• 대한골관절종양학회지
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• 제9권1호
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• pp.124-129
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• 2003

목적: 슬관절부에 발생한 제 3 기 거대세포종에 대해 수술적 치료 후 임상적, 방사선학적 결과를 알아보고자 후향적 분석을 시행하였다. 대상 및 방법: 1991년 3월부터 2000년 2월까지 슬관절부에 발생한 제 3기의 거대세포종으로 수술적 치료를 받은 21명의 환자를 대상으로 하였으며 추시기간은 최단 1년 최장 9년으로 평균 5.7년이었다. 수술방법으로11명에서 병소내 소파술 및 액화 질소 냉동 요법 후 시멘트 충진술을 시행하였고, 7명에서 병소내 소파술 시행 후 냉동 요법 없이 시멘트 충진술 또는 자가골 이식술을 시행하였다. 관절면의 파괴가 심했던 3명에서는 광범위 절제술 후 재건술을 시행하였다. 결과: 첫 수술 후 기능적 평가는 우수 및 양호가 13례, 보통이 4례, 실패가 4례였다. 국소 재발이나 감염으로 인해 실패로 판정되어 재수술을 시행한 4례에서 최종 추시시 기능적 결과는 우수 3례, 보통이 1례로, 전체적으로는 우수 및 양호가 16례, 보통이 5례였다. 소파술, 냉동요법 및 시멘트 충진술을 시행한 11명의 환자 중에는 1명(9.1%)에서 재발하였으며, 1명(9.1%)에서 슬관절의 퇴행성 변화를 보였으며, 냉동요법 없이 소파술 및 시멘트 충진술 또는 골이식을 받은 환자 7명중 2명(28.6%)에서 재발하였고, 1명에서(14.5%) 슬관절의 퇴행성 변화를 보였다. 결론: 철저한 소파술 및 냉동 보조요법은 슬관절부의 제 3기 거대 세포종 치료에 있어 유용한 방법이며, 광범위 절제술 및 재건술은 병변이 거대하고 관절면이 상당히 파괴되었거나, 수술 후 국소 재발로 인해 골파괴 및 관절 침범이 심한 경우에 시행하는 것이 바람직 할 것으로 사료된다.

• 대한골관절종양학회지
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• 제4권1호
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• pp.37-43
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• 1998

Between 1992 and 1996, 5 patients with the giant-cell tumor of the spine were treated. Four were female and one was male. The mean age was 34 years old, and the mean follow-up time was 36 months. The locations of the lesions were the cervical spine in 1, the thoracic spine in 3, and the lumbar spine in 1. Pain was the predominant presenting symptom in all cases and four had a neurological deficit. A combined anterior and posterior surgical approach wds as performed in all cases, which were also treated with AIF(anterior interbody fusion) and anterior and/or posterior instrumentation. Adjuvant radiation therapy was performed in 1 case of cervical spine. At the final follow-up, the pain and neurologic symptoms were improved. Radiologic examination showed no evidence of local recurrence and no failure of instrumentation of the spine.

• Imaging Science in Dentistry
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• 제51권2호
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• pp.149-154
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• 2021

Purpose: This study aimed to investigate the computed tomography and magnetic resonance imaging features of giant cell tumors in the temporomandibular joint region to facilitate accurate diagnoses. Materials and Methods: From October 2007 to June 2020, 6 patients (2 men and 4 women) at Yonsei University Dental Hospital had histopathologically proven giant cell tumors in the temporomandibular joint. Their computed tomography and magnetic resonance imaging findings were reviewed retrospectively, and the cases were classified into 3 types based on the tumor center and growth pattern observed on the radiologic findings. Results: The age of the 6 patients ranged from 25 to 53 years. Trismus was found in 5 of the 6 cases. One case recurred. The mean size of the tumors, defined based on their greatest diameter, was 32 mm (range, 15-41 mm). The characteristic features of all cases were a heterogeneously-enhancing tumorous mass with a lobulated margin on computed tomographic images and internal multiplicity of signal intensity on T2-weighted magnetic resonance images. According to the site of origin, 3 tumors were bone-centered, 2 were soft tissue-centered, and 1 was peri-articular. Conclusion: Computed tomography and magnetic resonance imaging yielded a tripartite classification of giant cell tumors of the temporomandibular joint according to their location on imaging. This study could help clinicians in the differential diagnosis of giant cell tumors and assist in proper treatment planning for tumorous diseases of the temporomandibular joint.

