Journal of Yeungnam Medical Science

Case reports

Palisaded encapsulated neuroma on the lower lip: a case report: Jung Eun Seol, Seong Min Hong, Sang Woo Ahn, Jong Uk Kim, Woo Jung Jin, So Hee Park, Hyojin Kim; J Yeungnam Med Sci. 2022;39(2):168-171. Published online July 9, 2021; DOI: https://doi.org/10.12701/yujm.2021.01088

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Abstract PDF: Palisading encapsulated neuroma is a rare, benign, cutaneous nerve sheath tumor. It usually occurs as an asymptomatic solitary skin-colored papule and commonly affects the nose and cheeks. Sometimes, it involves other sites, including the shoulder, upper arm, and trunk, but rarely involves the oral mucosa, including that of the lip. In our case, a 63-year-old female patient complained of a pinkish rubbery nodule on her lower lip. Histopathologic examination demonstrated a well-circumscribed nodule encapsulated by connective tissue stroma in the dermis. The nodule consisted of palisading spindle-shaped tumor cells with wavy and basophilic nuclei. The cells were arranged in streaming fascicles with multiple clefts and were strongly positive for S-100 proteins. To our knowledge, only three cases of palisading encapsulated neuroma on the lower lip have been reported in the Korean literature. Herein, we report a rare case of an oral palisaded encapsulated neuroma.

Pancreatic metastasis from malignant phyllodes tumor of the breast: Seung Eun Lee, Young Kyung Bae, Joon Hyuk Choi; Yeungnam Univ J Med. 2021;38(1):78-82. Published online November 27, 2020; DOI: https://doi.org/10.12701/yujm.2020.00759

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Pancreatic metastasis from malignant phyllodes tumor (PT) of the breast is rare, and only a few cases have been reported in the literature. Here, we report a case of pancreatic metastasis from malignant PT of the breast in a 48-year-old woman. She had had three episodes of recurrence of malignant PT in her right breast. She presented with epigastric pain for 2 months. Computed tomography and magnetic resonance imaging revealed a 6 cm-sized, well-defined, heterogeneous mass with peripheral enhancement in the body of the pancreas. Endoscopic ultrasonography-guided fine-needle aspiration was performed, and the pathologic report suggested spindle cell mesenchymal neoplasm. Subsequently, surgical excision was performed, and the mass was confirmed as a metastatic malignant PT. The imaging findings are discussed and the literature is briefly reviewed in this report.

Citations

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Integrating single‐cell and spatial transcriptomes reveals COL4A1/2 facilitates the spatial organisation of stromal cells differentiation in breast phyllodes tumours
Xia Li, Xuewen Yu, Jiaxin Bi, Xu Jiang, Lu Zhang, Zhixin Li, Mumin Shao
Clinical and Translational Medicine.2024;[Epub] CrossRef
Case report: Osteosarcomatous differentiation in the lung metastasis of a malignant phyllodes tumor
Ruijing Liu, Jingli Xue, Wen Liu, Beibei Jiang, Fuyun Shi, Zhenzheng Wang, Peifeng Li
Frontiers in Medicine.2023;[Epub] CrossRef
Diagnostic approach to fibroepithelial tumors of the breast
Frances Tresserra, María Angeles Martinez-Lanao, Melissa Fernandez-Acevedo, Cristina Castellet, Sonia Baulies
Revista de Senología y Patología Mamaria.2022; 35: S22. 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

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Abstract 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.

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A predictive model for recurrence in patients with borderline ovarian tumor based on neural multi-task logistic regression
Qiulin Ye, Yue Qi, Juanjuan Liu, Yuexin Hu, Xiao Li, Qian Guo, Danye Zhang, Bei Lin
BMC Cancer.2025;[Epub] CrossRef
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

Review article

Intraoperative consultation for ovarian tumors: Insun Kim; Yeungnam Univ J Med. 2019;36(3):163-182. Published online June 11, 2019; DOI: https://doi.org/10.12701/yujm.2019.00227

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Abstract PDF

The primary function of intraoperative frozen consultation is to provide an as accurate and prompt diagnosis as possible during surgery and to guide the surgeon in further management. However, the evaluation of frozen section (FS) is sometimes difficult because of suboptimal tissue quality and frozen artifacts compared with routinely processed tissue section. The pathologist responsible for the FS diagnosis requires experience and good judgment. Ovarian tumors are a heterogeneous group of tumors including primary surface epithelial tumors, germ cell tumors and sex cord-stromal tumors, secondary tumors, and other groups of tumors of uncertain histogenesis or nonspecific stroma. Intraoperative FS is a very important and reliable tool that guides the surgical management of ovarian tumors. In this review, the diagnostic key points for the pathologist and the implication of the FS diagnosis on the operator’s decisions are discussed.

