We report a case of linear scleroderrna associated with severe musculoskeletal atrophy of Ieft arm or disabling pansclerotic morphea of children. The patient was 11 year-old girl who has 8 years history of linear violaceoushued atrophic plaques on left arm and anterior chest, left sboulder region in a circumscribed sclerotic lesion. She had a history of injury on left forearrn at 3 years of age. One, month later, erythematous swelling and hardening of skin on left hand were developed and then progressed rapidlyfto other area for one year. However there was no signs of dyspnea, dysphagia, Raynauds phenomenon, myalgia, weakness and photcsensitivity. Diagnosis was confirmed by the characteristics of clinical features and histologic findings of skin and muscle and laboratory findings. As a therapeutic trial, low dose D-penicillamine was attempted.
Arm ; Atrophy* ; Child ; Deglutition Disorders ; Diagnosis ; Dyspnea ; Female ; Hand ; Humans ; Myalgia ; Penicillamine ; Scleroderma, Localized* ; Skin ; Thorax ; Upper Extremity*

PURPOSE: We analyzed disease free survival and the prognostic factors of liposarcoma in the extremity. MATERIALS AND METHODS: Between 1994 and 2005, of 44 patients who were diagnosed and treated for liposarcoma of the extremity, 40 patients were restrospectively analysed. 13 out of 40 patients got postoperative radiotherapy. We examined local recurrence, distant metastasis and disease free 5-year survival rate. We also analyzed clinical prognostic factors, such as age, gender, size of tumor, prior unplanned excision, histologic type, surgical excision margin and postoperative radiotherapy respectively. RESULTS: There were 3 cases of local recurrence and 4 cases of distant metastasis. The disease free 5-year survival rate was 85.0%. 26 patients presented with myxoid, 8 well differentiated, 4 round cell, 1 pleomorphic and 1 dedifferentiated histology. The disease free 5-year survival rate of mixoid, well differentiated and round cell liposarcoma were 100.0%, 84.6% and 75.0% (p=0.419). The 5-year disease free survival rate was 90.6% in negative surgical margin (n=25) and 62.5% in positive surgical margin (n=15) (p=0.003). CONCLUSION: Our study suggests that surgical excision margin is significant prognostic factor for 5-year disease free survival rate.
Disease-Free Survival ; Extremities ; Humans ; Liposarcoma ; Neoplasm Metastasis ; Recurrence ; Survival Rate

PURPOSE: Pigmented villonodular synovitis (PVNS) is a rare soft tissue tumor, which usually arises in larger joints, such as the knee. It has a high recurrence rate after surgical treatment. The purpose of this study is to evaluate and analyze the clinical results of diffuse-type pigmented villonodular synovitis cases that were treated with open total synovectomy. MATERIALS AND METHODS: Between 1994 and 2006, 21 patients who had diffuse-type pigmented villonodular synovitis were selectively reviewed. Among the 21 cases studied, 14 patients presented at the knee, 5 at the ankle, and 2 at the shoulder and elbow. The mean follow up period was 5.5 years (range, 36-157 months). The average age of the patients was 34 years consist of 7 men and 14 women. Clinical outcomes were analyzed retrospectively, including range of motion and complications. RESULTS: Open total synovectomy and adjuvant electrocautrization were done in all cases except one. During the regular follow-up period after the surgery, two patients showed symptoms of recurrence. After re-operation, only one case was pathologically confirmed as a recurrence. The patient who had partial synovectomy and the other patient who had second operation due to recur rence received additional radiation therapy. Clinical outcome scores were improved in every aspect (p<0.0001). 2 out of 14 Patients who had pigmented villonodular synovitis at the knee developed stiff knee after the surgery. CONCLUSION: After the open total synovectomy with electrocautrization, a low recurrence rate and satisfactory clinical outcome was achieved, observed in a minimum of 3 years of follow-up.
Animals ; Ankle ; Elbow ; Female ; Follow-Up Studies ; Humans ; Joints ; Knee ; Male ; Range of Motion, Articular ; Recurrence ; Retrospective Studies ; Shoulder ; Synovitis ; Synovitis, Pigmented Villonodular

In a retrospective study of 21 patients, in whom the acetabular fractures were suspected on initialradiographs, we compared and analysed the CT findings and plain radiographic findings and plain radiographicfindings. The results were as follow: 1. In patients with multiple trauma, no further change in position wasrequeired during CT examinations. 2. CT showed intraarticular loose bodies, which were invisible on plainradiographs. 3. CT was useful in detecting the fractures of acetabular rims, medial wall of acetabulum, andfemoral head. 4. CT permitted better evaluation of shape, extent, and degree of separation of fracture fragments.5. CT was helpful indetecting the associated fractures and soft tissue injuries. 6. CT also demonstrated theadequacy of reduction, the position of metallic fixation devices, and the presence or absence of remainingintraarticular osseous fragments after surgery.
Acetabulum ; Head ; Humans ; Multiple Trauma ; Retrospective Studies ; Soft Tissue Injuries

No abstract available.
Seizures*

No abstract available.

