Spontaneous Intracranial Epidural Hematoma Following Thoracolumbar Schwannoma Removal

We report a case of spontaneous intracranial epidural hematoma following the intraoperative course of a patient who had undergone surgical removal of a thoracolumbar schwannoma in olivo-ponto-cerebellar atrophy. To our knowledge there is no reported case in which the thoracolumbar schwannoma removal was followed by such a complication. Mechanical events leading to this complication are unclear. Abnormal results of a neurological examination in the early postoperative period should suggest this possibility.

Eight Cases of Mucin-hypersecreting Cholangiocarcinoma Similar to Intraductal Papillary Mucinous Tumor of the Pancreas / 대한소화기내시경학회지

BACKGROUND/AIMS: Mucin-hypersecreting cholangiocarcinoma is very similar to intraductal papillary mucinous tumor (IPMT) of the pancreas. But this disease is rare and its clinicopathologic features are not well known. The purposes of this study are to report our experience of eight patients with the tumor and to analyze the characteristics of its clinical, radiological and pathological finding. METHODS: Eight patients (3 men and 5 women, mean age 52 years) were diagnosed as having a mucin-hypersecreting cholangiocarcinoma among 4,570 cases of ERCP from 1995 to 1998. RESULTS: Recent or previous attacks of biliary pain or acute cholangitis were elicited in most of the patients. CT showed diffuse intra- and extra-hepatic duct dilatation in all patients and suspicious ill-defined mass shadow in 2 out of 8 patients. On cholangioscopic examination, a papillary mass or minute mucosal lesion was found in the dilated bile duct containing thick viscid mucin. Eight patients were recommended an operation and curative resection was performed in seven patients. Histologically, well-differentiated adenocarcinoma in the background of benign hyperplasia and adenoma was documented in all patients. CONCLUSIONS: Mucin- hypersecreting cholangiocarcinoma may be characterized by exceedingly similarity to IMPT of the pancreas in clinical, radiological and pathological features. Further investigation is needed for detailed information such as natural history and outcome.