ABSTRACT
Cutaneous metastasis of internal malignancies is rare and the incidence of metastatic skin lesions as the first symptom of disease is only 0.8% for patients with all types of malignancies. Furthermore, cutaneous metastasis from advanced gastric cancer is exceedingly rare. A 43-year-old man presented with a single, symptomatic, erythematous nodule on the chest wall. A biopsy taken from the nodule showed an adenocarcinoma of the poorly differentiated type. An endoscopic examination and biopsy was done and these showed the same histologic findings. We reported here on this unusual case of advanced gastric cancer and the patient's first symptom was a skin lesion.
Subject(s)
Adult , Humans , Adenocarcinoma , Biopsy , Incidence , Neoplasm Metastasis , Skin , Stomach Neoplasms , Thoracic WallABSTRACT
Angiolipoma is a benign tumor that is mainly observed in the subcutaneous tissue and is composed of mature adipose tissue and proliferative blood vessels. However, the condition is rare in the gastrointestinal tract including the colon. There was a case report of angiolipoma of the proximal ileum but there are no reports of angiolipoma of the colon in Korea. A 47-year-old man, who presented with intermittent left lower quadrant pain and hematochezia, underwent contrast enhancement CT, which revealed a huge mass with inhomogeneous density in the distal descending colon. The colonoscopy viewed a large polypoid mass with vascular engorgement, and a laparotomy was performed urgently due to the persistent abdominal pain, intussusception and hematochezia. The histology examination disclosed a benign angiolipoma. We report this case of symptomatic angiolipoma of the distal descending colon.
Subject(s)
Humans , Middle Aged , Abdominal Pain , Adipose Tissue , Angiolipoma , Blood Vessels , Colon , Colon, Descending , Colonoscopy , Gastrointestinal Hemorrhage , Gastrointestinal Tract , Ileum , Intussusception , Korea , Laparotomy , Subcutaneous TissueABSTRACT
Pseudohypoparathyroidism (PHP) is a rare clinical type of hypoparathyroidism. The patients with PHP show classic clinical and biochemical features of hypoparathyroidism, but elevated serum level of parathyroid hormone (PTH) and characteristic physical appearances termed 'Albright's hereditary osteodystrophy' (AHO). PHP is classified into types Ia, Ib, Ic and II according to the presence of AHO phenotype and the mechanism of PTH resistance. We experienced a case of PHP in a 12 year-old girl with carpopedal spasm, syncope and partial AHO. She showed very low serum calcium level (1.4 mmol/L), high phosphorus level (3.62 mmol/L) and high immunoreactive PTH level (186.6 ng/L). In the Ellsworth-Howard test, urinary cyclic adenosine monophosphate and phosphorus levels after an exogenous PTH injection remained unchanged. Therefore, we were able to classify the patient as either PHP type Ia or Ic. After the patient had been treated with daily calcium carbonate (1 g), cholecalciferol (250 IU) and calcitriol (0.5 microgram), her neurological signs and symptoms as well as her biochemical abnormalities of hypocalcemia and hyperphosphatemia were improved.
Subject(s)
Child , Female , Humans , Adenosine Monophosphate , Calcitriol , Calcium , Calcium Carbonate , Cholecalciferol , Hyperphosphatemia , Hypocalcemia , Hypoparathyroidism , Parathyroid Hormone , Phenotype , Phosphorus , Pseudohypoparathyroidism , Spasm , SyncopeABSTRACT
Pseudohypoparathyroidism (PHP) is a rare clinical type of hypoparathyroidism. The patients with PHP show classic clinical and biochemical features of hypoparathyroidism, but elevated serum level of parathyroid hormone (PTH) and characteristic physical appearances termed 'Albright's hereditary osteodystrophy' (AHO). PHP is classified into types Ia, Ib, Ic and II according to the presence of AHO phenotype and the mechanism of PTH resistance. We experienced a case of PHP in a 12 year-old girl with carpopedal spasm, syncope and partial AHO. She showed very low serum calcium level (1.4 mmol/L), high phosphorus level (3.62 mmol/L) and high immunoreactive PTH level (186.6 ng/L). In the Ellsworth-Howard test, urinary cyclic adenosine monophosphate and phosphorus levels after an exogenous PTH injection remained unchanged. Therefore, we were able to classify the patient as either PHP type Ia or Ic. After the patient had been treated with daily calcium carbonate (1 g), cholecalciferol (250 IU) and calcitriol (0.5 microgram), her neurological signs and symptoms as well as her biochemical abnormalities of hypocalcemia and hyperphosphatemia were improved.
