A Case of Acute Phlegmonous Esophagitis / 대한소화기내시경학회지

Phlegmonous esophagitis is an uncommon disease characterized by purulent infection of the esophageal wall, sparing the mucosa. Bacterial infection of the eosphagus is usually presented as a superimposed infection upon a preexisting viral or fungal esophagitis and most victims are immunocompromised hosts. A case was experienced involving an acute phlegmonous esophagitis in an 21-year-old man who was immunologically normal and whose main symptoms were epigastric pain and fever for one day. Esophagographic examination revealed a large ulceration of the eosphagus with exudation, and submucosal lesions. Due to its rarity, this case is herein reported with a review of the corresponding literature.

A Case of Humoral Hypercalcemia of Malignancy Associated with Hepatoma: A Case in which both PTHrP and 1,25 (OH) 2D were elevated / 대한내분비학회지

Hypercalcemia is one of the most common paraneoplastic syndromes and believed to occur through two general mechanisms, one humoral and the other local. The former mechanism has been termed humoral hypercalcemia of malignancy (HHM) and has been associated with the secretion of various cytokines, including parathyroid hormone-related protein (PTHrP). PTHrP beats sttuctural and functional similarities to PTH and seems to play a key role in the pathogenesis of HHM. We experienced the case of HHM associated with hepatoma, a rare cause of HHM, in 48 year-old male. We found no evidence of bone metastasis. In this case, contrary to our general acknowledgment, serum 1,25 (OH)D concentration was elevated. We report this case with a brief review of related literatures.

A Case of Pancreatic Serous Cystadenoma Associated with Papillary Thyroid Cancer / 대한암학회지

The most common pancreatic cystic lesion is pancreatic pseudocyst which represents about 85%. Primary cystic neoplasms represent about 10 to 15% of the lesion. Pathologically cystic neoplasms can be classified into serous cystadenoma, mucinous cystadenoma and papillary cystic neoplasm by epithelial lining-cell, whereas pseudocyst is characterized by fibrotic capsules. Mucinous form is known to be premalignant or malignant and serous cystadenoma was known to be benign in the past, but recently 4 cases of malignant transformation have been reported. Serous cystadenoma is described under a variety of names, including microcystic adenoma and glycogen-rich cystadenoma but recently macroqystic variants have been reported. Serous cystadenoma is most commonly seen in middle aged women with symptoms of vague upper abdominal pain or palpable mass. It is sometimes associated with extra- pancreatic diseases such as gallstones, diabetes mellitus, hypertension, duodenal ulcers, sterility, obesity and thymic dysfunction, but coexisting papillary thyroid cancer have been reported in only 2 cases to our knowledge. The pathogenesis of associated diseases is unknown and appears to be due to function of age of the patients or incidental occurrence. Herein, we report a patient who had a pancreatic serous cystadenoma coexisting with papillary thyroid cancer. Since pancreatic serous cystadenoma can occur in association with papaillary thyroid cancer, examination of thyroid seems to be advisable when pancreatic serous cystadenoma is found.

A Case of a Solitary Peutz-Jeghers Type Hamartomatous Polyp in the Duodenum with Upper Gastrointestinal Bleeding as the Initial Diagnosis / 대한소화기내시경학회지

Peutz-Jeghers syndrome is a genetic disorder consisting of mucocutaneous pigmentation and gastrointestinal polyposis. Although the polyp may be found in a solitary fashion in this syndrome, such a case is exceedingly rare and would result in a case report even in other countries. A solitary Peutz-Jeghers polyp had not been reported domestically until now, and thereby, the authors here present a case of a clinical experience of Peutz-Jeghers syndrome with a solitary hamartomatous polyp in the duodenum.

A Case of Mediastinal Cystic Parathyroid Adenoma Presenting as Acute Pancreatitis / 대한내분비학회지

Hypercalcemia due to hyperparathyroidism is rarely associated with acute pancreatitis. But, the relationship between hypercalcemia and pancreatitis still remains controvesial. Ectopic parathyroid adenoma with cystic change is one of the rare causes of hyperparathyroidism, and is usually located in neck and mediastinum. We report a case of mediastinal parathyroid adenoma with cystic change associated with acute pancreatitis. A 54-year-old male presented with epigastric pain for 3 days. The serum calcium, phosphate, elastase were 16.8mg/dL, 1.1 mg/dL, 2772.0 ng/mL respectively and his parathyroid hormone level in serum was 651.84 pg/mL. Chest CT showed a mediastinal mass with well defined inhomogenously enhanced density located between SVC and aorta. The patient was diagnosed to hyperparathyroidism with acute pancreatitis due to mediastinal parathyroid adenoma with cystic change, and was surgically removed. The surgical biopsy showed parathyroid adenoma with cystic change. After operation his general condition was improved and serum calcium, phosphate, amylase, lipase level were normalized.