• Journal of the Korean Orthopaedic Association
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• v.54 no.3
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• pp.276-280
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• 2019

Hepatocellular carcinoma is one of the most common cancers worldwide. Extrahepatic metastasis commonly occur in the lung, lymph, nodes, bone, and adrenal glands. On the other hand, a metastasis of hepatocellular carcinoma to the skeletal muscle is rare. A 42-year-old woman presented for evaluation of a palpable mass with tenderness in her right thigh area. She has been diagnosed with hepatocellular carcinoma and pulmonary metastasis seven years ago and has received treatment. We performed incisional biopsy with suspicion of hepatocellular carcinoma metastasis from imaging studies and blood test results. The patient was finally diagnosed with metastasis of hepatocellular carcinoma in the semimembranosus muscle and treated by extensive resection. We report this case with a review of the relevant literature.

• Radiation Oncology Journal
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• v.27 no.4
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• pp.210-217
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• 2009

Purpose: To assess the influence of cyclooxygenase-2 (COX-2) expression on the survival of patients with a combination of rectal cancer and lymph node metastasis. Materials and Methods: The study included rectal cancer patients treated by radical surgery and postoperative radiotherapy at the Dong-A university hospital from 1998 to 2004. A retrospective analysis was performed on a subset of patients that also had lymph node metastasis. After excluding eight of 86 patients, due to missing tissue samples in three, malignant melanoma in one, treatment of gastric cancer around one year before diagnosis in one, detection of lung cancer after one year of diagnosis in one, liver metastasis in one, and refusal of radiotherapy after 720 cGy in one, 78 patients were analyzed. The immunohistochemistry for COX-2 was conducted with an autostainer (BenchMark; Ventana, Tucson, AZ, USA). An image analyzer (TissueMine; Bioimagene, Cupertino, CA, USA) was used for analysis after scanning (ScanScope; Aperio, Vista, CA, USA). A survival analysis was performed using the Kaplan Meier method and significance was evaluated using the log rank test. Results: COX-2 was stained positively in 62 patients (79.5%) and negatively in 16 (20.5%). A total of 6 (7.7%), 15 (19.2%), and 41 (52.6%) patients were of grades 1, 2, and 3, respectively for COX-2 expression. No correlation was found between being positive of COX-2 patient characteristics, which include age (<60-year old vs. $\geq$60), sex, operation methods (abdominoperineal resection vs. lower anterior resection), degrees of differentiation, tumor size (<5 cm vs. $\geq$5 cm), T stages, N stages, and stages (IIIa, IIIb, IIIc). The 5-year overall and 5-year disease free survival rates for the entire patient population were 57.0% and 51.6%, respectively. The 5-year overall survival rates for the COX-2 positive and negative patients were 53.0% and 72.9%, respectively (p=0.146). Further, the 5-year disease free survival rates for the COX-2 positive and negative patients were 46.3% and 72.7%, respectively (p=0.118). The 5-year overall survival rates were significantly different (p<0.05) for the degree of differentiation, N stage, and stage, whereas the 5-year disease free survival rates were significant for N stage and stage. Conclusion: Being positive for and the degree of COX-2 expression did not have a significant influence on the survival of rectal cancer patients with lymph node metastasis. However, N stage and stage did significantly influence the rateof survival. Further analysis of a greater sample size is necessary for the verification of the effect of COX-2 expression on the survival of rectal cancer patients with lymph node involvement.

• Journal of Digestive Cancer Research
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• v.3 no.2
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• pp.108-112
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• 2015

A 54-year-old male patient who was diagnosed with advanced gastric cancer underwent a distal gastrectomy, D2 lymph node dissection, and adjuvant chemoradiotherapy. After a year, in a follow-up PET-CT, lymph node metastases were observed in the neck and abdomen, and therefore, the patient underwent chemotherapy. After treatment, the follow-up PET-CT revealed a growth of the posterior neck lymph node. Thus, an excisional biopsy was performed, and the growth was diagnosed as metastatic adenocarcinoma. Therefore, the patient received chemotherapy with FOLFIRI. Another follow-up PET-CT after chemotherapy revealed a growth in the right inguinal lymph node, and the patient underwent salvage radiotherapy for this lesion. The PET-CT taken for the response evaluation showed no evidence of further metastasis of the lymph node. We hereby report a case of advanced gastric cancer with neck and inguinal lymph node recurrence showing complete remission after palliative chemotherapy and salvage radiotherapy.

