Ectopic Endometriosis of the Extra-pelvic Cavity

PURPOSE: Endometriosis is the heterotropic occurrence of island of endometrial glands and stroma outside of uterus. It common occurs in pelvic cavity, but rarely at the ectopic area of extra-pelvic cavity. The aim of this study was to evaluate the clinical characteristics of extrapelvic endometriosis in order to help diagnosis and treatment. METHODS: Between January 2001 and June 2007, 22 patients who underwent surgery and was diagnosed as ectopic endometriosis of extra-pelvic cavity at Bundang CHA hospital were retrospectively reviewed with medical records and a telephone interview. RESULTS: All cases were women in their reproductive age, with a median age of 33 years (range 24~49 years). 17 of 22 cases were endometriosis in the scarring tissue of prior caesarean section wound on abdomen. 1 case in vaginal orifice on episiotomy wound of perineum, 1 case in femoral ring area and 3 cases in appendix. All patients except endometriosis of appendix, were presented with mass, pain and symptoms almost associated with menstruation. 18 of 22 cases were suspected of having extra-pelvic endometriosis due to their specific clinical features, 4 cases were suspected of hernia and acute appendicitis. All patients were treated with surgery. None has revisited to clinics due to recurrence. CONCLUSION: Women who have mass or lump in surgical scar and symptoms associated with menstruation period should be suspected of having endometriosis. Endometriosis of surgical scaring tissue should be treated by wide local excision to prevent local recurrence.

Peritoneal Metastasis of an Carcinoma in the Appendix

An adenocarcinoma of the appendix is a rare tumor, and so far only 130 cases have been reported worldwide. We report one patient with peritoneal seeding of an adenocarcinoma. A 51-year-old man was admitted to our hospital with the impression of intestinal obstruction. He had undergone an appendectomy 5 years ago due to acute appendicitis. At that time, postoperative histopathological analysis had revealed an adenocarcinoid tumor in the appendix. The patient had been told to visit our hospital for follow-up but he hadn't visited. When he finally visited our hospital diagnostic laparoscopy revealed the peritoneal seeding of a recurrent adenocarcinoma. A palliative right hemicolectomy was done to relieve the bowel obstruction. After recovering from operation, the patient was treated with the 5-fluoruracil, leucovorin, and oxaloplatin (FOLFOX). The patient was discharged in improved general condition with a future plan for regular cyclic chemotherapy.

The role of mammography on breast cancer patients in a hospital setting

From Oct. 1, 1983 to May 31, 1988, 6198 mammograms were taken and 443 mastectomies were performed at the Yonsei University Hospital, Seoul, Korea. Of these, 191 cases had preoperative mammography performed prior to surgery (study group) and 252 cases underwent mastectomies without preoperative mammography (control group). There were no significant differences between the two groups in pathological stages, axillary lymph node metastasis and size of the tumor, suggesting that little benefit is derived from the preoperative mammography in the hospital setting. However, there were a number of other findings, including a 14% incidence of multiple foci and localization of non-palpable cancer in 3% of cases, that could help us to make therapeutic plans and strategies for these patients.