Citations

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A Clinicopathological Study of Surface Epithelial Tumors of the Ovary: A Retrospective Analysis at a Tertiary Care Center in Jeddah, Saudi Arabia
Layla S Abdullah, Badraa Alahmadi, Reema Abonab, Salma Baeisa, Bodoor Alahmadi
Cureus.2025;[Epub] CrossRef
Gross mucinous multinodular appearance aids in the identification of ovarian metastases in low-grade appendiceal mucinous neoplasms during intraoperative consultation
Hiroshi Yoshida, Hiroki Tanaka, Takafumi Tsukada, Naoko Abeto, Mayumi Kobayashi-Kato, Yasuhito Tanase, Masaya Uno, Mitsuya Ishikawa, Tomoyasu Kato
Annals of Diagnostic Pathology.2021; 50: 151641. CrossRef
Diagnostic Accuracy and Discrepancies of Frozen Section Analysis in a Colombian Intermediate Care Center
Anggi Margarita Velez Bohorquez, Daniel Javier Vélez Bohórquez , Mabel Elena Bohórquez Lozano, Angela Cecilia Rios
Universitas Médica.2021;[Epub] CrossRef

Original article

What are the most important prognostic factors in patients with residual rectal cancer after preoperative chemoradiotherapy?: Sol-Min Kim, Ghilsuk Yoon, An Na Seo; Yeungnam Univ J Med. 2019;36(2):124-135. Published online April 1, 2019; DOI: https://doi.org/10.12701/yujm.2019.00157

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Abstract PDF

Background
We aimed to establish robust histoprognostic predictors on residual rectal cancer after preoperative chemoradiotherapy (CRT).
Methods
Analyzing known histoprognostic factors in 146 patients with residual disease allows associations with patient outcome to be evaluated.
Results
The median follow-up time was 77.8 months, during which 59 patients (40.4%) experienced recurrence and 41 (28.1%) died of rectal cancer. On univariate analysis, residual tumor size, ypT category, ypN category, ypTNM stage, downstage, tumor regression grade, lymphatic invasion, perineural invasion, venous invasion, and circumferential resection margin (CRM) were significantly associated with recurrence free survival (RFS) or/and cancer-specific survival (CSS) (all p<0.005). On multivariate analysis, higher ypTNM stage and CRM positivity were identified as independent prognostic factors for RFS (ypTNM stage, p=0.024; CRM positivity, p<0.001) and CSS (p=0.022, p=0.017, respectively). Furthermore, CRM positivity was an independent predictor of reduced RFS, irrespective of subgrouping according to downstage (non-downstage, p=0.001; downstage, p=0.010) or lymph node metastasis (non-metastasis, p=0.004; metastasis, p=0.007).
Conclusion
CRM status may be as powerful as ypTNM stage as a prognostic indicator for patient outcome in patients with residual rectal cancer after preoperative CRT.

Citations

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Poor nutrition and sarcopenia are related to systemic inflammatory response in patients with rectal cancer undergoing preoperative chemoradiotherapy
Shinya Abe, Hiroaki Nozawa, Kazushige Kawai, Kazuhito Sasaki, Koji Murono, Shigenobu Emoto, Junko Kishikawa, Tsuyoshi Ozawa, Yuichiro Yokoyama, Yuzo Nagai, Hiroyuki Anzai, Hirofumi Sonoda, Soichiro Ishihara
International Journal of Colorectal Disease.2022; 37(1): 189. CrossRef
Preoperative sarcopenia is a poor prognostic factor in lower rectal cancer patients undergoing neoadjuvant chemoradiotherapy: a retrospective study
Shinya Abe, Kazushige Kawai, Hiroaki Nozawa, Kazuhito Sasaki, Koji Murono, Shigenobu Emoto, Junko Kishikawa, Hiroaki Ishii, Yuichiro Yokoyama, Yuzo Nagai, Hiroyuki Anzai, Hirofumi Sonoda, Koji Oba, Soichiro Ishihara
International Journal of Clinical Oncology.2022; 27(1): 141. CrossRef
A Four-Methylated lncRNAs-Based Prognostic Signature for Hepatocellular Carcinoma
Le-En Liao, Dan-Dan Hu, Yun Zheng
Genes.2020; 11(8): 908. CrossRef

Case report

Imatinib-induced hepatitis treated by corticosteroids in a patient with metastatic gastrointestinal stromal tumor: Min Kyu Kang, Heon Ju Lee, Joon Hyuk Choi; Yeungnam Univ J Med. 2019;36(2):155-158. Published online January 21, 2019; DOI: https://doi.org/10.12701/yujm.2019.00115

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Abstract PDF

Imatinib mesylate is currently used as the first-line treatment for metastatic gastrointestinal stromal tumors (GISTs). Imatinib-induced hepatotoxicity in patients with GIST is very rare. Its features vary from subclinical elevation of serum aminotransferase to clinically apparent acute hepatitis, which is associated with immunologic reactions. Imatinib-induced hepatotoxicity with autoimmune-like features can be treated by the discontinuation of imatinib mesylate and the administration of oral steroids. Here, we report a case of late-onset imatinib-induced hepatitis with autoimmune-like features in a patient with metastatic GIST, which was improved by oral corticosteroids.

