배경/목적: 본 연구에서는 췌장 낭종을 가진 환자들 중 임상적 으로 분지형 췌관내유두상점액종양(branch-duct intraductal papillary mucinous neoplasm)으로 여겨지는 환자에서 췌장암 및 우려되는 특징의 누적 발생률을 조사하였다. 방법: 분지형 췌관내유두상점액종양으로 추적관찰한 환자 177명의 자료를 후향적으로 분석하였다. 영상 검사를 통해 주췌관과의 소통이 확인된 췌장 낭종을 ‘분지형 췌관내유두상 점액종양 의심’으로 정의하였고, 주췌관과의 명확한 소통이 없는 경우를 ‘분지형 췌관내유두상점액종양 추정’으로 정의 하였다. 결과: 환자 중 30.5%가 분지형 췌관내유두상점액종양 의심으로 분류되었다. 진단 시의 중위 연령은 64세였으며, 낭종 크기의 중앙값은 13 mm였다. 진단 시 19명(10.7%)의 환자가 우려되는 특징을 보였으며, 고위험 인자(high risk stigmata)를 보인 환자는 없었다. 70.5개월의 추적 기간 동안 3명의 환자에게서 췌장암이 발생하였으며 96개월 시점의 누적 발생률은 4.0% (95% 신뢰 구간[confidence interval, CI], 0.98-10.76%)였다. 진단 시 우려되는 특징이 없는 158명의 환자에서 우려되는 특징의 누적 발생률은 24개월 시점에 5.1% (95% CI, 2.37-9.28%)였고, 96개월 시점에 11.2% (95% CI, 6.34-17.53%)였다. 우려되는 특징의 발생은 분지형 췌관내 유두상점액종양 추정 군(p=0.102)과 75세 미만 환자(p=0.463) 에서 더 낮았으나, 이러한 차이는 통계적으로 유의하지 않았다. 특히, 75세 이상 환자 군에서는 2년이 지난 이후 우려되는 특징은 발생하지 않았다. 결론: 저위험 췌장 낭종 환자에서 췌장암 및 우려되는 특징의 누적 발생률은 현저히 낮았다. 또한, 첫 2년 동안 변화가 없는 고령 환자의 경우 감시를 중단하는 것을 고려할 수 있다.

Mucoepidermoid carcinoma (MEC) is the most prevalent malignant tumor originating from the salivary gland. The gradation of MEC is determined histologically based on cellular composition, with high-grade MEC presenting with distinct characteristics and clinical implications. A 56-year-old male presented with a 3-month history of right facial swelling and a recent onset of pain. A subsequent biopsy confirmed a malignant epithelial tumor, with further imaging assisting in determining the surgical approach. Comprehensive surgery, involving the removal of the right submandibular gland and reconstructive procedures, was undertaken. Histopathological evaluation post-surgery confirmed a high-grade MEC. The differentiation between inflammatory conditions and neoplastic lesions in the orofacial region can be challenging. The gradation of MEC is important in guiding therapeutic decisions. Among various classification systems, the Brandwein system offers detailed histopathological criteria that correlate reliably with clinical features. High-grade MECs, although less frequent, are aggressive and have a lower 5-year survival rate. Accurate histopathological diagnosis is crucial in devising an effective treatment plan. The presented case underlines the importance of a meticulous yet periodic follow-up, considering the aggressive nature of high-grade MECs.

Cellular myxoma is an uncommon type of myxoid benign tumor, predominantly occurring in adult female patients aged >40 years. This report aims to document a case of cellular myxoma that occurred in the buccal mucosa. Compared to intramuscular myxomas, cellular myxoma demonstrates hypercellularity and vascularity. Its manifestation in the soft tissue of the head and neck area is exceptionally rare. Generally, cellular myxoma manifests as a firm and immovable mass covered with normal oral mucosa, with no associated clinical symptoms. Homogenous low signal intensity on T1-weighted scans and high-signal intensity on T2-weighted magnetic resonance scans reveal cellular myxoma, as most lesions show well-defined margins and heterogeneous contrast enhancement. The significant histologic features include a focal or diffuse increase in cellularity with fibroblast-like cells and vascularity with an abundant collagenous matrix. Our presented case reflects these facts examinations, based on which a final diagnosis of cellular myxoma was made. Immunohistochemistry revealed locally and diffusely positive SMA and CD34. The clinical tendency of cellular myxoma with hypercellularity may affect the production of myxoid and collagenous substrates, and if complete resection is not performed, the possibility of local recurrence in the primarily affected region remains. Hence, complete surgical excision was performed under general anesthesia, and follow-up until a year after treatment revealed no observed recurrence. To achieve precise diagnosis and complete treatment without local recurrence, several diagnostic examinations should be considered.

