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Focused Review articles
Overview of hepatocarcinogenesis focusing on cellular origins of liver cancer stem cells: a narrative review
Jong Ryeol Eun
J Yeungnam Med Sci. 2025;42:3.   Published online November 11, 2024
DOI: https://doi.org/10.12701/jyms.2024.01088
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AbstractAbstract PDF
Hepatocellular carcinoma (HCC) accounts for 85% to 90% of primary liver cancers and generally has a poor prognosis. The hierarchical model, which posits that HCC originates from liver cancer stem cells (CSCs), is now widely accepted, as it is for other cancer types. As CSCs typically reside in the G0 phase of the cell cycle, they are resistant to conventional chemotherapy. Therefore, to effectively treat HCC, developing therapeutic strategies that target liver CSCs is essential. Clinically, HCCs exhibit a broad spectrum of pathological and clinical characteristics, ranging from well-differentiated to poorly differentiated forms, and from slow-growing tumors to aggressive ones with significant metastatic potential. Some patients with HCC also show features of cholangiocarcinoma. This HCC heterogeneity may arise from the diverse cellular origins of liver CSCs. This review explores the normal physiology of liver regeneration and provides a comprehensive overview of hepatocarcinogenesis, including cancer initiation, isolation of liver CSCs, molecular signaling pathways, and microRNAs. Additionally, the cellular origins of liver CSCs are reviewed, emphasizing hematopoietic and mesenchymal stem cells, along with the well-known hepatocytes and hepatic progenitor cells.
Pathology and diagnostic approaches to well-differentiated hepatocellular lesions: a narrative review
Joon Hyuk Choi, Swan N. Thung
J Yeungnam Med Sci. 2025;42:5.   Published online October 24, 2024
DOI: https://doi.org/10.12701/jyms.2024.00766
  • 1,191 View
  • 108 Download
AbstractAbstract PDF
Well-differentiated hepatocellular lesions (WDHLs) are liver tumors or nonneoplastic lesions in which the cells closely resemble normal hepatocytes. These lesions often include focal nodular hyperplasia, hepatocellular adenoma, macroregenerative nodule, dysplastic nodule, and well-differentiated hepatocellular carcinoma. The diagnosis of these lesions remains challenging because of their morphological similarities, particularly when examined using needle biopsy. The accurate diagnosis of WDHLs is crucial for patient management and prognosis. This review addresses the histopathological characteristics and diagnostic approaches of WDHLs.
Case report
Ruptured triple hormone-secreting adrenal cortical carcinoma with hyperaldosteronism, hypercortisolism, and elevated normetanephrine: a case report
Sin Yung Woo, Seongji Park, Kun Young Kwon, Dong-Mee Lim, Keun-Young Park, Jong-Dai Kim
J Yeungnam Med Sci. 2024;41(4):306-311.   Published online September 6, 2024
DOI: https://doi.org/10.12701/jyms.2024.00626
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AbstractAbstract PDF
We report a case of a ruptured triple hormone-secreting adrenal mass with hyperaldosteronism, hypercortisolism, and elevated normetanephrine levels, diagnosed as adrenal cortical carcinoma (ACC) by histology. A 53-year-old male patient who initially presented with abdominal pain was referred to our hospital for angiocoagulation of an adrenal mass rupture. Abdominal computed tomography revealed a heterogeneous 19×11×15 cm right adrenal mass with invasion into the right lobe of the liver, inferior vena cava, retrocaval lymph nodes, and aortocaval lymph nodes. Angiocoagulation was performed. Laboratory evaluation revealed excess cortisol via a positive 1-mg overnight dexamethasone suppression test, primary hyperaldosteronism via a positive saline infusion test, and plasma normetanephrine levels three times higher than normal. An adrenal mass biopsy was performed for pathological confirmation to commence palliative chemotherapy because surgical management was not deemed appropriate considering the extent of the tumor. Pathological examination revealed stage T4N1M1 ACC. The patient started the first cycle of adjuvant mitotane therapy along with adjuvant treatment with doxorubicin, cisplatin, and etoposide, and was discharged. Clinical cases of dual cortisol- and aldosterone-secreting ACCs or ACCs presenting as pheochromocytomas have occasionally been reported; however, both are rare. Moreover, to the best of our knowledge, a triple hormone-secreting ACC has not yet been reported. Here, we report a rare case and its management. This case report underscores the necessity of performing comprehensive clinical and biochemical hormone evaluations in patients with adrenal masses because ACC can present with multiple hormone elevations.
Focused Review article
Clinical significance of exosomal noncoding RNAs in hepatocellular carcinoma: a narrative review
Jae Sung Yoo, Min Kyu Kang
J Yeungnam Med Sci. 2025;42:4.   Published online February 8, 2024
DOI: https://doi.org/10.12701/jyms.2023.01186
  • 2,097 View
  • 66 Download
AbstractAbstract PDF
Hepatocellular carcinoma (HCC) is one of the most lethal malignancies worldwide, with poor prognosis owing to its high frequency of recurrence and metastasis. Moreover, most patients are diagnosed at an advanced stage owing to a lack of early detection markers. Exosomes, which are characterized by their cargos of stable intracellular messengers, such as DNA, RNA, proteins, and lipids, play a crucial role in regulating cell differentiation and HCC development. Recently, exosomal noncoding RNAs (ncRNAs), including microRNAs, long ncRNAs, and circular RNAs, have become increasingly important diagnostic, prognostic, and predictive markers of HCC. Herein, we discuss the clinical implications of exosomal ncRNAs, specifically those within the HCC regulatory network.
Case report
DaVinci SP-based simultaneous bilateral partial nephrectomy from the midline transperitoneal approach: a case report
Young Hwii Ko, Jong Gyun Ha, Jae Yoon Jang, Yeung Uk Kim
J Yeungnam Med Sci. 2024;41(1):48-52.   Published online January 4, 2024
DOI: https://doi.org/10.12701/jyms.2023.01032
  • 1,431 View
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AbstractAbstract PDF
While simultaneous bilateral partial nephrectomy with a conventional multiport robot has been consistently reported since the 2010s, the introduction of the DaVinci SP system (Intuitive Surgical, Sunnyvale, CA, USA) could provide a novel way to perform surgery on bilateral kidneys while innovatively reducing the number of incisions. In our first report worldwide, the patient with bilateral small renal mass (2.0 cm for the left and 1.5 cm for the right side) and preoperative normal renal function was placed in the lateral decubitus position on an inverted bed. After tilting the bed to be as horizontal as possible, a 4-cm incision was made in the lower part of the umbilicus for the floating trocar technique. The partial nephrectomy was performed reliably as with the conventional transperitoneal approach, and then the patient could be repositioned to the contralateral side for the same procedure, maintaining all trocars. Total operation time (skin to skin), total console time, and the left- and right-side warm ischemic times were 260, 164, 27, and 23 minutes, respectively, without applying the early declamping technique. The estimated blood loss was 200 mL. The serum creatinine right after the operation, on the first day, 3 days, and 90 days after surgery were 0.92, 0.77, 0.79, and 0.81 mg/dL, respectively. For 90 days after the procedure, no complications or radiologic recurrence were observed. Further clinical studies will reveal the advantages of using the DaVinci SP device for this procedure over traditional multiport surgery, maximizing the benefit of a single port-based approach.
Original articles
The effect and therapeutic compliance of adjuvant therapy in patients with cholangiocarcinoma after R0 resection: a retrospective study
Han Taek Jeong, Joonkee Lee, Hyeong Ho Jo, Ho Gak Kim, Jimin Han
J Yeungnam Med Sci. 2023;40(1):65-77.   Published online May 26, 2022
DOI: https://doi.org/10.12701/jyms.2022.00213
  • 3,967 View
  • 69 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract PDF
Background
This study aimed to compare clinical outcomes between surveillance and adjuvant therapy (AT) groups after R0 resection for cholangiocarcinoma (CCA).
Methods
A total of 154 patients who underwent R0 resection for CCA at the Daegu Catholic University Medical Center between January 2010 and December 2019 were included. Overall survival (OS) and progression-free survival (PFS) were analyzed.
Results
The median follow-up duration was 899 days. There were 109 patients in the AT group and 45 patients in the surveillance group. The patients in the AT group were younger (67 years vs. 74 years, p<0.001) and included more males (64.2% vs. 46.7%, p=0.044). The proportion of patients with stage III CCA was larger in the AT group than in the surveillance group (13.8% vs. 2.2%, p=0.005). In addition, AT did not improve OS (5-year OS rate, 69.3% in the AT group vs. 64.2% in the surveillance group, p=0.806) or PFS (5-year PFS rate, 42.6% in the AT group vs. 48.9% in the surveillance group, p=0.113). In multivariate analysis using the Cox proportional hazards model, stage III CCA (hazard ratio [HR], 10.81; 95% confidence interval [CI], 2.92–40.00; p<0.001) was a significant predictor of OS. American Society of Anesthesiologists classification II (HR, 0.50; 95% CI, 0.31–0.81; p=0.005), and American Joint Committee on Cancer stages II (HR, 3.14; 95% CI, 1.25–7.89; p=0.015) and III (HR, 8.08; 95% CI, 2.80–23.32; p<0.001) were independent predictors of PFS.
Conclusion
AT after R0 resection for CCA did not improve OS or PFS.

