• Journal of Gastric Cancer
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• v.11 no.1
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• pp.64-68
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• 2011

A 54 year old man was referred to our hospital with gastric cancer. The patient had a history of splenectomy and a left nephrectomy as a result of a traffic accident 15 years earlier. The endoscopic findings were advanced gastric cancer at the lower body of the stomach. Abdominal ultrasonography (USG) and magnetic resonance imaging demonstrated a metastatic nodule in the S2 segment of the liver. Eventually, the clinical stage was determined to be cT2cN1cM1 and a radical distal gastrectomy, lateral segmentectomy of the liver were performed. The histopathology findings confirmed the diagnosis of intrahepatic splenosis, omental splenosis. Hepatic splenosis is not rare in patients with a history of splenic trauma or splenectomy. Nevertheless, this is the first report describing a patient with gastric cancer and intrahepatic splenosis that was misinterpreted as a liver metastatic nodule. Intra-operative USG guided fine needle aspiration should be considered to avoid unnecessary liver resections in patients with a suspicious hepatic metastasis.

• Journal of Clinical Nutrition
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• v.10 no.2
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• pp.38-44
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• 2018

Purpose: Parenteral nutrition (PN) is known to provide therapeutic beneficial improvements in malnourished patients for whom enteral nutrition is not feasible. The objective of this study was to investigate the current clinical characteristics and utilization of PN in Korea. Methods: We analyzed the Health Insurance Review Agency National Inpatients Sample database from 2014 to 2016, which included 13% of all hospitalized patients in Korea. Adult patients aged 20 years or older and receiving premixed multi-chamber bag containing PN were included for this study. Patient characteristics, admission type, primary diagnosis, and hospital demographics were evaluated. SAS version 9.4 was used for data analysis. Results: From 2014 to 2016, 149,504 patients received premixed PN, with 226,281 PN prescriptions being written. The mean patient age was 65.0 years, and 81,876 patients (54.8%) were male. Premixed 3-chamber bag and 2-chamber bag PN solutions were utilized in 131,808 (88.2%) and 32,033 (21.4%) patients, respectively. The number of patients hospitalized through the emergency department were 70,693 (47.3%), whereas 43,125 patients (28.8%) were administered PN in intensive care units. In the adult PN patients, the highest primary diagnosis was malignant neoplasm of the stomach (8,911, 6.0%), followed by organism unspecified pneumonia (7,008, 4.7%), and gastroenteritis and colitis of unspecified origin (6,381, 4.3%). Overall, 34% of adult PN patients were diagnosed with malignancies, the most common being neoplasm of the stomach (17.7%), neoplasm of bronchus/lung (11.2%), neoplasm of colon (11.1%), and neoplasm of liver/intrahepatic bile ducts (10.0%). PN solutions were most frequently administered in the metropolitan area (55.0%) and in hospitals with more than 1,000 beds (23.6%). Conclusion: PN was commonly administered in older patients, with primary diagnosis of malignancy in a significant number of cases. This study is the first large-scale description of PN-prescribing patterns in real-world clinical practice in South Korea.

• Journal of Chest Surgery
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• v.43 no.1
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• pp.117-119
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• 2010

Choroidal melanoma is the most common primary intraocular cancer in adults. The predominant sites of metastasis that are associated with a poor prognosis are liver, lung and bone. The authors report here on a case of metastatic choroidal melanoma in the rib and bronchus, and this was all treated by surgical resection.

• Advances in pediatric surgery
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• v.11 no.2
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• pp.107-114
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• 2005

Primary liver tumors are uncommon in childhood, with a relative frequency of 3 % of all childhood tumors. Seventy-three cases of pediatric primary liver tumors operated on at single institution between 1986 and 2002 were reviewed. Malignant tumors included 37 cases of hepatoblastoma, 11 hepatocellular carcinomas, 6 undifferentiated (embryonal) sarcomas, and 1 mixed germ-cell tumor. Benign tumors constitute only 24.6 % of liver tumors, including 7 hemangioendotheliomas, 5 mesenchymal hamartomas, 3 congenital cysts, and one each with focal nodular hyperplasia and hemangioma. The common presenting clinical features were abdominal mass or abdominal distension. Anatomical hepatic resections were carried out in 38 cases, and nonanatomical resections in 34 cases. One patient died of a direct result of hepatic resection (1.4 %). The complication rate was 16.4 %.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.26 no.2
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• pp.125-132
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• 2022

