Bowel Perforation after Erlotinib Treatment in a Patient with Non-Small Cell Lung Cancer

Erlotinib is accepted as a standard second-line chemotherapeutic agent in patients with non-small cell lung cancer who are refractory or resistant to first-line platinum-based chemotherapy. There has been no previous report of bowel perforation with or without gastrointestinal metastases related to erlotinib in patients with non-small cell lung cancer. The exact mechanism of bowel perforation in patients who received erlotinib remains unclear. In this report, we report the first case of enterocutaneous fistula in a female patient with metastatic non-small cell lung cancer 9 months, following medication with erlotinib as second-line chemotherapy.

A Case of Atypical Giant Cell Arteritis Presenting as Raynaud's Phenomenon and Diagnosed by Random Temporal Artery Biopsy / 대한류마티스학회지

Giant cell arteritis (GCA) is a chronic vasculitis that mainly involves the cranial branches of arteries, and typically it presents with a cephalic sign such as a new headache, jaw claudication and/or visual symptoms. Although the tender, swollen or beaded arteries are adequate sites for biopsy, random temporal artery biopsy should be performed in all the patients suspected of suffering with GCA and even if cephalic signs are not present. Several cases of typical GCA have been reported in Korea, but so far there have been no reports of an atypical case presenting with Raynaud's phenomenon, and the patient was diagnosed by random temporal artery biopsy. Here we describe a case that showed the typical pathological findings of GCA in an asymptomatic temporal artery. The patient complained of only Raynaud's phnomenon and the patient was without any cephalic symptoms.

Renal Pelvic Hematoma Induced by Delayed Re-bleeding After Renal Biopsy / 대한신장학회지

Renal biopsy is a useful method for the diagnosis of kidney disease. Complications may occur and are usually associated with bleeding. However, delayed recurrent bleeding is so rare. We report a case of renal pelvic hematoma and hydronephrosis occurred by delayed re-bleeding after percutaneous needle renal biopsy. A 42-year-old woman was admitted to our institution via emergency room with gross hematuria and left flank pain, which had started on that day. Renal biopsy had been done 8 days earlier. Computed tomography (CT) angiography revealed left hydronephrosis caused by pelvic hematoma and we observed bloody urine in the left ureteral orifice on cystoscopy. Hydration, diuresis and double J stent insertion restored hydronephrosis and hematuria was disappeared. Even though renal pelvic hematoma by delayed bleeding occurs rarely after percutaneous needle kidney biopsy, we should consider this complication when delayed recurrent gross hematuria occurs after kidney biopsy.

Treatment of Pseudoaneurysm Caused by Insertion of Dual Lumen Catheter for Hemodialysis: A Case Report / 대한신장학회지

In patients with end-stage renal disease, cannulation of the central venous system with large-bore dual-lumen catheters is often necessary until a functioning vascular access can be created. However, the technique of placing a dual-lumen catheter can make complication. The right internal jugular vein is the preferred site of hemodialysis catheter placement because its complication rate was lower compared with the subclavian and left internal jugular veins. Common complications include severe bleeding, hematoma formation, pneumothorax and hemothorax, atrial or ventricular arrhythmias, malposition of the catheter, air embolism, secondary infections, and intraarterial placement of the catheter. We report an unusual case of pseudoaneurysm of the superior thyroidal artery complicating an attempt of internal jugular-vein catheterization which was successfully treated by endovascular coil embolization.

A Case of Polyarthritis Caused by Mycobacterium Marinum Infection Mistaken for Rheumatoid Arthritis / 대한류마티스학회지

Mycobacterium marinum (M. marinum) is a nontuberculosis mycobacterium that is normally associated with cutaneous lesions. Most cases occur after an individual has suffered minor trauma in association with contaminated fresh or salt water. In immunocompromised patients, M. marinum can cause osteomyelitis, synovitis and/or disseminated infection, which can be mistaken for rheumatoid arthritis (RA) or remitting seronegative symmetrical synovitis with pitting edema (RS3PE). Therefore, precise history taking and specimen culture are very important for early diagnosis and appropriate treatment. We report an unusual case of septic polyarthritis due to M. marinum that was diagnosed by culture and improved with antibiotic therapy.