[Show abstract][Hide abstract] ABSTRACT: The present study aimed to determine the difference between the clinical tumor stage (T stage) based on pre-operative ultrasound and the histopathological T stage subsequent to surgery in vacuum-assisted breast biopsy (VABB)-diagnosed breast cancer. Tumor sizes measured ultrasonography (USG) and histologically were retrospectively calculated and analyzed using paired t-tests in 209 patients diagnosed with breast cancer using VABB. The patients were classified into two groups, consisting of breast imaging reporting and data system (BI-RADS) category 4a or below, who underwent complete resection by VABB, and BI-RADS category 4b or above, who underwent incisional biopsy by VABB. The histopathological tumor size was found to be smaller compared with the USG-determined size in 92.3% of pT1a, 75.5% of pT1b, 44.2% of pT1c, 47.7% of pT2 and 0% of pT3 cases. Furthermore, the histopathological tumor size was smaller compared with the USG-determined size in 62.8% of cases classified as BI-RADS category 3-4a and in 53.7% of cases classified as BI-RADS category 4b-5. The smaller the primary tumor at the time of diagnosis by VABB, the higher the likelihood of pathological underestimation on post-operative histopathological assessment compared to pre-operative USG.
[Show abstract][Hide abstract] ABSTRACT: Klinefelter syndrome is the most common genetic form of male hypogonadism, but the phenotype becomes evident only after puberty. It is characterized by infertility, small testes, sparse body and facial hair, increased body weight, gynecomastia, increased LH and FSH, and a low level of testosterone. Early recognition and treatment of Klinefelter syndrome can significantly improve the patient's quality of life and prevent serious consequences. Here, we report an infertile man with a rare variant of Klinefelter syndrome with a 47, XY, i(X)(q10) karyotype.
Full-text · Article · Dec 2013 · Clinical and Experimental Reproductive Medicine
[Show abstract][Hide abstract] ABSTRACT: Percutaneous removal of benign breast tumors using ultrasound-guided vacuum-assisted breast biopsy (VABB) has been recently regarded as a feasible and safe method without serious complications. The aim of this study was to evaluate the efficacy and safety of the VABB in the treatment of benign phyllodes tumors, and to identify whether or not surgical re-excision is necessary for benign phyllodes tumors diagnosed and excised by VABB.
From January 2003 to December 2011, a total of 6,923 VABB were performed in 5,434 patients. Out of 6,923 lesions, 53 were benign phyllodes tumors. Among these, 31 lesions, with a follow-up period of longer than 24 months, were enrolled in this study. Ultrasonography follow-up was performed at 3 to 6 month intervals in order to assess recurrence. The mean follow-up period was 75.9±13.5 months (range, 24-94 months).
The mean patient age at presentation was 31.6±9.4 years. The mean size of the lesion was 1.60±0.88 cm. The majority of lesions, 74.2% (23 cases), were palpable, and 25.8% (8 cases) were non-palpable. Twenty-two lesions (71.0%) were classified as Breast Imaging Reporting and Data System category 3, and nine lesions (29.0%) were classified as category 4a, by ultrasonography. During the follow-up period, local recurrence developed in one lesion, making the local recurrence rate 3.2%.
If a benign phyllodes tumor is diagnosed, and sufficiently excised by VABB, observing the clinical course may be considered as an alternative to performing immediate wide local excision; this is the case despite the fact that it would need to be observed for a prolonged period of time.
[Show abstract][Hide abstract] ABSTRACT: Tuboovarian abscess occurred in pregnancy is a rare disease, especially which occurs after in vitro fertilization and embryo transfer (IVF-ET) is extremely rare. It is also difficult in diagnosis, because of its low incidence and nonspecific symptoms. Most of diagnosis is made in surgery. Although IVF currently is considered an effective treatment in women with endometriosis, there is the risk causing the infection of the endometrioma after oocyte retrieval. A case of tuboovarian abscess in IVF-ET pregnancy was presented and reviewed briefly.
[Show abstract][Hide abstract] ABSTRACT: Malignant mixed Müllerian tumor (MMMT) is a type of cancer that contains two cell types known as the adenocarcinoma and sarcoma. MMMT is a rare malignant cancer of the genital tract and particularly the prevalence of MMMT in the cervix is extremely rare. Due to the rare incidence of MMMT in cervix, its treatment has unestablished guidelines and has unclear prognosis. Based on the previous data, the prognosis of MMMT in the cervix is better than the prognosis of uterine MMMT. Here, we are reporting a case of cervix MMMT that is rapidly progressive with an extremely poor prognosis, which contradicts the previous data.
[Show abstract][Hide abstract] ABSTRACT: We assessed the effectiveness of high-dose progestins as a conservative treatment in young women with endometrial adenocarcinoma.
We retrospectively reviewed the hospital data of patients with endometrial cancer that were managed conservatively. Of those women with grade 1 endometrioid endometrial adenocarcinoma, we included those who were younger than 40 years and in whom the disease was clinically confined to the endometrium. A complete response was defined pathologically as the absence of tissue with adenocarcinoma or hyperplasia.