Citations

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  • Robotic Complete ALPPS (rALPPS)—First German Experiences
    Jörg Arend, Mareike Franz, Alexander Rose, Christine March, Mirhasan Rahimli, Aristotelis Perrakis, Eric Lorenz, Roland Croner
    Cancers.2024; 16(5): 1070.     CrossRef
The clinical outcomes of second-line chemotherapy in patients with advanced pancreatic cancer: a retrospective study
Hyun yeb Jung, Eun Mi Lee
J Yeungnam Med Sci. 2022;39(2):124-132.   Published online October 19, 2021
DOI: https://doi.org/10.12701/yujm.2021.01347
  • 5,400 View
  • 101 Download
  • 2 Web of Science
  • 2 Crossref
AbstractAbstract PDF
Background
Despite recent advances in first-line chemotherapy for advanced pancreatic cancer, standard treatment after the failure of initial chemotherapy has not been established. Hence, we aimed to retrospectively analyze the clinical characteristics and outcomes of second-line chemotherapy in patients with advanced pancreatic cancer.
Methods
We reviewed the clinical data of patients with advanced pancreatic cancer who underwent palliative chemotherapy at Kosin University Gospel Hospital between January 2013 and October 2020.
Results
Among 366 patients with advanced pancreatic cancer who had received palliative chemotherapy, 104 (28.4%) underwent at least one cycle of second-line chemotherapy. The median age of the patients at the time of initiating second-line treatment was 62 years (interquartile range, 57–62 years), and 58.7% (61 patients) of them were male. The common second-line chemotherapy regimens were 5-fluorouracil (FU) plus leucovorin, irinotecan, and oxaliplatin (33 patients, 31.7%); gemcitabine/nab-paclitaxel (29, 27.9%), gemcitabine±erlotinib (13, 12.5%); and oxaliplatin and 5-FU/leucovorin (12, 11.5%). The median overall survival (OS) and progression-free survival were 6.4 months (95% confidence interval [CI], 4.5–8.6 months) and 4.5 months (95% CI, 2.7–6.3 months), respectively. In a multivariate analysis, poor performance status (PS) (hazard ratio [HR], 2.247; p=0.021), metastatic disease (HR, 2.745; p=0.011), and elevated carcinoembryonic antigen (CEA) levels (HR, 1.939; p=0.030) at the beginning of second-line chemotherapy were associated with poor OS.
Conclusion
The survival outcome of second-line chemotherapy for advanced pancreatic cancer remains poor. However, PS, disease extent (locally advanced or metastatic), and CEA level may help determine patients who could benefit from second-line treatment.

Citations

Citations to this article as recorded by  
  • Efficacy and tolerance of LV5FU2-carboplatin chemotherapy in patients with advanced pancreatic ductal adenocarcinoma after failure of standard regimens
    Thomas Chaigneau, Lina Aguilera Munoz, Caroline Oger, Clémence Gourdeau, Olivia Hentic, Lucie Laurent, Nelly Muller, Marco Dioguardi Burgio, Marie-Pauline Gagaille, Philippe Lévy, Vinciane Rebours, Pascal Hammel, Louis de Mestier
    Therapeutic Advances in Medical Oncology.2023;[Epub]     CrossRef
  • Real-Life Results of Palliative Chemotherapy in Metastatic Pancreatic Ductal Adenocarcinoma
    Bianca Varzaru, Razvan A. Iacob, Adina E. Croitoru, Speranta M. Iacob, Cristina E. Radu, Stefania M. Dumitrescu, Cristian Gheorghe
    Cancers.2023; 15(13): 3500.     CrossRef
Case report
High-grade mucoepidermoid carcinoma in the thyroid gland with poor prognosis
Hyeong Chan Shin
Yeungnam Univ J Med. 2021;38(2):169-174.   Published online March 5, 2021
DOI: https://doi.org/10.12701/yujm.2021.00941
  • 6,330 View
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  • 4 Crossref
AbstractAbstract PDF
Mucoepidermoid carcinoma (MEC) is the most common malignant neoplasm of the salivary gland, but primary thyroid MEC has rarely been reported and usually has a good prognosis. Herein, I report a case of thyroidal MEC with a poor prognosis in an 82-year-old woman with an anterior neck mass. Ultrasonography and computed tomography revealed a thyroid mass. The patient initially underwent fine-needle aspiration, was diagnosed with malignancy, and underwent a right lobectomy. On gross examination, a 4.0×3.6×2.6 cm-sized ill-defined, unencapsulated, and infiltrative tan to whitish mass with necrosis was identified. Microscopically, epidermoid tumor cell nests or solid sheets were identified. Mucous cells that were positive for periodic acid–Schiff and mucicarmine stains were also identified within epidermoid cell nests. Frequent mitosis and necrosis were observed. Immunohistochemical staining for p40 and p63 was positive, and that for thyroid transcription factor-1 and PAX8 was focally positive. According to the Armed Forces Institute of Pathology grading system for salivary gland MEC, the current case was classified as high-grade MEC. After surgery, the patient suffered from dyspnea due to a remnant neck mass that compressed and obstructed the trachea; therefore, the patient refused further treatment. Thyroidal MECs are considered low-grade with a favorable prognosis, but there are several reported cases of thyroidal MEC with poor prognosis. The current case is a rare presentation of high-grade thyroidal MEC with a poor prognosis.

Citations

Citations to this article as recorded by  
  • Primary mucoepidermoid carcinoma of the thyroid with concomitant MAML2 gene rearrangement and BRAF V600E mutation – A case report
    Frederica Loghides, Brigid Aherne
    Oral Oncology Reports.2024; 9: 100154.     CrossRef
  • Mucoepidermoid carcinoma of the pancreas: A case report and literature review
    Huan Zhang, Shuyan Wang, Chunnian Wang
    Medicine.2024; 103(4): e36993.     CrossRef
  • Primary Thyroid Mucoepidermoid Carcinoma (MEC) Is Clinically, Prognostically, and Molecularly Different from Sclerosing MEC with Eosinophilia: A Multicenter and Integrated Study
    Hieu Trong Le, Truong P. X. Nguyen, Mitsuyoshi Hirokawa, Ryohei Katoh, Norisato Mitsutake, Michiko Matsuse, Ayaka Sako, Tetsuo Kondo, Nilesh Vasan, Young Mi Kim, Ying Liu, Lewis Hassell, Kennichi Kakudo, Huy Gia Vuong
    Endocrine Pathology.2023; 34(1): 100.     CrossRef
  • Overview of the 2022 WHO Classification of Thyroid Neoplasms
    Zubair W. Baloch, Sylvia L. Asa, Justine A. Barletta, Ronald A. Ghossein, C. Christofer Juhlin, Chan Kwon Jung, Virginia A. LiVolsi, Mauro G. Papotti, Manuel Sobrinho-Simões, Giovanni Tallini, Ozgur Mete
    Endocrine Pathology.2022; 33(1): 27.     CrossRef
Original article
The effectiveness of prophylactic ipsilateral central neck dissection in selected patients who underwent total thyroidectomy for clinically node-negative unilateral papillary thyroid carcinoma
Jin Gu Kang, Young Ah Kim, Jung Eun Choi, Soo Jung Lee, Su Hwan Kang
Yeungnam Univ J Med. 2020;37(3):202-209.   Published online April 10, 2020
DOI: https://doi.org/10.12701/yujm.2020.00031
  • 5,979 View
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  • 2 Crossref
AbstractAbstract PDF
Background
Prophylactic central neck dissection (CND) in clinically node-negative (cN0) papillary thyroid carcinoma (PTC) remains controversial. The purpose of this study was to evaluate the benefits of prophylactic ipsilateral CND compared with bilateral CND in total thyroidectomy for cN0 unilateral PTC.
Methods
We retrospectively enrolled 174 patients who underwent total thyroidectomies with prophylactic CND for cN0 unilateral PTC between January 2009 and May 2010. The prophylactic CND patients were divided into group 1, the ipsilateral CND group (n=74), and group 2, the bilateral CND group (n=100). The incidence of central lymph node metastasis (CLNM) and postoperative complications, such as hypoparathyroidism, recurrent laryngeal nerve injury, and recurrence were assessed.
Results
CLNM was found in 22 (29.8%) in group 1 and 69 (69%) in group 2. The incidence of postoperative severe hypocalcemia less than 7.0 was also significantly different (six patients [8.1%] in group 1 and 23 [23%] in group 2; p=0.009). Permanent hypoparathyroidism was significantly more frequent in group 2 (4.1% vs. 19%; p=0.005). However, the incidence of transient hypoparathyroidism, recurrence, and recurrent laryngeal nerve injury was not significantly different.
Conclusion
Prophylactic ipsilateral CND has advantage not only to reduce incidence of some complications but also to have similar recurrence rate compared with bilateral CND. We suggest that prophylactic ipsilateral CND may be safe and effective for selected patients undergoing total thyroidectomy for cN0 unilateral PTC.

Citations

Citations to this article as recorded by  
  • Comparison of prophylactic ipsilateral and bilateral central lymph node dissection in papillary thyroid carcinoma: a meta-analysis
    Yujie Li, Lingling Lao
    Brazilian Journal of Otorhinolaryngology.2023; 89(6): 101318.     CrossRef
  • Fine-Needle Pricking Test of the Parathyroid Gland during Thyroid Surgery in Predicting Parathyroid Function
    Ying-Jun Wu, Jian-Biao Wang, Fei-Bo Li, Lei Jin, Liang Zhou, Lei Xie, Claudio Casella
    International Journal of Endocrinology.2022; 2022: 1.     CrossRef
Review article
Current status of stereotactic body radiotherapy for the treatment of hepatocellular carcinoma
Jongmoo Park, Jae Won Park, Min Kyu Kang
Yeungnam Univ J Med. 2019;36(3):192-200.   Published online August 12, 2019
DOI: https://doi.org/10.12701/yujm.2019.00269
  • 9,564 View
  • 134 Download
  • 6 Crossref
AbstractAbstract PDF
Stereotactic body radiotherapy (SBRT) is an advanced form of radiotherapy (RT) with a growing interest on its application in the treatment of hepatocellular carcinoma (HCC). It can deliver ablative radiation doses to tumors in a few fractions without excessive doses to normal tissues, with the help of advanced modern RT and imaging technologies. Currently, SBRT is recommended as an alternative to curative treatments, such as surgery and radiofrequency ablation. This review discusses the current status of SBRT to aid in the decision making on how it is incorporated into the HCC management.

