• 제목/요약/키워드: postmastectomy lymphedema

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림프부종에 의한 신경포착증후군: 증례 보고 (A Case Report of Nerve Entrapment Syndrome with Lymphedema)

  • 김홍렬;안덕선
    • Archives of Plastic Surgery
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    • 제37권1호
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    • pp.95-98
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    • 2010
  • Purpose: One of the most common cause of upper extremity lymphedema is breast cancer surgery. We experienced the nerve entrapment syndrome which was associated with postmastectomy lymphedema. To the best of our knowledge, this is the first case report of lymphedema induced nerve entrapment syndrome on upper extremity in Korea. Methods: A 54-year-old woman presented with a tingling sensation on her right hand, which had been present for 1 year. On her history, she had a postmastectomy lymphedema on her right upper extremity for 20 years. Initial electromyography (EMG) showed that the ampulitude of the median, ulnar, and dorsal ulnar cutaneous nerve were decreased, and conduction block was also seen in median nerve across the wrist. In needle EMG, incomplete interference patterns were observed in the muscles innervated by median and ulnar nerves. In conclusion, electrophysiologic study and clinical findings suggested right median and ulnar neuropathy below the elbow. Therefore, we performed surgical procedures, which were release of carpal tunnel, Guyon's canal, and cubital tunnel. Results: The postoperative course was uneventful until the first two years. The tingling sensation and claw hand deformity were improved, however, the motor function decreased progressively. In 7 years after the operation, patient could not flex her wrist and thumb sufficiently. EMG which was performed recently showed that ulnar motor response was of low ampulitude. Moreover, median, ulnar, dorsal ulnar cutaneous, lateral antecubital cutaneous and median antebrachial cutaneous sensory response were unobtainable. Abnormal spontaneous activities were observed in upper arm muscles. In conclusion, multiple neuropathies were eventually developed at above elbow level. Conclusion: On treating nerve entrapments associated with lymphedema, medical professionals should be fully aware of the possibility of unpredictable results after the surgery, because of the pathophysiologic traits of chronic lymphedema.

유방 철제술후 임파육종의 치료 1예 (Radiation Treatment of Postmastectomy Lymphangiosarcoma)

  • 최일봉;김미희;길학준;김춘열;박용휘
    • Radiation Oncology Journal
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    • 제6권1호
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    • pp.81-84
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    • 1988
  • 유방절제술 후 임파육종은 유방암 환자에서 유방절제술 후 상지에 생기는 흔치 않은 악성 암이다. 유방절제술 후 임파육종에 평균 발병 연령은 63.9세이고 유방절제 후 발병할 때까지의 기간은 평균 10년 3개월이다. 유방절제술 후 임파육종은 혈관과 임파관에서부터 발생하는 것으로 알려져 있고 조직학적 소견은 진피의 부종과 악성세포로 둘러싸인 확장된 임파선이 특징이다. 견관절 분리술이나 전사분부 절제술 등의 광범위한 절제가 가장 효과적인 치료법으로 알려져 있고 방사선 치료를 포함한 다른 치료방법은 큰 도움이 않되는 것으로 보고되고 있다. 저자들은 유방절제술 후 만성 림프부종을 동반한 임파육종이 외부 방사선 조사에 의하여 종괴의 감소를 보여 이에 보고하는 바이다.

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유방암 수술 후 발생한 림프부종과 말초신경병증에 대한 도침술과 정맥자락술 집중치료 증례보고 (Acupotomy and venesection in Upper Limb Lymphedema and Peripheral neuropathy following Breast Cancer Surgery)

  • 장은하;김소연;김현식;김성철
    • 대한약침학회지
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    • 제12권4호
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    • pp.119-126
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    • 2009
  • Purpose: In order to estimate clinical effects of acupotomy and venesection in a patient with peripheral neuropathy and upper limb lymphedema following breast cancer surgery. Methods: From 17th August, 2009 to 29th August 2009, 1 female patient with peripheral neuropathy and upper limb lymphedema following breast cancer surgery was treated with general oriental medicine therapy(acupuncture, moxibustion, cupping, physical therapy, herbal medication) and acupotomy with venesection. Results: The patient's chief complaints- Lt hand numbness, Lt arm edema, Lt. wrist flexion limitation - were notably improved. Conclusions : This study demonstrates that oriental medical treatment with acupotomy and venesection therapy has significant effect in improving symptoms of peripheral neuropathy and upper limb lymphedema following breast cancer surgery, as though we had not wide experience in this treatment, more research is needed.

하지의 만성 림프부종에 발생한 혈관육종 - Stewart-Treves 증후군 - (Angiosarcoma in a Chronically Lymphedematous Leg - Stewart-Treves Syndrome -)

  • 전영수;심희석
    • 대한골관절종양학회지
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    • 제15권2호
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    • pp.178-183
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    • 2009
  • 혈관육종은 악성 연부 조직 종양 중 매우 드문 형태의 종양으로 그 중 만성 림프부종에 발생한 것을 Stewart-Treves syndrome이라 부르기도 한다. 이는 일반적으로 유방암의 치료로 행해지는 유방제거술 및 방사선 치료 후 상지의 장기간의 림프부종의 합병증으로 주로 발생되는 것으로 알려져 있으며 예후는 좋지 않은 것으로 보고하고 있다. 저자들은 17년 전 자궁암으로 자궁적출술을 받은 환자가 수술 후 발생한 장기간의 하지의 림프부종으로 인해 1년 전 타병원에서 대퇴부의 수술적인 치료를 받았으나 이 후 대퇴부의 혈관육종이 발생하여 광범위 절제술을 시행한 예를 경험하였기에 이를 문헌 고찰과 함께 보고하는 바이다.

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