Journal of Yeungnam Medical Science

Case report

Pancreatic metastasis from malignant phyllodes tumor of the breast: Seung Eun Lee, Young Kyung Bae, Joon Hyuk Choi; Yeungnam Univ J Med. 2021;38(1):78-82. Published online November 27, 2020; DOI: https://doi.org/10.12701/yujm.2020.00759

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Pancreatic metastasis from malignant phyllodes tumor (PT) of the breast is rare, and only a few cases have been reported in the literature. Here, we report a case of pancreatic metastasis from malignant PT of the breast in a 48-year-old woman. She had had three episodes of recurrence of malignant PT in her right breast. She presented with epigastric pain for 2 months. Computed tomography and magnetic resonance imaging revealed a 6 cm-sized, well-defined, heterogeneous mass with peripheral enhancement in the body of the pancreas. Endoscopic ultrasonography-guided fine-needle aspiration was performed, and the pathologic report suggested spindle cell mesenchymal neoplasm. Subsequently, surgical excision was performed, and the mass was confirmed as a metastatic malignant PT. The imaging findings are discussed and the literature is briefly reviewed in this report.

Citations

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Integrating single‐cell and spatial transcriptomes reveals COL4A1/2 facilitates the spatial organisation of stromal cells differentiation in breast phyllodes tumours
Xia Li, Xuewen Yu, Jiaxin Bi, Xu Jiang, Lu Zhang, Zhixin Li, Mumin Shao
Clinical and Translational Medicine.2024;[Epub] CrossRef
Case report: Osteosarcomatous differentiation in the lung metastasis of a malignant phyllodes tumor
Ruijing Liu, Jingli Xue, Wen Liu, Beibei Jiang, Fuyun Shi, Zhenzheng Wang, Peifeng Li
Frontiers in Medicine.2023;[Epub] CrossRef
Diagnostic approach to fibroepithelial tumors of the breast
Frances Tresserra, María Angeles Martinez-Lanao, Melissa Fernandez-Acevedo, Cristina Castellet, Sonia Baulies
Revista de Senología y Patología Mamaria.2022; 35: S22. CrossRef

Original article

Usefulness of intraoperative determination of central lymph node metastasis by palpation in papillary thyroid cancer: Wan Wook Kim, Jeeyeon Lee, Jin Hyang Jung, Ho Yong Park, Won Hwa Kim, Hye Jung Kim, Ji-Young Park, Ralph P. Tufano; Yeungnam Univ J Med. 2020;37(4):302-307. Published online April 22, 2020; DOI: https://doi.org/10.12701/yujm.2020.00122

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Abstract PDF: Background
This study evaluated the usefulness of judgment of central lymph node (LN) metastasis by surgeon’s palpation in papillary thyroid cancer.
Methods
This study included 127 patients who underwent thyroidectomy and central compartment node dissection between October 2014 and February 2015. The criterion for suspicious LNs was hardness.
Results
Of the 20.5% (28/127) of suspicious for metastatic LNs according to surgeon determination, 92.8% (26/28) were confirmed to be metastatic in the final pathological examinations. Metastatic LNs were found in 38 (38.3%) of 99 patients without suspicious LNs, 29 of whom (76.3%) had micrometastases. The sensitivity, specificity, and positive and negative predictive values for the determination of LN metastasis by a surgeon were 40.6%, 96.8%, 92.9%, and 61.6%, respectively.
Conclusion
Determination of central LN metastasis by a surgeon’s palpation may be useful to evaluate LNs owing to the high specificity and positive predictive values, especially in macrometastasis or high-risk LN disease.

