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TACE와 Sorafenib 치료 후 수술을 시행한 간세포암종
노금엽 ( Geum Youb Noh ),한철주 ( Chul Ju Han ),김연주 ( Youn Joo Kim ),양기영 ( Ki Young Yang ),박수철 ( Su Cheol Park ),김진 ( Jin Kim ),김유철 ( Yu Cheol Kim ),최윤희 ( Yoon Hee Choi ),이효락 ( Hyo Rak Lee ) 대한간암학회 2011 대한간암학회지 Vol.11 No.1
Surgical resection for hepatocellular carcinoma (HCC) is one of the managements, showing improved long term survival. Nowadays, it is being accepted as the main curative treatment. However, the biggest problem we used to face is that surgery cannot be applied at the point of presentation in many patients due to advanced stage. Here we present a case of 54 years old female, who had transarterial chemoembolization (TACE) and sorafenib due to advanced stage of HCC, and later underwent curative surgery due to remarkable response. She had a CT scan of abdomen, which showed multiple huge masses. HCC was confirmed by ultrasonography-guided liver biopsy. TACE was performed once. After TACE, the size of masses increased. Therefore, sorafenib was administered and then continued for 9 months. As partial response was obtained at that time, surgical resection was successfully done. In the pathological report of removed tumor, we could confirm total necrosis of tumor. Now, it`s been 6 months and she is followed up without any recurrence.
간세포암종에 대한 Cyberknife 치료 후 완전관해가 왔던 환자에서 하반신 마비가 발생한
노금엽 ( Geum Youb Noh ),한철주 ( Chul Ju Han ),김연주 ( Youn Joo Kim ),양기영 ( Ki Young Yang ),박수철 ( Su Cheol Park ),김진 ( Jin Kim ),김유철 ( Yu Cheol Kim ),김미숙 ( Mi Sook Kim ) 대한간암학회 2011 대한간암학회지 Vol.11 No.2
Radiation therapy (RT) is one of the managements for unresectable hepatocellular carcinoma (HCC). Traditionally, RT has played only a limited role in HCC treatment because of its low efficacy and the low tolerance of the liver for this modality. However, as the technology of RT grows rapidly in recent years, indication of RT for HCC has been extended remarkably. Stereotactic body radiation therapy (SBRT) is a technique that allows precise delivery of a large ablative radiation dose to the tumor while sparing normal surrounding tissue in 1 to 5 fractions. As RT becomes useful therapeutic strategy, the important problem is that there could be serious complication after RT. Here we present a case of 54 years old male with advanced stage of HCC, who underwent a serious neurologic complication of paraplegia following Cyberknife (CK) treatment. He had a huge HCC in right lobe of the liver, and initially transarterial chemoembolization (TACE) was performed with an unsatisfactory response. Therefore, CK was performed, and another TACE was done for a new lesion, which was followed by remarkable complete remission of the tumor. However, paraplegia developed in both of his lower extremities a year after CK. Investigation has shown radiation myelitis as the cause of paralysis. Three and a half years have passed since CK treatment, and HCC is still in complete remission state, however, paraplegia is persistent now. Radiation myelitis should be considered as a complication, when CK is applied to treatment of HCC.
폐 종괴로 나타난 원발성 골수섬유증 환자의 골수 외 조혈
김여명 ( Yeo Myeong Kim ),김현태 ( Hyeon Tae Kim ),노금엽 ( Geum Youb Noh ),강민수 ( Min Soo Kang ),장윤환 ( Yoon Hwan Chang ),김혜련 ( Hye Ryoun Kim ),이재철 ( Jae Cheol Lee ),김철현 ( Cheol Hyeon Kim ) 대한결핵 및 호흡기학회 2009 Tuberculosis and Respiratory Diseases Vol.67 No.3
Primary myelofibrosis is characterized by replacement of bone marrow with fibrotic tissue and the development of extramedullary hematopoiesis. Extramedullary hematopoiesis primarily involves the spleen and liver, but can also occur in the lungs. We report the case of an 80-year-old male who was admitted for evaluation of a lung mass and persistent thrombocytopenia. A percutaneous needle aspiration from the mass in the right lower lung showed myelopoietic cells with fatty tissue. A bone marrow biopsy revealed a hypercellular marrow with an increased number of atypical megakaryocytes. The final diagnosis was a prefibrotic stage of primary myelofibrosis leading to extramedullary hematopoiesis in the lung.