Two cases of unusual giant carcinoma of the pancreas are presented. Each presented with a large tumor mass with or without cystic change, either in the head or tail portion of the pancreas. A pleomorphic gaint cell carcinoma variant (case 1) differed from an epulis type (case 2) with nuclear atypism of giant cells, but widespread metastasis in both cases reflected the accountability of spindle cell element as an important parameter for the determination of their biological behavior.
Neoplasm Metastasis

Retrospective clinicopathologic analysis of 15 patients with the phyllodes tumors(PT) of the breast, diagnosed at SNUH over 6 years period, was done. By light microscopy, 8 cases were diagnosed as benign, and 7 cases were diagnosed as malignant. Mean ages o the patients were 37 and 34 years in malignant and benign, respectively. Most of those cases were presented with a palpable mass of the breast. None of the patients with malignant PT had distant metastasis, Local recurrences were experienced in 3 patients among the malignant PT, and one patient among the benign PT. One of 7 malignant PT was coexisted with simultaneous ipsilateral infiltrating duct carcinoma. The clinical course was not well correlated with pathologic features. The prognostic significances of several histopathologic parameters were assessed for possible correlation with local recurrence, metastasis and death; stromal cellularity, stromal cellular atypism, mitotic activity, tumor contour, necrosis, tumor size and heterologous stromal elements. Immunohistochemistry using antibody to vimentin, proliferating cell nuclear antigen(PCNA) and epidermal growth factor receptor(EGF-R) were analysed. In the 5 cases of benign PT, the stromal cells stained diffusely positive for vimentin and 3 cases of malignant tumors show similar staining for vimentin. The percentage of PCNA-positive cells were higher in the malignant PT than in the benign ones; they were 3.5% to 60% in malignancy, while they were less than 60% in all benign PT. The results of EGF-R staining were correlated with the histologic classification; only 2 cases out of 8 benign PT show diffusely positive staining of EGF-R in the cytoplasm, but 6 cases out of 7 malignant PT show positive findings.
Neoplasm Metastasis

The determination of proliferative activity in the colorectal mucosa has been used for different purposes as the estimation of cancer risk and the assessment of disease activity in ulcerative colitis. But the prognostic significance of proliferative activity in colorectal carcinomas remains controversial. To investigate the prognostic significance of proliferative activity in colorectal carcinomas, the author estimated the proliferative activity immunohisto chemically using the monoclonal antibody PCNA and compared with clinicopathological data in 62 colorectal carcinomas. The results were as follows: 1) The reactivity of PCNA was more pronounced at the infiltrative margins of the tumors and tumor cells within the vascular or lymphatic channels. 2) The mean PCNA index of colorectal carcinomas was 40.5?0.4%. PCNA indices had positive correlations with lymph node invasion(p<0.05), liver, metastasis(p<0.05), Dukes' stage(p<0.01) and TNM classification(p<0.01), and didn't correlated with location of tumor, size of tumor, histological type and lymphtic or vascular invasion. 3) The patients with high PCNA index(more than 45%) represented higher recurrence or metastasis rate(37.5%) than those with low PCNA index (less than 45%)(19.3%) in Dukes B or C colorectal carcinomas during the follow-up periods, but not significant statistically. These results suggested that the reactivity of PCNA may be a useful prognostic factors in colorectal carcinomas.
Neoplasm Metastasis

Bizarre parosteal osteochondromatous proliferation was first described in 1983, when Nora and his collegues reported 35 examples of a proliferative lesion involving bones of the hands and the feet. In 1993, Meneses reported 65 cases of this condition. A fourth of all the reported cases involved the long bones. It is important to identify the clinical, roentgenographic, and histologic characteristic to seperate it from other entities because it is a benign lesion with atypical microscopic features with a tendency to recur. Roentgenograms show a calcific mass attached to the underlying cortex having a broad base. Histologically, the lesion exhibites proliferative activity, irregular bony cartilaginous interfaces, and enlarged, bizarre, and binucleated chondrocytes. We reviewed the bone tumors, diagnosed in the KyungHee University Hospital, dated from 1984 to 1994. Five cases were revised to Nora's lesion, all of which were previously diagnosed as osteochondroma. The ages of the patients ranged from 12 to 57 years (median, 19 years), and all of them were males. Two cases involved the bones of hands and feet (metacarpal and talus), and 3 cases involved the long bones (humerus, fibula, and ulna). One lesion involving the humerus has a recurrence. No metastasis had been reported.
Neoplasm Metastasis

Primary meningeal melanocytoma of the central nervous system is extremely rare. We report a case of meningeal melanocytoma associated with Ota's nevus as a recurrent form in a 53-year old male. The meningeal melanocytoma was removed from right parietooccipital lobe 4 years ago and recurred in right parietal, occipital and left frontal lobes. Ultrastructurally, the tumor cells were characterized by the presence of numerous melanosomes and premelanosomes in their cytoplasm. Moreover, the tumor was lacking in histologic and ultrastructural features of pigmented meningioma, melanotic schwannoma and prolonged clinical course was different from primary meningeal melanoma or metastatic malignant melanoma.
Neoplasm Metastasis

