outcome compared to preoperative motor status. Results : MEP recordings were stable in amplitude (<50% reduction in amplitude) during surgery in 77 patients (91.7%). No postoperative motor deficit was found in 66 out of 77 patients with stable MEP amplitudes. However, postoperative paresis developed in 11 patients. False negative findings were associated with edema in peri-resectional regions and postoperative bleeding in the tumor bed. MEP decrease in amplitude (>50%) occurred in seven patients (8.3%). However, no deficit occurred postoperatively in four patients following preventive management during the operation. Three patients had permanent paresis, which could have been associated with vascular injury during tumor resection. Conclusions : MEP monitoring during supratentorial tumor surgery is feasible and safe. However, false negative MEP results associated with postoperative events may occur in some patients. To achieve successful monitoring, collaboration between surgeon, anesthesiologist and an experienced technician is mandatory.

갑상선 유두상 암종을 동반한 거대 경동맥체 종양 1예 (A Case of Huge Carotid Body Tumor with Thyroid Papillary Carcinoma)

  • 전진형;박일석;이원종;김성동;오석준;윤대영;노영수
    • 대한두경부종양학회지
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    • 제17권2호
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    • pp.221-225
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    • 2001
  • Carotid body tumor is a rare benign tumor arising from the paraganglionic tissue of neural crest. Surgical management remains the prefered treatment. Large carotid body tumors frequently encircle the internal carotid and external carotid arteries, and extensive bleeding often complicates the resection, increasing the risk of carotid artery rupture and damage to major cranial nerves. Recent improvements in surgical techniques and selective embolization have lessened the risks of surgical excision, decreased blood loss, and diminished the time required for resection. The review of literatures revealed a few cases of the carotid body tumor with papillary carcinoma of the thyroid. We report a case of the huge carotid body tumor with papillary carcinoma of the thyroid, which was removed by 4 times of preoperative embolization and transcervical approach.

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Silent Adenomas of Pituitary Gland : It's Immunohistochemical Features and Clinical Characteristics

  • Shim, Jae-Hyone;Song, Young-Jin;Kim, Dae-Chul;Park, Mi-Kyung;Choi, Sun-Seob;Kim, Ki-Uk
    • Journal of Korean Neurosurgical Society
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    • 제40권5호
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    • pp.330-335
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    • 2006
  • Objective : The aim of the study was to review the clinical and radiological findings of those non-functioning adenomas[NFAs] with positive immnoreactivity for anterior pituitary hormones. Methods : Sixty patients with pituitary adenoma were treated at the author's institution between January 2000 and July 2005. All consecutive patients were underwent transsphenoidal surgery by same operator. In addition to the routine histopathological examination, surgical specimen was examined by immunohistochemical staining against adenohypophyseal cells. And clinical analysis was performed by retrospective review of medical records, neuroimaging examinations and immunohistochemical technique. We classified these pituitary adenomas into functioning adenomas [group F], immuno-positive NFAs [group S, so-called silent adenoma] and immuno-negative NFAs [group N], and compared clinical and radiological differences between group F, N, and S. Results : Of the 60 cases, group F was 25, group S was 25, and group N was 10. Among the group S, 5 cases showed reactivity against PRL, 1 against GH, 1 against both PRL and GH, 1 against TSH and GH, 2 against ACTH, 11 against FSH and 4 against both LH and FSH. Radiologically, invasiveness was noted in 8 in group S, compared to 3 in group N and 1 in group F [p = 0.02]. Intratumoral bleeding was noted in 7 of group S, 2 of group N and 2 of group F [p >0.05]. Conclusion : Silent adenomas were thought to behave more aggressive than other subgroups of pituitary adenomas. And so we suggest the immunohistochemical study against adenohypophyseal cells may be helpful for evaluating clinical course of pituitary adenoma, expecially for, NFAs.

