1.A Case of Primary Adenosquamous Carcinoma of the Liver with Formation of Colonic Fistula.
Jae Uk SHIN ; Jin Tae JUNG ; Sung Soo YOU ; Joong Goo KWON ; Eun Young KIM ; Chang Hyeong LEE ; Ho Gak KIM ; Jae Bok PARK
The Korean Journal of Gastroenterology 2006;48(5):360-364
Primary adenosquamous carcinoma of the liver is generally considered as an extremely rare subtype of cholangiocarcinoma. It has been reported mostly in a form of case studies. As far as we know, there was only one case report on tumor related with biliary fistula. Recently, we experienced a case of primary adenosquamous carcinoma of liver with a formation of tumor-colonic fistula. A 54-year-old man was transferred to our hospital due to liver mass detected by abdominal ultrasonogram. Dynamic computed tomogram of liver showed a large irregular hypodense mass without rim enhancement in right lobe of liver and also suggested a fistula formation between the tumor and hepatic flexure of right colon. Colonoscopic examination showed a large colonic wall defect in hepatic flexure and a friable, nodular mucosa around the defected colonic wall. Extended right lobectomy and right hemicolectomy were done. Microscopically, the tumor was composed of squamous cell carcinoma mainly with foci of the adenocarcinoma component.
Carcinoma, Adenosquamous/*pathology/radiography/surgery
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Colonic Diseases/*pathology
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Colonoscopy
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Humans
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Intestinal Fistula/*pathology
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Liver Neoplasms/*pathology/radiography/surgery
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Male
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Middle Aged
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Tomography, X-Ray Computed
2.Undiffentiated Carcinoma with Osteoclast-like Giant Cells of the Pancreas.
Han Won JANG ; Won Kyu PARK ; Jay Chun CHANG ; Jae Woon KIM ; Young Kyung BAE ; Jun Hyuk CHOI ; Sung Su YUN ; Dong Dong LEE
The Korean Journal of Gastroenterology 2006;48(5):355-359
Undifferentiated carcinoma with osteoclast-like giant cells is a rare neoplasm of exocrine pancreas. Till recently, some cases have been reported, however histogenesis of the tumors are controversial and their characteristic findings have not been described yet. Thirty five-year-old men and 75-year-old men were presented with upper abdominal pain and a palpable mass. On computed tomography, one case showed a well enhancing solid tumor with low density and the other was showed a mainly cystic tumor with peripheral enhancement in the body and tail of the pancreas. One case accompanied multiple metastatic liver masses with subhepatic lymph node enlargement. Tumor staining was seen on angiography. Biopsy and pancreatectomy were performed. Pathological findings revealed tumors composed of neoplastic spindle shaped or pleomorphic large cells with scattered non-neoplastic osteoclast-like giant cells. In one case, there were small foci of adenocarcinoma components in the periphery of the tumor. On immunohistochemical stain, neoplastic cells showed focal positivity for epithelial membrane antigen and vimentin. Tumors were diagnosed as undifferented carcinoma with osteoclast-like giant cells. We report these rare cases with a review of literature.
Adult
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Aged
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Carcinoma/*pathology/radiography/surgery
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Giant Cells/*pathology
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Humans
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Male
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Osteoclasts/*pathology
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Pancreatic Neoplasms/*pathology/radiography/surgery
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Tomography, X-Ray Computed
3.Unclassified Mucinous Renal Cell Carcinoma: A Rare Histopathological Entity.
Omer A RAHEEM ; Elana GODEBU ; Seth A COHEN ; Ahmed SHABAIK ; J Kellogg PARSONS
Korean Journal of Urology 2014;55(10):690-692
Renal cell carcinoma (RCC) with mucin production is extremely rare. We present the case of a previously healthy 76-year-old woman who underwent a robotic-assisted laparoscopic right nephrectomy for a 5-cm heterogeneously enhancing right renal mass. Pathology revealed mucin-producing epithelial RCC. We discuss the presentation and pathological features of this case and comment on its definitive treatment.
