• 대한두경부종양학회지
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• 제31권2호
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• pp.39-42
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• 2015

Warthin's tumor is the second most common salivary gland benign tumor, typically occurring in the fifth to seventh decades of life which shows an indolent feature. It is usually found in the parotid gland but occasionally in extra-parotid locations such as peri-parotid lymph node. However, Report of solitary Warthin's tumor in cervical lymph node is unusual. We here report a case of 72-year-old male with simultaneous malignant melanoma on eyelid and cervical lymph node enlargement in cervical level II area thus mimicking malignancy metastasis. After excisional biopsy under the local anesthesia, pathology was reported as papillary cystadenoma lymphomatosum, which is a histologically pathognomic finding of Warthin's tumor. However, there was no suspicious tumorous lesion in major or minor salivary glands. This case suggests that Warthin's tumor should be considered as a possible pathology in solitary lymph node lesion of neck.

• 대한두경부종양학회지
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• 제23권1호
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• pp.41-45
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• 2007

A 60 years old female patient presented with $8{\times}6\;cm$ sized painless oval mass in the left parietal region. She had left lobectomy of thyroid gland 10 years ago. Cranial CT, MRI, FGD PET-CT showed a solid mass which invaded left parietal bone. After embolization, craniectomy with tumor excision was performed. Histological examination revealed metastatic follicular cancer originated thyroid gland, with vascular and dura invasion. Postoperatively, neck CT showed right thyroid multiple nodules and right level III multiple lymph node enlargement. Thyroid function test was normal, but level of thyroglobulin was high (72ng/ml). So she had right lobectomy of thyroid gland with lymph node dissection under a diagnosis of follicular carcinoma. But histological examination revealed adenomatous hyperplasia and not lymph node metastasis. After operation, she received radioiodine therapy of 150mCi and then the level of thyroglobulin normalized (8.4ng/ml). The patient is under follow-up since she had operation 4 months ago.

• Journal of Gastric Cancer
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• 제4권4호
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• pp.272-276
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• 2004

목적: 조기 위암의 경우 림프절 정이의 빈도가 $2\∼20\%$로 낮고 따라서 수술 범위를 최소화하려는 경향이 있다. 게다가 조기 위암의 경우 림프절 절제술의 적절한 범위 선택에 여러 의견들이 있는 상황이다. 본 연구는 위암의 경우 감시 림프절 및 하나의 림프절 전이가 있는 증례를 분석하여 림프절 절제술의 최소 범위를 찾고자 하는데에 있다. 대상 및 방법: 연세대학교 의과대학 외과학교실에서 2000년부터 2002년까지 치료적 위절제술 및 D2 림프절 절제술을 시행받은 78명의 환자를 대상으로 감시 림프절을 평가 하였다. 개복술후 25 mg의 indocyanine green을 5 ml의 생리 식염수에 혼합하여 원발 종양부위의 장막하층에 주입하여 5분 이내에 염색된 모든 림프절을 표시하였다. 또한 연세대학교 의과대학 외과학 교실에서 1997년부터 2001년까지 치료적 위절제술을 시행받은 환자중 하나의 림프절 전이를 보인 141명을 분석하였다. 결과: 감시 림프절을 평가한 78명의 환자 중 69명($88.5\%$)에서 감시 림프절이 확인되었고, 그중 60명($87\%$)의 환자에서 감시 림프절은 위주위 제1군 림프절에서 발견 되었으나 9명($13\%$)의 경우에서는 제2군 림프절에서 감시 림프절이 확인 되었다. 하나의 림프절 전이를 보인 141명의 전이 림프절의 해부학적 위치를 분석한 결과 125명($88.6\%$)에서는 위주위 제1군 림프절로 전이가 있었고 16명($11.4\%$)에서는 제2군 림프절로 전이를 하였다. 결론: 따라서 D1 림프절 절제술을 시행할 경우 위암에 있어서 조기 전이를 놓칠 수 있으며, 만약 림프절 절제술이 필요한 경우에 있어서는 D2 림프절 절제술이 최소 수술 범위라 할수 있겠다.

