• Title/Summary/Keyword: Residual neoplasm

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Surgical Treatment in Local Recurrence of Esophageal Cancer with Free Jejunal Graft -A Case Report (흉부식도암의 근치적절제후 국소 재발에서의 유리공장 이식술 -1례-)

  • 이종목;임수빈
    • Journal of Chest Surgery
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    • v.30 no.4
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    • pp.449-452
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    • 1997
  • We managed surgically a case of local recurrence in esophageal cancer Twenty month after transthoracic subtotal esophagectomy and csophago-gastrostomy, he su(fared from dysphagia. Chest CT and percutaneous needle aspiration biopsy showed . Local recurrence involving residual esophagus, thyroid gland, posterior membraneous portion of trachea. We did cervical esophagectomy, laryngectomy thyroidectomy, partial resection of trachea and reconstruction with free jejunal antograft successfully.

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Comparison of the Clinical Outcomes of Reconstruction Methods After Distal Gastrectomy: A Systematic Review and Meta-Analysis Based on Randomized Controlled Trials

  • Min, Jae-Seok;Kim, Rock Bum;Seo, Kyung Won;Jeong, Sang-Ho
    • Journal of Gastric Cancer
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    • v.22 no.2
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    • pp.83-93
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    • 2022
  • Background: To analyze the short- and long-term clinical outcomes of 2 reconstruction methods after distal gastrectomy for gastric cancer. Methods: Three keywords, "gastric neoplasm," "distal gastrectomy," and "reconstruction," were used to search PubMed. We selected only randomized controlled trial that compared the anastomosis methods. A total of 11 papers and 8 studies were included in this meta-analysis. All statistical analyses were performed using the R software. Results: Among short-term clinical outcomes, a shorter operation time, reduced morbidity, and shorter hospital stay were found for Billroth type I (B-I) than for Roux-en-Y (RNY) reconstruction in the meta-analysis (P<0.001, P=0.048, P<0.001, respectively). When comparing Billroth type II (B-II) to RNY, the operation time was shorter for B-II than for RNY (P<0.019), but there were no differences in morbidity or length of hospital stay (P=0.500, P=0.259, respectively).Regarding long-term clinical outcomes related to reflux, there were significantly fewer incidents of reflux esophagitis, reflux gastritis, and bile reflux (P=0.035, P<0.001, P=0.019, respectively) for RNY than for B-I in the meta-analysis, but there was no difference between the 2 methods in residual food (P=0.545). When comparing B-II to RNY, there were significantly fewer incidents of reflux gastritis (P<0.001) for RNY than for B-II, but the amount of residual food and patient weight gain showed no difference. Conclusion: B-I had the most favorable short-term outcomes, but RNY was more advantageous for long-term outcomes than for other methods. Surgeons should be aware of the advantages and disadvantages of each type of anastomosis and select the appropriate method.

Diagnostic Accuracy of Imaging Study and the Impact of Clinical Risk Factors on the Presence of Residual Tumor Following Unplanned Excision of Soft Tissue Sarcomas (악성 연부조직 종양에 대한 무계획적 절제술 후 잔여 종양의 영상학적 진단의 정확성과 임상적 위험인자)

  • Oh, Eunsun;Seo, Sung Wook;Jeong, Jeonghwan
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.2
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    • pp.150-156
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    • 2019
  • Purpose: This study examined the diagnostic accuracy of an imaging study to find the factors that affect the presence of residual tumors after an unplanned excision of sarcomas. Materials and Methods: Ninety-eight patients, who underwent a re-excision after unplanned surgery between January 2008 and December 2014, were enrolled in this study. Magnetic resonance imaging (MRI) was performed before reoperation in all patients. Positron emission tomography (PET)-computed tomography was performed on 54 patients. A wide re-excision and histology diagnosis were performed in all cases. The clinical variables were evaluated using univariate logistic regression and multivariate logistic regression. Results: The presence of a deep-seated tumor increases the risk of remnant tumors (odds ratio: 3.21, p=0.02, 95% confidence interval: 1.25-8.30). The sensitivity for detecting residual tumors is high in MRI (sensitivity 0.79). Conclusion: Deep-seated tumors have a significantly higher risk of remnant tumors. Because the negative predictive value of MRI and PET scans is very low, reoperation should be performed regardless of a negative result.