Skin malignancy initially misdiagnosed as a benign epidermal cyst

  • Chung, Chan Min;Wee, Sung Jae;Lim, Hyoseob;Cho, Sang Hun;Lee, Jong Wook
    • 대한두개안면성형외과학회지
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    • 제21권2호
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    • pp.123-126
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    • 2020
  • Skin cancer, which often occurs as a result of skin exposure to ultraviolet light radiation, usually presents with characteristic abnormal features, such as ulcerative lesions, irregular morphology, bleeding, and excessive growth. Therefore, skin cancer rarely resembles a benign tumor on visual inspection. Nonetheless, squamous cell carcinoma and basal cell carcinoma with nodular or polypoid features can have a similar appearance to that of benign tumors, meaning that they are sometimes misdiagnosed as benign. As benign and malignant tumors have some overlapping features, clinicians sometimes use additional imaging techniques such as ultrasonography to improve the accuracy of the diagnosis because even a malignant tumor that externally resembles a benign tumor generally has internal morphological features characteristic of malignancy, such as invasion and irregular borders. However, these imaging tools also have limitations, and punch or excisional biopsy can be needed if malignancy cannot be completely ruled out. Herein, we report a case of skin malignancy initially misdiagnosed as a benign epidermal cyst based on external visual inspection and ultrasonography.

원발성 종격동 종양 및 낭종의 임상적 고찰 (Clinical Review of Primary Mediastinal Tumors & Cysts)

  • 정종화
    • Journal of Chest Surgery
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    • 제23권2호
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    • pp.325-332
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    • 1990
  • Complications of the mediastinal tumors and cysts are malignant change, infection, bleeding, local invasion and mass effect to heart, lung and other mediastinal structures. But early surgical excision and proper treatments bring patients to good clinical course and results. Therefore mediastinal tumors and cysts are surgically interesting diseases We report the analysis of the 58 cases of mediastinal tumors and cysts, experienced in the Department of Cardiothoracic Surgery of the Kosin Medical College from July 1979 to June 1989. The results were as follows ; Sex ratio of male to female to female was 1.3: 1. Range of age was from 11 to 64 years and mean age was 34.3 years. The thymomas were 14 cases[24%], the teratomas were 19 cases[33%o], the neurogenic tumors were 10 cases[17%], the cysts were 9 cases[15%], the carcinomas were 3 cases[5%], the thyroid tumor was 1 case[2%], the Castleman’s disease was 1 case[2%] and unclassified tumor was 1 case[2%]. Malignant tumors were 12 cases [21%] of the 58 cases. Most frequent symptom was chest pain and discomfort and relationship of symptom and malignancy was significant. Complete removal of tumor was performed on the 47 cases[92%] and partial excision was 3 cases[6%]. Inoperable cases were treated with anticancer chemotherapy and radiotherapy. Postoperative complications were wound infection, Homer’s syndrome, phrenic nerve palsy, mediastinal hematoma and pleurisy. There was no case of postoperative mortality and good clinical course in surgically completely resected cases.

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악성 기관-기관지 종양에 대한 냉동 수술법 (Cryosurgery for Malignant Endobronchial Tumor)

  • 조종호;김광택;이성호
    • 대한기관식도과학회지
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    • 제18권1호
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    • pp.5-8
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    • 2012
  • 냉동 치료의 장점은 비침습적이며 통증이 없고 재치료가 가능하기 때문에 수술 고위험군, 재발환자 등에서 국소암 치료로서 적용될 수 있다는 점이다. 외부영상과 굴곡내시경을 통하여 위치를 파악하고 내시경으로 표적부위만을 냉동하기 때문에 주변조직의 손상이 거의 없으며 심폐 기능에 큰 위험을 주지 않는다. 처음 치료 후에도 치료를 한 부위나 다른 부위에도 여러 번의 추가적 치료가 가능하므로 치료로 불완전한 부분을 추가적으로 치료를 하여 좋은 결과를 얻을 수 있다. 냉동 수술의 특성을 잘 이용하여 적절한 환자에게 적용한다면, 기관-기관지의 폐색을 일으키는 악성 종양 환자들에게 좋은 치료방법의 하나라고 생각된다.

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A Case of Malignant Peripheral Nerve Sheath Tumor with Neurofibromatosis Type 1

  • Choi, Sang Kyu;Kim, Cheol Keun;Kim, Soon Heum;Jo, Dong In
    • Archives of Reconstructive Microsurgery
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    • 제26권1호
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    • pp.23-25
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    • 2017
  • The malignant peripheral nerve sheath tumor (MPNST) originates from neurofibromatosis type 1 (NF1). Because NF1 patients have many accompaniments with growth of additional masses, they usually overlook potential malignant changes in their masses. Our patient had two growing mass near the left elbow for several months; however, she ignored these masses until 7 days prior to writing this article, at which time they began bleeding. Traditionally, sarcoma including MPNST treatment consisted of amputation of the involved extremity. However, treatment now consists of surgical resection with adjuvant therapy. Therefore, we conducted resection of the mass and subsequent coverage with a local advancement flap. We believe that the most effective treatment for MPNST is early diagnosis and fast surgery, coupled with notification that there is always potential for malignant change in NF1 patient's masses.

