• Korean Journal of Head & Neck Oncology
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• v.39 no.2
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• pp.7-11
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• 2023

Adult fibrosarcoma is a malignant tumor comprising of spindle-shaped fibroblasts with variable collagen production. Due to their aggressive nature and high probability of local tumor recurrence, these tumors require accurate diagnosis and resection according to guidelines. A 57-year-old male presented to the clinic with a complaint of a palpable growing mass in the left scapular area. Examination of the back revealed a 6 cm protruding tumor with a nodular surface. We performed a wide excision, including the infraspinatus fascia layer and subsequent reconstruction using a parascapular island flap. Histopathological analysis demonstrated the typical microscopic features of adult fibrosarcoma. At the 3-year follow-up, there was no evidence of local recurrence and the resection margin was completely clear of tumor.

• Archives of Reconstructive Microsurgery
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• v.11 no.1
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• pp.67-72
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• 2002

Purpose : Treatment of giant cell tumor of distal radius can be treated in several ways according to the agressiveness of the tumor. We treated 3 cases of widely involved giant cell tumor of distal radius with wide resection and proximal fibular graft and report the results with review of literatures. Material and Method : We have treated 3 cases of giant cell tumor of the distal radius since last 1990. Among 3 cases, two cases were grade III radiologically and treated by wide resection of distal radius and vascularized proximal fibular graft, and one case, grade II radiologically, treated by distal radial resection and non-vascularized proximal fibular graft. We followed up clinical results of above three cases 9 years, 12 years and 2 years. Result : In all three cases, tranplanted fibula graft showed solid union but grade III tumors recurred at 4 year and 6 year postoperatively. One of the case which recurred 4 year later was treated with secondary wide resection and wrist fusion with autogenous iliac bone graft, and didn't show any recurrent finding for these 5 years after re-operation. And another grade III, which recurred at 6th post-operative year, is under follow-up for 6 years after recur without 2nd operation. Grade II case didn't show any recurrent findings on 2 year follow-up. Conclusion : Grade III cases recurred at 4 year and 6 year follow-up. The cause of recurrence was thought to be invasion of remaining tumor cell in the soft tissue. To prevent recurrence, complete resection of primary tumor was necessary.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.sup3
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• pp.231-237
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• 2016

Gastroesophageal cancer is one of the most common types of cancer worldwide. Despite significant developments in management, 5-year survival in the developing world is less than 20 percent. Due to restricted research about the impact of preoperative chemotherapy (POC) on tumor resection, pathological response and postoperative complications in Iran, we designed and implemented the present retrospective cross- sectional study on 156 patients with gastroesophageal cancer (GEc) between 2013 and 2015 at Shariati Hospital of Tehran. Two groups were included, the first group had previously received preoperative chemotherapy and the second group had only undergone surgery. All patients were followed for at least one year after the operation in terms of tumor recurrence, relapse free survival and one-year survival. The two groups were eventually compared regarding tumor resection, pathological response, postoperative complications, recurrence rate and survival. The mean age was $66.5{\pm}7.3years$ and 78 percent were male. The tumor resectability, pathological response and postoperative complications in the group which received POC were 93.5%, 21.8% and 12.8%, respectively, and in the surgery alone group figures for tumor resection and postoperative complications were 76% and 29.5%, respectively. Also based on our study the 5-year survival in the POC group was better (79.5% vs. 66.5%). Using standard neoadjuvant regimens (preoperative chemotherapy/chemoradiotherapy) beforesurgery could increase tumor resectability, pathological response, and improve the general status of the patients. Therefore using POC may be recommended over surgery alone.

