• 제목/요약/키워드: submucosal tumor

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흉강경을 이용한 식도의 거대 평활근종 절제술 -치험 1예- (VATS Resection of Giant Leiomyoma of the Esophagus -1 case-)

  • 황호영;한국남;김주현;김영태
    • Journal of Chest Surgery
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    • 제37권8호
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    • pp.715-717
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    • 2004
  • 59세 여자 환자가 무증상으로 우연히 발견된 후종격동 종괴를 주소로 내원하였다. 수술 전 시행한 식도조영술, 식도내시경 및 식도내시경적 초음파검사로 거대한 식도점막하 종양으로 식도근종이 의심되었다. 우측 흉강을 통해 흉강경수술을 시행하였는데, 종격동 흉막과 식도근육을 종절개한 후 종양을 적출하였다. 수술 후 시행한 식도조영검사에서 식도의 협착 및 누출소견은 없었으며 술 후 7일째에 합병증 없이 퇴원하였다.

식도의 신경집종 -1예 보고- (Schwannoma of the Esophagus - A case report-)

  • 백종현;이장훈;이동협;정태은;김미진;이정철
    • Journal of Chest Surgery
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    • 제37권11호
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    • pp.963-966
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    • 2004
  • 식도의 양성종양은 드물며 그 중에서도 신경집종은 매우 드물다. 2년 동안 서서히 진행하는 삼킴 곤란을 주소로 64세 남자가 방문하였다. 내시경과 흉부전산단층촬영에서 큰 점막하 종양이 관찰되었다. 수술시야에서 종양은 매우 단단했으며 주위조직과의 유착이 견고하였다. 식도절제술 및 식도위연결술을 시행하였다.

Risk Factors and Tumor Recurrence in pT1N0M0 Gastric Cancer after Surgical Treatment

  • Choi, Hee Jun;Kim, Su Mi;An, Ji Yeong;Choi, Min-Gew;Lee, Jun Ho;Sohn, Tae Sung;Bae, Jae Moon;Kim, Sung
    • Journal of Gastric Cancer
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    • 제16권4호
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    • pp.215-220
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    • 2016
  • Purpose: This study aimed to evaluate the rate, patterns, and risk factors associated with tumor recurrence in patients with T1N0 gastric cancer. Materials and Methods: The medical records of 8,753 patients with pathological T1N0M0 gastric cancer who underwent gastrectomy between 1994 and 2014 at Sungkyunkwan University School of Medicine were examined. Results: Among the 8,753 patients, 95 patients (1.1%) experienced tumor recurrence; this included 31 remnant, 27 hematogenous, 9 lymph nodal, 5 peritoneal, and 23 multiple-site recurrences. When patients were divided into two groups according to the presence of tumor recurrence, the following characteristics were higher in the recurrence group than in the non-recurrence group: older age (${\geq}65years$), male gender, undifferentiated histology, submucosal invasion, and venous invasion. In multivariate analysis, older age, male gender, tumor depth (sm2 and sm3 invasion), and venous invasion were independent risk factors for tumor recurrence. The recurrence rates were 0.7% in patients with less than two risk factors, 1.7% in those with two risk factors, 3.0% in those with three risk factors, and 6.3% in those with four risk factors (P<0.001). Conclusions: Although tumor recurrence is rare in pT1N0M0 gastric cancer, some patients with certain risk factors demonstrate an increased rate of tumor recurrence. Careful follow-up is required for patients with three or four risk factors.

식도의 양성 점막하 종양의 수술적 치료 (Surgical treatment of esophageal submucosal tumor)

  • 노동섭;박창권;금동윤;김재범
    • 대한기관식도과학회지
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    • 제15권1호
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    • pp.24-27
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    • 2009
  • Background: Benign tumors of the esophagus are rare. They include leiomyomas, gastrointestinal stromal tumors, neurofibromas and lipomas. In this study we present our experience with enucleation of these 13 tumors for 10 years. Material and Method: A retrospective review of patients who underwent enucleation of benign esophageal tumors between 1995 and 2005 was conducted. Symptom, tumor location and size, operative approach and outcomes after surgery were recorded. Result Thirteen patients were identified(leiomyoma: n=12; GIST n=l). Eight patients were men, five patients were women. Most of them were 4rd and 5th decade. The tumors arose in the lower(7 patients) and middle(6 patients) thirds of the esophagus. Eleven patients underwent a thoracotomy; the remainder were resected using VATS. All of patients underwent simple enucleation. There were no complications and recurrences after surgery. Conclusion: We present our experience with enucleation of these 12 leiomyomas and one GIST for 10 years.

