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Clinical Experience of Malignant Fibrous Histiocytoma in Maxillary Sinus.

Seung Oh HAN ; Seok Chan EUN ; Suk Joon OH ; Young Soo RHO

Journal of the Korean Cleft Palate-Craniofacial Association.2002;3(1):93-97.

Malignant fibrous histiocytoma is a connective tissue tumor containig fibroblast-like cells and histiocyte. It is one of the most common types of soft tissue sarcoma of late adult life but, the involvement of head and neck area is relatively rare. Although adequate modalities of treatment is performed, the prognosis of the tumor itself is not clear. Because of its highly malignant property and, as in cases of other regions of the body, devastating result would occur and aggressive treatment is required. Malignant fibrous histiocytoma shows variable histologic appearance, and may be classified into several subtypes(storiform- pleomorphic, myxoid, giant cell, inflammatory, angiomatoid) and the storiform-pleomorphic type is the most common type. The authors have recently experienced a case showing good clinical result to the present, after total maxillectomy and split thickness skin graft and postoperative radiotherapy(6400cGy) in the malignant fibrous histiocytoma involving the right maxillary sinus, so report this case with a review of literature.
Adult ; Connective Tissue ; Giant Cells ; Head ; Histiocytes ; Histiocytoma ; Histiocytoma, Malignant Fibrous* ; Humans ; Maxillary Sinus* ; Neck ; Prognosis ; Sarcoma ; Skin ; Transplants

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A Case of Basal Cell Nevus Syndrome with Symmetric Basal Cell Carcinomas on Neck.

Sae Hwan KIM ; Han Koo KIM ; Seung Han KIM ; Seung Hong KIM ; Tae Jin LEE

Journal of the Korean Cleft Palate-Craniofacial Association.2002;3(1):89-92.

Basal cell nevus syndrome is an autosomal dominant disorder characterized by developmental and skeletal anomalies, palmo-plantar pits, odontogenic keratocysts, ectopic calcification, and occurrence of various types of tumors including basal cell carcinoma. Within our country, 9 cases at dentistry and 3 cases at dermatology were reported. The patient was a 66-year-old woman. Chief complaint was multiple dark brownish colored papules which were symmetrically distributed around the neck. Excision and biopsy were done under general anesthesia and the wound was healed without complication. Histological examination of the lesion revealed 'basal cell carcinoma'. During the evaluation of metastasis of basal cell carcinoma, at PNS CT we found odontogenic keratocyst on the left alveolar process of maxilla by accident. Physical examination revealed pits of the palm and sole. These are consistent with the major diagnostic criteria for basal cell nevus syndrome. Hereby we report one case of basal cell nevus syndrome.
Aged ; Alveolar Process ; Anesthesia, General ; Basal Cell Nevus Syndrome* ; Biopsy ; Carcinoma, Basal Cell* ; Dentistry ; Dermatology ; Female ; Humans ; Maxilla ; Neck* ; Neoplasm Metastasis ; Odontogenic Cysts ; Physical Examination ; Wounds and Injuries

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A Case of Scalp Angiosarcoma.

Jong Gu KIM ; Duck Ho KO ; Nam Hoon KIM ; Chang Hoon JEONG

Journal of the Korean Cleft Palate-Craniofacial Association.2002;3(1):86-88.

Angiosarcoma is very rare but highly malignant soft tissue tumor derived from the vascular endothelium. This tumor is most commonly found in the skin and subcutaneous tissues. Angiosarcoma is known to cause early and widespread metastasis leading to a very poor prognosis of less than 24 months. We report a case of angiosarcoma developed in the temporoparietal scalp of a 84-year-old man. The patient was referred for us consultation after failed systemic antibiotic treatment, incision drainage treatment for "cellulitis" by the general physician. We performed excision and biopsy. The histologic finding of the lesion showed that irregular, complex vascular channels in dermis. The tumor cells were positive for Factor VIII-related antigen. The lesion was confirmed as cutaneous angiosarcoma. We recommended a radical surgery and reconstruction followed by adjuvant radiation, but the patient refused. The patient was expired 2 months thereafter because of a massive hemorrhagic pleural effusion by suspicious distant metastasis. Authors reported important aspects of clinical findings, histologic features and therapeutic options of the scalp angiosarcoma.
Aged, 80 and over ; Biopsy ; Dermis ; Drainage ; Endothelium, Vascular ; Hemangiosarcoma* ; Humans ; Neoplasm Metastasis ; Pleural Effusion ; Prognosis ; Scalp* ; Skin ; Subcutaneous Tissue ; von Willebrand Factor

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Parapharyngeal Second Branchial Cleft Cyst Extending to the Skull Base: A Lateral Transcranial Infratemporal fossa Approach.

Sang Yoon KANG ; Kyu Sang YANG ; Jung Yong AHN ; Jun PARK ; Sang Hun CHO

Journal of the Korean Cleft Palate-Craniofacial Association.2002;3(1):82-85.

