• Journal of Digestive Cancer Research
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• 제2권1호
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• pp.1-4
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• 2014

Palliative care for cancer aims to relieve the discomfort and pain from the cancer itself and associated conditions. Gastrointestinal cancers originate from the tube like structure of gastrointestinal tract and cause complications such as obstruction, bleeding, adhesion, invasion, and perforation to adjacent organ. Recent advances in interventional endoscopy enables endoscopy physicians to do safe and effective care for gastrointestinal cancer patients. Endoscopic palliation includes stent, hemostasis, nutritional support and targeted drug delivery. Self expandable metallic stent is one of the most important modalities in gastrointestinal palliation. Through the endoscopy or over the wire pre-placed by endoscopy, stents restore the gastrointestinal luminal patency and relieve the obstructive condition. Endoscopic hemostasis is another important palliation in gastrointestinal cancer patients. Epinephrine injection, argon plasma coagulation and thermal cauterization are usual modalities for hemostasis. Histoacryl glue and fibrin glue are also available. Hemostatic nanopowder spray is newly reported effective in benign disease and is supposed to be effective also in cancer bleeding. Enteral feeding tubes including gastro- or jejunostomy and nosoduodenal tubes are placed by using endoscopic guidance. Enteral feeding tubes role as the route of easily absorbable or semi-digested nutrients and effectively maintain both patients calorie requirements and gut microenvironment. Photodynamic therapy is the one of the outstanding medical employments of photo-physics. Especially for superficial cancers in esophagus, photodynamic therapy is very useful in cancer removal and maintaining organ structure. In biliary neoplasm, photodynamic therapy is well known to be effective in cancer ablation and biliary ductal patency restoration. Targeted drug delivery is the lastest issue in palliative endoscopy. Debates and questions are still on the table. In this article, the role of endoscopic interventions in palliative care for the gastrointestinal tumors will be thoroughly reviewed.

• 대한영상의학회지
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• 제82권4호
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• pp.971-976
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• 2021

유방 엽상종양은 전체 유방 종양의 1% 미만을 차지하는 드문 섬유상피종양이다. 엽상종양은 유관주위 버팀질 세포에서 기원하여 상피 성분과 버팀질 성분을 모두 포함하는 특징을 가지며, 조직학적으로 양성, 경계성, 악성으로 구분된다. 엽상종양의 상피 성분에서 암이 발생하는 것은 매우 드물기 때문에 이에 대한 영상의학적 소견은 명확히 정립된 바가 없다. 이에 저자들은 21세 젊은 여성에서 경계성 엽상종양 내에서 생긴 침윤성 유관암을 경험하였기에 자기공명영상을 포함한 영상의학적 소견과 조직병리학적 소견을 보고하고자 한다.

• 대한두경부종양학회지
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• 제40권1호
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• pp.19-22
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• 2024

Angioleiomyoma is benign smooth muscle tumor originating from the vascular wall. While they can occur in various anatomical locations, they are rarely reported in the vallecula region of the oropharynx. We present a case of a 58-year-old female patient with a five-year history of progressive dysphagia and throat discomfort. Laryngoscopy revealed a large, soft, mobile mass located on the right side of the vallecula. Radiological imaging further characterized the lesion as a well-circumscribed, heterogeneous mass. Surgical intervention in the form of Transoral Videolaryngoscopic Surgery (TOVS) was performed, leading to the successful removal of the mass. Histopathological analysis confirmed the diagnosis of angioleiomyoma.

