• 제목/요약/키워드: bone metastasis

검색결과 465건 처리시간 0.022초

Clinical Significance of CLDN18.2 Expression in Metastatic Diffuse-Type Gastric Cancer

  • Kim, Seo Ree;Shin, Kabsoo;Park, Jae Myung;Lee, Han Hong;Song, Kyo Yong;Lee, Sung Hak;Kim, Bohyun;Kim, Sang-Yeob;Seo, Junyoung;Kim, Jeong-Oh;Roh, Sang-Young;Kim, In-Ho
    • Journal of Gastric Cancer
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    • 제20권4호
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    • pp.408-420
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    • 2020
  • Purpose: Isoform 2 of tight junction protein claudin-18 (CLDN18.2) is a potential target for gastric cancer treatment. A treatment targeting CLDN18.2 has shown promising results in gastric cancer. We investigated the clinical significance of CLDN18.2 and other cell-adherens junction molecules (Rho GTPase-activating protein [RhoGAP] and E-cadherin) in metastatic diffuse-type gastric cancer (mDGC). Materials and Methods: We evaluated CLDN18.2, RhoGAP, and E-cadherin expression using two-plex immunofluorescence and quantitative data analysis of H-scores of 77 consecutive mDGC patients who received first-line platinum-based chemotherapy between March 2015 and February 2017. Results: CLDN18.2 and E-cadherin expression was significantly lower in patients with peritoneal metastasis (PM) than those without PM at the time of diagnosis (P=0.010 and 0.013, respectively), whereas it was significantly higher in patients who never developed PM from diagnosis to death than in those who did (P=0.001 and 0.003, respectively). Meanwhile, CLDN18.2 and E-cadherin expression levels were significantly higher in patients with bone metastasis than in those without bone metastasis (P=0.010 and 0.001, respectively). Moreover, we identified a positive correlation between the expression of CLDN18.2 and E-cadherin (P<0.001), RhoGAP and CLDN18.2 (P=0.004), and RhoGAP and E-cadherin (P=0.001). Conversely, CLDN18.2, RhoGAP, and E-cadherin expression was not associated with chemotherapy response and survival. Conclusions: CLDN18.2 expression was reduced in patients with PM but significantly intact in those with bone metastasis. Furthermore, CLDN18.2 expression was positively correlated with other adherens junction molecules, which is clinically associated with mDGC and PM pathogenesis.

Ilizarov술식을 이용한 사지 구제술 - 2례 보고 - (Limb-Salvage Surgery using Ilizarov Technique - Report of 2 cases -)

  • 조덕연;고은성;이지섭
    • 대한골관절종양학회지
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    • 제1권2호
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    • pp.226-232
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    • 1995
  • Survival rate of osteosarcoma has been improved recently due to the neoadjuvant and adjuvant chemotherapy. Limb-salvaging operation(LSO) has replaced the amputation technique without' lowering the survival rate. And there occurred a lot of patients who are suffering from the high cost of artificial implants and forced to choose amputation due to economic problem. In LSO, usually relatively high cost artifical implant is needed. When a patient and not afford such an expensive implant he had to choose an inexpensive way, amputation. Authors tried bone lengthening by adopting Ilizarov technique after wide resection of tumor in two patients. Bone transportation was successful in one patient and less successful in the other. One case in CDF(continuosly disease free since the surgical procedure) state at follow-up 3 year 4 months after knee joint fusion. And the other was given lobectomy for lung metastasis at postop. 1 year and 9 months, and given osteosynthesis for infected nonunion at the docking site. Bone transportation was thought to be a good method for the bony coverage of dead space caused by wide resection. Bone transportation technique was economical as well as biological We present two osteosarcoma patient who treated with Ilizarov bone transportation.

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유도화학요법 및 국소 치료 후 원격전이를 보인 국소 진행성 두경부암 환자군의 임상 특징 및 위험인자에 관한 연구 (Clinical Features and the Risk Factors of Distant Metastasis in Locally Advanced Advanced Head and Neck Cancer Patients after Induction Chemotherapy Followed Locoregional Control Therapy)

