Congenital esophageal stenosis caused by tracheobronchial remnants: A case report.

Congenital esophageal stenosis caused by tracheobronchial remnants is a rare anomaly in infants and children that results in dysphagia and recurrent pneumonia. An accurate diagnosis is needed because this anomaly does not respond well to instrumental dilatation, such as bougienage and balloon dilatation, and requires surgical resection. Herein, I report a case of congenital esophageal stenosis caused by tracheobronchial remnants with characteristic imaging findings.

Sphincter of Oddi incompetence associated with duodenal stenosis in a newborn: A case report.

Newborn incompetence of the sphincter of Oddi is rare. While there are many causes of reflux of air or ingested contrast material into the biliary tree in adults, in the newborn, it is usually due to incompetence of the sphincter of Oddi associated with partial or complete duodenal obstruction. This paper presents upper gastrointestinal series findings of incompetence of the sphincter of Oddi associated with duodenal stenosis in a 3-day-old newborn. If pneumobilia is identified in the newborn, although the possibility is low, clinicians should consider incompetence of the sphincter of Oddi with duodenal obstruction as well as portal vein gas.

[Rice Bodies Presenting as Intra-Articular Masses in Pediatric Idiopathic Arthritis: A Case Report]. / 소아기 특발성 ê´€ì ˆì—¼ 환자에서 ê´€ì ˆ 내 ì¢ ì–‘í˜•íƒœë¡œ 나타난 쌀소체: 증례 ë³´ê³ .

Rice bodies are commonly detected in adults with rheumatoid arthritis and rarely occur in children. An 11-year-old female adolescent who visited our hospital for evaluation of knee pain underwent a MRI scan, which revealed an intra-articular mass. Arthroscopic examination of the mass confirmed conglomerated rice bodies. We report a case of rice bodies that clinically presented as intra-articular masses.

[Complete Rupture of the Extensor Hallucis Longus Tendon with Accessory Slip Mimicking a Partial Rupture: A Case Report]. / 부분파열로 오인된 긴엄지발가락폄근의 주힘줄의 ì™„ì „íŒŒì—´ê³¼ 동반된 보조힘줄: 증례 ë³´ê³ .

The accessory tendon of the extensor hallucis longus is a common type of extensor hallucis longus variation. This is a case of a 38-year-old female patient who initially considered conservative treatment for a suspected partial rupture, but finally underwent surgery after being diagnosed with a complete rupture of the main tendon and accessory tendon medial to the main tendon on MRI scan.

[Primary Neuroendocrine Carcinoma of the Breast: A Case Report and Literature Review]. / ìœ ë°©ì—ì„œ 발생한 원발성 ì‹ ê²½ë‚´ë¶„ë¹„ì•”ì¢ : 증례 ë³´ê³ ì™€ ë¬¸í—Œê³ ì°°.

In general, neuroendocrine cancer develops in the digestive or respiratory tract, and when it is found in other organs, it is often due to metastasis. Primary neuroendocrine carcinoma of the breast occurs very rarely, and the exact clinical picture, radiological findings, treatment and prognosis are not well known. Furthermore, only a small number of literature reports have been published. Here, we report the imaging findings of primary neuroendocrine carcinoma in the breast of a 51-year-old female, along with a literature review.

[Radiologic Manifestations of Pulmonary Nuclear Protein in Testis Midline Carcinoma: A Case Report]. / 폐에 발생한 ê³ í™˜ 핵단백질 ì •ì¤‘ì„ ì•”ì˜ ì˜ìƒì˜í•™ì  소견: 증례 ë³´ê³ .

Nuclear portein in testis (NUT) midline carcinoma is a very rare and low-differentiating malignant epithelial tumor that differentiates very aggressively and has poor prognosis. NUT midline carcinoma occurring in the lungs in particular can be confused with other cancers because few cases have been reported in Korea to date and can show various histological forms. Reports of radiology findings are very rare worldwide. Here we report the imaging findings of pulmonary NUT midline carcinoma in a 25-year-old female along with pathological findings.

Imaging Findings of Metaplastic Breast Carcinoma with Chondroid Differentiation: A Case Reports.

