• Journal of Korean Neurosurgical Society
• /
• v.30 no.3
• /
• pp.376-380
• /
• 2001

A 54-year-old woman presented with an exophthalmos and a mass on her right eye, which proved to be recurred adenoid cystic carcinoma of the lacrimal gland. Orbital CT and MRI showed that tumor was located in the right orbit, but skin over right eye brow was also involved. There was no visualization of tumor extension into the intracranial compartment. The authors have performed an en bloc orbitectomy. Although en bloc orbitectomy is known to be useful in reducing recurrence, this case showed the tumor recurrence and even distant metastasis that occurred after total tumor removal via en bloc orbitectomy. As adenoid cystic carcinoma of lacrimal gland is known to have high rate of recurrence and metastasis, en bloc orbitectomy should be performed to reduce local advancement and distant metastasis. In case of distant metastasis, radiotherapy could be useful strategy in selected case.

• Archives of Plastic Surgery
• /
• v.33 no.3
• /
• pp.367-370
• /
• 2006

Surgical curettage or en bloc excision are the usual choice of treatment for osteoma. Local recurrence of osteoma after surgical treatment is not very common. We report a case of osteoma recurred at the grafted bone. A $5{\times}8cm$ sized osteoma of frontal bone was excised and then the defect was covered with calvarian bone and rib bone. Six years after reconstruction, recurrence from grafted area was noted. We completely removed the osteoma with enough normal tissue around it, after checking that the grafted bone has changed into an osteoma through a bicoronal incision. Then we covered the defect with a rib bone. The tissue was confirmed histologically as an osteoma. The recurrence of the tumor at the bone grafted site after osteoma excision is probably due to the fact that we covered grafted bone with periosteum left over osteoma. Therefore, we can learn that when we excise osteoma, galea should be carefully separated from the periphery of the tumor and that the periosteum should be completely removed, to prevent the osteoma from recurrence.

• Korean Journal of Head & Neck Oncology
• /
• v.29 no.2
• /
• pp.58-61
• /
• 2013

Early glottic cancer can be effectively treated with surgery or radiotherapy showing the comparable treatment results. Since radiation therapy may be better in terms of voice preservation, it tends to be preferred in early glottic cancer. Most common recurrence site is glottis after radiation therapy and complete remission of glottic primary site followed by local recurrence limited to neck is very rare. The authors are reporting a patient with regional recurrence of central neck lymph nodes after radiation therapy for T1a glottic cancer.

• Radiation Oncology Journal
• /
• v.30 no.2
• /
• pp.62-69
• /
• 2012

Purpose: To evaluate the treatment outcome and prognostic factor of postoperative radiotherapy for extremity soft tissue sarcoma (STS). Materials and Methods: Forty three patients with extremity STS were treated with conservative surgery and postoperative radiotherapy from January 1981 to December 2010 at Korea University Medical Center. Median total 60 Gy (range, 50 to 74.4 Gy) of radiation was delivered and 7 patients were treated with chemotherapy. Results: The median follow-up period was 70 months (range, 5 to 302 months). Twelve patients (27.9%) sustained relapse of their disease. Local recurrence occurred in 3 patients (7.0%) and distant metastases developed in 10 patients (23.3%). The 5-year overall survival (OS) was 69.2% and disease free survival was 67.9%. The 5-year local relapse-free survival was 90.7% and distant relapse-free survival was 73.3%. On univariate analysis, no significant prognostic factors were associated with development of local recurrence. Histologic grade (p = 0.005) and stage (p = 0.02) influenced the development of distant metastases. Histologic grade was unique significant prognostic factor for the OS on univariate and multivariate analysis. Severe acute treatment-related complications, Common Terminology Criteria for Adverse Events (CTCAE) grade 3 or 4, developed in 6 patients (14.0%) and severe late complications in 2 patients (4.7%). Conclusion: Conservative surgery with postoperative radiotherapy achieved a satisfactory rate of local control with acceptable complication rate in extremity STS. Most failures were distant metastases that correlate with tumor grade and stage. The majority of local recurrences developed within the field. Selective dose escalation of radiotherapy or development of effective systemic treatment might be considered.