Review article

Function of hepatocyte growth factor in gastric cancer proliferation and invasion: Sung Ae Koh, Kyung Hee Lee; Yeungnam Univ J Med. 2020;37(2):73-78. Published online February 20, 2020; DOI: https://doi.org/10.12701/yujm.2019.00437

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Abstract PDF

Cancer incidence has been increasing steadily and is the leading cause of mortality worldwide. Gastric cancer is still most common malignancy in Korea. Cancer initiation and progression are multistep processes involving various growth factors and their ligands. Among these growth factors, we have studied hepatocyte growth factor (HGF), which is associated with cell proliferation and invasion, leading to cancer and metastasis, especially in gastric cancer. We explored the intercellular communication between HGF and other surface membrane receptors in gastric cancer cell lines. Using complimentary deoxyribonucleic acid microarray technology, we found new genes associated with HGF in the stomach cancer cell lines, NUGC-3 and MKN-28, and identified their function within the HGF pathway. The HGF/N-methyl-N’-nitroso-guanidine human osteosarcoma transforming gene (c-MET) axis interacts with several molecules including E-cadherin, urokinase plasminogen activator, KiSS-1, Jun B, and lipocalin-2. This pathway may affect cell invasion and metastasis or cell apoptosis and is therefore associated with tumorigenesis and metastasis in gastric cancer.

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Reciprocal Regulation of Cancer-Associated Fibroblasts and Tumor Microenvironment in Gastrointestinal Cancer: Implications for Cancer Dormancy
Shih-Hsuan Cheng, Hsin-Ying Clair Chiou, Jiunn-Wei Wang, Ming-Hong Lin
Cancers.2023; 15(9): 2513. CrossRef
Expression of E-cadherin and N-cadherin in Epithelial-to-Mesenchymal Transition of Osteosarcoma: A Systematic Review
Leo Issagholian, Ethan Tabaie, Akshay J Reddy, Muhammad S Ghauri, Rakesh Patel
Cureus.2023;[Epub] CrossRef
Remodelling of the tumour microenvironment by the kallikrein-related peptidases
Srilakshmi Srinivasan, Thomas Kryza, Jyotsna Batra, Judith Clements
Nature Reviews Cancer.2022; 22(4): 223. CrossRef
Identification of hub pathways and drug candidates in gastric cancer through systems biology
Seyed Reza Salarikia, Mohammad Kashkooli, Mohammad Javad Taghipour, Mahdi Malekpour, Manica Negahdaripour
Scientific Reports.2022;[Epub] CrossRef
Signaling pathways and therapeutic interventions in gastric cancer
Zi-Ning Lei, Qiu-Xu Teng, Qin Tian, Wei Chen, Yuhao Xie, Kaiming Wu, Qianlin Zeng, Leli Zeng, Yihang Pan, Zhe-Sheng Chen, Yulong He
Signal Transduction and Targeted Therapy.2022;[Epub] CrossRef
Proteomic Signatures of Diffuse and Intestinal Subtypes of Gastric Cancer
Smrita Singh, Mohd Younis Bhat, Gajanan Sathe, Champaka Gopal, Jyoti Sharma, Anil K. Madugundu, Neha S. Joshi, Akhilesh Pandey
Cancers.2021; 13(23): 5930. CrossRef

Case report

Rapid progression from trochlear nerve palsy to orbital apex syndrome as an initial presentation of advanced gastric cancer: Eunjung Kong, Sung Ae Koh, Won Jae Kim; Yeungnam Univ J Med. 2019;36(2):159-162. Published online February 15, 2019; DOI: https://doi.org/10.12701/yujm.2019.00129

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Abstract PDF

The most cases with orbital metastases have been reported in patients with a prior established diagnosis of cancer and widespread systemic involvement. However, ocular symptoms can be developed as an initial presentation of cancer in patients without cancer history. We report a case of rapid progression from trochlear nerve palsy to orbital apex syndrome as an initial presentation of advanced gastric cancer.

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Neoplastic nerve lesions
Deep K. Patel, Kelly G. Gwathmey
Neurological Sciences.2022; 43(5): 3019. CrossRef

Case Reports

Metastatic eyelid cancer from gastric adenocarcinoma.: Ji Yoon Jung, Eun Joo Goo, Jae Chang Lee, Jay Song, Sung Ae Koh, Kyung Hee Lee, Young Kyung Bae; Yeungnam Univ J Med. 2016;33(2):142-145. Published online December 31, 2016; DOI: https://doi.org/10.12701/yujm.2016.33.2.142

