• Journal of Digestive Cancer Research
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• v.1 no.1
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• pp.43-47
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• 2013

There have been very few reports related to pancreatic cancer developing in the remnant pancreas after a resection for pancreatic cancer. We report two cases of repeated pancreatectomy for second primary pancreatic cancer. A 58-year-old man with a 2.3 cm sized low attenuated pancreatic tail mass on abdomen CT scan, received a distal pancreatectomy (adenosquamous carcinoma, stage IIB) and adjuvant chemoradiotherapy. A follow-up abdomen CT scan revealed a 2.0 cm sized pancreatic head mass in the remnant pancreas at 35 months after the distal pancreatectomy. He received a pancreaticoduodenectomy and diagnosed as ductal adenocarcinoma (stage IIA). Another 62-year-old female was declared pancreatic head mass on a regular health examination. An abdomen CT scan revealed a 3.6 cm sized mixed solid and cystic mass. She received a pylorus-preserving pancreaticoduodenectomy (ductal adenocarcinoma, stage IB) and adjuvant chemoradiation therapy. At 20 months after the resection, a 1.8 cm sized ill-defined low attenuated mass developing in the tail of remnant pancreas was detected on a follow-up abdomen CT scan. The patient received a distal pancreatectomy and diagnosed as ductal adenocarcinoma (stage IIA).

• 대한세포병리학회:학술대회논문집
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• 1992.06a
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• pp.11.1-11.1
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• 1992

• Journal of Gastric Cancer
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• v.7 no.4
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• pp.193-199
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• 2007

Purpose: Combined resection of an invaded organ in advanced gastric cancer (AGC) with infiltration of adjacent organs is essential to achieve R0 resection. However, when the tumor invades the head of the pancreas or duodenum, R0 resection interferes with the lower resectability and results in a higher morbidity. Wereviewed these cases retrospectively and considered the proper extent of the surgical resection. Materials and Methods: We retrospectively analyzed cases where patients underwent surgery for gastric adenocarcinoma at the Department of Surgery, Presbyterian Medical Center, between January 1998 and December 2003. Among the 45 patients who were suspected to have pancreatic head or duodenum invasion by a primary tumor or metastatic lymph nodes based on the operative findings, we included 22 patients without incurable factors. The patients were classified into three groups: 4 patients that underwent a combined resection (PD group), 12 patients that underwent a palliative subtotal gastrectomy (STG group) and 6 patients that underwent bypass surgery only (GJ group). We analyzed the clinicopathological features, operative data and results. Results: The patients of the PD group achieved R0 resection by PD with D3 Dissection in all Patients. A pancreatic fistula was observed in one patient (morbidity 25%). There was no surgery-associated mortality (mortality 0%). All patients of the PD group were in stage IV. However, the 2-year survival rate (SR) was 75% and the 5-year SR was 50%. Six patients of the STG group underwent surgery with marginal resection and the other six patients of the STG group had a positive distal resection margin. The 2-year SR was 41.7% and the 5-year SR was 16.7%. Most of the patients of group GJ were of old age (mean age: $72.7{\pm}8.6$ years) or had chronic diseases. The 2-year SR was 0%. Conclusion: Combined resection of the pancreas and duodenum in AGC with pancreatic head invasion is relatively safe with moderate morbidity and a lower mortality. One can expect long-term survival if combined resectionis performed in cases without incurable factors.

• Investigative Magnetic Resonance Imaging
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• v.14 no.2
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• pp.145-150
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• 2010

We report the case of a 16-year-old boy with a solid pancreatic mass which proved to be a nonfunctioning, malignant pancreatic neuroendocrine tumor (PNET). In pediatric patients, malignant pancreatic tumors are rare, especially malignant PNET. When dynamic contrast enhanced MRI showed a well enhancing solid pancreatic tumor on arterial and delayed phases and combined with malignant features, such as vascular invasion, invasion of adjascent organs, and lymphadenopathy, we should include malignant pancreatic neuroendocrine tumor in the differential diagnosis of childhood pancreatic tumors.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.3 no.1
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• pp.116-121
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• 2000

Solid and Papillary epithelial neoplasm of pancreas is a rare and low grade malignant tumor. It develops in 2nd or 3rd decades of young female and located in tail of pancreas predominantly. Prognosis is good despite its various histologic features, which suggest a malignant appearance. We report one case of solid and papillary epithelial neoplasm in head of pancreas in a 11-year-old girl who had been suffered from vomiting and right upper abdominal pain for 3 weeks.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.2 no.2
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• pp.194-203
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• 1999

