• The Journal of the Korean bone and joint tumor society
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• v.8 no.3
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• pp.90-95
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• 2002

A 42 year old male patient complained of increasing pain and mass around the right ankle with 4 months duration. Simple Roentgenogram and CT showed ill-defined osteolysis and cortical perforation in the neck of the right talus. The pathologic findings showed high grade osteoblastic osteosarcoma. The tumor mass of the ankle increased and pulmonary metastasis was found in spite of administrating of two cycles of preoperative chemotherapy. Below-knee amputation and open wedge pulmonary resection were performed for primary lesion and multiple pulmoanry metastasis, respectively. However, the patient died with multiple pulmonary metastasis in spite of three cycles of postoperative chemotherapy at ten months after the operation.

• Journal of Gastric Cancer
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• v.5 no.1
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• pp.57-64
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• 2005

At diagnosis, the majority of patients with gastric cancer are found to have local invasion or distant organ metastasis, even though the sole measure for a complete cure is a curative resection. A curative resection is hardly applicable for those with invasion and metastasis; thus, trials with neoadjuvant chemotherapy for downstaging the cancer should be considered. Docetaxel is a semisynthetic taxane that promotes tubulin polymerization and inhibits microtubule depolymerization. In recent studies, many metastatic gastric cancers were treated using neoadjuvant chemotherapy with docetaxel, and the response rates were reported. We report here two cases of locally advanced, non-resectable gastric cancer that were candidates for a curative resection after induction chemotherapy with docetaxel and cisplatin.

• The Journal of the Korean bone and joint tumor society
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• v.18 no.2
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• pp.59-65
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• 2012

Purpose: Multidisciplinary approaches of surgical resection and chemotherapy have been widely used for the treatment of non-metastatic osteosarcomas. We aimed to assess the effect of neoadjuvant chemotherapy for metastasis and disease-specific survival. Materials and Methods: Authors retrospectively reviewed 225 young (<30 years old) and non-metastatic osteosarcoma patients who underwent surgical resection and postoperative chemotherapy between February 1984 and July 2010. Mean age was 14.4 years old (ranged: 4-29 years old) and average follow-up period was 9.1 years (2-28 years). The patients were divided into two groups according to the application of preoperative chemotherapy. Both groups were compared with clinical characteristics, metastasis-free survival and disease-specific survival. Results: All of 225 patients, 32 patients were treated with postoperative chemotherapy and 193 patients were performed preoperative and postoperative chemotherapy. Postoperative chemotherapy group showed significantly high rate of amputation (p<0.001). Metastasis was occurred in 101 patients. Postoperative chemotherapy group indicated significant higher rate of metastasis (69% vs 41%, p=0.004) and early development of metastasis (mean: 11.5 vs 20.3 months, p=0.045) than pre-and postoperative chemotherapy group. Fifty-seven patients were died of osteosarcoma. Postoperative chemotherapy group revealed significant lower rate of 5-year disease-specific survival than pre-and postoperative chemotherapy group (51% vs 84%, p=0.001). Adult (>15 years) and large sized tumor (>8 cm) were meaningful risk factors of metastasis and disease-specific survival. Although, local recurrences were occurred in 13 patients, there was no significant difference. Conclusion: Neoadjuvant chemotherapy offers better disease-specific survival and metastasis-free survival.

• Journal of Chest Surgery
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• v.43 no.2
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• pp.228-231
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• 2010

An 80 year-old male with a medical history of angiosarcoma of the scalp visited the Emergency Department complaining of dyspnea, and the chest X-ray revealed pneumothorax. He has undergone scalp resection and radiotherapy three years ago due to angiosarcoma. Due to a persistent air leak, he underwent wedge resection of the lung and was pathologically diagnosed with metastatic angiosarcoma to the lung. He underwent radiotherapy following the lung resection, but he died from his disease at 15 month following surgery due to further aggravation of the lung metastasis. Angiosarcoma is a highly malignant tumor and it frequently occurs on the scalp and face in elderly patients. Angiosarcoma frequently metastasizes to the lung and it may cause pneumothorax as a consequence of a ruptured cavitary lesion. We report here on a case of pneumothorax that was caused by lung metastasis in an elderly patient with a history of angiosarcoma of the scalp.

• Journal of Chest Surgery
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• v.36 no.3
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• pp.175-181
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• 2003

Primary chest wall tumors originate from soft tissue, bone or cartilage of the chest wall and it comprises 1∼2% of all primary tumors. Resection of tumor is often indicated for chronic ulceration or pain, and long-term survival might be achieved after surgery depending on the histology and the surgical procedure. Material and Method: Retrospective study of 125 primary chest wall tumors (86 benign, 39 malignant) operated between Sep. 1976 to Mar 2001 were reviewed and their clinical outcomes were analyzed. Follow-up data were collected at the outpatient clinic. Result: All patients with benign tumors were treated by excision without recurrence or death, and most malignancies were treated by wide resection. Malignant fibrous histiocytoma and chondrosarcoma constituted 46.2% of the malignant neoplasm. There was no operative death. The overall 3-year survival for patients with primary malignant neoplasm was 76.0%, and the 10-year survival was 60.5%. All deaths were disease-related and the tumor recurred in 11 patients. There was no significant difference in survival between patients with resection margins less than 4 cm and those with resection margins greater than 4 cm. Conclusion: Chest wall resection offers excellent results for benign chest wall tumors and substantial long-term survival for malignant diseases. Safe resection margin of 4 cm or more did not correlate with the survival rate although the tumor recurrence correlated with poor survival.

