Mesenchymal Chondrosarcoma Arising from the Intrascrotal Extratesticular Soft Tissue: A Case Report

Intrascrotal extratesticular malignancies are rare, and the radiologic findings of extraskeletal chondrosarcoma have not been reported. We describe the radiologic findings of a case of mesenchymal chondrosarcoma arising from intrascrotal extratesticular soft tissue and represented by a complex, cystic, solid mass containing calcifications and hematoma.

The Effect of Embolotherapy for Acute Gastrointestinal Bleeding in Patient with Coagulopathy

PURPOSE: To analyse the causes of coagulopathy and determine the effect of embolotherapy on acute gastrointestinal(GI) bleeding coexisting with coagulopathy. MATERIALS AND METHODS: Between June 1991 and December 1998, 29 patients with acute GI bleeding (M:F =21:8, mean age, 57.8 years) underwent percutaneous embolotherapy and immediate cessation of bleeding was confirmed. The patients were divided into two groups: control (n =16) and those with coagulopathy (n =13), group membership being determined according to the criteria of >+/-2SD of normal prothrombin time (PT) and activated partial thromboplastin time (aPTT) ( PT >23 seconds, aPTT >40 seconds) at the time at which embolization was requested. Embolotherapy was, defined as clinically successful, if the patient was stable for at least three days, without bleeding, after technically successful embolization. The clinical success rate of embolization and the mortality rate were compared between the two groups, and the causes of coagulopathy statistically analysed. RESULTS: The clinical success rate of embolization was 75% (n =12) in the control group, compared with 38.5% (n =5) in the coagulopathic group (p < 0.05), while the mortality rate for the two groups was 6.3% (n =1) and 53.8% (n =7), respectively (p < 0.005). Statistically, massive transfusion and sustained shock before embolization were the causes of coagulopathy (p < 0.05). CONCLUSION: In coagulopathic patients with acute GI bleeding, embolotherapy induces transient bleeding control, but is unlikely to save lives.

Spiral CT Findings of Inflammatory Pseudotumor of the Liver

PURPOSE: To assess the spiral CT findings of inflammatory pseudotumor of the liver (IPTL), in order todistinguish this tumor from hepatocellular carcinoma, hepatic abscess or other space liver occupying lesions. MATERIALS AND METHODS: The spiral CT findings of IPTL were retrospectively evaluated in six patients. All caseswere confirmed by ultrasonography-guided gun biopsy. Four patients were men and two were women, and they were agedbetween 37 and 74 (mean, 49) years. The site, size, and number of IPTL were assessed, and their enhancementpatterns were evaluated during the arterial, portal and delayed phases of spiral CT. RESULTS: Five casesinvolveda solitary mass and in one there were multiple masses with surrounding small nodules. Four cases occurredin the right lobe and two in the left lobe. Four of five surrounding nodules were in the left lobe. During thearterial phase of spiral CT scanning, three layers were separated from four of five cases of solitary mass ; theywere composed of central and peripheral portions of low attenuation, and an intermediate portion ofisoattenuation. Delayed enhancement of the peripheral portion was prominent during the delayed phase. In the caseinvolving multiple masses three layers were not seen during the arterial phase, but during the delayed phaseenhancement was noted. CONCLUSION: The features of three layers, as seen on spiral CT, is considered to be veryspecific for distinguishing IPTL from other hepatic focal lesions.

Factors Related to Recurrence of Bladder Transitional Cell Carcinoma after Transurethral Resection of BladderTumor(TUR-BT)

PURPOSE: To evaluate factors related to the recurrence of TCC(transitional cell carcinoma) in the urinarybladder after transurethral resection of bladder tumor(TUR-BT). MATERIALS AND METHODS: We retrospectivelyreviewed 54 patients in whom TCC(transitional cell carcinoma) after TUR-BT had been confirmed. Recurrence wasevaluated by US, CT, cystoscopy and urine smear during the follow-up period of 6 months. The multiplicity, shape,size, and calcification of TCC, as revealed by radiologic studies, were evaluated retrospectively before TUR-BT.After TUR-BT, the histologic grade and pathologic stage of TCC were evaluated. RESULTS: According to themultiplicity of TCC, the recurrence rate was 66.7% in the multiple type and 28.6% in the single type(p=0.039) ;according to shape, this rate was 61.5% in the sessile type and 29.3% in the pedunculated type(p=0.0505), andaccording to mass size, the rate was 41.7% in tumors more than 3cm in diameter and 35.7% in tumors less than3cm(p=0.706). In the presence of calcification, the recurrence rate was 40.0% and in its absence, this rate was36.7%(p=0.885). Pathologically, the higher the grade and stage of TCC, the higher the recurrence rate(respectivelyp=0.010 and 0.041). CONCLUSIONS: Radiologically, multiple and/or sessile type TCC had a higher recurrence ratethan the single and/or pedunculated type. Pathologically, when the grade and stage of bladder tumor were higher,recurrence rates were higher.

CT and MR Findings of a Chordoid Meningioma: A Case Report

A 25-year-old woman with focal seizure, intermittent morning headache and vomiting for 2 years showed microcytic hypochromic anemia on peripheral blood smear and a 6x7.5cm sized intracranial mass with cystic and solid portions at the right temporoparietal convexity on brain CT and MRI which was hypervascular on cerebral angiography. Histopathologic findings on light microscopy suggested chordoma, but it was confirmed as a chordold meningioma by immunohistochemical study. The present case suggests that the diagnosis of chordold meningioma shoud be considered in a juvenile or young adult who is presented with an extra-axial mass with typical location of meningiomas, findings of chordomas on light microscopy, and clinical findings of Castleman syndrome.