A Clinical Study on Small Hepatocellular Carcinoma / 대한간학회지

BACKGROUND/AIMS: Cases of small hepatocellular carcinoma (HCC) have been increasing with the progress of diagnostic methods . In this study the screening methods for early diagnosis of HCC were re-evaluated, and comparative therapeutic analyses were perfomed. METHODS: A total of 110 patients with small HCC (< 5 cm and < 4 nodules ) were retrospectively analyzed. The patients were divided into four treatment groups ; unt reated group (No T x, n=12), transarterial-oily-chemoembolization group (TOCE, n=43), combined treatment group of percutaneous ethanol injection and TOCE (CEI, n=22), OP group ( OP, n=33). RESULTS: Small HCC occupied 22.6% of total HCC cases. Only one third of small HCC cases were detected during the regular screening. In this group, Alpha-fet oprotein as say provided a diagnostic clue in 50% of cases, ultras onography in 71%, and the combination of both in 88%. Five year survival rate and 5-year non-recurrence rate in small HCC was 29% and 37% respectively. Comparative therapeutic analys es showed t hat CEI and OP gave a better survival than TOCE in Child grade A. CEI prolonged survival in Child grade B wher eas TOCE did not. Only TOCE was tried and did not improve the survival in Child grade C. CONCLUSION: 1) A more strict screening is needed in high risk group of HCC. 2) As a first line of treatment in small HCC, OP or CEI can be selected in Child grade A, and CEI in Child grade B. In Child grade C, a less invasive treatment (PEIT , microwave coagulat ion therapy) should be investigated.

A Case of Insulinoma which was treated by Laparoscopic Enucleation / 대한내분비학회지

Insulinoma is a functional endocrine tumor arising from the beta cells of islets of Langerhans of pancreas. The only effective treatment of insulinoma was surgical removal of the tumor. Recently, laparoscopic surgery for islet cell tumors of the pancreas is introduced. Laparoscopic enucleation or resection of benign islet tumors results in a shorter hospital recovery and is a good alternative to open surgery We report a case of insulinoma that was treated sucessfully by laparoscopic enucleation.