• Title/Summary/Keyword: exenteration

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Postoperative Radiotherapy for Sebaceous Carcinoma of the Upper Eyelid (상안검 피지선암의 수술후 방사선 치료 1례)

  • Chung Su-Mi;Choi Byung-Ock;Choi Ihl-Bohing;Shin Kyung-Sub;Byoun Jun-Hee
    • Korean Journal of Head & Neck Oncology
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    • v.11 no.1
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    • pp.36-40
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    • 1995
  • Sebaceous carcinomas of the eyelids are uncommon but lethal tumors. Lesions are usually seen in the elderly, predominantly women. The meibomian glands of the tarsus are the most frequent site of origin. Less commonly, the tumor arises in other sebaceous glands, e.g., the gland of Zeis, eyebrow or caruncle. Regardless of the location, sebaceous malignancies must be considered aggressive neoplasms with a potential for regional and distant metastasis. Diagnosis may be difficult, given the low incidence and inconsistencies in histopathologic classification. Treatment requires wide surgical excision with removal of involved regional lymph nodes and exenteration is reserved for those patients with orbital involvement or diffuse intraepithelial neoplasia. Opinions are divided regarding the use of postoperative irradiation or chemotherapy. Recently we experienced 46-year-old male patient with a 12-month history of painless, firm nodule and conjunctivitis due to sebaceous carcinoma of the left upper eyelid. After surgery, serial sections of the entire conjunctiva and eyelids showed a positive cut margin in medial and lateral border. We report herein this patient that supports irradiation as the postoperative treatment of these tumors in selected patients with a review of literatures.

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Primary Retrobulbar Meningioma in a Dog (개에서 발생한 원발성 안구 후방 수막종 1례)

  • Ahn, Jae-Sang;Jeong, Man-Bok;Kim, Won-Tae;Kim, Se-Eun;Park, Young-Woo;Kim, Tae-Hyun;Ahn, Jeong-Taek;Ha, Jeong-Im;Kim, Dae-Yong;Choi, Min-Cheol;Yoon, Jung-Hee;Seo, Kang-Moon
    • Journal of Veterinary Clinics
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    • v.27 no.1
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    • pp.97-101
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    • 2010
  • A 13-year-old neutered female Maltese was referred to Veterinary Medical Teaching Hospital of Seoul National University with 8-month-history of gradually enlarging retrobulbar mass in the right eye. On the ophthalmic examinations, exophthalmos, exposure keratitis, and cataract were observed, and menace response was absent in the eye. The fellow eye was normal except for nuclear sclerosis. On the ocular ultrasonographic evaluation, a mass was identified in retrobulbar and periocular region in the right eye. Exenteration was performed in order to remove the mass. Histopathologic evaluation revealed that most part of the mass was composed of epithelial-like neoplastic cells. Invasion into adipose cells and osseous metaplasia around the mass were also confirmed. Based on the radiologic and histopathologic examination, the mass in the right eye was diagnosed as primary retrobulbar meningioma. Eleven months after the surgery, recurrence was not observed.

RECONSTRUCTION OF MIDFACIAL AND PALATAL DEFECTS AFTER MAXILLECTOMY (상악골 절제술후 발생한 중앙부및 구개 결손부의 재건)

  • Kim, Hoon;Choi, Mi-Suk;Choi, Sung-Won;Kim, Ho-Kyeom;Kim, Sung-Moon;Rim, Jae-Suk;Kwon, Jong-Jin
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.18 no.1
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    • pp.1-16
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    • 1996
  • There are various defects caused by trauma or resection of maignant tumor in the orofacial region, which can be reconstructed with various regional and pararegional flaps. Among these defects, it is very difficult to reconstruct palatal and midfacial defects after maxillectomy and patients have problems in speaking and swallowing of food. Therefore it is very important for surgeons to reconstruct these defects functionally and esthetically and to return the patients to the normal social activity. These defects are usually obturated with prosthodontic appliances to assist the phonation and swallowing. But nowadays surgical reconstruction by various flaps was considered and performed for better rehabilitation. For this purpose the forehead flap, the nasolabial flap, the tongue flap, the sternocleidomastoideous flap, the temporal flap, the latissimus dorsi flap, the scapular flap etc. are used. We reconstructed small-sized plalatal defects with tongue flap, medium-sized palatal and maxillary defects after maxillectomy with temporal myofascial flap and large midfacial defects including eyeball exenteration with latissimus dorsi myocutaneous flaps. Here we are to report 5 cases of these flaps used for the reconstruction of palatal and midfacial defects and consider the versatility, reliability and limitation in use of these flaps.