• The Journal of the Korean bone and joint tumor society
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• v.15 no.1
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• pp.65-68
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• 2009

Proliferating trichilemmal tumor(PTT) is a rare neoplasm derived from the outer root sheath of the hair follicle. Malignant transformation is rare, but abrupt enlargement of size, infiltrative growth, and non-scalp location are suggestive of malignant PTT. Histopathologic characteristics of malignant PTT are nuclear atypia, pleomorphism, and mitotic figures. Recurrence and metastasis have been documented in malignant PTT. Wide resection of the tumor with the normal tissue and accurate follow-up is the treatment of choice of the both malignant and benign PTT. We report a 51-year-old man with the mass on right 5th finger distal phalanx for 7 years. The tumor was excised with middle phalangiectomy, and based on the histopathologic findings of the tumor, this case was diagnosed as mailignant PTT. We cannot detect recurrence and metastasis because the patient was lost to follow-up.

• Journal of Chest Surgery
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• v.54 no.6
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• pp.460-465
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• 2021

Background: Metastasis and recurrence of primary cancer are the main causes of cancer mortality. Disseminated tumor cells refer to cancer cells that cause metastasis from primary cancer to other organs. Several recent studies have suggested that circulating tumor cells (CTCs) are associated with the clinical stage, cancer recurrence, cancer metastasis, and prognosis. There are several methods of isolating CTCs from whole blood; in particular, using a membrane filtration system is advantageous due to its cost-effectiveness and availability in clinical settings. In this study, an animal model of lung cancer was established in nude mice using the human large cell lung cancer cell line H460. Methods: Six-week-old nude mice were used. The H460 lung cancer cell line was injected subcutaneously into the nude mice. Blood samples were obtained from the orbital area before cell line injection, 2 weeks after injection, and 2 weeks after tumor excision. Blood samples were filtered using a polycarbonate 12-well Transwell membrane (Corning Inc., Corning, NY, USA). An indirect immunofluorescence assay was performed with the epithelial cell adhesion molecule antibody. The number of stained cells was counted using fluorescence microscopy. Results: The average size of the tumor masses was 35.83 mm. The stained cells were counted before inoculation, 2 weeks after inoculation, and 2 weeks after tumor excision. Cancer cells generally increased after inoculation and decreased after tumor resection. Conclusion: The CTC detection method using the commercial polycarbonate 12-well Transwell (Corning Inc.) membrane is advantageous in terms of cost-effectiveness and convenience.

• The Journal of the Korean bone and joint tumor society
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• v.3 no.1
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• pp.32-38
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• 1997

PURPOSE : For the reconstruction of large bone defect after tumor resection, it is possible to reuse the bone involved by tumor with some treatment to it. Several bone-reusing methods have been reported such as autoclaving, low-heat treatment(pasteurization) and intraoperative radiotherapy. We have used extracorporeally radiated autogenous bone graft for reconstruction after tumor resection, and analyzed the periods for junctional union, functional results and complications to know the indications of this method. METHODS : From Dec. 1993 to Sept. 1995, nine patients had taken autogenous bone graft with extracorporeal irradiation. Eight cases were osteosarcoma and 1 giant cell tumor. The graft sites were 5 in femur, 3 proximal tibia and 1 femur and tibia. Stage 3 was 1 case(GCT), Stage IIB 3 and Stage IIIB 5. After wide resection, surrounding soft tissue and intramedullary and extramedullary portion of the tumor were removed. Radiation was done in 5000cGy to the resected bone. Ender nails and bone cement were inserted and filled into the medulla to prevent fracture. RESULTS : Average follow-up period was 12.3(4 to 21) months. Average junctional union period in simple X-ray was 6.5 months in 4 cases. Average functional score following Enneking's criteria was 19(12-27). Complications were as follows ; condylar fractures and femur neck fracture in 4 cases, subluxation of the knee joint 3 and infection 1. Although local recurrence was detected in 1 case, the site of recurrence was not in the radiated bone but surrounding soft tissue. At final follow-up, no recurrence was found in one case(GCT), CDF 2, AWD 2, DOD 3, and died of chemotherapy related sepsis 1. CONCLUSIONS : Extracorporeally radiated bone autograft is considered to be a method for reconstruction of the large bone defect made by tumor resection, especially in the reconstruction around the joint.

