Cutaneous Metastasis from Cholangiocarcinoma as the First Clinical Sign: A Report of Two Cases

Cutaneous metastases from internal malignancies are uncommon. Furthermore, cutaneous metastases from cholangiocarcinoma are extremely rare. Here we report a case of two patients with distant cutaneous metastases of cholangiocarcinoma: 1) a 66-year-old man who presented with a solitary, erythematous nodule on the scalp and 2) a 44-year-old man who presented with multiple, erythematous nodules on the scalp, the chest wall, and the back. In both cases, the erythematous nodules were the first clinical signs of cholangiocarcinoma. Histopathological analyses of skin biopsy specimens of the two patients revealed adenocarcinomas with features similar to the original cholangiocarcinoma. Two cases of cholangiocarcinoma in which metastatic skin nodules appeared as the first sign of the disease are reported here, with a review of the relevant literature.

Clinical Role of F-18 Fluorodeoxyglucose Positron Emission Tomography for Diagnosis and Staging of Renal Tumors / 대한비뇨기과학회지

PURPOSE: The role of [18F]fluorodeoxyglucose-positron emission tomography (FDG-PET) in renal cell carcinoma remains to be clearly defined. The sensitivity, specificity and accuracy of FDG-PET to detect renal cell carcinomas and a distant metastatic disease were compared with other established imaging modalities, including computerized tomography (CT), chest PA and bone scan. MATERIALS AND METHODS: FDG-PET and conventional imaging techniques, including CT, chest PA and bone scan, were performed in 43 patients with primary renal tumors and/or metastatic diseases. Radical nephrectomy and metastatectomy were then performed. The results of FDG-PET were compared with the conventional imaging techniques and postoperative histopathological diagnoses. RESULTS: The postoperative histopathological diagnoses of the 43 patients were renal cell carcinomas in 41 and benign renal tumors in 2. The results of FDG-PET were true positive, equivocal and false negative in 26, 8 and 9 of the 41 patients with renal cell carcinomas, respectively. The results of the CT were true positive in all patients. The results of FDG-PET were true negative in 2 patients, but those of CT were false positive in 2 patients with benign renal leiomyoma and angiomyolipoma. Therefore, FDG-PET was less sensitive, but more specific and accurate, than CT for the evaluation of primary renal tumors. CT was false positive for retroperitoneal lymph node metastasis and at the ascending colon in each of 1 patient, but FDG-PET was true negative. FDG-PET detected unsuspected pulmonary metastatic diseases that were not detected on chest PA in 4 patients. FDG-PET was more sensitive, specific and accurate than CT in the evaluation of metastasis. CONCLUSIONS: FDG-PET was complementary to conventional imaging in the initial staging of renal cell carcinomas, but superior in evaluating the metastasis.

Pelvic Cavernous Hemangioma / 대한비뇨기과학회지

The majority of hemangiomas are small, benign vascular tumors. They can regress spontaneously as a result of fibrosclerosis, suggesting a conservative approach whenever possible. They require little, if any, treatment and are easy to differentiate from malignant tumors clinically and radiologically, and there is no evidence that hemangiomas ever become malignant. We report a case of a 54-year old man with extravesical cavernous hemangioma who was diagnosed with a malignant tumor preoperatively.

Sarcomatoid Renal Cell Carcinoma / 대한비뇨기과학회지

Cases of sarcomatoid renal cell carcinoma are very rare. It has been known that sarcomatoid renal cell carcinoma is an epithelial cell variant that has been metaplastically transformed with a very poor prognosis. Diagnosis of sarcomatoid renal cell carcinoma is performed by examining a nephrectomy specimen to see if epithelial and sarcomatoid components are variously mixed together. Therefore, the aim of this paper is to report five cases of sarcomatoid renal cell carcinoma.