Adenocarcinoma, Mucinous/*pathology/radiography/surgery
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Aged
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Carcinoma, Renal Cell/*pathology/radiography/surgery
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Female
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Humans
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Kidney Neoplasms/*pathology/radiography/surgery
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Nephrectomy/methods
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Robotic Surgical Procedures/methods
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Tomography, X-Ray Computed
4.A Case of Gastric Lymphoepithelioma-like Carcinoma Presenting as Panperitonitis by Perforation of Stomach.
Pyung Gohn GOH ; Eui Sik KIM ; Yun Jeung KIM ; Soo Youn LEE ; Hee Seok MOON ; Seok Hyun KIM ; Byung Seok LEE ; Hyun Yong JEONG
The Korean Journal of Gastroenterology 2011;58(4):208-211
Gastric lymphoepithelioma-like carcinoma is a rare carcinoma among gastric malignant tumor but has a good prognosis. The carcinoma has histologic feature characterized by small nest of cancer cells mixed with lymphoid stroma. We report a case with lymphoepithelioma-like carcinoma of stomach initially presenting as panperitonitis because of spontaneous tumor perforation. A 56-year-old man visited our emergency room because of epigastric pain. A preoperative abdominal CT scan showed a massive pneumoperitoneum in the upper abdomen, and the presence of gastric cancer in the lesser curvature of the stomach. An emergent laparotomy was performed followed by radical subtotal gastrectomy. Pathologic examination revealed that the tumor was a lymphoepithelioma-like gastric carcinoma.
Carcinoma/*diagnosis/pathology/therapy
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Combined Modality Therapy
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Humans
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Lymphoma/radiography/surgery
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Male
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Middle Aged
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Pneumoperitoneum/etiology/radiography/surgery
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Rupture, Spontaneous
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Stomach Neoplasms/*complications/*diagnosis/pathology/therapy
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Stomach Rupture/*complications/radiography/surgery
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Tomography, X-Ray Computed
5.Preoperative Radiologic and Postoperative Pathologic Risk Factors for Early Intra-Hepatic Recurrence in Hepatocellular Carcinoma Patients Who Underwent Curative Resection.
Honsoul KIM ; Mi Suk PARK ; Young Nyun PARK ; Hyunki KIM ; Kyung Sik KIM ; Jin Sub CHOI ; Sang Hoon AHN ; Kwang Hyub HAN ; Myeong Jin KIM ; Ki Whang KIM
Yonsei Medical Journal 2009;50(6):789-795
PURPOSE: The risk of hepatocellular carcinoma (HCC) recurrence must be considered ahead of surgery. This study was undertaken to identify pre-operative risk factors for early intrahepatic recurrence of HCC after curative resection in a large-scale. MATERIALS AND METHODS: We retrospectively reviewed the preoperative three-phase multi-detector CT (MDCT) and laboratory data for 240 HCC patients who underwent curative resection; tumor size, number, gross shape, capsule integrity, distinctiveness of tumor margin, portal vein thrombosis (PVT), alpha-fetoprotein level (AFP), and protein induced by vitamin K absence-II (PIVKA-II) levels were assessed. Surgical pathology was reviewed; tumor differentiation, capsule, necrosis, and micro-vessel invasion were recorded. RESULTS: HCC recurred in 61 patients within six months (early recurrence group), but not in 179 patients (control group). In univariate analysis, large tumor size (p = 0.018), shape (p = 0.028), poor capsule integrity (p = 0.046), elevated AFP (p = 0.015), and PIVKA-II (p = 0.008) were significant preoperative risk factors. Among the pathologic features, PVT (p = 0.023), Glisson's capsule penetration (p = 0.033), microvascular invasion (p < 0.001), and poor differentiation (p = 0.001) showed statistical significance. In multivariate analysis, only the histopathologic parameters of microvascular invasion and poor differentiation achieved statistical significance. CONCLUSION: Preoperative CT and laboratory parameters showed limited value, while the presence of microscopic vascular tumor invasion and poorly differentiated HCC correlated with higher risk of early recurrence after curative resection.