• Journal of the Korean Society of Radiology
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• v.82 no.4
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• pp.914-922
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• 2021

Purpose To investigate the efficacy and safety of radiofrequency ablation (RFA) for papillary thyroid microcarcinoma (PTMC) after > 10 years of follow-up. Materials and Methods This study included five patients who underwent RFA to treat PTMCs (five lesions, mean diameter 0.5 cm, range 0.4-0.7 cm) between November 2006 and December 2009. The inclusion criteria were histopathologically confirmed PTMCs, a single PTMC lesion without extrathyroidal extension, no metastasis, and ineligibility or refusal to undergo surgery. RFA was performed by a single radiologist using a radiofrequency generator and an internally cooled electrode. We retrospectively analyzed the procedure-induced complications, serial changes in ablated tumors, recurrence, and local as well as lymph node metastasis based on data obtained from medical records and radiological images. Results The mean follow-up period was 130.6 months (range 121-159 months). Three patients underwent a single RFA session, and two patients underwent two RFA sessions. We observed no procedure-induced complications. Three tumors completely disappeared after ablation, and ablation of the other two tumors resulted in the formation of a small scar that showed long-term stability (mean duration 16.8 months, range 12-27 months). At the last follow-up, no patient showed recurrence or lymph node metastasis, and serum thyroglobulin levels were within normal limits in all patients. Conclusion RFA may be effective and safe to treat low-risk PTMC in patients who refuse or are ineligible for surgery.

• 대한핵의학회:학술대회논문집
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• 1999.11a
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• pp.19.2-19.2
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• 1999

• The Korean Journal of Nuclear Medicine Technology
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• v.14 no.2
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• pp.133-137
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• 2010

Purpose: Breast cancer is known to be more vulnerable to bone metastasis and lymph node metastasis than other types of cancer, and nuclear examinations whole body bone scan and lymphoscintigraphy are performed commonly before and after breast cancer operation. In case whole body bone scan is performed on the day before lymphoscintigraphy, the radiopharmaceutical taken into and remaining in the bones provides anatomical information for tracking and locating sentinel lymph nodes. Thus, this study purposed to examine how much bone density affects in locating sentinel lymph nodes. Materials and Methods: The subjects of this study were 22 patients (average age $52{\pm}7.2$) who had whole body bone scan and lymphoscintigraphy over two days in our hospital during the period from January to December, 2009. In the blind test, 22 patients (average age $57{\pm}6.5$) who had lymphoscintigraphy using $^{57}Co$ flood phantom were used as a control group. In quantitative analysis, the relative ratio of the background to sentinel lymph nodes was measured by drawing ROIs on sentinel lymph nodes and the background, and in gross examination, each of a nuclear physician and a radiological technologist with five years' or longer field experience examined images through blind test in a five-point scale. Results: In the results of quantitative analysis, the relative ratio of the background to sentinel lymph nodes was 14.2:1 maximum and 8.5:1 ($SD{\pm}3.48$) on the average on the front, and 14.7:1 maximum and 8.5:1 ($SD{\pm}3.42$) on the average on the side. In the results of gross examination, when $^{57}Co$ flood phantom images were compared with images containing bones, the score was relative high as 3.86 ($SD{\pm}0.35$) point for $^{57}Co$ flood phantom images and 4.09 ($SD{\pm}0.42$) for bone images. Conclusion: When whole body bone scan was performed on the day before lymphoscintigraphy, the ratio of the background to sentinel lymph nodes was over 10:1, so there was no problem in locating lymph nodes. In addition, we expect to reduce examination procedures and improve the quality of images by indicating the location of sentinel lymph nodes using bone images as body contour without the use of a source.

• Nuclear Medicine and Molecular Imaging
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• v.42 no.1
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• pp.29-38
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• 2008