Among pancreatic cystic lesions, mucinous cystic neoplasm (MCN) and intraductal papillary mucinous neoplasm (IPMN) of the pancreas are precursor lesions of pancreatic adenocarcinoma. IPMN is characterized by intraductal papillary proliferation of mucin-producing epithelial cells that exhibit various degrees of dysplasia. IPMN is classified as the main duct type (MD-IPMN), mixed type and the branch duct type (BD-IPMN) according to the location of involvement, and into four histological subtypes (gastric, intestinal, pancreatobiliary, and oncocytic) according to the histomorphological and immunohistochemical characteristics. Most patients with MD-IPMN undergo tumor resection due to moderate to high risk of malignancy. Patients with BD-IPMN who do not undergo resection may develop malignant change, and concomitant separate pancreatic cancer occurs in 2-10% of patients with IPMN. Patients with BD-IPMN who do not undergo resection should do careful surveillance including endoscopic ultrasound sonography for the early detection of malignant change and separate pancreatic cancer.

Taxillus yadoriki (Siebold) Dancer is a parasitic plant that grows on camellia trees and is common on Jeju Island. The branches of T. yadoriki have long been used to treat various diseases, including hypertension, diabetes mellitus, viral infections, and arthritis. Although recent studies reported that T. yadoriki has anticancer effects in various human cancer cell lines, including lung cancer, the exact molecular mechanisms supporting its anticancer effects are not well understood. This study aims to assess the anticancer effect of the methanol extract of T. yadoriki branches (METY) on mucoepidermoid carcinoma (MEC) cell lines (MC3 cells and YD15 cells) and explore its mechanism of action. Inhibitory activity of MEC cell proliferation was assessed using the CCK-8 assay. The mechanism of the anticancer effect on METY-treated MC3 cells and YD15 cells was evaluated with Hoechst 33342 stain and Western blot. After treating MC3 cells and YD15 cells with METY for 48 hours, the cytotoxicity of MC3 and YD15 cells increased, and nuclear fragmentation increased in both METY-treated MEC cells. Caspase-3 and cleaved PARP activation demonstrated apoptosis of METY-treated MEC cells. Cell proliferation inhibition with METY was alleviated in METY-treated MEC cells pretreated with zVAD-FMK, supporting the cell proliferation inhibition effect by apoptosis. METY-induced apoptosis in MEC cells occurs through MAP kinase pathways such as p38 and pAkt. MEC cell. METY-induced apoptosis of MEC cells occurs via the p38 and pAkt MAPK pathways. Therefore, METY may be a promising anticancer candidate for the MEC therapeutic strategy.

According to the classification of World Health Organization, primary adenocarcinomas of the sinonasal tract can be initially classified as salivary and non-salivary types. The latter are further divided into intestinal and non-intestinal types. Sinonasal intestinal-type adenocarcinoma(ITAC) is rare adenocarcinoma subtype, which is closely occupational exposure to hardwood dusts, leather. In this study, we present a case of ITAC in a 68-year-old man. We successfully treated with wide excision and soft tissue reconstruction with free anterolateral thigh flap.

There are still debated about surveillance interval, duration, diagnostic modality and treatment for intraductal papillary mucinous neoplasm (IPMN) of the pancreas. In recent guidelines, ‘high risk stigmata (HRS)’ and ‘worrisome feature (WF)’ are defined as predictive factors for malignancy in IPMN. IPMNs with HRS and main duct- IPMN are more likely to accompany malignancies, thus require surgery. However, in the case of only WF, since the risk of malignancy is different for each factor, the management decision can be variable according to the number of overlapping WFs. In addition, for segmental main pancreatic duct dilatation without enhancing mural nodules, careful surveillance might be considered rather than immediate surgery. In IPMN patients with elderly or severe comorbidities, treatment strategy should be determined based on surgical and malignant risk assessment. To date, the natural course of IPMN patients with HRS and WF is not well understood, thus further studies with a large number of patients are needed.