Metaplastic carcinoma of the breast is a heterogeneous group of neoplasms with mixed epithelial and mesenchymal differentiation. Metaplastic carcinoma of the breast is a rare and aggressive malignancy, with high recurrence and metastasis. Metaplastic carcinoma with chondroid differentiation is an uncommon subtype that tends to have a relatively good prognosis than that of other subtypes. We report the imaging features of three cases of pathologically proven metaplastic carcinoma with chondroid differentiation as follows: a high-density mass with amorphous or coarse heterogeneous calcifications on mammography; a microlobulated or partially indistinct, complex cystic, and solid mass on sonography; and a relatively circumscribed or partially indistinct, irregular mass with heterogeneous T2 high-signal intensity and heterogeneous or rim enhancement with initial fast enhance ment and delayed washout on MRI.

[A Rare Case of Thoracic Intradural Epidermoid Cyst after Spinal Cord Stimulator Insertion: A Case Report]. / 척수 자극기 ì‚½ìž ìˆ ì„ 받았던 환자에게 드물게 생긴 흉추부 경막내 표피양 ë‚­ì¢ : 증례 ë³´ê³ .

Spinal epidermoid cysts are extremely rare benign tumors and can be congenital or acquired. Acquired spinal epidermoid cysts are found in the lumbosacral region. To our knowledge, no case of epidermoid cyst related to spinal cord stimulator insertion has yet been reported. We report the MRI findings of a rare case of thoracic intradural epidermoid cyst acquired after spinal cord stimulator insertion in a 50-year-old female.

A 6-Month-Old Girl with Incontinentia Pigmenti Presenting as Status Epilepticus.

Incontinentia pigmenti (IP) is an uncommon neurocutaneous syndrome. Its initial diagnosis is based primarily on characteristic papulovesicular skin lesions and early-onset neonatal seizures. In contrast to typical early neurologic manifestations, we encountered a normally developed 6-month-old female patient with hyperpigmented whorls on her body. Following respiratory syncytial virus infection and fever, the patient exhibited status epilepticus. Brain magnetic resonance imaging studies of the patient were compatible with the findings of acute encephalopathy in IP. Genetic analysis showed an 11.7 kb deletion within the gene encoding inhibitor of kappa-B kinase gamma. The patient was treated with anticonvulsants and subsequently reached expected developmental milestones after discharge. These findings indicate that when a patient presents with status epilepticus, meticulous examination for skin lesions should be performed to determine whether the patient has a neurocutaneous syndrome, such as IP.

Adenovirus infection with serious pulmonary sequelae in Korean children.

INTRODUCTION: Varying clinical progress and long-term pulmonary sequelae have been associated with different adenoviral serotypes. OBJECTIVE: The purpose of this study was to determine the association between serotype and clinical profiles of pediatric adenoviral pneumonia cases that occurred in Korea from 1996-1998. METHODS: Nasopharyngeal aspirate samples from 44 adenovirus-positive patients presenting with acute severe respiratory disease were sent to reference laboratories for serotyping. Clinical course and chest X-rays were analyzed during the acute phase, and HRCTs were performed during the convalescent phase to identify long-term pulmonary complications. RESULTS: Ad-7 was associated with the most severe clinical course and resultant long-term pulmonary sequelae, followed by milder clinical course and lower frequency of sequelae in Ad-3 cases, and even milder outcomes in children infected with Ad-5. CONCLUSIONS: In complicated adenoviral pneumonia, certain serotypes prevail with Ad-7 being the most severe. Continued serotyping with the eventual goal of creating a database for the early diagnosis, treatment and prognostication of adenoviral pneumonia is needed.

Seminoma in undescended testis.

A testicular carcinoma in intraabdominal undescended testis can mimic other mesenteric or retroperitoneal mass. The identification of pampiniform plexus draining the mass can play an important role in diagnosis of testicular carcinoma in undescended testis. We report a case of seminoma in intraabdominal undescended testis, draining into pampiniform plexus and thrombus within it.

Radiological spectrum of hepatic mesenchymal hamartoma in children.