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Mucormycosis Management in COVID-19 Era: Is Immediate Surgical Debridement and Reconstruction the Answer?

  • Gupta, Samarth;Goil, Pradeep;Mohammad, Arbab;Escandon, Joseph M.
    • Archives of Plastic Surgery
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    • v.49 no.3
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    • pp.397-404
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    • 2022
  • Background Excessive use of corticosteroids therapy along with gross immunocompromised conditions in the novel coronavirus disease 2019 (COVID-19) pandemic has raised the risks of contracting opportunistic fungal infections. Here, we describe our experience with the implementation of a surgical protocol to treat and reconstruct rhino-orbital-cerebral mucormycosis. Methods A retrospective review of our prospectively maintained database was conducted on consecutive patients diagnosed with mucormycosis undergoing immediate reconstruction utilizing our "Mucormycosis Management Protocol." All patients included in this study underwent reconstruction after recovering from COVID-19. Wide local excision was performed in all cases removing all suspected and edematous tissue. Reconstruction was done primarily after clear margins were achieved on clinical assessment under a cover of injectable liposomal amphotericin B. Results Fourteen patients were included. The average age was 43.6 years and follow-up was 24.3 days. Thirteen patients had been admitted for inpatient care of COVID-19. Steroid therapy was implemented for 2 weeks in 11 patients and for 3 weeks in 3 patients. Eight patients (57.1%) had a maxillectomy and mucosal lining resection with/without skin excision, and six patients (42.8%) underwent maxillectomy and wide tissue excision (maxillectomy and partial zygomatic resection, orbital exenteration, orbital floor resection, nose debridement, or skull base debridement). Anterolateral thigh (ALT) flaps were used to cover defects in all patients. All flaps survived. No major or minor complications occurred. No recurrence of mucormycosis was noted. Conclusion The approach presented in this study indicates that immediate reconstruction is safe and reliable in cases when appropriate tissue resection is accomplished. Further studies are required to verify the external validity of these findings.

The Role of Postoperative Pelvic Radiation Therapy in Rectal Cancer (직장암에 있어서 수술후 방사선치료의 역할)

  • Ahn, Yong-Chan;Kim, Jae-Sung;Yun, Hyong-Geun;Ha, Sung-Whan;Park, Charn-Il
    • Radiation Oncology Journal
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    • v.9 no.1
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    • pp.93-102
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    • 1991
  • To evaluate the role of postoperative pelvic radiation therapy in rectal cancer, a retrospective analysis was done on 189 patients with modified Astler-Coiler stages B2+3, Cl , and C2+3 who were treated from February 1979 to June 1980. Forty-seven patients were staged as B2+3,17 as Cl, and 125 as C2+3. As a curative resection,41 received low anterior resection,143 received abdomino-perineal resection, and five received pelvic exenteration. The survival and disease-free survival rates of the total patients at five year were $45.3\%\;and\;44.1\%$, respectively. The stage was an important prognostic factor for survival and disease-free survival: the survival rates at five year were $63.4\%$ in stage B2+3, $62.4\%$ in C1, and $37.2\%$ in C2+3 (p<0.005): the disease-free survival rates at five year were $55.7\%$ in B2+3, $65.7\%$ in C1, and $30.4\%$ in C2+3, respectively (p<0.01). The liver was the most frequently involved organ of recurrence followed by the lung and the perineum. The patients who received low anterior resection achieved better disease-free survival but were more prone to late radiation bowel morbidities than those who received abdominoperineal resection. Postperative Pelvic radiation therapy Proved to be effective in locoregional disease control but did not prevent the appearance of distant metastasis, which was of major concern in advanced stages. Patterns of treatment failure, and factros relating to radiation morbidity are discussed, and therapeutic options for better results are proposed.

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