• 대한족부족관절학회지
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• 제11권1호
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• pp.1-7
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• 2007

Purpose: Tumors arising in the foot and ankle are uncommon and the malignant tumors are known to be rare compared with those of the other sites. We analyzed the clinical data of patients who have been diagnosed as having a tumor of the foot and ankle. Materials and Methods: From 1989 to 2006, we analyzed 185 patients who have been treated surgically and were pathologically confirmed of having tumors of the foot and ankle. Their clinical characteristics were reviewed retrospectively. Results: One hundred and fifty-seven cases were benign (84.9%) and 28 cases (15.1%) were malignant. 108 cases (58.4%) were benign soft tissue tumors and 49 cases (26.5%) were benign bone tumors. Malignant tumors included 17 cases (9.2%) of soft tissue tumors, 8 cases (4.3%) of primary bone tumors and 3 cases (1.6%) of metastatic bone tumors. The most common benign soft tissue tumor was ganglion (23 cases). Enchondroma (9 cases) was the most common among the benign bone tumors. Malignant peripheral nerve sheath tumor was the most common malignant tumor (4 cases). The predilection site for benign tumors was at the forefoot around toes while for the malignant tumor was around the ankle. 4.6% of benign soft tissue tumors and 8.2% of benign bone tumors had locally recurred and 14 cases (50%) of malignant tumor were confirmed as having distant metastasis. Conclusion: The ratio of malignant tumor and its metastasis rate was high. Therefore, the histopathologic confirmation is essential when treating tumors of the foot and ankle.

• 대한골관절종양학회지
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• 제1권2호
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• pp.181-188
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• 1995

Malignant tumor of the pelvic bone has nonspecific symptom and it is not easily detected by physical examination or by radiologic study in early stage, because of its anatomical characteristics. Associated with their variety of disease entity, the treatment of malignant pelvic bone tumor is a problematic point. We have analysed 36 cases of malignant pelvic bone tumors diagnosed at the Severance hospital from 1968 to 1993 to provide a reference for diagnosis and treatment of the malignant pelvic bone tumors. We found that the chondrosarcoma(27.8%) and the osteogenic sarcoma(27.8%) were the most common type of pelvic bone malignancy, and then, in the order of incidence, there were Ewing's sarcoma(16.7%), malignant fibrous histiocytoma(11.1%). There were differences of the age distribution among each diseases and the average age was Ewing's sarcoma 20.5, osteogenic sarcoma 27.2, chondrosarcoma 40.0, malignant fibrous histiocytoma 64.8, respectively. Three of the 5 patients with low grade tumors survived(60%), whereas 3 of the 17 patients with high grade tumors survived(18%). The survival rate of the low grade malignant group was 60%, the high grade was 18%.

• 대한골관절종양학회지
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• 제9권1호
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• pp.69-76
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• 2003

목적: 족부에 발생하는 종양의 임상적 특성과 병리학적 특성 및 분포 등을 조사하여, 족부 종양을 진단하고 치료하는데 기초 자료를 제공하고자 한다. 대상 및 방법: 족부 종양 환자 141명의 142 종양을 대상으로 하였다. 대상환자들은 모두 조직검사를 통하여 진단이 된 환자들이었다. 대상이 되었던 환자들의 의무기록과 영상 검사들을 후향적으로 검토하여 종양의 역학적 조사와, 임상적 특성과 수술의 방법을 확인하였고, 병리학적 특성을 조사하였다. 종양이 발생 위치는 Kirby 등이 제안한 구역(zone)에 따라 분류하였다. 결과: 여자는 75명이었고 남자는 66명으로 여자가 조금 많았다. 전체 환자들의 평균 나이는 33.2세였다. 양성 연부조직 종양이 68예로 가장 많았고, 양성 골종양이 57예, 악성 연부조직 종양이 12예, 악성 골종양이 5예의 순이었다. 양성 연부조직 종양 중에는 결절종이 36예로 가장 많았고, 양성 골종양 중에서는 조갑하 외골종이 18예, 악성 연부조직 종양 중에서는 편평 상피 세포암이 7예, 악성 골종양으로는 폐암의 전이 병소가 2예였다. 환자들의 임상 증상으로 통증은 악성 골종양 환자들이 가장 높은 비율로 호소하였고, 증상 발현 기간은 양성 연부조직 종양이 가장 길었고, 신경학적 증상은 양성 연부조직 종양에서만 3예가 있었다. 종양의 평균 크기는 악성 골종양이 가장 크고, 양성 골종양이 가장 작았다. 구역별 분포는 전체적으로 5 구역에 59예로 가장 많았고, 4 구역에 10예로 가장 적었으며, 양성 골종양에서는 5 구역, 양성 연부조직 종양에서는 1 구역, 악성 골종양에서는 1, 2 구역, 악성 연부조직 종양에서는 5 구역에서 가장 많았다. 수술 방법으로 병소내 혹은 변연부 절제술, 소파술 혹은 소파술 및 골이식 수술, 족지 절단수술, 슬관절 하 절단술과 사지구제술 등이 있었다. 결론: 족부에 발생하는 종양은 드물고 종류가 다양하면서 대부분(88%) 양성 종양이었으나, 진단 과정에서 환자의 나이, 통증 유무, 증상 발현 기간, 종양의 크기 및 발생 구역 등을 고려하여 악성 종양의 가능성을 배제하지 않음으로써 올바른 치료를 할 수 있을 것으로 사료된다.

