• Journal of Gastric Cancer
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• 제24권1호
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• pp.122-134
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• 2024

Most gastric subepithelial tumors (SETs) are asymptomatic and are often incidentally discovered during endoscopic procedures conducted for unrelated reasons. Although surveillance is sufficient for the majority of gastric SETs, certain cases necessitate proactive management. Laparoscopic wedge resection, although a viable treatment option, has its limitations, particularly in cases where SETs (especially those with intraluminal growth) are not visualized on the peritoneal side. Recent advances in endoscopic instruments and technology have paved the way for the feasibility of endoscopic resection of SETs. Several promising endoscopic techniques have emerged for gastric SET resection, including submucosal tunneling endoscopic resection, endoscopic full-thickness resection (EFTR), laparoscopic and endoscopic cooperative surgery (LECS), and non-exposure EFTR (non-exposed endoscopic wall-inversion surgery and non-exposure simple suturing EFTR). This study aimed to discuss the indications, methods, and outcomes of endoscopic therapy for gastric SETs. In addition, a simplified diagram of the category of SETs according to the therapeutic indications and an algorithm for the endoscopic management of SET is suggested.

• 대한기관식도과학회지
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• 제15권1호
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• pp.24-27
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• 2009

Background: Benign tumors of the esophagus are rare. They include leiomyomas, gastrointestinal stromal tumors, neurofibromas and lipomas. In this study we present our experience with enucleation of these 13 tumors for 10 years. Material and Method: A retrospective review of patients who underwent enucleation of benign esophageal tumors between 1995 and 2005 was conducted. Symptom, tumor location and size, operative approach and outcomes after surgery were recorded. Result Thirteen patients were identified(leiomyoma: n=12; GIST n=l). Eight patients were men, five patients were women. Most of them were 4rd and 5th decade. The tumors arose in the lower(7 patients) and middle(6 patients) thirds of the esophagus. Eleven patients underwent a thoracotomy; the remainder were resected using VATS. All of patients underwent simple enucleation. There were no complications and recurrences after surgery. Conclusion: We present our experience with enucleation of these 12 leiomyomas and one GIST for 10 years.

• Journal of Gastric Cancer
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• 제13권2호
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• pp.93-97
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• 2013

Purpose: Endoscopic submucosal dissection has recently been practiced on a differentiated type of early gastric cancer. However, there is no clear evidence for endoscopic treatments of signet ring cell carcinoma. The aim of this study is to identify the predictive clinicopathological factors for lymph node metastasis in signet ring cell carcinoma for assisting endoscopic submucosal dissection trials. Materials and Methods: A total of 186 patients with early signet ring cell carcinoma who underwent radical curative gastrectomy between January 2001 and September 2009 were enrolled in this study. Retrospective reviews of their medical records are being conducted. Several clinicopathologic factors were being investigated in order to identify predictive factors for lymph nodes metastasis: age, gender, tumor size, type of operation, tumor location, gross type, ulceration, Lauren's classification, depth of invasion, and lymphatic invasion. Results: The lymph node metastasis rate for signet ring cell carcinoma was 4.3% (n=8). Of the 186 lesions with early signet ring cell carcinoma, 91 (48.9%) tumors were larger than 15 mm in size and 40 (21.5%) showed submucosal invasions in the resection specimens. In multivariate analysis, only the lymphatic invasion (P<0.0001) showed an association with lymph node metastasis. To evaluate cutoff values for tumor sizes in the presence of lymph node metastasis, early signet ring cell carcinomas with lymphatic invasions were excluded. In the absence of lymphatic invasion, mucosal cancer with tumor sizes <15 mm had no lymph node metastasis. Conclusions: Endoscopic submucosal dissection can be performed on patients with early signet ring cell carcinoma limited to the mucosa and less than 15 mm.

• 대한상부위장관⦁헬리코박터학회지
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• 제18권4호
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• pp.258-263
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• 2018

Follicular lymphoma is the most common form of low-grade B cell lymphoma. Follicular lymphoma occurs predominantly at lymph node sites and rarely in the gastrointestinal tract. Rare gastrointestinal follicular lymphoma is most commonly found in the small intestine, especially in the duodenum, and appears as multiple granules. However, gastric follicular lymphoma mostly appears as a subepithelial tumor. We observed two primary gastric follicular lymphomas that resembled subepithelial tumors located in the body of the stomach. Endoscopic ultrasound revealed hypoechoic lesions located in the submucosa layer. Since endoscopic forceps biopsies were inconclusive, we performed endoscopic submucosal dissection, which resulted in a final pathologic diagnosis of follicular lymphoma. Because of the indolent nature of gastrointestinal follicular lymphoma, the "watch and wait" strategy can be applied in the early phase. The identification of endoscopic characteristics of gastric follicular lymphoma can be helpful for differential diagnosis and decision of treatment strategy. Therefore, we report two cases of primary gastrointestinal follicular lymphoma diagnosed following endoscopic submucosal dissection.

