• Journal of Yeungnam Medical Science
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• 제38권3호
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• pp.231-234
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• 2021

We report a rare case of metachronous lymphoma with two distinct cell lineages in a 75-year-old man. The patient complained about having nasal obstruction for 2 years and extranodal natural killer (NK)/T-cell lymphoma of the nasal type was diagnosed from a biopsy. The immunohistochemical staining for CD56 and in situ hybridization for Epstein-Barr virus (EBV)-encoded small RNA (EBER-ISH) were positive and the tumor cells were negative for CD20. After 13 months of concurrent chemoradiotherapy, the patient presented with swelling of the left testis. Positron emission tomography scan detected an abnormal uptake in the testis. A diffuse large B-cell lymphoma, not otherwise specified, was diagnosed from subsequent radical orchiectomy. The immunohistochemical staining revealed to be positive for CD20, BCL2, BCL6, and MYC and negative for CD10 and EBER-ISH.

• 대한한방내과학회지
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• 제34권4호
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• pp.466-477
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• 2013

Objectives : To report and demonstrate the effect of decreasing ascites volume by SB intraperitoneal injection to a refractory ascites patient with synchronous colorectal liver metastasis and metachronous peritoneal carcinomatosis. Methods : Two cycles of intraperitoneal and intravenous SB injection were conducted. Each injection cycle was made up of 4 days. Nine vials of SB were injected to the patient every day. To compare the volume of ascites between pret- and post-treatment, follow-up computed tomography was done on June 3, 2013. To observe other therapeutic effects of SB injection, laboratory tests were conducted periodically. Results : On the follow-up computed tomography images, the amount of ascites and pleural effusion had decreased compared to the April 30, 2013 computed tomography images. The levels of aspartate transaminase, alanine aminotransferase and lactate dehydrogenase decreased significantly from May 9, to May 30, 2013. The amount of oral intake increased constantly during hospitalization. The patient's symptoms such as abdominal distension, abdominal pain and dyspnea were improving until discharge. Conclusions : Even if thiese results cannot be applied to every synchronous colorectal cancer liver metastasis patient, we demonstrated that SB intraperitoneal injection has ascites-decreasing effect to refractory ascites patients with synchronous colorectal liver metastasis and metachronous peritoneal carcinomatosis.

• Journal of Gastric Cancer
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• 제24권3호
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• pp.280-290
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• 2024

Purpose: Despite annual endoscopy, patients with metachronous remnant gastric cancer (MRGC) following proximal gastrectomy (PG) are at times ineligible for endoscopic resection (ER). This study aimed to clarify the clinical risk factors for ER inapplicability. Materials and Methods: We reviewed the records of 203 patients who underwent PG for cT1 gastric cancer between 2006 and 2015. The remnant stomach was categorized as a pseudofornix, corpus, or antrum. Results: Thirty-two MRGCs were identified in the 29 patients. Twenty MRGCs were classified as ER (ER group, 62.5%), whereas 12 were not (non-ER group, 37.5%). MRGCs were located in the pseudo-fornix in 1, corpus in 5, and antrum in 14 in the ER group, and in the pseudofornix in 6, corpus in 4, and antrum in 2 in the non-ER group (P=0.019). Multivariate analysis revealed that the pseudo-fornix was an independent risk factor for non-ER (P=0.014). In the non-ER group, MRGCs at the pseudo-fornix (n=6) had more frequent undifferentiated-type histology (4/6 vs. 0/6), deeper (≥pT1b2; 6/6 vs. 2/6) and nodal metastasis (3/6 vs. 0/6) than non-pseudo-fornix lesions (n=6). We examined the visibility of the region developing MRGC on an annual follow-up endoscopy one year before MRGC detection. In seven lesions at the pseudofornix, visibility was only secured in two (28.6%) because of food residues. Of the 25 lesions in the non-pseudo-fornix, visibility was secured in 21 lesions (84%; P=0.010). Conclusions: Endoscopic visibility increases the chances of ER applicability. Special preparation is required to ensure the complete clearance of food residues in the pseudo-fornix.

