The Clinical Characteristics of Giant Cell Tumor of Bone with Aneurysmal Bone Cyst / 대한정형외과학회잡지

PURPOSE: The purpose of this study was to evaluate the difference in clinical features, process, and prognosis depending on the presence of secondary aneurysmal bone cysts (ABCs) in patients with giant cell tumors. MATERIALS AND METHODS: A total of 33 patients who underwent surgery for giant cell bone tumors between March 2009 and April 2013 were selected. Data on clinical features were obtained from medical records and pathological and radiological review, including age, sex, location, and size of the tumor, and Campanacci grade, as well as whether there was any pathological fracture, local recurrence, distant metastasis, or malignant transformation. The Student t-test and Fisher exact test were used for comparison of the differences in clinical features by the presence or absence of ABCs. RESULTS: Local recurrence occurred in 6 of the 33 cases, 3 each were in the groups with and without ABCs; however, the difference was not statistically significant. In total, nine cases had pathological fractures, seven were in the group with ABC and two were in the group without ABC (p=0.013). No statistically significant differences in age, sex, location and size of the tumor, or Campanacci grade were observed between the groups with and without ABCs. CONCLUSION: There was no difference in the frequency of local recurrence between the groups with and without ABCs. However, pathological fracture occurred more frequently in the group with ABCs compared to the group without ABCs.

Comparison of the Diagnostic Usefulness of Conventional Magnification and Near-focus Methods with Narrow-band Imaging for Gastric Epithelial Tumors

BACKGROUND/AIMS: Dual-focus two-stage optical lens technology has been introduced recently. In near-focus mode (NFM), endoscopists can easily examine the mucosal tissue and capillary networks. This study compared the magnified images obtained using NFM and the conventional magnification method (CMM) under narrow-band imaging in patients with gastric epithelial tumors. MATERIALS AND METHODS: An experienced endoscopist performed endoscopy using NFM and CMM in patients with gastric epithelial tumors. We studied 40 images from 40 endoscopy sessions in 20 selected patients. Ten endoscopists rated the image quality independently on a 5-point Likert scale (from poor=1 to excellent=5) in terms of microsurface structure, microvascular structure, and the demarcation line. RESULTS: The gastric epithelial tumors comprised 10 cases of early gastric cancer, 2 of high-grade dysplasia, and 8 of low-grade dysplasia. The median number of magnified images for each method was 11. The mean observation time (+/-SD) for magnification was 99.9+/-64.1 s in NFM and 91.5+/-64.6 s in CMM (P=0.54). The image quality score for the microsurface structure was higher with NFM than CMM (4.09+/-0.39 vs. 3.73+/-0.40, P=0.015), while that for microvascular structure was lower with NFM than in CMM (3.53+/-0.45 vs. 4.29+/-0.45, P=0.001). CONCLUSIONS: Magnification using NFM provides higher-quality images of the microsurface structure, although its optical zoom is limited compared with CMM. Since NFM can obtain magnified images easily by pushing a button on the scope, it is useful for evaluating gastric epithelial tumors.

Modic Degenerative Marrow Changes in the Thoracic Spine : A Single Center Experience

OBJECTIVE: The purposes of this study were to evaluate the prevalence, types, and locations of Modic changes (MCs) in the thoracic spine in a large number of subjects, and to investigate the relation between the distributions of MCs and disc herniations (DHs) in the thoracic spine. METHODS: Two experienced musculoskeletal radiologists assessed the presence of MCs and DHs by consensus in the thoracic MRIs of 144 patients with non-specific back pain. Patient ages ranged from 22 to 88 years (mean=53.3+/-14.66 years), and 72 were female (50%). The prevalence, distribution, relation of MCs and DHs was recorded. RESULTS: MC was observed in 8 of the 144 patients (5.6%) and 10 of 1728 segments (0.58%). The most common MC was type II. Of the 8 patients exhibiting MC, 6 had type II (75.0%), and 2 had mixed MCs (type I/II or type II/III). MCs were distributed mainly at the mid-thoracic level (from T5/6 to T9/10). DH was detected in 18 patients (12.5%), 36 of 1728 segments (2.1%). Of the 10 segments exhibiting MC, 5 had DHs at the same level (50.0%). Accordingly, DH was strongly associated with MC (p=0.000). CONCLUSION: A low prevalence of MC was observed in the thoracic spine, and type II MC predominated. The low prevalence of MC in the thoracic spine suggests that it was caused by a relative lack of mobility as compared with the cervical and lumbar spines. And DHs were found to be strongly associated with MCs even in the thoracic spine.

Spontaneous Systemic Tumor Embolism Caused by Tumor Invasion of Pulmonary Vein in a Patient with Advanced Lung Cancer

We describe a 72-year-old man who presented with left hemiparesis due to acute cerebral infarction in the right fronto-temporal lobe. Three months prior to admission, he was hospitalized for right hemiparesis due to the acute cerebral infarction in the left anterior cerebral artery territory. To investigate the cause of his recurrent embolic event, a chest computed tomography scan and echocardiography were performed, which revealed advanced lung cancer invading contiguously through the pulmonary veins to the right main pulmonary artery and left atrium. Tumor embolism is a rare cause of stroke, occurring with primary or metastatic neoplasms of the lung. Echocardiography is a useful tool in patients with cerebral embolic episodes.

Detection of distant metastasis to skeletal muscle by 18F-FDG-PET in a case of intrahepatic cholangiocarcinoma / 대한간학회지

Intrahepatic cholangiocarcinoma is a rare malignancy that originates from the epithelial cells of the intrahepatic bile ducts. Intrahepatic cholangiocarcinoma can metastasize in lymphatic chains, including the hepatoduodenal ligament, and it often invades adjacent organs or metastasizes to other visceral organs such as the lungs, bones, adrenal glands, and brain. However, distant skeletal muscle metastasis is very rare. Moreover, a metastatic skeletal muscle tumor rarely shows specific symptoms, making it difficult to identify in a routine examination. A 45-year-old man with a chief complaint of right upper quadrant abdominal pain was admitted to our hospital. Abdominal ultrasound and computed tomography with contrast enhancement showed a malignant mass in the right hepatic lobe, and 2-[18F] fluoro-2-deoxy-D-glucose positron-emission tomography revealed distant skeletal muscle metastases in the thorax and buttock. The patient underwent an ultrasound-guided percutaneous needle biopsy for the metastatic low-echo masses in the skeletal muscle.