• Investigative Magnetic Resonance Imaging
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• 제20권4호
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• pp.264-268
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• 2016

Benign fibrous histiocytoma (BFH) is a rare benign primary skeletal tumor that occurs commonly in the long bones, spine and pelvis. BFH constitutes a diagnostic challenge because it shares clinical background, radiological characteristics, and histological features with other fibrous lesions such as non-ossifying fibroma, giant cell tumor. We present a case of BFH with cystic change that occurred in the distal femur. We did not identify any case of BFH with cystic change involving the majority of the lesion that occurred in the metaepiphysis of the long bone.

• Journal of Yeungnam Medical Science
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• 제20권2호
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• pp.117-128
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• 2003

Thallium-201 scintigraphy is used to discriminate the malignant bone tumor from the benign by qualitatively and quantitatively, and to predict the response of preoperative chemotherapy in osteosarcoma, by comparing the changes of thallium uptake ratio after chemotherapy to the tumor necrosis ratio. Thallium-201 scintigraphy scan should be done prior to surgical biopsy. PICKER Prism 2000 gamma camera with high resolution parallel hole collimator is usually used for scanning. The patient is injected with 2-3mCi of Tl-201 and the early phase is checked in 30 minutes and delayed phase in 3 hours. The scan images are visually evaluated by a blinded nuclear medicine physician. We could evaluate true positive, true negative, false positive and false negative by the comparison of results with those of biopsy, and calculate positive and negative predictive value(%), sensitivity(%), specificity(%) and diagnostic accuracy(%). For the quantitative analysis of thallium uptake, we drew the region of interest on the tumor side and contralateral normal side as mirror image, and calculated the uptake ratio with dividing the amount of gamma count in tumor side by normal side. We could calculate the percent changes of thallium uptake ratio in early and delayed phase, and compare them to the ratio of tumor necrosis. Thallium-201 scintigraphy proved as useful imaging study to discriminate malignant bone tumor from benign, but had exception in giant cell tumor and low grade malignant bone tumors. We can use T1-201 scan to differentiate the benign from the malignant tumor, and to evaluate the response of preoperative chemotherapy or radiotherapy, and to determine the residual tumor or local recurrence. For the better result, we need to have a more detail information about false positive cases and a more objective and quantitative reading technique.

• 대한골관절종양학회지
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• 제6권1호
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• pp.47-51
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• 2000

수부에 발생하는 연골점액양 섬유종은 매우 드문 양성 종양의 하나이다. 방사선학적으로, 병리학적으로, 수부에 발생하는 다른 양성 종양, 즉 내연골증, 연골아세포증, 거대세포수복성 육아종, 연골육종과 감별하여야 한다. 저자는 59세 여자 환자와 19세 남자 환자에서 수지에 발생한 연골점액양 섬유종을 경험하여 이에 보고하며, 특히 비특이적인 임상적 발현과 특징적인 방사선학적, 병리학적 소견을 기술하였다.

• 대한골관절종양학회지
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• 제10권2호
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• pp.71-78
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• 2004

목적: 최근 체험한 59례의 거대 세포종 중 골 소파술 및 시멘트 충전술을 시행한 37례의 재발의 특성과 이를 예방할 수 있는 방법에 대해 알아 보고자 한다. 대상 및 방법: 1995년 1월부터 2000년 3월까지 본원 정형외과에 입원하여 진단적 생검 또는 수술적 치료에 의하여 병리학적으로 거대 세포종으로 확진되고, 그 치료로 골 소파술과 Burring 후 시멘트 충전술을 시행했던 3 7례의 재발의 위치, 특성, 시기에 관하여 분석하였다. 결과: 총 37례 환자 중 일차 치료(Curettage & Cementation) 후 13례에서 재발하여 35%의 재발율을 보였다. 일차 치료 후 재발까지의 기간은 평균 16 개월로 분석되었으며, 최단 5개월에서 최장 3년 7개월이었다. 2례를 제외하고는 모두 2년 내에 재발하였다. 재발 부위는 수술적 접근 후 창(Window)을 만든 부위의 인접한 피질골에서 대부분 관찰되었으며(11례), 2례는 수술적 접근을 한 골 시멘트의 심부(골수강측)에 발생하였다. 골 소파 술 후의 시멘트 충전술은 즉각적 안정성과 빠른 재활, 재발의 조기 발견의 유용성이 있다. 또한 이론적으로 주변의 남아있는 종양세포를 사멸시킬 수 있는 장점을 가지고 있다. 수술을 시행한 실제 임상 례에서 재발의 부위가 수술시 충분한 소파가 안된 부위(Window를 작게 내어 불충분한 소파가 된 부위, 주위 해부학적 구조상 건, 인대의 기시부나 종지부로 소파가 안된 부위)에서 대부분(85%)이 재발하였다. 결론: 거대 세포종의 치료에 있어서 골 소파술과 Burring 후 시멘트 충전술이 많이 사용되고 있다. 또한 소파술 후 보조적인 치료로서 페놀, $H_2O_2$를 이용한 화학적 소작, 냉동요법, 무수 알코올 등이 소개 되었지만, 아직 그 효과가 입증된 것이 없다. 많은 경우 주위의 인대나 건의 기시부나 종지부 또는 다른 해부학적 구조로 불충분한 창(Window)으로 인해, 수술적 접근을 한 부위의 골 소파술 및 Burring 이 불완전하게 되는 경향이 발생할 수 있다. 본 연구에서 재발의 부위는 대부분(85%)에서 불충분한 개창술이 된 부위에서 발생하였다. 즉, 중요한 해부학적 구조가 있더라도 충분한 개창술과 광범위한 소파와 Burring이 재발을 방지하는 가장 중요한 요소가 되리라 사료된다. 본 연구에서 거대세포종의 재발은 대부분 2년 이내에 발생하였다. 특히 이 기간에는 철저한 추적검사를 통하여 재발에 유의해야 한다.

