• 대한영상의학회지
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• 제82권4호
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• pp.964-970
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• 2021

이중 담관 기형은 매우 드문 선천 기형의 한 종류이다. 이중 담관 기형과 동반한 담관암의 증례가 보고된 적이 있으나 담관암의 전 침습적 병변인 관내 유두종이 이중 담관 기형과 함께 동반한 증례는 보고된 적이 없다. 우리는 64세 여성에게서 발견된 이중 담관 기형과 동반된 관내 유두종을 보고하고자 한다. 환자는 간 우엽 절제술을 시행하였으며 병리 결과에서 관내 유두종, 이중 담관 기형으로 진단되었다. 이에 대한 증례를 간단한 문헌 고찰과 함께 보고한다.

• Journal of Digestive Cancer Research
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• 제2권2호
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• pp.78-81
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• 2014

담관암은 예후가 불량한 암으로 전암성 병변의 병리, 임상적 특징, 예후 등의 이해가 중요할 것으로 생각된다. 관내 유두상 종양은 드문 질환으로 만성적인 담관의 염증이 동반되어 있는 환자에서 발생 위험이 증가하며 비교적 느리게 성장하고 덜 침습적인 특징이 있으나 악성 전환 가능성이 높은 질병이므로 첫 진단 시 조직학적으로 양성이라 하더라도 적극적인 치료를 고려하도록 권고하고 있다. 이에 질병의 자연경과에 대한 보고는 적어, 저자들은 치료없이 8년간 경과 관찰하여 담관암으로 진행한 담관내 유두상 종양 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• Journal of Yeungnam Medical Science
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• 제29권2호
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• pp.136-140
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• 2012

A 61-year-old male who complained of right upper quadrant pain was referred to the authors for evaluation after his computed tomography suggested biliary adenocarcinoma. The lesion consisted of multiple cysts with papillary mass and peri-ampullay mass. The patient underwent an operation due to a clinical suspicion of biliary cystadenocarcinoma, but the pathology confirmed biliary papillomatosis (BP) after diagnosing intrahepatic papillary neoplasm with high-grade dysplasia and invasive adenocarcinoma with papillary neoplasm from the distal common bile duct to the duodenum. BP is a disease characterized by multiple papillary masses. Its cause has yet to be discovered. It commonly manifests as bile duct dilation but rarely as a ductal cystic change. Under computed tomography or magnetic resonance imaging, both the BP and the cystic neoplasm can show bile duct dilation and a papillary mass, which makes their differential diagnosis difficult. A confirmative diagnosis can be made through a pathologic examination. BP is classified as a benign disease that can become malignant and may recur, though rarely. Its treatment of choice is surgical resection. Laser ablation or photodynamic therapy can be used for unresectable lesions. In the case featured in this paper, biliary papillomatosis was difficult to differentiate from cystic adenocarcinoma due to diffusely scattered multiple large cystic lesions in the liver, and it was histologically confirmed to have become malignant with cystic duct dilation after the operation. This case is reported herein with a literature review.

• Journal of Yeungnam Medical Science
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• 제39권3호
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• pp.250-255
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• 2022

In 2010, the World Health Organization classified mucin-producing bile duct tumors of the liver into two distinct entities; mucinous cystic neoplasm of the liver (MCN-L) and intraductal papillary mucinous neoplasm of the bile duct. We present the case of a patient with MCN-L having a uniquely pedunculated shape. A 32-year-old woman was referred to our institution with a diagnosis of biliary cystic neoplasm. She had undergone left salpingo-oophorectomy for ovarian cancer 15 years ago. Imaging studies showed an 8 cm-sized well defined, multiloculated cystic lesion suggesting a mucinous cystic neoplasm. The cystic mass was pedunculated at the liver capsule and pathologically diagnosed as MCN-L. The mass was resected with partial hepatectomy. The patient recovered uneventfully. She was discharged 7 days postoperatively. The patient has been doing well for 6 months after the operation. The patient will be followed up annually because of the favorable postresection prognosis of MCN-L.

