An adrenal carcinosarcoma is extremely rare with reported three cases. This neoplasm is extremely aggressive with distant metastasis arising from the sarcomatous component. A 48-year-old female was present with abdominal distention for 1 month. All laboratory studies were within normal reference range including urinary and serum corticosteroids. The tumor consist typical areas of adrenal carcinoma and sarcoma. Sarcomatous elements were identified and confirmed both immunohistochemically and ultrastructurally. After radical resection, the patient developed rapid local and distant metastatic recurrence and died three months after surgery. This is the first reported case of adrenal carcinosarcoma in korea.
Adrenal Cortex Hormones ; Carcinosarcoma* ; Female ; Humans ; Immunohistochemistry ; Korea ; Middle Aged ; Neoplasm Metastasis ; Recurrence ; Reference Values ; Sarcoma

In Korea chronic lymphocytic leukemia(CLL) is a rare diesase with evidence immunologic incompetence. The immunodeficiency of patients with CLL could place them at increased risk of new cancers. The incidence of secondary malignancy, including lung cancer has increased in patients with CLL and this should be also considered in the differential diagnosis of a new pulmonary infiltrate appearing in patients with known CLL. A-73-year old male patient with CLL was admitted to our hospital because of dyspnea. Chest X-ray showed multiple scattered small nodules in both lung fields and alveolar consolidation mass at right lower lung. Histopathological examination of the bronchoscopic biopsy specimen demonstrated that he had a moderatly differentiated adenacarcinoma of lung. Since we experienced a case of metachronous adenocarcinoma of lung in patient with known CLL, we report this with a review of literatures.
Adenocarcinoma* ; Biopsy ; Diagnosis, Differential ; Dyspnea ; Humans ; Incidence ; Korea ; Leukemia* ; Lung Neoplasms ; Lung* ; Male ; Thorax

Placental and fetal involvement by matenal malignancy is rare. We report a case of placental metastasis from advanced gastric carcinoma in a 27 year-old woman. The patient also had disseminated bone metastasis, bone marrow involvement, malignant ascites, multiple lymphadenopathy, and disseminated intravascular coagulopathy. Cut surface of the placental body showed many, variable-sized, grayish white nodules and plaques. Light microscopic finding showed sheets of poorly differentiated adenocarcinoma in intervillous spaces. Villi were not invaded. Despite palliative chemotherapy the patient died of massive gastric cancer bleeding. But the patients child is alive and doing well with age of 11 months. We suggest that the presence of malignancy in pregnancy demands complete evaluation of the placenta and adequate follow-up of the infant for the sign of involvement.
Adenocarcinoma ; Adult ; Ascites ; Bone Marrow ; Child ; Drug Therapy ; Female ; Follow-Up Studies ; Hemorrhage ; Humans ; Infant ; Lymphatic Diseases ; Neoplasm Metastasis* ; Placenta ; Pregnancy ; Stomach Neoplasms

PURPOSE: In order to avoid functional disability that may be caused by radical excision or amputation in extremity soft tissue sarcomas, authors employed limb-conserving surgery together with extemal radiation therapy plus interstitial brachytherapy. MATERIALS AND METHODS: From June 1995 to Febrary 1997, 10 extremity soft tissue sarcoma patients were treated with limb-conserving surgery and external radiation therapy plus interstitial brachytherapy. In six patients, whose histologic diagnoses were made at the time of surgery, wide or marginal excision and interstitial brachytherapy was done 4 weeks before postoperative external radiation therapy. In four patients whose histologic confinnations were done before definitive treatment, preoperative external radiation therapy was given 4 weeks before surgery and interstitial brachytherapy. The types of surgery were wide excision in five patients, and marginal excision in five patients. Gross or microscopic residual was left at the surgical resection margins in four patients. The brachytherapy dose ranged from 17.5 Gy to 24 Gy and external beam radiation did from 40 Gy to 45 Gy. RESULTS: With the median follow-up duration of 21.5 months(range: 13 to 29 months); one local recurrence, and three new distant metastases were observed. There were three patients with wound complications attributable to the current treatment regimen. CONCLUSION: Satisfactory local tumor control may be achievable with limb-conserving surgery and external radiation therapy plus brachytherapy in patients with extremity soft tissue sarcomas, while more caution should be used to avoid wound problems.
Amputation ; Brachytherapy* ; Diagnosis ; Extremities* ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Recurrence ; Sarcoma* ; Wounds and Injuries