Purpose: The aim of this study was to investigate the feasibility of 3 ' -[F-18]fluoro-3 ' -deoxythymidine positron emission tomography(FLT-PET) for the detection of locally advanced breast cancer and to compare the degree of FLT and 2' -deoxy-2 ' -[F-18]fluoro-d-glucose(FDG) uptake in primary tumor, lymph nodes and other normal organs. Material & Methods: The study subjects consisted of 22 female patients (mean age; $42{\pm}6$ years) with biopsy-confirmed infiltrating ductal carcinoma between Aug 2005 and Nov 2006. We performed conventional imaging workup, FDG-PET and FLT PET/CT. Average tumor size measured by MRI was $7.2{\pm}3.4$ cm. With visual analysis, Tumor and Lymph node uptakes of FLT and FDG were determined by calculation of standardized uptake value (SUV) and tumor to background (TB) ratio. We compared FLT tumor uptake with FDG tumor uptake. We also investigated the correlation between FLT tumor uptake and FDG tumor uptake and the concordant rate with lymph node uptakes of FLT and FDG. FLT and FDG uptakes of bone marrow and liver were measured to compare the biodistribution of each other. Results: All tumor lesions were visually detected in both FLT-PET and FDG-PET. There was no significant correlation between maximal tumor size by MRI and SUVmax of FLT-PET or FDG-PET (p>0.05). SUVmax and $$SUV_{75} (average SUV within volume of interest using 75% isocontour) of FLT-PET were significantly lower than those of FDG-PET in primary tumor (SUVmax; $6.3{\pm}5.2\;vs\;8.3{\pm}4.9$, p=0.02 /$SUV_{75};\;5.3{\pm}4.3\;vs\;6.9{\pm}4.2$, p=0.02). There is significant moderate correlation between uptake of FLT and FDG in primary tumor (SUVmax; rho=0.450, p=0.04 / SUV75; rho=0.472, p=0.03). But, TB ratio of FLT-PET was higher than that of FDG-PET($11.7{\pm}7.7\;vs\;6.3{\pm}3.8$, p=0.001). The concordant rate between FLT and FDG uptake of lymph node was reasonably good (33/34). The FLT SUVs of liver and bone marrow were $4.2{\pm}1.2\;and\;8.3{\pm}4.9$. The FDG SUVs of liver and bone marrow were $1.8{\pm}0.4\;and\;1.6{\pm}0.4$. Conclusion: The uptakes of FLT were lower than those of FDG, but all patients of this study revealed good FLT uptakes of tumor and lymph node. Because FLT-PET revealed high TB ratio and concordant rate with lymph node uptakes of FDG-PET, FLT-PET could be a useful diagnostic tool in locally advanced breast cancer. But, physiological uptake and individual variation of FLT in bone marrow and liver will limit the diagnosis of bone and liver metastases.

• The Journal of the Korean bone and joint tumor society
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• v.11 no.1
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• pp.94-99
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• 2005

Paraganglioma is a neoplasm consisting of sympathetic neuroendocrine cells, which arise from neural ectoderm of extra-adrenal paraganglia. It often occurs in thyroid, carotid body, mediastinum, lung, duodenum, the retroperitoneal area and periaortic area. Malignant paraganglioma is defined not by the histological diagnosis, but by spread to regional lymph nodes or distant metastasis. Rare bone metastasis mostly occurs in the base of skull or spine, and even it rarely metastasizes to pelvis or femur. We would like to report two cases of paraganglioma; one in the subcutaneous fat layer that was mistaken for a vascular tumor, and the other in the retroperitoneal space with early bone metastasis.

• Journal of Veterinary Clinics
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• v.31 no.3
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• pp.226-232
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• 2014

An 8-month-old domestic shorthair cat presented with decreased activity and anorexia. Diagnostic imaging revealed cranial mediastinal mass and enlarged mesenteric lymph nodes. Fine needle aspirates showed a marked increase in malignant lymphocytes. Multicentric lymphoma (stage V-b) was diagnosed. The cat treated with COP protocol chemotherapy, and complete remission was induced. CNS relapse developed 314 days after the initiation of chemotherapy. Treatment with rescue protocol greatly reduced the clinical signs for a short period. The cat was in partial remission for 33 days and overall survival time was 383 days. Multicentric T-cell lymphoma with brain involvement was confirmed after necropsy by histopathology and immunohistochemistry.

• Korean Journal of Head & Neck Oncology
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• v.32 no.2
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• pp.15-18
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• 2016

Pleomorphic adenoma is the most common benign neoplasm of salivary glands. Pleomorphic adenoma can metastasis without malignant transformation. Metastasizing pleomorphic adenoma is equal to pleomorphic adenoma histologically yet metastasis to distant sites. Most Metastasizing pleomorphic adenoma are diagnosed many years following the initial treatment. 45-year-old man was found to have an asymptomatic right submandibular mass. A right submandibular gland excision and selective neck dissection was performed and pathology confirmed metastasizing pleomorphic adenoma. We report this case with a brief literature review.