Citations

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  • Radiation therapy, radiosurgery, chemotherapy and targeted therapies for metastatic spine tumors: WFNS Spine committee recommendations
    Vashisht Sekar, Jamie Walsh, Luke H. Pearson, Ori Barzilai, Salman Sharif, Mehmet Zileli
    Neurosurgical Review.2024;[Epub]     CrossRef
  • Dosimetric Comparison Study Between Free Breathing and Breath Hold Techniques in Patients Treated by Liver-Directed Stereotactic Body Radiation Therapy
    Atsuto Katano, Tomoyuki Noyama, Kosuke Morishima, Yuki Nozawa, Hideomi Yamashita
    Cureus.2023;[Epub]     CrossRef
  • The role of stereotactic body radiotherapy (SBRT) in the treatment of recurrent / progressive lung lesions after primary treatment
    H. Demir, S. Özdemir, N. Işık, G. Yaprak
    International Journal of Radiation Research.2023; 21(4): 727.     CrossRef
  • Gastric Fistula After MR-Guided Stereotactic Body Radiation Therapy for Hepatocellular Carcinoma
    Sarah Goodchild, Matthew N. Mills, Russell F. Palm, Sarah E. Hoffe, Jessica M. Frakes
    Applied Radiation Oncology.2023; 12(4): 40.     CrossRef
  • MRI features of treated hepatocellular carcinoma following locoregional therapy: a pictorial review
    Mohanned Alnammi, Jeremy Wortman, Jaclyn Therrien, Jalil Afnan
    Abdominal Radiology.2022; 47(7): 2299.     CrossRef
  • Radiofrequency ablation versus laparoscopic hepatectomy for treatment of hepatocellular carcinoma: a systematic review and meta-analysis
    Shan Jin, Shisheng Tan, Wen Peng, Ying Jiang, Chunshan Luo
    World Journal of Surgical Oncology.2020;[Epub]     CrossRef
Original article
Assessment of solid components of borderline ovarian tumor and stage I carcinoma: added value of combined diffusion- and perfusion-weighted magnetic resonance imaging
See Hyung Kim
Yeungnam Univ J Med. 2019;36(3):231-240.   Published online June 13, 2019
DOI: https://doi.org/10.12701/yujm.2019.00234
Correction in: J Yeungnam Med Sci 2020;37(2):147
  • 9,157 View
  • 86 Download
  • 5 Crossref
AbstractAbstract PDF
Background
We sought to determine the value of combining diffusion-weighted (DW) and perfusion-weighted (PW) sequences with a conventional magnetic resonance (MR) sequence to assess solid components of borderline ovarian tumors (BOTs) and stage I carcinomas.
Methods
Conventional, DW, and PW sequences in the tumor imaging studies of 70 patients (BOTs, n=38; stage I carcinomas, n=32) who underwent surgery with pathologic correlation were assessed. Two independent radiologists calculated the parameters apparent diffusion coefficient (ADC), Ktrans (vessel permeability), and Ve (cell density) for the solid components. The distribution on conventional MR sequence and mean, standard deviation, and 95% confidence interval of each DW and PW parameter were calculated. The inter-observer agreement among the two radiologists was assessed. Area under the receiver operating characteristic curve (AUC) and multivariate logistic regression were performed to compare the effectiveness of DW and PW sequences for average values and to characterize the diagnostic performance of combined DW and PW sequences.
Results
There were excellent agreements for DW and PW parameters between radiologists. The distributions of ADC, Ktrans and Ve values were significantly different between BOTs and stage I carcinomas, yielding AUCs of 0.58 and 0.68, 0.78 and 0.82, and 0.70 and 0.72, respectively, with ADC yielding the lowest diagnostic performance. The AUCs of the DW, PW, and combined PW and DW sequences were 0.71±0.05, 0.80±0.05, and 0.85±0.05, respectively.
Conclusion
Combining PW and DW sequences to a conventional sequence potentially improves the diagnostic accuracy in the differentiation of BOTs and stage I carcinomas.

Citations

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  • Comparison of conventional diffusion-weighted imaging, diffusion kurtosis imaging and intravoxel incoherent motion in characterization of sonographically indeterminate adnexal masses
    Gurkawal Kaur, Smita Manchanda, Raju Sharma, Surabhi Vyas, Devasenathipathy Kandasamy, Smriti Hari, Neerja Bhatla, Sandeep R. Mathur
    Abdominal Radiology.2024; 49(5): 1512.     CrossRef
  • Advances in fertility preserving surgery for borderline ovarian tumors
    Mingdan Wang, Kuiran Liu
    European Journal of Obstetrics & Gynecology and Reproductive Biology.2022; 270: 206.     CrossRef
  • Recurrence characteristics and clinicopathological results of borderline ovarian tumors
    Lina Niu, Huihui Tian, Yongjun Xu, Jieqiong Cao, Xu Zhang, Junli Zhang, Jiajia Hou, Weiqin Lv, Junxia Wang, Li Xin, XuFeng Dong, Tao Xu, Yuan Nan, Hua Wei, Xinting Chai, Na Li, Yan Ni, Yun Shang, Lizhen Zhang, Ye Zhao
    BMC Women's Health.2021;[Epub]     CrossRef
  • Erratum to “Assessment of solid components of borderline ovarian tumor and stage I carcinoma: added value of combined diffusion- and perfusion-weighted magnetic resonance imaging”
    See Hyung Kim
    Yeungnam University Journal of Medicine.2020; 37(2): 147.     CrossRef
  • Minimal apparent diffusion coefficient value of the solid component to differentiate borderline and malignant ovarian epithelial tumours: a preliminary report
    Sahat B.R.E. Matondang, Avrilia Ekawati, Andrijono Andrijono, Hartono Tjahjadi, Joedo Prihartono
    Polish Journal of Radiology.2020; 85: 250.     CrossRef
Case report
Estrogen-secreting adrenocortical carcinoma
You Jeong, Sung Chul Cho, Hee Joon Cho, Ji Soo Song, Joon Seog Kong, Jong Wook Park, Yun Hyi Ku
Yeungnam Univ J Med. 2019;36(1):54-58.   Published online December 20, 2018
DOI: https://doi.org/10.12701/yujm.2019.00017
  • 6,908 View
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  • 2 Crossref
AbstractAbstract PDF
Adrenocortical carcinoma is a rare type of endocrine malignancy with an annual incidence of approximately 1–2 cases per million. The majority of these tumors secrete cortisol, and a few secrete aldosterone or androgen. Estrogen-secreting adrenocortical carcinomas are extremely rare, irrespective of the secretion status of other adrenocortical hormones. Here, we report the case of a 53-year-old man with a cortisol and estrogen-secreting adrenocortical carcinoma. The patient presented with gynecomastia and abdominal discomfort. Radiological assessment revealed a tumor measuring 21×15.3×12 cm localized to the retroperitoneum. A hormonal evaluation revealed increased levels of estradiol, dehydroepiandrosterone sulfate, and cortisol. The patient underwent a right adrenalectomy, and the pathological examination revealed an adrenocortical carcinoma with a Weiss’ score of 6. After surgery, he was treated with adjuvant radiotherapy. Twenty-one months after treatment, the patient remains alive with no evidence of recurrence.