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Abstract PDF: Gastric cancer is the most common cancer in Korean males and can easily spread to distant organs such as the liver, lungs, brain, or bones. However, skin metastasis, particularly of the eye, is rare. Metastatic eyelid cancer is extremely rare; metastases from internal organs have not been reported so far. We recently experienced a patient with metastatic eyelid cancer from adenocarcinoma of the stomach. A 62-year-old female was admitted with a right upper eyelid mass and foreign body sensation. She had a history of stomach cancer of 3 years. She was treated by chemotherapy and radiotherapy for pathologic fracture. After receiving supportive care for 2 years, the mass appeared on her right pupil. Punch-biopsy of the mass was performed and histological examination revealed adenocarcinoma, the same as the initial histological result. We report this case with a review of related literature.

Pulmonary epithelioid hemangioendothelioma misconceived as pulmonary metastasis of other malignancies.: Gi Tark Noh, Kyoung Ju Lee, Hee Jung Sohn, Kyung Han Lee, Won Seok Heo, Byung Sung Koh, Un Mi Han, Young A Bae; Yeungnam Univ J Med. 2016;33(1):72-75. Published online June 30, 2016; DOI: https://doi.org/10.12701/yujm.2016.33.1.72

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Abstract PDF

Pulmonary epithelioid hemangioendothelioma (PEH) is a rare, low-to-intermediate malignant tumor of endothelial origin. Computed tomography (CT) findings of PEH demonstrate multiple small bilateral nodules; however, to the best of our knowledge, there were no reports on PEH coexisting with other malignancies. Here, we reported on a case involving PEH in a patient with colon cancer and breast cancer which was misconceived as pulmonary meta-stasis. A 63-year-old woman who suffered from constipation for 2 weeks visited our hospital. Colonoscopy showed a large mass with obstruction on hepatic flexure. The histological diagnosis was adenocarcinoma of the ascending colon. Multiple nodules in both lungs and breast were observed on a chest CT scan. A core biopsy of a breast nodule was performed and a diagnosis of invasive ductal carcinoma of the left breast was made. Pulmonary nodules observed on the chest CT scan was considered as pulmonary metastasis from colon or breast cancer. Laparoscopic right hemicolectomy was performed. At the same time, wedge resection of the lung was performed and pathological diagnosis was PEH. Radiologic features of PEH were difficult to distinguish from lung metastasis. Therefore the author reported a rare case involving PEH in a patient with primary malignancy of colon and breast.

Citations

Citations to this article as recorded by

A Case of Pulmonary Epithelioid Hemangioendothelioma with Literature Review
Thu Thu Aung, Andrew Chu, Divya Kondapi, Danny Markabawi, Kanish Mirchia, Pratibha Kaul
Case Reports in Oncological Medicine.2020; 2020: 1. CrossRef
New Insights about Pulmonary Epithelioid Hemangioendothelioma: Review of the Literature and Two Case Reports
Romeu Duarte Mesquita, Marta Sousa, Carmen Trinidad, Eugénia Pinto, Iosu Antón Badiola
Case Reports in Radiology.2017; 2017: 1. CrossRef

Recurrent acinic cell carcinoma in the parotid gland with cardiac metastasis and hypertrophic osteoarthropathy.: Sung Yun Jung, Dong Won Lee, Min Geun Gu, Tae Hun Kwon, Sung Ae Ko, Joon Hyuk Choi, Jang Won Sohn, Myung Soo Hyun; Yeungnam Univ J Med. 2014;31(1):33-37. Published online June 30, 2014; DOI: https://doi.org/10.12701/yujm.2014.31.1.33

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Abstract PDF: Acinic cell carcinoma (ACC) is an uncommon malignant tumor of the salivary glands that is difficult to diagnose. It grows slowly and shows distant metastasis rarely. We experienced a case of recurrent ACC in the parotid gland with cardiac metastasis and hypertrophic osteoarthropathy. The 29-year-old man had been suffering from severe multiple bones and joints pain for 2 months. Ten years earlier, he underwent superficial parotidectomy due to a right subauricular mass. The mass was diagnosed with ACC. After surgery, the tumor recurred twice. Then the patient was diagnosed with cardiac metastasis via positron emission tomography-computed tomography and trans-thoracic echocardiography. He also had hypertrophic osteoarthropathy with multiple bone metastasis. He was given palliative radiotherapy and conservative treatment. ACC in the parotid gland with cardiac metastasis and hypertrophic osteoarthropathy has not yet been reported in literature. From this case, it is recommended to evaluate multiple distant metastasis in the ACC of the parotid gland when joint and bone pain are present.

