• Korean Journal of Head & Neck Oncology
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• v.34 no.2
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• pp.35-38
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• 2018

Mucinous adenocarcinoma (MAC) is a rare malignant neoplasm that occasionally occurs in the large intestine (colon), followed by the pancreas, ovary, lung, prostate, and breast. It is characterized by large amounts of extracellular epithelial mucin that contains tumor cell nests. We herein present a unique case of MAC originating from minor salivary gland, the second to be reported in literature in South Korea. We report a case of MAC in the tongue considered to be developed from minor salivary gland with a review of literature.

• Advances in pediatric surgery
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• v.12 no.2
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• pp.221-231
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• 2006

Solid pseudopapillary tumor (SPT) of the pancreas occurs most frequently in the second or third decades of life, and is prevalent in females. Unlike other pancreatic malignancy, SPT usually has a low malignancy potential. This study reviews our clinical experience and surgical treatment of pancreatic SPT. Admission records and follow-up data were analyzed retrospectively for the period between January 1996 and January 2003. Five patients with a pancreatic mass were operated upon and SPT was confirmed by pathology in each case. The male to female ratio was 1: 4. The median age was 13.8 years. Findings were vague upper abdominal pain (n=5, 100 %) and an abdominal palpable mass (n=3, 60 %). The median tumor diameter was 6.8cm and the locations were 2 in the pancreatic head (40 %) and 3 in the pancreatic tail (60 %). Extra-pancreatic invasion or distant metastasis was not found at the initial operation in all five cases. A pyloruspreserving pancreaticoduodenectomy (n=1) and a mass enucleation (n=1) were performed in two patients of pancreatic head tumors. For three cases of tumors in pancreatic tail, distal pancreatectomy (n=2) and combined distal pancreatectomy and splenectomy (n=1) were performed. The median follow-up period was 60 months(12-117month). During the follow-up period, there was no local recurrence, nor distant metastasis. Postoperative adjuvant chemotherapy or radiotherapy was not carried out. All five children were alive during the follow up period without any evidence of disease relapse. SPT of the pancreas in childhood has good prognosis and surgical resection of the tumor is usually curative.

• Journal of Gastric Cancer
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• v.19 no.4
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• pp.484-492
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• 2019

Few surgeons have adopted pancreaticoduodenectomy (PD) for the treatment of advanced gastric cancer (AGC) invading the pancreas or duodenum because it remains controversial whether its prognostic benefits outweigh the high morbidity rates in such advanced cases. However, recent technical advances have revived diverse surgical procedures in minimally invasive approaches. Inspired by this trend, laparoscopic PD procedures have been performed for AGC in our institute since 2014. We recently performed a laparoscopic Whipple's operation in a case of cT4b gastric cancer with invasion of the pancreatic head and duodenum.

• Journal of Trauma and Injury
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• v.24 no.2
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• pp.68-74
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• 2011

Purpose: Although pancreas injury is rare in abdominal trauma, it poses a challenge to the surgeon because its clinical features are not prominent and the presence of main duct injury cannot be easily identified by imaging studies. Furthermore, severe pancreas injuries require a distal pancreatectomy or a pancreaticoduodnectomy which are associated considerable morbidity and mortality. We reviewed the clinical features of and outcomes for patients with pancreas injury. Methods: For 10 years from Jan. 2001 to Dec. 2010, thirty-four patients were diagnosed as having pancreas injury by using an explo-laparotomy. Patients successfully treated by non-operative management were excluded. Patients were divided into early (n=18) and delayed surgery groups (n=11) based on an interval of 24hours between injury and surgery. The clinical features of and the outcomes for the patients in both groups were compared. Results: Males were more commonly injured (82.4% vs.17.6%). The mean age was 37.2 years. The injury mechanisms included vehicle accidents (62.9%, 22/34), assaults (20%, 7/34), and falls (11.4%, 3/34). The head and neck of the pancreas was most commonly injured, followed by the body and the tail (16, 12, and 6 cases).Of the 34 patients, 26 (76.5%) patients had accompanying injuries. Grade 1 and 2 occurred in 14 (5 and 9) patients, and grade 3, 4, and 5 occurred in 20 (16, 3, and 1) patients. The early and delayed surgery groups showed no difference in surgical outcomes. Two patients with grade 3 in the early surgery group died after surgery,one due to massive hemorrhage and the other due to septic shock. Of the five patients initially managed non-operatively, three developed peripancreatic necrosis and two developed pseudocyst. All five patients were successfully cured by surgery. Conclusion: All cases of pancreas injury in this study involved blunt injury, and accompanying injury to major vessels or the bowel was the major cause of mortality. Surgery delayed for longer than 24 hours after was not associated with adverse outcomes.

• 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.

• Journal of Trauma and Injury
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• v.36 no.3
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• pp.261-264
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• 2023

Pancreatic trauma occurs in 0.2% of patients with blunt trauma and 5% of severe abdominal injuries, which are associated with high mortality rates (up to 60%). Traumatic pancreatoduodenectomy (PD) has significant morbidity and appreciable mortality owing to complicating factors, associated injuries, and shock. The initial reconstruction in patients with severe pancreatic injuries aggravates their status by causing hypothermia, coagulopathy, and acidosis, which increase the risk for early mortality. A staging operation in which PD follows damage control surgery is a good option for hemodynamically unstable patients. We report the case of a patient who was treated by staging PD for an injured pancreatic head.

