• 제목/요약/키워드: Liver neoplasm

검색결과 92건 처리시간 0.028초

Intrahepatic Splenosis Mimicking Liver Metastasis in a Patient with Gastric Cancer

  • Kang, Kyu-Chul;Cho, Gyu-Seok;Chung, Gui-Ae;Kang, Gil-Ho;Kim, Yong-Jin;Lee, Moon-Soo;Kim, Hee-Kyung;Park, Seong-Jin
    • Journal of Gastric Cancer
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    • 제11권1호
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    • pp.64-68
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    • 2011
  • A 54 year old man was referred to our hospital with gastric cancer. The patient had a history of splenectomy and a left nephrectomy as a result of a traffic accident 15 years earlier. The endoscopic findings were advanced gastric cancer at the lower body of the stomach. Abdominal ultrasonography (USG) and magnetic resonance imaging demonstrated a metastatic nodule in the S2 segment of the liver. Eventually, the clinical stage was determined to be cT2cN1cM1 and a radical distal gastrectomy, lateral segmentectomy of the liver were performed. The histopathology findings confirmed the diagnosis of intrahepatic splenosis, omental splenosis. Hepatic splenosis is not rare in patients with a history of splenic trauma or splenectomy. Nevertheless, this is the first report describing a patient with gastric cancer and intrahepatic splenosis that was misinterpreted as a liver metastatic nodule. Intra-operative USG guided fine needle aspiration should be considered to avoid unnecessary liver resections in patients with a suspicious hepatic metastasis.

성인 입원환자의 정맥영양요법 사용 현황 (Parenteral Nutrition in Hospitalized Adult Patients in South Korea)

  • 옥미영;이세라;김현아
    • Journal of Clinical Nutrition
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    • 제10권2호
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    • pp.38-44
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    • 2018
  • Purpose: Parenteral nutrition (PN) is known to provide therapeutic beneficial improvements in malnourished patients for whom enteral nutrition is not feasible. The objective of this study was to investigate the current clinical characteristics and utilization of PN in Korea. Methods: We analyzed the Health Insurance Review Agency National Inpatients Sample database from 2014 to 2016, which included 13% of all hospitalized patients in Korea. Adult patients aged 20 years or older and receiving premixed multi-chamber bag containing PN were included for this study. Patient characteristics, admission type, primary diagnosis, and hospital demographics were evaluated. SAS version 9.4 was used for data analysis. Results: From 2014 to 2016, 149,504 patients received premixed PN, with 226,281 PN prescriptions being written. The mean patient age was 65.0 years, and 81,876 patients (54.8%) were male. Premixed 3-chamber bag and 2-chamber bag PN solutions were utilized in 131,808 (88.2%) and 32,033 (21.4%) patients, respectively. The number of patients hospitalized through the emergency department were 70,693 (47.3%), whereas 43,125 patients (28.8%) were administered PN in intensive care units. In the adult PN patients, the highest primary diagnosis was malignant neoplasm of the stomach (8,911, 6.0%), followed by organism unspecified pneumonia (7,008, 4.7%), and gastroenteritis and colitis of unspecified origin (6,381, 4.3%). Overall, 34% of adult PN patients were diagnosed with malignancies, the most common being neoplasm of the stomach (17.7%), neoplasm of bronchus/lung (11.2%), neoplasm of colon (11.1%), and neoplasm of liver/intrahepatic bile ducts (10.0%). PN solutions were most frequently administered in the metropolitan area (55.0%) and in hospitals with more than 1,000 beds (23.6%). Conclusion: PN was commonly administered in older patients, with primary diagnosis of malignancy in a significant number of cases. This study is the first large-scale description of PN-prescribing patterns in real-world clinical practice in South Korea.

기관지 및 늑골에 전이된 맥락막 흑색종의 수술적 치료 - 1예 보고 - (Surgical Resection of Metastatic Choroidal Melanoma in the Rib and Bronchus - A case report -)

  • 박병준;최용수
    • Journal of Chest Surgery
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    • 제43권1호
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    • pp.117-119
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    • 2010
  • 맥락막 흑색종은 성인에서 가장 빈번한 안구 내 종양이다. 간, 폐, 뼈로 전이를 잘하며 그 예후는 나쁜 것으로 알려져 있다. 본 논문에서 저자들은 늑골 및 기관지에 전이된 맥락막 흑색종에 대하여 수술적 절제를 하였으며 이를 보고하고자 한다.