Subject(s)
Child , Female , Humans , Adenosine Monophosphate , Calcitriol , Calcium , Calcium Carbonate , Cholecalciferol , Hyperphosphatemia , Hypocalcemia , Hypoparathyroidism , Parathyroid Hormone , Phenotype , Phosphorus , Pseudohypoparathyroidism , Spasm , SyncopeABSTRACT
We experienced a case of primary gastric tuberculosis presented with melena. A 61-year-old male was admitted with epigastric pain and melena. Upper endoscopy revealed an irregular shaped gastric ulcer on the posterior wall of the body. Histological examination of endoscopic specimen revealed chronic inflammation with fibrosis, granulomas and acid-fast bacilli. Cultures for acid-fast bacilli subsequently grew Mycobacterium tuberculosis. There was no evidence of the tuberculous lesion anywhere else. Primary gastric tuberculosis remains an extremely uncommon clinical entity; the definitive diagnosis is made by biopsy and positive culture for the organism. We report a case of primary gastric tuberculosis with review of the literature.
Subject(s)
Humans , Male , Middle Aged , Biopsy , Diagnosis , Endoscopy , Fibrosis , Granuloma , Inflammation , Melena , Mycobacterium tuberculosis , Stomach Ulcer , TuberculosisABSTRACT
Cavernous hemangiomas are unusual tumors with a propensity for skin and liver involvement and rarely involving adrenal gland.Adrenal hemangiomas are nonfunctioning tumors, usually discovered at autopsy. In 1955, Johnson and Jeppensen reported the first adrenal hemangioma to be removed surgically.One case of emangioma of the adrenal gland was reported in Korea. We report a case of a cavernous hemangioma of the adrenal gland which was successfully treated surgically.In addition, we review the clinical, radiographic, and pathologic features of this disease. With the advance of diagnostic thchniques in arterography, ultrasound, and computerized tomography, preoperative recognition and diagnosis should be simplified and surgical removal carried out to rule out possible malignancy, preclude traumatic rupture, or relieve symptoms of the mass.
Subject(s)
Adrenal Glands , Autopsy , Diagnosis , Hemangioma , Hemangioma, Cavernous , Korea , Liver , Rupture , Skin , UltrasonographyABSTRACT
Leiomyosarcomas make up approximately 1 to 3% of all gastric neoplasms. The most prevalent age group was 6th and 7th decades. The main symptoms and signs were abdominal pain and bleeding. They most frequently involve gastric body and often ulcerate and bleed. Diagnosis can be established only by exploratory operation and histologic examination. Leiomyosarcomas rarely invade adjacent viscera and characteristically do not metastasize to lymph nodes, but they may spread to the liver and lungs. The treatment of choice is surgical resection. We report two cases of gastric leiomyosarcoma which was successfully treated surgically.