• Korean Journal of Radiology
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• 제23권7호
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• pp.763-772
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• 2022

Objective: Preoperative differential diagnosis of follicular-patterned lesions is challenging. This multicenter cohort study investigated the clinicoradiological characteristics relevant to the differential diagnosis of such lesions. Materials and Methods: From June to September 2015, 4787 thyroid nodules (≥ 1.0 cm) with a final diagnosis of benign follicular nodule (BN, n = 4461), follicular adenoma (FA, n = 136), follicular carcinoma (FC, n = 62), or follicular variant of papillary thyroid carcinoma (FVPTC, n = 128) collected from 26 institutions were analyzed. The clinicoradiological characteristics of the lesions were compared among the different histological types using multivariable logistic regression analyses. The relative importance of the characteristics that distinguished histological types was determined using a random forest algorithm. Results: Compared to BN (as the control group), the distinguishing features of follicular-patterned neoplasms (FA, FC, and FVPTC) were patient's age (odds ratio [OR], 0.969 per 1-year increase), lesion diameter (OR, 1.054 per 1-mm increase), presence of solid composition (OR, 2.255), presence of hypoechogenicity (OR, 2.181), and presence of halo (OR, 1.761) (all p < 0.05). Compared to FA (as the control), FC differed with respect to lesion diameter (OR, 1.040 per 1-mm increase) and rim calcifications (OR, 17.054), while FVPTC differed with respect to patient age (OR, 0.966 per 1-year increase), lesion diameter (OR, 0.975 per 1-mm increase), macrocalcifications (OR, 3.647), and non-smooth margins (OR, 2.538) (all p < 0.05). The five important features for the differential diagnosis of follicular-patterned neoplasms (FA, FC, and FVPTC) from BN are maximal lesion diameter, composition, echogenicity, orientation, and patient's age. The most important features distinguishing FC and FVPTC from FA are rim calcifications and macrocalcifications, respectively. Conclusion: Although follicular-patterned lesions have overlapping clinical and radiological features, the distinguishing features identified in our large clinical cohort may provide valuable information for preoperative distinction between them and decision-making regarding their management.

• Korean Journal of Radiology
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• 제22권11호
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• pp.1809-1821
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• 2021

Ovarian cystadenofibroma is a benign ovarian tumor that is characterized by a consistent percentage of masses, which remain indeterminate in ultrasonography and require magnetic resonance (MR) investigation; they may mimic borderline or malignant lesions. Three main morphologic patterns, resembling different ovarian neoplasms, can be identified in cystadenofibromas: multilocular solid lesions, unilocular cystic lesions with parietal thickening, and purely cystic masses. However, a cystoadenofibroma has typical features, such as T2-weighted hypointensity associated with no restrictions in diffusion-weighted imaging (the so-called "dark-dark appearance") and progressive post-contrast enhancement (type I perfusion curve). The purpose of this study was to review the features of ovarian cystadenofibromas in MR imaging and to suggest pearls and pitfalls regarding their correct diagnosis.

• Tuberculosis and Respiratory Diseases
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• 제53권5호
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• pp.542-549
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• 2002

Background : 본 연구의 목적은 폐암 수술 후 흉벽의 종양 재발 검출에 있어 Tl-201 폐 SPECT의 유용성을 평가해보고자 하였다. Methods : 총 28명의 환자를 대상으로 하였고 이중 14명의 수술 후 흉벽에의 폐암의 재발이 추적 CT 검사에서 의심이 되었던 환자와 10명의 방사선학적, 이학적소견과 흉수의 세포검사모두에서 양성으로 판명된 수술 후 흉막 삼출을 보이는 환자군과 4명의 만성 결핵성 농흉 환자군을 대조군으로 포함하였다. 모든 환자군에서 111 MBq의 Tl-201을 정맥 주사 후 30분과 4시간후에 전신 평면 영상과 흉곽에 대한 SPECT를 시행하였다. 종양의 Tl-201섭취는 2명의 판독자에 의하여 다음의 4단계로 나누어 평가하였다; no uptake:0, similar to contralateral lung:1, higher than contralateral lung but less than heart:2 and similar to heart:3. Results : 수술 후 흉벽에의 폐암의 재발이 추적 CT 검사에서 의심이 되었던 환자 14명 중 13명에서 Grade 3또는 2의 강하게 증가된 Tl-201의 섭취를 보였다. 그리고 14명중 2명에서는 CT에서 관찰되지 않았던 다른 부위의 종양 재발을 확인 할 수 있었다. 반면에, 양성 수술 후 흉막 삼출군에서는 섭취가 없거나(8/10) 또는 허탈된 폐에 미미한 (grade 1) Tl-201의 섭취만을 보였다. 만성 결핵성 농흉군에서는 비교적 균일하게 경계를 보이는 미약한 정도의 (grade 1 or 2) Tl-201의 섭취를 보였다. Conclusion : Tl-201 폐 SPECT는 폐암 수술 후 흉벽의 종양 재발 검출에 있어 CT에서 제공하는 형태학적인 정보이외의 종양 재발에 관한 기능적 정보를 더 제공하며, PET이 없는 기관에서 사용 가능한 유용한 방법이 될 수 있을 것으로 생각된다.

