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성민경(Min Kyung Seung),유동도(Dong Do You),장기택(Kee Taek Jang),허진석(Jin Seok Heo),최성호(Seong Ho Choi),최동욱(Dong Wook Choi) 한국간담췌외과학회 2010 한국간담췌외과학회지 Vol.14 No.2
Pancreatic tumors are primary in most cases. Pancreatic metastases associated with other primary malignancies, especially pancreatic metastasis of leiomyosarcoma, are infrequent. A 49-year-old woman underwent surgical resection of a mass in the right groin, which was diagnosed as a leiomyosarcoma and she was well for 4 years without evidence of disease recurrence. As part of her routine follow-up, an abdominal computed tomography (CT) identified a cystic neoplasm of the pancreas. Pylorus-preserving pancreaticoduodenectomy was performed. Microscopically, the tumor was composed of spindle cells with a predominantly fascicular pattern, which was consistent with a leiomyosarcoma that was metastatic to the pancreas. We report here a unique case of pancreatic metastasis from a leiomyosarcoma, which was resectable and mimicked a primary cystic neoplasm.
제한적 절제술과 근치적 절제술 후의 췌장루와 당뇨 발생에 대한 비교분석
최민영(Min Young Choi),유동도(Dong Do You),이형근(Hyung Geun Lee),허진석(Jin Seok Heo),최성호(Seong Ho Choi),최동욱(Dong Wook Choi) 한국간담췌외과학회 2009 한국간담췌외과학회지 Vol.13 No.3
Purpose : Pancreaticoduodenectomy (PD) or distal pancreatectomy (DP) are treatments used for pancreatic benign neoplasms even though both of these treatments result in significant loss of normal pancreatic parenchyma; this leads to subsequent impaiment of exocrine and endocrine pancreatic function. The purpose of this study is to provide short-and long-term result of limited resection (LR) in a single center. Methods : Two-hundred thirty patients who had undergone pancreatic resection between April 1998 and September 2008 for benign neoplasms were reviwed retrospectively. DP was performed in 102 patients, LR in 77, PD in 51 patients. The definitions of the International Study Group of Pancreatic Fistula (ISGPF) were applied to postoperative pancreatic fistulas (POPF), perioperative endocrine function was evaluated through oral glucose tolerance test. Results: LR includes 42 enucleation, 24 central pancreatectomy, and 11 uncinate process resection, No deaths occurred to patients during the study review period; POPF was detected in 50 patients(65%), 37 patients with grade A and 13 patients with grade B of C, POPF occurred 65% of the time after LR, more frequently compared to the occurrance after PD of DP (58%), but this was not statistically significant (P=322). After LR, there waere 2 patients with new onset diabetes(3%), while 26(17%) patients developed diabetes after DP or PD(P=002). Comcpusion : LR may preserve endocrine and exocrine function, While motality is low with the use of LR is associated with a higher pancreatic-leaking rate. The precise management of benign pancreatic lesions remains evolution.
A Case of Primary Hepatic Malignant Paraganglioma without Hypertension
Heuy Seong Lee(이희성),Hyung Geun Lee(이형근),Dong Do You(유동도),Jin Seok Heo(허진석),Seong Ho Choi(최성호),Dong Wook Choi(최동욱) 한국간담췌외과학회 2009 한국간담췌외과학회지 Vol.13 No.1
Paraganglioma is an unusual neoplasm that is embryologically derived from neural crest cells. The most common location of this neoplasm is the adrenal medulla, where these tumors are known as pheochromocytoma. It is extremely rare that paragangliomas occur in the liver. There are only 7 reports of primary hepatic paraganglioma. A 56-year-old man was referred to XX Medical Center. Hypertension was not found. He had suffered from jaundice, headache and weight loss for the 4 previous weeks, but hypertension was not present. The total bilirubin was 7.7 mg/dl and the CA19-9 level was 56.3 U/dl. The tumor was diagnosed as intrahepatic cholangiocarcinoma on the computed tomography image. After biliary drainage via endoscopic nasobiliary drainage, surgical exploration was carried out; right trisectionectomy with caudate lobectomy, portal vein resection and anastomosis were then done. The final pathological diagnosis was primary hepatic malignant paraganglioma of the intrahepatic duct. There has been no evidence of recurrence on the follow up CT images during the 24 month follow up period.