ABSTRACT
Objectives@#To report a case of chordoma mimicking adenocarcinoma in a 52-year-old woman.Summary of Literature Review: Chordoma, a rare malignant tumor of primitive notochordal origin, accounts for 1-4% of all bone malignancies. Chordoma mimicking esophageal adenocarcinoma in the posterior mediastinum is unique. @*Materials and Methods@#A 52-year-old asymptomatic woman was referred to our center with an incidentally detected posterior mediastinal mass and no significant medical history. The mass was diagnosed on a routine medical screening by esophagogastroduodenoscopy and the patient was receiving yearly follow-up. An increase in size was noticed during the second year of follow-up on endoscopic ultrasonography and the patient was referred to the Department of Gastrointestinal Surgery of our hospital. This paper was written after receiving institutional review board (IRB) approval (KC20ZASI0214). @*Results@#En bloc resection was performed for the growing thoracic mass and pathologic findings confirmed it to be chordoma. A followup computed tomography examination was conducted at 8 months, as well as magnetic resonance imaging at 1 year, and there was no local recurrence. @*Conclusions@#Posterior mediastinal chordoma at the thoracic level is very rare. Furthermore, it is difficult to diagnose because its immunohistochemical characteristics mimic those of esophageal adenocarcinoma, meaning that it can be missed. Management is a challenge due to its anatomical location and additional local invasion. Therefore, a multidisciplinary approach is needed, including careful consultation with the patient to provide the optimal treatment for the best possible outcome.
ABSTRACT
Objectives@#To report a case of chordoma mimicking adenocarcinoma in a 52-year-old woman.Summary of Literature Review: Chordoma, a rare malignant tumor of primitive notochordal origin, accounts for 1-4% of all bone malignancies. Chordoma mimicking esophageal adenocarcinoma in the posterior mediastinum is unique. @*Materials and Methods@#A 52-year-old asymptomatic woman was referred to our center with an incidentally detected posterior mediastinal mass and no significant medical history. The mass was diagnosed on a routine medical screening by esophagogastroduodenoscopy and the patient was receiving yearly follow-up. An increase in size was noticed during the second year of follow-up on endoscopic ultrasonography and the patient was referred to the Department of Gastrointestinal Surgery of our hospital. This paper was written after receiving institutional review board (IRB) approval (KC20ZASI0214). @*Results@#En bloc resection was performed for the growing thoracic mass and pathologic findings confirmed it to be chordoma. A followup computed tomography examination was conducted at 8 months, as well as magnetic resonance imaging at 1 year, and there was no local recurrence. @*Conclusions@#Posterior mediastinal chordoma at the thoracic level is very rare. Furthermore, it is difficult to diagnose because its immunohistochemical characteristics mimic those of esophageal adenocarcinoma, meaning that it can be missed. Management is a challenge due to its anatomical location and additional local invasion. Therefore, a multidisciplinary approach is needed, including careful consultation with the patient to provide the optimal treatment for the best possible outcome.
ABSTRACT
Lumbar interbody fusion (LIF) is an effective and popular surgical procedure for the management of various spinal pathologies, especially degenerative diseases. Currently, LIF can be performed with posterior, transforaminal, anterior, and lateral approaches by open surgery or minimally invasive surgery (MIS). Each technique has its own advantages and disadvantages. In general, posterior LIF is a well-established procedure with good fusion rates and low complication rates but is limited by the possibility of iatrogenic injury to the neural structures and paraspinal muscles. Transforaminal LIF is frequently performed using an MIS technique and has an advantage of reducing these iatrogenic injuries. Anterior LIF (ALIF) can restore the disk height and sagittal alignment but has inherent approach-related challenges such as visceral and vascular complications. Lateral LIF and oblique LIF are performed using an MIS technique and have shown postoperative outcomes similar to ALIF; however, these approaches carry a risk of injury to psoas, lumbar plexus, and vascular structures. Herein, we provide a detailed description of the surgical procedures of each LIF technique. We shall then consider the pearls and pitfalls, as well as propose surgical indications and contraindications based on the available evidence in the literatures.
ABSTRACT
PURPOSE: Measles is one of the most highly communicable infectious disease, but has become a rare disease with the widespread use of vaccine. Recently, however, resurgence of the disease in school aged or adolescents who had received the vaccine before or at the 15 month warrants reappraisal of the efficacy of the vaccination. The purpose of this study was to investigate positive prevalence of antibody and its quantitative titers in different age groups in order to determine necessity and appropriate time of booster vaccine. METHODS: We measured measles antibody in the sera of 192 children from different age groups(61 cases from 4-6 years of age, 40 cases from 8-9 years of age, 47 cases from 12-13 years of age, 44 cases from 15-16 years of age). Eight to ten children from each group were selected and quantitative antibody titers were measured by EIA(measles Ig G EIA SEIKEN) method. RESULTS: 1) The positive prevalence of measles antibody in four to six year age group(72%) was significantly lower than the expected positive prevalence of measles antibody(95%) (p<0.001). 2) Median antibody titer in twelve to thirteen year age group tended to be relatively lower than the other age groups. 3) There was no significant differences in the positive prevalence of measles antibody and median titers between sex. CONCLUSIONS: This data supported that the booster vaccination be needed at four to six years of age.