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Endoscopic Resection of Xanthogranulomatous Gastritis Presenting as a Subepithelial Tumor: A Case Report

  • Kim, Tae Wan;Kim, Tae Ho;Kim, Chang Whan;Chang, Jae Hyuck;Han, Sok Won;Kim, Jae Kwang
    • 대한상부위장관⦁헬리코박터학회지
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    • 제18권3호
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    • pp.198-203
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    • 2018
  • Xanthogranulomatous gastritis (XGG) presenting as a subepithelial tumor (SET) is a very rare entity. We report a case of SET-like XGG diagnosed and treated with endoscopic resection. A 55-year-old female patient was initially referred with a 1.5-cm SET located at the anterior wall of the middle antrum. Endoscopic ultrasound examination revealed submucosal invasion without any perigastric lymph node enlargement. Endoscopic resection was performed for an accurate diagnosis and treatment, and the lesion was diagnosed histopathologically as XGG. At the 18-month follow-up after endoscopic resection, there was no evidence of XGG recurrence. SET-like XGG is very rare and the diagnosis is a preoperative challenge. However, inflammatory tumors should be considered in the differential diagnosis of SET.

조기위암에서 림프절 전이 및 재발에 영향을 주는 위험인자 분석 (Risk Factors Affecting Lymph Node Metastasis and Recurrence in Early Gastric Cancer)

  • 신종근;신영도;윤충;주흥재
    • Journal of Gastric Cancer
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    • 제1권2호
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    • pp.119-123
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    • 2001
  • Purpose: The prognosis of operated early gastric cancer is quite excellent and the 5-year survival rate shows to be over $90\%$. The less extensive treatment has been considered to be attractive. However, lymph node metastasis remains a main risk factor for recurrence of early gastric cancer. The author performed this study in order to determine which clinicopathologic factors of early gastric cancer influence lymph node metastasis and recurrence. Materials and Methods: A retrospective study was conducted on 222 patients with early gastric cancer who had been treated by gastrectomy combined with D2 or more extended lymph node dissection between January 1991 and December 1997 at the Department of Surgery, Kyunghee University Hospital. Results: Lymph node metastasis was observed in 26 patients ($11.7\%$), and the depth of tumor invasion and tumor size among clinicopathologic factors affected lymph node metastasis. The 5-year recurrence rate was $4.4\%$, and it was revealed that lymph node metastasis and depth of tumor invasion had a greater effect on recurrence than other clinicopathologic factors. Conclusion: The high risk factors of early gastric cancer in recurrence were submucosal tumor invasion, tumor size more than 2 cm, and lymph node metastasis. Patients of early gastric cancer with such high risk factors should undergo radical gastric resection than limited surgery. (J Korean Gastric Cancer Assoc 2001;1:119-123)

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연속 대절편 제작을 이용한 후두암의 병리조직학적 연구 (Histopathologic study of laryngeal cancer with serial section)

  • 이강대;이종덕;유태현
    • 대한기관식도과학회:학술대회논문집
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    • 대한기관식도과학회 1993년도 제27차 학술대회 초록집
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    • pp.90-90
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    • 1993
  • 후두암의 치료계획에 있어 어려운 점들로는 종양의 3차원적 위치, 점막하를 통한 전파, 후두연골의 침윤 여부 등이다. 특히 후두연골 침윤은 국소재발과 경부전이의 빈도가 높아 예후가 좋지 않다. 저자들은 후두암의 전파와 후두연골에의 침윤 양상을 이해하고 술전 임상적 진단의 정확도를 높여 치료방향을 설정하는데 도움을 얻고자 1991년 4월부터 1992년 11월까지 후두암으로 혹은 전적출술을 시행했던 예중 18례의 후두표본을 대상으로 연속 대절편을 제작하여 병리조직학적 관찰을 하고 다음과 같은 결과를 얻었다. 1. 후두연골 침윤의 양상은 주로 연골의 골화된 부위를 침범하였고 골화되지 않은 연골의 침윤은 매우 드물었다. 2. 침윤된 골화연골에서는 연골막이 건전하더라도 골수를 통해 전파하였다. 3. 연골막은 종양전이의 아주 강한 방어벽이었다. 4. 후두연골 침윤의 빈도는 갑상연골, 피열연골, 윤상연골, 후두개연골 순이었고 횡성문암에서는 후두연골 침윤이 88.9 % 로 상당히 높았다. 5. 후두연골 침윤여부에 대한 술전 CT의 민감도는 100%, 특이도 62.5%, 정확도 82.3%이다.