• Journal of Korean Neurosurgical Society
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• 제63권1호
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• pp.119-135
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• 2020

Objective : To investigate the epidemiology of newly-diagnosed, histologically-confirmed (NDHC) central nervous system (CNS) tumours and its changes over a 21-year period in a regional hospital in Hong Kong. Methods : This is a single-institute retrospective descriptive study of patients undergoing surgery for CNS tumours in a regional hospital of Hong Kong in the period from January 1996 to December 2016. The histological definition of CNS tumours was according to the World Health Organization classification, while the site definition for case ascertainment of CNS tumours was as set out by the Central Brain Tumour Registry of the United States. Patients of any age, who had NDHC CNS tumours, either primary or secondary, were included. The following parameters of the patients were retrieved : age at diagnosis, gender, tumour location, and histological diagnosis. Population data were obtained from sources provided by the Government of Hong Kong. The incident rate, estimated by the annual number of cases per 100000 population, for each histology grouping was calculated. Statistical analyses, both including and excluding brain metastases, were performed. Statistical analysis was performed with Microsoft Excel, 2016 (Microsoft, Redmond, WA, USA). Results : Among the 2134 cases of NDHC CNS tumours, there were 1936 cases of intracranial tumours and 198 cases of spinal tumours. The annual number of cases per 100000 population of combined primary intracranial and spinal CNS tumours was 3.6 in 1996, and 11.1 in 2016. Comparing the 5-year average annual number of cases per 100000 population of primary CNS tumours from the period 1996-2000 to 2011-2015, there was an 88% increase, which represent an increase in the absolute number of cases by 4.52 cases/100000 population. This increase was mainly contributed by benign histologies. In the aforementioned periods, meningiomas increased by 1.45 cases/100000 population; schwannomas by 1.05 cases/100000 population, and pituitary adenomas by 0.91 cases/100000 population. While gliomas had a fluctuating 5-year average annual number of cases per 100000 population, it only had an absolute increase of 0.51 cases/100000 population between the 2 periods, which was mainly accounted for by the change in glioblastomas. Conclusion : This retrospective study of CNS tumour epidemiology revealed increasing trends in the incidences of several common CNS tumour histologies in Hong Kong, which agrees with the findings in large-scale studies in Korea and the United States. It is important for different geographic locations to establish their own CNS tumour registry with well-defined and structured data collection and analysis system to meet the international standards.

• Asian Pacific Journal of Cancer Prevention
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• 제17권5호
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• pp.2597-2603
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• 2016