OBJECTIVE: A hepatic mesenchymal hamartoma is an uncommon benign tumor in children and little is known about the spectrum of its radiological features. The purpose of this study is to describe the spectrum of radiological features of a hepatic mesenchymal hamartoma in children. MATERIALS AND METHODS: Thirteen children with a pathologically confirmed hepatic mesenchymal hamartoma (M:F = 7:6; mean age, 3 years 2 months) were included in our study. Ultrasonography (US) was performed in nine patients including color and power Doppler US (n = 7). CT scans were performed in all patients. We evaluated the imaging findings of the hepatic mesenchymal hamartomas and the corresponding pathological features. RESULTS: Each patient had a single tumor (mean diameter: 13 cm [1.8-20 cm]). On CT and/or US, four patients (31%) had a "multiseptated cystic tumor", five patients (38%) had a "mixed solid and cystic tumor", and four patients (31%) had a "solid tumor." The septa of the cystic portion were thin in the multiseptated cystic tumors and irregularly thick in the mixed solid and cystic tumors as seen on US. On a post-contrast CT scan, solid portions or thick septa of the tumors showed heterogeneous enhancement. The amount of hepatocytes was significantly different among the three tumor groups according to the imaging spectrum (p = 0.042). CONCLUSION: A hepatic mesenchymal hamartoma in children can show a wide spectrum of radiological features, from a multiseptated cystic tumor to a mixed solid and cystic tumor, and even a solid tumor.

[Clinical characteristics of intussusception in children: comparison between small bowel and large bowel type].

BACKGROUND/AIMS: Small bowel intussusception is rarely diagnosed in children. And its studies have not been frequently reported. While surgical treatment has been considered as standard treatment in small bowel intussusception in adult population, spontaneous reduction of it is increasingly reported recently. Therefore, we analyzed the clinical features and outcome of small bowel intussusception in children compared with ileocolic intussusception. METHODS: 95 children with the diagnosis of intussusception who visited Sanggye-Paik hospital were included in this study between March 2000 and December 2003. We retrospectively reviewed the clinical records and imaging findings. Ultrasonographic studies were performed by an experienced pediatric radiology staff using SEQUOIA 512 machine (probe 4-8 MHz). RESULTS: A total of 80 patients with ileocolic intussusception (41 male, 39 female) and 15 patients (11 male, 4 female) with small bowel intussusception were diagnosed. Children with small bowel intussusception were older than ileocolic intussusception (mean age: 40 months vs. 16 months). The presenting symptoms of small bowel intussusception were vomiting, irritability, abdominal pain, bloody stool, and abdominal mass in order and were not different with those of ileocolic intussusception. While in ileocolic intussusception group, reduction was done by gastrograffin enema (73.8%), spontaneous reduction (0%) and surgical reduction (26.3%), spontaneous reduction was done in 73.3% and surgical reduction in 20% in small bowel intussusception group. CONCLUSIONS: Small bowel intussusception in children occurred in older age than ileocolic intussusception and was reduced spontaneously in large proportion.

Clinical and electroencephalographic features of infantile spasms associated with malformations of cortical development.

The aim of this study was to reveal the clinical and encephalographic (EEG) features of infantile spasms (IS) with malformations of cortical development (MCDs). The clinical features, EEG findings, neuroimaging studies and outcomes of various therapeutic modalities for 27 patients with IS and MCDs were reviewed. Background activities of EEG on the MCDs, i.e. asymmetric hypsarrhythmia, localized persistent polymorphic slowing, asymmetric slowing and diffuse fast activities, were shown in 22, 15, 9 and 2 patients, respectively. Partial epileptiform discharges such as localized paroxysmal fast activities, spindle-shaped fast activities and subclinical seizures were shown in 15, 8 and 10 patients, respectively, and the lateralized prominence of generalized paroxysmal fast activities and generalized sharp and wave discharges in 4 and 5 patients, respectively. MCDs were suspected in 5 patients, as revealed by EEG and/or functional neuroimagings without distinct magnetic resonance imaging lesions, and confirmed by pathologic findings. Of the 11 patients treated with surgical resection, 8 became seizure free. EEG features can be very useful in the identification of underlying cortical dysgenesis in patients with IS. However, in one patient who underwent epilepsy surgery in early infancy, we observed easy bleeding and difficult hemostasis from friable vascular and parenchymal tissues. Various EEG features can be very useful in screening underlying MCDs. In addition, epilepsy surgery can be an effective therapeutic modality in many patients with otherwise medically intractable IS with MCDs. However, surgical intervention in extremely young infants should be performed with caution.