Adult
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Aged
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Carcinoma, Hepatocellular/metabolism/pathology/*radiography/*surgery
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Female
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Humans
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Liver Neoplasms/metabolism/pathology/*radiography/*surgery
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Male
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Middle Aged
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Neoplasm Recurrence, Local/metabolism/*pathology/*radiography
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Retrospective Studies
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Risk Factors
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Tomography, X-Ray Computed
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alpha-Fetoproteins/metabolism
6.Spontaneous Regression of Pulmonary and Adrenal Metastases Following Percutaneous Radiofrequency Ablation of a Recurrent Renal Cell Carcinoma.
Heejung KIM ; Byung Kwan PARK ; Chan Kyo KIM
Korean Journal of Radiology 2008;9(5):470-472
The spontaneous regression of metastatic lesions from renal cell carcinoma (RCC) is extremely rare, but may be encountered following cytoreductive treatments. We report a case of a recurrent RCC with multiple metastatic lesions which spontaneously regressed after undergoing radiofrequency ablation of the renal tumor.
Adrenal Gland Neoplasms/radiography/*secondary
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Aged, 80 and over
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Carcinoma, Renal Cell/radiography/*secondary/*surgery
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*Catheter Ablation
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Humans
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Kidney Neoplasms/*pathology/radiography/*surgery
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Lung Neoplasms/radiography/*secondary
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Male
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Neoplasm Recurrence, Local
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Remission, Spontaneous
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Tomography, X-Ray Computed
7.Imaging Findings in a Case of Mixed Acinar-Endocrine Carcinoma of the Pancreas.
Won Jung CHUNG ; Jae Ho BYUN ; Seung Soo LEE ; Moon Gyu LEE
Korean Journal of Radiology 2010;11(3):378-381
Mixed acinar-endocrine carcinoma (MAEC) of the pancreas is extremely uncommon. We report here a rare case of MAEC of the pancreas presenting as watery diarrhea. This is the first report in the English-language literature that describes the imaging findings of MAEC of the pancreas, including computed tomography (CT), magnetic resonance (MR) imaging, and MR cholangiopancreatography features.
Carcinoma, Acinar Cell/*pathology/*radiography/surgery
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Cholangiopancreatography, Magnetic Resonance/methods
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Diagnosis, Differential
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Diarrhea
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Endocrine Gland Neoplasms/*pathology/*radiography/surgery
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Female
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Humans
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Magnetic Resonance Imaging/methods
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Middle Aged
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Pancreas/pathology/radiography/surgery
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Pancreatectomy
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Pancreatic Neoplasms/*pathology/*radiography/surgery
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Splenectomy
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Tomography, X-Ray Computed/methods
8.Adenocarcinoma in Horseshoe Kidney.
Rajinder JHOBTA ; Amarpreet Singh BAWA ; Ashok Kumar ATTRI ; Robin KAUSHIK
Yonsei Medical Journal 2003;44(4):744-746
An adenocarcinoma arising in a horseshoe kidney (HK) is rare. The case of a forty five-year-old male patient, presenting with a recurrent, painless hematuria, is reported. On investigation the patient was found to have a horseshoe kidney, with an adenocarcinoma in the left hemi-kidney, which was treated surgically, with a hemi-nephrectomy, of the involved part, being performed to excise the tumor. A brief review of the relevant literature is also presented.
Carcinoma, Renal Cell/*complications/pathology/surgery
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Human
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Kidney/*abnormalities/radiography
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Kidney Neoplasms/*complications/pathology/surgery
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Lymph Node Excision
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Male
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Middle Aged
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Nephrectomy/methods
9.CT Detection of Hepatocellular Carcinoma in Advanced Liver Cirrhosis: Correlation of Helical CT and Explanted Liver.