Backgrounds/Aims: It is generally accepted that non-anatomical resection (NAR) in colorectal liver metastasis (CRLM) has comparable safety and efficacy compared to anatomical resection (AR); however, there are reports that AR may have better outcomes in KRAS mutated CRLM. This study aimed to determine the effects of KRAS mutations and surgical techniques on survival outcomes in CRLM patients. Methods: Two hundred fifty patients who underwent hepatic resection of CRLM with known KRAS mutational status between 2007 and 2018 were analyzed. A total of 94 KRAS mutated CRLM and 156 KRAS wild-type CRLM were subdivided by surgical approach and compared for short- and long-term outcomes. Results: In both KRAS wild-type and mutated type, there was no difference in estimated blood loss, postoperative complications, and 30-day mortality. There was no difference in disease-free survival (DFS) between AR and NAR in both groups (p = 0.326, p = 0.954, respectively). Finally, there was no difference in intrahepatic DFS between AR and NAR groups in both the KRAS groups (p = 0.165, p = 0.516, respectively). Conclusions: The presence of KRAS mutation may not be a significant factor when deciding the approach in simultaneous resection of CRLM.

• Journal of Yeungnam Medical Science
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• v.29 no.2
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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 Digestive Cancer Research
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• v.3 no.2
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• pp.105-107
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• 2015

Pancreatic cancer is commonly presented with distant metastasis. However metastasis to central nervous system (CNS) of pancreatic cancer was rarely reported. 79-years-old man was hospitalized with sudden onset right arm dysesthesia and weakness. In brain magnetic resonance imaging, multifocal high signal intensity lesions in cerebral and cerebellar cortices were observed. Leptomeningeal and parenchymal enhanced lesions were also noted in contrast-enhanced T1 images suggesting a metastasis from the pancreatic cancer. Stroke like manifestation of CNS metastasis of pancreatic cancer is extremely rare. Careful history taking and evaluation should be performed to find the origin of the sudden neurologic deficit.

• Radiation Oncology Journal
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• v.31 no.4
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• pp.267-272
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• 2013

Although significant advances in the treatment of intrahepatic lesions, it is reported that the prognosis for patients with hepatocellular carcinoma (HCC) who have extrahepatic metastasis remains poor. We report a patient with lung, liver, brain, bone and subcutaneous metastasis from HCC who has survived more than 7 years maintaining relatively good performance status as a result of repeated therapies. A 55-year-old male patient with HCC underwent right lobectomy of the liver and cholecystectomy in September 2006. He received wedge resection for lung metastasis twice (July 2009, January 2011) and Gamma Knife stereotactic radiosurgery for brain metastasis (April 2011). Over the last 3 years, he has developed metastasis in subcutaneous tissues, muscle, and bone with pain. He has undergone 7 courses of radiotherapies for subcutaneous tissues, muscle, and bone metastasis and been prescribed sorafenib and he is still capable of all self-care.

• Journal of Veterinary Clinics
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• v.19 no.4
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• pp.443-446
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• 2002

A primary metastatic malignant plasma cell tumor was presented in a 7-year-old, female, mixed breed dog. The dog was admitted to Veterinary Teaching Hospital at College of Veterinary Medicine, Seoul National University after suffering from depression, anorexia, and dyspnea. The dog was euthanized due to poor prognosis. At necropsy, numerous, firm and tan round nodules, 1 to 2 cm in diameter were noted in the ribs. The nodules formed chain or were occasionally coalescing, causing osteolysis of the ribs. A large amount of clear fluid was present in the thoracic cavity. The spleen and liver were markedly enlarged and congested. Histologically, the nodular masses were diagnosed as plasma cell tumor which was believed to be originated from the rib. Evidence of metastasis was observed in the spleen, liver, and kidney.

• Journal of Physiology & Pathology in Korean Medicine
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• v.29 no.1
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• pp.72-78
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• 2015

This study aims to report a case of rectosigmoid neuroendocrine tumor patient with liver metastasis whose outstanding carcinoid symptom was mucosal diarrhea for more than 10 times a day. Three different herbal decoctions were administered orally for the treatment of diarrhea which was among carcinoid symptoms from diffuse metastatic liver lesion. The herbal decoctions given were modified Lijung-tang, modified Sambaek-tang and modified Jeokseokjiuyeoryang-tang. The administration period was 5, 14 and 9 days respectively. Frequency of patient's mucosal diarrhea had increased consistently during hospitalization. It had almost doubled compared to pre-hospitalization up to 27 times/24 hrs. But during the period of modified Sambaek-tang administration, frequency of diarrhea was maintained between 9 to 15 times/24hrs. There was no difference of liver tumors between Nov 16th 2013 and Dec 9th 2013 in computed tomography images. Three conventional established herbal prescriptions administered in this case didn't show any favorable effect on improving mucosal diarrhea induced by carcinoid symptoms of a rectosigmoid neuroendocrine tumor with liver metastasis. Even if modified Sambaek-tang showed partial effect on frequency of diarrhea, we concluded that it was not sufficient to be a therapeutic method of the diarrhea as carcinoid symptom. Furthermore, it is necessary to conduct additional studies about the diarrhea of neuroendocrine tumor with liver metastasis.