• Korean Journal of Head & Neck Oncology
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• v.21 no.2
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• pp.115-120
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• 2005

Background and Objectives: Minor salivary gland tumors vary in their primary sites, histopathology and biological behavior. Therefore, various factors are considered in selecting the treatment modality and predicting the prognosis. We performed this study for the purpose of getting further understanding and more supporting ideas for the diagnosis and treatment of minor salivary gland tumor. Materials and Methods: A retrospective analysis of the patients with 52 cases of minor salivary gland tumor who were treated at the Hanyang University Hospital from 1996 to 2003 was performed. We analyzed demography, symptoms, histopathology, treatment and outcomes by the review of medical records. Results: Among 52 cases of minor salivary gland tumor, 46% were classified as benign and 54% were classified as malignant tumors. The most common benign tumor was pleomorphic adenoma. Adenoid cystic carcinoma(15/28) was the most common in malignant tumors. Eight patients were males and sixteen patients were females in benign tumors and 10 patients were males and 18 patients were females in malignant tumors. The most common site of benign tumor was the palate(17/22), whereas malignant tumors were most common in the nasal cavity and paranasal sinus(9/28). Asymptomatic mass was the most common symptom. According to the criteria given by the AJCC on staging, stage III and IV(21/28) were more common than stage I and 11(7/28). All benign tumors were treated with simple excision and had no recurrence. In malignant tumors, 25 patients underwent radical excisional operation and 13 patients of them had postoperative radiation therapy. Three of them were treated with additional chemotherapy. In whom treated with radical operation, 9 patients had recurrence. Three were recurred at the primary site with neck node metastasis, 3 were recurred at the primary site with lung metastasis, 1 was recurred at the primary site with neck node and lung metastasis, 1 was recurred only at neck node. Conclusion: In minor salivary gland tumor, malignant was more common than benign. Malignant tumor originated from minor salivary gland were more frequently diagnosed at advanced stage with high recurrence rate and distant metastasis. Early detection of the disease is needed to improve the prognosis of the patients with malignant tumors of the minor salivary glands.

• Korean Journal of Head & Neck Oncology
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• v.19 no.1
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• pp.25-33
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• 2003

Background and Objectives: The Herpes Simplex type 2 Defective Infectious Single Cycle virus (DISC virus) is attenuated virus originally produced as viral vaccines but are also efficient gene transfer vehicle. The main goals of this study were to examine the efficiencies of the gene transfer using DISC vectors for various head and neck squamous cell carcinoma cell lines and to evaluate the efficacy of vaccination with DISC virus carrying a immunomodulatory genes (GM-CSF) as cancer therapy in a organotopic oral cavity squamous cell cancer model. Materials and Methods : We determinated the gene transfer efficiency of DISC virus by x-gal stain method and proved gene and protein expression of DISC-GMCSF transfected SCCVII cells by RT-PCR and ELISA method. Also we evaluated the ex vivo vaccination effects of SCCVII/GMCSF (DISC-GMCSF transfected SCCVII vaccine) vaccine on preventing the recurrence of micro-residual tumor. After the vaccination of SCCVII/GMCSF, specific cytotoxic T-cell responses was evaluated by CTL assay. Results: At an MOI of 10 DISC virus showed 64-88% of transfection rates in various head and neck squamous cancer cell lines. SCCVII cells transduced by DISC virus vector (MOI=10) carrying the GM-CSF gene, produced 4.5 nanogram quantities of GM-CSF per $10^6$ cells. In vivo vaccination using tumor cells transduced ex vivo with DISC-GMCSF resulted in better protection rate against subsequent tumor recurrence in organotopic oral cavity cancer model. Although tumor free survival rate was not statistically significantly increased in vaccination group (p=0.078), tumor specific cytotocic T-cell responses were significantly increased in SCCVII/GMCSF vaccination group. Conclusion: These data demonstrate that; 1) The DISC virus vector is capable of efficient gene transfer to various head and neck squamous cancer cell lines, 2) GM-CSF secreting genetically modified tumor vaccine (SCCVII/GMCSF) efficiently protected against tumor recurrence in organotopic micro-residual oral cavity cancer model and produced tumor specific cytotoxic T-cell response. DISC virus-mediated, cytokine gene transfer may prove to be useful as a clinical therapy for head and neck cancers.