Jae Hoon LIM ; Min Ju KIM ; Liu Wei CHIANG ; Hyo Keun LIM ; Cheol Keun PARK ; Seung Woon PAIK ; Kwang Cheol KOH ; Jae Won JOH
The Korean Journal of Hepatology 2002;8(2):201-208
OBJECTIVE: The objective of this study was evaluate the diagnostic efficacy of three-phase helical dynamic CT in the detection of hepatocellular carcinomas in patients with advanced liver cirrhosis. MATERIALS AND METFODS: Three-phase helical dynamic CT in 77 patients with advanced liver cirrhosis was evaluated prospectively before orthotopic liver transplantation. The histopathologically confirmed hepatocellular carcinomas in the explanted livers were compared with pretransplantation CT results by one-to-one correlation. RESULTS: Histopathologic examination of the explanted livers revealed 72 hepatocellular carcinomas in 41 patients. The size of the hepatocellular carcinomas was 0.5-14.0 cm (mean, 1.6 cm). The use of helical dynamic CT enabled the detection of 38 of 72 hepatocellular carcinomas (sensitivity, 53%). Fifteen of 35 (43%) hepatocellular carcinomas smaller than 2 cm and 23 of 37 (62%), hepatocellular carcinomas ranging from 2.0 cm to 14.0 cm were detected. Patient sensitivity and specificity in the detection of hepatocellular carcinoma were 81% (33/41) and 94% (34/36), respectively. CONCLUSIONS: Three-phase helical dynamic CT is insensitive for detection of hepatocellular carcinomas in patients with advanced liver cirrhosis, especially for hepatocellular carcinomas smaller than 2 cm.
Adolescent
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Adult
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Biopsy
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Carcinoma, Hepatocellular/complications/pathology/*radiography/surgery
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Female
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Human
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Liver/*pathology
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Liver Cirrhosis/*complications
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Liver Neoplasms/complications/pathology/*radiography/surgery
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Male
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Middle Aged
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Prospective Studies
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Sensitivity and Specificity
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*Tomography, Spiral Computed
10.Metastasis of Colon Cancer to Medullary Thyroid Carcinoma: A Case Report.
So Jung YEO ; Kyu Jin KIM ; Bo Yeon KIM ; Chan Hee JUNG ; Seung Won LEE ; Jeong Ja KWAK ; Chul Hee KIM ; Sung Koo KANG ; Ji Oh MOK
Journal of Korean Medical Science 2014;29(10):1432-1435
Metastasis to the primary thyroid carcinoma is extremely rare. We report here a case of colonic adenocarcinoma metastasis to medullary thyroid carcinoma in a 53-yr old man with a history of colon cancer. He showed a nodular lesion, suggesting malignancy in the thyroid gland, in a follow-up examination after colon cancer surgery. Fine needle aspiration biopsy (FNAB) of the thyroid gland showed tumor cell clusters, which was suspected to be medullary thyroid carcinoma (MTC). The patient underwent a total thyroidectomy. Using several specific immunohistochemical stains, the patient was diagnosed with colonic adenocarcinoma metastasis to MTC. To the best of our knowledge, the present patient is the first case of colonic adenocarcinoma metastasizing to MTC. Although tumor-tumor metastasis to primary thyroid carcinoma is very rare, we still should consider metastasis to the thyroid gland, when a patient with a history of other malignancy presents with a new thyroid finding.
Adenocarcinoma/pathology/surgery
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Biopsy, Fine-Needle
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Carcinoma, Medullary/diagnosis/radiography/*secondary
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Colonic Neoplasms/*pathology/surgery
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Humans
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Male
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Middle Aged
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Neoplasms, Second Primary/*diagnosis
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Thyroid Gland/pathology
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Thyroid Neoplasms/diagnosis/radiography/*secondary
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Thyroid Nodule/diagnosis