Glucagonoma syndrome with severe erythematous rash: A rare case report.

RATIONALE: Glucagonoma is a rare neuroendocrine tumor of the pancreas. Glucagonoma syndrome is often misdiagnosed as other skin lesions by clinicians due to a typical clinical sign of necrolytic migratory erythema (NME) with severe erythematous rash. PATIENT CONCERNS: A 48-year-old female patient was admitted to our department because she presented with unclear recurrent severe erythematous rash. The patient was diagnosed as skin disease. DIAGNOSES: Histopathologic examination revealed a pancreatic glucagonoma. Immnohistochemical staining of tumor tissue was positive for glucagon. INTERVENTIONS: The distal pancreatectomy plus splenectomy was performed in 2017. OUTCOMES: The skin lesions disappeared after surgery. She was followed up and showed no recurrence until now. LESSONS: Clinicians should consider the diagnosis of glucagonoma according to the typical initial symptoms. Early diagnosis is very important to provide a better prognosis. A multidisciplinary approach is effective in patients with unresectable metastatic tumors.

Orthotopic liver transplantation for patients with Caroli's disease.

BACKGROUND: Caroli's disease, a rare congenital hepatic disease, has a poor prognosis, especially in patients with diffuse dilatation of the bile ducts. But liver transplantation has been a curative option. The aim of this study was to investigate the feasibility and rationality of orthotopic liver transplantation as an indication for patients with diffuse Caroli's disease. METHODS: The data from 3 patients with diffuse Caroli's disease who had undergone orthotopic liver transplantation in our unit were analyzed retrospectively. RESULTS: On postoperative day 7, patient 1 had acute rejection which was relieved after pulse treatment with methylprednisolone. He was discharged from hospital on postoperative day 27 and has been in good health for 82 months. Patient 2 had no acute rejection or severe complications, but died of chronic graft dysfunction 34 months postoperatively. Patient 3 had acute rejection on postoperative days 10 and 35, complicated with pulmonary infection, pleural effusion and opportunistic infection. After successful treatment, she resumed work and has been followed up for 47 months. Her condition is good. CONCLUSION: Liver transplantation can offer an effective therapy for patients with diffuse Caroli's disease, and can provide satisfactory long-term results.

[Diagnosis and treatment of intrahepatic biliary cystadenocarcinoma-a report of 11 cases].

BACKGROUND & OBJECTIVE: Intrahepatic biliary cystadenocarcinoma (IBC) is a rare intrahepatic malignant tumor which is scarcely reported, and there is relatively little experience in the diagnosis and treatment. This study was to analyze the clinicopathologic features, diagnosis, and treatment of IBC. METHODS: Clinical data of 11 patients with pathologically confirmed papillary IBC, treated between Mar. 1999 and Oct. 2006 with surgical operation in West China Hospital, were analyzed retrospectively. Of the 11 patients, 2 were men and 9 were women, with a median age of 54 (range 45-68). RESULTS: The chief complaints of the IBC patients were pain and distention in the epigastrium. Four cases were determined by immunohistochemistry, and showed cytokeratin 7 (CK7) expression. Four patients showed infiltration of carcinoma cells in the surrounding liver tissues; 3 of them received palliative hepatectomy and 1 received radical excision; they survived for 12-23 months. The rest 7 showed carcinoma cells confined to the cyst wall, and received radical excision; 3 of them survived for over 3 years; of the rest 4 patients, 1 received operation again 10 months later because of tumor recurrence and was still alive 14 months after the second operation, 1 suffered from intrahepatic multi-metastasis 12 months after operation and received expectant treatment, 1 suffered from ascites 15 month after operation and died without further treatment, 1 was lost during follow-up. CONCLUSIONS: IBC occurs mainly in elder women, and its malignant degree is lower than that of solid carcinoma. The prognosis of the patients with IBC confined to the cyst wall after complete tumor removal is better than that of the patients with IBC infiltrated into the liver.

[Evaluation of the liver reserve using lidocaine test on experimental liver injuries in rats].

OBJECTIVES: To study the effectiveness of the lidocaine test in evaluating the liver reserve of rats with experimental liver injury in different phases. METHODS: 40 healthy male Wistar rats were divided randomly into experimental and control groups. Rats of the experimental group received subcutaneous CCl4 in oil injection, and rats of the control group received saline injections. Monoethylglycinexylidide (MEGX) test, common hepatic function tests and histological examination of the livers were performed on all the rats. RESULTS: With the development of the severity in liver injury, the concentrations of the serum MEGX in lidocaine test decreased gradually, which were consistent with liver histological changes. However, the results from the common liver function tests were all abnormal in the experimental group and were not consistent with the liver histological changes. CONCLUSION: The results obtained from the MEGX test are more agreeable to liver histological changes than those from common liver function tests. The results from the MEGX test can represent liver histological changes concisely.

[Relationship between CO II gene of mtDNA of Lucilia sericata and latitude interval].

OBJECTIVE: To deduce the region that the geographical species of Lucilia sericata come from and determine the scene of crime (SOC) based on the gene analysis of mtDNA CO II. METHODS: A 635 bp region for CO II of 4 Lucilia sericata (belong to 2 geographical species) were collected and sequenced, compared with the data of GenBank. A neighbour-joining tree with the Tamura and Nei model was constructed by MEGA2.1 package. The number of inherit intervals of inner-species were analyzes by Kimura's two-parameter model and used for construction the relationships between hereditary and latitude interval by SPSS10.5 soft. RESULTS: It showed that they had the relationships between inherit and latitude interval for the 8 geographical species of Lucilia sericata for CO II. CONCLUSION: This method can be the evidence deducing the region that the geographical species of Lucilia sericata come from and further to determine the scene of crime (SOC).