Citations

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The prevalence of hepatic and thyroid toxicity associated with imatinib treatment of chronic myeloid leukaemia: a systematic review
Mansour Tobaiqy, Nawal Helmi, Katie MacLure, Sylvia Saade
International Journal of Clinical Pharmacy.2024; 46(2): 368. CrossRef
Investigation of the role of NLRP3 inflammasome activation in new-generation BCR-ABL1 tyrosine kinase inhibitors-induced hepatotoxicity
Ege Arzuk
Toxicology Letters.2024; 400: 71. CrossRef
Antioxidant-Based Preventive Effect of Phytochemicals on Anticancer Drug-Induced Hepatotoxicity
Ji Eon Park, Chi-Hoon Ahn, Hyo-Jung Lee, Deok Yong Sim, Su Yeon Park, Bonglee Kim, Bum Sang Shim, Dae Young Lee, Sung-Hoon Kim
Antioxidants & Redox Signaling.2023; 38(16-18): 1101. CrossRef

Case Reports

Tumoral calcinosis and calciphylaxis treated with subtotal parathyroidectomy and sodium thiosulphate.: Hyunjeong Cho, Yongjin Yi, Eunjeong Kang, Seokwoo Park, Eun Jin Cho, Sung Tae Cho, Rho Won Chun, Kyu Eun Lee, Kook Hwan Oh; Yeungnam Univ J Med. 2016;33(1):68-71. Published online June 30, 2016; DOI: https://doi.org/10.12701/yujm.2016.33.1.68

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Abstract PDF: Tumoral calcinosis (TC) is a condition resulting from extensive calcium phosphate precipitation, primarily in the periarticular tissues around major joints. Calciphylaxis is a fatal ischemic vasculopathy mainly affecting dermal blood vessels and subcutaneous fat. This syndrome is rare and predominantly occurs in patients with end-stage renal disease. Here, we report on a rare case involving a patient with TC complicated with calciphylaxis. Our patient was a 31-year-old man undergoing hemodialysis who presented with masses on both shoulders and necrotic cutaneous ulcers, which were associated with secondary hyperparathyroidism, on his lower legs. He underwent subtotal parathyroidectomy, and sodium thiosulfate (STS) was administered for 27 weeks. Twenty months after beginning the STS treatment course, he experienced dramatic relief of his TC and calciphylaxis.

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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Abstract 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.

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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

Recurrent thymic carcinoid tumor in familial isolated primary hyperparathyroidism.: Jeong Eun Song, Mu Hyun Shon, Ga Young Kim, Da Young Lee, Jung Hun Lee, Jong Ho Kim, Ho Sang Shon, Ji Hyun Lee, Eon Ju Jeon, Eui Dal Jung; Yeungnam Univ J Med. 2014;31(2):131-134. Published online December 31, 2014; DOI: https://doi.org/10.12701/yujm.2014.31.2.131

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Abstract PDF: Familial isolated primary hyperparathyroidism(FIPH) is associated with multiple endocrine neoplasia type 1 (MEN1) syndrome, primary hyperparathyroidism accompanied by jaw-tumor syndrome, and familial hypocalciuric hypercalcemia. FIPH may be an early stage of MEN1 or an allelic variant of MEN1. Thymic carcinoid tumor is a rare tumor in MEN1 syndrome. Here, the authors report the case of a 40-year-old man diagnosed with recurrent thymic carcinoid tumor and FIPH. Both the patient and his elder sister had been previously diagnosed to have FIPH with a novel frameshift mutation in the MEN1 gene. Initially, the patient underwent thymectomy because of an incidental finding of a mediastinal mass in his chest X-ray, and had remained asymptomatic over the following 4 years. Pancreas computed tomography conducted to evaluate MEN1 syndrome revealed anterior and middle mediastinal masses, and resultantly, massive mass excision was performed. Histological findings disclosed atypical carcinoids with infiltrative margins. In view of the thymic carcinoid tumor relapse that occurred in this patient, the authors recommend that regular pancreas and pituitary imaging studies be conducted for FIPH associated with a MEN1 gene mutation.

A Case of Type 1 Neurofibromatosis Associated with Multiple Metastatic Gastrointestinal Stromal Tumors.: Hyo Jin Jang, Sung Ae Koh, Da Eun Jeong, Ji Yoon Jung, Eun Ju Goo, Kyoung Hee Lee, Joon Hyuk Choi, Myung Soo Hyun; Yeungnam Univ J Med. 2013;30(2):105-108. Published online December 31, 2013; DOI: https://doi.org/10.12701/yujm.2013.30.2.105

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Abstract PDF: Type 1 neurofibromatosis (von Recklinghausen's disease, NF-1) is an autosomal-dominant neurocutaneous-disorder characterized by systemic cafe'-au-lait spots, multiple cutaneous neurofibromas, axillary or inguinal freckling, and Lisch nodules (pigmented iris hamartomas). Approximately 10-25% of NF1 patients have gastrointestinal neoplasms. Gastrointestinal stromal tumor (GIST) in patients with neurofibromatosis is most commonly found in the small bowel and the stomach, and approximately 60% of such patients have multiple tumors or multiple tumor sites. Although, the increased incidence of GIST in patients with neurofibromatosis is well documented in pathology literature in English, but has rarely been documented in Korea. Here, we report a case of multiple GISTs in a 48-year-old woman accompanied by NF1. She was admitted to Yeungnam University Hospital with complaints of melena and dyspnea. A contrast-enhanced computed tomography (CT) scan revealed that multiple soft tissue masses were occupying the entire peritoneal cavity. An ultrasonogram- guided biopsy was performed and the tumors were found to have been composed of tumor cells that were positive for c-kit protein. The patient was put on Imatinib mesylate treatment, and further follow-up will be carried out.

