• Journal of Digestive Cancer Research
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• 제1권1호
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• pp.48-51
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• 2013

73세 남자 환자로 약 1개월 전부터 상복부 불편감 주소로 본원 내원 후 시행한 상부 내시경 검사상 하체부 전벽측의 조기위암으로 내시경 점막하 박리술을 시행하였다. 조직검사 결과 저분화도(poorly differentiated type)의 선암이 발견되었고, 절제면의 암세포 침범 소견은 없었으나, 점막하 2층(900 um)까지 침윤된 소견과 일부 림프선 전이 소견이 보여 위 절제 수술(subtotal gastrectomy)을 시행하였다. 조직검사 결과 점막층에 국한된 저분화도의 선암이 발견되었고, 그 외 림프절 전이 등의 소견은 보이지 않아 수술 후 병기 1기의 조기위암(T1N0M0, stage IA) 으로 진단 후 추가적인 항암치료 없이 추적관찰을 하였다. 이후 6개월 마다 복부 전산화단층촬영술과 상부 내시경 검사를 시행하였으며, 수술 후 2년째 시행한 복부 전산화단층촬영 결과 간의 다발성의 전이성암으로 의심되는 소견이 관찰되었다. 간 조직 검사를 시행하였고, 조직검사 결과 저분화도의 선암으로 발견되었으며, 원발 병소를 확인하기 위해 면역화학 검사를 시행한 결과 췌담도 계통의 암에서 특징적으로 보일 수 있는 CK7과 CK19이 강양성 소견을 보여 담도암의 간전이로 의심하였다. 이후 췌담도 MRI 및 PET 검사 등을 시행 하였으나, 담도암 등의 소견은 관찰되지 않았다. 위암은 특징적으로 발생 기전에서 다양한 내적 및 외적 원인들(nitrosamine, H. pylori, E-cadherin mutation 등)로 인해 면역 화학 조직검사 결과가 다양하게 나타날 수 있기 때문에(heterogeneous cytokeratin expression pattern) 면역화학 검사 결과만으로 위암 가능성을 배제할 수 없는 것으로 보고되고 있다. 따라서 위암의 간전이로 진단 후 항암치료를 시행하였으며, 면역화학 검사에서 췌담도 계통의 암으로 오인되었던 재발성 전이성 위암의 증례 1례를 문헌고찰과 함께 보고한다.

• Journal of Gastric Cancer
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• 제14권4호
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• pp.279-283
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• 2014

We report a case of primary gastric malignant melanoma that was diagnosed after curative resection but initially misdiagnosed as adenocarcinoma. A 68-year-old woman was referred to our department for surgery for gastric adenocarcinoma presenting as a polypoid lesion with central ulceration located in the upper body of the stomach. The preoperative diagnosis was confirmed by endoscopic biopsy. We performed laparoscopic total gastrectomy, and the final pathologic evaluation led to the diagnosis of primary gastric malignant melanoma without a primary lesion detected in the body. To the best of our knowledge, primary gastric malignant melanoma is extremely rare, and this is the first case reported in our country. According to the literature, it has aggressive biologic activity compared with adenocarcinoma, and curative resection is the only promising treatment strategy. In our case, the patient received an early diagnosis and underwent curative gastrectomy with radical lymphadenectomy, and no recurrence was noted for about two years.

• Journal of Chest Surgery
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• 제25권10호
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• pp.1087-1092
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• 1992

We underwent two surgical resection of synchronous primary esophageal squamous cell carcinoma and gastric adenocarcinoma after obtaining histologic comfirmation 74-years old male pateint was recieved esophagectomy & total gastrectomy with esophagojejunostomy and 59-years old man was recieved near total esophagectomy and total gastrectomy with esophagocolo-gejunostomy. Their was no postoperative complications. The hospital day was 15 and 21 days postoperatively. All of them started oral intake at 7 days postoperatively and possible soft diet soon. We conclude that total resection of esophagus and stomach is the recommendable methods for prolong the life of double primary cancer patients of esophagus and stomach. Also, the reconstruction of the esophagus with colon or jejunal transposition is one of the recommenable procedure for curative surgical resection of double primary cancer in esophagus and stomach. And we also wish to emphasize the importance of detailed preopertive gastric examination for detect of gastric lesion and of careful intraoperative inspection of the gastric mucosa in patients with esophageal cancer whose preoperative gastric examination provide inconclusive evidence due to the severe esophageal stenosis.

• Journal of Gastric Cancer
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• 제2권1호
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• pp.26-28
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• 2002

Carcinomas of the stomach can spread to adjacent structure by local extension or metastasize to lymph nodes, peritoneum and distant organs. However, the incidence of metastatic bladder cancer originated at the stomach is very rare. A fifty-five year-old man admitted complaining of epigastric pain for 2 months. A large ulceroinfiltrative lesion was seen in the low body, which was confirmed poorly differentiated adenocarcinoma by histological examination. Abdominopelvic CT scan showed wall thickening at the greater curvature side of gastric body and urinary bladder. Urine cytology was negative. By transurethral resection of bladder, he was diagnosed as metastatic adenocarcinoma of the bladder. We report a case of stomach cancer with metastasis to urinry bladder.

