Transcavernous Approach for Invasive Pituitary Adenoma

OBJECTIVE: Surgical management of invasive pituitary tumor is challengeable with conventional transsphenoidal approach(TSA) or pterional intradural approach alone. Gross total resection of pituitary adenoma influences its prognosis favorably, so transcavernous approach(TCA) is essential in invasive pituitary tumor. This study is performed to evaluate and analyze the surgical results of TCA in cases of invasive pituitary adenoma. METHODS: From November 1995 to May 2002, nine cases of invasive pituitary adenoma were treated. The authors reviewed medical records and radiological findings. Pterional transzygomatic or orbitozygomatic transcavernous approach was selected for tumors extended below or above the third ventricle floor respectively and intradural removal of tumor with suprasellar extension was combined. Surgical results including hormonal function, recurrence, completeness of tumor resection, and postoperative complications were evaluated and analyzed. RESULTS: Eight patients were treated with TSA followed by TCA and one with TCA alone. Total resection was achieved in seven cases, subtotal resection in one, and partial resection in one. Postoperative complications included temporary third nerve palsy in four cases and facial paresthesia in two. There was no recurrence during follow-up period. CONCLUSION: Transcavernous approach alone or combined with TSA is essential surgical procedure for total removal of invasive pituitary adenomas with acceptable morbidities.

Pulmonary Cryptococcosis: Report of 2 cases / 대한흉부외과학회지

Cryptococcus neoformans is a ubiquitous fungus found worldwide, particularly in soil contaminated by pigeon droppings. Pulmonary cryptococcosis occurs rarely in immunocompetent individuals. The risk of cryptococcal infection increases with the degree of immunal compromise, in human immunodeficiency virus infection especially. Pulmonary cryptococcosis is most frequently encountered as asymptomatic single or multiple pulmonary nodules found by routine chest x-ray examination. The diagnosis is most often made in these situations by the histology of the resected lesion. Acute progressive pneumonia may occur, with symptoms of cough, sputum production, fever, and weakness. The clinical picture is not pathognomonic. The yeasts are stained well by any of the special stains for fungi. Treatment is now indicated for all cases given a diagnosis of cryptococcosis, even if the diagnosis has been made by resecton of a solitary, asymptomatic pulmonary nodule.

A Case of Aplastic Anemia in 2 Consecutive Pregnancies / 대한산부인과학회잡지

Aplastic anemia in pregnancy is an extremely rare condition with high maternal morbidity and mortality rates. Prognosis is poorer when aplastic anemia is complicated during pregnancy and many such patients have an unsuccessful pregnancy outcome. The relationship between aplastic anemia and pregnancy remains uncertain. Intensive hematological support remains the mainstay of therapy and a successful obstetric outcome can be best accomplished with the close clinical collaboration of the hematologist and the obstetrician. We report here a case of a 24-year-old woman with aplastic anemia, she experienced two consecutive vaginal deliveries. We present it with brief review of literature.

Aggressive Angiomyxoma at Ischiorectal Fossa / 대한산부인과학회잡지

Aggressive angiomyxoma is a rare soft tissue tumor associated with high risk of local recurrence but lacks metastatic potential. This tumor arise from soft tissue of the perineum or lower pelvis, and affect predominantly yonug women. Aggressive angiomyxoma should be distinguished from more common benign and malignant tumor or tumor like conditions of the pelvic soft part. We report a case of an ususual angiomyxoma in ischiorectal fossa with a brief review of the literature.

A Case of Primary Pulmonary Lymphoma of Bronchus-Associated Lymphoid Tissue associated with Systemic Lupus Erythematous / 결핵

A primary pulmonary malignant lymphoma is a rare disease. It is thought to be a category of non-Hodgkin's lymphoma arising from the bronchous-associated lymphoid tissue (BALT). The majority of primary pulmonary lymphomas are low-grade, small B-cell lymphomas, which are associated with Sjogren's syndrome and similar autoimmune disorders. A case of primary pulmonary low-grade B-cell lymphoma arising from the BALT was encountered in a patient with systemic lupus erythematosus. A 54-year-old man was admitted to the hospital for the evaluation of left pleuritic chest pain and multiple joint pain in both hands. Serologic tests for collagen vascular disease were performed. The results of ANA and anti-ds-DNA were all positive. The computed tomography of the chest showed patchy concolidations in the left lower lobe with a pleural effusion and a video-assisted thoracoscopic biopsy was performed. Here we report a case of low-grade B-cell lymphoma of BALT in a patient with systemic lupus erythematosus with a review of the relevant leteratures.