소아 원발성 간종양 (Primary Hepatic Tumors in Children)

  • 정형중;김현영;정성은;박귀원;김우기
    • Advances in pediatric surgery
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    • 제11권2호
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    • pp.107-114
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    • 2005
  • Primary liver tumors are uncommon in childhood, with a relative frequency of 3 % of all childhood tumors. Seventy-three cases of pediatric primary liver tumors operated on at single institution between 1986 and 2002 were reviewed. Malignant tumors included 37 cases of hepatoblastoma, 11 hepatocellular carcinomas, 6 undifferentiated (embryonal) sarcomas, and 1 mixed germ-cell tumor. Benign tumors constitute only 24.6 % of liver tumors, including 7 hemangioendotheliomas, 5 mesenchymal hamartomas, 3 congenital cysts, and one each with focal nodular hyperplasia and hemangioma. The common presenting clinical features were abdominal mass or abdominal distension. Anatomical hepatic resections were carried out in 38 cases, and nonanatomical resections in 34 cases. One patient died of a direct result of hepatic resection (1.4 %). The complication rate was 16.4 %.

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Can the presence of KRAS mutations guide the type of liver resection during simultaneous resection of colorectal liver metastasis?

  • Munseok Choi;Dai Hoon Han;Jin Sub Choi;Gi Hong Choi
    • 한국간담췌외과학회지
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    • 제26권2호
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    • pp.125-132
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    • 2022
  • Backgrounds/Aims: It is generally accepted that non-anatomical resection (NAR) in colorectal liver metastasis (CRLM) has comparable safety and efficacy compared to anatomical resection (AR); however, there are reports that AR may have better outcomes in KRAS mutated CRLM. This study aimed to determine the effects of KRAS mutations and surgical techniques on survival outcomes in CRLM patients. Methods: Two hundred fifty patients who underwent hepatic resection of CRLM with known KRAS mutational status between 2007 and 2018 were analyzed. A total of 94 KRAS mutated CRLM and 156 KRAS wild-type CRLM were subdivided by surgical approach and compared for short- and long-term outcomes. Results: In both KRAS wild-type and mutated type, there was no difference in estimated blood loss, postoperative complications, and 30-day mortality. There was no difference in disease-free survival (DFS) between AR and NAR in both groups (p = 0.326, p = 0.954, respectively). Finally, there was no difference in intrahepatic DFS between AR and NAR groups in both the KRAS groups (p = 0.165, p = 0.516, respectively). Conclusions: The presence of KRAS mutation may not be a significant factor when deciding the approach in simultaneous resection of CRLM.

낭성 담도 확장을 동반한 담도 유두종증 1예 (A Case of Biliary Papillomatosis with Cystic Dilatation of Bile Duct)

  • 박유미;이광원;윤선옥;하지윤;박소영;이정호;장성일
    • Journal of Yeungnam Medical Science
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    • 제29권2호
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    • pp.136-140
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    • 2012
  • A 61-year-old male who complained of right upper quadrant pain was referred to the authors for evaluation after his computed tomography suggested biliary adenocarcinoma. The lesion consisted of multiple cysts with papillary mass and peri-ampullay mass. The patient underwent an operation due to a clinical suspicion of biliary cystadenocarcinoma, but the pathology confirmed biliary papillomatosis (BP) after diagnosing intrahepatic papillary neoplasm with high-grade dysplasia and invasive adenocarcinoma with papillary neoplasm from the distal common bile duct to the duodenum. BP is a disease characterized by multiple papillary masses. Its cause has yet to be discovered. It commonly manifests as bile duct dilation but rarely as a ductal cystic change. Under computed tomography or magnetic resonance imaging, both the BP and the cystic neoplasm can show bile duct dilation and a papillary mass, which makes their differential diagnosis difficult. A confirmative diagnosis can be made through a pathologic examination. BP is classified as a benign disease that can become malignant and may recur, though rarely. Its treatment of choice is surgical resection. Laser ablation or photodynamic therapy can be used for unresectable lesions. In the case featured in this paper, biliary papillomatosis was difficult to differentiate from cystic adenocarcinoma due to diffusely scattered multiple large cystic lesions in the liver, and it was histologically confirmed to have become malignant with cystic duct dilation after the operation. This case is reported herein with a literature review.

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수술적 절제술 후 간에 재발한 췌장암에서 항암화학요법과 종양절제술로 완전 관해를 보인 증례 (A Case of Pancreatic Cancer Recurred in Liver after Surgical Resection, in Complete Response after Chemotherapy and Tumorectomy)

  • 손준혁;이재우;장동기;이상협;류지곤;김용태
    • Journal of Digestive Cancer Research
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    • 제3권2호
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    • pp.105-107
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    • 2015
  • 췌장암은 예후가 매우 불량한 암으로 수술적 절제술을 시행하여도 대부분의 경우 재발을 한다고 알려져 있다. 재발을 하는 경우 대개 항암화학요법을 시행하게 되나, 그 반응 또한 좋지 않은 것으로 알려져 있다. 간에 국소적으로 재발을 했을 경우 종양절제술을 시행하는 것에 대해서는 몇몇 보고가 있는 정도이며, 생존율을 향상시킬 수 있는지에 대해서는 연구가 거의 없는 상태이다. 본 증례는 유문보존 췌십이지장 절제술 시행 후 간에 국소적으로 재발한 췌장암에 대하여 gemcitabine 및 capecitabine과 oxaliplatin 병합 항암화학요법을 시행하였으나 크기가 증가하였고, 이에 종양절제술을 시행하였으며, 이후 장기생존을 보였던 경우로 매우 드문 증례를 경험하였기에 보고하는 바이다.