Purpose: The aim of this study was to review our experience with laparoscopic-assisted colectomy (LACs), and to evaluate its feasibility and safety for surgical treatment of colorectal diseases, including cancer. Methods: Between September 2002 and September 2005, a LAC was performed in 58 patients. Of these, 6 cases of conversion to open colectomy were excluded from the analysis. Fifty conventional open colectomy (OCs) with clinicopathologic characteristics comparable to those of the LACs were selected and matched as a control group for comparative analysis regarding short-term oncologic and perioperative outcomes. The mean follow-up period was 13.8 (2~37) months. Results: Thirteen complications, involving 11 patients, occurred. The mean operative time of the LAC was longer than that of the OC (215 min vs. 179 min; P<0.0001). However, earlier restoration of bowel function was achieved in the LAC as measured by postoperative first flatus (2.8 days vs. 3.8 days) and intake of a clear liquid diet (4.7 days vs. 5.8 days). There was no significant difference in hospital stay (LAC vs. OC, 10.2 days vs. 11.8 days). In patients with malignancy, the proximal resection margin in the LAC was significantly shorter than that in the OC (9.2 cm vs. 13.3 cm; P<0.0001). However, there were no significant differences in the mean numbers of harvested lymph nodes (LAC vs. OC, 16.6 vs. 19.3; P=0.4330) and the mean distal resection margins (LAC vs. OC, 6.9 cm vs. 6.0 cm; P=0.1359). There were 3 distant metastases and one local recurrence during follow-up in the LAC group, but no port-site recurrence. Conclusions: In this study, we could not receive an advantage of shorter hospital stay due to the relatively high complication rate for a LAC, which may reflect a learning curve. Earlier postoperative recovery of bowel function and equal pathologic extent of resection in the LAC suggest that the LAC is an acceptable alternative procedure in the treatment of colorectal diseases, including malignancy. More experience with the LAC is necessary to overcome the learning curve. Affirmative long-term oncologic outcomes of are expected for the LAC.
Neoplasm Metastasis

Gastrointestinal stromal tumors are notorious for their unpredictable clinical behavior. To assess the cellular proliferating activities, four different methods were used: mitotic count, nucleolar organizer region(AgNOR) staining, immunostaining of proliferating cell nuclear antigen (PCNA) and DNA ploidy were used on 39 cases of gastrointestinal stromal tumors. Additionally, we analysed cellularity, cellular atypism and necrosis. Among 39 cases of gastrointestinal stromal tumors, 11 cases were diagnosed as benign lesions according to clinicopathologic findings. Malignant lesions were arbitrarily classified into low grade(n=ll) and high grade(n=17) on the basis of absence or presence of recurrence, metastasis or tumor-related death during the follow-up period. Numbers of mitosis, AgNORs, PCNA index and DNA ploidy were correlated with grades of tumor and prognosis. Among them, AgNORs counting appeared to be the most useful in predicting prognosis. Numbers of mitosis, PCNA index and DNA ploidy showed varying degrees of overlap among the 3 groups. Among the histological parameters, cellular atypia showed some relationship with the prognosis that others did not reveal.
Neoplasm Metastasis

To evaluate correlation between the amount of oncogene products in tumor cell extracts and malignant potentiality in breast tumor, immunohistochemical staining for the ras Oncogene products was performed in the sections of benign and malignant lesions of the breast. The results obtained were as follows: 1) The positive reaction to ras Oncogene products was usually observed in the cytoplasm and cell membrane. 2) The ratio of positive reaction was 30.4% in epithelial hyperplasia of fibrocystic disease, 26.5% in fibroadenoma. 49.5% in intraductal carcinoma 71.6% in infiltrating ductal carcinoma, 85.2% in metastatic infiltrating ductal carcinoma, and 89.7% in relatively preserved neighboring lobules of infiltrating ductal carcinoma. In conclusion, the ras oncogene products are found by a significantly higher ratio in the more aggressive lesions, and the infiltrating ductal carcinoma might represent its potential of malignant transformation. 3) The expression of ras oncogene was heterogeneous in primary as well as metastatic mammary carcinomas.
Neoplasm Metastasis

Synovial sarcoma is one of the most common malignant soft tissue tumors in paraarticular regions. However, it is very rare to occur without any apparent relationship to synovial or articular structures. We report a case of synovial sarcoma manifested as a subcutaneous nodule in the upper lip. A 12-year-old boy complained of a palpable tender mass in the upper lip for several months. Under the impression of a benign soft tissue neoplasm, surgical excision was done. The mass, 1.5 cm in maximum diameter, was easily separated from surrounding tissues. Microscopically, this tumor showed a characteristic biphasic pattern of synovial sarcoma. On immunohistochemical and ultrastructural studies, the tumor cells showed evidence of epithelial differentiation. There was no evidence of joint-related, primary lesions or metastatic foci. This report describes a case of synovial sarcoma arising in very unusual location and size for histologically typical synovial sarcoma.
Neoplasm Metastasis

No abstract available.
Neoplasm Metastasis*