A Case of Sacral Tuberculosis Mimicking Metastatic Bone Tumor with Elevated CA 19-9.: Kyung Yoon Chang, Kyung Sun Ha, Kyung Seon Park, Eun Hui Sim, Jae Ho Byun; Yeungnam Univ J Med. 2011;28(2):196-201. Published online December 31, 2011; DOI: https://doi.org/10.12701/yujm.2011.28.2.196

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Abstract PDF

A 73-year-old male presented a six-month history of buttock pain radiating into his thigh. The MRI revealed a large enhancing mass lesion involving the sacrum, with extension into the sacral canal. The tumor markers were measured to distinguish skeletal metastasis of carcinoma from primary bone tumor. The CA 19-9 was elevated. Despite the investigation, the primary site of cancer could not be found. Sacral bone biopsy was done. The pathologic examination revealed necrosis, chronic granulomatous inflammation, and multinucleated giant cells, consistent with tuberculosis. Sacral tuberculosis is rare in patients with no history of tuberculosis. Such solitary osteolytic lesions involving the subarticular region of large joints may mimic bone neoplasms and may be called "tuberculous pseudotumors." This case report intends to emphasize that bone tuberculosis should be a differential diagnosis in the presence of atypical clinical and radiological features. As tuberculous lesions may be mistaken for neoplasms, a small amount of fresh tissue should be sent for culture even if clinical diagnosis of a tumor seems likely. Described herein is a case of sacral tuberculosis mimicking metastatic bone tumor with elevated CA 19-9.

Citations

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Isolated Sacral Tuberculosis: A Case Report and Review of Literature of this Rare Sacral Pathology
Harshit Arora, Vasudha Sharma, Waryaam Singh, Lavanya Arora, Sumer Singh Nanda, Rajesh Pasricha
EMJ Neurology.2023;[Epub] 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

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Abstract 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

A Case of Gastric Glomus Tumor.: Jin Sung Lee, Sun Taek Choi, Hyun Uk Lee, Byung Jin Kwon, Ji Eun Lee, Si Hyung Lee; Yeungnam Univ J Med. 2011;28(2):165-172. Published online December 31, 2011; DOI: https://doi.org/10.12701/yujm.2011.28.2.165

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Abstract PDF: Gastric glomus tumor is a rare mesenchymal tumor that originates from modified smooth muscle cells of the glomus body. Glomus tumors are commonly observed in peripheral soft tissue, such as dermis or subungal region, but rarely in the gastrointestinal tract. A 39-year-old woman was admitted due to epigastric soreness. Upper gastrointestinal endoscopy revealed a subepithelial mass measuring 3.5cm with central ulceration at the lesser curvature-posterior wall of the antrum. Characteristically, contrast enhanced abdominal computed tomography scan demonstrated high enhancement of the submucosal mass up to the same level of the abdominal aorta in the arterial phase; this enhancement persisted to delayed phase. Due to the risk of bleeding and malignancy, wedge resection of the submucosal tumor was performed. Histologic findings were compatible with a glomus tumor.

Review

Anterior Mediastinal Tumor.: Jae Kyo Lee; Yeungnam Univ J Med. 2010;27(2):98-104. Published online December 31, 2010; DOI: https://doi.org/10.12701/yujm.2010.27.2.98

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Abstract PDF: Primary anterior mediastinal neoplasms comprise a diverse group of tumors and account for 50% of all mediastinal masses. Thymic epithelial neoplasm are most common and classified into thymoma, invasive thymoma, and thymic carcinoma. Neuroendocrine differentiation of thymic epithelial neoplasm are rare malignancies. Germ cell tumor (GCT) is second most common anterior mediastinal tumor and most of them are mature cystic teratoma. Malignant mediastinal GCT are rare than benign. Primary thoracic lymphoma is rare than thoracic involvement of systemic lymphoma and most common location of primary thoracic lymphoma is anterior mediastinum. The clinical and radiologic appearance of the most common masses are reviewed.

Original Article

Efficacy of Unresectable or Recurred Gastric Cancer Treated with TS-1 Chemotherapy or TS-1/CDDP Combination Chemotherapy: Se Won Kim, Sang Woon Kim, Sun Kyo Song; Yeungnam Univ J Med. 2007;24(2 Suppl):S391-398. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S391

