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췌장의 고형 가유두상 종양의 수술 후 추적 기간 중 발생한 주위림프절 및 다발성 간전이 1예
김유경 ( You Gyung Kim ),김병익 ( Byung Ik Kim ),김슬기 ( Seul Ki Kim ),김학수 ( Hak Soo Kim ),김홍주 ( Hong Ju Kim ),조용균 ( Yong Kyun Cho ),전우규 ( Yu Gyu Jeon ) 대한간암학회 2018 대한간암학회지 Vol.18 No.2
Solid pseudo-papillary neoplasm (SPN) of pancreas is a rare epithelial neoplasm of pancreas with a low malignant potential, occurs most commonly in young females. Here, we report a rare case of woman who has severe hepatomegaly due to multiple hepatic metastases of SPN of pancreas. At the time of diagnosis, a SPN was detected at only pancreas and there was no evidence of metastasis. So, she received subtotal pancreatectomy and total splenectomy. After 2 years of follow up, multiple small hepatic metastases were presented. In spite of three times of radiofrequency ablation, the burden of hepatic metastasis has increased continuously and multiple intra-abdominal lymph nodes metastases were detected, and ascites and peripheral edema occurred. However, because of benign feature of SPN and extremely rare incidence of recurrence and metastasis, there is no specific treatment guideline for metastatic SPN. Through multidisciplinary care service, we planned to do radiotherapy followed by a transarterial chemoembolization (TACE). But the patient could not have a scheduled radiation therapy due to deterioration of liver function. So changing the strategy of treatment, followed by TACEs were done alone. Although the size of SPN is not reduced, the extent of SPN and complication of SPN (ascites, peripheral edema, abdominal pain and so on) are being controlled. (J Liver Cancer 2018;18:168-174)
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박창영,이상종,김병익,편유장,유종현,전우규,김명숙 대한소화기내시경학회 1996 Clinical Endoscopy Vol.16 No.4
Gastric carcinoid tumors were previously believed to be rare lesions, representing less than 2% of all carcinoid tumors and less than 1% of all stomach neoplasms. More recent studies have demonstrated that they may constitute as much as l0-30% of carcinoid tumors. We recently experienced a 35-years old businessman with gastric carcinoid tumor who camplained of postprandial epigastric discomfort. Gastrofiberscope showed protruding mass with central depression and erasion which was located on greater curvature of lower body and its size was 1 x 1 cm. Gastroendoscopic biopsy was per formed. It was identified to carcinoid tumor(Argyrophilic tumor). EUS(endoscopic ultrasonography) revealed that the lesion was limited to submucosa without evidence of any metastasis to adjacent lymph node. The carcinoid tumor was successfully removed by endoscopic polypectomy. Gastrofiberscope and EUS 9months after polypectomy showed that the lesion was nearly normal mucosa without submucosal thickening.
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