Citations

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  • Gynecomastia in a Man With Adrenal Mass
    Jasmine Saini, Patrick Navin, Michael Rivera, Irina Bancos
    JCEM Case Reports.2023;[Epub]     CrossRef
  • Adrenocortical Carcinoma: Updates of Clinical and Pathological Features after Renewed World Health Organisation Classification and Pathology Staging
    Alfred King-yin Lam
    Biomedicines.2021; 9(2): 175.     CrossRef
Case Reports
Cytokeratin 20 negative Merkel cell carcinoma consistent with negative Merkel cell polyomavirus
Osung Kwon, Hyun Chung, Joonsoo Park
Yeungnam Univ J Med. 2017;34(2):293-297.   Published online December 31, 2017
DOI: https://doi.org/10.12701/yujm.2017.34.2.293
  • 2,237 View
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AbstractAbstract PDF
Merkel cell carcinoma (MCC) is a rare neuroendocrine tumor that is highly aggressive in nature and indolent in progression. The common risk factors for MCC are senility, prolonged exposure to sunlight, and immune deficient states. Moreover, Merkel cell polyomavirus has recently been characterized to be significantly associated with pathogenesis of MCC, including the expression of Cytokeratin 20 (CK20). Diagnosis is often difficult since histopathological results require a number of differential diagnoses through immunohistochemical (IHC) stains with other cutaneous malignancies. A 67-year-old man presented with a solitary domeshaped erythematous round mass on the left upper arm for 2 months. Biopsy and IHC studies revealed findings consistent with Merkel Cell Carcinoma of neuroendocrine origin. Common IHC stains usually confirm positive findings for CK20, which is also recognized as the key component in making the diagnosis. We present a CK20 negative MCC in light of expanding the knowledge of unusually stained IHC results in MCC.
Partial spontaneous remission of small cell lung carcinoma with neurologic symptom
Kyung Hyun Yun, Sung Heon Song, Chung Hyoun Kim, Chan Hee Hwang, Jun Ho Lee, Je Hyoung Choi, Sun Young Kim
Yeungnam Univ J Med. 2017;34(2):275-278.   Published online December 31, 2017
DOI: https://doi.org/10.12701/yujm.2017.34.2.275
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AbstractAbstract PDF
Small cell lung carcinoma (SCLC) is a cancer that shows aggressive behavior, early spread to distant sites, and frequent association with distinct paraneoplastic syndromes. Spontaneous remission of cancer, particularly of SCLC, is a rare biological event. Cases involving spontaneous regression of SCLC were reported, and were associated with paraneoplastic syndromes of the nervous system. This article reports on a 78-year-old man with SCLC in remission, with neurological symptoms. The patient visited the hospital because of generalized weakness, and imaging studies revealed a mass in the lower lobe of the left lung, pathological evaluation showed SCLC. The patient refused oncologic treatment and was treated only with conservative care. In follow-up study the diameter of the mass had decreased from initial 32 mm, 9 months after admission to 20 mm, 17 months after admission to 13 mm. The patient kept complaining of generalized weakness, dizziness, and paresthesia of limbs. We assumed that, in this case, the spontaneous remission of lung cancer was related to the immunologic response directed against the tumor, which is believed to be an important factor in the pathogenesis of paraneoplastic neurologic syndromes.
Double primary lung adenocarcinoma diagnosed by epidermal growth factor receptor mutation status
Oh Jung Kwon, Min Hyeok Lee, Sung Ju Kang, Seul Gi Kim, In Beom Jeong, Ji Yun Jeong, Eun Jung Cha, Do Yeun Cho, Young Jin Kim, Ji Woong Son
Yeungnam Univ J Med. 2017;34(2):270-274.   Published online December 31, 2017
DOI: https://doi.org/10.12701/yujm.2017.34.2.270
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AbstractAbstract PDF
A nodular density was detected on a chest radiograph taken from a 57-year-old Korean woman who was visiting a hospital for a routine check. Chest computed tomography revealed a 4.8 cm lobulated mass in the right lung and another focal nodular lesion in the left lung; biopsies of both lungs revealed adenocarcinoma. We conducted DNA sequencing and peptide nucleic acid clamping to investigate the potential double primary lung cancer. The results verified that the mass in the right lung had a mutation in the epidermal growth factor receptor, whereas the nodule in the left lung had a wild-type sequence, showing that these two were genetically different cancers from one another. Thus, we demonstrate that genetic testing is useful in determining double primary lung cancer, and we herein report on this case.
Review
The roles of endoscopic ultrasound in the diagnosis of pancreatobiliary cancer.
Kook Hyun Kim
Yeungnam Univ J Med. 2016;33(2):77-84.   Published online December 31, 2016
DOI: https://doi.org/10.12701/yujm.2016.33.2.77
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AbstractAbstract PDF
Pancreatic cancer, the 4th leading cause of cancer-related death in the United States, has a very poor prognosis. Cholangiocarcinoma originates from either intrahepatic or extrahepatic bile duct, and its incidence is gradually increasing worldwide. Endoscopic retrograde cholangiopancreatography with brush cytology has a high false-negative rate for the diagnosis of biliary malignancy. Recently, endoscopic ultrasonography (EUS) has emerged as the potential modality to detect pancreatic cancer. EUS-guided fine needle aspiration for cytologic analysis made it possible to overcome the obstacle in differentiating between benign and malignant lesions in the pancreatobiliary lesion, and it has been well established as a safe and effective procedure. Herein, the clinical application of EUS in the diagnosis of pancreatobiliary cancer was reviewed.
Case Reports
Secondary adrenal insufficiency caused by sorafenib administration in a patient with hepatocellular carcinoma.
Soo Yeon Jo, Soo Hyung Ryu, Mi Young Kim, Jeong Seop Moon, Won Jae Yoon, Jin Nam Kim
Yeungnam Univ J Med. 2016;33(2):155-158.   Published online December 31, 2016
DOI: https://doi.org/10.12701/yujm.2016.33.2.155
  • 2,344 View
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AbstractAbstract PDF
Sorafenib (Nexavar) has been regarded as a treatment for unresectable hepatocellular carcinoma (HCC), with side effects that include hand-foot skin reaction, diarrhea, rash, fatigue, hypertension, nausea, anorexia, weight loss, and alopecia. Thyroid disorder, such as endocrine side effect, has also been reported. However no case involving adrenal insufficiency has been reported. Here, we report a case of adrenal insufficiency which occurred after taking sorafenib in a patient with HCC. A 56-year-old man visited our hospital due to right upper quadrant abdominal pain and he was diagnosed as multiple disseminated and unresectable HCCs with portal vein invasion; therefore transarterial chemoembolization was performed and sorafenib administration was started. Two months later, he was admitted to the hospital complaining of severe fatigue. The laboratory results showed cortisol of <0.2µ g/dL and adrenocorticotropic hormone of <1.00 pg/mL. The patient had no history of taking steroids or herbal medications. Secondary adrenal insufficiency was diagnosed and prednisolone 10 mg per day was started immediately; as a result, fatigue remarkably improved. This may be the first report indicating a possible association between sorafenib and adrenal insufficiency and it implies that the possibility of adrenal insufficiency should be considered in patients taking sorafenib who complain of severe fatigue.
POEMS syndrome misdiagnosed as bone metastasis in a patient with thyroid cancer.
Sang Ah Baek, Hun Mo Ryoo, Sung Hwa Bae, Yoon Young Cho, Seong gyu Kim, Ga Young Kim, Min Keun Kim
Yeungnam Univ J Med. 2015;32(2):122-126.   Published online December 31, 2015
DOI: https://doi.org/10.12701/yujm.2015.32.2.122
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AbstractAbstract PDF
Polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (POEMS) syndrome is a monoclonal plasma cell disorder. Patients with POEMS syndrome also have various clinical manifestations including generalized edema, pleural effusion, ascites, papilledema, and sclerotic bone lesions. These manifestations can lead to a misdiagnosis or delayed diagnosis. We recently experienced a 51-year-old male patient with POEMS syndrome whose sclerotic bone lesion was misdiagnosed as malignant bone metastasis of papillary thyroid carcinoma. We reassessed the patient and found polyneuropathy, hepatosplenomegaly, hypothyroidism, partial hypopituitarism, immunoglobulin G lambda-type monoclonal gammopathy, hypertrichosis, ascites, and multiple sclerotic bone lesions, all of which led us to a diagnosis of POEMS syndrome. Treatment with thalidomide and dexamethasone resulted in clinical and radiological improvement. The patient has remained in remission after peripheral blood stem cell transplantation.
Tumor lysis syndrome following sorafenib treatment in hepatocellular carcinoma.
Shin Young Kim, Hee Yeon Kim, Yu Seung Kim, Sang Min Lee, Chang Wook Kim
Yeungnam Univ J Med. 2015;32(1):47-49.   Published online June 30, 2015
DOI: https://doi.org/10.12701/yujm.2015.32.1.47
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AbstractAbstract PDF
Sorafenib is indicated for the treatment of advanced hepatocellular carcinoma (HCC), but although rare, tumor lysis syndrome (TLS) can be fatal in HCC patients with a large tumor burden. The authors describe the case of a 55-year-old hepatitis B carrier who visited our clinic with progressive dyspnea for 3 weeks. Chest and abdominal computed tomography revealed a huge HCC in the left lobe of the liver with invasion of the inferior vena cava, right atrium, and pulmonary arteries. After 8 days of sorafenib administration, TLS was diagnosed based on the characteristic findings of hyperuricemia, hyperkalemia, and acute kidney injury with massive tumor necrosis by follow-up imaging. Despite discontinuation of sorafenib and supportive care, the patient's clinical course rapidly deteriorated. The authors describe a rare but fatal complication that occurred soon after sorafenib initiation for HCC. Careful follow-up is required after commencing sorafenib therapy for the early diagnosis and management of TLS.

Citations

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  • A case of hepatocellular carcinoma caused severe tumor lysis by ramucirumab
    Yuhi Sakamoto, Keizo Kato, Hiroshi Abe, Takeshi Yonezawa, Sadahiro Ito, Makiko Ika, Kiichiro Yoza, Mamika Ohara, Shogo Sakasai, Shohei Shimizu, Shinji Endo
    Kanzo.2021; 62(3): 129.     CrossRef
  • Sorafenib-induced tumor lysis syndrome in a patient with metastatic hepatocellular carcinoma ☆
    Sardar Zakariya Imam, Mohammad Faizan Zahid, Muhammad Asad Maqbool
    Hematology/Oncology and Stem Cell Therapy.2020; 13(3): 168.     CrossRef
Review
Cellular origin of liver cancer stem cells.
Jong Ryeol Eun
Yeungnam Univ J Med. 2015;32(1):1-7.   Published online June 30, 2015
DOI: https://doi.org/10.12701/yujm.2015.32.1.1
  • 2,350 View
  • 28 Download
AbstractAbstract PDF
Over several decades, a hierarchical cancer stem cell (CSC) model has been established in development of solid cancers, including hepatocellular carcinoma(HCC). In terms of this concept, HCCs originate from liver CSCs. Clinically HCCs show a wide range of manifestations from slow growth to very aggressive metastasis. One of the reasons may be that liver CSCs originate from different cells. This review describes the basic concept of CSCs and the cellular origin of liver CSCs.
Original Article
Weekly irinotecan and carboplatin for patients with small cell lung cancer.
Hye Won Lee, Eu Gene Jeong, Dong Hyun Kim, Hyuk Lee, Bo Hyoung Kang, Soo Jung Um, Meesook Roh, Choonhee Son
Yeungnam Univ J Med. 2014;31(2):82-88.   Published online December 31, 2014
DOI: https://doi.org/10.12701/yujm.2014.31.2.82
  • 2,241 View
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AbstractAbstract PDF
BACKGROUND
Lung cancer is the most common cause of cancer-related death worldwide and in Korea, and small cell lung cancer (SCLC) is the most deadly tumor type in the different lung cancer histology. Chemotherapy is the main strategy of the treatment for SCLC, and etoposide and platinum regimen has been the only standard chemotherapy for about 30 years. To test feasibility of weekly divided dose irinotecan and carboplatin for Korean patients is the aim of this study. METHODS: Patients with histologically or cytologically confirmed extensive stage SCLC were included. Patients with limited stage (LD), who could not tolerate concurrent chemoradiotherapy were also included. All the patients received irinotecan 60 mg/m2, carboplatin 2 area under the curve at day 1, 8, and 15 every 4 weeks. Study regimen was discontinued when the disease progressed or intolerable side effects occurred. No more than 6 cycles of chemotherapy were given. RESULTS: Total 47 patients were enrolled, among them 9 patients were LD. Overall response rate was 74.5% (complete response, 14.9%; partial response, 59.6%). Side effects greater than grade 3 were neutropenia (25.5%), fatigue (12.8%), thrombocytopenia (8.5%), sepsis (4.3%), and pancytopenia (2.1%). There was no treatment related death. CONCLUSION: Weekly divided irinotecan and carboplatin regimen is effective, and safe as a first line therapy for both stage of SCLC. Large scaled, controlled study is feasible.
Case Reports
Lipiodol-induced pneumonitis following transarterial chemoembolization for ruptured hepatocellular carcinoma.
Haewon Kim, Yong Hoon Kim, Hong Jin Yoon, Kwang Hoon Lee, Seung Moon Joo, Min Kwang Byun, Jung Il Lee, Kwan Sik Lee, Ja Kyung Kim
Yeungnam Univ J Med. 2014;31(2):117-121.   Published online December 31, 2014
DOI: https://doi.org/10.12701/yujm.2014.31.2.117
  • 2,989 View
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AbstractAbstract PDF
Transarterial chemoembolization (TACE) is a widely accepted nonsurgical modality used for the treatment of multinodular hepatocellular carcinoma (HCC). The careful selection of the candidate is important due to the risk of developing various side effects. Fever, nausea, abdominal pain, and liver enzyme elevation are commonly known side effects of TACE. Hepatic failure, ischemic cholecystitis, and cerebral embolism are also reported, although their incidence might be low. Pulmonary complication after TACE is rare, and the reported cases of lipiodol pneumonitis are even rarer. A 53-year-old man was treated with TACE for ruptured HCC associated with hepatitis B virus infection. On day 19 after the procedure, the patient complained of dyspnea and dry cough. Chest computed tomography showed diffuse ground glass opacities in the wholelung fields, suggesting lipiodol-induced pneumonitis. After 2 weeks of conservative management, the clinical symptoms and radiologic abnormalities improved. Reported herein is the aforementioned case of lipiodol-induced pnemonitis after TACE, with literature review.