• Journal of Gastric Cancer
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• 제4권3호
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• pp.186-191
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• 2004

Primary small-cell carcinomas of the stomach are rare and aggressive malignancies with poor survival rates. Preoperative diagnosis is difficult and a standard treatment is not yet established. We have recently experienced two cases of a primary small-cell carcinoma of the stomach. The first case was a 65-year-old man with epigastric soreness. Endoscopic biopsy showed an adenocarcinoma. He underwent a radical subtotal gastrectomy with D2 lymph-node dissection. Pathology revealed a collision tumor of a smallcell carcinoma and an adenocarcinoma with submucosal invasion and with metastasis in 20 out of 48 lymph nodes (T1N3M0). The second case was a 64-year-old man with epigastric soreness. Endoscopic biopsy revealed a small-cell carcinoma. There was no evidence of a primary tumor in the lung. A radical subtotal gastrectomy with D2 lymph-node dissection was performed. Pathology showed a pure smallcell carcinoma with proper muscle invasion and with metastasis in 1 out of 36 lymph nodes (T2aN1M0).

• 대한핵의학회지
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• 제38권5호
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• pp.344-346
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• 2004

A 69-year-old woman was presented with progressed dysphagia, gastric soreness and weight loss during 2 months. She was performed abdomen x-ray, EGDS and abdomen CT. Abdomen x-ray demonstrated punctuate calcification on LUQ. EGDS showed an ulceroinfiltrative mass with bleeding on cardia to antrum of stomach. And CT showed diffuse gastric wall thickness with multiple calcifications. Biopsy of the stomach and esophagus during EGDS examination revealed an adenocarcinoma, with signet ring cell type, infiltrating the wall of the stomach and the distal esophagus. Then acne scan was performed a few days later. It revealed intense uptake in LUQ, corresponding to the calcium containing neoplasm seen on the abdomen x-ray, EGDS and abdomen CT. And there was no evidence of any metastatic lesion and thyroid uptake on the bone scan. There are many reports about accumulation of the tracer in extraosseous lesion, but only a few literatures were reported about gastric calcification in stomach cancer. More over, no reports showed CT images. We are performed many diagnostic examinations and found well correlation between them. The reason of gastric calcification is considered with calcium deposition within extracellular space due to hemorrhage or necrosis. Other possibility offered to explain gastric calcification have been increased blood flow and/or increased neovascularity with capillary leaks of tracer, and specific enzymatic (phosphatases) receptor binding of tracer. So, it was happened ion exchange between intracellular calcium and phosphate groups of tracer.

• Journal of Gastric Cancer
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• 제15권2호
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• pp.139-142
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• 2015

Hepatic metastasis of early gastric cancer (EGC) following subtotal gastrectomy with lymphadenectomy is rare. We report the case of a 61-year-old male patient who was diagnosed with EGC that was initially treated using endoscopic submucosal dissection (ESD) and subsequently underwent laparoscopic subtotal gastrectomy. Histopathological examination of the patient's ESD specimen showed a moderately differentiated tubular adenocarcinoma invading the submucosa without lymphatic invasion. The deep margin of the specimen was positive for adenocarcinoma, and he subsequently underwent laparoscopic distal gastrectomy. The patient developed liver metastasis 15 months after the operation and then underwent liver resection. Histology of the resected specimen confirmed the diagnosis of two foci of metastatic adenocarcinoma originating from stomach cancer. Immunohistochemical analysis of the specimen demonstrated overexpression of human epidermal growth factor receptor 2. The patient was treated with trastuzumab in combination with chemotherapy consisting of capecitabine and cisplatin. Twenty-four months after the operation, the patient remained free of recurrence.

• 생명과학회지
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• 제21권3호
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• pp.417-423
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• 2011

사이모신 베타 4와 관련 단백질인 HIF-$1{\alpha}$ 및 VEGF의 발현을 여러 인간 암 조직에서 tissue microarray를 사용하여 조사하였다. 사이모신 베타 4는 골육중, 대장 선암, 식도 편평세포암, 신장 및 방광의 이행세포암, 폐암 및 간암에서 많이 발현되었으며 HIF-$1{\alpha}$은 비강 역위성 유두종, 폐암 및 식도 편평세포암에서 강한 발현을 보였으며 대체로 발현되는 양상이나 위치가 사이모신 베타 4와 일치하는 것으로 관찰되었다. VEGF는 암 조직에서보다 암조직에 분포된 혈관내피에서 강하게 발현되는 양상을 나타내었으며 암세포에서는 사이모신 베타 4나 HIF-$1{\alpha}$에 비해 강하게 발현되지 않았다. 위암, 간 혈관육종, 담낭 선암과 자궁 내막 선암에서 적당 수준의 VEGF 발현이 관찰되었으며 VEGF의 발현 양상 및 위치는 위암, 골육종, 지방종, 폐암, 간암, 담낭 선암, 식도 편평세포암, 대장 및 직장암, 신세포암을 포함하는 특정 암에서 사이모신 베타 4 및 HIF-$1{\alpha}$와 일치하는 것으로 관찰되었다.

• Journal of Gastric Cancer
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• 제11권3호
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• pp.180-184
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• 2011

Letrozole is a drug used in the treatment of postmenopausal women with breast and ovarian tumours. There is no evidence in the literature indicating its use in treating gastric cancer. We present a 68 year old lady admitted from the emergency department with weight loss, malaise and anaemia. Investigations confirmed the presence of two different primary tumours in the left breast and the stomach. Following that this patient with oestrogen receptor positive breast cancer and oestrogen receptor negative gastric cancer was treated with letrozole for her breast cancer followed by a gastric resection. Independent histology by two pathologists pre-operatively diagnosed gastric adenocarcinoma. Post-operatively, independent analysis of the resected stomach, omentum and lymph nodes revealed no evidence of gastric cancer. Therefore we conclude that there is a possibility of letrozole having an effect on gastric cancer. Further studies are needed.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제2권2호
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• pp.217-221
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• 1999

저자들은 2주간의 간헐적 상복부 동통과 식욕결핍을 호소하는 15세 남아에서 위 내시경과 조직 생검으로 진단된 원발성 위 림프종 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.