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S Hsueh

Publications and source records attributed to S Hsueh.

At least 73 records · Page 4Linked to original sources
PubMed1996

Recurrent spinal stenosis caused by tophaceous gout: a case report and review of literature.

A 57-year-old man with severe gouty arthritis for over 20 years was admitted because of persistent back and leg pain and neurogenic claudication. Lumbar spinal stenosis from the L4 to L5 level was diagnosed after admission and decompressive laminectomy was done. However, about 10 months later, another surgery with laminectomy of L2 and L3 and postero-lateral fusion was performed due to post-laminectomy instability with recurrence of stenosis. The pathology of the resected ligmentum flava had tophi deposition. At the one-year follow-up examination after the second operation, the patient was pain free and had resumed daily activity.

Arthritis, Gouty↗
PubMed1996

Treatment of giant cell tumor of long bone.

From 1981 to 1991, sixty-eight patients with giant cell tumors of their long bones were treated and followed-up at Chang Gung Memorial Hospital. Thirty-three males and thirty-five females between the ages of 14 and 76 (average, 32 years) were followed for an average duration of 3.5 years (range, 2.5 years to 7.3 years). Forty-five primary lesions and 23 cases of recurrent lesions were diagnosed. Seventeen patients were classified as grade II while 51, as grade III. Surgical procedures included intralesional curettage and wide resection. The local recurrent rate following surgery was 13% (9/68). The overall outcome was 85% (58/68) good or excellent results. Complications included one superficial infection, 9 local recurrences and 3 fractures of fixation devices. In addition, one patient with a lung metastasis was noted. In the primary lesion group, there were 9 grade II and 10 grade III lesions treated by curettage and grafting. Of these 4 grade II and 5 grade III patients had local recurrences. The recurrent rate was 47% (9/19) following intralesional curettage with cancellous bone graft (8/16) or bone cement (1/3). The average period before local recurrence was 10.4 months. Seven of the 9 recurrent patients received radical resections and allograft reconstruction with good results at short-term follow-up. The other two patients were lost in follow-up. The cases in the curettage group had shown low recurrent rate (1/10) after 1989 and high recurrent rate (8/9) before 1989 (p < 0.001). The most important factor for local recurrence appeared to be inadequate curettage with similar recurrence rates regardless of the type of bone graft used. A careful approach to the surgical margin including use of a dental burr and local adjuvant treatment with phenol, the rate of local recurrence may be decreased. There were no recurrences in the wide resection group. Although radical resection yield a best chance for cure, the sacrifice of the joint with subsequent arthroplasty resulted a compromise of the joint function.

Adolescent↗
PubMed1996

Malakoplakia of urinary tract: report of two cases with emphasizing the histologic spectrum and the morphogenesis of Michaelis-Gutmann bodies.

Two cases of urinary tract malakoplakia, one in right kidney and the other one in urinary bladder, were reported. Both cases affected middle-aged female patients with long-term urinary tract infection. Their clinical presentation simulated a neoplasm. The diagnosis entirely depended on pathologic examination. The former case also extensively involved the retroperitoneum, liver and duodenum. The latter case was unusually associated with Pseudomonas infection. Electron microscopy showed that the morphogenesis of Michaelis-Gutmann bodies occurred within the phagolysosomes. Initially, small myelin-like figures-containing phagolysosomes were undergoing to fuse to form a large one. Then, the membranous fragments and myelin-like figures served as nucleation sites. The nucleation sites could be multiple in the same phagolysosome. Needle shaped crystalline material began to deposit by unknown mechanism. Finally, mature Michaelis-Gutmann bodies were well formed. But no bacteria were identified. The two cases were successfully managed with surgical resection then sulfamethoxazole-trimethoprim treatment. Finally, it was emphasized that frozen section of tumor biopsy avoided unnecessary radical surgery in the latter case.

Female↗
PubMed1996

Tumor-associated hypereosinophilia: report of four cases.

Hypereosinophilia is a rare manifestation of cancer. We reported four cases of tumor-associated hypereosinophilia. These cases presented with peripheral hypereosinophilia and disseminated metastatic malignancies. All cases were male, including two cases with cancer of unknown primary site, one with hepatocellular carcinoma, and one with a liver tumor. The age ranged from 27 to 55 years. They all had liver involvement. Two cases had bone marrow metastases. The leukocyte counts ranged from 78,600/microliters to 190,000/microliters. The percentage of eosinophils ranged from 20% to 77%. The eosinophil counts ranged from 15,720 to 126,350/microliters with a mean of 74,700/microliters. The first three cases died within 8 days after the malignancies were pathologically confirmed. We suggest that peripheral hypereosinophilia is a poor prognostic sign which is frequently associated with disseminated cancer.