Citations

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  • Lipiodol Pneumonitis Following Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma
    Sungkeun Kim, Hee Yeon Kim, Su Lim Lee, Young Mi Ku, Yoo Dong Won, Chang Wook Kim
    Journal of Liver Cancer.2020; 20(1): 60.     CrossRef
  • Secondary adrenal insufficiency caused by sorafenib administration in a patient with hepatocellular carcinoma
    Soo Yeon Jo, Soo Hyung Ryu, Mi Young Kim, Jeong Seop Moon, Won Jae Yoon, Jin Nam Kim
    Yeungnam University Journal of Medicine.2016; 33(2): 155.     CrossRef
Columnar variant of papillary carcinoma in the thyroglossal duct cyst with progression to lung metastasis.
Yujung Yun, Hye Jung Park, Young Ki Lee, Yongin Cho, Beoduel Kang, Hyun Ju Kim, Jung Hee Lee, Moo Nyun Jin, Dong Yeob Shin
Yeungnam Univ J Med. 2014;31(2):103-108.   Published online December 31, 2014
DOI: https://doi.org/10.12701/yujm.2014.31.2.103
  • 2,335 View
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AbstractAbstract PDF
Thyroglossal duct cyst (TGDC) carcinoma generally shows a favorable prognosis. If metastasis is present latently, it may not threaten the patient's life immediately. It has been shown, however, that larger than 1 cm papillary carcinoma (PC), level VI metastasis to the lymph node (LN), which is the nearest to the thyroid, independently predicts a worse prognosis. In the case presented herein, a 61-year-old female patient was diagnosed with an about 3 cm PC in the TGDC, particularly the columnar variant subtype, one of the aggressive variants. She had occult papillary thyroid microcarcinoma, but no LN metastasis. Even though she underwent the Sistrunk procedure and total thyroidectomy with central compartment neck dissection followed by high-dose radioactive iodine remnant ablation, however, the cancer cells spread to level IV neck LN, and finally to the lung. Therefore, when a patient is diagnosed with an aggressive histologic variant of PC in the TGDC, even without LN metastasis, the invasive surgical approach and close postoperative surveillance are necessary, with consideration of the risk of disease progression. Therefore, if it is possible to stratify the risk for patients, higher-risk patients can be offered a more invasive therapeutic approach.
Recurrent acinic cell carcinoma in the parotid gland with cardiac metastasis and hypertrophic osteoarthropathy.
Sung Yun Jung, Dong Won Lee, Min Geun Gu, Tae Hun Kwon, Sung Ae Ko, Joon Hyuk Choi, Jang Won Sohn, Myung Soo Hyun
Yeungnam Univ J Med. 2014;31(1):33-37.   Published online June 30, 2014
DOI: https://doi.org/10.12701/yujm.2014.31.1.33
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AbstractAbstract PDF
Acinic cell carcinoma (ACC) is an uncommon malignant tumor of the salivary glands that is difficult to diagnose. It grows slowly and shows distant metastasis rarely. We experienced a case of recurrent ACC in the parotid gland with cardiac metastasis and hypertrophic osteoarthropathy. The 29-year-old man had been suffering from severe multiple bones and joints pain for 2 months. Ten years earlier, he underwent superficial parotidectomy due to a right subauricular mass. The mass was diagnosed with ACC. After surgery, the tumor recurred twice. Then the patient was diagnosed with cardiac metastasis via positron emission tomography-computed tomography and trans-thoracic echocardiography. He also had hypertrophic osteoarthropathy with multiple bone metastasis. He was given palliative radiotherapy and conservative treatment. ACC in the parotid gland with cardiac metastasis and hypertrophic osteoarthropathy has not yet been reported in literature. From this case, it is recommended to evaluate multiple distant metastasis in the ACC of the parotid gland when joint and bone pain are present.
A Case of Metastatic Hepatocellular Carcinoma of the Orbit.
Young Joo Yang, Seung Hyeon Bae, Il Young Jang, Mi Jung Jun, Ji Won Jung, Ji Hyun An, Ju Hyun Shim
Yeungnam Univ J Med. 2013;30(2):152-155.   Published online December 31, 2013
DOI: https://doi.org/10.12701/yujm.2013.30.2.152
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AbstractAbstract PDF
Orbital metastasis from hepatocellular carcinoma is very rare, with only 14 biopsy-proven cases from hepa tocellular carcinoma cases reported in English literature and three cases reported in Korea. Common symptoms of orbital metastasis are proptosis, visual loss, ocular pain and oculomotor dysfunction. For its precise diagnosis, we can perform fine needle aspiration biopsy, orbit CT or MRI, and ultrasonography. Radiotherapy is the mainstay in the treatment of orbital metastasis. In addition, chemotherapy, hormonal therapy and surgical intervention can play a role in the treatment of orbital metastasis according to the primary cancer and symptoms. However, the prognosis of orbital metastasis is poor. We report herein a rare case of a patient with orbital metastasis from hepatocellular carcinoma, which was treated with various modalities that included resection, and who had good clinical and radiological responses to radiation therapy and sorafenib (Nexavar, Bayer HealthCare).
Long-Term Complete Remission in an Acute Myeloid Leukemia Patient with Isolated Central Nervous System Relapse after Allogeneic Hematopoietic Stem Cell Transplantation.
Myung Jin Kim, Sung Ae Ko, Hyo Jin Jang, Da Eun Jeong, Jeung Min Park, Kyoung Hee Lee, Min Kyoung Kim, Young Kyung Bae, Myung Soo Hyun
Yeungnam Univ J Med. 2012;29(2):96-101.   Published online December 31, 2012
DOI: https://doi.org/10.12701/yujm.2012.29.2.96
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AbstractAbstract PDF
Allogeneic hematopoietic stem cell transplantation (HSCT) is considered the optimal curative treatment for acute myeloid leukemia (AML), but some patients develop bone marrow relapse due to remnant leukemia, and few patients develop extramedullary relapse without bone marrow relapse. Isolated extramedullary relapse (IMER) is defined as extramedullary relapse without bone marrow relapse. IMER has been reported in various sites, including the skin, soft tissue, and central nervous system(CNS). Isolated CNS relapse is relatively rare and is associated with poor prognosis due to the absence of an optimal treatment for it. Reported herein is a case involving an adult AML woman who suffered from isolated extramedullary relapse in the CNS after allogeneic HSCT. She was treated with intrathecal chemotherapy and whole-brain and spine radiotherapy, followed by systemic chemotherapy. She is currently well, with no evidence of leukemia recurrence for over six years.

Citations

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  • Post-transplant leukemia relapse in organs: biology. and behavior in 585 reports
    Isabel Cunningham
    Critical Reviews in Oncology/Hematology.2021; 157: 103170.     CrossRef
A Case of Basal Cell Carcinoma in a Patient with Membranous Glomerulonephritis.
Chan Hee Kyung, So Hee Kim, Beom Jin Lim, Hee Sung Ko, Hee Jin Park, Hae Won Kim, Dong Ha Park, Jung Eun Lee
Yeungnam Univ J Med. 2012;29(2):141-144.   Published online December 31, 2012
DOI: https://doi.org/10.12701/yujm.2012.29.2.141
  • 1,770 View
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AbstractAbstract PDF
Membranous glomerulonephritis can manifest as a paraneoplastic syndrome. The presence of evidence that supports the relationship between malignancy and membranous glomerulonephritis remains unresolved, though. Membranous glomerulonephritis has been commonly reported as associated with solid or hematologic malignancy, such as lung cancer, prostate cancer, and gastro-intestinal cancer, but its concomitant existence with skin cancer is rare. This paper reports a case of membranous glomerulonephritis combined with basal cell carcinoma that was successfully treated with the excision of the basal skin cell carcinoma.
A Case of Biliary Papillomatosis with Cystic Dilatation of Bile Duct.
Yoo Mi Park, Kwangwon Rhee, Sun Och Yoon, Ji Yoon Ha, So Young Park, Jung Ho Lee, Sung Ill Jang
Yeungnam Univ J Med. 2012;29(2):136-140.   Published online December 31, 2012
DOI: https://doi.org/10.12701/yujm.2012.29.2.136
  • 2,223 View
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AbstractAbstract PDF
A 61-year-old male who complained of right upper quadrant pain was referred to the authors for evaluation after his computed tomography suggested biliary adenocarcinoma. The lesion consisted of multiple cysts with papillary mass and peri-ampullay mass. The patient underwent an operation due to a clinical suspicion of biliary cystadenocarcinoma, but the pathology confirmed biliary papillomatosis (BP) after diagnosing intrahepatic papillary neoplasm with high-grade dysplasia and invasive adenocarcinoma with papillary neoplasm from the distal common bile duct to the duodenum. BP is a disease characterized by multiple papillary masses. Its cause has yet to be discovered. It commonly manifests as bile duct dilation but rarely as a ductal cystic change. Under computed tomography or magnetic resonance imaging, both the BP and the cystic neoplasm can show bile duct dilation and a papillary mass, which makes their differential diagnosis difficult. A confirmative diagnosis can be made through a pathologic examination. BP is classified as a benign disease that can become malignant and may recur, though rarely. Its treatment of choice is surgical resection. Laser ablation or photodynamic therapy can be used for unresectable lesions. In the case featured in this paper, biliary papillomatosis was difficult to differentiate from cystic adenocarcinoma due to diffusely scattered multiple large cystic lesions in the liver, and it was histologically confirmed to have become malignant with cystic duct dilation after the operation. This case is reported herein with a literature review.
A Case of Adrenocortical Carcinoma Secreting Cortisol and Aldosterone.
Jiyoon Ha, Min Kyung Kim, Yoon Jin Cha, Seung Kyu Kim, Gi Young Yun, Kwangwon Rhee, Joon Seong Park, Eun Suk Cho, Chul Woo Ahn, Jong Suk Park
Yeungnam Univ J Med. 2012;29(2):132-135.   Published online December 31, 2012
DOI: https://doi.org/10.12701/yujm.2012.29.2.132
  • 2,245 View
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AbstractAbstract PDF
Adrenocortical carcinomas are rare and frequently aggressive tumors that may be functional (hormone-secreting) and may cause Cushing's syndrome or virilization, or non-functional and manifest as an abdominal mass. This paper reports the case of a 77-year-old woman with cortisol- and aldosterone-secreting adrenal carcinoma. The patient complained of general weakness, a moon face, and weight gain. She also had hypokalemia and hypertension. Her endocrinological data showed excessive aldosterone production and non-suppressible cortisol production in a low-dose dexamethasone suppresion test. Her abdominal CT showed a right adrenal mass. She underwent right adrenalectomy, and her histology revealed the presence of adrenocortical carcinoma. After adrenalectomy, her hypokalemia returned to normal and she is being treated with hydrocortisone.
Huge Hepatocellular Carcinoma Abruptly Developed within 3 Months.
Sang Hyuk Lee, Byung Ik Kim, Chang Uk Chon, Ki Bae Bang, Eun Haeng Jeong, Jeong Yeon Seo, Eun Hye Park, Ji Soo Seol
Yeungnam Univ J Med. 2012;29(1):48-53.   Published online June 30, 2012
DOI: https://doi.org/10.12701/yujm.2012.29.1.48
  • 1,871 View
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AbstractAbstract PDF
Hepatocellular carcinoma (HCC) is the second leading cause of cancer-related deaths in South Korea. To decrease its mortality rate, its early detection is very important. Screening for HCC detection has been accepted as the management modality for patients with chronic liver disease. Reported herein is a case involving the marked rapid growth of HCC detected at an advanced stage in a screening test with a 3 months interval. A 49-year-old male patient with chronic hepatitis B was admitted to the hospital due to a liver mass detected on CT scan. The patient underwent a first CT scan 3 months earlier, and no tumor was detected. Follow-up CT scan was performed and showed a 9.1 cm HCC with portal vein thrombosis. Percutaneous liver biopsy was performed, and the diagnosis of hepatocellular carcinoma was confirmed. In the pertinent guidelines, the recommended screening interval for HCC is 6-12 months, but the screening interval and additional diagnostic methods should be considered due to the variation in the HCC growth rate according to the patient's clinical characteristics.
Original Article
Differentiation of Chromophobe Renal Cell Carcinoma and Clear Cell Renal Cell Carcinoma by Using Helical CT.
Hong Chul Kim, Jae Ho Cho
Yeungnam Univ J Med. 2012;29(1):14-18.   Published online June 30, 2012
DOI: https://doi.org/10.12701/yujm.2012.29.1.14
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AbstractAbstract PDF
BACKGROUND
The purpose of this study was to differentiate chromophobe renal cell carcinoma and clear cell renal cell carcinoma on helical CT. METHODS: The CT images of 9 patients histopathologically proven to have chromophobe renal cell carcinoma and 20 patients with clear cell renal cell carcinoma were reviewed. The tumor sizes, margins, enhancement degrees and patterns, presence or absence of calcification, and tumor spread patterns (including perinephric changes, venous invasion, lymphadenopathy, and distant metastasis) were compared. RESULTS: All the chromophobe renal cell carcinomas showed well-demarcated margins. Thechromophobe renal cell carcinomas showed milder enhancements than the clear cell renal cell carcinomas. The sensitivity and specificity for differentiating the chromophobe renal cell carcinoma from the clear cell renal cell carcinoma were 100 and 88%, respectively, when 101 Hounsfield units was used as the cut-off value in the corticomedullary phase, and 95 and 100% when a less-than-three-time enhancement change was used as a cut-off value in the corticomedullary phase (p<0.05). The chromophobe renal cell carcinomas (67%) tended to show a homogeneous enhancement whereas the clear cell renal cell carcinomas (85%) usually showed a heterogeneous enhancement (p<0.05). Statistical analysis revealed that the frequencies of the tumor spread pattern and calcification in the two subtypes didnot differ significantly (p>0.05). CONCLUSION: The CT findings of the chromophobe renal cell carcinomascompared to those of the clear cell renal cell carcinomas showed that there were mild enhancements in the corticomedullary phase, homogeneous enhancements, and well-demarcated margins.