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Abstract PDF: Purpose：Although several chemotherapy regimens used against advanced and recurred gastric cancer have been studied extensively in an attempt to further improve the prognosis of patients, no standard chemotherapeutic regimens have been established. The aim of this study was to determine the anti-tumor efficacy and safety of TS-1 or TS-1 plus cisplatin (CDDP). Materials and Methods：From December 2004 to June 2007, we treated 43 patients with unresectable or recurred gastric cancer either with 80 mg/m2 of TS-1 for 28 days, which was followed by a 2-week rest, or with 80 mg/m² of TS-1 for 28 days and 60 mg/m² of CDDP on day 3 every 6 weeks.
Results
：Tumor response rates in the primary chemotherapy group and in the recurrent group were 46.7% and 21.4%, respectively. The median survival rates in the primary and the recurrent group were 14 months and 8 months, and it was not significantly different. But the one-year survival rates according to the kinds of regimens (TS-1 or TS-1/CDDP group) were significantly different (P=0.0014). The incidences of grade 3 or 4 adverse effects were 18%, respectively.
Conclusion
：The anti-tumor efficacy and safety of TS-1 and TS-1 plus CDDP in unresectable or recurred gastric cancer patients seemed to be high with modest adverse effects, thus suggesting the possible use of this regimen for unresectable or recurred gastric cancer patients.

Case Reports

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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Abstract PDF: 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.

Desmoplastic Small Round Cell Tumor: A Case Report.: Joon Hyuk Choi, Sung Soo Yun, Jay Chun Chang; Yeungnam Univ J Med. 2006;23(1):90-95. Published online June 30, 2006; DOI: https://doi.org/10.12701/yujm.2006.23.1.90

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Abstract PDF: Desmoplastic small round cell tumor (DSRCT) is a rare and highly malignant mesenchymal tumor found in the abdominal cavity. It mainly affects young male patients. We report a case of DSRCT that occurred in the abdominal cavity of a 50-year-old man. The tumor was characterized by small round tumor cells with irregular nests in the prominent desmoplastic stroma. The tumor cells showed immunoreactivity for epithelial membrane antigen, desmin, vimentin, and neuron specific enolase.

Two Cases of Jejunal Gastrointestinal Stromal Tumor Diagnosed by Capsule Endoscope.: Jae Won Choi, Ji Eun Lee, Byung Ik Jang, Tae Nyeun Kim, Sun Kyo Song, Young Kyong Bae; Yeungnam Univ J Med. 2006;23(1):131-137. Published online June 30, 2006; DOI: https://doi.org/10.12701/yujm.2006.23.1.131

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Abstract PDF: Small bowel tumors have been difficult to diagnose because of low incidence and absence of specific symptoms. There are no efficient and accurate tests available for diagnosis. Capsule endoscopy is an efficient diagnostic tool for small bowel disease and obscure gastrointestinal bleeding. We diagnosed two cases of small bowel gastrointestinal stromal tumor (GIST) diagnosed by capsule endoscopy that were treated by surgery. A 68 year old male presented with abdominal pain. The capsule endoscopy showed fungating ulcer mass at the jejunum. A 55 year female presented with melena. The capsule endoscopy showed an intraluminal protruding mass with a superficial ulcer at the jejunum. Two cases were diagnosed with GIST after surgery. We report these two case diagnosed by capsule endoscopy and review the medical literature.

Original Article

The Analysis of the Cytokine Expression in Musculoskeletal Tumors.: Joon Han Lee, Eun Seok Kwak, Oog Jin Shon, Hee Sun Kim, Duk Seop Shin; Yeungnam Univ J Med. 2003;20(2):187-196. Published online December 31, 2003; DOI: https://doi.org/10.12701/yujm.2003.20.2.187

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Abstract PDF: The cytokines are the hormone-like proteins, which are produced in the mononuclear cells. They have many roles, such as immune mediators, cell differentiations, angiogenesis. The chemokines have chemotactic effects which control the host immune response. There were few reports about the cytokines associated with musculoskeletal tumors. From late 1980s, the cytokine studies of bone tumors such as osteosarcoma were started, but most studies for benign and malignant musculoskeletal tumors were left to be explored. To evaluate the characteristics of the cytokines in variable musculoskeletal tumors, tissues were obtained from the seven patients who visited the Yeungnam University hospital from February to July 2000. They were lipoma (1 case), parosteal osteoma (1 case), enchondroma (2 cases), pigmented villonodular synovitis (1 case), ganglion (1 case), and metastaic squamous cell carcinoma (1 case). The gene experession of the cytokines were analyzed by RNase protection assay (RPA) and reverse transcription-polymerase chain reaction (RT-PCR). The lipoma and parosteal osteoma expressed MIP-1beta, and IP-10 genes. The two enchondromas showed different results, one expressed all of MIP-1alpha, MIP-1beta and IP-10 genes but the other expressed none of above. The pigmented villonodular synovitis strongly expressed MIP-1alpha and IP-10 when compared with the other cases. The ganglion did not express all of the chemokines mentioned above. And the metastatic squamous cell carcinoma expressed all of the chemokines and especially IP-10 was highly expressed. Even though this study has only a few cases, these results provide a basis for the cytokine mediating network study in musculoskeletal tumors.