캡슐내시경으로 발견된 공장의 위장관 간질성 종양 2 예 (Two Cases of Jejunal Gastrointestinal Stromal Tumor Diagnosed by Capsule Endoscope)

  • 최재원;문희정;장병익;김태년;송선교;배영경
    • Journal of Yeungnam Medical Science
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    • 제23권1호
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    • pp.131-137
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    • 2006
  • Small bowel tumors have been difficult to diagnose because of low incidence and absence of specific symptoms. There are no efficient and accurate tests available for diagnosis. Capsule endoscopy is an efficient diagnostic tool for small bowel disease and obscure gastrointestinal bleeding. We diagnosed two cases of small bowel gastrointestinal stromal tumor (GIST) diagnosed by capsule endoscopy that were treated by surgery. A 68 year old male presented with abdominal pain. The capsule endoscopy showed fungating ulcer mass at the jejunum. A 55 year female presented with melena. The capsule endoscopy showed an intraluminal protruding mass with a superficial ulcer at the jejunum. Two cases were diagnosed with GIST after surgery. We report these two case diagnosed by capsule endoscopy and review the medical literature.

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Effect of anti-rheumatic agents on periodontal parameters and biomarkers of inflammation: a systematic review and meta-analysis

  • Han, Ji-Young;Reynolds, Mark A.
    • Journal of Periodontal and Implant Science
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    • 제42권1호
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    • pp.3-12
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    • 2012
  • Purpose: Anti-rheumatic agents target common molecular pathways of inflammation in rheumatoid arthritis (RA) and periodontitis. The purpose of this study was to determine the relative effect of anti-rheumatic agents on the levels of inflammatory biomarkers and periodontal inflammation in RA patients with periodontitis. Methods: A systematic review and meta-analysis were conducted of studies comparing periodontal parameters of inflammation, such as bleeding on probing, and biomarkers of inflammation in RA patients with periodontitis and healthy adults with and without periodontitis. The search included the electronic databases MEDLINE, Cochrane Database of Systematic Reviews, and Google Scholar, inclusive through October 2011, with no language restrictions. Hand searches were conducted of the bibliographies of related journals and systematic reviews. Observational and interventional studies assessing the effects of antirheumatic therapy qualified for inclusion. Two reviewers performed independent data extraction and risk-of-bias assessment. Of the 187 identified publications, 13 studies fulfilled the inclusion criteria. Results: When compared to healthy adults without periodontitis, RA subjects were found to have significantly higher levels of bleeding on probing and limited evidence of higher levels of interleukin-$1{\beta}$ and tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$) in gingival crevicular fluid and saliva. No consistent differences were found in periodontal parameters and inflammatory biomarkers between RA subjects and adults with periodontitis. Studies evaluating the effect of anti-TNF-${\alpha}$ therapy in RA subjects with periodontitis have yielded inconsistent results. Conclusions: There are limited data, however, to suggest that anti-TNF-${\alpha}$ agents can reduce local production of inflammatory cytokines and periodontal inflammation in RA patients with periodontitis.

설 기저부에 발생한 염증성 가성종양 1예 (A Case of Inflammatory Pseudotumor at Tongue Base)

  • 이현섭;허세형;진성민;이상혁
    • 대한후두음성언어의학회지
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    • 제22권1호
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    • pp.56-59
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    • 2011
  • Inflammatory pseudotumor is characterized by the presence of a mass that may mimic malignancy and is composed of spindle cells mixed with variable amounts of extracellular collagen, lymphocytes, and plasma cells It is benign tumor commonly involves lung and orbit and rarely that occurs in the head and neck The cause and pathogenesis of inflammatory pseudotumor still remain controversial. Some bacterial infection or chronic irritation may have prompted some speculation that an initially reactive process can change into an overt neoplastic disease. It tends to affect children and young adults than old ages. We present a case of inflammatory pseudotumor involving the tongue base, in a 73-year-old patient with repeated oral bleeding that aggravated over a few days. Clinical examination showed angiomatous polyp like findings in oropharynx that easy bleeding tendency. CT images showed well defined soft tissue mass with focal enhancement. After surgery, tumor was finally diagnosed inflammatory pseudotumor by histopathologic examinations showed plasma cells and inflammatory cells in variable fibrotic tissues.

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