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내시경 초음파 유도하에 세침흡인 세포검사로 진단한 위의 위장관 기질 종앙 1예 보고 (Endoscopic Ultrasound-Guided Fine Needle Aspiration Cytology in the Diagnosis of a Gastrointestinal Stromal Tumor of the Stomach -A Case Report -)

  • 김루시아;김형길;주영채;박인서;최석진;한지영;김선희;이돈행;김준미
    • 대한세포병리학회지
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    • 제19권2호
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    • pp.178-182
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    • 2008
  • We report here a case of a gastrointestinal stromal tumor (GIST) in the stomach that was diagnosed by endoscopic ultrasound-guided fine needle aspiration cytology (EUS-FNA). A 67 year old male patient underwent regular check-ups for five years due to the presence of a submucosal tumor that was found in the fundus of the stomach incidentally. EUS-FNA was performed to evaluate the tumor, which had increased in size from 1 cm to 2.8cm. A cytologic smear revealed cohesive sheets or clusters of spindle cells with elongated nuclei. Immunohistochemical staining revealed a strong positive reaction for c-kit and CD34, without any reaction for smooth muscle actin and Ki-67. Therefore, a diagnosis of GIST was made.

제2기 위암에서 3 Subgroup간의 비교 분석 (Comparative Analysis of Three Subgroups in Stage II Stomach Cancer)

  • 서병선;김병식;김용호;육정환;오성태;김완수;박건춘
    • Journal of Gastric Cancer
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    • 제1권1호
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    • pp.32-37
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    • 2001
  • Purpose: Three subgroups of stage II stomach cancer (T1N2M0, T2N1M0, T3N0M0) by UICC-TNM staging system show obvious survival difference to each other, which becomes the pitfall of the current staging system. We analyzed the survival and relapse pattern of stage II stomach cancer patients in three subgroups retrospectively to prove the need for change in staging system. Materials and Methods: From July 1989 to December 1995, curative gastric resection was performed in 1,037 patients with gastric adenocarcinoma, and among them 268 patients ($26\%$) were in stage II. The number in each of subgroups (T1N2M0, T2N1M0, and T3N0M0) were 17, 139 and 112 respectively. Survival and relapse pattern were analyzed and median follow up period was 46 months. Results: The 3-year cumulative survival rates of T1N2M0, T2N1M0, and T3N0M0 were $50\%,\;80\%,\;and\;76\%$ respectively (p=0.001). And the 3-year cumulative survival rates of T1N2M0 was comparable to those of 2 subgroups of stage IIIa (T2N2M0, T3N1M0), $47\%\;and\;45\%$ (p>0.05). Peritoneal recurrence was the most frequent in T3N0M0. And hematogenous spread was more frequent in T2N1M0 while nodal spread was more frequent in T1N2M0. Ten out of 17 cases of T1N2M0 died of recurrence. Most of them showed submucosal tumor with depressed lesion and mean tumor size was 3.3 cm. Conclusions: Up-staging of T1N2M0 should be considered because it has the lowest survival rate and the worst prognosis among the three subgroups of Stage II stomach cancer patients. In early gastric cancer patients with high-risk factors (large tumor size, invasion into the submucosal layer, and lymphatic vessel involvement), lymph node dissection and postoperative adjuvant therapy is recommended in an attempt to prevent recurrence in the form of lymph node metastasis.

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흉강경을 이용한 상부식도 펑활근종의 수술 치험 -1례 보고- (Thoracoscopic Surgery of Upper Esophageal Leiomyoma -One Case Report-)

  • 정진용;심성보
    • Journal of Chest Surgery
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    • 제29권5호
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    • pp.585-588
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    • 1996
  • 식도평활근종은 식도암에 비해 매우 드물지만 식도양성종양의 대부분을 차지한다. 식도질환의 수술 은 개흥을 통해 시행되 었으나 흥강경수슬의 발달과 함께 일부 식도수술을 흉강경을 이 용하여 수술을 하 게되었다. 저자들은 상부식도에 발생한 평활근종을 흥강경을 이용하여 절제하고 좋은 결과를 얻었다. 환자는 24세 남자로 내원 2개월전부터 발생한 흥골후방 불쾌감과 경미한 연하곤란을 호소하였다. 식도 위장관촬영과 식도경검사에서 상부식도에 점막의 변화없는 점 막하종양이 있었으며 흉부전산화단층 및 자기공명영상 촬영으로 종양의 위치,크기 및 주위조직으로의 침범과 종격동 림프절종대가 없음을 확인 하였다. 종양은 흥강경을 이용하여 제거하였고, 크기는 4$\times$2xlcm로 병리조직검사상 평활근종으로 진 단되었다. 환자는 수술후 10일째 이상없이 퇴원하였다.

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