Fourteen patients were included. Their mean age was 30.0 ± 4.8 years and the mean follow-up period was 47.3 ± 29.7 months. Twelve patients received 30-500 mg/day medroxyprogesterone acetate and two received 160 or 240 mg/day megestrol acetate. The median duration of treatment was 6 months (range 3-15 months) and 13 (93%) patients showed a complete response. Endometrial pathology reappeared in four patients (4/13, 31%) including two relapses, three of whom developed after the patients gave birth. Six patients used a combined oral contraceptive or a progestin-releasing intrauterine device as a maintenance therapy and experienced no recurrence. Four women (4/7, 57%) conceived successfully seven times with assisted-reproductive technology. No adverse effects of the progestins or tumor-related death were noted.
High-dose progestin therapy can be an effective conservative treatment in young patients with well-differentiated early-stage endometrial cancer. If patients wish to preserve their fertility even after they have completed childbearing, maintenance therapy with a cyclic oral contraceptive or a progestin-releasing intrauterine device may be an option to prevent recurrence.
No preview · Article · Jun 2011 · Archives of Gynecology
[Show abstract][Hide abstract] ABSTRACT: Ovarian stromal tumors containing Leydig cell components are rare. Only a few cases of ovarian stromal Leydig cell tumors characterized by clusters of Leydig cells have been reported to date. Here, we present the first case report of a 65-year-old woman with a cellular fibroma of the ovary containing Leydig cell hyperplasia. Microscopic examination revealed the proliferation of spindle cells arranged in intersecting bundles with mild nuclear atypia and an average of 2-3 mitotic figures per ten high-power fields. Multifocal nests of polygonal cells with abundant eosinophilic cytoplasm and round nuclei were seen within the spindle cells. Final pathology of the tumor revealed a cellular fibroma including Leydig cell hyperplasia.
Full-text · Article · Mar 2010 · Journal of Gynecologic Oncology
[Show abstract][Hide abstract] ABSTRACT: To evaluate the influence of doxazosin and finasteride on histologic findings in benign prostatic hyperplasia accompanied by prostatitis, and to examine the factors related with prostate carcinogenesis.
Prostate tissue from 17 cases of prostatic hyperplasia were divided into three groups; group 1: no medication history, group 2: both doxazosin and finasteride for at least 6 months before surgery; group 3: doxazosin for a minimum of 6 months before transurethral resection. Formalin-fixed, paraffin-embedded sections were stained with hematoxylin and eosin stain and immunohistochemistry for COX-2, CD3, CD68, VEGF, and GSTP (glutathione S-transferase pi).
CD3 showed a tendency toward decreased staining intensity and extent in group 3 (p = 0.026, p = 0.004, respectively). CD68 showed a different staining extent among the three groups (p = 0.020). For VEGF, the staining extent showed different results between groups 2 and 3 (p = 0.044). There was no correlation between COX-2 and VEGF in group 1. However, a positive correlation between COX-2 and GSTP1 was demonstrated in group 2 (p = 0.000).
Doxazosin-treated prostate tissue showed decreased inflammatory reaction. GSTP1 expression was decreased in combined treatment with doxazosin and finasteride. These findings suggest that finasteride may interfere with the anti-inflammatory reaction. Finasteride also decreases angiogenesis. However, the meaning of our observations is limited by small sample size.
No preview · Article · Feb 2008 · Urologia Internationalis
[Show abstract][Hide abstract] ABSTRACT: DNA in most cells is regularly damaged by endogenous and exogenous mutagens. Unrepaired damage can result in apoptosis or may lead to unregulated cell growth and cancer. Inheritance of genetic variants at one or more loci results in reduced DNA repair capacity. This hospital-based case-control study examined whether polymorphisms in the DNA repair gene X-ray repair cross-complementing groups 1 (XRCC1) (Arg194Trp[C > T], Arg280His[G > A] and Arg399Gln[G > A]) play a role in susceptibility to skin cancer. We genotyped these polymorphisms for 212 histopathologically confirmed skin cancer cases (n = 114 basal cell carcinoma, n = 98 squamous cell carcinoma) and 207 age- and sex-matched healthy control cases in Korea. We found that individuals with the Arg/Gln and Arg/Gln + Gln/Gln genotypes at XRCC1 Arg399Gln(G > A) had an approximately 2-fold increased risk of basal cell carcinoma compared to individuals with the Arg/Arg genotype (adjusted odds ratio [AOR] = 2.812, 95% confidence interval [CI] 1.32-5.98, and AOR = 2.324, 95% CI 1.11-4.86). However, we observed that the 194Trp allele of the Arg194Trp(C > T) polymorphism was inversely associated with squamous cell carcinoma risk (Trp/Trp, AOR = 0.06, 95% CI 0.006-0.63). Our data suggest that the Arg194Trp and Arg399Gln polymorphisms may be differentially associated with skin cancer risk.
[Show abstract][Hide abstract] ABSTRACT: Apocrine carcinoma is a rare breast cancer and its frequency is about 0.4% of all breast cancers. Little is known about its clinical behavior and prognosis. To our knowledge, few studies have reported the radiologic appearances of apocrine carcinoma in the breast and there has been no such report from Korea. We describe the sonographic findings of a case of apocrine carcinoma in the breast. The sonographic findings are microlobulated heterogeneous hypoechoic lesion that has a central markedly hypoechoic portion and a peripheral mixture of iso and hypoechgenecity.