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13 "Recurrence"
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Case report
Locally recurrent primary adrenal leiomyosarcoma discovered incidentally 7 years after initial surgery: a case report
Myungsoo Im, Doohwa Kim, Soree Ryang, Bo Hyun Kim
Kosin Med J. 2026;41(1):85-90.   Published online March 20, 2026
DOI: https://doi.org/10.7180/kmj.25.129
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Abstract PDFPubReader   ePub   
Primary adrenal leiomyosarcoma (PAL) is an aggressive, rare tumor that is frequently diagnosed at an advanced stage. We report the case of a 65-year-old female patient with hypertension who presented with stabbing lower abdominal pain and unintentional weight loss. Abdominal computed tomography (CT) demonstrated a 10.4×8.2×8.1 cm heterogeneous left adrenal mass without biochemical evidence of hormonal hypersecretion. Retroperitoneal left adrenalectomy was performed without complications, and histopathological examination confirmed a moderately differentiated adrenal leiomyosarcoma. The patient was followed at the outpatient oncology clinic for 5 years with no evidence of recurrence. Seven years after the initial surgery, a newly detected left suprarenal mass was identified on imaging. Abdominal CT revealed a new, well-circumscribed 7.1×6.4×6.2 cm heterogeneous mass. Laparoscopic resection of the recurrent mass was performed. Pathological examination again revealed a moderately differentiated leiomyosarcoma with positive surgical margins but no lymphovascular invasion. Immunohistochemical staining was positive for smooth muscle actin, desmin, h-caldesmin, neuron-specific enolase, and synaptophysin, findings consistent with recurrent adrenal leiomyosarcoma. This case demonstrates that PAL can recur locally after prolonged disease-free intervals, underscoring the importance of extended surveillance, potentially beyond 10 years.
Original articles
The solid predominant subtype as an independent risk factor for recurrence in patients with pathologic stage I lung adenocarcinoma
Chul Ho Lee, Yun-Ho Jeon
Kosin Med J. 2023;38(2):117-125.   Published online June 8, 2023
DOI: https://doi.org/10.7180/kmj.23.103
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Abstract PDFPubReader   ePub   
Background
Increasingly many patients have been diagnosed with stage I adenocarcinoma due to the use of low-dose chest computed tomography for lung cancer screening. Therefore, this study aimed to analyze tumor recurrence based on the predominant subtype in patients with stage I lung adenocarcinoma who underwent lobectomy.
Methods
We retrospectively analyzed 114 patients who underwent lobectomy for pathologic stage I lung adenocarcinoma from June 2001 to July 2019.
Results
In univariate analyses, significant factors were current smoking at the time of surgery (p=0.029), pathologic tumor size (p=0.006), central tumor location (p=0.003), maximum standardized uptake value on positron emission tomography-computed tomography (p=0.001), and the solid predominant subtype (p=0.012). In the multivariate analysis, only the solid predominant subtype (hazard ratio, 9.702; 95% confidence interval, 1.179–79.874; p=0.035) was an independent risk factor.
Conclusions
If the solid subtype is predominant in pathologic findings, adjuvant chemotherapy after standard surgical resection may be considered to help reduce the risk of tumor recurrence and increase survival.
Observational Study for Adverse Effects and Discontinuation with Long-Term Post-Operative Hormonal Treatment for Endometriosis in Real-World Practice
In Hye Kim, Hyungjoon Yoon, Hyun Joo Lee, Hye Kyung Noh, Jong Kil Joo, Ki Hyung Kim
Kosin Med J. 2021;36(2):116-124.   Published online December 31, 2021
DOI: https://doi.org/10.7180/kmj.2021.36.2.116
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  • 2 Citations
Abstract PDFPubReader   ePub   
Objectives

To evaluate the side effects and causes of discontinuation of either combined oral contraceptives or dienogest (DNG) used to prevent recurrence in patients with surgically confirmed endometriosis.