  • 이혜원;백동훈;이경남;조은정;김효정;설영미;송무곤;최영진;신호진;정주섭;조군제
    • 대한두경부종양학회지
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    • 제27권2호
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    • pp.177-182
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    • 2011
  • Backgrounds : Head and neck cancer is one of the most prevalent cancers in the world. It tends to remain localized at the primary site and regional lymph nodes, but if distant metastasis occurs, it has a poor prognosis. This study was performed to evaluate the prevalence of distant metastasis and to determine the risk factor in locally advanced head and neck cancer after induction chemotherapy followed locoregional control therapy. Methods : A retrospective review was performed in 420 patients with locally advanced head and neck cancer who treated with induction chemotherapy followed locoregional control therapy from January 2001 to December 2010. Among them, 31 patients who had distant metastasis as first relapse within 2 years after termination of therapy were analyzed for clinical features and the risk factors of distant metastasis. Results : The overall incidence of distant metastasis was 7.3%. The bone, lung, and liver were the most frequent metastatic organs. In univariate analysis, nodal stage, nasopharyngeal cancer, laryngeal cancer, G3/G4 neutropenia during induction chemotherapy, and concurrent chemoradiotherapy were the influencing factors for distant metastasis. In multivariate analysis, advanced N stage and nasopharynx were the risk factors of distant metastasis, and grade 3/4 neutropenia during induction chemotherapy was considered to decrease distant metastasis. Conclusion : This study suggests that the advanced N stage is the risk factor of distant metastasis and Grade 3/4 neutropenia during induction chemotherapy can be beneficial against distant metastasis in locally advanced head and neck cancer patients treated with induction chemotherapy followed locoregional control therapy.

Chondrosarcoma Apoplexy in Thoracic Spine

  • Kim, Sang Woo;Kim, Min Su;Jung, Young Jin
    • Journal of Korean Neurosurgical Society
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    • 제53권1호
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    • pp.46-48
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    • 2013
  • Chondrosarcoma is a very uncommon malignant primary bone tumor, especially, it occurs extremely rare in the spine. A 52-year-old man was admitted to the emergency room with sudden paraplegia. Twelve hours prior to a paraplegic event, he visited an outpatient clinic with discomfort and tenderness around the medial border of the right scapular, and his neurologic status was absolutely intact. Magnetic resonance imaging showed a lobulated soft tissue mass from T3 to T5, which extended to the epidural space. Computed tomography scans showed soft tissue mass on the spinal posterior arch and osteolytic change of the adjacent bony structures. Emergent surgery was performed and the lesion was removed. Dark reddish blood and gel-like material were encountered around the dura and posterior arch during the operation. Multiple pulmonary nodules were found on a chest CT scan and a biopsy of one of them had been proven to be a metastasis of chondrosarcoma. The histologic examination showed dedifferentiated chondrosarcoma. The patient's neurologic deficit was improved slowly from ASIA A to ASIA D. Chondrosarcoma in the spine is extremely rare, even more with acute hemorrhage and sudden expansion into the epidural space. We named it chondrosarcoma apoplexy. We should consider the possibility of a hemorrhagic event when the patient's neurologic deficit worsens suddenly with spinal bone tumor.

A forehead hematoma as the initial clinical sign of lung cancer

  • Park, Jonghyun;Kang, Shin Hyuk;Kim, Woo Seob;Kim, Han Koo;Bae, Tae Hui
    • 대한두개안면성형외과학회지
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    • 제21권3호
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    • pp.198-201
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    • 2020
  • Primary lung cancer commonly metastasizes to the brain, bones, liver, and adrenal glands. In some cases, bone metastasis serves as the first presenting sign of lung cancer with bone pain and headache, but it is not common. The incidence of skull metastasis in lung squamous cell carcinoma (SCC) is low, and there have been only a few cases of skull metastases serving as the first sign of malignancy with skull mass and epidural bleeding; however, no similar cases have been reported regarding that of hematoma. We report a case of an 84-year-old man who first presented with a simple forehead hematoma and was eventually diagnosed with SCC of the lung.

위암에서 $^{18}F-FDG$ PET의 임상 이용 (Clinical Application of $^{18}F-FDG$ PET in Gastric Cancer)

  • 윤미진;김태성;황희성
    • Nuclear Medicine and Molecular Imaging
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    • 제42권sup1호
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    • pp.39-45
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    • 2008
  • PET or PET/CT detects only less than 50% of early gastric cancer and 62-98% of advanced gastric cancer. Therefore, mass screening programs are recommended for all adults over the age of 40 for early detection and early treatment of gastric cancer through endoscopy or various radiological tests. The most important step after diagnosis of gastric cancer is accurate staging, which mainly evaluates tumor resectability to avoid unnecessary surgery. Important factors that affect tumor resectability are whether the tumor can be separated from adjacent organs or important blood vessels, the extent of lymph node metastasis, presence of peritoneal metastasis, or distant organ metastasis. To evaluate the extent of local tumor invasion, anatomical imaging that has superior spatial resolution is essential. There are a few studies on prognostic significance of FDG uptake with inconsistent results between them. In spite of lower sensitivity for lymph node staging, the specificity of CT and PET are very high, and the specificity for PET tends to be higher than that for CT. Limited data published so far show that PET seems less useful in the detection of lung and bone metastasis. In the evaluation of pleural or peritoneal metastasis, PET seems very specific but insensitive as well. When FOG uptake of primary tumor is low, distant metastasis also tends to show low FDG uptake reducing its detection on PET. There are only a few data available in the evaluation of recurrence detection and treatment response using FDG PET or PET/CT.