• 치과방사선
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• 제19권1호
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• pp.137-147
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• 1989

CT findings of proven 25 malignant tumors of the maxillary sinus were retrospectively analyzed to be of help in the diagnosis and treatment. The results were follows: 1. Average age was 54 years old, and eighteen were males and seven were females with a ratio of 2.6:1 2. The most common histopathologic feature was squamous cell carcinoma (19 cases) and others were two cases of adenoid cystic carcinoma, one case of malignant fibrous histiocytoma, mucoepidermoid tumor, histiocytic lymphoma, unidentified malignant tumor. 3. CT findings were sinus opacificaqtion (4%), soft tissue mass (92%), low densities within soft tissue mass (44.%), air densities within soft tissue mass (24%), osteosclerosis (4%), bone destruction (92%), bone displacement (32%), fat plane obliteration (76%). 4. CT in the malignant maxillary sinus tumors approved the value in evaluation of tumor extension to nasal cavity, ethmoid sinus, orbit, infratemporal fossa, pterygopalatine fossa, pterygoid fossa, pterygoid muscle, cheek skin and intracranial cavity. 5. Twenty four cases (96%) were stage Ⅲ, stage Ⅳ according to AJCC TNM classification. 6. Bone findings were destruction, displacement, sclerosis and most frequent site of bone destruction was the medial wall of the antrum(92%). 7. Tumor growth pattern showed destructive pattern in 18 cases(72%), and squamous cell carcinoma showed destructive pattern. (P<0.05)

• Journal of Chest Surgery
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• 제20권4호
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• pp.723-729
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• 1987

A retrospective study of 21 cases of chest wall tumors, 12 benign and 9 malignant, was carried out to review their clinical radiological and pathological features. On age distribution, most cases [80.9%] were found in 4th to 6th decades. The sex ration [M:F] was represented as 2.5:1. Of the 21 lesions, there were 8 cases of soft tissue tumors, 4 cases of bone and cartilage origined tumors and 9 malignant tumors which included 3 metastatic tumors. The overall mortality was 22.2% and all of the deaths were found in the malignant tumors. All of the patients with benign tumors were treated by excision without recurrence. Distinction between benign and malignant chest wall tumors was not possible using radiographic criteria unless cortical destruction and involvement of soft tissue were visualized. On the basis of our analysis, we believe that all tumors of chest wall should be considered malignant until proven otherwise and that wide excision should be carried out. This is necessary not only to obtain as adequate diagnosis but also to provide the best chance for cure in both benign and malignant lesions.

• 대한족부족관절학회지
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• 제5권1호
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• pp.74-81
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• 2001

Purpose: We analyzed 35 patients of malignant tumors of the foot and ankle to evaluate clinical manifestation. result of treatment and prognosis. Materials and Methods: Thirty five patients who were histologically confirmed for malignant tumors of the foot and ankle from September 1984 to May 1999 were investigated. Results: There were 16 males and 19 females. with an average age 38.3 years. Ten tumors were originated from bone and 25 from soft tissue; osteosarcoma (8) was the most common bone tumor and synovial sarcoma (8) and malignant melanoma (6) were common in soft tissue tumors. Surgical procedures included; marginal resection (2), limb salvage procedure after wide resection (5) for bone tumors, and amputation (12), wide resection (4), marginal resection (5) for soft tissue tumors. In some cases, perioperative chemotherapy and radiotherapy were given. There were 2 local recurrences and 11 metastases; 5 metastases were found at the time of initial diagnosis. Average follow-up was 3.5 years. Conclusion: We conclude that suspicion and early diagnosis are important in malignant tumors of the foot and ankle, and the resection margin must be obtained more thoroughly during surgery with perioperative adjuvant therapy, if necessary.

