• 대한영상의학회지
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• 제84권1호
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• pp.311-317
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• 2023

컴퓨터단층촬영 유도 경피적 바늘 생검은 폐 이상 진단에 중요한 역할을 하며, 안전하고 효과적이지만 기흉, 출혈, 객혈, 공기 색전증 및 종양 파종과 같은 합병증의 위험이 있다고 알려져 있다. 그러나 시술 후 발생한 기종에 대한 증례 보고는 드물다. 저자들은 원발성 폐암의 경피적 바늘 생검 직후 발생한 기종 2예를 보고하고자 한다. 시술 후 단기 추적검사 컴퓨터단층 촬영에서 바늘 경로를 따라 새로 생긴 결절의 경우 혈종으로 찬 기종을 의심해야 한다.

• Journal of Chest Surgery
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• 제35권8호
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• pp.608-610
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• 2002

폐암의 흉막 파종은 그 예후가 매우 불량하며, 경정맥 항암화학요법 이외에는 일반적으로 다른 치료가 시행 되지 않고 있다. 저자들은 층막 파종이 있는 두 명의 환자에게 온열요법을 병행한 흡막강내 고농도 항암약제의 관류요법을 시행하였기에, 그 결과를 문헌 고찰과 함께 보고하고자 한다.

• Journal of Yeungnam Medical Science
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• 제34권1호
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• pp.132-136
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• 2017

Leiomyosarcoma (LMS) of the small intestine is a rare tumor, accounting for about 1% of all malignant mesenchymal lesions in the gastrointestinal tract. Since small bowel tumors are initially asymptomatic and nonspecific, delayed diagnosis and treatment are common. We found that a 44-year-old male patient who came in for lower abdominal pain had partial obstruction in the small bowel. Multiple ascites and ileal tumors involving peritoneal seeding were observed from his abdominal computed tomography. He was diagnosed as epithelioid LMS involving peritoneal transition after surgical resection, and the outpatient department has planned for a conservative therapy with observation. To the best of our knowledge, ileal epithelioid LMS accompanying a huge omental mass, with a size of 18 cm in dimension, and peritoneal seeding has not yet been reported in Korea. We report this rare case with literature review.

• 대한두경부종양학회지
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• 제32권1호
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• pp.21-23
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• 2016

The aim of this report was to present a rare case of a tracheotomy site recurrence after operation and post-operative radiotherapy in head and neck squamous cell carcinoma patient. Tracheotomy site recurrence other than subglottic cancer is very rare in head and neck cancer patient. The granulation tissue around tracheotomy was a fertile "soil" for tumor cell implantation. Midline mucosal sparing block which was used to decreased acute toxicity during post-operative radiotherapy could be facilitating the tumor cell implantation. The head and neck surgeon should try every effort to reduce contamination of cancer cells during operation and consider the entire operative field should be included in post-operative radiation portals.

• Journal of Chest Surgery
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• 제29권5호
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• pp.517-523
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• 1996

원자력병원에서는 1988년 5월부터 1994년 6월까지 373명의 비소세포 폐암 환자를 개흥하였으며, 이 중 병 리 학적 병기 lIIB로 판명된 48명의 겨록을 분석하였다. 74 병소는 대 혈관(26례), 심장(5례), 동측폐 전이 (4ET ), 식도(4El ), 기관 분기를(3례), 종격동(2례), 기관(1례), 및 척추 체부(1례) 등의 침범과 늑막 파종(늑막 전이, 15례)이었다. 수술은 48명중 25명에서 확대 폐절제및 림프절 절제를 시행하였으나, 23 례 에서는 시험 개흥술만 시행하였으며, 가장 흔한 절제 불가능의 원인은 늑막 파종이 었다. 절제 군의 수 술 유병률과 사망률은 각각 32 % (8125), 16 % (4125)이었고, 시험 개흥술 군에서는 각각 4% (1123), 0% (0123)이었다 수술 후 대부분의 환자에서 (37148) 항암 치료 또는 방사선 치료 등의 보조요법을 병 행하였 다. 수숲 후 1년 및 3년 생존률은 수술 사망을 포함하여 절제 군에서는 각각 57.2%, 23.8 % (중앙값, 15개 횡)이 었으며, 시험 개흥군에서는 각각 48.4%, 0 % (중앙값, 7개 월)이 었다(Log-Rank test, p = 0.17). 이상의 결과로,74환자의 일부에서 확대 폐절제의 역할이 인정 된다고 할 수 있으나 수술의 위험성 이 높으므 \ulcorner환자의 선택에 신중을 기해야 하며, 불필요한 개흥을 피하기 위해서는 늑막 파종과 종격동 구조물의 침습을수술전에 발견하기 위한보다 정교한 진단 및 병기 결정 과정이 요구된다.

• 대한영상의학회지
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• 제82권4호
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• pp.1000-1004
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• 2021

경피적 흉부 생검은 폐 병변을 병리학적으로 진단하는 데 있어서 필수적인 최소 침습 시술이다. 매우 드물기는 하지만 흉막과 흉벽에 종양의 파종이 경피적 흉부 생검의 합병증으로 생길 수 있다. 유방은 흉곽의 앞쪽에 위치하기 때문에 경피적 흉부 생검 시 흉곽의 앞쪽에서 접근할 때 바늘이 유방을 지나는 것을 피할 수 없는 경우가 있다. 이에 저자들은 유방의 만져지는 종괴로 내원한 51세 여성에서 경피적 흉부 생검 경로를 따라 생긴 전이성 폐 법랑모세포종의 파종을 경험하였기에 영상 소견과 함께 증례 보고한다.

