• Advances in pediatric surgery
• /
• v.1 no.1
• /
• pp.79-84
• /
• 1995

Two cases with papillary cystic neoplasm of the pancreas are reviewed and discussed. Up to recently, the tumors have been misclassified as nonfunctioning islet cell tumor or carcinoma, acinar cell carcinoma, papillary cystadenocarcinoma, or pancreatoblastoma. It frequently has been managed with aggressive surgery such as pancreatoduodenectomy. The tumors are well encapsulated and the cut surfaces are characteristically solid and hemorrhagic. Ultrasonography and CT scan are the most useful tools for the diagnosis. The neoplasms usually behave like a very low grade malignancy, so complete removal is the treatment of choice for the tumor arising anywhere in the pancreas. We have a boy and a girl who have papillary cystic neoplasm. The boy was 12 years old and the girl was 14 years old. Both underwent distal pancreatectomy and the progress were uneventful. We have a boy and a girl who have papillary cystic neoplasm. The boy was 12 years old and the girl was 14 years old. Both underwent distal pancreatectomy and the progress were uneventful.

• Journal of Korean Neurosurgical Society
• /
• v.43 no.5
• /
• pp.246-249
• /
• 2008

Cause of pituitary apoplexy has been known as hemorrhage, hemorrhagic infarction or infarction of pituitary adenoma or adjacent tissues of pituitary gland. However, pituitary apoplexy caused by pure infarction of pituitary adenoma has been rarely reported. Here, we present the two cases pituitary apoplexies caused by pituitary adenoma infarction that were confirmed by transsphenoidal approach (TSA) and pathologic reports. Pathologic report of first case revealed total tumor infarction of a nonfunctioning pituitary macroadenoma and second case partial tumor infarction of ACTH secreting pituitary macroadenoma. Patients with pituitary apoplexy which was caused by pituitary adenoma infarction unrelated to hemorrhage or hemorrhagic infarction showed good response to TSA treatment. Further study on the predisposing factors of pituitary apoplexy and the mechanism of infarction in pituitary adenoma is necessary.

• Journal of Chest Surgery
• /
• v.26 no.11
• /
• pp.894-898
• /
• 1993

Pulmonary sequestration is an uncommon congenital pulmonary malformations characterized by presence of nonfunctioning lung tissue which receives its blood supply mostly from the anomalous systemic arteries. We have experienced a 30 year old male patient with a mediastinal mass complaining of intermittent chest pain, and the mass was histologically confirmed as extralobar pulmonary sequestration. The anomalous blood supply origined from the right pulmonary artery but there was no communication with the tracheobronchial tree. He underwent operation through midsternotomy incision for the purpose of concurrent resection of enlarged thymus noted on chest CT.

• Journal of Chest Surgery
• /
• v.21 no.4
• /
• pp.793-796
• /
• 1988

Pulmonary sequestration is an unusual congenital malformation characterized by the presence of nonfunctioning lung tissue which usually has no communication with the normal bronchial tree and receives its blood supply from an anomalous systemic artery. We present a case of extralobar pulmonary sequestration experienced recently. The patient was 13 month old female with a complaint of fever, coughing and tachypnea. Chest film showed large homogeneous opacity in left lower lung field. At operation, a homogeneous mass was located between the left upper lobe and lower lobe, measuring 4X6X5cm in dimension. The aberrant artery was originated from the descending thoracic aorta, 1 cm in length and 3 mm in diameter. After division and ligation of the aberrant artery, sequestrectomy and lingular segmentectomy was done due to abscess formation. The postoperative course was smooth. She was discharged on postoperative thirteenth day.

• Tuberculosis and Respiratory Diseases
• /
• v.53 no.1
• /
• pp.66-70
• /
• 2002

Pulmonary Sequestration is a rare congenital malformation during embryouic development which results in a cystic mass of nonfunctioning lung tissue. A diagnosis of a pulmonary sequestration has traditionally relied upon identifying the pathological arterial vessels by arteriography, computed tomography, and magnetic resonance imaging. We reported a case of pulmonary sequestration diagnosed by Doppler sonography and subsequent CT angiography. A 21-year-old-woman admitted to hospital for an investigation of recurrent pneumonia with left lower chest pain. A doppler ultrasound sonography showed an aberrant blood supply from the descending thoracic aorta to the left lower chest lesion. The pulmonary sequestration was confirmed by the subsequent CT angiograph.

• Journal of Chest Surgery
• /
• v.28 no.8
• /
• pp.797-800
• /
• 1995

Pulmonary sequestration is an uncommon congenital pulmonary malformation characterized by presence of nonfunctioning lung tissue which receives its blood supply mostly from the anomalous systemic arteries - descending thoracic aorta or abdominal aorta, subclavian artery, innominated artery and internal mammary artery, etc. In our country, 39 cases were reported previously. The patient was a 40 years old woman and admitted due to productive cough for 1 year. The chest X-ray and chest C-T showed a dense mass containing a large cavity with air-fluid level and multiple radiolucent cysts in the right lower lung field. On the operative field, we could identify an aberrant large artery [ $\phi$7mm which arose directly from the descending thoracic aorta at eighth thoracic spinal level and fed the sequestrated portion of the right lower lobe. The aberrant artery was double ligation after division. Only sequestrated lobe on the superolateral lesion of the right lower lobe was resected because of nonseparated lobes in all the right lobes. An abnormal vein and bronchiole were ligated with black silk. The patient`s postoperative course was unevenful.