Reviews

The Role of Thallium-201 Scintigraphy in Bone and Soft Tissue Tumor.: Duk Seop Shin; Yeungnam Univ J Med. 2003;20(2):117-128. Published online December 31, 2003; DOI: https://doi.org/10.12701/yujm.2003.20.2.117

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Abstract PDF: Thallium-201 scintigraphy is used to discriminate the malignant bone tumor from the benign by qualitatively and quantitatively, and to predict the response of preoperative chemotherapy in osteosarcoma, by comparing the changes of thallium uptake ratio after chemotherapy to the tumor necrosis ratio. Thallium-201 scintigraphy scan should be done prior to surgical biopsy. PICKER Prism 2000 gamma camera with high resolution parallel hole collimator is usually used for scanning. The patient is injected with 2-3mCi of Tl-201 and the early phase is checked in 30 minutes and delayed phase in 3 hours. The scan images are visually evaluated by a blinded nuclear medicine physician. We could evaluate true positive, true negative, false positive and false negative by the comparison of results with those of biopsy, and calculate positive and negative predictive value(%), sensitivity(%), specificity(%) and diagnostic accuracy(%). For the quantitative analysis of thallium uptake, we drew the region of interest on the tumor side and contralateral normal side as mirror image, and calculated the uptake ratio with dividing the amount of gamma count in tumor side by normal side. We could calculate the percent changes of thallium uptake ratio in early and delayed phase, and compare them to the ratio of tumor necrosis. Thallium-201 scintigraphy proved as useful imaging study to discriminate malignant bone tumor from benign, but had exception in giant cell tumor and low grade malignant bone tumors. We can use T1-201 scan to differentiate the benign from the malignant tumor, and to evaluate the response of preoperative chemotherapy or radiotherapy, and to determine the residual tumor or local recurrence. For the better result, we need to have a more detail information about false positive cases and a more objective and quantitative reading technique.

Nonmyeloablative stem cell transplantation.: Myung Soo Hyun; Yeungnam Univ J Med. 2002;19(1):11-27. Published online June 30, 2002; DOI: https://doi.org/10.12701/yujm.2002.19.1.11

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Abstract PDF: Allogenic hematopoietic stem cell transplantation is one of the effective therapy for several hematologic malignancies. Transplantation preparative regimen is designed to eradicate the patient's underlying disease and immunosuppress the patient adequately to prevent rejection of donor's hematopoietic stem cells. so, Conventional myeloablative preparative regimens with high-dose chemotherapy or radiotherapy are related to high rate of morbidity and mortality. however, It has become clear that the high-dose therapy dose not eradicate the malignancy in some patients, and that the therapeutic benefit of allogenic transplantation is largely related to graft-versus-leukemia/graft-versus-tumor (GVL/GVT) effect. An new approach is to utilize less toxic, nonmyeloablative preparative regimens to achieve engraftment and allow GVL/GVT effects to developed. This strategy reduces the risk of treatment-related mortality and allows transplantation for elderly and those with comorbidities that preclude high-dose chemoradiotherapy.

Case Reports

Vaginal removal of mature cystic teratoma in postmenopausal woman.: Ki Mog Jung, Hyun Woo Lee, Ki Wan Kim, Min Whan Koh; Yeungnam Univ J Med. 2001;18(2):293-296. Published online December 31, 2001; DOI: https://doi.org/10.12701/yujm.2001.18.2.293

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Abstract PDF: Mature cystic teratomas, commonly called dermoid cysts, are the most common benign germ cell tumors of ovary in women of reproductive age. Mature cystic teratoma that constitutes 10-25% of ovarian tumors and 95% of teratoma, is germ cell tumor of the ovary. This occurs frequently in women less than 20 years old, but it can be found upto 10-20% in postmenopausal women. And in women over the age of 50, a mature cystic teratoma is likely to change into malignant form. Traditional surgical methods of mature cystic teratoma treatment include transabdominal cystectomy, oophorectomy, hysterectomy and(or) bilateral salphingooophorectomy. Recently laparoscopic approach replaces transabdominal surgeries in many cases. Vaginal removal of mature cystic teratoma is unique and rare. Compared with laparotomy, transvaginal approach is characterized by shorter hospital stay and lower morbidity rate. Compared with laparoscopic operation, transvaginal approach has advantages of no visible operative scar and lower intra-operative tumor spillage. The decision for surgical methods is related with patients' situations and surgeon's preference. We report 1 case of vaginal removal of mature cystic teratoma as a part of vaginal hysterectomy in old age patient.

Primary Cardiac Lymphoma: Case Report.: Jun Ho Bae, Jong Suk Lee, Hyung Jun Kim, Min Kyung Kim, Young Ho Park, Gue Ru Hong, Jong Sun Park, Dong Gu Sin, Young Jo Kim, Bong Sup Sim; Yeungnam Univ J Med. 2000;17(1):82-86. Published online June 30, 2000; DOI: https://doi.org/10.12701/yujm.2000.17.1.82

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Abstract PDF: Primary cardiac lymphoma defined as involving only the heart and pericardium, is very rare and is diagnosed predominantly late in the course of illness or autopsy. This tumor is commonly fatal and until recently were rarely diagnosed antemortem. Recently, it was reported in patients with acquired immunodeficiency syndrome. We report a case of primary cardiac lymphoma in a 56 year old female who showed progressive exertional dyspnea. On echocardiogram and CT scan, large ill defined mass was demonstrated in right atrial and ventricular wall. It was diagnosed as B-cell type lymphoma on open cardiac biopsy.