Background : Mucoepidermoid carcinoma (MEC) is the most common primary epithelial malignant salivary gland tumor in both adults and children. Histological grading of MEC is subjective, but plays an important role in predicting patient prognosis. Immunohistochemistry can accurately diagnose diseases and help with treatment and prognosis. The review of this paper was intended to be helpful in the differential diagnosis of mucinous epidermoid carcinoma. Methods : A PubMed search was carried out. Well-known biomarkers for mucoepidermoid carcinoma were searched in PubMed, and their differences with oral squamous cell carcinoma were compared. Results : When PubMed searched “oral mucoepidermoid carcinoma, biomarker”, a total of 241 papers were found, among which cytokeratin(22), Muc1(membrane-bound mucin1, 9), Muc4( membrane-bound mucin4, 6), Muc5ac (membrane-bound mucin5ac, 4), Muc5b (membrane-bound mucin5b, 3), p63 (15), PCNA (15), p53 (20), EGFR (Epidermal growth factor receptor, 21), c-erbB2 (HER2, 14), and pAKT (2) were searched and investigated. The biomarkers retrieved above were compared with those expressed in squamous cell carcinoma. Conclusion : Due to the above biomarkers, it is possible to classify mucoepidermoid carcinoma and differentiate it from other salivary gland tumors or oral squamous cell carcinoma.

Although fine-needle aspiration biopsy (FNAB) has been widely accepted as a valuable tool for differential diagnosis of head and neck tumors, the diagnostic value of FNAB in the management of salivary gland tumors has been questioned. This case report presents a patient with mucoepidermoid carcinoma of parotid gland diagnosed as pleomorphic adenoma by FNAB and discusses the pitfalls in the diagnosis of malignant salivary gland tumors.

Mucoepidermoid carcinoma(MEC) is the most common salivary gland malignancies. As its name implies, the MEC is composed of a mixture of mucus-secreting cells and epidermoid cells. Histologically, MECs have been categorized into one of three grades : low, intermediate, or high grade. Although the MEC is the most common salivary gland tumor in both adults and children, MEC of sublingual gland accounts for only 1% of epithelial salivary tumors. This case report presents the histopathological features and management of MEC of the sublingual gland.

The myxoma(odontogenic myxoma, myxofibroma) of the jaws is a benign, usually slow-growing infiltrative tumor of connectice tissue. This article describes a case history of the treatment of recurred odontogenic myxofibroma in the maxilla and further discusses the appropriate management of such cases with reference to the literature review. A 55-year-old male patient presented with a gingival swelling in the right side of maxilla. He had history of second time recurred disease. Microscopically, a high cellularity fibrous tumor with fibroblastic cells was observed. Tumor cells were composed of stellate and spindle shaped fibroblasts. Islands of odontogenic epithelium were seen in the specimen. The final diagnosis was made with odontogenic myxofibroma in consideration of twice-time recurrences and histological characteristics. Because of the high likelihood of recurrence, an accurate differential diagnosis of pathology at the time of initial visit is very important in determining treatment options, and immunohistochemical tests may be helpful. Also close following up is required.(155 words)

Mucinous adenocarcinoma (MAC) refers to a malignant neoplasm that belongs to a subtype of adenocarcinoma which produces mucin. The World Health Organization has classified MAC as a tumor of salivary gland origin and it is extremely rare. Therefore, its characteristics are not well-known. This study reports a case of MAC of minor salivary gland origin, which occurred in the oral commissure of an 82-year-old female patient, and a systematic review on existing cases of MAC of salivary origin. Based on the study’s findings, it is safe to assume that the occurrence of lymph node metastasis is an important factor in determining the prognosis of patients with MAC.

Background: Mucoepidermoid carcinoma (MEC) is the most common malignant epithelial tumor of the salivary gland in the oral cavity. In South Korea, it occurs most frequently in the palate, retromolar area, floor of the mouth, buccal mucosa, and other areas of the oral cavity. MEC is rare in children and adolescents under 20 years of age, but it is the most common malignant salivary gland tumor in this group. Reconstructive surgery is often required due to cystic lesions or resection of malignancy in the oral cavity. Buccal fat pad (BFP) is a flap that is reliable and suitable for reconstructing oral defects because it has a low complication rate and small volume change over time. Case Presentation: We report the case of a 12-year-old female patient with low-grade MEC on light soft palate with no neck metastasis. After tumor resection the palatal mucosal defect was reconstructed with a BFP flap. Conclusion: The purpose of this article is to discuss the features and treatment methods of MEC that is rarely occurring in children, and the usefulness of BFP for reconstruction. Therefore, we will make a precise diagnosis and treatment as we examine the clinical feature and review the literature.

Natural products are vastly utilized as a source of chemotherapeutic agents for human cancers. Kochia scopraia is traditionally used for the cure of urological and dermatological diseases. Recently, methanol extract of Kochia scoparia (MEKS) has been shown to have anti-cancer activity to various human cancers. However, there is no report demonstrating the anti-cancer activity of MEKS in human mucoepidermoid carcinoma (MEC) cells. In this study, the authors studied the effects of MEKS on the cell proliferation and underlying mechanism in YD15 human MEC cells. MEKS decreased YD15 cell proliferation proven by trypan blue exclusion assay and induced apoptosis, evidenced by cell cycle analysis and western blotting. Autophagy induction by MEKS was verified by western blotting. In addition, MEKS regulated the expression of phosphorylated Akt, phosphorylated p38 and Nrf2 protein. This results can imply that MEKS might be a potential candidate for the treatment of human MEC cells.

