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변경도 ( Kyung Do Byun ),허찬영 ( Chang Young Hur ),김기훈 ( Ki Hoon Kim ),박정익 ( Jeong Ik Park ),김광희 ( Kwang Hee Kim ),김태현 ( Tae Hyun Kim ),최창수 ( Chang Soo Choi ),최영길 ( Young Kil Choi ) 대한임상종양학회 2009 Korean Journal of Clinical Oncology Vol.5 No.1
유방외 종양으로부터 유방으로의 전이는 매우 드문 것으로 되어 있다. 난소 및 유방으로의 동시 다발성전이는 더욱 드물다. 45세 여자가 5년 전 위암으로 근치적 위아전절제술 및 위십이지장문합술을 시행하였고 문합부 폐쇄, 좌측 요도 폐쇄와 크루켄베르크종양으로 내원하였다. 문합부 폐쇄는 스텐트 삽입으로, 좌측 요도 폐쇄는 Double J catheter 삽입으로, 크루켄베르크종양은 FOLFOX 항암치료를 시행하였다. 10차 항암치료 후 크루켄베르크종양의 크기 증가로 전자궁적출술 및 양측 난소 난관 절제술을 시행하였고 전이성 signet ring형 암이었다. 한달 후 양측 유방종괴가 만져져 시행한 초음파에서 양측 유방의 염증성 침윤이 관찰되었다. 3차례의 Paclitaxel 항암치료 후 양측 변형 근치 유방절제술을 시행하였고 전이성 signet ring형 암을 보였다. Estrogen 수용체 및 Progesterone 수용체, c-erbB-2 음성이었다. 환자는 현재 생존중이며 추가 항암요법을 고려중에 있다. Metastatic deposits to the breast from extramammarian tumors are rare. Both ovary and breast metastasis are more rare. A 45-year-old woman who had underwent radical subtotal gastrectomy and gastroduodenal anastomosis 5 years ago visited our hospital due to the obstruction of anastomotic site, the obstruction of left ureter and Krukenberg`s tumor. She underwent stent insertion on anastomotic obstruction, Double J catheter insertion on the obstruction of left ureter and FOLFOX chemotherapy on Krukenberg`s tumor. After 10 cycles chemotherapy, she underwent total hysterectomy and bilateral salphingooophorectomy because of the enlarged size of Krukenberg`s and the pathologic report was metastatic signet ring cell carcinoma. Since palpable masses were felt in both breast after one month she was examined breast ultrasonography so she was reported inflammatory infiltration of both breast. After 3 cycles of Paclitaxel chemotherapy she underwent both modified radical mastectomy so she was pathologically reported metastatic signet ring cell carcinoma. Estrogen and progesterone receptors and c-erbB-2 were negative. Now She is alive and is under consideration additional chemotherapy.
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변경도(Kyung-Do Byun),하태권(Tae-Kwun Ha),유성목(Sung-Mock Ryu),김태현(Tae-Hyun Kim),김상효(Sang-Hyo Kim) 대한두경부종양학회 2009 대한두경부 종양학회지 Vol.25 No.2
Purpose :For the past 10 years, the incidence of thyroid cancer has been rapidly increased in female popula-ion showing current incidence of 12,000 new thyroid cancer patients annually in Korea. Though differentiated thyroid cancer is known to show favorable prognosis and excellent long-term survival from slow growth and late distant metastasis, we re-evaluated prognostic factors of recurrence and mortality following surgical procedures based on our cases. Material and Methods :954 Patients of DTC surgically treated at Department of Surgery, Inje University Busan Paik Hospital between 1980 and 2004 were reviewed in the aspects of the surgical procedures, clinical staging, risk factors, recurrence and their outcome through median follow-up period of 10.5 years. Results :Recurrence in remnant thyroid, cervical nodes, and distant metastasis were observed in 84 pa-ients(8.8%), and 31 patients were confirmed to be died of locoregional recurrence of cancer and distant metas-asis. Regarding the risk factors to recurrence, tumor size, extrathyroidal extension, nodal metastasis, and capsular invasion were significant predictors(p<0.05). Local recurrence and distant metastasis had no statistical signi-icance according to age, sex, pathology, surgery, and lymphovascular invasion. Overall 10-year survival rate was 92.4%, but low, intermediate, and high-risk patient showed 100%, 94.4%, and 70.5% respectively. Conclusion :The significant factors influencing local recurrence and distant metastasis were tumor size, extrathyroidal ex-ension, LN metastasis, capsular invasion. In order to improve survival rate of high-risk group, appropriate and aggressive management should be recommended.
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Sumin Ha(하수민),Tae Hyun Kim(김태현),Anbok Lee(이안복),Kyung-Do Byun(변경도),Jae Woong Han(한재웅),Min Sung Ahn(안민성),Kwang Hee Kim(김광희),Ki Beom Bae(배기범),Ha Kyoung Park(박하경),Jae Ho Shin(신재호),Sang Hyuk Seo(서상혁) 대한종양외과학회 2015 Korean Journal of Clinical Oncology Vol.11 No.2
Purpose: Oncoplastic surgery (OPS) has emerged as the latest ideal surgery in treatment of breast cancer. The purpose of this study is to evaluate the cosmetic outcome of volume displacement surgery and patients’ satisfaction in Korean women with relatively small breast size. Methods: This is a retrospective study of 173 patients who had volume displacement of OPS between January 2008 and December 2013. Cosmetic outcome was evaluated by patients’ questionnaire and a doctor. The patients’ satisfaction was assessed by a questionnaire divided into four categories; cosmetic satisfaction, satisfaction on operative method, femininity, and side effects. Relationship between removed specimen volume and patients’ satisfaction was also analyzed. Results: About 90% of patients answered above the fair in cosmetic items and operative methods, only less than 5% of all patients reported of severe complications such as cramps or limitations of exercise. The patients’ cosmetic satisfaction score were significantly inversely related with removed specimen volume and doctor’s cosmetic assessment was also accordance with this result (P<0.05). Most patients preferred good contour over short scar regardless of age and marital status (good contour 54% vs. short scar 21%). Conclusion: Volume displacement of OPS brings both the best possible cosmetic outcome and high patient satisfaction for Korean women with a small size of breast in breast cancer surgery. It is highly suggestive that Korean women considers good contour more than the size of scar; therefore, volume displacement of OPS is a recommendable means of breast cancer surgery for Korean women.
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