Purpose: Childhood pancreatitis has more various and somewhat different etiology than adult. Until now the analysis of severity in childhood pancreatitis were not well-known, although several studies have been made. Therefore, we studied the etiology and complications in childhood pancreatitis and analyzed whether Ranson and CT criteria could be applicated to evaluate the severity of childhood pancreatitis patients. Methods: The records of 30 patients with pancreatitis under 15 years of ages who were diagnosed in Asan medical center were reviewed. Age, sex, history, etiology, clinical features and treatment was reviewed in all patients but complications, Ranson and CT criteria were available in only 12 patients. Correlation between the number of complications and both Ranson and CT criteria were calculated with Spearman correlation coefficient. Results: 1. Median age at diagnosis was 7.3 years of age. 28 cases were acute pancreatitis and 2 cases were chronic pancreatitis. 2. Etiology: choledochal cyst(8 cases), drug (7 cases), trauma (4 cases), infection (3 cases), biliary stone or bile sludge (3 cases), idiopathic (2 cases) Hemolytic uremic syndrome, pancreatic duct obstruction, iatrogenic (1 case). 3. Local complications were ascites (5 cases), pseudocyts (4 cases) and systemic complications were hyperglycemia (4 cases), hypocalcemia (3 cases), pleural effusion (3 cases), etc. 4. Positive correlation was found between the number of complication and Ranson creteria (r=0.78, P=0.0016) and between the number of complication and CT criteria (r=0.65, P=0.015) in 13 cases. Conclusion: A trial to search the biliary duct anomaly may help to find the causes of childhood idiopathic pancreatitis, and both Ranson and CT criteria can be applicated to pediatric patients to evaluate the severity of childhood pancreatitis.

• Journal of the Korean Society of Radiology
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• v.84 no.2
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• pp.512-517
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• 2023

Transanastomotic pancreatic duct stent placement during reconstruction following pancreaticoduodenectomy is widely performed to prevent postoperative pancreatic fistulas and duct stenosis. However, stent-related complications, such as stent occlusion and migration, may occur. Here, we report a rare case of a migrated pancreatic duct plastic stent. After pylorus-preserving pancreaticoduodenectomy, the stent migrated to the jejunum and served as a nidus of the stent-stone complex, which developed jejunal obstruction. The stent-stone complex was removed by explorative laparotomy.

• Journal of the Korean Society of Radiology
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• v.81 no.6
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• pp.1497-1503
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• 2020

Inflammatory myofibroblastic tumors (IMTs) are rare. They are characterized by myofibroblastic spindle cell proliferation with a varying degree of inflammatory cell infiltration. IMT can occur in any anatomic location but has been reported in the lung, mesentery, and omentum, mainly in children or young adults. It rarely occurs in the pancreas and is often difficult to distinguish from other tumors, including some malignant ones. Therefore, it can be challenging to make a radiological diagnosis of IMT. Here, we present a case of IMT that occurred in the pancreas head of a middle-aged female. The patient's ultrasonography, computed tomography, and magnetic resonance imaging findings are presented along with a review of the literature.

• Investigative Magnetic Resonance Imaging
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• v.6 no.2
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• pp.129-136
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• 2002

Purpose : To evaluate the usefulness of MRCP in the diagnosis of the variable causes of common bile duct(CBD) dilatation, except stone or tumor Materials and methods : Twenty-six patients(M:F=15:11, mean age; 62 years) with both MRCP and ERCP were included in this study. Dynamic MRCP(n=12) and contrast-enhanced MRI(n=10) of abdomen were also added. Dilatation of CBD, intrahepatic ducts and pancreatic duct was evaluated, including coexistence of intrahepatic ductal stone, pancreatic pseudocyst, and papillary or papillary edema. The criteria of CBD dilatation was over than 7mm(n= 21, without cholecystectomy) or 10 mm(n=5, with cholecystecto-my) in diameter on T2-weighted coronal image. Results : The mean diameter of CBD was 12.7mm without cholecystectomy(9-19 mm) and 13.0 mm with cholecystectomy(10-15mm), respectively(p 〉0.05). Cholangitis(n=11, 42.3%), chronic pancreatitis(n=8, 30.8%), stenosis of distal CBD(n= 6, 23.1%), periampullary diverticulum(n=3, 11.5%), stenosis of ampulla of Vater(n=2, 7.7%), dysfunction of sphincter of Oddi(n=2, 7.7%), acute focal pancreatitis in the pancreatic head(n=2, 7.7%), papillitis(n=1, 3.8%), pseudocyst in the pancre atic head(n = 1, 3.8%), and ascaris in CBD(n=1, 3.8%) were noted. Pancreatic duct dilatation(n=10, 38.5%) and duodenal diverticulum(n=3, 11.5%) were also seen on MRC P. On dynamic MRCP(12 patients), distal CBD was visualized in 2 patients(16.7%), which was not shown on routine MRCP. Only 1 patient(10.0%) showed papillitis with slightly enhancing papilla on contrast-enhanced MRI (10 patients). Conclusion : MRCP was thought to be helpful in the evaluation of the causes of CBD dilatation, not caused by stone or tumor, especially in the cases of stenosis of distal CBD and chronic pancreatitis, dysfunction of sphincter of Oddi on dynamic MRCP and cholangitis and pericholangitic abnormality on contrast-enhanced MRI.

• Journal of the Korean Society of Radiology
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• v.83 no.1
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• pp.189-193
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• 2022

Hemorrhage after pancreaticobiliary surgery is an infrequent but fatal complication. It is primarily caused by rupture of the pseudoaneurysm, and treatment options include endovascular coil embolization or endovascular stent-graft placement. Herein, we report a case of migration of an arterial stent-graft that was placed in the common hepatic artery to treat pseudoaneurysm after pylorus-preserving pancreaticoduodenectomy. The stent-graft migrated to the jejunum and was eventually excreted from the body.