• 대한기관식도과학회지
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• 제15권2호
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• pp.36-41
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• 2009

Background : Controversy exists whether patients with esophageal carcinoma are best managed with classical Ivor Lewis esophagectomy(ILO) as combined thoracic and abdominal approach or transhiatal esophagectomy(THO). The THO approach is known to be superior with respect to operative time, morbidity and mortality, and length of stay, especially at poor pulmonary function patient, but may represent an inferior cancer operation due to inadequate mediastinal clearance compared with ILO. Accordingly, we estimated the THO role at esophageal cancer to compare each operative approach. Material and Method : From January 2002 to December 2007, we performed a retrospective review of all esophagectomies performed at Keimyung University Dongsan Medical Center; 36 underwent THO, and 11 underwent ILO. Result : There were all men and squamous cell carcinoma but 1 woman at ILO group, 2 women at THO group. There were no significant differences between THO and ILO with age, sex, location of tumor, mean tumor length. There were significant differences at preoperative pulmonary function test(In ILO group, average FEV1 is $2.65{\pm}0.6\;L/min$ and iIn THO group, average FEV1 is $2.07{\pm}0.7\;L/min$). The amount of blood transfusion, hospital stay, leak rates and respiratory complication, hospital mortality rate were not significantly different. Conclusion : There was no significant difference in the post-operative complication, hospital mortality rate, long-term survival of patients of both operative method. THO method had lower mobidity and mortality at poor pulmonary function patient than ILO method. Hence, THO is a valid alternative to ILO for patients with poor general condition or expected post-operative respiratory complication.

• 대한두경부종양학회지
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• 제13권1호
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• pp.62-68
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• 1997

The papillary carcinoma is the most common malignant neoplasm of thyroid gland and the prognosis is better than anyother type of thyroid carcinoma. However, the thyroid is closed to the important organs such as esophagus, trachea and larynx, there are some possibilities to invade these organs. In case of advanced disease, not only surrounding structures but also mediastinum and cervical lymphatic chain can be involved or distant metastasis develops frequently. Therefore in these cases the prognosis is worse and the rate of inoperable case is more than those of non-metastatic group. Generally, the treatment modality for papillary thyroid carcinoma consists of surgery, postoperative thyroid hormone and radioiodine therapy. If the tumor invades surrounding structures, cervical lymph node or mediastinum, total thyroidectomy and wide excision of tumor invaded area including mediastinal dissection and neck dissection is necessary. Recently, the authors have experienced a case of locally invasive and recurred papillary thyroid carcinoma without treatment for 7 years. The patient was performed previously thyroid lobectomy and isthmusectomy 13 years ago. We had determinded surgical therapy for this patient and performed mass excision with overlying skin, completion total thyroidectomy, right type I modified radical neck dissection, left lateral neck dissection, thoracotomy with supramediastinal dissection, shaving of diffusely involved trachea and skin defect reconstruction with pectoralis major myocutaneous flap. After operation 2 cycles of radioiodine therapy were taken. Now the patient is following up at the outpatient base and no evidence of disease state for postoperative 16 months. So we report on this case with a brief review of literature.

• Journal of Yeungnam Medical Science
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• 제35권1호
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• pp.114-120
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• 2018

Tracheal tumors are rare and difficult to diagnose. Moreover, delays in diagnosis are very common because the symptoms are nonspecific. As a result, tracheal tumors are commonly mistreated as chronic obstructive pulmonary disease or bronchial asthma. We report a case of a 49-year-old male who presented with a 3-month history of dyspnea and cough. Chest computed tomography scan showed a $1.5{\times}1.3cm$ homogenous tumor originating from the right lateral wall of the tracheobronchial angle into the tracheal lumen as well as a $0.5{\times}0.4cm$ round nodular lesion at the right upper lobe with multiple mediastinal lymph nodes enlargement. Bronchoscopic findings revealed a broad-based, polypoid lesion nearly obstructing the airway of the right main bronchus. The patient was diagnosed with pleomorphic adenoma which is the most common benign tumor of the salivary glands, but rarely appears in the trachea. Upon surgery, tracheal pleomorphic adenoma and co-existing active pulmonary tuberculoma that had been mistreated as bronchial asthma over 3 months was revealed. Following surgery, the patient underwent anti-tuberculosis treatment. No recurrence has been detected in the 3 years since treatment and the patient is now asymptomatic.

• Korean Journal of Radiology
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• 제2권3호
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• pp.132-137
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• 2001

Objective: The aim of our study was to describe and compare the radiologic findings of esophageal leiomyomas. Materials and Methods: The chest radiographic (n = 12), esophagographic (n = 12), CT (n = 12), and MR (n = 1) findings of surgically proven esophageal leiomyomas in 12 consecutive patients [ten men and two women aged 34 - 47 (mean, 39) years] were retrospectively reviewed. Results: The tumors, surgical specimens of which ranged from 9 to 90 mm in diameter, were located in the upper (n = 1), middle (n = 5), or lower esophagus (n = 6). In ten of the 12 patients, chest radiography revealed the tumors as mediastinal masses. Esophagography showed them as eccentric, smoothly elevated filling defects in 11 patients and a multilobulated encircling filling defect in one. In 11 of the 12 patients, enhanced CT scans revealed a smooth (n = 9) or lobulated (n = 2) tumor margin, and attenuation was homogeneously low (n = 7) or iso (n = 4). In one patient, the tumor signal seen on T2-weighted MR images was slightly high. Conclusion: Esophageal leiomyomas, located mainly in the middle or distal esophagus, are consistently shown by esophagography to be mainly eccentrically elevated filling defects and at CT, lesions showing homogeneous low or isoattenuation are demonstrated.