PURPOSE: The survival rate according to the methods of treatment was significantly higher in the osteosarcoma patients in which limb salvage operation with neoadjuvant chemotheraphy. The purpose of this study is to analyze the results of treatment in the Stage IIB osteosarcoma patients who treated with modified T10 protocol. MATERIALS AND METHODS: From Jun. 1990 to Oct. 1997, thirty eight cases of Enneking's stage IIB osteosarcoma in extremities, were treated with neoadjuvant chemotherapy by modified T10 protocol of Rosen. Their mean age was 22 years old (8 months to 55 years). And average duration of follow up is 29 months(10 manths to 88 months). The preoperative chemotherapy consisted of high dose methotrexate(HDMTX)(above 12 years old: 8 g/m2, below 12 years old: 12 g/m2), adriamycin(ADR)(30 mg/m2/day x 2), intraarterial cisplatin(CDDP)(100 mg/m2) or ifosfamide (IFO)(1.8 g/m2/day x5). The preoperative tailoring was performed according to the radiologic response after chemotherapy. If the patient revealed good response, we continued the chemotherapy next one more cycle and if not, stoped the chemotherapy or changed the cisplatin to ifosfamide. The postoperative chemotherapy consisted of HDMTX, adriamycin, ifosfamide or cisplatin with 4 cycles. According to the pathologic response to the pre-operative chemotherapy, we use HDMTX, ADR, CDDP in good response group and HDMTX, ADR, IFO in poor response group respectively. RESULTS: On the latest follow up, 27 patients were continuous disease free(CDF 27/38), 4 patients were alive with disease(AWD) and 6 patients were died of disease(DOD) and I case was died of bone marrow and hepatic failure due to complication of chemotherapy. According to Kaplan-Meier's plot, the overall 5 years survival rate was 73.6%, and continuous disease free 5 years survival rate being 64%. The comparison of continuous disease free survival rates between good radiologic response group and poor response group showed 73% and 55%. The continuous disease free survival rates according to the pathologic response in good response group and poor were 90 % and 55%. During the chemotherapy, the most serious complications were leukocytopenia and bone marrow failure. These were controled by granulocyte colony stimulating factor(G-CSF) and leukotrophic agent. Other minor complications were nausea, vomiting, headache and extrapyramidal symptom, which were easily managed by simple conservative measure. CONCLUSION: It was obtained that the overall 5 years survival rate was 73.6%, and continuous disease free 5years survival rate being 64% with modified T10 protocol.
Bone Marrow ; Child ; Cisplatin ; Disease-Free Survival ; Doxorubicin ; Drug Therapy* ; Extremities ; Follow-Up Studies ; Granulocytes ; Headache ; Humans ; Ifosfamide ; Leukopenia ; Limb Salvage ; Liver Failure ; Nausea ; Osteosarcoma ; Survival Rate* ; Vomiting ; Young Adult

PURPOSE: Fractionated stereotactic radiation therapy(FSRT) is a new modality that combines the accurate focal dose delivery of stereotactic radiosurgery with the biological advantages of conventional radiotherapy. We report our early experience using FSRT for intracranial malignant tumor. MATERIALS AND METHODS: Between October 1995 and December 1996, 16 patients(9 males and 7 females aged between 10~64 years) with central nerve system malignancy were treated using FSRT. Sixteen patients had the following diagnosis: 6 high-grade gliomas, 1 pineoblastoma, 4 germinomas, 2 medulloblastomas, and 3 solitary brain metastases. Using the Gill-Thomas-Cosman relocatable head frame and multiple non-coplanar therapy, the daily dose of 2 Gy(3 Gy in metastasis) was irradiated at 85~100% isodose surface. RESULTS: Although the follow-up period is relatively short(range; 2~18 months), post- treatment clinical courses in 16 patients have been consistent with changes similar to those found after conventional radiation therapy. No significant adverse effects were observed in our neurological and radiological studies. Four out of 5 patients with high grade glioma died from progressive disease, surviving from 7 to 17 months(median 14 months), but patients with pineoblastoma, germinoma and medulloblastoma showed no evidence of recurrence. All patients with metastasis obtained a neurologic response, but two among them died with extracranial progression and one die from multiple intracranial metastasis.In overall patient setup with scalp measurements, reproducibility was found to have mean of 1.1+/-0.6 mm from the baseline reading. CONCLUSION: FSRT and relocatable stereotactic head frames were well tolerated with minimal transient acute side effects. Subacute or late complications were not observed, because the follow-up period was short. We expect that FSRT might be a good indication for; recurrent disease with previous radiation therapy history, tumors of relatively large volume, lesions adjacent to radiosensitive organs, and as a boost, following conventional radiation therapy.
Brain ; Diagnosis ; Female ; Follow-Up Studies ; Germinoma ; Glioma ; Head ; Humans ; Male ; Medulloblastoma ; Neoplasm Metastasis ; Pinealoma ; Radiosurgery ; Radiotherapy ; Recurrence ; Scalp