Two Cases of Pelvic Actinomycosis associated with Intrauterine Contraceptive Device (IUD) / 대한산부인과학회잡지

Actinomycosis is difficult to diagnose preoperatively because of non-specific clinical feature. We usually have excessively invasive treatment for actinomycosis. So, we must rule out actinomycosis in the case of patients with a complaint of lower abdominal pain with a long time IUD inserted state and laboratory findings suggestive of inflammation. We experienced two cases of pelvic actinomycosis associated with IUD and report these cases with a brief review of literatures.

Infection status of Clonorchis sinensis in residents of Hamyang-gun, Gyeongsangnam-do, Korea

Oriental liver fluke (Clonorchis sinensis) infection was surveyed among residents of Hamyang-gun, Gyeongsangnam-do, Korea during the period of January 2001 to March 2002. Total 1,041 stool samples were collected from residents who visited Public Health Center and its branches in Hamyang-gun and examined using formalin-ether sedimentation method. The overall egg positive rate was 16%, male showing higher positive rate (21%) than female (10%). The age group of 30 to 50 years had the highest egg positive rate of C. sinensis from 20% to 22%. The positive examinees were treated with praziquantel and educated individually to prevent reinfection. Egg positive rate in this area was decreased when compared with results recorded in the past, however, still remained more than 10%. This study suggests that periodic examination, treatment as well as education of residents should be continued and systematized.

A Case of Primary MALT Lymphoma of the Breast / Journal of the Korean Cancer Association, 대한암학회지

Primary malignant lymphoma of the breast is rare. The incidence of primary malignant lymphomas of the breast is 0.04% to 0.5% of all malignant tumors of the breast and 0.07% of all non-Hodgkin's lymphomas, and comprises 1.7% of extranodal malignant lymphomas that occur in Western countries. The incidence of mucosa- associated lymphoid tissue (MALT) lymphoma of the breast is reported to be between 0% and 75% of all primary malignant breast lymphomas in United States and Japan, but the incidence in Korea is unknown. MALT is characterized by indolent behavior and good has a prognosis. The authors report on a patient who has a primary MALT lymphoma of the breast. She was treated by surgical excision, which was followed by radiation therapy. Histologically, her lymphoma type transformed into a diffuse large B-cell tumor after 10months. She received combination chemotherapy and achieved a complete state of remission. She then underwent autologous peripheral blood stem cell transplantation along with high dose chemotherapy. To our knowledge, this is the first case report in the literature in Korea.

A Case of Trichoblastic Fibroma in Scrotum / 대한비뇨기과학회지

We report a case of trichoblastic fibroma involving the scrotum in a 60-year-old man. Trichoblastic fibroma is very rare and benign trichogenic tumor that has both epithelial and mesenchymal components and histologically recount the embryologic development of the hair follicle. The diagnosis was confirmed by histopathologic examination.

A Case of Hepatic Carcinoid Tumor Regression with Octreotide / 대한간학회지

Somatostatin analogue octreotide is commonly used for the treatment of carcinoid syndrome. Octreotide also has an antiproliferative effect in neuroendocrine tumors and has demonstrated tumor reduction in patients having advanced carcinoid tumor. This is a case report of a patient who had metastatic liver carcinoid tumor and showed marked regression of liver metastasis after octreotide therapy.

A case of Neurilemmoma of the Larynx / 대한이비인후과학회지

Neurilemmoma is a benign tumor which may develop from the nerve sheath of the cranial, sympathetic, and peripheral nerves. This tumor is characteristically solitary and well-capsulated. About 25% of this tumor occurs in the head and neck region and the acoustic nerve is most frequently involved, but neurilemmoma of the larynx is rare. Recently, authors experienced a case of neurilemmoma occured in the paraglottic space of the larynx. The tumor was successfully removed through lateral thyrotomy approach. So we report this case with literature review.

Leiomyoma of the Nasal Septum: a case report / 대한이비인후과학회지

Leiomyoma is a tumor rarely occurring in the nose and the paranasal sinus. It constitutes about 1% of all benign tumors arising in the head and neck area. This is probably due to the paucity of smooth muscle in the nose. We experienced a case of leiomyoma originating in the right side of the nasal septum in a 50-year- man. It was successfully removed by endoscopic surgery, and we report this case with literature.