• Korean Journal of Head & Neck Oncology
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• v.35 no.2
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• pp.45-49
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• 2019

Large cell neuroendocrine carcinoma is a rare epithelial neuroendocrine malignancy and is preferentially located in gastrointestinal tract and pancreas. Cases of large cell neuroendocrine carcinoma have been reported in many other locations, including the thymus, gallbladder, prostate, larynx, salivary glands, nasopharynx, tonsil and mastoid. However, primary sinonasal large cell neuroendocrine carcinoma never have been reported in Korea. We experienced a case of primary large cell neuroendocrine carcinoma arising from left maxillary sinus recently. A 82-year-old male patient presented with nasal obstruction and epistaxis. The biopsy revealed large cell neuroendocrine carcinoma with poor differentiation. After a general evaluation, the patient was staged as cT3N0M0. The patient was treated by combined radiotherapy and chemotherapy. We report this rare case with literature review.

• Korean Journal of Head & Neck Oncology
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• v.15 no.1
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• pp.76-79
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• 1999

The relationship between acute pancreatitis and hyperparathyroidism has been described extensively in the past. Despite the rarity, the clinical progression of pancreatitis associated with hyperparathyroidism has been known to be so rapid and severe that it may cause death. When, furthermore, the pancreatitis is caused by hyperparathyroidism, the recovery from disease can be hardly expected unless the hyperparathyroidism is corrected. We present a case of acute pancreatitis in a 68-year-old man that have been caused by primary hyperparathyroidism. The clues of hyperparathyrodism were hypercalcemia and elevated parathyroid hormone, but he showed subtle or negative symptoms of hypercalcemia. After the excision of parathyroid adenoma, serum calcium level returned to normal and the symptoms and function of pancreas were recovered.

• Korean Journal of Radiology
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• v.22 no.8
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• pp.1300-1309
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• 2021

Objective: To assess the feasibility and reproducibility of pancreatic surface lobularity (PSL) quantification derived from abdominal computed tomography (CT) in a population of patients free from pancreatic disease. Materials and Methods: This retrospective study included 265 patients free from pancreatic disease who underwent contrast-enhanced abdominal CT between 2017 and 2019. A maximum of 11 individual PSL measurements were performed by two abdominal radiologists (head [5 measurements], body, and tail [3 measurements each]) using dedicated software. The influence of age, body mass index (BMI), and sex on PSL was assessed using the Pearson correlation and repeated measurements. Inter-reader agreement was assessed using the intraclass correlation coefficient (ICC) and Bland Altman (BA) plots. Results: CT images of 15 (6%) patients could not be analyzed. A total of 2750 measurements were performed in the remaining 250 patients (143 male [57%], mean age 45 years [range, 18-91]), and 2237 (81%) values were obtained in the head 951/1250 (76%), body 609/750 (81%), and tail 677/750 (90%). The mean ± standard deviation PSL was 6.53 ± 1.37. The mean PSL was significantly higher in male than in female (6.89 ± 1.30 vs. 6.06 ± 1.31, respectively, p < 0.001). PSL gradually increased with age (r = 0.32, p < 0.001) and BMI (r = 0.32, p < 0.001). Inter-reader agreement was excellent (ICC 0.82 [95% confidence interval 0.72-0.85], with a BA bias of 0.30 and 95% limits of agreement of -1.29 and 1.89). Conclusion: CT-based PSL quantification is feasible with a high success rate and inter-reader agreement in subjects free from pancreatic disease. Significant variations were observed according to sex, age, and BMI. This study provides a reference for future studies.

• Journal of Yeungnam Medical Science
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• v.15 no.1
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• pp.36-46
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• 1998

Solid and papillary epithelial neoplasm of pancreas is a rare tumor, usually affecting young women, and its histogenesis is still controversial. This study was performed to define the clinicopathologic features and cellular origin of this tumor. Eight female cases of solid and papillary epithelial neoplasm of pancreas were studied by analyzing the clinicopathologic findings and immunohistochemical and electron-microscopic findings. The age of eight cases ranged from 21 to 54 years (mean, 34 years). The tumors developed in the tail (4 cases), body-tail (2 cases), body (1 case) and head (1 case). The mean diameter of tumors was 9.3 em (range, 5.5 to 13 cm). Tumors showed solid, cystic and hemorrhagic areas. Histologically, the tumor cells were uniformly round or polygonal in shape, and formed solid sheets and papillary pattern. On the immunohistochemical stain, 8 cases (100%) were immunoreactive for ${\alpha}1$-antitrypsin, 7 cases (87.5%) for cytokeratin, 7 cases (87.5%) for progesterone receptor, 6 cases (75%) for vimentin, and 1 case (12.5%) for synaptophysin, respectively. None of them were immunoreactive for estrogen receptor. Electron microscopic examination showed many mitochondria, annulate lamellae and canaliculi-like gap. These findings suggest that solid and papillary epithelial tumor of pancreas possibly originates from totipotent stem cells.