Adult↗
PubMed1995

Malignant mixed müllerian tumor of the uterine corpus--analysis of 12 cases.

Clinical and histopathological features of 12 patients with malignant mixed müllerian tumor of the uterine corpus presenting to Chang Gung Memorial Hospital from January 1988 to September 1993 were retrospectively investigated. The age distribution ranged from 43 to 76 years with a median of 56, and post-menopausal bleeding was the most common symptom in these patients. There was 60% (6/10) of discrepancy in histologic diagnosis between the specimens of dilatation and curettage and that of hysterectomy. All patients received total hysterectomy and bilateral salpingo-oophorectomy, and 10 with retroperitoneal lymph node dissection. Nine patients received cisplatin based chemotherapy, one received radiation only, one received sequential chemotherapy and irradiation, and one underwent concurrent chemoradiation as adjuvant. Two-year survival in patients with stage I-II was 70% (95% C.I.: 34%, 100%) and that of stage III, 25% (95% C.I.: 0.67%). There was 42% (5 of 12) progression/recurrence rate, all developed within 2 years. An effective adjuvant chemotherapy after comprehensive surgery including a total abdominal hysterectomy, bilateral salpingo-oophorectomy and lymph node dissection may be needed for a satisfactory improvement in the patients' survival.

Adult↗
PubMed1995

Osteosarcoma of jaw: the experience of Chang Gung Memorial Hospital.

Seven cases with Osteosarcoma (OS) of the jaw were retrospectively reviewed. There were five female and two male patients. Their ages ranged from 14 to 57 years with a mean of 39 years. Seventy-one percent of the patients were older than 30 years old. Jaw swellings were the most frequent complaints occurring on an average of 3 months before diagnosis. Four cases occurred in mandible and three cases developed from maxilla. Most cases were lytic lesions on roentgenography. Four were osteoblastic, 2 were chondroblastic, and 1 was histologic classification. Six of the 7 cases received surgery. Postoperatively, 3 of them received both radiotherapy and chemotherapy, 1 received chemotherapy only and 1 received radiotherapy only. One case received palliative chemotherapy only because of the locally far advanced disease. Four cases died of regional failure without any metastatic lesions (survival ranged from 5 months to 22 months). Two cases survived more than 4 years without any recurrence. The median survival time was 22 months. We concluded that OS of the jaw has different natural courses from OS of the long bones and the regional failure seems to be the main problem in jaw OS.

Adolescent↗
PubMed1994

Renal malacoplakia with secondary hepato-duodenal involvement.

Renal parenchymal malacoplakia is uncommon, and coexistence of extensive invasion into the liver and duodenum is extremely rare. Typically, there is an associated long-term urinary tract infection. We report on a 53-year-old woman with a history of diabetes and recurring pyelonephritis, who presented with a renal tumor and upper gastrointestinal bleeding. Surgical intervention included radical nephrectomy, lymphadenectomy, segmental hepatectomy, cholecystostomy, duodenorrhaphy, jejunostomy and appendectomy. There was no surgical morbidity. A pathologist confirmed the diagnosis of malacoplakia. All of the diagnostic criteria, including hematoxylin and eosin stain, iron stain, calcium stain and electron microscopy of Michaelis-Gutmann bodies, were classic. The literature is reviewed.

Duodenal Diseases↗
PubMed1994

Elevated serum CA-125 in tuberculous peritonitis: report of a case.

A 37-year-old female presented with a 2-month history of abdominal distention. Omentum masses with massive ascites were found and ovarian cancer with peritoneal carcinomatosis was suspected. Her serum CA-125 level was over 500 U/ml before therapy. Tuberculous peritonitis was diagnosed via peritoneal biopsy. The serum CA-125 level returned to normal after antituberculous therapy. Elevated serum CA-125 does not always indicate ovarian malignancy. This tumor marker may be used to monitor the disease activity in non-neoplastic ascitic states.

Adult↗
PubMed1994

Treatment of malignant germ cell tumors of the ovary.

Thirty-five patients with ovarian germ cell malignancies presenting from 1982 to 1992 were studied. The pathologic diagnoses were immature teratoma in 11 patients, endodermal sinus tumor in eight, dysgerminoma in 12, and mixed germ cell tumor in four. The median age at presentation was 20 years. Postoperative multiple-agent chemotherapy was given to 28 patients. Five out of 35 (14%) patients died of malignancy, three with endodermal sinus tumors with stage Ia, Ic, and IIIc, respectively, one with stage IIIc dysgerminoma, and one with stage IIIc mixed germ cell tumor. The other 30 patients were alive without evidence of disease from 14 to 124 months, with a median follow-up of 52 months. All eleven patients with immature teratoma were alive with no evidence of disease at 20 to 104 months of follow-up. Four patients with stage I, grade 1 immature teratoma were successfully treated with surgery alone. The other seven patients were treated with adjuvant chemotherapy and were disease-free. One patient with stage IIIc dysgerminoma was treated with surgery and radiotherapy but died of disease. The other eleven patients were safely treated with surgery and adjuvant chemotherapy with vincristine, actinomycin-D and cyclophosphamide (VAC) or platinum-based chemotherapy. For the more virulent tumors such as endodermal sinus tumor and mixed germ cell tumor, platinum-based chemotherapy should be used exclusively in view of the high failure rate of the VAC regimen. Preservation of fertility for young patients with malignant ovarian germ cell tumors is possible in the early stages of disease and in selected cases of advanced disease.