Marjolin's ulcer seated upon an old cicatrix, especially old burn scar, which may chiefly degenerated into a squamous cell carcinoma with propensity for metastasis. We are experienced two cases of Marjolins ulcer recently. A 54-year-old male who had a Marjolins ulcer(15x40cm) on his left lower extremity. He was experienced burn at the age of eight and rice sized ulcer was developed at the site of burn scar about 21 years ago. The ulcer progressively enlarged in size to reach 15x40cm for 21 years. The pathologic diagnosia was squamous cell carcinoma grade 1, but cancer cells invaded to deep dermie and subcutaneous tissues. Severe skin lesion and irreversible osteoporotic degeneration on knee joint of affected limb were present. So he was treated by high above knee amputation. Another 58-year-old female who had a Marjolins ulcer(10x20cm) on her right lower extremity. She was experienced burn at the age of forty eight and bean sized ulcer was developed at the site of burn scar about 1 year ago. The pathological diagnosis was squamous cell carcinoma grade 1 and invasian of cancer cells was limited upper dermis. On lymph node biopsy, the histological diagnosis was within normal limit. So she was treated radical surgical excision with split thickness skin graft(Mesh).
Amputation ; Biopsy ; Burns ; Carcinoma, Squamous Cell ; Cicatrix ; Dermis ; Diagnosis ; Extremities ; Female ; Humans ; Knee ; Knee Joint ; Lower Extremity ; Lymph Nodes ; Male ; Middle Aged ; Neoplasm Metastasis ; Skin ; Subcutaneous Tissue ; Ulcer*

Cowden syndrome (CS) is a rare genodermatosis that is characterized by multiple hamartomatous tumors of an ectodermal, mesodermal and endodermal origin. CS is associated with an increased risk of malignancy and especially breast cancer, thyroid cancer, uterine cancer and renal cell carcinoma. The characteristic features of the disease are mucocutaneous findings, including multiple facial trichilemmomas, oral mucosal papillomatosis and acral keratoses. Multiple sclerotic fibroma is also known to be a clue to diagnose CS. We herein emphasize that multiple sclerotic fibromas of the skin are an important marker of CS, which may also be helpful for making an early diagnosis.
Breast Neoplasms ; Carcinoma, Renal Cell ; Early Diagnosis ; Ectoderm ; Endoderm ; Fibroma ; Hamartoma Syndrome, Multiple ; Keratosis ; Mesoderm ; Papilloma ; Skin ; Thyroid Neoplasms ; Uterine Neoplasms

The incidence of cutaneous metastases of primary tumor has been reported to be rare, as compared with metastasis of other internal organ. Carcinoma of the breast is most common cause of cutaneous metastasis in women. We report here on a case of telangiectactic metastatic breast carcinoma in a 65-year-old female who had violaceous plaques and vesicles over the right side of the neck. Histopathological examinations of the cutaneous lesion revealed aggregations of tumor cells within the dilated blood vessels in the dermis.
Aged ; Blood Vessels ; Breast ; Dermis ; Female ; Humans ; Incidence ; Neck ; Neoplasm Metastasis

Granulocyte colony-stimulating factor (G-CSF) is a hematopoietic growth factor (HGF) with many applications in cancer therapy. Many cutaneous adverse reactions associated with G-CSF have been reported in recent years, including injection site reactions, pyoderma gangrenosum, Sweet's syndrome, cutaneous leukocytoclastic vasculitis, and widespread folliculitis. We report a case of vasculitis with atypical myeloid cell induced by G-CSF on the lower extremities
Folliculitis ; Granulocyte Colony-Stimulating Factor* ; Granulocytes* ; Lower Extremity ; Myeloid Cells* ; Pyoderma Gangrenosum ; Sweet Syndrome ; Vasculitis ; Vasculitis, Leukocytoclastic, Cutaneous