• Journal of Yeungnam Medical Science
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• 제28권2호
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• pp.180-186
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• 2011

Obstruction of the bile duct owing to the direct extension of a tumor is occasionally found in patients with a hepatic neoplasm, but bile duct tumor thrombus caused by the intrabiliary transplantation of a free-floating tumor is a rare complication of hepatocellular carcinoma A 50-year-old woman was diagnosed with HCC with bile duct tumor thrombi. She received transarterial chemoembolization (TACE) because her liver function was not suitable for surgery at the time of diagnosis. After TACE, infected biloma occurred recurrently. Thus, resection of the HCC, including the bile duct tumor thrombi, was performed. Six months after the surgery, recurred HCC in the distal common bile duct as drop metastasis was noted. The patient was treated with tomotherapy and has been alive for three years as of this writing, without recurrence. The prognosis of HCC with bile duct tumor thrombi is considered dismal, but if appropriate procedures are selected and are actively carried out, long-term survival can occasionally be achieved.

• 한국간담췌외과학회지
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• 제27권4호
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• pp.415-422
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• 2023

Backgrounds/Aims: Although cancer survivors are at higher risk of developing second primary malignancies, cancer surveillance strategies for them have not yet been established. This study aimed to identify first primary cancers that had high risks of developing second primary exocrine pancreatic cancer (EPC). Methods: Data on individuals diagnosed with primary cancers between 1993 and 2017 were obtained from the Korea Central Cancer Registry. The standardized incidence ratios (SIRs) of second primary EPCs were analyzed according to the primary tumor sites and follow-up periods. Results: Among the 3,205,840 eligible individuals, 4,836 (0.15%) had second primary EPCs, which accounted for 5.8% of the total EPC patients in Korea. Between 1 and 5 years after the diagnosis of first primary cancers, SIRs of second primary EPCs were increased in patients whose first primary cancers were in the bile duct (males 2.99; females 5.03) in both sexes, and in the small intestine (3.43), gallbladder (3.21), and breast (1.26) in females. Among those who survived 5 or more years after the diagnosis of first primary cancers, SIRs of second primary EPCs were elevated in patients whose first primary cancers were in the bile duct (males 2.61; females 2.33), gallbladder (males 2.29; females 2.22), and kidney (males 1.39; females 1.73) in both sexes, and ovary (1.66) and breast (1.38) in females. Conclusions: Survivors of first primary bile duct, gallbladder, kidney, ovary, and female breast cancer should be closely monitored for the occurrence of second primary EPCs, even after 5 years of follow-up.

• Journal of Korean Neurosurgical Society
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• 제65권1호
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• pp.57-63
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• 2022

Objective : To study the factors relating to operative treatment for spinal metastasis in Thailand during 2005-2014 and to determine the hospital costs, mortality rate, and incidence of perioperative complication. Methods : Inpatient reimbursement data from 2005 to 2014 was reviewed from three national healthcare organizations, including the National Health Security Office, the Social Security Office, and the Comptroller General's Department. The search criteria were secondary malignant neoplasm of bone and bone marrow patients (International Classification of Diseases 10th revision, Thai modification codes [ICD 10-TM], C79.5 and C79.8) who underwent spinal surgical treatment (ICD 9th revision, clinical modification procedure with extension codes [ICD 9-CM], 03.0, 03.4, 03.09, and 81.0) during 2005-2014. Epidemiology, comorbidity, and perioperative complication were analyzed. Results : During the study period, the number of spinal metastasis patients who underwent operative treatment was significantly increased from 0.30 to 0.59 per 100000 (p<0.001). More males (56.14%) underwent surgical treatment for spinal metastasis than females. The most common age group was 45-64 (55.1%). The most common primary tumor sites were the unknown origin, lung, breast, prostate, and hepatocellular/bile duct. Interestingly, the proportion of hepatocellular/bile duct, breast, and lung cancer was significantly increased (p<0.001). The number of patients who had comorbidity or in-hospital complication significantly increased over time (p<0.01); however, the in-hospital mortality rate decreased. Conclusion : During the last decade, operative treatment for spinal metastasis increased in Thailand. The overall in-hospital complication rate increased; however, the in-hospital mortality rate decreased.

