Herpes Simplex Encephalitis after Concurrent Chemoradiotherapy in Nasopharyngeal Cancer: A Case Report / 대한내과학회지

Herpes simplex encephalitis (HSE) is a rare viral encephalitis in adults. A high (70%) mortality rate with serious complications has been reported even after active, appropriate management. The association between HSE and immune suppression is unclear, but there are case reports of cancer patients in which HSE concomitantly developed after whole brain radiation or high-dose steroid treatment. The clinical manifestations and laboratory findings of these patients are atypical compared to the general population. Although brain magnetic resonance images reveal typical HSE findings, cerebrospinal fluid (CSF) analysis might be normal in cancer patients. We report a case of HSE in a 48-year-old male diagnosed with nasopharyngeal cancer and treated with concurrent chemoradiation. This patient had a normal cell count in CSF, but HSE was finally diagnosed from positive polymerase chain reaction test results. After administration of acyclovir and systemic steroid treatment, the patient had a good clinical course with few neurologic sequelae.

A Case of Signet-ring Cell Gastric Carcinoma of which the First Symptom was Skin Lesions / 대한피부과학회지

Cutaneous metastases of internal malignancies are rare and the incidence of metastatic skin lesions as the first symptom of disease is only 0.8% in patients of all malignancies. Furthermore, cutaneous metastasis from adenocarcinoma of the stomach has been found to be exceedingly rare. A 39-year-old woman presented with multiple, asymptomatic, erythematous nodules on her scalp and back. A biopsy taken from the nodule showed a signet ring cell type of adenocarcinoma. A gastroendoscopic examination and biopsy was done and showed the same histologic findings. The diagnosis of cutaneous metastasis of signet-ring cell gastric carcinoma was made. It is clinically worth reporting that the first symptom was skin lesions of the scalp and back.