Myxoid Cellular Neurothekeoma: A New Entity of S100-Negative, CD68-Positive Myxoid Neurothekeoma

Neurothekeoma is a rare cutaneous neoplasm, occurring as a cutaneous papule or nodule on the face, shoulders, and upper extremities. Neurothekeoma has been subclassified as either the myxoid, cellular, or mixed type, depending on the amount of myxoid matrix and on immunohistochemical analysis. We observed a clinical case with conflicting histopathological and immunohistochemical findings. In this case, microscopic examination showed the typical presentation of myxoid neurothekeoma; however, immunohistochemical staining was negative for S100 protein and positive for CD68, which is the characteristic pattern of cellular neurothekeoma. We report a very rare form of myxoid cellular neurothekeoma of the face in a young woman.

A Case of Apocrine Carcinoma on the Pubis / 대한피부과학회지

Apocrine carcinoma is a rare malignant epithelial tumor of apocrine sweat glands. It manifests as a painless, slow-growing, firm or cystic red nodule with focal ulcerations. These tumors are capable of hematogenous dissemination to visceral organs and lymphatic spread. Their occurrence has been reported mainly in the axilla and breast area. We present a case of apocrine carcinoma arising from the pubis, where it rarely occurs. An 83-year-old man displayed a 3.5x3.0 cm-sized irregular-shaped mass with a crust. Histopathologic examination revealed a complex glandular appearance of cribriform and cord-like pattern tumor nests throughout the dermis. The tumor was positive in immunohistochemical staining for EMA, PAS diastase, and GCDFP-15.

Basal Cell Carcinoma of the Perineum Manifestating as Subcutaneous Nodule / 대한피부과학회지

No abstract available.

A Case of Multiple Osteoma Cutis in Infant / 대한피부과학회지

No abstract available.

An Atypical Giant Angiomyxoma with Multiple Superficial Angiomyxomas / 대한피부과학회지

Superficial angiomyxoma (SAM), often referred to as cutaneous myxoma, is a rare benign myxoid tumor of soft tissue. It commonly manifests as a single mass, but is occasionally detected as multiple tumors in Carney's complex. Nowadays, however, SAM is regarded as an independent cutaneous tumor regardless of whether Carney's complex is present. SAM occurs most commonly on the trunk, limbs, head, and neck. Herein we report a rare case involving a 21-year-old woman who presented with multiple tumors consisting of a single giant pedunculated mass surrounded by multiple nodules on her left labium major. Histological analysis revealed that the tumors were composed of widely scattered bland spindle-shaped or stellate cells with ill-defined cytoplasm and variably sized vessels within a basophilic myxoid stroma. The tumors were completely removed by total excision and primary closure with an excellent cosmetic outcome.

Clinical analysis of the 118 Cases of Sporotrichosis Over 42 Years in Kwangju and Chonnam (1967~2009) / 대한의진균학회지

BACKGROUND: Sporotrichosis is a chronic, deep fungal infection caused by a dimorphic fungus, Sporothrix schenckii. It is widely variable in incidence, distribution and clinical pattern. Clinical manifestations are greatly variable, with important involvement of the skin and the superficial lymphatic system. Although sporotrichosis is the most common deep fungal infection in Korea, few reports have included a long term investigation and survey of sporotrichosis. OBJECTIVE: We investigated patients' records for 42 years to identify the prevalence, epidemiological features and changes in clinical findings on sporotrichosis. METHODS: We carried out a retrospective analysis of 118 patients with sporotrichosis for 42 years (1997~2009) by reviewing the medical records and making phone calls to patients if needed. RESULTS: The incidence of sporotrichosis is on a decreasing tendency at this time and incidents were more common for rural residents (80 cases, 67.8%) than urban residents (38 cases, 32.2%). Lymphocutaneous type (86 cases, 73%) is more common than fixed cutaneous type (32 cases, 27%) and the most frequent occupation of patients was farmer (71 cases, 60%). Seasonally, 42 cases (36%) occurred in winter (December to February), showing higher incidency than any other season. The most common site of the skin lesion was right upper extremity. CONCLUSION: We found considerable changes in prevalence, seasonal distribution and clinical findings of sporotrichosis over 42 years.

