Hamartoma of the Spleen

Splenic hamartomas are rare benign tumors, which are usually small in size and asymptomatic and which are discovered incidentally at surgery or autopsy. The authors report on a case of splenic hamar toma in a 35-year-old man with intermittent left upper quardrant pain, who underwent an elective splenc tomy. Final pathology confirmed diagnosis of a hamartoma of the red pulp in the spleen. The patient's symptoms were resolved after the splenectomy. A splenic hamartoma should be kept in mind in the differential diagnosis of splenic tumors. The authors suggest that a splenectomy is indicated in cases where malignancy cannot be excluded and in cases of associated clinical symptoms or hematologic disorders.

Primary Neoplasms of the Small Bowel

BACKGROUND: Primary tumor of the small bowel is uncommon less than 6% of all gastrointestinal tumors. Its symptoms and signs are nonspecific and its diagnosis is difficult. METHODS: We analyzed 43 patients with primary small bowel tumor who had undergone operations at the Chungnam National University Hospital from January 1990 to December 1997. RESULTS: 1) In total 43 cases, 19 cases (44.2%) were male and 24 cases (55.8%) were female, benign tumors were 13 cases (30.2%) and malignant tumors were 30 cases (69.8%). The mean age was 51 year. 2) The primary sites of benign tumors were the duodenum in 5, jejunum in 3, ileum in 5 cases. The primary sites of malignant tumors were the duodenum in 13, jejunum in 9, ileum in 8 cases. 3) Polyp was most common benign tumor (30.7%), and leiomyosarcoma was most common malignant tumor (43.3%). 4) The most common symptom was abdominal pain (65.1%), followed by melena (34.9%) and weight loss (20.9%). The most common sign was palpable mass (39.5%) and anemia (39.5%). 5) In the duodenal tumors, the detectabilities of endoscopy and upper gastrointestinal series were 68.8% and 71.4%, respectively. In the jejunal and the ileal tumors, the detectabilities of small bowel series were 62.5% and 71.4%, respectively and those of abdominal computed tomogram were 50.0% and 42.9%, respectively. The accuracy of preoperative diagnosis was 7 cases (53.8%) in benign and 20 cases (66.7%) in malignant tumor. 6) In cases of malignant tumor, curative resection was performed in 18 cases (60.0%), palliative resection was performed in 10 cases (33.3%), and bypass procedure was performed in 2 cases (6.7%). In cases of benign tumor, small bowel resection was performed in 9 cases and excision of duodenal polyp was performed in 2 cases. 7) The mean follow-up period of malignant tumor of 27 cases except 3 hospital mortality cases was 35 months. During this time, 7 cases were dead due to recurrence. The mean survival time of 7 mortality cases was 20.4 months, of them 4 cases were leiomyosarcoma, 2 cases were adenocarcinoma, and 1 case was lymphoma. CONCLUSIONS: Because diagnosis of small bowel tumor is difficult and confirmed in late stage, high degree of suspicion and endeaver to discover it is important.

Cystosarcoma Phyllodes of the Breast

BACKGROUND: Cystosarcoma phyllodes are relativly rare neoplasms of the breast and have an unpredictable clinical behavior. This study is to determine whether histological features correlate with clinical behavior, and which operation method affect recurrence. METHODS: This study reviewed the histological features and clinical outcomes in 12 patients with phyllode tumors of the breast diagnosed at Chungnam University Hospital from 1989 to 1998. RESULTS: The pathological results revealed benign forms were in 8 cases and malignant forms in 4 casese. As to the nature of the growth, the tumors in 10 cases grew rapidly 10 cases were rapid in nature, but two malignant tumors not. One of the 4 malignant tumors was high grade, the others were borderline. Eight (8) patients were had been treated conservatively (7 cases, wide tumor excision; 1 case, excisional biopsy), and 4 cases patients underwent radical operation (2 cases, modified radical mastectomy; other 2 cases, simple mastectomy). Only one patient with borderline malignancy, who underwent modified radical mastectomy, experienced recurrence. CONCLUSIONS: Tumor growth & histological features do not correlate with recurrence, and wide resection should to be primary treatement and axillary dissection is not worthwhile.