• Investigative Magnetic Resonance Imaging
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• 제22권3호
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• pp.177-181
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• 2018

Intraperitoneal metastatic hepatocellular carcinoma (HCC) is uncommon. Although rare, it can spontaneously rupture and cause hemoperitoneum similar to primary HCC in the liver. We present a case of intraperitoneal metastatic HCC that had spontaneously ruptured and appeared as an irregularly margined hemorrhagic mass with T1 high and T2 dark signal intensities on magnetic resonance imaging. Ruptured HCC is a life-threatening emergency with high mortality rate. Spontaneously ruptured intraperitoneal metastatic HCC should be considered if a patient with a history of HCC presents with acute abdomen, although rare.

• Radiation Oncology Journal
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• 제30권4호
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• pp.213-217
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• 2012

Purpose: To evaluate treatment outcome of patients with high risk locally advanced gastric cancer after postoperative chemoradiotherapy. Materials and Methods: Between May 2003 and May 2012, thirteen patients who underwent postoperative chemoradiotherapy for gastric cancer with resection margin involvement or adjacent structure invasion were retrospectively analyzed. Concurrent chemotherapy was administered in 10 patients. Median dose of radiation was 50.4 Gy (range, 45 to 55.8 Gy). Results: The median follow-up duration for surviving patients was 48 months (range, 5 to 108 months). The 5-year overall survival rate was 42% and the 5-year disease-free survival rate was 28%. Major pattern of failure was peritoneal seeding with 46%. Locoregional recurrence was reported in only one patient. Grade 2 or higher gastrointestinal toxicity occurred in 54% of the patients. However, there was only one patient with higher than grade 3 toxicity. Conclusion: Despite reported suggested role of adjuvant radiotherapy with combination chemotherapy in gastric cancer, only very small portion of the patients underwent the treatment. Results from this study show that postoperative chemoradiotherapy provided excellent locoregional control with acceptable and manageable treatment related toxicity in patients with high risk locally advanced gastric cancer. Thus, postoperative chemoradiotherapy may improve treatment result in terms of locoregional control in these high risk patients. However, as these findings are based on small series, validation with larger cohort is suggested.

• Radiation Oncology Journal
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• 제38권1호
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• pp.26-34
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• 2020

Purpose: Intensity-modulated radiotherapy (IMRT) allows for more precise treatment, reducing unwanted radiation to nearby structures. We investigated the safety and feasibility of IMRT for anaplastic ependymoma patients below 3 years of age. Materials and Methods: A total of 9 anaplastic ependymoma patients below 3 years of age, who received IMRT between October 2011 and December 2017 were retrospectively reviewed. The median equivalent dose in 2 Gy fractions was 52.0 Gy (range, 48.0 to 60.0 Gy). Treatment outcomes and neurologic morbidities were reviewed in detail. Results: The median patient age was 20.9 months (range, 12.1 to 31.2 months). All patients underwent surgery. The rates of 5-year overall survival, freedom from local recurrence, and progression-free survival were 40.6%, 53.3%, and 26.7%, respectively. Of the 9 patients, 5 experienced recurrences (3 had local recurrence, 1 had both local recurrence and cerebrospinal fluid [CSF] seeding, and 1 had CSF seeding alone). Five patients died because of disease progression. Assessment of neurologic morbidity revealed motor dysfunction in 3 patients, all of whom presented with hydrocephalus at initial diagnosis because of the location of the tumor and already had neurologic deficits before radiotherapy (RT). Conclusion: Neurologic morbidity is not caused by RT alone but may result from mass effects of the tumor and surgical sequelae. Administration of IMRT to anaplastic ependymoma patients below 3 years of age yielded encouraging local control and tolerable morbidities. High-precision modern RT such as IMRT can be considered for very young patients with anaplastic ependymoma.

• Journal of Gastric Cancer
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• 제14권2호
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• pp.123-128
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• 2014

Purpose: Since there are no proven tumor markers that reflect the course of gastric cancer, carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) are commonly used alternatives. However, the degree of progression that corresponds to an increase in these markers, and the values of these markers at different cancer stages, remains unclear. Materials and Methods: This study enrolled 1,733 gastric cancer patients who underwent surgery and whose pre-operative CEA and CA19-9 levels were known. Survival curves and mean values of the two markers were compared according to the degree of cancer progression: serosa-unexposed (SU), serosa-exposed (SE), direct invasion (DI), localized seeding (P1), and extensive seeding (P2). Results: The 5-year overall survival rates at each stage differed significantly, except between DI and P1 patients (17.1% vs. 10.5%, P=0.344). The mean CEA values in SU, SE, DI, P1, and P2 patients were 5.80, 5.48, 13.36, 8.06, and 22.82, respectively. The CA19-9 values for these patients were 49.40, 38.97, 101.67, 73.77, and 98.57, respectively. The increase in CEA in P2 patients was statistically significant (P=0.002), and the increases in CA19-9 in DI and P2 patients were significant (P=0.025, 0.007, respectively). There was a fair correlation between the two markers in P2 patients (r=0.494, P<0.001). Conclusions: CA19-9 can be used to assess DI of gastric cancer into adjacent organs. Both markers are useful for predicting the presence of extensive peritoneal seeding.