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A patient who has survived for a long period with repeated radiotherapies for multifocal extrahepatic metastases from hepatocellular carcinoma

  • Jo, Sunmi;Shim, Hye Kyung
    • Radiation Oncology Journal
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    • 제31권4호
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    • pp.267-272
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    • 2013
  • Although significant advances in the treatment of intrahepatic lesions, it is reported that the prognosis for patients with hepatocellular carcinoma (HCC) who have extrahepatic metastasis remains poor. We report a patient with lung, liver, brain, bone and subcutaneous metastasis from HCC who has survived more than 7 years maintaining relatively good performance status as a result of repeated therapies. A 55-year-old male patient with HCC underwent right lobectomy of the liver and cholecystectomy in September 2006. He received wedge resection for lung metastasis twice (July 2009, January 2011) and Gamma Knife stereotactic radiosurgery for brain metastasis (April 2011). Over the last 3 years, he has developed metastasis in subcutaneous tissues, muscle, and bone with pain. He has undergone 7 courses of radiotherapies for subcutaneous tissues, muscle, and bone metastasis and been prescribed sorafenib and he is still capable of all self-care.

개에서 전이성 악성형질세포종양 (Malignant Metastatic Plasma Cell Tumor in a Dog)

  • 김방현;최재훈;정승우;김대용;윤화영;한홍율
    • 한국임상수의학회지
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    • 제19권4호
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    • pp.443-446
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    • 2002
  • A primary metastatic malignant plasma cell tumor was presented in a 7-year-old, female, mixed breed dog. The dog was admitted to Veterinary Teaching Hospital at College of Veterinary Medicine, Seoul National University after suffering from depression, anorexia, and dyspnea. The dog was euthanized due to poor prognosis. At necropsy, numerous, firm and tan round nodules, 1 to 2 cm in diameter were noted in the ribs. The nodules formed chain or were occasionally coalescing, causing osteolysis of the ribs. A large amount of clear fluid was present in the thoracic cavity. The spleen and liver were markedly enlarged and congested. Histologically, the nodular masses were diagnosed as plasma cell tumor which was believed to be originated from the rib. Evidence of metastasis was observed in the spleen, liver, and kidney.

간전이가 있는 직장구불결장의 신경내분비 종양 환자의 카르시노이드 증후에 의해 발생한 설사에 대한 한약 치료 시도 : 증례 보고 (Herbal Medicine Therapeutic Attempt for Diarrhea Induced by Carcinoid Symptoms of Rectosigmoid Neuroendocrine Tumor with Liver Metastasis Patient : a Case Report)

  • 전형준;김종민;조종관;이연월;유화승
    • 동의생리병리학회지
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    • 제29권1호
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    • pp.72-78
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    • 2015
  • This study aims to report a case of rectosigmoid neuroendocrine tumor patient with liver metastasis whose outstanding carcinoid symptom was mucosal diarrhea for more than 10 times a day. Three different herbal decoctions were administered orally for the treatment of diarrhea which was among carcinoid symptoms from diffuse metastatic liver lesion. The herbal decoctions given were modified Lijung-tang, modified Sambaek-tang and modified Jeokseokjiuyeoryang-tang. The administration period was 5, 14 and 9 days respectively. Frequency of patient's mucosal diarrhea had increased consistently during hospitalization. It had almost doubled compared to pre-hospitalization up to 27 times/24 hrs. But during the period of modified Sambaek-tang administration, frequency of diarrhea was maintained between 9 to 15 times/24hrs. There was no difference of liver tumors between Nov 16th 2013 and Dec 9th 2013 in computed tomography images. Three conventional established herbal prescriptions administered in this case didn't show any favorable effect on improving mucosal diarrhea induced by carcinoid symptoms of a rectosigmoid neuroendocrine tumor with liver metastasis. Even if modified Sambaek-tang showed partial effect on frequency of diarrhea, we concluded that it was not sufficient to be a therapeutic method of the diarrhea as carcinoid symptom. Furthermore, it is necessary to conduct additional studies about the diarrhea of neuroendocrine tumor with liver metastasis.