A Case of Metastatic Hepatocellular Carcinoma of the Orbit.: Young Joo Yang, Seung Hyeon Bae, Il Young Jang, Mi Jung Jun, Ji Won Jung, Ji Hyun An, Ju Hyun Shim; Yeungnam Univ J Med. 2013;30(2):152-155. Published online December 31, 2013; DOI: https://doi.org/10.12701/yujm.2013.30.2.152

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Abstract PDF: Orbital metastasis from hepatocellular carcinoma is very rare, with only 14 biopsy-proven cases from hepa tocellular carcinoma cases reported in English literature and three cases reported in Korea. Common symptoms of orbital metastasis are proptosis, visual loss, ocular pain and oculomotor dysfunction. For its precise diagnosis, we can perform fine needle aspiration biopsy, orbit CT or MRI, and ultrasonography. Radiotherapy is the mainstay in the treatment of orbital metastasis. In addition, chemotherapy, hormonal therapy and surgical intervention can play a role in the treatment of orbital metastasis according to the primary cancer and symptoms. However, the prognosis of orbital metastasis is poor. We report herein a rare case of a patient with orbital metastasis from hepatocellular carcinoma, which was treated with various modalities that included resection, and who had good clinical and radiological responses to radiation therapy and sorafenib (Nexavar, Bayer HealthCare).

Burnt-out Metastatic Prostate Cancer.: Dong Suk Shin, Dong Hoe Koo, Suhyeon Yoo, Deok Yun Ju, Cheol Min Jang, Kwan Joong Joo, Hyun Chul Shin, Seoung Wan Chae; Yeungnam Univ J Med. 2013;30(2):116-119. Published online December 31, 2013; DOI: https://doi.org/10.12701/yujm.2013.30.2.116

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Abstract PDF: A burnt-out prostate cancer tumor is a very rare clinical entity. The term 'burnt-out' refers to a primary tumor that has spontaneously and nearly completely regressed without treatment. Since metastasis of prostate cancer is usually encountered in the presence of advanced disease, distant metastasis with an undetectable primary tumor is very rare. We report herein a case of a burnt-out prostate cancer tumor that metastasized to the thoracic (T) spine and caused cord compression. A 66-year-old man visited the Emergency Department due to weakness of both legs for the past two days. His blood and urine tests were normal at the time. His spine magnetic resonance imaging (MRI) scans looked like bone metastasis that involved the T-7 vertebral body and a posterior element, and caused spinal cord compression. Other images, including from the brain MRI, neck/chest/abdomino-pelvic computed tomography (CT) scan and 18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET) and endoscopy, revealed no lesions that suggested malignancy. After total corpectomy T-7 and screw fixation/fusion at T5 to T10, the pathology report revealed a metastatic carcinoma that was strongly positive for prostate-specific antigen (PSA). The serum PSA value was 1.5 ng/mL. The transrectal 12-core prostate biopsy and ultrasonography showed no definitive hypoechoic lesion, but one specimen had slight (only 1%) adenocarcinoma with a Gleason score of 6 (3+3). The final diagnosis was burned-out prostate cancer with an initial normal PSA value. Although metastatic disease with an unknown primary origin was confirmed, a more aggressive approach in seeking the primary origin could provide a more specific treatment strategy and greater clinical benefit to patients.

