Myoid Hamartoma of the Breast with Synchronous Contralateral Breast Cancer: Report of a Case / 한국유방암학회지

Myoid hamartomas of the breast parenchyma are extremely rare, benign breast neoplasms. Only 15 cases of the parenchymal myoid hamartoma of the breast have currently been described in the medical literature written in English. A 46-year-old woman presented with a huge right breast myoid hamartoma and synchronous contralateral left periareolar cancer. We discuss the clinical features, the radiologic findings, the pathologic findings and the management of this type of lesion. Surgeons should be aware that myoid hamartoma is a rare benign tumor, but it can be the cause of a palpable mass in the breast.

Myoid Hamartoma of the Breast with Synchronous Contralateral Breast Cancer: Report of a Case / 한국유방암학회지

Myoid hamartomas of the breast parenchyma are extremely rare, benign breast neoplasms. Only 15 cases of the parenchymal myoid hamartoma of the breast have currently been described in the medical literature written in English. A 46-year-old woman presented with a huge right breast myoid hamartoma and synchronous contralateral left periareolar cancer. We discuss the clinical features, the radiologic findings, the pathologic findings and the management of this type of lesion. Surgeons should be aware that myoid hamartoma is a rare benign tumor, but it can be the cause of a palpable mass in the breast.

A Mucocele-Like Tumor of the Breast Associated with Ductal Carcinoma In Situ and Mucinous Carcinoma: A Case Report / 한국유방암학회지

A Mucocele-like tumor (MLT) of the breast is a rare lesion and is pathologically characterized by mucin-filled cysts and extravasated mucin present in the adjacent stroma. Since the first report of an MLT of the breast by Rosen in 1986, an MLT has been considered as part of a diverse spectrum of pathological lesions including benign tumors, atypical ductal hyperplasia (ADH), ductal carcinoma in situ (DCIS) and mucinous carcinomas. We described a case of an MLT of the breast associated with DCIS and a mucinous carcinoma in a 46-year-old female patient who was treated with a left modified radical mastectomy and a sentinel lymph node biopsy. This case supports the concept of a spectrum of pathological lesions for an MLT, including benign lesions, columnar hyperplasia, ADH, DCIS and mucinous carcinomas.

The Clinical Significance of the Estrogen Receptor beta Expression for Endocrine Therapy in Patients with ERalpha-negative and Progesterone Receptor-positive Breast Carcinoma / 한국유방암학회지

PURPOSE: Estrogen receptor (ER) is the key therapeutic target in breast cancer. ERbeta has recently been identified to be distinct from ERalpha. In contrast to ERalpha, the functions of ERbeta in breast cancer are still unclear. We sought to determine whether the expression of ERbeta can be used as a predictive marker for endocrine therapy for patients with ERalpha-negative breast cancer. METHODS: Formalin-fixed, paraffin-embedded tumor specimens from 52 patients with ER-/PR+ invasive breast cancer were immunostained for their ERbeta expression. These patients were treated with adjuvant tamoxifen. The results were correlated with various clinicopathological variables and the follow-up data. The expressions of p53 and HER-2/neu were also analyzed and correlated with the ERbeta status. RESULTS: An ERbeta expression was observed in 53.8% (28/52) of the breast cancer samples. There was no correlation between the ERbeta expression and the other clinicopathologic factors (age, tumor size, histologic type, nodal status, histological grade, stage, therapeutic modality, progesterone receptor (PR) expression, p53 expression and HER-2/neu expression). Recurrence was present in 7.7% (2/26) of the patients whose tumors had an ERbeta expression, as compared to the presence of recurrence in 36.4% (8/22) of the patients whose tumors had no ERbeta expression (p<0.05). The patients with ERbeta negative-tumors revealed lower disease free survival rate than those with ERbeta positive-tumors (p<0.05). Of the 52 patients, 10 (19.2%) were p53 positive, and 11 (21.2%) were HER-2/neu positive. No significant correlations were observed between ERbeta and p53 or HER-2/neu. CONCLUSION: These results suggest that ERbeta might be a predictive marker of a response to endocrine therapy in patients with ER-/PR+ invasive breast cancer, although this needs to be confirmed by additional studies.

Inguinal Hernia Repair under Local Anesthesia in Octogenarians

PURPOSE: We are to describe the clinical characteristics and treatment outcomes in patients aged between 80 and 89 years who underwent inguinal hernia repair under local anesthesia. METHODS: We retrospectively reviewed the medical records of patients aged between 20 and 89 years who underwent tension free hernia repair under local anesthesia by a single surgeon between June 2001 and January 2009 and compared clinical characteristics and outcomes between octogenarians who were the eldest and sexagenarians whose incidence was the highest. RESULTS: Of the 514 patients, the number of octogenarians was 52 (8.6%) and sexagenarians were 225 (35.0%). Body mass index (BMI) was 22.5 kg/m2 in octogenarians and 23.7 kg/m2 in sexagenarians (P=0.003). Underlying diseases were present in 67.3% of octogenarians and 73.5% of sexagenarians (P=0.238). The incidence of liver disease was significantly lower in the octogenarians (1.9% vs 15.7%, P=0.004). The proportion of patients who underwent local anesthesia was significantly higher among the octogenarians (94.5% vs 82.2%, P=0.014). Operative time and postoperative hospital stay had no significant difference between both groups. Postoperative complications developed in 4 (7.7%) of the octogenarians and in 18 (9.7%) of the sexagenarians. Scrotal swelling was developed most frequently and surgery-related mortality did not developed in both groups. CONCLUSION: If local anesthesia is used appropriately, inguinal hernia repair in octogenarians is a safe procedure as like in sexagenarians and may reduce the psychiatric burden related to complications for both surgeons and elderly patients.

Predictive Factors Related to Lymph Node Metastases in Patients with Papillary Thyroid Microcarcinomas Less than 5 mm in Size / 대한내분비외과학회지

PURPOSE: Papillary thyroid cancer is the most common histological type of malignancy that originates from the thyroid. The disease has an excellent prognosis, despite characteristically being associated with lymph node metastases. According to the World Health Organization, a papillary thyroid microcarcinoma (PTMC) is defined as papillary carcinoma measuring ≤1 cm in the greatest dimension. We present the clinico-pathological features and investigate predictive factors related with lymph node metastases in patients with papillary thyroid microcarcinomas less than 5 mm in size. METHODS: Between January 2003 and June 2005, 75 patients underwent surgical treatment for thyroid papillary cancer less than 5 mm in size at the Department of Endocrine Surgery at our hospital. We analyzed the age of patients, gender, presence of symptoms, multifocality, combined thyroid disease, tumor size, capsular invasion, presence of a lymph node metastasis, tumor location, operative method and postoperative complications by use of Pearson's chi-squared test. RESULTS: Lymph node metastases most frequently occurred in patients with a lateral neck mass at presentation (p=0.004). Patients with capsular invasion of the thyroid showed a high rate of lymph node metastases (p=0.027). In patients with combined thyroid disease such as thyroiditis, more lymph node metastases were observed (p=0.018). CONCLUSION: Preoperative symptoms at presentation (especially a lateral neck mass) and tumors with capsular invasion had a high potential to cause lymph node metastases. Factors such as a lateral neck mass, capsular invasion, and combined thyroiditis may be predictive of a lymph node metastasis and are helpful in the determination of proper treatment.