• Journal of Chest Surgery
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• 제38권8호
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• pp.589-593
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• 2005

식도에 발생하는 신경초종은 매우 드문 질환으로 알려져 있으며, 술 전 대부분 식도 점막하종양으로 진단된다 확진은 술 후 시행되는 면역조직화학 검사에 의해 내려진다. 본원에서는 3개월 동안의 연하곤란을 주소로 내원한 63세 여자 환자와, 2개월간의 간헐적인 연하곤란을 주소로 내원한 39세의 여성에서 발생한 식도 점막하 종양을 우측개흉술을 통한 식도 절제술 및 종양 적출술을 각각 시행하여 제거하였다. 술 후 면역조직화학 검사 결과 2예 모두 S-100양성으로 나타나 식도의 양성 신경초종으로 확진되었다.

• Journal of Digestive Cancer Research
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• 제2권1호
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• pp.24-27
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• 2014

본 증례에서는 우연히 한 환자에서 위장관 간질 종양과 점막하 종양 형태의 MALT 림프종을 동시에 발견하였고, 이를 내시경적 절제술로 치료한 사례이다. 현재 환자는 절제술 후 2년 동안 질병의 진행 없이 외래에서 경과 관찰 중이다. 아직 MALT 림프종과 위장관 간질종양에서 내시경적 점막하 절제술은 정립된 치료 방법이 아니지만, 본 증례처럼 성공적으로 치료될 수 있음을 경험하였기에 문헌고찰과 함께 보고하는 바이다. 아직은 내시경적 절제술로 치료한 사례가 적지만, 향후 내시경적 절제술 후 긴 기간 동안 추적 관찰된 증례들이 모인다면 조기위암처럼 표준화된 치료법으로 시행될 수 있기를 기대한다.

• Tuberculosis and Respiratory Diseases
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• 제48권1호
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• pp.91-95
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• 2000

성인의 기관에서 발생한 점액선 선종은 매우 드문 종양으로 대부분 양성이다. 저자 등은 객혈을 주소로 내원한 환지에서 발견된 기관의 점액선 선종 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• Journal of Gastric Cancer
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• 제15권1호
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• pp.68-73
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• 2015

Gastric cancer that mimics a submucosal tumor is rare. This rarity and the normal mucosa covering the protuberant tumor make it difficult to diagnosis with endoscopy. We report two cases of advanced gastric cancer that mimicked malignant gastrointestinal stromal tumors preoperatively. In both cases, the possibility of cancer was not completely ruled out. In the first case, a large tumor was suspected to be cancerous during surgery. Therefore, total gastrectomy with lymph node dissection was performed. In the second case, the first gross endoscopic finding was of a Borrmann type II advanced gastric cancer-like protruding mass with two ulcerous lesions invading the anterior wall of the body. Therefore, subtotal gastrectomy with lymph node dissection was performed. Consequently, delayed treatment of cancer was avoided in both cases. If differential diagnosis between malignant gastrointestinal stromal tumor and cancer is uncertain, a surgical approach should be carefully considered due to the possible risk of adenocarcinoma.

• Journal of Chest Surgery
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• 제47권1호
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• pp.59-62
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• 2014

Primary epithelial-myoepithelial carcinoma (EMC) of the lung is an extremely rare neoplasm that originates from submucosal bronchial glands and has been found in the salivary glands, breast tissue, and sweat glands. However, only a few cases in the respiratory tract have been identified. In the literature, most pulmonary EMCs have been reported to have developed endobronchially although a few EMC cases have been presented as intraparenchymatous tumors. We have identified a case of primary EMC that developed in the peripheral lung parenchyma.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제12권1호
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• pp.57-63
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• 2009

평소 복부 팽만을 보인 2세 남아가 내원 3일 전부터 간헐적인 구토를 동반하여 시행한 복부 방사선 사진에서 좌상복부에서 석회화 소견을 관찰하여 상부 위장관내시경과 복부 전산화 단층 사진을 시행하였다. 술 후 병리 검사에서 상당히 빈도가 드문 석회화 섬유 종양을 발견하였기에 보고하는 바이다.