담관내 유두상 점액 종양은 담관내에서 흔히 발견되며, 최근에는 전암성 병변으로 인식되어 왔다. 담관내 상피세포의 유듀상 성장과 점액생성 및 그로 인한 간내담관의 확장을 특징으로 한다. 수술적 절제가 악성 변화를 막기 위한 최선의 방법이다. 담관내 유두상 점액 종양에 대한 연구가 증가하고 있지만 수술이외의 치료에 대한 보고는 많지 않다. 우리는 75세 여자 환자가 우연히 담관내 유두상 점액 종양으로 진단 받고 아르곤 플라즈마 응고소작술로 성공적 치료를 받은 경우를 보고한다. 환자의 나이와 동반질환 등을 고려하여 수술 적 절제보다는 아르곤 플라즈마 응고소작술을 시행하였고, 치료 4주 후 시행한 경피 경간 담도내시경에서 잔여종양의 증거는 없었다.

Background: Cisplatin is a well-known platinum-containing anti-cancer drug against bladder, ovarian, lung and testicular cancer. However, the potential effects and molecular targets of cisplatin in human mucoepidermoid carcinoma (MEC) are not fully understood. Here, we investigated the apoptotic effect and underlying mechanism of cisplatin in human MEC cells. Methods: The potential effects of cisplatin were evaluated by trypan blue exclusion assay, Western blotting, 4’-6-diamidino-2-phenylindole (DAPI) staining, live/dead assay and immunocytochemistry. Results: Cisplatin suppressed cell growth and enhanced expression of cleaved PAPR in MC3 and YD15 cells. Cisplatin caused morphological change of nuclei and increased the number of ethidium homodimer-1-stained cells. In addition, cisplatin commonly increased Bax activation in both cells, while other Bcl-2 family proteins were not affected. Conclusions: These results suggest that cisplatin might induce apoptosis by activating Bax protein, which would provide baseline data for development of effective treatment strategy against MEC.

For the last few decades, especially during summer Korean aquaculture industry has been huge economic loss due to massive blooms caused by Cochlodinium polykrikoides. Moreover, high dispersion speed along the coast and high cell densities (above 10,000 cells ml−1) of C. polykrikoides resuling in red tides for a longer duration (at least for 30 days). C. polykrikoides can be used as a prolific source of extracellular sulfated polysaccharides. Sulfated polysaccharides have showed strong antiviral properties against influenza virus. However, little has been investigated about industrial application of sulfated polysaccharides as a high valuable byproduct from C. polykrikoides. Current commercial microalgal biomass production systems are costly and require advanced instrumental and cultural facilities. From economic point of natural blooms of C. polykrikoides, therefore it is likely to be utilized as a cost-effective way of microalgal biomass production for commercial applications.

췌장의 점액성 낭성 종양(mucinous cystic neoplasm)은 국내 다기관 연구에 의하면 전체 췌장 낭성 종양의 약 25%를 차지하고 있다. 대부분 중년 여성에게 호발하고, 병변은 췌장 체부 및 미부에 위치하며, 점액성 낭선암(mucinous cystadenocarcinoma) 으로 악화될 수 있는데, 크기가 서서히 증가하므로 이의 파열은 매우 드문 합병증이다. 저자들은 72세 남성에서 발생한 췌장 점액성 낭선암의 자발 파열 증례를 문헌 고찰과 함께 보고하는 바이다.

급성 췌장염 중에 1차 검사에서 원인이 불명확한 경우 급성 특발성 췌장염이라고 하며 그 중 종양에 의한 것은 비교 적 드물지만 진단이 늦어질 경우 예후가 좋지 않아 먼저 의심하는 것이 매우 중요하다. 본 증례는 급성 특발성 췌장염 환자에서 악성종양을 의심하고 적극적으로 추적관찰하던 과정에서 초음파내시경상 이상소견이 확인되었고, 적절한 시기에 수술을 결정하여 췌관내유두상점액종양 관련 침습 암을 진단한 경우이다. 따라서 원인이 불분명한 췌장염에 대해 악성종양을 의심하는 것이 필요함을 강조함과 동시에 초음파내시경의 추적관찰이 진단에 도움이 된 실제 사례를 보고함으로써 앞으로의 진료 및 의사결정에 유익할 것으로 보여 문헌과 함께 보고하는 바이다.