• Tuberculosis and Respiratory Diseases
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• 제46권6호
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• pp.879-883
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• 1999

폐내 림프절은 흉부엑스선상 폐결절로 나타나는 드문 질환으로 방사선 소견만으로는 악성종양과 감별하기 어렵다. 저자는 중엽과 하엽의 늑막표면 근처에 위치하는 직경 1cm 이하의 다발성 결절을 흉강경하 생검하여 폐내 림프절로 확진한 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• Radiation Oncology Journal
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• 제33권4호
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• pp.301-309
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• 2015

Purpose: To identify prognostic factors for disease progression and survival of patients with extracranial oligometastatic breast cancer (EOMBC), and to investigate the role of radiation therapy (RT) for metastatic lesions. Materials and Methods: We retrospectively reviewed the medical records of 50 patients who had been diagnosed with EOMBC following standard treatment for primary breast cancer initially, and received RT for metastatic lesions, with or without other systemic therapy between January 2004 and December 2008. EOMBC was defined as breast cancer with five or less metastases involving any organs except the brain. All patients had bone metastasis (BM) and seven patients had pulmonary, hepatic, or lymph node metastasis. Median RT dose applied to metastatic lesions was 30 Gy (range, 20 to 60 Gy). Results: The 5-year tumor local control (LC) and 3-year distant progression-free survival (DPFS) rate were 66.1% and 36.8%, respectively. High RT dose (${\geq}50Gy_{10}$) was significantly associated with improved LC. The 5-year overall survival (OS) rate was 49%. Positive hormone receptor status, pathologic nodal stage of primary cancer, solitary BM, and whole-lesion RT (WLRT), defined as RT whose field encompassed entire extent of disease, were associated with better survival. On analysis for subgroup of solitary BM, high RT dose was significantly associated with improved LC and DPFS, shorter metastasis-to-RT interval (${\leq}1month$) with improved DPFS, and WLRT with improved DPFS and OS, respectively. Conclusion: High-dose RT in solitary BM status and WLRT have the potential to improve the progression-free survival and OS of patients with EOMBC.

• 대한두경부종양학회지
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• 제8권2호
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• pp.82-90
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• 1992

A pathologic review was made of 1547 cases of thyroid nodule during the 20 years from 1970 to 1989 at the department of Head and Neck surgery of Presbyterian Medical Center in Chonju. 1547 cases were analysed in regard to cancer incidence of thyroid nodule, correlation of preoperative diagnosis with pathology and of frozen section diagnosis with final pathology, surgical procedures employed in managing thyroid itself, location of metastatic nodes, further definite procedure in cnacer cases, effectiveness of prophylactic neck dissection with lymph node pathology. The results are summarized as follows: 1) The cancer incidence of thyroid nodule was 21.7%. 2) The incidence of thyroid cnacer in total neoplasms increased from 1.6% to 2.9%. 3) The thyroid cancer was prevalent in female(5.9:1) and in fifth, fourth and sixth decade of life. 4) The incidence of solitary cold nodule in thyroid cancer was 72.7% (210/289). S) The incidence of thyroid cancer in solitary cold nodule was 28.7% (210/782). 6) The false negative of frozen section (1240 cases) was 19.8%. 7) Histologically, well differentiated carcinoma comprises about 94% of all cases and papillary carcinoma was 78.5% of all cases 8) The most frequent lymphatic metastasis was pre- & paratrachel nodes(63.3%), followed by Level III(50%) and Level II(47.7%). 9) 47.7% among 130 cases of papillary adenocarcinoma and 12.5% among 16 cases of follicular adenocarcinoma, each group treated with prophylactic neck dissection, were confirmed to be occult cervical node metastasis.

• Journal of Gastric Cancer
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• 제1권3호
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• pp.150-154
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• 2001