The Advantages of Rectangular Titanium Cage(RABEA) Fusion after Anterior Cervical Discectomy: Comparative Study of Fibula Allograft

OBJECTIVE: To study the safety and efficacy of using rectangular titanium cage(RABEA) for anterior cervical fusion, we have compared the results of fusion performed by using fibula allograft and RABEA cage. METHODS: Total of 74 patients with single level cervical discectomy were included in this study. Allogenic fibula bone graft alone was done in 38 patients and RABEA cage was inserted in 36 patients. Retrospective clinical analysis was based on review the symptoms and radiological findings on both two groups at postoperative 12 months. RESULTS: Solid fusion was achieved in 95% of patients who received rectangular titanium cage and 74% of patients who received fibula allograft. According to Odom's criteria, 92% of patients were found to have excellent or good results in the RABEA cage group and 68% of patients in allograft group. Functional outcome was assessed according to Odom's criteria and patient's postoperative satisfaction index(PSI). Better clinical outcome and solid fusion could be achieved by rectangular titanium cage fusion than allogenic fibula graft after single level anterior cervical discectomy. CONCLUSION: We believe that RABEA cage is an effective and safe cervical fusion substitute for single level cervical fusion after discectomy.

Primary Leptomeningeal Malignant Melanoma

Primary leptomeningeal malignant melanoma is rare entity. We present a case of primary leptomeningeal malignant melanoma of 66-year-old male, who had suffered severe headache, confusion, and right hemiparesis. The brain computed tomography and magnetic resonance image revealed a well enhancing mass with hemorrhage in the left fronto-parietal region. Total surgical removal of the lesion was performed without neurological deficit. He died at home 6 months after operation. Probably, it seems that the cause of death was poor general condition due to obtunded mentality or brain herniation due to increased intracranial pressure. The literature on this subject is briefly reviewed.

Spinal Neurogenic Tumors: Outcome after Resection of the Involved Nerve Root

OBJECTIVE: The aim of this study is to determine the treatment strategies for spinal neurogenic tumor involving nerve root and to evaluate the outcome after resection of the root. METHODS: The retrospective review of 76 cases of spinal cord tumors, operated between 1992-2001, was done. We underwent surgery for 22 cases of spinal neurogenic tumors with somatosensoty evoked potential monitoring. Resection of the affected nerve root was necessary in 15 cases for complete removal of the tumor. In six patients of these the resected nerve root was relevant for upper or lower limb function and five patients underwent end to end anastomosis. RESULTS: There were 12 men and 10 women and the mean age was 43 years. The tumors were located most frequently in the lumbar area(7 cases, 31.8%). The most common initial symptoms were radiating pain(18 cases, 81.8%) and mean duration of presentation was 39.3 weeks. In all cases, tumor was removed totally except one case of schawannoma which is dumbbell-shaped and huge extradural extension to retroperitoneal cavity. The postoperative outcomes on discharge were improved in 16 cases(72.7%). Among 15 cases of tumor resection together with involving nerve root, 13 cases(86.7%) were improved. All the cases performed end to end neural anastomosis were inproved. CONCLUSION: The results indicate that resection of the involved nerve root usually do not produce neurological deficit and complete removal of tumor with the involved nerve root is one of the appropriate and safe procedure. Also, end to end anastomosis of resected nerve root contribute to the chance of regeneration and functional recovery.

Surgical Experience of Intracranial Aneurysm in a Patient with Polycystic Kidney: Case Report

Rupture of cerebral aneurysm is a significant cause of morbidity and mortality in patients with polycystic kidney. Although many authors have emphasized the relationship between these two diseases, the exact pathogenesis has yet to be identified yet. Recently a number of authors have emphasized the defect of chromosome 16 as the basis of pathogenesis of these disease. We have treated surgically a case of P2-3 junction aneurysm in a 44 year-old male with bilateral polycystic kidneys. While abdominal ultrasonograph had revealed multiple microcysts of the liver, four vessel angiographies futher revealed marked arteriosclerotic changes of cerebral arteries. The aneurysmal neck was successfully clipped through subtemporal approach resulting in good outcome. The above mentioned cases of cerebral aneurysm with polycystic kidney will be discussed with respect to its pathogenesis and treatment modality along with literature review.

Three Cases of Free Tentorial Edge Meningioma

The authors report the clinical features, radiologic findings and the operative management of three patients with tentorial free edge meningioma. The frequent symptoms and signs were headache, facial pain, tinnitus, dizziness, increased intracranial pressure and cranial nerves deficits. Tentorial free edge meningiomas are not only very rare but also very difficulty in total removal without complications. In this presentation, we are discussed the nature of this tumor and operative technique with review of literature.