To rsion of the Accessory Spleen with Infarction: CT Features in a Case Report

Torsion of the accessory spleen is a rare entity that can have variable clinical presentations. We report case involving an 11-year-old boy with severe abdominal pain and a mass that was found to be due to infarction of the accessory spleen, which was twisted on its pedicle. CT revealed a low-attenuating mass with peripheral inflammatory changes in the left upper abdomen. The mass was pathologically confirmed as torsion of the ac-cessory spleen with infarction.

Embryonal Rhabdomyosarcoma of the Retroperitoneum in a Child: A Case Report

Rhabdomyosarcoma is the most common soft tissue sarcoma occurring in children, though retroperitoneal rhabdomyosarcoma is rare. We experienced a case of embryonal rhabdomyosarcoma of the retroperitoneum in a 43-month-old child, and describe the CT , MRI and pathologic findings.

Massive Ovarian Edema / 대한산부인과학회잡지

No abstract available.

A case of Lipoleiomyoma of the Uterus / 대한산부인과학회잡지

No abstract available.

Pleomorphic Xanthoastrocytoma with Peritumoral Edema: A Case Report

Pleomorphic xanthoastrocytoma is a rare, usually benign, supratentorial tumor involving the leptomeninges and superficial cortex, and usually occurs during the second and third decades. We experienced a case of right frontotemporal pleomorphic xanthoastrocytoma with moderate peritumoral edema in a 28-year-old female who complained of seizures and headache, and describe the CT, MRI and pathologic findings.

Two Cases of Fetal Bilateral Renal Agenesis / 대한산부인과학회잡지

Fetal bilateral renal agenesis is a lethal congenital anomaly. An early and reliable prenatal diagnosis is extremely important as it may offer options for pregnancy termination as early as possible. The criteria for the ultrasonographic diagnosis of bilateral renal agenesis are severe oligohydramnios, nonvisualization of the bladder, and the empty renal fossa. However, severe oligohydramnios makes it difficult to diagnose the disease because of poor sonographic resolution. We present two cases of bilateral renal agenesis, one is diagnosed by ultrasonography after amnioinfusion at 24 weeks gestation, the other is diagnosed postnatally after term delivery.

A Clinical Analysis and Treatment of Traumatic Cervical Spine Patients

The authors reviewed 90 patients with traumatic cervical spine injury admitted to our department between January, 1993 and December, 1997. The most common age group was 21-30 years old. The male to female ratio was 7.2 : 1. Motor vehicle accident was the most frequent cause of traumatic cervical spine injury. The most common mechanism of injury was compressive and then distractive flexion. The C2 body fracture was the commonest of the vertebral body fractures and C5/6 dislocation was the most common involved level of injured vertebrae. Forty-seven of these patients were managed with conservative treatment and the remaining 43 patients underwent surgery. The conservative treatment was consisted of skeletal traction, neck collar and Halo-vest application. Of 43 patients operated, 24 patients were performed by anterior approach and 10 by posterior approach and remaining 9 patients were treated by anterior approach after posterior approach. According to Modified Frankel's grading system, the rates of neurological impr-ovement at anterior approach, posterior approach and combined approach were 79.2%, 60.0% and 66.0%, respec-tively. Difference of improvement rates did not have clinical significance. There were 76 types of associated injuries were observed in 51 patients. The most common associated injury was head trauma and surgical intervention was required in 5 patients among them. The common complications were respiratory disorder, bed sore, urinary tract infection, gastrointestinal bleeding, pin site infection in decreasing order of frequency. The most common cause of death was respiratory disorder including pneumonia, atelectasis, acute respiratory distress syndrome and pulmonary edema.

A case of plasma cell type castleman's disease that transformed into a malignant lymphoma / 대한내과학회지

Castleman's disease is a benign disorder characterized by hypervascular lymphoid hyperplasia. The etiology of the disease is still unknown. Although it may occur at the various sites such as peritoneum, retroperitoneum, pelvic lymph node, muscle and lung, it occurs most commonly at the mediastinum. Even though specific pathophysiologic relations are still not clearly determined between two different histologic types -hyaline vascular type and plasma cell type-, there were several previous reports dealing with the plasma cell type transformed or progressed into different types of malignancies such as malignant lymphoma, Kaposi's sarcoma and Hodgkin's disease. We experienced a case of plasma cell type Castleman's disease that transformed into a malignant lymphoma and report this case with review of literatures.