Purpose: Multiple early gastric cancers were found in $6.9\∼11.7\%$ of patients with early gastric cancer. The goal of this study was to clarify the clinicopathologic features of and to investigate treatment strategy for multiple early gastric cancer. Materials and Methods: Of 967 patients with an gastric adenocarcinoma who were treated by surgical resection during the period of $1993\∼1998$ at the Department of Surgery, Korea University College of Medicine, 267 patients had early gastric cancer. A retrospective analysis of the clinicopathologic differences between the main and the accessory lesions in multiple early gastric cancer was carried out. A comparative analysis was also conducted between solitary early gastric cancer and multiple early gastric cancer. Results: Of 267 patients with early gastric cancer, multiple early gastric cancers were found in 12 patients ($4.5\%$), including 10 men and 2 women. Eleven patients with multiple early gastric cancer had one accessory lesion and 1 patient had 2 accessory lesions. Of the 13 accessory lesions, 7 ($53.8\%$) were located in the same region as the main lesion. The most frequent combination of macroscopic types for the main lesion and the accessory lesion were depressed and depressed types (6 cases, $46.1\%$). The most frequent histologic type of main lesion was a well differentiated adenocarcinoma in 7 ($58.3\%$) of the 12 cases; the accessory lesion was also well differentiated in 4 of those 7 cases. Of the 13 accessory lesions, 4 ($30.8\%$) had been overlooked preoperatively; most of them were located in the lower third of the stomach and were IIb or IIc type and measured less than 1 cm in diameter. Lymph node metastasis was detected in 1 patient ($8.3\%$). The clinicopathologic features of multiple early gastric cancer were not different from those of solitary early gastric cancer. Conclusion: In multiple early gastric cancer, the main and the accessory lesions showed similar differentiation, and lymph node metastasis was less frequent than in solitary early gastric cancer. Therefore, limited procedures, including endoscopic mucosal resection, may be indicated if each lesion of the multiple early gastric cancer fits the criteria for treatment strategy.

• Journal of Chest Surgery
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• 제7권1호
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• pp.37-46
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• 1974

52 cases of metastatic lung tumor, including 22 [42.3%] choriocarcinoma., 13[25%] liver cancer, 6 [7.5%] stomach cancer, 2 bone tumor, etc, were reviewed at Busan National University Hospital, during a 5 year period ending with 1974. The age distribution of metastatic lung tumor were same in second decade to 5th decade. The most common appearances of roentgenograms of metastatic lung tumor were that of multinodular [42.3%], diffuse acinar [21.1%],infiltrative or pneumonic[21.1%], solitary lesion [9.6%] and diffuse micronodular [5.7%]. The metastatic lesions originated from choriocarcinoma revealed multinodular and acinar in roentgenogram, and the lesions originated from liver and stomach cancer revealed infiltrative and acinar. In our series, the positive hilar lymph node enlargement was encountered in 12 cases, of which 4 were in liver cancer and 3 were in stomach cancer. Pleural effusion was also encountered in 5 cases, of which 3 were in liver cancer. The treatment of this series was almost conservative except of 2 cases of pulmonary resection, and the reason of this limited cases of surgical treatment was seemed due to the delayed direction of metastasis to lung beyond the proper indication of surgery.

• Journal of Gastric Cancer
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• 제17권2호
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• pp.186-191
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• 2017

The role of nodal station No. 14v (along the superior mesenteric vein) in lymphadenectomy for distal gastric cancer remains elusive. A 73-year-old woman underwent endoscopic submucosal dissection for gastric cancer, and was referred to our division for additional surgery because of pathologically non-curative resection. A laparoscopic distal gastrectomy with D1+ dissection was performed, with a final diagnosis of pT1bN1M0, Stage IB (2 nodal metastases to No. 6). Four months post-surgery, abdominal computed tomography revealed a 14-mm solitary nodule along the superior mesenteric vein. The lesion was excised and pathologically identified as a lymph node metastasis. Adjuvant chemotherapy with tegafur-gimeracil-oteracil potassium (S-1) was administered for the metastasis. Presently the patient survives without recurrence, 5.5 years after the second operation. Our findings suggest that there is lymphatic flow from the No. 6 to the No. 14v nodal station. Some patients with a No. 6 metastasis may benefit from a No. 14v lymphadenectomy, even in early-staged disease.

• Journal of Gastric Cancer
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• 제4권4호
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• pp.277-281
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• 2004

조기위암은 림프절 전이에 상관없이 위점막이나 점막하층까지 암이 국한된 것으로 정의된다. 진행성 위암에 동반된 간전이율은 $5\~12\%$이나 조기위암에 동반된 간전이는 드물다. 64세 여자 환자나 상복부 통증을 주소로 성빈센트 병원에 내원하여 시행한 위내시경 검사에서 위전정부에 폴립형 종괴가 있었으나 간전이 소견은 없었다. 수술 시 간에 단일 전이가 발견되었으며, 2군 림프절을 포함하여 원위부 아전절제술과 전이된 간이 절제술을 시행하였다. 조직검사에서 위전정부의 종괴는 선종의 일부에 선암성 변화가 있었고 이는 위점막에 국한되어 있었으며, 절제된 간은 선암의 소견을 보였다. 저자들은 조기위암에 동반된 간전이 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.