Original Articles

MR Imaging of Uterine Malignant Mixed Mullerian Tumor: Comparison with Endometrial Carcinoma.: Jae Ho Cho, Jeen Woo Kim, Jay Chun Chang, Bok Hwan Park, Jung Sik Kim; Yeungnam Univ J Med. 1999;16(2):296-301. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.296

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Abstract PDF: BACKGROUND
Generally, it is difficult to differentiate uterine malignant mixed Mullerian Tumor(MMMT) from endometrial carcinom in radiological and clinical aspects. Our purpose is to investigate MR findings that distinguishes MMMT from endometrial carcinoma. MATERIALS AND METHODS: We retrogradely evaluated the magnetic resonance imaging findings of pathologically proven 5 cases of malignant mixed Mullerian Tumor(MMMT) and 13 endometrial carcinomas to know the differential points of these two tumors originating in the endometrial cavity. The size of the mass, presence or absence of myometrial or uterine cervical invasion, growth pattern of the mass, signal intensity and degree and pattern of contrast enhancement were analyzed and compared. RESULTS: The length of the long axis of the MMMT was 1.5-9.0cm(average, 5.7cm) but that of the endometrial carcinoma was 0.5-6.0cm(average, 2.5cm). Invasion of uterine cervix which was found in 3 MMMT cases, dilated the endometrial cavity and the lumen of the uterin cervix and showed the pattern of growing into the external os. Invasion of uterine cervix was found in only one case of endometrial carcinoma. The presence or absence of myometrial invasion, the signal intensity and homogeneity on T1-and T2-weighted images, and the degree and patterns of contrase enhancement showed no significant difference. CONCLUSION: Any specific finding to differentiate MMMT from endometrial carcinoma was not ascertained. However, MMMT can be suspected if the size of the endometrial mass is greater than 5cm and if the mass dilates the enocervical canal and invades the uterine cervix.

Clinical Experience of Nephron Sparing Surgery for Renal Tumor with a Normal Opposite Kidney.: Jun Young Lee, Jung Hyun Kim, Kang Min Lee, Ki Hak Moon, Hee Chang Jung, Tong Choon Park; Yeungnam Univ J Med. 1999;16(1):94-100. Published online June 30, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.1.94

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Abstract PDF: The aims of this retrospective study were to determine whether a nephron sparing surgery might be feasible in patients with a small solid renal tumor. Materials and methods: Between 1988 and 1999, 21 patients with radiologically detectable small solid renal tumor underwent enucleoresection, wedge resection and polar segmental nephrectomy. The mean age of the 11 men and 10 women in this study was 43 years (range 14 to 68). According to the preoperative radiological diagnosis, 15 among the 21 patients were considered to have renal cell carcinoma, 4 were considered to have angiomyolipoma, and the remaining 2 patients were difficult to differentiate as renal tumors radiologically. Among 15 patients considered to have renal cell carcinoma, 14 were found to have renal cell carcinoma and the remaining one patient was diagnosed as having oncocytoma on pathologic examination. Radiological determination of angiomyolipoma in four patients was confirmed to be correct on pathological examination. The 2 patients whose radiological diagnose wasdificult were founf to have cavernous hemangioma and angiomyolipoma. One patient with renal cell carcinoma developed arteriocaliceal fistula, the only immediate complication in this series, and underwent nephrectomy on postoperative 10th day. The mean follow-up duration for the 14 patients with renal cell carcinoma was 18.6 months(range:1-103). There were no other tumor involvement in the resection margins following the nephron sparing surgery. These results suggest that nephron sparing surgery provides an effective treatment for patients with a single, small, unilateral, localized renal tumor. Longer follow-up is suggested for more definite verification of the role of nephron sparing surgery.

Use of Sonography in the Differential Diagnosis between Phylloides Tumor and Giant Fibroadenoma.: Jong Oh Choi, Jae Woon Kim, Won Kyu Park, Mi Soo Hwang, Bok Hwan Park; Yeungnam Univ J Med. 1996;13(2):295-301. Published online December 31, 1996; DOI: https://doi.org/10.12701/yujm.1996.13.2.295

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Abstract PDF: Phylloides tumor is very similar to giant fibroadenoma in that they have benign appearance in breast radiologic image. Fibroadenoma has no malignant potential, but phylloides tumor is locally recurrent, invasive and may occasionally metastasize. It thus appears that evaluation of the differential point of the two tumor groups by radiologic study is very important. We retrospectively compared sonographic find;.ngs of 6 cases of phylloides tumor with those of 4 cases of fibroadenoma, which proved pathologically in Ye mgnam University Hospital from 1984 to 1986. The mean age of the patients were 31.8 years old(from 14 to 41 years old) in phylloides tumor and 28.8 years old (from 17 to 40 years old) in giant fibroadenoma, respectively. The viewpoints of this analysis were size, shape and contour of the masses, internal echo pattern, posterior enhancement, and especially the existence of peripheral cyst or septal band echo. We found that diffenentiation of these two tumors by sonography was difficult. But peripheral cyst was found only in phylloides tumor and septal band echo was found largely in giant fibroadenoma. Although the existence of peripheral cyst or septal band echo in the breast mass was not pathognomonic findings, we suggest that the existence of septal band echo is preferential finding to fibroadenoma, and peripheral cyst is preferential finding to phylloides tumor.