• Journal of Korean Neurosurgical Society
• /
• v.37 no.1
• /
• pp.16-19
• /
• 2005

Objective: This study is designed to evaluate the clinical outcome, the safety and the effectiveness of the open sella methods(OSM) with intentionally staged transsphenoidal approach(TSA) for giant pituitary adenomas(GPA). Methods: Eight patients with GPA were managed by the OSM with intentionally staged TSA. There were 5 nonfunctioning adenomas, 2 prolactin-secreting adenomas, and 1 growth hormone-secreting adenoma. Among them, 6 patients underwent two times of TSA, one patient underwent three times of TSA, and the other patient underwent two times of TSA followed by radiation therapy. The mean time interval between staged operations was 3.9 months except for one case. Results: Seven out of the eight patients with GPA treated with the OSM with intentionally staged TSA showed that the tumors were completely removed on magnetic resonance imaging and that they were free from headache and visual problem suffered previously. Only one patient experienced severe complications including panhypo-pituitarism, cerebrospinal fluid rhinorrhea and permanent diabetes insipidus. Conclusion: With the surgical treatment for 8 cases of GPA, which extended to the suprasellar and parasellar area, we suggest that the OSM with intentionally staged TSA is a safe and effective method in management for GPA.

• The Korean Journal of Cytopathology
• /
• v.18 no.1
• /
• pp.74-80
• /
• 2007

Parathyroid tumors may be difficult to distinguish from thyroid follicular lesions, especially when a tumor is nonfunctioning. We report here two cases of asymptomatic parathyroid carcinoma preoperatively misdiagnosed as thyroid follicular lesions, and one case of parathyroid adenoma showing hyperparathyroidism, and review the cytologic features favoring the diagnosis of parathyroid neoplasm. The cytologic findings that are characterized by clean background, monomorphic small cells, cohesive three-dimensional papillary clusters, small tight clusters with scattered naked nuclei, and well-defined clear cytoplasm favor a diagnosis for the parathyroid lesions. Cytologic findings such as macrofollicular structure, presence of colloid and macrophages, and presence of perivacuolar cytoplasmic granules on May-Grunwald-Giemsa stain support a diagnosis of a thyroid follicular lesion. The cytomorphology of parathyroid tumors is so variable that the distinction from a thyroid lesion cannot be based on the presence or absence of a single feature only but on the cytologic features as a whole.

• Investigative Magnetic Resonance Imaging
• /
• v.14 no.2
• /
• pp.145-150
• /
• 2010

We report the case of a 16-year-old boy with a solid pancreatic mass which proved to be a nonfunctioning, malignant pancreatic neuroendocrine tumor (PNET). In pediatric patients, malignant pancreatic tumors are rare, especially malignant PNET. When dynamic contrast enhanced MRI showed a well enhancing solid pancreatic tumor on arterial and delayed phases and combined with malignant features, such as vascular invasion, invasion of adjascent organs, and lymphadenopathy, we should include malignant pancreatic neuroendocrine tumor in the differential diagnosis of childhood pancreatic tumors.

• Journal of Korean Neurosurgical Society
• /
• v.29 no.7
• /
• pp.929-934
• /
• 2000

Objective : The results of secondary transsphenoidal surgery(TSS) for either residual or recurring pituitary adenomas have been reported to be unfavorable. To evaluate the effectiveness of secondary TSS, we analyzed the surgical results of residual or recurred pituitary adenomas in patients who underwent secondary TSS from 1992 to 1998. Material and Methods : Among the 95 patients who underwent TSS during this period, 14(15%) received repeated TSS. Two of the 14 patients underwent three TSS. Among the 11 patients with pituitary adenomas, three had nonfunctioning tumors ; six prolachnomas ; two GH-secreting adenomas. The remaining three patieats had craniopharyngioma, pituitary abscess and hemangioendothelioma respectively. The interval between the two surgical procedures ranged from one week to 33 months(mean ; 12 months). Causes of the secondary TSS were tumor recurrence in 11 patients, intentional staged operation in three, persistent disease despite medical therapy and CSF leak after initial operation in one respectively. Treatments prior to secondary TSS were medical treatment only in eight patients. Results : During the repeated operationtss some adhesion was noted in septal mucous membrane. The sphenoid cavity was filled with fibrous tissue which correlated with the methods of reconstruction of the sellar floor at the previous operation. There was no statistically significant difference in success rate of surgery between the initial and the second TSS(86% vs 81%). The complication rate was similar between the two procedures. There was no statistically significant factors affecting the results of second TSS. Conclusion : Transsphenoidal reoperation was regarded as a suitable approach for treating recurrent pituitary adenomas in spite of some degree of operative difficulties. In patients with transsphenoidally resectable tumor residuals or recurrences confirmed by magnetic resonance imaging, remissions can be obtained with high probability, especially in secondary surgery after an staged decompression.