• Parasites, Hosts and Diseases
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• 제60권6호
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• pp.413-417
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• 2022

We retrospectively evaluated the clinical and imaging features of 6 patients with bone hydatid disease confirmed by surgery and pathological examination. Among the 6 patients, 2 were infected with Echinococcosis granulosus metacestode and 4 were infected with E. multilocularis metacestode. The 2 cases with cystic echinococcosis were diagnosed by computed tomographic (CT) examination, and other 4 cases were diagnosed by magnetic resonance (MR) imaging. On the initial evaluation, 1 case each was misdiagnosed as a giant cell tumor or neurogenic tumor, and 2 were misdiagnosed as tuberculosis. The imaging manifestations of bone hydatid disease are complex, but most common findings include expansive osteolytic bone destruction, which may be associated with sclerosing edges or dead bone formation, localized soft tissue masses, and vertebral lesions with wedge-shaped changes and spinal stenosis. Combining imaging findings with the patient's epidemiological history and immunological examinations is of great help in improving the diagnosis and differential diagnosis of bone hydatid disease.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제50권1호
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• pp.49-55
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• 2024

Neurofibromatosis type 1 (NF1) is an autosomally dominant tumor suppressor syndrome and multisystem disease. Central giant-cell granulomas (CGCGs) can be seen in patients with NF1. A 21-year-old female was diagnosed with two CGCGs, one in the mandible and then one in the maxilla, in a 7-year period. Increased incidence of CGCGs in NF1 patients was thought to be caused by an underlying susceptibility to developing CGCG-like lesions in qualitatively abnormal bone, such as fibrous dysplasia. However, germline and somatic truncating second-hit mutations in the NF1 gene have been detected in NF1 patients with CGCGs, validating that they are NF1-associated lesions. Oral manifestations in patients with NF1 are very common. Knowledge of these manifestations and the genetic link between NF1 and CGCGs will enhance early detection and enable optimal patient care.

• Archives of Reconstructive Microsurgery
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• 제16권2호
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• pp.125-132
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• 2007

Introduction: Ulna is nearly equal to radius in function and bony architecture and strength in forearm. But in lower extremity, fibula is 1/5 of tibia in anatomic and functional point so we can find fibula transposition is commonly used in defect of tibia. We cannot find other article about segmental forearm bone transposition in man. The purpose of this study was to report our clinical and functional result of undergoing segmented transposition of ipsilateral ulna with its own vascular supply in defect of radius in 6 cases. Material and method: From June 1994 to October 2007, 7 segmented bone transpositional grafts in forearm were performed in Kyung Hee Medical Center. The distribution of age was from 20 years old to 73 years old. There was male in 6 cases and female in 1 case. The causes of operation were giant cell tumor in 1 case and traumatic origin in 6 cases; it was nonunion in 2 cases and fracture with severe comminution in 4 cases. Ipsilaterally segmented ulna keeping its own vascular supply was transported to defect of radius in severe traumatic patients and one patient whose tumor in radius had been excised. Transported ulna was fixed to proximal and distal radius remnants by plate and screw. In one case with giant cell tumor, transported ulna was connected to radius across wrist joint as wrist joint fusion. Joint preserving procedures were performed in 6 cases with crushing injury of radius. Results: We could obtain solid bony union in all cases and good functional results. The disadvantage was relative shortening of forearm, but we could overcome this problem. Conclusion: We think that ipsilateral segmented ulna transposition keeping its own vascular supply to radius can be perfomed with one of procedures in cases with wide defect in radius.