• Journal of Gastric Cancer
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• v.7 no.1
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• pp.42-46
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• 2007

Usually in the subtotal gastrectomy, the left and the right gastric arteries, as well as the left and the right gastroepiploic arteries are ligated. Thus, to avoid a blue stomach surgeons preserve the spleen and the short gastric arteries. When a radical subtotal gastrectomy with splenectomy is performed, meticulous caution is necessary; otherwise, the subtotal gastrectomy might have to be changed to a total gastrectomy to prevent a blue stomach. We report the case of a 67-year-old woman who had distal stomach cancer with a splenic solitary mass, for which splenic meatastasis could be excluded. We planned and performed a laparoscopy-assisted radical subtotal gastrectomy with splenectomy as the diagnostic and therapeutic option. In this case, to avoid a remnant stomach infarction or total gastrectomy we saved the left gastric artery and vein with clearing perivascular soft tissue, lymphatics, and lymph nodes. Thus the radical therapeutic goal was reached, and serious complications were avoided.

• Journal of Gastric Cancer
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• v.6 no.3
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• pp.154-160
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• 2006

Purpose: According to the 2nd English Edition of the Japanese Gastric Cancer Association (JGCA) in 1998, in case of distal gastric cancer, the 14v (superior mesenteric vein) lymph node (LN) is included in the N2 group. However, in Korea, a modified radical gastrectomy is performed, and a 14v LN dissection is not done as a routine procedure. Thus, we investigated the rate of metastatic 14v LNs, evaluated the necessity of dissection of the 14v LN, and searched for indications of 14v LN dissection. Materials and Methods: From April 2004 to August 2005, we enrolled the patients who were diagnosed as having advanced gastric cancer in the distal third portion of the stomach. We peformed a distal gastrectomy with D2 lymph node dissection as defined in the 2nd English edition of the JGCA classification. We calculated the positive rate of metastatic LNs of each station and analyzed the relationship between the positive rates of No.6 LNs and 14v LNs. We also compared the positive 14v LN group with the negative 14v LN group. Results: The total number of patients was 50, the mean age was 56 (range $30{\sim}80$) years, and sex ratio (Male/Female) was 1.63 : 1. In 47 (94%) cases, distal a gastrectomy with gastroduodenostomy was done, and in the remaining 3 (6%) cases, a distal gastrectomy with gastrojejunostomy was done. The most frequently metastatic LNs were nos. 3 and 6 (54%). The metastatic rate of the f4v LN was 10%, which was similar to that of LN no. 9. In the comparison of the 14v positive group with the 14v negative group, there were significant differences in the numbers of metastatic LNs (mean 25.4 vs 4.91, P<0.001) and the numbers of metastatic no. 6 LNs, (mean 6.8 vs 1.42, P<0.001), and if no. 6 LNs were metastatic, the possibility of metastasis to the 14v LN was 19.2%. In the 14v positive group, all cases were more than stage 3 by the UICC 6th edition. Conclusion: In cases of advanced cancer with metastasis to the no. 6 IN, there was a good chance of metastasis to the 14v LN. Thus, in the operative field, if the tumor is advanced to more than stage 3 by the UICC classification and the no. 6 LN is metastatic, a 14v LN dissection is necessary. However, the usefulness of a 14v LN dissection should be evaluated prospectively through an analysis of tumor recurrence and long-term survival.

• Journal of Chest Surgery
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• v.35 no.1
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• pp.73-76
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• 2002

Adenoid cystic carcinoma is a very slowly growing and directly invasive cancer. The treatment of choice is complete surgical resection but if major complications associated with remaining carcinoma occur, aggressive conservative treatment to prevent complication is able to gain long term survival even though remaining carcinoma metastases to other organs. We experienced a case of surgical treatment of uncontrollable fever that caused by multiple lung abscesses due to obstruction of left main bronchus with adenoid cystic carcinoma. The post operative course was uneventful for 4 months to now.

• Journal of Chest Surgery
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• v.37 no.10
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• pp.888-891
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• 2004

Basaloid-squamous cell carcinoma, a biologically high-grade variant of squamous cell carcinoma, is predominantly located at upper aerodigestive tract but it is extremely rare in the esophagus. Recently we experienced a case of basaloid-squamous cell carcinoma of esophagus. A 64 year-old man was referred to our hospital because of mucosal nodularity at 35 cm apart from the incisor in endoscopic examination. Result of Biopsy was squamous cell carcinoma. Left transthoracic esophagectomy was performed. Histologically, the lesion of tumor was basaloid-squamous cell carcinoma and no lymph node metastasis was found.

• Journal of Chest Surgery
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• v.37 no.11
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• pp.955-958
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• 2004

Mucoepidermoid carcinoma is an uncommon lesion that accounts for approximately 1% of primary malignant bronchial gland tumors and less than 0.2% of all lung neoplasm. This tumor presents with symptoms of bronchial irritation or obstruction. Distant metastasis is uncommon, therefore complete surgical resection is the treatment of choice. The prognosis of tumor correlates with on the histologic grade of tumor. We experienced mucoepidermoid carcinoma in a 15 year-old girl with symptoms of cough and blood tinged sputum. The patient underwent successful removal of tumor by bilobectomy via explorothoracotomy after chest CT and bronchoscopic biopsy.