Small Cell Carcinoma of the Gallbladder: A Case Report

Small cell carcinoma of the gallbladder is a type of neuroendocrine tumor and very rare. We report ultrasound, CT and MR findings of a small cell carcinoma of the gallbladder that was confirmed by pathology. Small cell carcinoma of the gallbladder was seen as a well-defined mass with peripheral rim enhancement in the gallbladder. In spite of the large size of the mass, direct and extensive invasion of the liver was not detected. However, there were many metastatic lymph nodes.

Non-Functioning, Malignant Pancreatic Neuroendocrine Tumor in a 16-Year-old Boy: A Case Report

We report the case of a 16-year-old boy with a solid pancreatic mass which proved to be a nonfunctioning, malignant pancreatic neuroendocrine tumor (PNET). In pediatric patients, malignant pancreatic tumors are rare, especially malignant PNET. When dynamic contrast enhanced MRI showed a well enhancing solid pancreatic tumor on arterial and delayed phases and combined with malignant features, such as vascular invasion, invasion of adjascent organs, and lymphadenopathy, we should include malignant pancreatic neuroendocrine tumor in the differential diagnosis of childhood pancreatic tumors.

Nested PCR for Detection of Malassezia Species from Patient Skin Scales and Clinical Strains / 대한피부과학회지

BACKGROUND: Due to recent identification of new Malassezia (M.) species, M. dermatis, and M. equi, the genus Malassezia was revised into eleven species that have been isolated from human and animal skin. This has further substantiated the need for molecular techniques to distinguish the various Malassezia species. OBJECTIVE: We aimed to make the nested polymerase chain reaction (PCR) using species-specific primers with specificity and sensitivity as a diagnostic tool for differentiating the various Malassezia species from skin scales and fungal cells rapidly and accurately. In addition, we evaluated the common causative Malassezia species in the patients with seborreheic dermatitis, pityriasis versicolor or pityrisporum folliculitis. METHODS: Malassezia species-specific primers were designed based on DNA sequencing of the ribosomal RNA gene. The standard strains of eight members of the genus Malassezia such M. pachydermatis, M. furfur, M. sympodialis, M. globosa, M. obtuse, M. restricta, M. slooffiae, and M. dermatis were used for positive control. Each Malassezia species was cultured separately and two or three standard species were cultured together on Modified Leeming and Notman agar (MLNA) media plates. In addition, twenty-five clinical strains of Malassezia species isolated from the skin of patients with dermatological conditions and twenty-three samples of skin scale were used as well. RESULTS: The nested PCR assay with primers for all eight Malassezia species were species-specific since it amplified DNA only from the target Malassezia species, and could differentiate mixed, that is, the two or three Malassezia species of all standard strains grown on MLNA medium precisely. Detection of Malassezia species from clinical strains and patient skin scales using the nested PCR assay was 96% (24/25) and 87% (20/23), respectively. M. globosa, M. sympodialis, M. restricta were the most common causative Malassezia species in patients with pityriasis versicolor, pityrosporum folliculitis, seborrheic dermatitis, respectively. CONCLUSION: Nested PCR using species-specific primers is useful and reliable in the detection of various Malassezia species from patient skin scales as well as cultured fungal cells.

A Case of Disseminated Fusarium solani Infection ina Patient with Acute Myeloid Leukemia / 대한피부과학회지

Fusarium species are known as ubiquitous soil saprophytes and human skin contaminants. Infections caused by Fusarium species are increasing in frequency among immunocompromised hosts. We report a rare case of fatal disseminated infection caused by Fusarium solani in an acute myeloid leukemia patient. Skin biopsy specimen revealed multiple branched hyphae and spores in the vessel with thrombus formation, and fungal culture showed a fuzzy, whitish colony. Direct sequencing of 28S rRNA gene confirmed the isolate as Fusarium solani.

A Case of Paraneoplastic Pemphigus Presenting with Generalized Exfoliative Dermatitis / 대한피부과학회지

We describe a 56-year-old Korean man with paraneoplastic pemphigus (PNP) associated with persistent generalized exfoliative dermatitis (GED). He developed multiple scattered flaccid bullae on the erythematous base with scales over his face, upper trunk and extremities, with mucosal involvement for 4 months. Due to myasthenia gravis he also suffered from ptosis, general weakness, and weight loss of 10 kg for a month. A computed tomography and histopathological examination of the chest revealed a mass in the anterior mediastinum which was confirmed as thymoma. During the course of disease, his erythematous patch with crust lesions became confluent, and then GED developed. After total thymectomy, GED waxed and waned for 2-years and eventually disappeared. Herein, we report an interesting case of PNP associated with persistent GED for at least 2 years, even though the patient had been treated with surgery and medication.

A Case of Multiple Xanthogranuloma Similar to the Histopathological Findings of Malignant Melanoma / 대한피부과학회지

Juvenile xanthogranuloma (JXG) is a benign histiocytic proliferative disorder in which one, several, or occasionally numerous red to yellow nodules are present. The lesion may be present at birth, but usually arises in early infancy. Adult-onset xanthogranuloma differs clinically from juvenile xanthogranuloma in that the lesion is usually solitary, does not involve internal organs and generally does not resolve spontaneously. We report a case of multiple xanthogranuloma in an adult which occurred on the scalp, face and trunk of a 37-year-old. This report describes the clinical, histologic and immunochemical findings of xanthogranuloma that mimic malignant melanoma.

A Case of Norwegian Scabies in Patient with Acute Myeloid Leukemia Associated Graft-versus-host Disease / 대한피부과학회지

Norwegian scabies is a crusted non-itchy rash caused by massive infestation with the mite Sarcoptes scabiei. It is usually associated with immunosuppression or neurologic impairment, although it has rarely been reported in normal persons. We report a case of Norwegian scabies in 6-year old girl with acute myeloid leukemia associated graft-versus-host disease. The lesion showed pruritic, hyperkeratotic scaly plaques and fissures on the entire body. Application of a mineral oil preparation from hyperkeratotic areas showed numerous scabies mites. Treatment with 10% crotamiton cream for two weeks resulted in marked regression of the skin lesions, but finally she died of sepsis due to deterioration of her systemic conditions.

Radical Resection of Inferior Vena Cava Leiomyosarcoma; Hepatic and IVC Resection with Vascular Reconstruction and Kidney Autotransplantation / 대한이식학회지

Malignant sarcomas arising from the wall of blood vessels are extremely rare. It tends to enlarge by intra- or extra-luminal extension rather than infiltration, in some instances the tumor origin from the IVC invaded adjacent vital structures limit the extent of the resection. However, a wide and complete surgical resection provided the best chance for prolonged survival in patients. We experienced one case of IVC tumor invaded to right renal vein and liver. In a 52-year-old women suffering right frank pain, right upper retroperitoneal mass was found. In preoperative CT, MRI, Vena Cavogram, the mass was invaded to the right and quadate lobe of the liver, adrenal gland, and right renal vein. We performed the en-block resection including the right hepatic and quadate lobe, IVC and both kidney, and then IVC was reconstructed with graft (PTFE) and uninvolved left kidney was autotransplanted at right peritoneal space. Postoperatively, the patient was recovered satisfactory without complication. Because only way of preventing the development of recurrence is the radical resection of the IVC tumor including adjacent organs, a preoperative accurate staging and aggressive treatment are recommended.