Branchial cleft cysts, sinuses, and fistulae are classified as first, second, third and fourth branchial cleft anomalies. They represent the congenital anomalies resulting from defects in the normal maturation of the branchial apparatus. Second branchial cleft anomalies occur more commonly than other branchial cleft anomalies. Most branchial cysts from the second branchial cleft are found deep in the sternocleidomastoid muscle or along its anterior border. Recognizing and diagnosing lateral neck cysts correctly are not difficult for an expert physician, although an unusual localization may cause problems in differential diagnosis. Complete excision of branchial cleft cysts is necessary to avoid recurrence. Approaches to the lesions are depending on the location and extent of the lesion. This article presents an unusual case of parapharyngeal branchial cleft cyst extending the skull base. Excision of the lesion was achieved via the lateral transcranial infratemporal fossa approach with zygomato-temporal craniotomy. This approach provides access not only to all of the subcranial tissues that underlie the middle cranial fossa, but to the maxillary or sphenoid sinus.
Branchial Region* ; Branchioma* ; Cranial Fossa, Middle ; Craniotomy ; Diagnosis, Differential ; Fistula ; Neck ; Recurrence ; Skull Base* ; Skull* ; Sphenoid Sinus

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A Case of Primary Malignant Lymphoma of the Parotid Gland.

Kyu Sang YANG ; Sang Yoon KANG ; Jeong Yun SHIM ; Jun PARK ; Sang Hun CHO

Journal of the Korean Cleft Palate-Craniofacial Association.2002;3(1):77-81.

The malignant lymphoma originating in the parotid gland is relatively rare, constituting 0.3% of all reported malignancies. Malignant lymphoma is a neoplastic proliferation of cell in the lymphoreticular system and devided as Hodgkin's disease and non-Hodgkin's lymphoma. Non-Hodgkin's lymphoma occurs primarily in lymph nodes and is rarely found in extralymphatic organs. In general, malignant lymphoma originating in the parotid gland is histologically described as non- Hodgkin's lymphoma, frequently belongs to the B-cell type and rarely relapses into other sites. Recently, we have experienced a malignant lymphoma in the left parotid gland. It was diffuse large B-cell type, stage I. In the imaging examination, exhibited homogeneity of the tumor. It was well defined margin and no infiltration into the adjacent tissue. The patient underwent superficial parotidectomy and combination chemotherapy with CHOP-regimen. He have been followed for 6 months and no relapse occurred. We report this case with a brief review of literature.
B-Lymphocytes ; Drug Therapy, Combination ; Hodgkin Disease ; Humans ; Lymph Nodes ; Lymphoma* ; Lymphoma, Non-Hodgkin ; Parotid Gland* ; Recurrence

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Correction of Constricted Ear.

Joo Hwan LIM ; Tai Kyun IM ; Ra Yong KO ; Jang Deog KWON ; Kap Sung OH

Journal of the Korean Cleft Palate-Craniofacial Association.2002;3(1):71-76.

The constricted ear was suggested by Tanzer for the purpose of obviating the confusion involving lop ear, cup ear and prominent ear as defect whose helix turns down, and scapha and fossa triangularis are narrowed. The constricted ear has a spectrum of severity and therefore, requires a graded surgical approach. Tanzer has described the degree of deformities of the constricted ear as falling into three groups. For the correction of constricted ear, there are numerous techniques but we have had difficulties in adopting these techniques in various type. We also describe the various constricted ear as the Tanzer's classification and adopted three methods to each type, banner flap(group I), concha cartilage graft (group II) and rib cartilage graft(group III) for reducing postoperative deformity and confusion in correcting the ear deformities. Constricted ear repairs must be individualized to accomodate each specific deformity. We corrected 22 cases of constricted ear in 20 patients using each optimal method described above according to the degree of deformities. Mild deformities need only reshaping and adjusting of existing tissues, moderate deformities need additional skin and severe deformities require a cartilage graft. For correction of constricted ear, accurate identification of the severity of deformity is essential. The results were satisfactory and we report our experience with relative literatures.
Cartilage ; Classification ; Congenital Abnormalities ; Ear* ; Humans ; Ribs ; Skin ; Transplants

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Cleft Palate and Congenital Alveolar Synechiae Syndrome: A Case Report and Literature Review.

Kang Young CHOI ; Ki Ho CHUNG ; Jung Dug YANG ; Ho Yun CHUNG ; Byung Chae CHO

Journal of the Korean Cleft Palate-Craniofacial Association.2008;9(1):41-44.

Cleft palate and congenital alveolar synechia is a rare syndrome. Only eight cases have been previously reported. It consists of a spectrum of facial anomalies always including cleft palate and congenital alveolar synechiae without other abnormalities. This report described an unusual case of congenital alveolar synechial band spanning posterior alveolar of the two jaws with cleft palate. Previously reported cases showed bilaterally or anteriorly located fibrous band. In our department, a new born revealed unilateral posterior synechia. Under brief intravenous sedation, synechium was divided using bipolar diathermy in the nursery at 3 days of age because of poor feeding. This division allowed full jaw opening after brief passive exercise. The patient is growing and maturing as expected with no complications. This patient is supposed to be the first reported case of isolated unilateral alveolar synechium combined with cleft palate in the worldwide.
Cleft Palate ; Diathermy ; Humans ; Jaw ; Nurseries

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A Case Report of Lymphangioma Circumscriptum on Scalp.

