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다형성 교모세포종에서 광범위 전적출술후 단기 재발된 치험 1예
박호권,강중식,조준,문창택,장상근,임정애 건국대학교 의과학연구소 2003 건국의과학학술지 Vol.13 No.-
Glioblasty/ma Multiforme(GBM) is the one of the most common malignant tumors in central nervous system(CNS). The incidence of the tumor is about 12% of all CNS tumors and about 50% of all intracranial tumors. Though the development of the microsurgical technique, radiosurgical technique, and chemotherapy works effectively, complete cure of the GBM has not been achieved. It has been known that the prognosis of GBM depends on the extent of surgical tumor removal, remained tumor volume, radiation dose, and chemotherapy. Not only patient's age but also tumor characteristics such as MRI enhancement, angiogenesis and necrosis are also very important prognostic factors. Authors experienced very aggressive GBM in aged woman, who received gross total tumor removal, but refused other therapeutic motalities postoperatively. Very rapid recurrence of GBM and global cerebral edema in aged woman should be considered fatal. This case demonstrates the effectiveness of aggressive removal and the limited usefulness of neurosurgical tools in GBM recurrence. Authors would suggest that the early diagnostic effort and the verified neurosurgical therapy for malignant tumor are still strongly requested to make better prognosis.
이주용,조준,박호권,장상근,문창택,한혜승,이경룡 건국대학교 의과학연구소 2004 건국의과학학술지 Vol.14 No.-
The authors in this manuscript aimed to provide a practical importance of the differential diagnosis of intracranial brain tumor with emphasis on non-neoplastic abnormalities such as cytotoxic edema of the penumbra zone in strokes. The well known SOLs are cerebral ischemic, inflammatory and dysplastic lesions, which intraaxially imitate glioma and other neurogenic tumors. Brain tumor is the one of common intracranial space-occupying lesions (SOLs) on the diagnostic images. However, many non-neoplastic lesions may be indistinguishable from tumors. Especially, early mortality used to be caused by space-occupying hyperacute ischemic stroke, brain edema and herniations. For the retrospective analysis, the authors reviewed the patient charts, the emergency brain Computerized Tomography (CT), magnetic resonance imaging (MRI), clinical stroke history. From Jan. 2003 to Dec. 2003, we managed total 61 acute strokes in ICU. Even though we operated six decompressive craniotomies, nine stereotactic craniotomies including two procedures of brain biopsy and three extraventricular drainage procedures, three patients (4.91%) were finally expired out from the induced herniation and medullary failure by those aggressive strokes. 43 patients (70.5%) were recovered good from stroke attack. 15 patients (24.6%) were improved with residual neurologic deficits. In conclusion, aside from growing efforts of the radiologist to make the early diagnostic impression, the authors suggest that urgent neurosurgical explorations with the pathologic diagnostic decision should be requested to decrease the fatality.
원발성 중추신경계 림프종의 과거력을 가진 환자에서의 후각신경모세포종
이주용(Joo-Yong Lee),고영초(Young-Cho Koh),조준(Joon Cho),최우진(Woo Jin Choe),임소덕(So-Dug Lim),박호권(Ho-Kwon Park),김진국(Jin-Kook Kim) 대한두개저학회 2006 대한두개저학회지 Vol.1 No.1
Olfactory neuroblastoma is a rare malignant tumor arising from the olfactory neuroepithelium. A 48-year-old male patient with a prior medical history of primary Central Nervous System (CNS) lymphoma presented with severe epistaxis of sudden onset. Radiologic study revealed a left ethmoidal tumor. A biopsy done at a local ENT clinic revealed a highly malignant tumor. Minimally invasive craniofacial resection was undergone for this malignant tumor with anterior skull base invasion. Pathology confirmed the diagnosis of olfactory neuroblastoma with no evidence of primary CNS lymphoma. We report a case of olfactory neuroblastoma in a patient with a history of primary CNS lymphoma.