• Korean Journal of Head & Neck Oncology
• /
• v.12 no.1
• /
• pp.26-31
• /
• 1996

Radiation therapy in T1 glottic cancer offers an excellent cure rate with preservation of voice. From 1983 to 1992 eighty nine patients with TNM staged T1N0M0 invasive squamous cell carcinoma of the glottis were treated at the Dept. of Radiation Oncology, Yonsei Cancer Center, Yonsei University. There were 84 men and 5 women with median age of 59 years. All patients were treated either with Co-60 teletherapy unit or 4MV linear accelerator with an median dose of 6400 cGy(6000-7000 cGy), 200 cGy per day, 5 days in a week. Fourteen local failures have been observed and the median time to local recurrence was 17 months. There were no nodal failure without local recurrence or distant metastases. The 5 year local control rate was 84.3%. The 5 year actuarial surivival rate and the 5 year disease free survival rate were 89.2%, 87.5%, respectively. The 5 year actuarial survival rate and the 5 year disease free survival rate of the nineteen patients with anterior commissure involvement were 77.8% and 74.5% which were lower than those of seventy patients without anterior commissure involvement(91.6%, 90.6%)(p < 0.05). Among the several influencing factors, anterior commissure involvement was the significant prognostic foctor. Final local control rate, taking into account the salvage surgery, was 89.9% at 5 years.

• Archives of Plastic Surgery
• /
• v.38 no.6
• /
• pp.798-802
• /
• 2011

Purpose: A wart is caused by epidermal infection with the human papilloma virus. Although wart naturally disappears in some cases, it require treatment because of pain, aesthetic problem, and the possibility of malignant change. Conventional non-surgical treatment cannot be a fundamental solution for the pain and has such disadvantages as frequent recurrence and difficulties in achieving a satisfactory outcome. A surgical procedure was performed on patients with wart and the procedure had a good outcome. Methods: We investigated the gender, age, lesion site, mean treatment duration, and presence or absence of recurrence in 21 patients with a wart within the period of January 2007 to July 2011. For local lesions, primary closure, including subcuticular suture after the excision, was performed. If the defect size was too big to do primary closure, we performed rotation flap. For wide multiple lesions, a split thickness skin graft was performed. Results: Among the 21 patients, 12 patients were male and 9 patients were female, and their mean age was 42 years (SD=17.38, range: 11~75 years). The lesion site was the foot in 10 patients, the hand in 8 patients, the face in 2 patients, and the scalp in 1 patient. The mean treatment duration was 13.5 days (SD=4.36, range: 6~15 days) for the primary closure or rotation flap, and 18.5 days (SD=2.12, range: 17~20 days) for the skin graft. 20 patients were cured without recurrence. No recurrence was observed in the patients who underwent primary closure or rotation flap. One of the two patients who underwent a skin graft of their wart that had covered their entire palm had local recurrence in part of her finger tips. Conclusion: We performed surgical procedure on recalcitrant wart. As a results, we can treat it with short treatment duration, low recurrence rate and less scarring and get high patient satisfaction.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.20 no.2
• /
• pp.136-140
• /
• 2009

Background and Objectives: Recurrent respiratory papillomatosis (RRP) is difficult to treat because of its tendency to recur and spread throughout the aerodigestive tract. We aimed to estimate the effect of intralesional injections of cidofovir in patients with RRP. Materials and Method: Within the period from January 2003 to July 2007, 13 patients aged 2 to 61 years were treated with intralesional injections of cidofovir combined with surgical excision of RRP. Cidofovir was injected intralesionaly at a concentration of 5 mg/cc after complete removal of the papilloma with $CO_2$ laser or microdebrider. We evaluated the effect of intralesional cidofovir therapy by comparing pre-treatment mean interval of recurrence with post-treatment interval of recurrence. Results: Of 13 patients, two patients showed complete response during follow up period and four patients showed partial response. Seven patients did not respond to cidofovir at all. Mean pre-treatment mean interval of recurrence was 9 months and mean post-treatment interval of recurrence was 13.1 months (p=0.039). There was a statistical significance between the injected dose of cidofovir and post-treatment interval of recurrence (p=0.009). There were no local or systemic side effects caused by cidofovir. Conculsion : Intralesional injection of cidofovir seems to have a potential of a safe and effective adjuvant therapy of RRP. There was a positive correlation between the injected dose of cidofovir and patient clinical outcomes so that administration of higher doses and more frequency of injections should be needed to reduce recurrence. Further study regarding injection therapy regimen for RRP is required.