• Journal of Gastric Cancer
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• 제6권4호
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• pp.237-243
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• 2006

목적: 간전이 위암환자들을 대상으로 치료 결과를 알아보고 생존 분석을 통해 예후를 확인하고자 하였다. 대상 및 방법: 1990년 3월부터 2006년 3월까지 영남대학교 영남의료원 내과 및 외과에 내원한 위암환자 중 간전이가 발견된 85예(동시성 62예, 이시성 23예)를 대상으로 후향적 연구를 시행하였다. 임상병리학적 인자와 위절제술, 간전이병소 절제술 및 항암화학요법 등 치료 관련 인자들에 대해 생존분석을 실시하였다. 결과: 간전이 위암환자들의 중앙생존기간은 11개월(동시성 11개월, 이시성 17개월)이었다. 동시성 간전이군의 경우 위절제율은 24.1%, 간전이병소 절제율은 16.1%였다. 간외 전이 동반율은 23.5%였고 생존기간에 차이가 있었다(P<0.05). 간전이 병소 절제 및 위절제군, 위절제군, 비절제군의 중앙생존기간은 각각 60개월 이상, 10개월 및 9개월이었다(Fig. 1, P<0.05). 이시성 간전이군의 경우 위암절제 후 무병생존기간의 중앙치는 8개월이었으며 초기병기와 간전이 빈도 사이에는 차이가 없었다. 동시성 간전이군에서는 단변량 분석 결과 간외 전이, 위절제술, 간전이 병소 절제술, 외과적 절제 형태 및 항암화학요법에 대한 반응이 유의하였고 다변량 분석 결과 간전이병소 절제술, 항암화학요법에 대한 반응 및 간외 전이가 독립적 예후인자였고, 이시성 간전이군에서는 간외 전이, 항암화학요법에 대한 반응 및 원발암 세포의 분화도가 유의하였고 간외 전이가 독립적 예후인자였다. 결론: 간전이 위암환자에서 예후는 간전이 병소의 절제, 원발 병소의 절제, 간외 전이 유무 및 항암화학요법에 대한 반응여부에 의해 결정되므로 치료에 있어 간외 전이가 없는 경우 보다 적극적인 절제 노력과 항암화학요법이 생존율 향상에 기여할 것으로 판단된다.

• Journal of Gastric Cancer
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• 제3권3호
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• pp.139-144
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• 2003

Purpose: Because of an improving gastric cancer detection program and treatment methods, we can expect improved survival of patients with gastric cancer. Given the longer survival times, the chance of an occurrence of multiple primary malignant tumors other than stomach is increased in the same patients. The purpose of this study is to analyze the clinical characteristrics and the survival of patients with gastric cancer and other malignancies. Materials and Methods: A retrospective study of 3669 patients with gastric cancer observed at our department between January 1994 to December 2002 was conducted. Associated tumors were diagnosed using the Warren and Gates criteria, and included tumors that were not considered to be a metastasis, invasion, or recurrence of the gastric cancer. Results: Of all 3669 patients, $2.07\%$ (n=76) had primary tumors other than gastric cancer, $63\%$ of which were synchronous (n=48) and $37\%$ metachronous (n=28). The mean age of the study group was 64.9 (65.5 in males, 61.8 in females), and the male-to-female ratio was 4.8 : 1. The most common cancer associated with gastric cancer was a hepatocellular carcinoma ($23.7\%$), followed by colorectal cancer ($17.1\%$), esophageal cancer ($10.5\%$), breast cancer ($6.6\%$). Of the 45 patients who had undergone a resection, 14 were in stage I, 12 in stage II, 13 in stage III, and 6 in stage IV. No statistically significant differences were found between the synchronous and the metachronous groups with regard to age, sex ratio, differentiation, and stage. The 5-year survival rates of the metachronous and the resected patients were significantly higher than those of the synchronous and the non resected patients, respectively. Conclusion: Due to increasing length of the follow-up period for patients with gastric cancer, another malignancy may develop in other organs. Therefore, physicians should pay attention to detect other cancers early in these patients, and a surgical resection is recommended as the treatment of choice in the management of multiple primary cancer associated with gastric cancer.