Methods

We retrospectively analyzed the medical records of 213 women with endometriosis who had been treated with combined oral contraceptives (ethinyl estradiol 0.02 mg/drospirenone 3 mg [EE/DRSP]) or DNG 2 mg for 12 months or more. The side effects reported by the patients, laboratory parameters, causes of discontinuation of medication, and recurrence rates were evaluated one, two, three, four, and five years after starting medication (Y1, Y2, Y3, Y4, and Y5).

Results

EE/DRSP were administered to 59 patients, while DNG was administered to 154 patients. The mean durations of postoperative use of EE/DRSP and DNG were 44.5 ± 22.6 months and 23.6 ± 13.5 months, respectively. The prevalence of side effects was 27.1%, 19.0%, 10.0%, 10.5%, and 7.4% in the EE/DRSP group and 29.2%, 15.7%, 14.0%, 23.1%, and 0.0% in the DNG group at Y1, Y2, Y3, Y4, and Y5, respectively. The discontinuation rates were 1.7%, 1.7%, 4.0%, 0.0%, and 7.4% at Y1, Y2, Y3, Y4, and Y5, respectively, in the EE/DRSP group and 10.4%, 3.3%, 4.0%, 3.8%, and 0.0% at the same times in the DNG group. The recurrence rates were less than 4% in both the groups.

Conclusions

The side effects of commonly prescribed postoperative hormone treatments were relatively mild, and the occurrence of side effects decreased with continuous administration. Further, the long-term use of postoperative hormone treatments is likely to prevent recurrence of endometriosis after surgery.

Citations

Citations to this article as recorded by  
  • Efficacy and safety endpoints of dienogest treatment of endometriosis: a systematic review
    Maria I. Yarmolinskaya, Elena N. Andreeva, Vitaly F. Bezhenar, Alexander A. Popov, Sofya A. Cherkashina
    Journal of obstetrics and women's diseases.2025; 74(4): 86.     CrossRef
  • Promoting Physical Activity and Limiting Sedentary Behaviors to Manage Pain in Endometriosis: What Are the Psychosocial Variables to Take into Account?
    Tracy Milane, Ulysse Herbach, Marie-Anne Jean, Géraldine Escriva-Boulley
    Women's Reproductive Health.2025; : 1.     CrossRef
Cribriform Pattern at the Surgical Margin is Highly Predictive of Biochemical Recurrence in Patients Undergoing Radical Prostatectomy
Kyung Hwan Kim, Ja Yoon Ku, Chan Ho Lee, Won Young Park, Hong Koo Ha
Kosin Med J. 2019;34(2):95-105.   Published online December 31, 2019
DOI: https://doi.org/10.7180/kmj.2019.34.2.95
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  • 1 Citations
Abstract PDFPubReader   ePub   
Objectives

We investigated the relationship between cribriform patterns and biochemical recurrence in patients with positive surgical margins after radical prostatectomy.

Methods

This study was based on radical prostatectomy specimens obtained from 817 patients (165 with margin-positive status) collected at a single center between 2010 and 2016. We retrospectively analyzed and compared body mass index, preoperative prostate-specific antigen, Gleason score, operative methods, postoperative Gleason score, pathological T-stage, tumor percentage involvement, lymphatic and perineural invasion, prostate-specific antigen nadir, location and length of the positive margin, cribriform pattern status, and Gleason grade at the surgical margin in terms of their association with biochemical recurrence. Risk factors for biochemical recurrence were also investigated.

Results

21% (31/146) of surgical margin-positive patients had a cribriform pattern. Nadir prostate-specific antigen, perineural invasion and biochemical recurrence rates were significantly higher in cribriform pattern present group than absent group (P = 0.031, 0.043 and 0.045, respectively). According to the Cox regression model, postoperative Gleason score, tumor percentage involvement, location and length of the positive margin, and the presence of a cribriform pattern at the surgical margin were significant predictive factors of biochemical recurrence (P = 0.022, < 0.001, 0.015, 0.001, and 0.022, respectively). Moreover, the biochemical recurrence risk was approximately 3-fold higher in patients with a cribriform pattern at the surgical margin than in those without (HR: 3.41, 95% CI 1.20-9.70, P = 0.022).