Citations

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  • Density of Orbital Fat and Extraocular Muscle in Thyroid-Associated Myopathy and Idiopathic Orbital Myositis
    Hye Mi Cheong, Woo Jin Jeong, Hee Bae Ahn
    Journal of the Korean Ophthalmological Society.2013; 54(11): 1641.     CrossRef
Case Reports
A Case of Mixed Papillary Thyroid Tumor and Squamous-Cell Carcinoma.
Ho Su Kim, Jong Ryeal Hahm, Tae Sik Jung, Jung Hwa Jung, Soo Kyoung Kim, Sang Min Lee, Soon Il Chung
Yeungnam Univ J Med. 2011;28(2):206-210.   Published online December 31, 2011
DOI: https://doi.org/10.12701/yujm.2011.28.2.206
  • 2,112 View
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  • 1 Crossref
AbstractAbstract PDF
The occurrence of a mixed tumor containing papillary thyroid carcinoma (PTC) and primary squamous-cell carcinoma (SCC) is rare because there is no squamous epithelium in the thyroid gland. Reported herein is a 30-year-old female with mixed PTC and primary SCC of the thyroid presented as thyroid incidentaloma. Fine-needle aspiration biopsy of the thyroid nodule revealed the presence of malignant thyroid cells. The histopathological examination following total thyroidectomy yielded two mixed, morphologically distinct histotypes that included PTC and SCC. After total thyroidectomy, the patient underwent radioactive iodine therapy. No recurrence or metastasis occurred during the 20-month follow-up period after the operation.

Citations

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  • Meta-Analysis of Squamous Cell Carcinoma of Thyroid
    Hyun Seok Shim, Oh Jin Kwon, Joon Seok Ko, Jung Je Park, Jin Pyeong Kim, Chan Ryeul Jeong, Seung Hoon Woo
    Korean Journal of Otorhinolaryngology-Head and Neck Surgery.2013; 56(7): 425.     CrossRef
Hepatocellular Carcinoma with Bile Duct Tumor Thrombi.
Hye Sun Shin, Ji Young Hong, Jung Woo Han, Fa Mee Doh, Gi Jeong Kim, Do Young Kim, Sang Hoon Ahn, Gi Hong Choi
Yeungnam Univ J Med. 2011;28(2):180-186.   Published online December 31, 2011
DOI: https://doi.org/10.12701/yujm.2011.28.2.180
  • 2,102 View
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  • 1 Crossref
AbstractAbstract PDF
Obstruction of the bile duct owing to the direct extension of a tumor is occasionally found in patients with a hepatic neoplasm, but bile duct tumor thrombus caused by the intrabiliary transplantation of a free-floating tumor is a rare complication of hepatocellular carcinoma. A 50-year-old woman was diagnosed with HCC with bile duct tumor thrombi. She received transarterial chemoembolization (TACE) because her liver function was not suitable for surgery at the time of diagnosis. After TACE, infected biloma occurred recurrently. Thus, resection of the HCC, including the bile duct tumor thrombi, was performed. Six months after the surgery, recurred HCC in the distal common bile duct as drop metastasis was noted. The patient was treated with tomotherapy and has been alive for three years as of this writing, without recurrence. The prognosis of HCC with bile duct tumor thrombi is considered dismal, but if appropriate procedures are selected and are actively carried out, long-term survival can occasionally be achieved.

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  • Lipiodol-induced pneumonitis following transarterial chemoembolization for ruptured hepatocellular carcinoma
    Haewon Kim, Yong Hoon Kim, Hong Jin Yoon, Kwang Hoon Lee, Seung Moon Joo, Min Kwang Byun, Jung Il Lee, Kwan Sik Lee, Ja Kyung Kim
    Yeungnam University Journal of Medicine.2014; 31(2): 117.     CrossRef
Review
Combined Hepatocellular-Cholangiocarcinoma: Recent Progress in Pathology and Classification.
Joon Hyuk Choi
Yeungnam Univ J Med. 2011;28(1):1-12.   Published online June 30, 2011
DOI: https://doi.org/10.12701/yujm.2011.28.1.1
  • 2,139 View
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AbstractAbstract PDF
Primary liver carcinomas have been classified into hepatocellular carcinoma, cholangiocarcinoma, and combined hepatocellular-cholangiocarcinoma (CHC). CHC is a tumor containing unequivocal, intimately mixed elements of both hepatocellular carcinoma and cholangiocarcinoma. It forms a small but significant proportion of primary liver carcinomas. The origin and pathogenesis of CHC have not been well established. According to the 2010 WHO classification, CHCs are categorized into 2 groups: the classical type and a subtype with stem cell features. This review describes recent progress in pathology and classification of CHC.

Citations

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  • Synchronous Double Primary Hepatic Cancer: Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma
    Jin Ok Kim, Dae Won Jun, Kiseok Jang
    The Korean Journal of Gastroenterology.2013; 62(2): 135.     CrossRef
Case Reports
Dynamic CT Finding of Pelioid HCC; Case Report.
Rak Chae Son, Jae Woon Kim, Jae Chun Chang
Yeungnam Univ J Med. 2010;27(2):146-149.   Published online December 31, 2010
DOI: https://doi.org/10.12701/yujm.2010.27.2.146
  • 1,763 View
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AbstractAbstract PDF
Pelioid hepatocellular carcinoma (HCC), a type of atypical HCC, is a rare histologic type of HCC. The radiologic findings of the pelioid HCC is differ from the typical type of HCC. To our knowledge, this case report is the second literature to show the enhancing features of a pelioid HCC on dynamic computed tomography (CT). Here we describe the dynamic CT findings in a case of surgically confirmed pelioid HCC.
A Case of Hepatocellular Carcinoma with intradural growth Presenting as Obstructive Jaundice.
Sung Bum Kim, Tae Nyeun Kim, Sung Jun Kim, Ho Chan Lee, Jae Hyun Park, Jong Ryul Eun, Byung Ik Jang, Heon Ju Lee, Sung Su Yun, Young Kyung Bae
Yeungnam Univ J Med. 2008;25(2):165-170.   Published online December 31, 2008
DOI: https://doi.org/10.12701/yujm.2008.25.2.165
  • 1,849 View
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AbstractAbstract PDF
The incidence of hepatocellular carcinoma presenting as obstructive jaundice is 0.7~9%. The mechanisms of obstructive jaundice include bile duct invasion by tumor, tumor thrombi, blood clots, direct bile duct compression by tumor, and intraductal tumor growth. We report a rare case of hepatocellular carcinoma with intraductal growth. A 46-year-old woman was admitted due to colicky right upper abdominal pain and jaundice for 4 days. Computed tomography showed dilatation of the left intrahepatic duct, and endoscopic retrograde cholangiography showed a filling defect in the left main intrahepatic duct. We performed a left lobectomy with a Roux-en-Y hepaticojejunostomy. The tumor was diagnosed as a hepatocellular carcinoma with intraductal growth.
A Case of Primary Mucinous Cystadenocarcinoma.
Jun Ho Ji, Hwa Jung Lee, Seung Chan Park, Jung Chul Park, Eun Jung Choi, Hye Jin Seo, Won Sik Lee, Jung Lim Lee, Byung Jo Bae, Kyung Rak Shon, Kyung Hee Lee
Yeungnam Univ J Med. 2008;25(2):134-138.   Published online December 31, 2008
DOI: https://doi.org/10.12701/yujm.2008.25.2.134
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AbstractAbstract PDF
Primary retroperitoneal mucinous cystadenocarcinoma is a very rare malignancy, and little is known concerning its pathogenesis, optimal treatment, and prognosis. A 29-year-old pregnant woman (21 weeks) presented with abdominal discomfort. CA 19-9, CA 125, and CEA were normal. Abdominal CT scanning revealed a 19x15x13 cm retroperitoneal tumor. Exploratory laparotomy and tumor excision were performed. Mucinous retroperitoneal implants were removed as completely as possible. Histologically, the tumor showed focal areas of capsular invasion, but free resection margins. The uterus and both ovaries were normal in appearance. No adjuvant therapy was pursued. Six months later, peritoneal and bilateral ovarian metastases were discovered.Hence, we report the details of this case of primary retroperitoneal mucinous cystadeno-carcinoma and present a review of the literature.

