Primary Mucinous Adenocarcinoma of the Lower Eyelid

Purpose@#We report a case of a primary mucinous adenocarcinoma of the lower eyelid diagnosed in patient with a painless mass.Case summary: A 62-year-old male visited our clinic with a painless mass of the left lower eyelid of increasing the size for 2 months. Orbital computed tomography and magnetic resonance imaging revealed an approximately 2 cm well-defined ovoid, homogeneous enhancing mass in the left lower eyelid. A biopsy was performed under general anesthesia, and histopathologic examination confirmed mucinous adenocarcinoma. Final diagnosis was made as primary mucinous adenocarcinoma since torso positron emission tomography and computed tomography found no abnormal findings and extensive resection was performed for complete resection of the tumor. @*Conclusions@#Primary mucinous adenocarcinoma that occurs in the eyelid is a very rare malignant tumor, and a systemic examination to determine whether it is metastatic is essential, and due to its high local recurrence, regular follow-up after extensive resection is required.

Metastatic colon cancer of an ovarian cancer origin mimicking primary colon cancer: A case report

Metastatic colorectal cancer is rare and its origins are difficult to define if the gross features of colorectal cancer mimic primary colorectal cancer. However, accurate diagnosis is essential because the treatment and prognosis may vary depending on the origin of the cancer. This report is about a 74-year-old female patient with metastatic sigmoid colon cancer of ovarian origin that mimicked primary sigmoid colon cancer. She spent a 3-year period disease-free from ovarian cancer after surgery and adjuvant chemotherapy. At the time of initial diagnosis, the cancer was diagnosed as a primary sigmoid colon cancer, because the cancer appeared to be a solitary intra-luminal fungating mass. However, the final pathologic result showed that the cancer was metastatic sigmoid colon cancer of ovarian origin and it was confirmed by immunohistochemical staining of cytokeratins-7, -20, and Wilms tumor-1. Therefore, even if colorectal cancer is a single intra-luminal lesion, patients should be suspected of having metastatic colorectal cancer if they have other cancer histories. At this time, immunohistochemical staining using various cancer markers may be a useful tool to distinguish the origin of cancer.

A case of undifferentiated carcinoma with osteoclast-like giant cells of the pancreas / 대한내과학회지

An osteoclast-like giant cell tumor of the pancreas is a very rare neoplasm, with only three cases reported in Korea. Due to the rarity of this tumor type, few clinical data are available. We present a case of undifferentiated carcinoma with osteoclast-like giant cell tumor arising in the tail of the pancreas in a 72-year-old woman hospitalized to evaluate epigastric pain and a palpable abdominal mass. Magnetic resonance imaging revealed the presence of a large enhancing mass with septation arising from the tail of the pancreas. A distal pancreatectomy with splenectomy was performed. The pathological diagnosis was undifferentiated carcinoma with osteoclast-like giant cell tumor. Here, we describe the histopathological and immunohistochemical findings and review the clinical features of the cases reported in the Korean literature.

A case of primary hepatic epithelioid hemangioendothelioma with spontaneous rupture / 대한간학회지

Primary hepatic epithelioid hemangioendothelioma is a rare neoplasm of endothelial origin. The clinical manifestations are nonspecific, ranging from complete absence of symptoms to hepatic failure and death. Spontaneous rupture of a hepatic epithelioid hemangioendothelioma is an extremely rare presentation. We present a case of primary hepatic epithelioid hemangioendothelioma in a 65-year-old male patient with alcoholic liver cirrhosis. He was hospitalized due to epigastric pain and multiple liver masses on abdominal ultrasound. Dynamic liver CT imaging revealed multiple peripheral nodular enhanced mass lesions with delayed centripetal enhancement, and the adjacent collection of high-attenuation fluid along the liver capsule. Abdominal tapping revealed blood in the peritoneal cavity. Primary hepatic epithelioid hemangioendothelioma with spontaneous rupture was finally diagnosed based on a histopathologic examination revealing positive immunohistochemical staining for CD34.