• Imaging Science in Dentistry
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• 제32권2호
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• pp.81-87
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• 2002

Purpose : To investigate the diagnostic significance of cortical changes in the bone of diseased jaws utilizing computed tomography (CT). Materials and Methods: Computed tomographic images of 91 patients, consisting of 7 osteomyelitis, 46 cysts, 18 benign tumors, and 20 malignant tumors, were analyzed. The pattern of cortical expansion was classified into three types: no expansion (N), buccal or lingual expansion (B/L), and buccolingual expansion (B & L). The pattern of cortical destruction was classified into four types: no destruction (N), point destruction (PO), gross destruction (GR), and permeative destruction (PE). The pattern of periosteal reaction was classified into four types: parallel, irregular, spicule, and Codmans triangle. The relationship between the pattern of cortical bone changes and diseases of the jaws was assessed. Results: When the pattern of cortical expansion was compared to diseases of the jaw, N-type was most prevalent in cases of osteomyelitis and malignant tumors, B/L-type with cysts, and B&L-types with benign tumors. Comparison between the pattern of cortical bone destruction with diseases of the jaw showed strong correlations between PO and PE-types to osteomyelitis, N-type with cysts, N and GR-types with benign tumors, and GR-type with malignant tumors. Finally, the relationship between the pattern of periosteal reaction to diseases of the jaw showed a strong correlation between parallel-type to osteomyelitis and spicule-type to malignant tumors. Conclusion : The pattern of cortical expansion and cortical destruction is useful in differentiating diseases of the jaws.

• 대한골관절종양학회지
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• 제5권4호
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• pp.201-207
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• 1999

Malignant tumors of the hand are very rare. Between 1989 and 1998, 17 patients with malignant tumors of the hand were evaluated for clinical features, prevalence, treatment and results. The mean age was 45 years and median duration of follow-up was 38 months. A painless mass was the most common symptom and the most common lesion was the digit. Fifteen cases of soft tissue and 2 cases of bone tumor were diagnosed. On pathology, soft tissue tumors were comprised of 8 cases of malignant melanoma, 2 cases of angiosarcoma and 1 case each of malignant fibrous histiocytoma, malignant peripheral nerve sheath tumor, extraskeletal chondrosarcoma, and squamous cell carcinoma. Bone tumors were metastatic tumors and each originated from the rectal cancer or lung cancer. Lymph node involvements were noted in 4 cases of malignant melanoma and 1 case of squamous cell carcinoma. Six cases of metacarpo-phalangeal joint disarticulation and 4 cases of phalanx amputation were performed. Wide excision, ray amputation and below-elbow amputation were also performed. Three cases expired due to metastasis and progression of the original lesion. Among the surviving 14 cases, a malignant melanoma had metastasis on the axillary lymph node and 13 cases showed no local recurrence or metastasis during the follow-up.

• 대한골관절종양학회지
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• 제14권2호
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• pp.86-94
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• 2008

$^{18}F$-FDG PET/CT는 해부학적 영상과 함께 생리적인 변화를 보여주는 영상을 동시에 제공함으로써 진단적 영상검사에 많은 발전을 가져왔고, 근골격계 종양을 평가하는데 새롭고 독창적인 방법으로 등장 하였다. 최근 PET/CT는 골 전이를 찾는데, 골 연부조직 종양의 시기 결정 및 재시기 결정에 많이 사용되고 있다. 또한 악성 근골격계 종양의 치료에 대한 평가와 치료 후 추시에서 국소 재발이나 원격 전이를 찾아내는 데 유용하게 사용되고 있다. 향후 근골격계 종양에 대한 PET/CT의 연구 자료가 축적되고, 발전된다면 초기 진단에도 유용하게 쓰일 수 있을 것으로 사료된다. 이 논문은 근골격계 종양의 평가를 위한 $^{18}F$-FDG PET/CT의 효율적인 적용에 대하여 문헌 고찰과 함께 살펴보고자 한다.

• 대한골관절종양학회지
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• 제14권1호
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• pp.10-16
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• 2008

효과적인 항암 약물요법의 발달과 사지의 절단술에 따르는 기능적인 경제적인 비효율성은 뼈의 원발성 암 환자에서 사지 구제술의 발달을 가져 왔다. 소아에서의 사지 구제술은 종양의 광범위 절제 시 성장판이 같이 절제되어 건측과의 사지 길이 차이가 발생하게 될 수 있고 소아 환자들의 왕성한 활동성 때문에 견고하고 내구성 있는 재건술이 필요하다. 소아 환자에서 악성 골종양의 절제 후 성장한 만큼 대치물의 길이도 같이 늘일 수 있는 확장형 종양 대치물(expandable tumor prosthesis)을 이용한 재건술이 시행되어 왔으나 모든 환자에서 만족스러운 결과를 가져오진 못하였다. 최근 들어 확장형 종양 대치물의 발달로 합병증의 발생을 줄이면서 비침습적인 방법으로 사지 길이를 맞추고 종양 대치물의 수명을 길게 하는 시도들이 늘고 있다. 본 논문에서는 확장형 종양 대치물의 적응증, 특성 및 합병증 등에 대해서 짚어 보고자 한다.