• Radiation Oncology Journal
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• 제1권1호
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• pp.111-118
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• 1983

To evaluate natural history of ovarian dysgerminoma and role of radiation therapy in treatment of ovarian dysgerminoma, retrospective study was carried out in 5 nonirradiated cases and 20 irradiated cases. Conclusions are as follows: 1. Radiation therapy is essential in treatment of ovarian dysgerminoma. 2. Even in stage 1 a, significant recurrence rate is expected in surgery only group. 3. Even in recurrent cases, if adequate radiotherapy is given in stage 1-3, we can predict near complete curability and in stage 4, we can get considerable benefit. 4. Dysgerminoma beyond stage 2 is highly fatal without radiotherapy. 5. Involved field irradiation including whole abdomen and booster RT on bulky tumor area is sufficient in radiotherapy of stage 1, 2, 3, without paraaortic node involvement. Further mediastinal and supraclavicular irradiation is indicated in stage 4 or stage 1, 2, 3, with paraaortic involvement. 6. If bilateral salphingoophorectomy was done. Elective irradiation is recommended in any condition because preservation of ovarian function is not further needed. 7. In cases of small encapsulated stage 1a, We can delay post op. RT under close observation in order to preserve fertility.

• 대한세포병리학회지
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• 제11권1호
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• pp.41-45
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• 2000

Thymoma is the most common anterior mediastinal tumor in adults. Rarely, it is presented as the anterior neck mass, commonly located in the anterolateral aspect of the neck or adjacent to the thyroid. We experienced two cases of fine needle aspiration cytology of thymoma, mimicking thyroid mass. The first case was an ectopoic cervical thymoma in a 31-year-old female. The fine needle aspiration cytology was misinterpreted as reactive hyperplasia of lymph node. But the histologic diagnosis was thymoma, predominantly lymphocytic type. The second case was an invasive thymoma in a 66-year-old female, who complained a large anterior neck mass. The fine needle aspiration cytology revealed biphasic population of some clusters of epithelial cells and scattered lymphocytes. The cytologic diagnosis was thymoma and was confirmed as invasive thymoma after the biopsy. Therefore, when the cytologic feature of anterior neck mass shows the both lymphocyte and epithelial component, the differential diagnosis should Include the possibility of thymoma.

• Journal of Chest Surgery
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• 제38권1호
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• pp.80-83
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• 2005

43세 남자 환자가 호흡곤란과 호흡시 나타나는 천명음을 주소로 내원하였다. 환자는 과거력상 1년전에 식도파열로 인하여 식도격리술과 식도위문합수술을 시행받았다. 흉부 컴퓨터 단층촬영상 기관을 압박하는 식도점액류가 마치 종격동 종양처럼 나타났다. 수술은 우측 개흉술을 통하여 식도를 절제하였다. 저자들은 이를 치험하였기에 보고하는 바이다.

• Tuberculosis and Respiratory Diseases
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• 제57권2호
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• pp.197-200
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• 2004

흉부방선균증은 임상양상 및 방사선학적 소견이 폐의 기타 염증성 질환이나 악성암과 유사한 경우가 많아 감별진단에서 놓치기 쉬우나, 대부분 항생제 치료에 좋은 반응을 보이므로 조기진단을 위한 적극적 접근으로 심각한 합병증의 발생 및 불필요한 수술을 막아야 한다. 저자들은 폐암을 의심하여 시행한 검사도중 폐를 침범하는 방선균증을 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• Tuberculosis and Respiratory Diseases
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• 제75권2호
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• pp.71-74
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• 2013

Benign schwannoma is the most common neurogenic tumor in the mediastinum. Mediastinal benign schwannomas are most often asymptomatic and rarely accompanied by bloody pleural effusion. In the clinical analysis of 7 cases of pulmonary schwannomas, pleural effusion, and blood invasion were evident in 3 patients with malignant schwannoma. Herein, we report a rare case of giant, benign schwannoma presented with total collapse of right lung by massive, bloody pleural effusion.

• Journal of Chest Surgery
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• 제33권9호
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• pp.734-737
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• 2000

Background: McKeown first described two autopsy cases of esophageal small cell carcinoma (SMC) in 1952; about 230 cases have since been reported in the literature. Small cell carcinoma has been reported to account for 0.4% to 7.6% of all esophageal malignancies. SMC of the esophagus as regarded as having a poor prognosis with frequent systemic dissemination. Choice of treatment remains controversial. Material and Method: From August 1987 to December 1998, a review of the records and histologic sections of 8 patients with primary small cell carcinoma of the esophagus seen in 11 years was undertaken. Result: Small cell carcinoma of the esophagus constituted 1.5% of all esophageal cancers. The median age was 61.5 years(range from 42 to 71 years). Seven patients were male, tumor was mainly located in the middle and lower thirds(6 cases) of the esophagus. Pure SMC is 5 cases, and mixed SMC is 3 cases. Operative procedure were as follow: transthoracic esophagectomy with thoracic or cervical reconstructon in 7 patients, transhiated esophagectomy with cervical reconstruction in one. The operative death was none. Adjuvant chemotherapy was performed in 7 patients except one who had poor general condition. Recurrence was observed in 4 patients(mediastinal LN, abdominal LN, SCN, bone). The overall median survival was 15.9 months. Only one patient survived for more than 5 years. Conclusion: We considered that esophageal SMC should be regarded as a systemic disease, and multimodality treatment including chemotherapy should be used. Surgery may be offered in selected patients to manage local disease as part of a chemotherapy based treatment program.