Abnormal Blood Flow Between a Pericardial Mass and Right Atrium Detected by Echocardiography in a Case of a Ruptured Angiosarcoma of the Right Atrium

Spontaneous rupture of a primary cardiac angiosarcoma is a rare condition with a poor prognosis. The authors describe the case of a 48-year-old man with abnormal blood flow from a pericardial mass to the right atrium 3 months after pericardiocentesis. The flow was presumed to have occurred due to rupture of this cardiac angiosarcoma of the right atrial wall and pericardium into the right atrial cavity.

Abnormal Blood Flow Between a Pericardial Mass and Right Atrium Detected by Echocardiography in a Case of a Ruptured Angiosarcoma of the Right Atrium

Spontaneous rupture of a primary cardiac angiosarcoma is a rare condition with a poor prognosis. The authors describe the case of a 48-year-old man with abnormal blood flow from a pericardial mass to the right atrium 3 months after pericardiocentesis. The flow was presumed to have occurred due to rupture of this cardiac angiosarcoma of the right atrial wall and pericardium into the right atrial cavity.

A Case of Pneumatosis Cystoides Intestinalis / 대한소화기내시경학회지

Pneumatosis cystoides intestinalis (PCI) is characterized by the presence of multiple gas-filled cysts within the bowel wall. PCI may be idiopathic or secondary to a variety of disorders. Theories to explain cyst development include injury to the intestinal wall, a break in the mucosal barrier and rupture of a pulmonary bleb. PCI has been associated with chronic obstructive pulmonary disease, use of non-steroidal anti-inflammatory drugs, collagen vascular disease, organ transplantation, necrotizing enterocolitis, pseudomembranous colitis, and mechanical obstruction. PCI is usually found incidentally on an imaging study. Oxygen therapy has become the treatment of choice for patients with symptoms caused by pneumatosis. We experienced a case who found to have PCI by simple abdomen, computed tomography and colonoscopy in a diabetic patient who visited hospital due to abdominal pain accompanying with congestive heart failure. So, we report a case of PCI in a 53-year old woman with the review of recent literatures.

Carpal Tunnel Syndrome caused by tuberculous tenosynovitis in a patient on long-term hemodiaysis / 대한내과학회지

Carpal Tunnel Syndrome (CTS) in patients undergoing long-term hemodialysis is caused by a variety of etiologic factors. Especially deposition of dialysis-related amyloidosis has been regarded as one of important etiologic factors. Although tuberculosis (TB) of wrist is a rare form of extrapulomary TB occurring in approximately 1% of osteoarticular TB in nonuremic patients, occurrence of the CTS as a result of TB tenosynovitis in these patients has been previously reported. To our best knowledge, TB tenosynovitis in hemodialysis patients has not been reported in spite of high incidence of extrapulmonary TB. We report a case of CTS due to TB tenosynovitis in the 53-year-old male receiving hemodialysis for more than eighteen years, confirmed by biopsy in flexor tendon. Initially we made a hasty conclusion that CTS in the patient was caused by dialysis-related amyloidosis.

A Prospective Study on Duodenitis, Duodenal Ulcer, and Gastric Metaplasia in Children Infected by Helicobacter pylori / 대한소아소화기영양학회지

