• Asian Pacific Journal of Cancer Prevention
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• 제13권12호
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• pp.6087-6091
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• 2012

Context: Patients diagnosed with a cancer have a life time risk of developing another de novo malignancy depending on various inherited, environmental and iatrogenic risk factors. Of late the detection of new primary has increased mainly due to refinement in both diagnostic and treatment modalities. Cancer victims are surviving longer and thus are more likely to develop a new metachronous malignancy. Aims: To report our observed trend of increase in prevalence of both synchronous and metachronous second malignant neoplasms among cancer victims and to review the relevant literature. Settings and Design: A hospital based retrospective collection of prospective data of patients diagnosed with second denovo malignancy. Materials and Method: The study was conducted over a 5 year period from July 2008 to June 2012. All patients diagnosed with a histologically proven second malignancy as per Warren Gate's criteria were included. Various details regarding sex, age at presentation, synchronous or metachronous, treatment and outcome were recorded. Conclusions: The occurrence of multiple primary malignancies is not rare. Awareness of the possibility alerts the clinician in evaluation of patients with a known malignancy presenting with unusual sites of metastasis. Individualizing the treatment according to the stages of the primaries will result in durable cancer control particularly in synchronous double malignancy.

• 한국간담췌외과학회지
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• 제28권1호
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• pp.53-58
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• 2024

Backgrounds/Aims: Double duct sign (DDS) (dilated common bile and pancreatic duct) is synonymous with pancreatic head/peri-ampullary tumor (PHPAT). There is limited evidence on whether incidental DDS (I-DDS) is associated with an increased risk of malignancy. This study aimed to evaluate 5-year outcomes of I-DDS. Methods: Patients were categorized according to their risk of malignancy. 'Low-risk' patients, including those with I-DDS between 2010 and 2015, were analyzed in this study. The primary outcome was incidence of PHPAT within five years of identification of DDS. Histology results from endoscopic ultrasound-guided biopsy were considered diagnostic. Secondary outcomes were incidence of benign causes, extent of follow-up investigations, and clinical indicators of malignancy in patients with DDS. Results: Among 103 patients with DDS, 20 had I-DDS. Subsequent follow-up of these 20 patients found no patient with PHPAT, two (10%) patients with chronic pancreatitis, and 18 (90%) patients with no cause found. The median follow-up duration for 'low-risk' patients was 7.3 years (range, 6-11 years). The mean number of follow-up investigations per patient was two (range, 0-9). Investigations included computed tomography (n = 27), magnetic resonance cholangiopancreatography (n = 23), endoscopy (n = 16), and ultrasound (n = 14). Patients with jaundice were more likely to have malignancy (p < 0.01). Those with abdominal pain were more likely to have a benign cause (p < 0.01). Hyperbilirubinemia and/or deranged liver enzymes and raised CA19-9 were more likely to be associated with PHPAT (p < 0.01). Conclusions: Patients with I-DDS have a low risk of developing PHPAT within five years.

• 대한두경부종양학회지
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• 제32권2호
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• pp.69-72
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• 2016

Lung cancer is one of high mortality malignancy. It is known that skin metastasis from lung cancer is uncommon. We report a very rare case of finger tip metastasis from double primary cancer of the lung and lower lip. A 79 year-old man diagnosed with non small cell lung cancer presented with protruding solid mass in his lower lip. It showed central necrosis with purulent discharge. It had appeared rapidly growing features. Simultaneously, another solid mass accompanying painful swelling without skin lesion was found in his left middle finger tip. Both two solid masses were moderately differentiated squamous cell carcinomas. Lower lip mass was a primary cancer, while middle finger tip mass was diagnosed with clinically metastatic cancer from lung or lower lip, which means that it had double primary cancer origin.

• Childhood Kidney Diseases
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• 제23권2호
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• pp.116-120
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• 2019

Bilateral renal obstruction is a rare critical condition, requiring a prompt diagnostic approach and treatment to restore the renal function. The most commonly observed obstructive uropathy in children is congenital malformation, such as posterior urethral valves and bilateral ureteropelvic junction obstruction. Malignant pelvic masses obstructing the ureter are widely reported in adults but are rarely observed in children. The treatment of ureteral obstruction related to pelvic malignancy is a therapeutic challenge with a median survival duration of 3-7 months in adults; however, pediatric patients with pelvic malignancy leading to ureteral obstruction had better outcomes, with a reported 5-year mortality rate of 20%, than the adult patients. Here, we report a rare case of bilateral ureteral obstruction associated with pelvic rhabdomyosarcoma presenting with acute kidney injury treated by ureteral diversion with double J stent, and concommittent emergency hemodialysis, leading to restoration of good renal function. We suggest that bilateral ureteral obstruction should be released as soon as possible using surgical or interventional approach to minimize the obstruction period, and subsequential chemotherapy may contribute to improvement of survival and recovery of renal function.