Conclusions

A cribriform pattern at the surgical margin is a significant predictor of biochemical recurrence in patients who undergo radical prostatectomy.

Citations

Citations to this article as recorded by  
  • Length of positive surgical margins after radical prostatectomy: Does size matter? – A systematic review and meta-analysis
    Athul John, Alicia Lim, Rick Catterwell, Luke Selth, Michael O’Callaghan
    Prostate Cancer and Prostatic Diseases.2023; 26(4): 673.     CrossRef
Analysis of factors related systemic recurrence after breast conserving surgery in stage I breast cancer
Yoon-Seok Kim, Dong-Won Ryu, Chung-Han Lee
Kosin Med J. 2018;33(3):289-296.   Published online December 31, 2018
DOI: https://doi.org/10.7180/kmj.2018.33.3.289
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Abstract PDFPubReader   
Objectives

In these days, patients with stage I breast cancer have increased by regular health examination and diagnostic tool development. The aim of this retrospective study is to identify systemic recurrence related factors after breast conserving surgery (BCS) for stage I breast cancer.

Methods

In this study, we analyzed the correlation between systemic recurrence and pathologic factors. We reviewed 223 patients who underwent BCS for stage I breast cancer. Postoperative pathologic factors, recurrent rates and sites were studied. In addition, preoperative patients'data were also collected. Statistical analysis was done by using PASW 16.0 (SPSS Inc., Chicago, IL, USA).

Results

Systemic recurrence was found in 16 patients (7.17%) within 5 years after primary surgery. 5 patients had lymphatic invasion and 6 patients had vascular invasion. Lymphatic and vascular invasion had statistical correlation with systemic recurrence (P = 0.004, P = 0.001).

Conclusions

In this retrospective study, we can conclude that vascular invasion and lymphatic invasion are related systemic recurrence after BCS for stage I patients. Further studies with large cohort will be required to fully understand the risk factors of systemic recurrence for stage I breast cancer patients.

Empirical antibiotics for recurrent urinary tract infections in children
Hyun Gil Choi, Ji Young Lee, Chi Eun Oh
Kosin Med J. 2018;33(2):159-170.   Published online December 31, 2018
DOI: https://doi.org/10.7180/kmj.2018.33.2.159
  • 3,745 View
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Abstract PDFPubReader   ePub   
Objectives

The purpose of this study was to compare antibiotic resistance patterns between first urinary tract infection (UTI) and recurrent UTI groups and to obtain information regarding empirical antibiotic selection for treating recurrent UTI.

Methods

We retrospectively reviewed 148 children treated for UTIs from January 2009 to June 2016. The patients were divided into two groups: first UTI (N = 148) and recurrent UTI (17 patients and 20 episodes).

Results

In both groups, Escherichia coli was the most frequent causative organism, accounting for 89.9% and 75.0% in the first and recurrent UTI groups, respectively. When E. coli or Klebsiella pneumoniae was the causative organism, extended-spectrum β-lactamase (ESBL)-producing organisms were more frequent in the recurrent UTI group (17.6%) than in the first UTI group (14.0%); however, this difference was not statistically significant (P = 0.684). Cefotaxime was the most frequently used first-line empirical antibiotic in both groups. In the first UTI and recurrent UTI groups, 7.4% and 15.0% of patients were treated with intravenous antibiotics as definitive therapy, respectively (P = 0.250). Fifteen out of 17 patients having a second UTI had different causative organisms or antibiotic susceptibility patterns compared to their previous episode.

Conclusions

Escherichia coli was the most frequent causative organism in the recurrent UTI group. There were no differences in the proportion of ESBL-producing organisms between the first UTI and recurrent UTI groups. Therefore, when a UTI recurs in children, the antibiotics effective on the most common causative organism might be administered as empirical antibiotics.