Paratesticular Alveolar Rhabdomyosarcoma with Multiple Lymph Nodes Metastasis Successfully Treated with Chemotherapy.: Ha young Lee, Myung Soo Hyun, Kyung Hee Lee, Min Kyoung Kim, Sung Ae Koh, Se Hoon Sohn, Sung Woo Park, Dong Geun Kim, Myung Jin Kim, Hyo Jin Jang, Mi Jin Kim; Yeungnam Univ J Med. 2011;28(1):70-76. Published online June 30, 2011; DOI: https://doi.org/10.12701/yujm.2011.28.1.70

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Abstract PDF: Rhabdomyosarcomas are soft tissue sarcomas; while extremely rare in adults, they are one of the most common neoplasms in children and adolescents. Histologically, they can be classified into embryonal(ERMS), alveolar(ARMS), pleomorphic, and undifferentiated types. The ARMS type is very rare, and is associated with a poor prognosis. Common primary sites of ARMS are the trunk and extremities. We report on a case of paraaortic, supraclavicular, and axillary lymph node metastasis from paratesticular ARMS treated with VAC(vincristine, dactinomycin, cyclophosphamide)/ IE(ifosfamide, etoposide) chemotherapy in a young adult. Administration of six cycles of chemotherapy with VAC/ IE resulted in complete remission. The patient has maintained complete remission over the past 27 months.

Original Articles

Cone-Beam CT Image-Guided Radiosurgery of Brain Metastasis : Technical Note and Clinical Application: Sei-One Shin, Sang Mo Yun; Yeungnam Univ J Med. 2007;24(2 Suppl):S591-597. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S591

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Abstract PDF: Background
：This study was performed to test feasibility of CBCT(cone-beam computerized tomography) guided radiosurgery. Materials and Methods：We used CBCT which was mounted on a retractable arm at 90° to the treatment source. CBCT images were overlapped on the digitally reconstructed images from simulation CT scan. Then, 3 dimensional volumetric CT image matching was performed. If there were any positioning errors, automated patient re-positioning was done.
Results
：A radiosurgery treatment plan was carried out with a set of specially designed multiple non-coplanar arcs. The goal of plan was to deliver single session 18 Gy at periphery of the target. We treated a patient with a solitary brain metastasis from left upper lung cancer. Serial imaging study for treatment response revealed a satisfactory result with no remarkable treatment related side effects.
Conclusion
：CBCT image guided radiosurgery system is very simple and could be a convenient image guiding modality for stereotactic radiosurgery or fractionated radiotherapy with an acceptable geometric accuracy and radiation exposure.

The effect of Transarterial Chemoembolization(TAE) on Lung metastasis of Hepatocellular Carcinoma.: Heon Ju Lee, Jong Ryul Eun, Young Doo Song, Chan Won Park; Yeungnam Univ J Med. 2000;17(1):66-74. Published online June 30, 2000; DOI: https://doi.org/10.12701/yujm.2000.17.1.66

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Abstract PDF: BACKGROUND
During follow up period after transarterial embolization(TAE), cases of pulmonary metastasis were more prevalent in TAE-treated patients than in TAE-untreated patients. Therefore, a study was conducted to evaluate whether TAE increases the incidence of pulmonary metastasis of hepatocellular carcinoma and to clarify the risk factors for pulmonary metastasis. METHODS: From march 1991 to march 1995, 156 patients who had been diagnosed with hepatocellular carcinoma by serology, and radiographic and histologic method at Yeungnam university hospital were involved in this study. We excluded 12 patients with lung metastasis on initial diagnosis and the others. The remaining 144 patients had been followed up for at least 5 months, and divided into four groups according to lung metastasis and trans-arterial embolization treatment, and evaluated the age, sex, child-pugh score, liver cirrhosis, and the level of AFP. RESULTS: Pulmonary metastasis was found in 18.0% (26/144), of witch 92.3%(24/26) and 7.7%(2/26) of the patients with and without transarterial chemoembolization, respectively. Of thepatients, 23.5% (24/102) with TAE had lung metastais during follow-up periods and 4.7% (2/42) without TAE had lung metastasis. there was more likelihood for lung metastasis after TAE, but there was no difference between two groups in age, sex, child-pugh class, the presence of liver cirrhosis, and AFP. CONCLUSIONS: The incidence of pulmonary metastasis of hepatocellular carcinoma after TAE was higher. child-pugh class was the only related clinical precipitating factors for pulmonary metastasis in TAE in our study. Our results suggest that regular chest X-ray check-up may be more frequently needed by patients who had TAE treatment for hepatocellular carcinoma.

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