A 42-years-old woman had undergone operation for cholecochal cyst with gallbladder cancer 9 years ago. Pathology revealed a polypoid mass in the gallbladder with liver infiltration as poorly differentiated adenocarcinoma. Computed tomography, magnetic resonance cholangiopancreatography, and endoscopic ultrasound showed a newly developed suspected solid nodule in the peripheral portion of cystic lesion in the pancreas head. She underwent a pylorus preserving pancreaticoduodenectomy for the suspected mucinous cystic neoplasm of the pancreas. Pathology revealed poorly differentiated adenocarcinoma. The remnant choledochal cyst had developed to cholangiocarcinoma, which mimicked cystic neoplasm of the pancreas.
Adenocarcinoma ; Cholangiocarcinoma ; Cholangiopancreatography, Magnetic Resonance ; Choledochal Cyst ; Common Bile Duct ; Female ; Gallbladder ; Gallbladder Neoplasms ; Head ; Humans ; Liver ; Mucins ; Pancreas ; Pancreatic Cyst ; Pancreaticoduodenectomy ; Pylorus

PURPOSE: The purpose of this report is to describe the proton therapy system at Samsung Medical Center (SMC-PTS) including the proton beam generator, irradiation system, patient positioning system, patient position verification system, respiratory gating system, and operating and safety control system, and review the current status of the SMC-PTS. MATERIALS AND METHODS: The SMC-PTS has a cyclotron (230 MeV) and two treatment rooms: one treatment room is equipped with a multi-purpose nozzle and the other treatment room is equipped with a dedicated pencil beam scanning nozzle. The proton beam generator including the cyclotron and the energy selection system can lower the energy of protons down to 70 MeV from the maximum 230 MeV. RESULTS: The multi-purpose nozzle can deliver both wobbling proton beam and active scanning proton beam, and a multi-leaf collimator has been installed in the downstream of the nozzle. The dedicated scanning nozzle can deliver active scanning proton beam with a helium gas filled pipe minimizing unnecessary interactions with the air in the beam path. The equipment was provided by Sumitomo Heavy Industries Ltd., RayStation from RaySearch Laboratories AB is the selected treatment planning system, and data management will be handled by the MOSAIQ system from Elekta AB. CONCLUSION: The SMC-PTS located in Seoul, Korea, is scheduled to begin treating cancer patients in 2015.
Cyclotrons ; Helium ; Humans ; Korea* ; Metallurgy ; Particle Accelerators ; Patient Positioning ; Proton Therapy* ; Protons* ; Radiation Oncology ; Respiratory System ; Seoul