Subject(s)
Humans , Abdominal Pain , Diagnosis , Hemorrhage , Leiomyosarcoma , Liver , Lung , Lymph Nodes , Stomach Neoplasms , Stomach , Ulcer , VisceraABSTRACT
Behcet's disease is a recurrent and multisystemic disorder which usually persists over many years. In 1937 Behcet described a chronic relapsing triple symptom complex of recurrent oral ulceration, genital ulceration and ocular inflammation. Other manifestations of the syndrome include arthritis, cutaneous vasculitis, thrombophlebitis, epididymitis, ulcers of gastrointestinal tract and meningoencephalitis. Recently, a case was experienced involving intestinal Behcet's syndrome with duodenal ulcer bleeding. A 32-year-old male patient was admitted due to hematemesis, and epigastric pain. The patient had ulcers on the oral mucosa, soft palate, external genitalia, and anus. An irregularly marginated ulcer with bleeding was found on the anterior of the duodenal bulb through esophago- gastroduodenoscopic examination. The patient was diagnosed with Behcet's disease and was treated with steroids. In this paper, the case of duodenal bulb involvement of Behcet's disease is reported with a review of relevant literature.
Subject(s)
Adult , Humans , Male , Anal Canal , Arthritis , Behcet Syndrome , Duodenal Ulcer , Epididymitis , Gastrointestinal Tract , Genitalia , Hematemesis , Hemorrhage , Inflammation , Meningoencephalitis , Mouth Mucosa , Oral Ulcer , Palate, Soft , Steroids , Thrombophlebitis , Ulcer , VasculitisABSTRACT
Although a pathogenic mechanism of hemolytic anemia complicated with viral hepatitis is unknown, it is suggested that there are four mechanisms; 1) In the individual who has predisposition to hemolytic anemia, viral infection accelerates the red cell destruction & hemolysis become obvious. 2) Directly, virus itself injures to the red cell membrane. 3) The serious liver failure & hypersplenism induce the hemolysis. 4) Autoimmune hemolytic anemia because of immunological abnormality caused by viral infection. We experienced a case of autoimmune hemolytic anemia in 33-year-old male patient who was diagnosed as chronic lobular hepatitis B with biopsy. Diagnosis was estabilished by clinical features, blood cell count, routine urinalysis, direct & indirect Coombs test, liver function test, immunoglobulin quantitations, hepatitis B marker, bone marrow aspiration, and liver biopsy. This case was treated with corticosteroid and transfusion. During follow-up, he has been well tolerated.
Subject(s)
Adult , Humans , Male , Anemia, Hemolytic , Anemia, Hemolytic, Autoimmune , Biopsy , Blood Cell Count , Bone Marrow , Cell Membrane , Coombs Test , Diagnosis , Follow-Up Studies , Hemolysis , Hepatitis B , Hepatitis , Hypersplenism , Immunoglobulins , Liver , Liver Failure , Liver Function Tests , UrinalysisABSTRACT
Malignant fibrous histiocytoma is a pleomorphic sarcoma in adults, which occurs principally as a mass on an extremity or in the abdominal cavity or retroperitoneum. It typically involved deep fascia or skeletal muscle and only rarely was confined to the subcutis without fascial involvement. Malignant fibrous histiocytomas developed in the intraabdominal organs are very rare and only few cases have been reported until now. Here, we report a case of malignant fibrous histiocytomar developed in the stomach of a 46-year old male who showed clinical and histologic features of malignant fibrous histiocytoma without any identified etiologic factors. The patient was treated successfully with surgery, and has had no recurrence since, during the ensuring one and a half yars.
Subject(s)
Adult , Humans , Male , Middle Aged , Abdominal Cavity , Extremities , Fascia , Histiocytoma, Malignant Fibrous , Muscle, Skeletal , Recurrence , Sarcoma , StomachABSTRACT
Spontaneous hemorrhage in the patients undergoing hemodialysis is the ralatively common problem, but spontaneous mediastinal hemorrhage in such patients reported only few cases. We experienced a case of spontaneous mediastinal hemorrhage in chronic hemodialysis patient who complained of continuous pleuritic chest pain and mild dyspnea. The diagnosis was made dy chest computed tomography,magnetic resonance imaging and percutaneous fine needle aspiration of liquified dark reddish old blood material guided by ultrasonography. Treatment is usually conservative, with blood volume replacement and intensive hemodialysis using regional heparinization. We report on a patient undergoing hemodialysis due to endstage renal disease who developed spontaneous mediastinal hemorrhage.