Ovarian cancer is a highly malignant neoplasm with high mortality rates. Research to identify markers facilitating early detection has been pursued for many years. Currently, diagnosis is based on the CA 125 and HE4 markers, as well as the ROMA algorithm. The search continues for new proteins that meet the criteria of good markers A total of 90 patients were included in the present study, allocated into: group 1, ovarian cancer, with 29 patients; group 2, endometrial cysts, with 30s; and group 3, simple ovarian cysts, with 31. Following histopathological verification, the CA 125, HE4, and metalloproteinase 3 (MMP3) levels were determined and the ROMA algorithm was calculated for all patients. The mean concentrations of all determined proteins, CA 125, HE4, and MMP3, as well as the ROMA values, were significantly higher in group 1 (ovarian cancer) compared to group 3 (simple ovarian cysts). The highest significant differences for the CA 125 levels (p<0.000001) and ROMA (p<0.000001) values were observed in postmenopausal women. For HE4, statistical significance was at the level of p=0.00001 compared to p=0.002 for MMP3. For the differentiation between ovarian cancer and endometrial cysts, the respective AUC ratios were obtained for CA 125, HE4, and MMP3 levels, as well as the ROMA values ( 0,93 / 0,96 / 0,75 / 0,98). After removing the post-menopausal patients, the MMP3 AUC value for ovarian cancer vs. benign ovarian cysts increased to 0.814. For post-menopausal women, the MMP3 AUC value for ovarian cancer vs. endometrial cysts was 0.843. As suggested by the results above, both the CA 125 and HE4 markers, as well as the ROMA algorithm, meet the criteria of a good diagnostic test for ovarian cancer. MMP3 seems to meet the criteria of a good diagnostic test, particularly in postmenopausal women; however, it is not superior to the tests used to date.

• Tuberculosis and Respiratory Diseases
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• 제59권2호
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• pp.198-203
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• 2005

드물게 발생하는 말단비대증은 성장호르몬 및 IGF-1의 증가에 따라 악성 및 양성 종양의 발생이 증가하는 것으로 알려지고 있어 이에 대한 조기 발견과 치료에 노력을 기울여야 할 것이다. 저자들은 58세 남자가 객혈을 주소로 내원하여 폐의 편평 상피 세포암과 위선암 및 대장 폴립이 동반된 말단비대증 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제31권2호
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• pp.170-177
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• 2005

The pleomorphic adenoma is well recognized as the most common salivary neoplasm. We examined 49 patients who had received surgical excision of the pleomorphic adenoma from 1989 to 1998 with over 5 years follow-up period. We retrospectively evaluated the patients' age, sex, chief complaints, surgical methods, and recurrence or complication rates after analysis of one's clinical and surgical records. The results are as follows : 1. There were 15 cases in parotid gland, 23 cases in palate, 8 cases in submandibular gland, and 3 cases in cheek. The ratio of male to female was 1 : 1.13. The mean age was 44. The tumor of submandibular gland occurred in more younger age than that of other salivary gland. 2. In 15 patients of parotid pleomorphic adenoma, there was 1 case(6.7%, 1/15) of recurrence. That was transformed into the malignant pleomorphic adenoma after 4 years of first surgery. We performed superficial parotidectomy of 9 cases(56.2%, 9/16), total parotidectomy of 6 cases(37.5%, 6/16), and radical parotidectomy of 1 case(6.3%, 1/16). 3. We used the rotational Sternocleidomastoid muscular flap to cover the exposed facial nerve in 12 cases(75%) after parotidectomy(7 cases of superficial parotidectomy and 5 cases of total parotidectomy). We could see 3 cases(18.7%) of facial nerve palsy and 1 case(6.3%) of Frey's syndrome after parotidectomy. We examined Frey's syndrome in only 1 case which was not used SCM muscular flap after parotidectomy. 4. In 23 patients of palatal pleomorphic adenoma, there were 2 cases(8.7%) of recurrence. In recurrence cases, We performed re-excision after 4 and 5 years of first surgery, respectively. We preserved partial thin overlying palatal mucosa during tumor excision in 5 cases(20%), which were proved as benign mixed tumor in preoperative biopsy. That mucosa-preserved cases had thick palatal mucosa, did not show mucosa ulceration and revealed well encapsulated lesions in preoperative CT. 5. In palatal tumors, we could see the 13 cases(52%) of bony invasion in preoperative CT views and the 4 cases(16%) of oro-nasal fistula after tumor excision. In two cases of recurrence, one(20%, 1/5) was in palatal mucosa-preserved group and the other(5.5%, 1/18) was in palatal mucosa-excised group. 6. We excised tumors with submandibular glands in the all cases of submandibular pleomorphic adenoma. There was no specific complication or recurrence in these cases. 7. After excision of the cheek pleomorphic adenomas, we could not see any complication or recurrence.