• 농업과학연구
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• 제13권2호
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• pp.311-317
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• 1986

식욕부진(食慾不振) 및 복부팽만(腹部膨滿)을 충남대학교(忠南大學校) 농과대학부속가축병원(農科大學部屬家畜病院)에 의뢰(依賴)된 11년(年)된 암컷 잡종견(雜種犬)을 병리조직학적(病理組織學的)으로 관찰(觀察)한 바 담관세포암으로 진단(診斷)하였고 그 결과(結果)는 다음과 같다. 임상적(臨床的) 소견(所見)으로 복부팽만(腹部膨滿), 식욕부진(食慾不振), 호흡곤란(呼吸困難), 및 침울(沈鬱) 등(等)을 관찰(觀察)할 수 있었고, 혈중(血中) GOT, GPT, LDH 및 BUN등(等)은 정상치(正常値)보다 증가(增加)하였으며 총단백량 및 Albumin 은 약간 감소(減少)하였다. 육안적(肉眼的) 소견(所見)으로 간장(肝臟)은 종대, 표면(表面)에는 많은 백색(白色)의 꽃양배추양 결절(結節)이 있었으며 직경(直徑) 3~4cm의 낭형성(囊形成)이 있었다. 낭내(囊內)에는 황백색(黃白色)의 교상물질(膠狀物質)이 차 있었다. 해부학적(解剖學的)으로 본종양을 간내(肝內) 담관암으로 분류(分類)하였다. 조직학적(組織學的)으로 본종양은 관상암과 담관낭종암이 혼합(混合)되어 있었으며 관상암은 관상구조(管狀構造)가 특징(特徵)으로 내피세포(內皮細胞)는 입방형(立方形) 또는 원계형(圓桂形)이며 결합조직(結合組織)의 증식(增殖)을 볼 수 있었다. 그리고 담관낭종암은 단층(單層)및 중층입방형(中層立方形) 또는 국주형세포(國柱形細胞)로 덮혀 있었다.

• Asian Pacific Journal of Cancer Prevention
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• 제13권5호
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• pp.1995-1997
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• 2012

Background: Brain metastasis from cholangiocarcinoma (CCA) is a rare but fatal event. To the best of our knowledge, only few cases have been reported. Herein, we report the incident rate and a first case series of brain metastases from CCA. Methods: Between January 2006 and December 2010 5,164 patients were treated at Srinagarind hospital, Khon Kaen University; of those, 8 patients developed brain metastasis. Here we reviewed clinical data and survival times. Results: The incident rate of brain metastases from CCA was 0.15%. The median age of the patients was 60 years. Tumor subtypes were intrahepatic in 6 and hilar in 2 patients. All suffered from symptoms related to brain metastasis. Three patients were treated with whole-brain radiation therapy (WBRT), one of whom also underwent surgery. The median survival after the diagnosis of brain metastasis was 9.5 weeks (1-28 weeks). The longest survival observed in a patient in RPA class I with two brain lesions and received WBRT. Conclusion: This is a first case series of brain metastases from CCA with the incident rate of 0.15%. It is rare and associated with short survival time.

• 한국간담췌외과학회지
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• 제28권3호
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• pp.364-370
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• 2024

Backgrounds/Aims: We evaluated long-term pancreatic functional outcomes, including pancreatic volumetry after pancreaticoduodenectomy (PD) for peri-ampullary neoplasm. Methods: We retrospectively reviewed 353 patients with a 12-month follow-up who underwent elective pancreaticoduodenectomies for peri-ampullary neoplasms at a single university hospital between January 2011 and December 2020. Perioperative and postoperative outcomes, long-term pancreatic endocrine functions, and pancreatic volume changes 12 month postoperatively were evaluated. Results: The mean age was 65.4 years, and the sex ratio was 1.38. The patients with prediagnosed diabetes mellitus (DM) comprised 31.4%. The peri-ampullary neoplasm origins were: the pancreas (49.0%), common bile duct (27.2%), ampulla of Vater (18.4%), and duodenum (5.4%). The 1-week, and 3-, 6-, and 12-month postoperative proportions of patients with DM diagnosed before surgery combined with new-onset postoperative DM were 39.7%, 42.8%, 43.9%, and 49.6%, respectively. The preoperative and postoperative 1-week, and 3-, 6-, and 12-month mean pancreatic volumes were 82.3, 38.7, 28.1, 24.9, and 25.5 mL, respectively. Univariate risk factor analyses for new-onset DM after PD observed no significant difference between the 'No DM after PD' and 'New-onset DM after PD' groups. Conclusions: Following PD for peri-ampullary neoplasms, pancreatic endocrine functions and volumes continued to decrease for a minimum of 12 months. The current study did not identify any causal relationship between pancreatic endocrine dysfunction and pancreatic atrophy following PD.