Central pncreatectomy (CP) can be one of procedures for function-preserving pancreatectomy for patients with benign or low grade malignant pancreatic tumors. Surgeons have to deal with two cut surface of the pancreas when performing CP, which can be associated with severe complication, such as postoperative pancreatic fistula. Fine and delicate surgical skill is highly required for safe CP. With the advance of minimally invasive surgery, CP is now thought to be one of appropriate procedures for function-preserving minimally invasive pancreatectomy. Robotic surgery is thought to make complicated surgical procedure easy and effective. Recently, Korean robotic surgical system, Revo-i, was successfully developed by Meeraecompany and have been proved its safety and feasibility in several recent reports. A 56-year old woman was referred for a body of pancreatic lesion. Contrast abdominopelvic CT revealed a pancreatic body tumor measuring around 1.2 cm in diameter. The patient underwent a robot-assisted central pancreatectomy using Revo-i. The patient endured the procedure well and was discharged to home at postoperative day 9. This report showed a successful case of central pancreatectomy performed with the Korean robotic surgical system Revo-i.

There is a potential risk that lobular carcinoma in situ (LCIS) on preoperative biopsy might be diagnosed as ductal carcinoma in situ (DCIS) or invasive carcinoma in the final pathology. This study aimed to evaluate the rate of upgrade of LCIS on preoperative biopsy to DCIS or invasive carcinoma. Materials and MethodsData of 55 patients with LCIS on preoperative biopsy were analyzed. All patients underwent surgery between 1991 and 2016 at Severance Hospital in Seoul, Korea. We analyzed the rate of upgrade of preoperative LCIS to DCIS or invasive cancer in the final pathology. The clinicopathologic features related to the upgrade were evaluated. ResultsThe rate of upgrade of LCIS to DCIS or invasive carcinoma was 16.4% (9/55). In multivariate analysis, microcalcification and progesterone receptor expression were significantly associated with the upgrade of LCIS (p=0.023 and 0.044, respectively). ConclusionThe current study showed a relatively high rate of upgrade of LCIS on preoperative biopsy to DCIS or invasive cancer. The presence of microcalcification and progesterone receptor expression may be potential predictors of upgradation of LCIS on preoperative biopsy. Surgical excision of the LCIS during preoperative biopsy could be a management option to identify the concealed malignancy.

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Background: There is a potential risk that lobular carcinoma in situ (LCIS) on preoperative biopsy might be diagnosed as ductal carcinoma in situ (DCIS) or invasive carcinoma in the final pathology. This study aimed to evaluate the rate of upgrade of LCIS on preoperative biopsy to DCIS or invasive carcinoma.Methods: Data of 55 patients with LCIS on preoperative biopsy were analyzed. All patients underwent surgery between 1991 and 2016 at Severance Hospital in Seoul, Korea. We analyzed the rate of upgrade of preoperative LCIS to DCIS or invasive cancer in the final pathology. The clinicopathologic features related to the upgrade were evaluated.Results: The rate of upgrade of LCIS to DCIS or invasive carcinoma was 16.4% (9/55). In multivariate analysis, microcalcification and progesterone receptor expression were significantly associated with the upgrade of LCIS (P = 0.023 and 0.044, respectively).Conclusions: The current study showed a relatively high rate of upgrade of LCIS on preoperative biopsy to DCIS or invasive cancer. The presence of microcalcification and progesterone receptor expression may be potential predictors of upgradation of LCIS on preoperative biopsy. Surgical excision of the LCIS during preoperative biopsy could be a management option to identify the concealed malignancy.

According to the American Joint Committee on Cancer's 8th Edition Manual, lobular carcinoma in situ (LCIS) is no longer considered a malignant disease, although it may be a precursor to the development of breast cancer. The present study aimed to evaluate the clinicopathological features and prognosis of LCIS. Methods: This study retrospectively analyzed clinicopathological features and prognosis data of LCIS among patients who underwent breast surgery at Severance Hospital, Seoul, South Korea from 1991 to 2016. Results: Of the 47 patients, 49 cases of LCIS were confirmed by postoperative pathology. The mean patient age was 48.15± 8.34 years. Most patients (81.6%) did not have palpable tumors at diagnosis, and 51.0% showed no microcalcification on mammography. Breast-conserving surgery was performed more frequently than total mastectomy (77.6% vs. 22.4%). The mean tumor size was 1.63± 2.11 cm. There were only 3 cases of pleomorphic LCIS. Hormone receptor-positive tumors were noted in 47 cases, however, the hormone receptor status was unknown in the other 2 cases. There were no LCIS recurrences or deaths during the follow-up period (mean 56 months). Conclusion: LCIS is often incidentally diagnosed without clinical symptoms, especially in women aged < 50 years. The prognosis of LCIS is excellent in cases that are surgically treated.