• 대한두개안면성형외과학회지
• /
• 제17권3호
• /
• pp.176-179
• /
• 2016

Primary cutaneous mucinous carcinoma (PCMC) is a rare low-grade malignant neoplasm derived from the eccrine glands. PCMC most commonly arises in the head and neck, with the eyelid being the most common site of origin. This case report describes a 51-year-old male with a painless, pigmented superficial nodular lesion over his right lower eyelid. The lesion was considered to be benign, and the initial treatment was simple excision with a 3-mm margin. However, histologic examination revealed the diagnosis of PCMC, and the patient underwent re-excision of the tumor site with an additional 3-mm margin from the initial scar. Histologic study of this second margin was free of any malignant cells. The patient experienced no postoperative complication or recurrence after 2 years. In our case, the skin lesion had benign morphologic findings and was strongly suspected to be a benign mass. Physicians should be aware of this tumor and be able to differentiate it from benign cystic or solid eyelid lesions.

• Journal of Digestive Cancer Reports
• /
• 제9권1호
• /
• pp.8-18
• /
• 2021

Although many guidelines for pancreatic cystic neoplasms focus on the management of intraductal papillary mucinous neoplasm of the pancreas (IPMN) at the highest oncological risk, there are many issues that surgeons need to consider at the time to plan the surgical procedures based on characteristics of IPMN subtypes, such as multiplicity of branch duct-IPMN (BD-IPMN) and intraductal spreading of main duct-IPMN (MD-IPMN). For multifocal BD-IPMN, partial pancreatectomy would be selected to remove BD-IPMN with predictors of malignancy, while the other lesions without risk factors can be left, although total pancreatectomy might be considered if the patients have a strong family history of pancreatic cancer. Partial pancreatectomy would be also adequate procedure for MD-IPMN if negative surgical margin for high-grade dysplasia or invasive carcinoma were achieved. It has become to be well-known that patients with BD-IPMN are at increased risk for developing not only IPMN-associated pancreatic ductal adenocarcinoma (PDAC) but also PDAC independent from the IPMN. Hence, the detection of a concomitant PDAC is also an important focus for strategies after resection of BD-IPMNs. Our recent analysis of patients after partial pancreatectomy for MD-IPMN with negative surgical margin identified an unexpected recurrence pattern, which we called "monoclonal skip" recurrence. MD-IPMN seems to be disseminated in the pancreatic ductal systems and MD-IPMN with identical genetic background was detected in the remnant pancreas even in a long time after index surgery. We proposed strategies of postoperative surveillance based on characteristics and natural history of each morphological subtype.

• Investigative Magnetic Resonance Imaging
• /
• 제12권2호
• /
• pp.107-114
• /
• 2008

목적 : 3T MR 기기를 이용하여, 췌장 주위에 발생한 낭성 종양에 대하여, 생체내, 그리고 생체외 생체내 자기공명분광법(magnetic resonance spectroscopy: MRS)를 획득한 후, 생체외 핵자기공명 (nuclear magnetic resonance, NMR) 스펙트럼을 기준으로 비교함으로써, 낭성 종양의 감별 진단에 있어 MRS의 적용 가능성을 알아보고자 하였다. 대상 및 방법 : 췌장 주위에 발행한 12예의 낭성 종양(점액성 낭성 종양=5, 췌담관내 유두종=5, 가성 낭종=1, 및 림프관종 n=1)을 대상으로 3.0T 생체내, 생체외 양성자 MRS 및 9T NMR 스펙트럼을 획득하였다. NMR의 피크와 상응하는 생체내, 생체외 양성자 MRS에서 관찰되는 피크의 존재유무를 알아보았으며, 특정 질환을 예측하는 피크에 대하여 알아보았다. 결과 : 생체내 MRS는 NMR과 민감도 29.6%, 특이도 82.6% 그리고, 67.7%의 정확도를 보였으며 (p=0.096, McNemar test), 생체외 MRS는 생체내 MRS는 민감도 57.1%, 특이도 92.6%, 그리고, 82.3%의 정확도를 보였다 (p = 0.362, McNemar test). 질병간의 스펙트럼의 차이는 NMR에서 췌담관내 유두종의 경우에서 점액성 낭성 종양에 비해 3.5-4.0 ppm에서 유의하게 많은 피크를 보였다 (p=0.026). 결론 : 결론적으로, NMR 이용한 화학물질 분석은 낭성 종양의 감별 진단에 도움이 될 가능성이 있는 기법으로 생각되지만, 생체내 및 생체외 MRS는 임상에 적용되기 위해서는 많은 기술적 발전을 필요로 하는 것으로 생각된다.