신장암의 다발성 골격근 전이 - 1례 보고 - (Multifocal Skeletal Muscle Metastasis from Kidney Cancer (Transitional Cell Carcinoma) - A Case Report -)

  • 이승구;강용구;박원종;정진화;서유준
    • 대한골관절종양학회지
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    • 제8권2호
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    • pp.48-53
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    • 2002
  • 상피암의 인접 골격근으로의 직접 전파는 많이 보고되었으나, 골격근으로의 원격전이는 드물고 특히 다발성 전이는 매우 드문 것으로 알려져 있다. 골격근내의 가변적인 혈류량, 근수축이나 난류성 혈류 등과 같은 물리적인 요인, 골격근내의 산성 환경, 젖산, 세포외 기질의 단백분해효소 억제인자 등이 골격근으로의 원격 전이를 억제하는 원인으로 제시되고 있다. 저자들은 최근 다발성 골격근 전이를 동반한 신장암(이행성 상피세포암) 1례를 경험하였기에 이를 보고하는 바이다.

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비소세포성 폐암의 척추 전이로 발생한 암성통증에 대한 초오 약침을 포함한 한방 치료 1례 (A Case Report of a Non-small Cell Lung Cancer Patient Metastasis to Vertebra with Cancer Pain Improved by Traditional Korean medicine including Aconitum Ciliare Decaisne Pharmacopuncture)

  • 윤미정;조나경;이유리;최홍식;김승모;김경순
    • 대한암한의학회지
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    • 제24권2호
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    • pp.33-41
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    • 2019
  • Objectives : The purpose of this case report is to examine clinical application of Traditional Korean medicine including aconitum ciliare decaisne pharmacopuncture for cancer pain caused by bone metastasis of non small cell lung cancer. Methods : The patient diagnosed as non small cell lung cancer was treated with pharmacopuncture, acupuncture, electroacupuncture and herbal medicine. We used NRS(Numeric rating scale) and ECOG PS(Eastern Cooperative Oncology Group Performance Status) to observe the effect of the treatment. Results : After the treatment, NRS of cancer pain and ECOG PS score decreased. Also, the frequency of using rapid-onset opioids decreased. Conclusions : This study suggests Traditional Korean medicine treatment including aconitum ciliare decaisne pharmacopuncture is effective in cancer pain control caused by metastasis to bone with multiple organs with non small cell lung cancer.

임파절에 전이한 골육종 - 1례 보고 - (Lymph Node Metastasis of Osteosarcoma - A Case Report -)

  • 황성관;박희전;윤여승;나중호;오진록;김기호;김동진;양경무;조미연
    • 대한골관절종양학회지
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    • 제4권1호
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    • pp.65-70
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    • 1998
  • Osteosarcoma is the most common primary bone tumor except for multiple myeloma. Hematogenous spread of osteosarcoma presents the t1susal route of dissemination. Lung metastasis is the most common, however the lymph node involvement is quite rare. In addition, according to Mirra, radiologically detectable involvement of lymph node is an extremely rare manifestation of osteosarcoma. The authors had experienced a patient with an osteosarcoma of the right distal femur which spread to the right inguinal lymph node and lung. After preoperative chemotheraphy, a limb salvage operation was performed around the lesion of right distal femur and the right inguinal lymph nodes were dissected. A adjuvant postoperative chemotheraphy was performed. After the treatment, there was no recurrence of osteosarcoma or any other metastatic evidence for two years and 8 months.

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전이된 암 환자에서 풍선 후만 성형술과 동시에 시행한 경피적 추궁근 성형술 - 증례보고 - (Percutaneous Pediculoplasty and Balloon Kyphoplasty in a Vertebral Metastatic Cancer Patient - A case report -)

  • 조지연;서정훈;신화용;최용민;방문선;이상철;김용철
    • The Korean Journal of Pain
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    • 제20권2호
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    • pp.213-218
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    • 2007
  • Percutaneous vertebroplasty and balloon kyphoplasty have been accepted as effective treatment modalities for vertebral compression fractures in patients with vertebral metastasis. However, when these procedures are conducted in patients with lytic lesions of the vertebral pedicle, polymethylmethacrylate leakage through the lytic lesions that occurs during percutaneous pediculoplasty can increase the procedural risks due to the immediate vicinity of neural structures. In spite of this risk, there are not many available reports on safer methods of pediculoplasty. Here we report a case of vertebral metastasis in which the pedicle infiltration of cancer was successfully treated by pediculoplasty using a bone filler device that contained thick bone cement during a balloon kyphoplasty procedure.