Dong Gwan LEE ; Hea Kyeong SHIN ; Jung Hyun SEOUL ; Jun CHOI

Journal of the Korean Cleft Palate-Craniofacial Association.2008;9(1):38-40.

PURPOSE: Lymphangioma circumscriptum is a rare, congenital benign hamartous malformation, caused by the saccular dilatation of lymph channels lines by normal, single cell, lymphatic endothelia that present as local eruptions of persistent, grouped, translucent vesicles. The lymphangioma circumscriptum lesions may occur on axillary fold shoulder, neck proximal limbs and buccal mucosa. We reported a rare case of lymphangioma circumscriptum on the scalp. METHODS: A 15-year-old girl with a 5x3cm sized lymphangioma circumscriptum on scalp was examined. It was defined a boundry by ultrasound. And then, a tissue crescent type expander with 120cc normal saline was inserted on occipital area for a month. After confirmed safety margin of the excised lymphangioma circumscriptum on frozen biopsy and the scalp flap was elevated and covered with empty space. RESULTS: A histopathologic finding revealed that lymphangioma circumscriptum. During 11 months follow up, no relapse was found. CONCLUSION: We described a rare case of lymphangioma circumscriptum on scalp. By using a tissue expander and excision, we achieved no recurrence and aesthetically satisfactory outcome.
Adolescent ; Biopsy ; Dilatation ; Extremities ; Follow-Up Studies ; Humans ; Lymphangioma ; Mouth Mucosa ; Neck ; Recurrence ; Scalp ; Shoulder ; Tissue Expansion Devices

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2 Cases of Pneumosinus Dilatans.

Young Cheon NA

Journal of the Korean Cleft Palate-Craniofacial Association.2008;9(1):35-37.

Pneumosinus Dilatans consists of an abnormal dilatation of the paranasal sinuses which contain air only and lined by normal mucosa. It is a rare condition, the etiology of which is unclear. A 16 year old male complained frontal bossing which developed slowly. Simple X-ray and CT showed abnormal distension of frontal sinus. Another 19 year old male complained slowly growing left cheek mass. Simple X-ray and CT showed abnormal distension of anteromedial wall of maxillary sinus. In view of the cosmetic appearance, operations were performed. Distended sinuses walls were removed and reconstructed using Medpore(R). I report 2 cases of pneumosinus dilatans which developed in frontal and maxillary sinuses and the literature reviewed.
Cheek ; Cosmetics ; Dilatation ; Frontal Sinus ; Humans ; Male ; Maxillary Sinus ; Mucous Membrane ; Paranasal Sinuses

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A Case Report of Lymphoepithelioma-like Carcinoma on the Temple.

Gwang Jin OH ; Nae Ho LEE ; Kyung Moo YANG

Journal of the Korean Cleft Palate-Craniofacial Association.2008;9(1):31-34.

INTRODUCTION: Lymphoepithelioma-like carcinoma of the skin (LELCS) is a rare cutaneous tumor of low grade malignancy and microscopically resembles lymphoepitheliomatous malignancies in the nasopharynx, palatine tonsils, salivary glands and uterine cervix. LELCS presents as scarlet-colored firm nodules or plaques on the face, scalp, or shoulder of middle-aged to elderly individuals. MATERIAL AND METHODS: A 72 year-old female had complained a papule like lesion with intermittent pruritis on the left temple for 2 years. But the lesion was changed to scarlet-colored firm nodule with ulceration. The mass was diagnosed as LELCS on the biopsy. And to confirm that the mass is not metastatic lymphoepithelioma-like carcinoma from other sites or direct tumor extension from the nasopharynx, selective radiographic and laboratory tests were done carefully. RESULTS: Wide excision was performed with general endotracheal anesthesia. The tumor is composed of island of large epithelial cells surrounded by as dense infiltrate of lymphocytes. Immunohistochemical staining with cytokeratin and epithelial membrane antigen(EMA), the tumor cells were positive reaction for stain. And Epstein-Barr virus genome was not detected by in situ hybridization. So, the tumor was confirmed as LELCS. CONCLUSION: LELCS was described by Swanson at 1988, but has not been reported in the field of plastic surgery of Korea. We report a case of primary LELCS that occurred in the left temple with clinical characteristics, histologic features and references.
Aged ; Anesthesia ; Biopsy ; Cervix Uteri ; Epithelial Cells ; Female ; Genome ; Herpesvirus 4, Human ; Humans ; In Situ Hybridization ; Keratins ; Korea ; Lymphocytes ; Membranes ; Nasopharynx ; Palatine Tonsil ; Pruritus ; Salivary Glands ; Scalp ; Shoulder ; Skin ; Surgery, Plastic ; Ulcer

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