Background: Using the Latissimus dorsi (LD) muscle flap is one of the popular surgical technique for breast reconstruction. However, usually, long postoperative scar was remained on donor site which does not have disease. The authors applied the endoscopy-assisted surgery to harvest the LD muscle flap for breast reconstruction. Methods: From July 2018 to July 2019, five consecutive patients with breast cancer underwent partial mastectomy with endoscopy-assisted LD muscle flap reconstruction. The clinic-pathologic factors were analyzed and the cosmetic outcomes were assessed with breast shape, scarring of breast and back. A 4-6 cm of lateral incision (donor site scar) was designed and LD muscle was harvested under endoscopic surgery without gas inflation. And the harvested LD muscle was inserted for partial breast reconstruction after the cancer surgery was done. Results: Mean operative time was 116.4 min (range, 92-134) and there was no major postoperative complication. The satisfactory degree of cosmetic outcomes were shown better in patient's survey than that of surgeon's. Conclusions: The endoscopy-assisted LD muscle flap harvesting would be useful technique to eliminate a large donor site incision in partial breast reconstruction.
ObjectiveTo demonstrate a variety of MR imaging findings of orbital inflammatory pseudotumors with extraorbital extension.Materials and MethodsWe retrospectively reviewed the MR features of five patients, who were diagnosed clinically and radiologically as having an orbital inflammatory pseudotumor with extraorbital extension.ResultsThe types of orbital pseudotumors were a mass in the orbital apex (n = 3), diffuse form (n = 2), and myositis (n = 1). The extraorbital extension of the orbital pseudotumor passed through the superior orbital fissure in all cases, through the inferior orbital fissure in two cases, and through the optic canal in one case. The orbital lesions extended into the following areas: the cavernous sinus (n = 4), the middle cranial fossa (n = 4), Meckel's cave (n = 2), the petrous apex (n = 2), the clivus (n = 2), the pterygopalatine fossa and infratemporal fossa (n = 2), the foramen rotundum (n = 1), the paranasal sinus (n = 1), and the infraorbital foramen (n = 1). On MR imaging, the lesions appeared as an isosignal intensity with gray matter on the T1-weighted images, as a low signal intensity on the T2-weighted images and showed a marked enhancement on the post-gadolinium-diethylene triamine pentaacetic acid (post-Gd-DTPA) T1-sequences. The symptoms of all of the patients improved when they were given high doses of steroids. Three of the five patients experienced a recurrence.ConclusionMR imaging is useful for demonstrating the presence of a variety of extraorbital extensions of orbital inflammatory pseudotumors.
Background: The coronavirus disease 2019 (COVID-19) outbreak in South Korea has affected the diagnosis, treatment, and follow-up protocols of various cancers. This study investigated the patterns of delaying surgery for breast cancer during the COVID-19 outbreak in South Korea and evaluated factors that may have affected the decision to delay surgery. Methods: From February 18 to April 18, 2020, which was the critical period for COVID-19 in South Korea, patients with breast cancer who were scheduled for surgery were evaluated in terms of their decision in delaying the procedure. The patients were divided into two groups: delaying and non-delaying surgery groups. The association between personal and clinicopathological factors and delaying surgery was evaluated. Results: In patients belonging to the delaying surgery group, the mean delay period was 15.9 (standard deviation [SD], ±10.9) days. Patients in the non-delaying surgery group were relatively younger ( p = 0.003), single ( p = 0.038), had planned mastectomy ( p = 0.041), received needle biopsy for diagnosis ( p = 0.021), and had a higher clinical N stage ( p = 0.049) and multifocal lesions of breast cancer ( p = 0.020). However, there were no significant differences in terms of the pathological T and N stages between the two groups. Conclusion: During the COVID-19 outbreak, there was no occurrence of nosocomial infection in the non-delaying surgery group and no statistical difference in pathological stage between the delaying and non-delaying surgery groups. Although patients in the delaying surgery group tended to be relatively older and married and had planned small-scale surgery with a good prognosis of breast cancer, the prognosis did not appear to have changed whether delaying or proceeding with surgery for breast cancer during the COVID-19 outbreak.
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