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  • MR Imaging of Primary Retroperitoneal Mucinous Cystadenocarcinoma in Pregnant Woman
    Jisun Lee, Bum Sang Cho, Yook Kim, Kyung Sik Yi, Min Ho Kang, Seung Young Lee, Sung Jin Kim, Kil Sun Park
    Journal of the Korean Society of Magnetic Resonance in Medicine.2013; 17(3): 243.     CrossRef
A Case of Pancreatic Acinar Cell Carcinoma.
Hwa Jung Lee, Jun Ho Ji, Seung Chan Park, Jung Chul Park, Eun Jung Choi, Hye Jin Seo, Won Sik Lee, Jung Lim Lee, Byung Jo Bae, Kyung Rak Shon, Kyung Hee Lee
Yeungnam Univ J Med. 2008;25(2):128-133.   Published online December 31, 2008
DOI: https://doi.org/10.12701/yujm.2008.25.2.128
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Acinar cell carcinoma is a rare tumor that represents 1~2% of all pancreatic cancers. Clinical and radiologic findings are inconclusive in this disease. Acinar cell carcinoma is characterized by rapid progression and early metastasis, which lead to its poor prognosis. A 41-year-old man was admitted to our hospital for abdominal pain. Abdominal computed tomography (CT) and positron emission tomography-computed tomography (PET-CT) showed a splenic mass, which was being invaded by a pancreatic tail mass and which had increased 18F-fluorodeoxyglucose (FDG) uptake. Primary radical distal pancreatectomy and splenectomy were performed. Pathologic findings revealed an acinar cell carcinoma of the pancreas. The patient underwent a total gastrectomy three months later because of gastric recurrence. Four months later, multiple hepatic metastases were discovered, and the patient underwent a left hepatectomy. During treatment with capecitabine, there was no evidence of tumor progression for 14 months. We report a case of metastatic pancreatic acinar cell carcinoma, which did not progress for an extended period while the patient was being treated with capecitabine.
Review
Long Term Effects of Lamivudine and Adefovir dipivoxil in Chronic Hepatitis B Patients on the Development of Hepatocellular Carcinoma.
Heon Ju Lee
Yeungnam Univ J Med. 2008;25(1):1-18.   Published online June 30, 2008
DOI: https://doi.org/10.12701/yujm.2008.25.1.1
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Although Lamivudine and adefovir dipivoxil are efficacious drugs for preventing hepatocellular carcinoma (HCC) in chronic hepatitis B patients, their efficacy is far from completely satisfactory. The risk of liver cirrhosis and HCC begins to increase at an HBV DNA level of 10(4) copies/ml. Even with latent or past HBV infection, episomal covalently closed circular DNA(cccDNA) plays a key rolein the persistence, relapse and resistance of HBV in its natural course or during therapy. The annual incidence of HCC in YUMC is 1.8% and 4.7% patients/year in the antiviral treatment and control groups, respectively. The ability to achieve a high rate of sustained HBV suppression with low risk of drug resistance is the ultimate goal in the treatment of chronic HBV infection. The efficacy of universal immunization with striking reductions in the prevalence of HBV in localized countries needs to be spread worldwide. With hepatitis B immunization and effective antiviral therapy, global control of HBV infection and HBV-related complications, including HCC, are possible by the end of the first half of the 21st century.
Case Reports
Adenoid Cystic Carcinoma of the Breast -A Case Report-
Jun Mo Kim, Mi Soo Hwang, Su Hwan Kang, Soo Jung Lee, Young Kyung Bae
Yeungnam Univ J Med. 2007;24(2 Suppl):S749-754.   Published online December 31, 2007
DOI: https://doi.org/10.12701/yujm.2007.24.2S.S749
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Adenoid cystic carcinoma (ACC) is a rare malignant neoplasm of the breast accounting for approximately 0.1% of all breast carcinomas with a total 200 cases reported in the literature. In contrast to the aggressive nature of ACC in other organs, ACC of the breast is known to have an excellent prognosis. Recently we experienced the first case of ACC of the breast at Yeungnam University hospital. The case was diagnosed by preoperative fine needle aspiration cytology. We report a case of ACC of the breast managed with breast conserving surgery and review the literature.
Surgical Treatment of Renal Cell Carcinoma with Acute Pulmonary Embolism Using Deep Hypothermic Circulatory Arrest -A Case Report-
Dong Hyup Lee, Dong Chun Park
Yeungnam Univ J Med. 2007;24(2 Suppl):S731-736.   Published online December 31, 2007
DOI: https://doi.org/10.12701/yujm.2007.24.2S.S731
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Renal cell carcinoma occasionally invades the inferior vena cava and rarely extends to the right atrium and occurred massive pulmonary embolism. A healthy 54-year-old man presented to the emergency room with anterior chest pain, dyspnea and hypotension from which he had been suffering for several hours. We diagnosed him as left renal cell carcinoma with acute both pulmonary arteries embolism. The patient underwent a complex surgical procedure in which left radical nephrectomy, inferior vena cava thrombectomy and both pulmonary arteries thromboembolectomy under deep hypothermic circulatory arrest. Total circulatory arrest time was 44 minutes. We should use many inotropic agents for weaning of cardiopulmonary bypass. The patient had many postoperative complications including of acute renal failure, respiratory distress and sepsis. He died from septic shock and multi organ failure at 36th postoperative day.
A Case of Clear Cell Adenocarcinoma of the Uterine Cervix
Sung-Chul Park, Yoon-Ki Park, Doo Jin Lee, Sung-Ho Lee
Yeungnam Univ J Med. 2007;24(2 Suppl):S652-657.   Published online December 31, 2007
DOI: https://doi.org/10.12701/yujm.2007.24.2S.S652
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Clear cell adenocarcinoma of cervix is a very rare malignancy of the uterine cervix. The etiology and pathogenesis are unclear. Clear cell adenocarcinomas have been reported most commonly in women with a history of in utero exposure to diethylstilbesterol (DES), these tumors also can develope in the absence of exposure to DES. These tumors account for 4% to 9% of adenocarcinomas of the cervix. We report a case of clear cell adenocarcinoma in the uterine cervix of 40 years-old women who was not related to DES with a brief review of literature.
A Case of Gefitinib (Iressa(R))-associated Tumor Lysis Syndrome in Adenocarcinoma of the Lung.
Kyu Jin Kim, Won Jong Park, Sung Ken Yu, Kyeong Cheol Shin, Jin Hong Chung, Myung Soo Hyun, Kwan Ho Lee
Yeungnam Univ J Med. 2006;23(2):221-226.   Published online December 31, 2006
DOI: https://doi.org/10.12701/yujm.2006.23.2.221
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The tumor lysis syndrome has been described as biochemical disturbances associated with rapid destruction of tumor cells and subsequent synchronized massive release of cellular breakdown products sufficient to overwhelm excretory mechanisms and the body's normal reutilization capacity. The cardinal signs of the tumor lysis syndrome are hyperkalemia, hyperphosphatemia, hypocalcemia and hyperuricemia. Gefitinib (Iressa) is an oral, selective epidermal growth factor receptor (EGFR) inhibitor that has activity in female, non-smoker and non-small cell lung cancer with an EGFR mutation. Gefitinib is a well tolerated drug with few side effects. It has been associated with skin rash, diarrhea, nausea, a decrease in liver function and interstitial lung disease. However, there is no prior report of the tumor lysis syndrome associated with gefitinib. We report a case of a 54 year-old woman who developed tumor lysis syndrome that might have been induced by gefitinib after the treatment of adenocarcinoma of lung with an EGFR mutation.
Review
Premalignant Lesions of Gallbladder Carcinoma and Treatment.
Sung Su Yun
Yeungnam Univ J Med. 2006;23(2):152-161.   Published online December 31, 2006
DOI: https://doi.org/10.12701/yujm.2006.23.2.152
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Carcinoma of the gallbladder is an uncommon but highly malignant tumor with a poor five year survival rate. Early detection is very important for successful treatment because this tumor is very hard to cure in cases where it has advanced beyond the reach of surgical treatment. The purpose of this review was to evaluate risk factors for carcinoma of the gallbladder and determine the best management approach.. Solitary polys, more than one cm are considered to be predisposing factors for gallbladder carcinoma when they are found to be echopenic, sessile, and with a high cell density. Anomalous union of the pacreato-biliary duct(AUPBD) without a choledochal cyst is also considered to increase risk for gallbladder carcinoma. A polyps size of more than one cm and an AUPBD are indications for prophylactic cholecystectomy. The presence of gallstones is a well-established risk factor for the development of gallbladder carcinoma; risk appears to correlate with the stone size and the duration of chronic cholecystitis. Metaplastic changes of the gallbladder epithelium present with chronic cholecystitis and may indicate a premalignant lesion. Abnormal forms of cholecystitis such as xanthogranulomatous or a porcelain gallbladder also have malignant potential; cholecystoenteric fistula as well as bacterial infection of the gallbladder(typhoid, helicobacter species) also has malignant potential. In this review, the risk factors associated with carcinoma of the gallbladder are summarized with special attention to gallstones, polyps,AUPBD, and chronic inflammation.
Original Articles
Analysis of Matrix Metalloproteinase-9 Expression in Renal Cell Carcinoma.
Ji Yoon Kim, Tong Choon Park
Yeungnam Univ J Med. 2006;23(1):82-89.   Published online June 30, 2006
DOI: https://doi.org/10.12701/yujm.2006.23.1.82
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BACKGROUND
Matrix metalloproteinases (MMPs) are involved in the degradation of the extracellular matrix, which is an important step in tumor invasion and metastasis. A positive correlation between the expression of MMP-9 and aggressive behavior of renal cell carcinomas (RCCs) has been reported. MMP-9 expression in RCCs and adjacent normal kidney tissues were examined in this study. MATERILAS AND METHODS: Twenty-five patients pathologically diagnosed as clear cell RCCs, from specimens obtained at radical nephrectomy, between May 2003 and December 2004 were enrolled in this study. MMP-9 activity was estimated using gelatin zymography, and quantified using a laser densitometer. The results were compared with clinicopathological characteristics. RESULTS: The expression of MMP-9 was significantly elevated in the RCC compared with non-tumor kidney specimens (p<0.01). The levels of MMP-9 expression in the RCC patients with large tumors (>4 cm) or vascular invasion were significantly higher than in those without these clinical manifestations (p<0.01). There were also significant differences in the expression of MMP-9 among T stages (p<0.01). The tissue MMP-9 level was the highest in nuclear grade 4, but there was no statistical significance between the histological grades (p=0.17). CONCLUSIONS: These results suggest that enhanced MMP-9 expression contributes to carcinogenesis and tumor progression in the later stages of RCC.
The Effect of Percutaneous Bilateral Metalic Stent for Hilar Cholangiocarcinoma.
Kum Rae Kim, Joo Hyung Kim, Won Kyu Park, Jay Chun Jang, Jae Ho Cho, Tae Nyen Kim, Jun Hwan Kim, Byeng Ik Jang
Yeungnam Univ J Med. 2005;22(2):211-220.   Published online December 31, 2005
DOI: https://doi.org/10.12701/yujm.2005.22.2.211
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AbstractAbstract PDF
BACKGROUND
The purpose of this study was to determine the effectiveness of a percutaneously placed self-expanding metallic stent for the relief of biliary obstruction in patients with hilar cholangiocarcinoma. MATERIALS AND METHODS: From November 2001 to December 2004, 48 patients with hilar cholangiocarcinoma were prospectively studied. After percutaneous placement of bilateral self- expanding, uncovered metallic stents, follow-up evaluation was carried out until July 2005. RESULTS: There were 4 cases of Bismuth type II, 21 cases of Bismuth type IIIa, 8 cases of Bismuth type IIIb and 15 cases of Bismuth type IV. Stent placement was technically successful in all patients. All patients had satisfactory biliary drainage, resulting in one week drainage rate of 72.8% and final drainage rate of 91.1%. There were 12 cases (21.3%) of abdominal pain requiring analgesics and 1 case (7.1%) of cholangitis; both were successfully managed with conservative treatments. Late complications occurred in four patient (8.3%), including two patients with cholangitis, one patient with liver abscess, and one patient with biloma; all were appropriately managed by percutaneous drainage. The average length and median durations of stent patency and Median Survival Time Were 303 Days (Range, 60~815) And 338 Days (Range, 60~1175), Respectively. CONCLUSION: Placement of a percutaneous metallic stent is an effective and safe method for palliation of patients with hilar cholangiocarcinoma.

