Photodynamic Therapy Followed by Left Hepatectomy Used to Treat an Intraductal Papillary Mucinous Neoplasm of the Bile Duct / 대한내과학회지

Mucin-hypersecreting bile duct tumors, which closely resemble intraductal papillary mucinous neoplasms of the pancreas, are rare, and both the clinical features and management thereof are poorly understood. As the biliary tract and the pancreas share a common origin, the two diseases may exhibit homologous histopathological features. Certain intraductal papillary tumors of the bile duct are associated with production of large amounts of mucin that disturb bile flow and cause severe biliary dilatation, obstructive jaundice, and cholangitis. Herein, we report on a patient with an extensive intraductal papillary mucinous neoplasm of the bile duct, involving both the right and left intrahepatic ducts. The ducts were subjected to photodynamic therapy, followed by left hepatectomy. The surgical specimen revealed an adenocarcinoma with a negative resection margin. Photodynamic therapy of the intrahepatic ducts was well-tolerated in the present case, and may serve as a useful therapeutic option for selected patients with intraductal papillary mucinous neoplasms of the bile duct.

Prognostic Factors and Characteristics of Pancreatic Neuroendocrine Tumors: Single Center Experience

PURPOSE: Pancreatic neuroendocrine tumors (PNET) are a rare subgroup of tumors. For PNETs, the predictive factors for survival and prognosis are not well known. The purpose of our study was to evaluate the predictive factors for survival and disease progression in PNETs. MATERIALS AND METHODS: We retrospectively analyzed 37 patients who were diagnosed with PNET at Severance Hospital between November 2005 and March 2010. Prognostic factors for survival and disease progression were evaluated using the Kaplan-Meier method. RESULTS: The mean age of the patients was 50.0+/-15.0 years. Eight cases (21.6%) were described as functioning tumors and 29 cases (78.4%) as non-functioning tumors. In univariate analysis of clinical factors, patients with liver metastasis (p=0.002), without resection of primary tumors (p=0.002), or American Joint Committee on Cancer/Union for International Cancer Control (AJCC/UICC) stage III/IV (p=0.002) were more likely to demonstrate shorter overall survival (OS). Patients with bile duct or pancreatic duct invasion (p=0.031), sized-lesions larger than 20 mm (p=0.036), liver metastasis (p=0.020), distant metastasis (p=0.005), lymph node metastasis (p=0.009) or without resection of primary tumors (p=0.020) were more likely to demonstrate shorter progression-free survival (PFS). In multivariate analysis of clinical factors, bile duct or pancreatic duct invasion [p=0.010, hazard ratio (HR)=95.046] and tumor location (non-head of pancreas) (p=0.036, HR=7.381) were confirmed as independent factors for predicting shorter PFS. CONCLUSION: Patients with liver metastasis or without resection of primary tumors were more likely to demonstrate shorter OS. Patients with bile duct or pancreatic duct invasion or tumors located at body or tail of pancreas were more likely to demonstrate shorter PFS.

Two Cases of Pancreatic Ductal Adenocarcinoma, Manifested as Solid Pseudopapillary Tumor and Intraductal Papillary Mucinous Neoplasm / 대한소화기학회지

Compared with other types of cancers, pancreatic cancer is one of the most dreadful malignancies and is fifth leading cause of cancer-related death in Korea. It is difficult to expect early diagnosis or improvement in prognosis due to lack of specific early symptoms and effective diagnostic methods. Whereas cystic neoplasm of the pancreas is a rare type of pancreatic tumor, surgical resection provides good prognosis because of its low possibility of local invasion or distant metastasis. In case of pancreatic cystic tumor, radiologic differentiation between benign and malignant lesions is crucial for the selection of appropriate treatment and the prediction of prognosis. And ductal adenocarcinoma of pancreas presenting in cystic form is an uncommon type of cystic tumor, making it extremely rare among all pancreatic malignancies. We report two cases of atypical pancreatic ductal adenocarcinoma presenting as solid pseudopapillary tumor and intraductal papillary mucinous neoplasm, respectively.

Primary lymphoma of genitourinary tract / 대한내과학회지

BACKGROUND: The primary lymphoma of genitourinary tract is very rare and reported sporadically in Korea. Therefore the aim of this study is to evaluate the clinical characteristics with therapeutic outcome in 15 cases of primary lymphoma of genitourinary tract. METHODS: Reviewed retrospectively medical records of 15 cases with primary lymphoma of genitourinary tract who had been diagnosed from January, 1990 to May, 2002, we analysed the clinical characteristics, stage, disease free survival and overall survival. RESULTS: There were 8 cases of lymphoma of testis, 3 cases of uterine cervix and body, 1 case of ovary, 1 case of vagina, and 2 cases of kidney. The histologic types were all diffuse large B cell, except 5 cases (3 cases T/NK cell, 1 case low grade MALT lymphoma, and 1 case precursor B cell lymphoblastic lymphoma). The median survival duration of all cases is 8.0 months, showing the similarity to that of testis lymphoma (7.0 months). CONCLUSION: In comparison with the prognosis of the lymphomas in uterine body and cervix, it was worse for the testicular and renal lymphoma, even though 3 cases of T/NK cell lymphoma impacted on the prognosis of testicular lymphoma. Therefore, with simultaneous elucidation of the prognostic factors systemically, therapeutic strategy must be continuously sought.