• 대한두개안면성형외과학회지
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• 제22권1호
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• pp.38-44
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• 2021

Background: The free flap surgical method is useful for the reconstruction of head and neck defects. This study retrospectively analyzed the results of head and neck reconstructions using various types of free flaps over the past 30 years. Methods: Between 1989 and 2018, a total of 866 free flap procedures were performed on 859 patients with head and neck defects, including 7 double free flaps. The causes of vascular crisis and salvage rate were analyzed, and the total flap survival rate calculated among these patients. Additionally, the survival and complication rates for each flap type were compared. Results: The 866 cases included 557 radial forearm flaps, 200 anterolateral thigh flaps, 39 fibular osteocutaneous flaps, and 70 of various other flaps. The incidence of the vascular crisis was 5.1%; its most common cause was venous thrombosis (52.3%). Salvage surgery was successful in 52.3% of patients, and the total flap survival rate was 97.6%. The success rate of the radial forearm flap was higher than of the anterolateral flap (p< 0.01), and the primary sites of malignancy were the tongue, tonsils, and hypopharynx, respectively. Conclusion: The free flap technique is the most reliable method for head and neck reconstruction; however, the radial forearm free flap showed the highest success rate (98.9%). In patients with malignancy, flap failure was more common in the anterolateral thigh (5.5%) and fibular (5.1%) flaps.

• 대한골관절종양학회지
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• 제17권2호
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• pp.95-99
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• 2011

악성 연부조직 종양 수술 후 이시성(metachronous)으로 발생하는 악성 골졸양은 매우 드물다. 이시성 종양은 두 경부 또는 복부에 주로 발생하며, 사지에 발생하는 경우는 더욱더 드물다. 저자들은 48세 남자환자에서 근위 대퇴부 악성 지방 육종의 광범위 변연 절제술 후 발생한 근위 경골 유잉육종/원시 신경 외배엽 세포종 1예를 경험하여 문헌 고찰과 함께 보고하는 바이다. 육종 환자들에게서는 이와 같이 이차적으로 악성 종양이 발생할 확률이 높아지기 때문에 추시 기간 동안 잠복 종양(occult tumor)에 대한 검사가 필요하겠다.

• Journal of Gastric Cancer
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• 제9권2호
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• pp.63-67
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• 2009

비장 변연부 림프종(Splenic marginal zone lymphoma)은 드문 종양이며, 주로 노년층에서 발견되며, 절반 이상이 10년 이상 생존할 만큼 양호한 경과를 보인다. 본원에서는 이전에 보고된 바가 없는 비장 변연부 림프종과 조기위암이 동시에 발견된 환자의 수술적 치료를 경험하였기에 보고하는 바이다. 74 세 남자환자로 5년 전 알코올성 간경화를 진단 받은 이후 추적관찰 중 시행한 위내시경 검사에서 유문부에 조기위암이 발견되었다. 복부 전산화 단층 촬영 결과, 경미한 간경화와 비장비대, 복강 내 림프절병증이 관찰되었고, 근치적 절제를 위해 위 아전절제술을 시행하였다. 수술 당시 경미한 간경화와 비장이 매우 커져 있는 것과 더불어 다수의 복부 림프절비대가 관찰되었다. 이후 조직 검사 결과에서 조기위암과 림프절에서 비장 변연부 B 세포 림프종으로 진단되었다. 환자는 회복 후 골수검사와 PET 검사 등을 시행하였으며, 조직검사와 같은 결과를 얻었다. 이후 환자는 항암치료 계획 중이다. 비장 변연부 림프종은 Schmid 등에 의해 처음 명명되었으며, 비호치킨성 림프종의 1~2%를 차지한다. 이는 진단 당시 평균 나이가 65세이고, 드문 질환이지만 완만한 경과로 긴 생존 기간을 가지므로 추가로 악성종양이 발생될 수 있다. 대부분 진단 당시 무증상이며, 심각한 혈구 감소증이 없거나, 중등도의 비장비대를 동반한 무증상의 환자는 경과를 관찰하는 것이 타당하다. 본 환자는, 조기 위암 수술 중 발견되어 비장 변연부 림프종으로 진단된 경우로, 동시에 발견된 경우는 보고된 바가 없다. 드물기는 하지만, 비장 변연부 림프종을 가진 환자의 주의 깊은 추적 관찰로 이차로 발생되는 악성 종양을 조기에 발견하는 것이 중요하다.

