A Case of Multiple Tumors Located in Structures Other than the Colon in a Patient with Familial Adenomatous Polyposis / 대한내과학회지

Most patients with familial adenomatous polyposis (FAP) undergo prophylactic colectomy. As a result, extracolonic manifestations including benign and malignant tumors are more common in patients with FAP, and duodenal cancer is now the main cause of death. However, duodenal adenomas and carcinomas are detected less frequently in Korea and Japan than in Western countries, and gastric cancer is more prevalent than in Western countries. In the present case, a 63-year-old man, who had undergone a total colectomy and an ileostomy 14 years previously, presented at our outpatient clinic complaining of discomfort at the ileostomy site. The patient had adenomas in the gallbladder and ileum, and adenocarcinomas in the duodenum and stomach. The interval between development of duodenal cancer and stomach cancer was only 4 months. Therefore, we suggest that more frequent endoscopic surveillance may be needed for these cases.

Clinical Features and Treatment of Peripunctal Tumors

PURPOSE: To investigate the clinical features and treatment results in peripunctal tumors. METHODS: A retrospective medical record review was conducted on patients that were clinically diagnosed with peripunctal tumor from October 2005 to June 2011 in Dong-A University Hospital. RESULTS: Twenty nine peripunctal tumors were identified. Five cases (17.2%) were involving upper eyelid and 22 cases (75.9%) were involving lower eyelid. Two cases (6.9%) were involving both upper and lower eyelid, which one of them were involving the conjunctiva as well. One of the patients (3.5%), underwent simple observation without surgery. Simple surgical resection and biopsy were performed in 7 cases (24.1%), and additional silicone tube intubation or Minimonoka insertion were carried-out in 21 cases (72.4%). Histology revealed 15 cases (53.6%) of melanocytic nevus, 5 cases (17.9%) of basal cell carcinoma, 2 cases (7.1%) of seborrheic keratosis, and others including malignant melanoma, squamous papilloma, epidermal cyst, and et cetra. CONCLUSIONS: In conclusion, Peripunctal tumors are mostly found on the lower lids and, they are surgical resection and biopsy should be considered in all cases of peripunctal tumors since they have a potential for spreading to the lacrimal system. It is advised to perform a silicone tube intubation or minimonoka insertion along with the surgical excision to preserve the function of the punctum.

A Case of Dengue Fever with Maculopathy

Dengue fever is transmitted principally by Aedes aegypti, which is not infested in Korea. Therefore, all Korean patients with dengue fever are imported cases from endemic areas such as Southeast Asia. Although disease manifestation and complication of dengue fever are various, ocular involvement is rare. We encountered a patient infected with dengue virus, imported from the Philippines. After defervescence from dengue fever, he complained of blurred vision. Blot hemorrhage with retinal infiltration in the macular area was observed in both eyes. Maculopathy by dengue fever was treated with systemic and intraocular glucocorticoid for two weeks; his ocular condition then showed improvement.

A Case of Acute Hepatitis B by Occult HBV Infection without HbsAg Seroconversion / 대한내과학회지

Many studies have recently reported reactivation in hepatitis B surface antigen (HBsAg)-negative subjects with the use of biologic agents such as rituximab. However, occult hepatitis B virus infection itself has little clinical impact. We experienced a case of acute exacerbation caused by occult hepatitis B infection without HBsAg seroconversion. No mutation was found on the major hydrophilic loop of the S protein. The patient recovered from acute exacerbation after antiviral therapy. In conclusion, acute exacerbation can be induced by occult hepatitis B virus infection itself without reactivation. In such a case, antiviral therapy should be considered.