• Clinical Endoscopy
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• 제55권6호
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• pp.703-725
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• 2022

Colonoscopic polypectomy is effective in decreasing the incidence and mortality of colorectal cancer (CRC). Premalignant polyps discovered during colonoscopy are associated with the risk of metachronous advanced neoplasia. Postpolypectomy surveillance is the most important method for the management of advanced metachronous neoplasia. A more efficient and evidence-based guideline for postpolypectomy surveillance is required because of limited medical resources and concerns regarding colonoscopy complications. In these consensus guidelines, an analytic approach was used to address all reliable evidence to interpret the predictors of CRC or advanced neoplasia during surveillance colonoscopy. The key recommendations state that the high-risk findings for metachronous CRC following polypectomy are as follows: (1) adenoma ≥10 mm in size; (2) 3 to 5 (or more) adenomas; (3) tubulovillous or villous adenoma; (4) adenoma containing high-grade dysplasia; (5) traditional serrated adenoma; (6) sessile serrated lesion (SSL) containing any grade of dysplasia; (7) serrated polyp of at least 10 mm in size; and (8) 3 to 5 (or more) SSLs. More studies are needed to fully comprehend the patients most likely to benefit from surveillance colonoscopy and the ideal surveillance interval to prevent metachronous CRC.

• 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.

• Advances in pediatric surgery
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• 제17권1호
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• pp.58-64
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• 2011

Minimally invasive techniques for pediatric inguinal hernia repair have been evolving in recent years. We applied the laparoscopic method to repair pediatric inguinal hernia using the techniques of sac transection and intra-corporeal ligation. Between November 2008 and August 2010, 67 pediatric patients (47 boys and 20 girls) with inguinal hernias were included in this study. Postoperative activities, pain, and complication were checked prospectively at regular follow-up. One patient presented with clinically bilateral hernia, and three patients had metachronous hernias. Thirty-two cases out of 63 patients with unilateral hernias had a patent processus vaginalis on the contralateral side. Mean operation time was $35{\pm}11.4$ minutes for unilateral hernias and $43{\pm}11$ minutes for bilateral hernias. There were no intra-operative complications. One patient had a small hematoma on the groin postoperatively, which subsided spontaneously in a week. Recurrence and metachronous hernia were not found at follow up. In summary, laparoscopic inguinal repair in children is safe, easy to perform and has an additional advantage of contralateral exploration. Further studies should include long term follow-up.

• Journal of Chest Surgery
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• 제44권2호
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• pp.159-164
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• 2011

Background: Renal cell carcinoma has shown less response to systemic therapies including chemotherapy, radiation, and immunotherapy than other cancers. Surgery has therefore become an important treatment tool. The protocol for treatment is the same for pulmonary metastasis of renal cell carcinoma. We performed surgery for pulmonary metastatic renal cell carcinomas and analyzed the results. Materials and Methods: We retrospectively analyzed 15 patients who had undergone pulmonary metastasectomy from renal cell carcinoma at our hospital from January 2005 to December 2009. Results: No patients had extrathoracic metastatsis. The mean age was 60.2 years (range 35~73). There were 12 male and 3 female patients. The number of synchronous and metachronous patients were 8 and 7, respectively. The mean survival times of synchronous and metachronous patients were 32.6 and 42.9 months, respectively. 6 patients had single lesions and 9 patients had multiple (more than 3) lesions. The surgical procedures included wedge resection (10), lobectomy (2), wedge resection with segmentectomy (2), and segmentectomy (1). Median observation and survival time were 54.1 and 34.9 months. The 1-year and 3-year survival rates were 80% and 50%, respectively. Conclusion: Pulmonary resection for pulmonary metastatic renal cell carcinoma was found to be a safe and effective treatment modality when complete resection was performed.

• Journal of Yeungnam Medical Science
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• 제5권2호
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• pp.221-230
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• 1988

최근 저자들은 1987년부터 1988년까지 2년간 영남의대 부속병원 외과에서 수술 및 병리 조직학적으로 확진된 다발성 원발성 악성 종양 6예를 경험하였기에 이를 연령, 발생 빈도, 호발 장기, 유발 인자, 가족력 등을 분석함으로서 외과의에게 다발성 원발성 악성 종양에 대한 관심을 고조시키고자 문헌고찰과 함께 보고하는 바이다. 1. 평균연령은 54.1세였으며 최저 38세부터 최고 67세였다. 2. 남자 3예, 여자 3예로 남녀비는 1:1이었으며 발생 빈도는 0.31%였다. 3. 호발 부위는 위암, 유방암, 대장암 순이었으며 이 중 1예는 초기 위암 및 초기 대장암이었으며 위암과 다발성 골수종을 동반한 예도 1예 있었다. 4. 면역 검사는 DNCB, CMI, T4/T8 ratio를 측정하였으나 현저하게 면역 저하된 경우는 없었다. 5. 가족력은 1예로서 17%였으며 위암이었다.