UNUSUAL PERIPHERAL OSTEOMAS: REPORT OF 2 CASES (악골 골종 2례 : 증례보고)

  • Suh, Chang-Ho;Lee, Doo-Hee;Kim, Hyung-Soon;Bae, Jung-Soo;Joo, Hyun-Ho;Weon, Dong-Whan;Kim, Il-Hyun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.3
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    • pp.276-279
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    • 2001
  • Osteoma is defined as a benign neoplasm of bony tissue. Osteomas are divided into two groups: central and peripheral by origin, compact and cancellous by histopathologic findings. Solitary osteoma of jaw bone, not related with Gardner syndrom, is relatively uncommon. We present two cases of huge solitary peripheral osteomas: compact type exophyting osteoma on the inferolingual side of mandibular angle and cancellous type on the residual ridge of posterior maxilla, which is extremely rare.

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Chordoid Glioma Originating in the Intrasellar and Suprasellar Regions: Case Report

  • Hwang, Jisun;Lee, Aleum;Chang, Kee-Hyun;Moon, Ah Rim;Hwang, Sun-Chul;Hong, Hyun Sook
    • Investigative Magnetic Resonance Imaging
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    • v.19 no.2
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    • pp.117-121
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    • 2015
  • Chordoid glioma is a rare, low-grade brain neoplasm typically located in the third ventricle. Herein, we report an unusual case of histologically confirmed chordoid glioma located in the pituitary fossa and suprasellar region, not attached to the third ventricle. A 57-year-old woman presented with a 2-month history of headache and visual disturbance. Magnetic resonance imaging revealed an ovoid mass in the pituitary fossa and suprasellar region, compressing the optic chiasm without involvement of the third ventricle. The tumor showed low signal intensity on T1-weighted images and iso- to high signal intensity on T2-weighted images, with strong and homogenous contrast enhancement. Subtotal resection was performed via the transcranial approach, and the patient subsequently received adjuvant gamma knife radiosurgery. However, the residual mass showed disease progression 5 months after the initial surgery.

A Case of Inoperable Advanced Papillary Thyroid Carcinoma Maintaining Long-term Stable Disease State after Palliative Aim Radiation Therapy Alone (수술이 불가능하여 고식적 목적의 외부방사선 단독치료 후 장기 안정병변 상태를 유지하고 있는 진행된 갑상선 유두암 1예)

  • Tae Hyun Kim;Hong Gyun Wu
    • Korean Journal of Head & Neck Oncology
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    • v.40 no.1
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    • pp.7-13
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    • 2024
  • The current standard of treatment for differentiated thyroid cancer is surgical resection followed by radioactive iodine therapy according to the recurrence risk. However, external beam radiotherapy may be recommended in limited cases where surgical resection is impossible or residual gross lesion remains or the aforementioned standard therapy is deemed insufficient in achieving local control. We report a case of 59 year old patient who presented with advanced papillary thyroid carcinoma of right neck but was unable to receive surgical resection due to underlying Eisenmenger syndrome. He received radiation therapy of 67.5 Gy in 30 fractions with palliative aim with no further treatment and has been maintaining long-term stable disease state for 38 months. Herein, we report a rare case of palliative aim radiation therapy alone for advanced papillary thyroid carcinoma with literature review.

Usefulness of Preoperative Breast MRI in Breast Cancer Diagnosed After Excisional Biopsy (유방 절제 생검 후 유방암이 진단된 환자에서 수술 전 자기공명영상의 유용성)

  • Wui, Jung-Hyun;Kang, Bong-Joo;Cha, Eun-Suk;Kim, Sung-Hun;Jung, Na-Young;Choi, Jae-Jeong
    • Investigative Magnetic Resonance Imaging
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    • v.12 no.2
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    • pp.161-169
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    • 2008
  • Purpose : The aim of this study was to evaluate the usefulness of MRI performed after excisional biopsy to diagnose residual cancer and additional lesions. Materials and Methods : A total of 16 patients who had breast cancer diagnosed by excisional biopsy underwent preoperative breast MRI between March 2005 and August 2007 were included. MRI findings were considered positive for residual cancer if focal, thick, or irregular rim enhancement or adjacent enhancing lesion was identified around the postoperative biopsy cavity. And additional lesions separated from biopsy cavity including multifocal, multicentric, or contralateral lesion were evaluated. We evaluated the diagnostic accuracy of MRI, comparing MRI with histopathologic finding, and the impact of MRI on surgical planning. Results : The sensitivity and specificity of MRI for detecting residual disease considering rim enhancement were 85.7%(6/7) and 55.6%(5/9). Additional lesions including multifocal, multicentric, or contralateral lesion were found in 6 patients. In 7 patients, results of MRI findings changed surgical treatment planning. Conclusion : The pattern of rim enhancement on MRI after excisional biopsy is not differential point to evaluate remnant lesion. But MRI has an important role to help the detection of multifocal or multicentric, or contralateral breast malignancies, resulting in beneficial change in surgical treatment planning.