• 구강회복응용과학지
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• 제25권4호
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• pp.329-336
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• 2009

선천적 기형이나 후천적인 외상 또는 신생물에 의해 상악골 절제술을 받은 경우, 상악에서 발생하는 구강내 결손은 흔히 비강과 상악동 및 구강이 연결된 형태로 나타난다. 이러한 상악골의 결손은 구강과 비강이 교통되어 발음, 저작, 연하 등의 기능에 이상을 초래하게 된다. 이러한 경우에도 보철치료의 기본적인 목표가 적용되며, 후천적 상악 결손부에 수복되는 폐색장치는 발음, 연하, 저작 기능을 회복할 수 있어야 하고, 적절한 심미적 만족을 제공해야 하며, 환자가 편안하게 사용할 수 있어야 한다. 상악 폐색장치의 무게를 감소시키는 것은 잔존 조직의 건강과 정상적인 기능 및 환자의 안락함을 개선시킬 수 있다. 개방형 폐색장치는 결손부의 크기에 따라 6.55~33.06% 까지 무게를 줄여줌으로써 환자에게 편안함과 편의성을 제공해 주며, 생리적 기능을 향상시켜 치아와 지지 조직에 불필요하게 가해지는 부하를 감소시켜 준다. 본 증례는 hemi-maxillectomy를 시행한 환자에서 이중온성법을 이용하여 기존의 방법보다 더 균일한 의치상 두께를 가진 폐색장치를 제작하여 환자의 기능적, 심미적인 만족을 얻었기에 이를 보고하는 바이다.

• Asian Pacific Journal of Cancer Prevention
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• 제17권10호
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• pp.4563-4566
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• 2016

Background/Objective: The aim of this study was to perform a comparative evaluation of the yields of conventional brush cytology and brush cytology with negative pressure in the diagnosis of malignant biliary strictures. Methods: A total of 132 consecutive patients undergoing endoscopic were identified. Of these, 88.0 had brush cytology after ERCP and 44 were Brush cytology with negative pressure. Retrograde cholangiopancreatography (ERCP) including brush cytology and brush cytology with negative pressure in patients with biliary strictures between 2012-2015. Endoscopic retrograde cholangiography was performed with a standard videoduodenoscope Olympus TFJ 160-R (Olympus, Hamburg, Germany) and brush cytology with a Cook medical Double Lumen Biliary BrushTM (Cytology). Means and standard frequencies were used to calculate variables. Results: Positive results for malignancy were obtained in 22 of 88 patients (25%) by brush cytology and 31 of 44 patients (70.4 %) by brush cytology with negative pressure. Conclusions: Sensitivity of cytology sampling could be maximized by negative pressure during ERCP.

• Archives of Plastic Surgery
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• 제32권3호
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• pp.381-384
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• 2005

Rhabdomyosarcoma is a rare malignancy of head and neck region. When rhabdomyosarcoma occurs in maxillary area, total maxillectomy is necessary. Total maxillectomy causes defects of orbital floor, palate, gingiva, and alveolar bone, causing severe facial deformity and functional impairment. Immediate maxillary reconstruction has to cover both bone and soft tissue to minimize cosmetic and functional problems. The fibular osteocutaneous free flap can provide paranasal, gingiva, oral mucosal lining and foundation for dental prosthesis, thus ensuring good cosmetic results and mastication, phonation function. We have experienced a reconstruction case of a 19-year-old man with rhabdomyosarcoma of the left maxillary sinus. The patient underwent total maxillectomy and neck dissection. We designed a fibular free flap that had a vascularized bone segment and a double skin paddle. Surgical outcomes were excellent in cosmetic and functional aspects.