Case reports
Recurrent fetal postpartum stress induced cardiomyopathy after normal vaginal delivery
Yong-Sun Noh, Sung-Ho Her, Jong Bum Kwon, Chan Joon Kim, Tae-Seok Kim
Kosin Med J. 2017;32(2):244-250.   Published online December 29, 2017
DOI: https://doi.org/10.7180/kmj.2017.32.2.244
  • 3,547 View
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  • 1 Citations
Abstract PDFPubReader   ePub   

Stress induced cardiomyopathy is a disease that shows a dysfunction of the ventricle, but it can be rapidly reversible. It often occurs in older women primarily who suffers from emotional or physical stress. There are some case reports about postpartum stress induced cardiomyopathy. Most of the patients are recovered naturally within days to weeks. We report a case of a 37 years-old woman, who had experienced postpartum stress induced cardiomyopathy 8 years ago, revisited hospital because of cardiomyopathy after secondary delivery. Herein we report a rare case of recurrent stress induced cardiomyopathy after secondary normal vaginal delivery.

Citations

Citations to this article as recorded by  
  • Takotsubo Cardiomyopathy in Pregnancy: A Focused Review
    Heena Garg, Shashi Singh, Rashmi Ramachandran, Anjan Trikha
    Journal of Obstetric Anaesthesia and Critical Care.2023; 13(2): 142.     CrossRef
A Case of Steroid Resistant Minimal Change Disease Associated with Portal Vein Thrombosis Treated by Combined Immunosuppressive Agents
Hyo Jin Jung, Su Mi Lee, Seo Hee Rha, Seong Eun Kim, Young Ki Son, Ki Seung Kim, Won Suk An
Kosin Med J. 2017;32(1):90-98.   Published online June 30, 2017
DOI: https://doi.org/10.7180/kmj.2017.32.1.90
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Abstract PDFPubReader   ePub   

Minimal change disease (MCD) is a common cause of nephrotic syndrome and relatively well responds with steroid treatment. However, nearly half of patients with MCD experience recurrence of nephrotic syndrome. Thromboembolic events including renal vein thrombosis may occur in patients with MCD, but portal vein thrombosis rarely occurs. We experienced a case of frequent relapse/steroid dependent MCD with nephrotic syndrome progressed to steroid resistance associated with portal vein thrombosis. This patient showed complete remission of MCD and resolution of portal vein thrombosis after treatment with corticosteroid, cyclosporine, mycophenolate mofetil, and anticoagulant.

A Case of Pulmonary Paragonimiasis Mimicking Chronic Eosinophilic Pneumonia
Sae Jin Park, Hee Kyoo Kim, Bong Joon Kim, Cheon Woo Lee, Chul Ho Oak, Man Hong Jung
Kosin Med J. 2010;25(2):154-158.   Published online December 31, 2010
  • 792 View
  • 3 Download
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Original article
Postoperative Adjuvant Chemotherapy and Concurrent Chemoradiotherapy in Patients with Rectal Cancer of Stage 2 and 3
Ho Sup Lee, Yang Soo Kim
Kosin Med J. 2008;23(4):162-169.   Published online December 31, 2008
  • 671 View
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Case report
A Case of Advanced Gastric Cancer with Solitary Perianal Metastasis
Kyung Hyun Choi, Ki Young Yoon, Sang Ho Lee
Kosin Med J. 2007;22(2):210-212.   Published online December 31, 2007
  • 713 View
  • 1 Download
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Original articles
Prognostic Factors of Recurrence and Progression in T1 Bladder Transitional Cell Carcinoma
Eun Ho Son, Seok Su Jo, Chang Kyu Lee, Hyun Yul Rhew
Kosin Med J. 2001;16(1):112-119.
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Clinical Indications of Nephron Sparing Surgery
Cheol Bo Park, Ju Seok Kang, Chang Gyu Lee, Hyun Yul Rhew
Kosin Med J. 2002;17(1):41-47.
  • 828 View
  • 0 Download
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