• The Korean Journal of Nuclear Medicine
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• v.35 no.3
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• pp.117-124
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• 2001

Serum thyroglobulin measurement and I-131 whole-body scintigraphy (WBS) are well-established methods for the detection of recurrence in the follow-up of patients with thyroid carcinoma. However, inconsistent results are observed frequently, and these two methods are not always able to detect recurrence. In some patients, serum thyroglobulin level is elevated but the WBS is negative, because the recurrent tumor is too small and below the sensitivity of the diagnostic scan, or there is a dissociation between thyroglobulin synthesis and the iodine frapping mechanism. In such cases, various nuclear imaging methods including Tl-201 Tc-99m-sestamibi, and F-18-FDG PET can be used besides anatomical imaging methods. Among them, FDG PET localizes recurrent lesions in WBS-negative thyroid carcinoma with high accuracy. Several studies have suggested that empirical high-dose I-131 therapy resulted in a high rate of visualization in post-therapy scans with evidence of subsequent improvement. An important question is when to operate on patients with recurrent tumor. We believe that surgical removal is the best means of treatment for patients with localized persistent tumor, despite the high-dose I-131 therapy. with tumor in thyroid remnant, and with isolated recurrence in the lymph node, lung or bone. In addition, we recommend palliative resection of locally unresectable mass with subsequent treatment with high-dose I-131 therapy. Before I-131 therapy, the evaluation of sodium-iodide symporter expression in thyroid carcinoma can predict iodine uptake. Retinoic acid is known to induce redifferentiation, and to enhance I-131 uptake in thyroid carcinoma. Retinoic acid therapy may represent an alternative approach before high-dose I-131 therapy.

• Radiation Oncology Journal
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• v.35 no.2
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• pp.153-162
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• 2017

Purpose: To evaluate intracranial control after surgical resection according to the adjuvant treatment received in order to assess the optimal radiotherapy (RT) dose and volume. Materials and Methods: Between 2003 and 2015, a total of 53 patients with brain oligometastases from non-small cell lung cancer (NSCLC) underwent metastasectomy. The patients were divided into three groups according to the adjuvant treatment received: whole brain radiotherapy (WBRT) ${\pm}$ boost (WBRT ${\pm}$ boost group, n = 26), local RT/Gamma Knife surgery (local RT group, n = 14), and the observation group (n = 13). The most commonly used dose schedule was WBRT (25 Gy in 10 fractions, equivalent dose in 2 Gy fractions [EQD2] 26.04 Gy) with tumor bed boost (15 Gy in 5 fractions, EQD2 16.25 Gy). Results: The WBRT ${\pm}$ boost group showed the lowest 1-year intracranial recurrence rate of 30.4%, followed by the local RT and observation groups, at 66.7%, and 76.9%, respectively (p = 0.006). In the WBRT ${\pm}$ boost group, there was no significant increase in the 1-year new site recurrence rate of patients receiving a lower dose of WBRT (EQD2) <27 Gy compared to that in patients receiving a higher WBRT dose (p = 0.553). The 1-year initial tumor site recurrence rate was lower in patients receiving tumor bed dose (EQD2) of ${\geq}42.3Gy$ compared to those receiving <42.3 Gy, although the difference was not significant (p = 0.347). Conclusions: Adding WBRT after resection of brain oligometastases from NSCLC seems to enhance intracranial control. Furthermore, combining lower-dose WBRT with a tumor bed boost may be an attractive option.