PURPOSE: To establish new in vitro model systems that better reflect in vivo condition, multicellular tumor spheroids(MTS) and raft culture were developed using cell lines of squamous cell carcinoma(SCCHN) of the head and neck. In these 3-dimensional systems, the expression of cell surface molecules which are important for modulation of physiology of tumor cells were studied with or without the treatment of interferon(IFN)-gamma. MATERIALS AND METHODS: Four SCCHN cell lines were used for MTS and raft culture. The effects of interferon-gamma on SCCHN cells were examined by immunohistochemistry. RESULTS: All cell lines formed MTS, but only Tu-138 showed a good stratification at the air-liquid interface in the raft culture system. Immunohistochemical studies of MTS using monoclonal antibodies revealed a strong staining for MHC class I, no staining for MHC-DR, a weak patch expression of ICAM-1 and a central strong staining for integrin a 6. Staining patterns were similar for the raft cultures except integrin a 6(intense full-thickness positivity). In both systems, IFN-gamma enhanced the expression of MHC-DR and ICAM-1. No significant change was found in the expression of MHC class I and integrin a 6. CONCLUSIONS: MTS and raft culture system were established successfully from the SCCHN cell lines. IFN-gamma can modulate the surface molecules of tumor cells in the 3-dimensional culture systems.
Antibodies, Monoclonal ; Carcinoma, Squamous Cell* ; Cell Line ; Head* ; Immunohistochemistry ; Intercellular Adhesion Molecule-1 ; Interferon-gamma ; Neck* ; Physiology

No abstract available.
Gonadotropins* ; Humans

No abstract available.
Bystander Effect* ; Carcinoma, Hepatocellular* ; Cell Line* ; Ganciclovir* ; Herpes Simplex* ; Phosphotransferases* ; Simplexvirus*

PURPOSE: Hepatocellular carcinoma (HCC) is one of the most common cancers in many parts of the world, however the molecular mechanisms underlying liver cell transformation remain obscure. The instability of microsatellite sequences dispersed in the genome has been linked to a deficiency in cellular mismatch repair. This phenotype has been frequently observed in various human neoplasms and is regarded as a major factor in tumorigenesis. To investigate cumulative genetic changes related with apoptosis during development and progression of HCC, we examined DNAs isolated from 12 Korean HCCs and their adjacent non-tumorous parts to look for evidence of microsatellite instability (MSI). MATERIALS AND METHODS: Twelve microsatellite loci (D6S271, D6S426, D13S153, D13S263, D17S849, D17S938, D17S945, D18S474, D18S64, D19S420, D.19S418 and D19S210) were amplified by PCR from 12 Korean HCCs, and analyzed using an automated DNA analyzer. RESULTS: The high percentages of the MSI were found for the loci of D6S426 (33.3%) and D17S945 (25.0%). The related genes with high frequency of MSI were noted in the wafl (41.7%) and p53 (25.0%). From this study, fifty eight percent of HCCs (7/12) showed MSI with at least one marker. CONCLUSION: This results suggest that the analysis of MSI in HCC might be useful for identifying genes whose loss of function contributes to the development of liver cancer. Furthennore, this method may give a more rapid and accurate sizing of the PCR products of microsatellite; making the routine assessment of MSI possible in many clinical fields.
Apoptosis ; Carcinogenesis ; Carcinoma, Hepatocellular* ; DNA ; DNA Mismatch Repair ; Genome ; Humans ; Liver ; Liver Neoplasms ; Microsatellite Instability* ; Microsatellite Repeats* ; Phenotype ; Polymerase Chain Reaction*