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Evaluation of Post-Neoadjuvant Chemotherapy Pathologic Complete Response and Residual Tumor Size of Breast Cancer: Analysis on Accuracy of MRI and Affecting Factors (신보강화학요법 후 유방암의 병리학적 완전 관해 예측 및 잔류 암 평가: 유방자기공명영상의 정확도 및 영향인자 분석)

  • Hyun Soo Ahn;Yeong Yi An;Ye Won Jeon;Young Jin Suh;Hyun-Joo Choi
    • Journal of the Korean Society of Radiology
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    • v.82 no.3
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    • pp.654-669
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    • 2021
  • Purpose To evaluate the accuracy of MRI in predicting the pathological complete response (pCR) and the residual tumor size of breast cancer after neoadjucant chemotherapy (NAC), and to determine the factors affecting the accuarcy. Materials and Methods Eighty-eight breast cancer patients who underwent surgery after NAC at our center between 2010 and 2017 were included in this study. pCR was defined as the absence of invasive cancer on pathological evaluation. The maximum diameter of the residual tumor on post-NAC MRI was compared with the tumor size of the surgical specimen measured pathologically. Statistical analysis was performed to elucidate the factors affecting pCR and the residual tumor size-discrepancy between the MRI and the pathological measurements. Results The pCR rate was 10%. The diagnostic accuracy of MRI and the area under the curve for predicting pCR were 90.91% and 0.8017, respectively. The residual tumor sizes obtained using MRI and pathological measurements showed a strong correlation (r = 0.9, p < 0.001), especially in patients with a single mass lesion (p = 0.047). The size discrepancy between MRI and the pathological measurements was significantly greater in patients with the luminal type (p = 0.023) and multifocal tumors/non-mass enhancement on pre-NAC MRI (p = 0.047). Conclusion MRI is an accurate tool for evaluating pCR and residual tumor size in breast cancer patients who receive NAC. Tumor subtype and initial MRI features affect the accuracy of MRI.

Comparision of Risk Factors in Lung Cancer Surgery of Above 70-Year Old Patients (70세이상 환자에 대한 폐암 수술의 위험성 비교)

  • 장인석;심영목;김진국;김관민;유정우
    • Journal of Chest Surgery
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    • v.32 no.1
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    • pp.32-37
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    • 1999
  • Background: Early detection and surgical resection offer the most advantage out of all cures for lung cancer. Elderly patients may fail to benefit maximally from these interventions because of their general condition and residual lung function. To study the impact of age on stages, histology, symptoms, and treatments of the patients with non-small cell lung cancer, we undertook a retrospective review. Material and Method : Two hundred eleven patients with non-small cell lung cancer were operated on at Samsung Seoul hospital between October 1994 and June 1997. Patients were arbitrarily arbitrarily by age less than 70 years(176 patients) and 70 years or more(35 patients), and their medical records were reviewed. Result: There were no differences in pathologic staging and diagnosis. But there were differences in surgical methods, complications, and mortality rates between the two groups. There were much more complications in the 70 years or more group(p=0.02). We chose less invasive surgical methods in the 70 years or more group. Conclusion: More complications were experienced in the 70 years or more group. Although thoracic operation imparts the greatest survival advantage, this benefit is diminished in elderly patients because of their high complications and mortality rate. We recommend serious consideration of surgical indications and operative methods.

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Tumor Infiltrating Lymphocytes in Ovarian Cancer

  • Gasparri, Maria Luisa;Attar, Rukset;Palaia, Innocenza;Perniola, Giorgia;Marchetti, Claudia;Donato, Violante Di;Farooqi, Ammad Ahmad;Papadia, Andrea;Panici, Pierluigi Benedetti
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.9
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    • pp.3635-3638
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    • 2015
  • Several improvements in ovarian cancer treatment have been achieved in recent years, both in surgery and in combination chemotherapy with targeting. However, ovarian tumors remain the women's cancers with highest mortality rates. In this scenario, a pivotal role has been endorsed to the immunological environment and to the immunological mechanisms involved in ovarian cancer behavior. Recent evidence suggests a loss of the critical balance between immune-activating and immune-suppressing mechanisms when oncogenesis and cancer progression occur. Ovarian cancer generates a mechanism to escape the immune system by producing a highly suppressive environment. Immune-activated tumor infiltrating lymphocytes (TILs) in ovarian tumor tissue testify that the immune system is the trigger in this neoplasm. The TIL mileau has been demonstrated to be associated with better prognosis, more chemosensitivity, and more cases of optimal residual tumor achieved during primary cytoreduction. Nowadays, scientists are focusing attention on new immunologically effective tumor biomarkers in order to optimize selection of patients for recruitment in clinical trials and to identify relationships of these biomarkers with responses to immunotherapeutics. Assessing this point of view, TILs might be considered as a potent predictive immunotherapy biomarker.