Citations

Citations to this article as recorded by  
  • A Comparison of Y-Type and T-Type Metallic Bilateral Biliary Stents in Patients with Malignant Hilar Biliary Obstruction
    Esther Koh, Gong Yong Jin, Seung Bae Hwang, Eun Jung Choi, Ji Soo Song, Young Min Han, Keun Sang Kwon
    Journal of the Korean Society of Radiology.2013; 68(4): 297.     CrossRef
Case Report
Sinonasal Undifferentiated Carcinoma.
Yong Dae Kim, Dong Suk Kwak, Hyung Joong Lee, Jae Heun Sin, Chang Hoon Bai, Si Yeon Song
Yeungnam Univ J Med. 2004;21(1):120-126.   Published online June 30, 2004
DOI: https://doi.org/10.12701/yujm.2004.21.1.120
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Sinonasal Undifferentiated Carcinoma (SNUC) is a very rare, highly aggressive malignant tumor of the nasal cavity and paranasal sinuses. SNUC tends to present with advanced-stage disease, often with intracranial invasion. It requires an aggressive multimodality therapy that includes surgical resection. A cure rate of less than 20% is generally reported in the literature, with most patients dying within 1 year of onset of the disease. Three patients diagnosed as SNUC were treated at the Yeungnam University Medical Center between the years 2000 and 2003 were analyzed retrospectively. All patients presented with the disease very advanced. The three cases were given chemotherapy or chemotherapy with radiotherapy. Two patients died of the disease, surviving only 6 and 11 months following treatment, respectively. We did a follow-up on just the one remaining case with incomplete controlled disease for 27 months. The overall prognosis of SNUC is very poor. We consider that more intensive multimodality therapies are recommended for all patients with SNUC.
Original Articles
Preoperative Staging of Endometrial Carcinoma by MRI.
See Hyung Kim, Jae Ho Cho, Bok Hwan Park
Yeungnam Univ J Med. 2002;19(2):116-125.   Published online December 31, 2002
DOI: https://doi.org/10.12701/yujm.2002.19.2.116
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BACKGROUND
In patients with endometrial carcinoma, preoperative evaluation of exact staging has important prognostic and therapeutic implications. The incidence of pelvic and aortic lymph node involvement in endometrial carcinoma depends on grade of tumor differentiation and depth of myometrial invasion. MATERIAL AND METHOD: To evaluate whether MRI provides a preoperative assessment for staging of endometrial carcinoma, MRI was undertaken in 28 patients, a few weeks before operation. Myometrial invasion was devided in three categories, and involvement of cervix, adnexa, and pelvic cavity were classified. RESULTS: The results of MR imaging were compared with these of pathology. The preoperative MRI staging of endometrial carcinoma was correct in 22 out of 28 patients. In the evaluation of myometrial invasion, the MR imaging underestimated in 4 cases and overestimated in 1 case. CONCLUSION: In patients with endometrial carcinoma, MR imaging is very useful in the assessment of the depth of myometrial invasion, stromal invasion of cevix, lymphatic & pelvic metastases and extent of the lesion.
The Role of Radiotherapy in Treatment of Hepatocellular Carcinoma.
Jong Ryul Eun, Kyo Won Choi, Heon Ju Lee, Mung Se Kim
Yeungnam Univ J Med. 2000;17(2):137-145.   Published online December 31, 2000
DOI: https://doi.org/10.12701/yujm.2000.17.2.137
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BACKGROUND
Hepatocellular carcinomal(HCC) has been considered to be relatively radioresistant. The role of radiotherapy(RT) in the treatment of HCC is controversial. But RT has a role in the treatment of hepatocellular carcinoma as a single or combination modalities. The effect of radiotherapy on HCC was evaluated. Patients and METHODS: From January 1984 through January 2000, a total of 18 patients with unresectable HCC underwent radiotherapy alone or in conjunction with transarterial embolization(TAE). We reviewed the medical ecords of patients treated with RT and measured the tumor size using measured the tumor size using planimetry method. The Kaplan-Meier method was used to calculate the survival rate. RESULTS: The RT patients were 15 men and 3 women. The mean age was 51 years. four(22.2%) of them were accompanied with ascites. Eleven(61.1%) of them were accompanied with liver cirrhosis and their functions were 6, 3, 2 in each Child-Pugh A, B, C, respectively. A partial response(PR) was observed in 2 patients(11.1%), minimal response(MR) in 4 patients (22.2%) and no change(NC), in 11 patients(61.1%), whereas progressive disease(PD) was seen in 1 patients(6%), respectively. CONCLUSIONS: Although the radiotherapy in HCC did not improve the survival rate. it decreased the tmor size. Radiotherapy strengthens the therapeutic efficacy when combined with TAE, but more studies are needed.
The effect of Transarterial Chemoembolization(TAE) on Lung metastasis of Hepatocellular Carcinoma.
Heon Ju Lee, Jong Ryul Eun, Young Doo Song, Chan Won Park
Yeungnam Univ J Med. 2000;17(1):66-74.   Published online June 30, 2000
DOI: https://doi.org/10.12701/yujm.2000.17.1.66
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BACKGROUND
During follow up period after transarterial embolization(TAE), cases of pulmonary metastasis were more prevalent in TAE-treated patients than in TAE-untreated patients. Therefore, a study was conducted to evaluate whether TAE increases the incidence of pulmonary metastasis of hepatocellular carcinoma and to clarify the risk factors for pulmonary metastasis. METHODS: From march 1991 to march 1995, 156 patients who had been diagnosed with hepatocellular carcinoma by serology, and radiographic and histologic method at Yeungnam university hospital were involved in this study. We excluded 12 patients with lung metastasis on initial diagnosis and the others. The remaining 144 patients had been followed up for at least 5 months, and divided into four groups according to lung metastasis and trans-arterial embolization treatment, and evaluated the age, sex, child-pugh score, liver cirrhosis, and the level of AFP. RESULTS: Pulmonary metastasis was found in 18.0% (26/144), of witch 92.3%(24/26) and 7.7%(2/26) of the patients with and without transarterial chemoembolization, respectively. Of thepatients, 23.5% (24/102) with TAE had lung metastais during follow-up periods and 4.7% (2/42) without TAE had lung metastasis. there was more likelihood for lung metastasis after TAE, but there was no difference between two groups in age, sex, child-pugh class, the presence of liver cirrhosis, and AFP. CONCLUSIONS: The incidence of pulmonary metastasis of hepatocellular carcinoma after TAE was higher. child-pugh class was the only related clinical precipitating factors for pulmonary metastasis in TAE in our study. Our results suggest that regular chest X-ray check-up may be more frequently needed by patients who had TAE treatment for hepatocellular carcinoma.

JYMS : Journal of Yeungnam Medical Science
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