PURPOSE: Helicobacter pylori (H. pylori) infection has been known to be vital in the pathogenesis of duodenal ulcer disease in children as well as in adults. But the relationship between H. pylori infection and the histopathologic findings of the duodenum has not been explained obviously in children yet. So the aim of this study is to determine whether duodenitis and/or gastric metaplasia in the duodenum increases the risk of duodenal ulcer disease in children infected by H. pylori. METHODS: From October 2001 to April 2004 gastric and duodenal biopsies were performed in 177 children who visited Department of Pediatrics, Gil Hospital, Gachon Medical School. Biopsy sections were stained with hematoxylin and eosin and also with Giemsa for identification of H. pylori. The grades of duodenitis and gastric metaplasia were classified from 0 to 3 and from 0 to 4, respectively. RESULTS: The incidence of H. pylori infection was 54% in total patients. Amongst 163 children with duodenitis there was a lack of correlation between H. pylori infection and the grade of duodenitis. Amongst 11 patients with duodenal ucler, only 4 children were infected by H. pylori. And amongst 5 patients with gastric metaplasia, H. pylori and duodenal ulcer were detected in 2 and 3 children, respectively. The occurrence of duodenal ulcer and gastric metaplasia were increased significantly in proportion to the grade of duodenitis (p<0.0001 and p=0.0365, respectively). CONCLUSION: As opposed to the results of previously reported articles, there were lacks of correlation between H. pylori infection and duodenitis, duodenal ulcer, and gastric metaplasia. So further study hould be done to clarify the effect of H. pylori on the duodenal histopathology in children infected by H. pylori.

Primary Ovarian Non-gestational Choriocarcinoma in a Young Women A Case Report / 대한산부인과학회잡지

Primay ovarian choriocarcinoma is very rare disease. Especially, non-gestational choriocarcinoma of ovary has worse prognosis than gestational tumor. Here, we report a non-gestational pure ovarian choriocarcinoma in 11 years old woman with the review of literature.

A Case of Synchronous Double Primary Cancer with Esophageal Small Cell Carcinoma and Lung Squamous Cell Carcinoma / 대한소화기내시경학회지

Double primary cancer means that more than two cancers with different origin exist independently in an individual. The diagnosis of double primary cancer was determined by following criteria. Each of the tumors must present a definite picture of malignancy, each must be distance, and the probability of one being a metastasis of the other must be excluded. Primary small cell carcinoma in the esophagus is relatively rare, and rarer when it is combined with other malignant disease. A review of the Korean medical literature failed to reveal any previously described the case of syn-chronous double primary cancer of primary esophageal small cell carcinoma and squamous cell carcinoma of lung. Recently, we have experienced a case of double primary cancer, a 65-year-old man with primary esophageal small cell carcinoma and squamous cell carcinoma of lung, which were diagnosed by endoscopic biopsy and bronchoscopic biopsy.

Two Cases of Rotor Syndrome in Siblings / 대한소아소화기영양학회지

We experienced two cases of Rotor syndrome in brothers who were a 13 year-old boy and an 11 year-old boy, respectively. They presented with icteric scleras for a few months. Their common laboratory characteristics were as follows: Direct bilirubin was more increased than indirect bilirubin, but aminotransferases were normal. Plasma indocyanine green (ICG) test revealed hepatic excretory defect: plasma ICG concentrations 15 minutes after intravenous injection were 80.45% and 78.28%, respectively. 99mTc-DISIDA Hepatobiliary scan showed that severely decreased hepatic extraction with mild cardiac blood pool, markedly delayed biliary excretion in both intra- & extra- hepatic bile ducts, delayed visualization of gall bladder, and markedly delayed intestinal biliary passage. Needle liver biopsy showed normal hepatic histology without pigmentation.

A Case of Gastritis Cystica Profunda Associated with Gastric Perforation and Hypertrophic Gastric Folds / 대한소화기내시경학회지

Gastritis cystica profunda (GCP) is a rare disease in which cystically dilated gastric foveolae or glands extend into the muscularis mucosae or below. The pathogenesis of GCP has been described as an interruption of the muscularis mucosae and migration of epithelial elements to submucosa caused by presence of suture materials after surgery or erosion of the gastric mucosa in chronic gastritis and ischemia. Macroscopically, GCP may present not only as a giant gastric mucosal folds but also as a submucosal tumor or as solitary or diffuse polyps. An endoscopic ultrasonographic (EUS) findings clearly differ from findings in the other disordes. The combination of EUS and mucosectomy appears to be very useful for the diagnosis of GCP. Therefore, all unnecessary surgical procedures should be avoided in cases of GCP. We report a case of GCP associated with gastric perforation which presented as diffuse giant gastric folds and clinically advanced gastric cancer was suspected.