• Journal of Korean Neurosurgical Society
• /
• v.58 no.3
• /
• pp.248-253
• /
• 2015

Objective : The treatment of giant cell tumor (GCT) is mainly performed surgically. However, GCT in spine seems difficult to treat because of the limited surgical accessibility and proximity. In this report, we analyzed the outcome of GCT treatment in spine. Methods : Between 2000 and 2012, 19 patients received treatment for GCT in spine. Median age at their first diagnosis was 31 years, 10 patients were male, and 9 female. Fourteen tumors were located in the sacrum, 1 in cervical, 1 in thoracic and 3 in lumbar spine. As primary treatment, gross total removal (GTR) was done in 6 patients, and subtotal removal (STR) in 13 patients. Radiation therapy (RT) as an adjuvant therapy was performed in 2 cases in GTR group and 10 cases in STR group. Results : During the follow-up, 7 patients had local recurrence (36.8%). The average period until recurrence after primary treatment was 14 months. No recurrence was detected in GTR group. Recurrence was noted in 7 out of 13 patients who underwent STR. These differences were statistically significant (p=0.024). A median of recurrence free period (RFP) was 84 months. Also average RFP of the RT group was 112 months, and non-RT group was 65 months. These differences were statistically significant (p=0.041). Conclusion : Treatment of choice for GCT in spine is a complete removal of tumor without neurological deficits. In case of incomplete removal, radiation therapy may be a useful adjuvant treatment modality.

• Asian Pacific Journal of Cancer Prevention
• /
• v.14 no.8
• /
• pp.4717-4721
• /
• 2013

Complete surgical resection of the primary tumour is a crucial predictive step for head and neck squamous cell carcinoma (HNSCC), because incomplete resection may lead to increase in the recurrence rate. Molecular cancer markers have been investigated as potential predictors of prognosis marker, to identify patients who are at high risk of local recurrence. This retrospective study aimed to determine the prognostic correlation between p53 and eIF4E expression and clinical characteristics, recurrence and overall survival. Forty eight HNSCC patients were selected between 2006 and 2009 diagnosed at the Royal Darwin Hospital, Darwin, Northern Territory, Australia. Out of 48, only those 24 with negative surgical margins with hematoxylin and eosin (HandE) were chosedn for further analysis. A total of 77 surgical margins were obtained and subsequently analysed by immunohistochemical (IHC) staining with monoclonal p53 and polyclonal eIF4E antibodies. Contingency table and ${\chi}^2$-test were used to investigate the correlation between p53 and eIF4E expression and clinical characteristics, recurrence and overall survival of the HNSCC patients. The follow up period was 74 months (range 1-74 months). The Kaplan-Meier method was used to generate recurrence and survival curves. This is a first retrospective study of Northern Territory patients, including Indigenous and non-Indigenous Australians. Molecular study of surgical margins could help to identify patients with and without clear margins after surgery and help in choice of the most appropriate adjuvant treatment for HNSCC patients.

• Journal of Chest Surgery
• /
• v.52 no.3
• /
• pp.148-154
• /
• 2019

Background: This study investigated the clinical outcomes of surgical treatment of primary chest wall soft tissue sarcoma (CW-STS). Methods: Thirty-one patients who underwent surgery for CW-STS between 2000 and 2015 were retrospectively reviewed. The disease-free and overall survival rates were estimated using the Kaplan-Meier method, and prognostic factors were analyzed using a Cox proportional hazards model. Results: The median follow-up duration was 65.6 months. The most common histologic type of tumor was malignant fibrous histiocytoma (29%). The resection extended to the soft tissue in 14 patients, while it reached full thickness in 17 patients. Complete resection was achieved in 27 patients (87.1%). There were 5 cases of local recurrence, 3 cases of distant metastasis, and 5 cases of combined recurrence. The 5-year disease-free rate was 49%. Univariate analysis indicated that incomplete resection (p<0.001) and stage (p=0.062) were possible risk factors for recurrence. Multivariate analysis determined that incomplete resection (p=0.013) and stage (p=0.05) were significantly associated with recurrence. The overall 5- and 10-year survival rates were 86.8% and 64.3%, respectively. No prognostic factor for survival was identified. Conclusion: Long-term primary CW-STS surgery outcomes were found to be favorable. Incomplete microscopic resection and stage were risk factors for recurrence.