Clinical Experiences of the Orbital Tumors: Kyung Ha Lee, Wha Sun Chung; Yeungnam Univ J Med. 1996;13(1):78-85. Published online June 30, 1996; DOI: https://doi.org/10.12701/yujm.1996.13.1.78

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Abstract PDF: The authors reviewed 95 cases (46 men and 49 women) of the orbital tumors diagnosed histopathologically at the Department of Ophtalmology, Yeungnam University Hospital from March 1984 through August 1994. Seventy-five cases of benign tumors were found evenly in all decades, but twenty cases of malignant tumors were noticed more frequently in 1st, 6th, and 7th decades. The frequency of benign orbital tumors was in this order; dermolipoma (21%, 20 cases), dermoid cyst (11.6%, 11 cases), mucocele (8.4%, 8 cases), lipoma (7.4%, 7 cases) and pleomorphic adenoma (5.3%, 5 cases). Of malignant orbital tumors, the frequency was in this order; retinoblastoma (3 cases), malignant melanoma (2 cases), sebaceous carcinoma (2 cases), and maxillary sinus carcinoma (2 cases). Malignant orbital tumors of 8 expired patients were revealed as secondary or metastatic tumors.

Case Reports

A Case of Solitary Glomus Tumor.: Hae Ook Cho, Dong Hoon Shin, Jong Soo Choi, Ki Hong Kim; Yeungnam Univ J Med. 1996;13(1):152-157. Published online June 30, 1996; DOI: https://doi.org/10.12701/yujm.1996.13.1.152

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Abstract PDF: We report a case of subungual solitary glomus tumor in a 28-year-old female, who has suffered from pain and tenderness of the left 4th finger tip for about 5 years. Simple surgical excision was performed for removal of the tumor mass and for the relief of the subjective symptoms. No recurrence has been observed for 5 months following excision of the tumor.

CT findings of Desmoid tumor arising at Abdominai Wall.: Dae Hyoun Cho, Jae Ho Cho, Jae Chun Chang; Yeungnam Univ J Med. 1995;12(2):386-392. Published online December 31, 1995; DOI: https://doi.org/10.12701/yujm.1995.12.2.386

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Abstract PDF: Desmoid tumor is a type of fibromatosis usually arise in deep musculo-aponeurotic structures, primarily of the trunk and extremities. It is characterized by proliferation of fibroblastic tissue and does not metastasize but may be locally aggressive. Eventhough the surgical margin reveals clean, recurrence often occurs. To analyze the extent of the tumor and homodynamic characteristics exactly, we performed IV bolus CT. Desmoid tumors show peripheral rim enhancement on early phase scan and more strong, central enhancement on late phase IV bolus CT, which reflects abundant fibroblastic components of the tumor. We report two cases of pathologically confirmed desmoid tumor performed IV bolus CT.

Original Article

Metastatic tumors in supraclavicular lymph node: pathological analysis of 125 cases.: Dong Sug Kim, Hae Joo Nam, Won Hee Choi, Tae Sook Lee; Yeungnam Univ J Med. 1991;8(2):70-75. Published online December 31, 1991; DOI: https://doi.org/10.12701/yujm.1991.8.2.70

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Abstract PDF: Supraclavicular lymph nodes are unique in that they can attract metastases from almost anywhere in the body and most common sites of metastasis from an unknown primary source. 125 cases which had been diagnosed as metastatic supraclavicular lymph node during the period between May 1983 and August 1991, were analyzed pathologically, and following distinctive characteristics could be outlined: 1) The most frequent sites of metastasis from primary lesions are lung (43%), stomach (23%), lymphoreticular (6%), biliary (5%), esophagus (2%), and pancreas (2%). 2) Histologic examination of metastatic supraclavicular lymph node revealed adenocarcinoma (57%), squamous cell carcinoma (12%), undifferentiated carcinoma (9%), small cell carcinoma (7%), malignant lymphoma (6%), malignant melanoma (1%) and undetermined carcinoma (8%). 3) In cases that histologic types were squamous cell carcinoma, undifferentiated carcinoma, small cell carcinoma and undetermined carcinoma, the most frequent primary site was lung.

Case Report

Treatment of bone tumors with a custom-made prosthetic replacement.: Hyun Kug Shin, Jae Sung Suh, Jong Chul Ahn, Joo Chul Ihn; Yeungnam Univ J Med. 1991;8(1):206-214. Published online June 30, 1991; DOI: https://doi.org/10.12701/yujm.1991.8.1.206

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Abstract PDF: We treated three cases of bone tumors-giant cell tumor, chondroblastoma and malignant fibrous histiocytoma-with a custom-made prosthetic replacement. The patients were followed from 10 months to 18 months, postoperatively. The results of these study are as follows: 1. Satisfactory anatomic restoration 2. Early ambulation 3. Good function 4. Biomechanically sound reconstruction

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