Adolescent↗
PubMed1994

Small cell carcinoma of the uterine cervix with neurosecretory granules associated with pregnancy. A case report.

An extremely rare case is reported of small cell carcinoma of the cervix with a fulminating course complicating pregnancy. The primary lesion was first noted in the 27-year old patient at 36 weeks of gestation. Cesarean section followed by radical hysterectomy with bilateral pelvic lymph node dissection was performed. Brain and breast metastases occurred two months after primary surgery, while adjuvant radiotherapy to the pelvis was ongoing. The patient died suddenly of massive tumor emboli in the brain. The microscopic and ultrastructural findings, immunohistochemical studies and flow cytometric analysis are presented.

Adult↗
PubMed1994

Hematogenous osteomyelitis with inflammatory cyst formation mimicking a soft-tissue tumor.

Reported is a case of hematogenous osteomyelitis of the femur with inflammatory cyst formation mimicking a soft-tissue tumor. A 15-year-old boy with a three-year history of a gradually enlarging soft-tissue mass of his left thigh was found to have an aborted acute hematogenous osteomyelitis complicated by an inflammatory cyst that was probably caused by inadequate antibiotic therapy. The osteomyelitis and its inflammatory cyst were treated with excisional debridement and six weeks of antibiotic therapy. The patient remains well five years later, with no clinical or radiologic evidence of recurrence. This is a new variant of chronic osteomyelitis that has not previously been reported.

Adolescent↗
PubMed1994

Alveolar soft part sarcoma of the vagina. A case report.

We present a case of alveolar soft part sarcoma of the vagina in an 18-year-old woman. The presenting symptoms were menometrorrhagia and a painless vaginal mass. The tumor was in the vaginal stroma with intact mucosa. Periodic acid-Schiff stain showed positive diastase-resistant crystals in some of the tumor cells. Electron microscopy demonstrated characteristic intracytoplasmic crystals. Formaldehyde-induced fluorescence stain showed no catecholamines, and Grimelius stain showed no argyrophilic granules. Black pigment was found within some tumor cells; it proved to be melanin pigment by Masson-Fontana stain. The tumor mass recurred four months after local excision. Following the second surgical removal, the patient received adjuvant radiotherapy to the whole pelvis, including the vagina. At this writing she was currently alive, without evidence of recurrence, five years after the primary diagnosis.

Adolescent↗
PubMed1993

The uses and limitations of DNA flow cytometry in stage IB or II cervical carcinoma.

BACKGROUND: The role of flow cytometry in predicting prognosis for cervical carcinoma remains unclear. METHODS: Flow cytometric analysis was performed on tissues, fixed in formaldehyde solution and embedded in paraffin, from 411 patients with Stage IB or II cervical carcinoma who had been treated with radical abdominal hysterectomy and bilateral pelvic lymphadenectomy. RESULTS: DNA aneuploid-multiploid tumors were found in 37.5%, tetraploid in 4.6%, and diploid-peridiploid in 57.9%. Five-year recurrence-free survival rates of the three groups were 74.3%, 77.8%, and 76.4%, respectively (P > 0.05). DNA aneuploidy and DNA index (DI) of greater than 1.3 were highly correlated to parametria extension. In univariate analysis, pelvic lymph node metastases, stage, parametrial extension, depth of cervical stromal invasion, tumor size, and DI (1.3, 1.4, 1.5 as breakpoint) were significant prognostic factors. DNA ploidy, S-phase fraction, and S-G2M fraction were not significant. In multivariate analysis, DI of greater than 1.3, pelvic node metastases, clinical Stage II, and depth of stromal invasion greater than two-thirds of full cervical thickness were independent and significant variables. The prognostic index (PI), defined by the model, was able to categorize the patients into three distinct risk groups. The 5-year recurrence free survival rates of the low-, intermediate-, and high-risk groups were 89.5%, 73.0%, and 58.9%, respectively (P < 0.0001). CONCLUSIONS: The prognostic value of the DI as a single variable is promising and warrants additional investigation to establish its appropriate use.

Adult↗