A Case of Sarcomatoid Combined Hepatocellular-Cholangiocarcinoma / 대한소화기학회지

Combined hepatocellular-cholangiocarcinoma (HCC-CC) with sarcomatoid features is an extremely rare primary liver cancer, of which only four cases have been reported. We report a case of sarcomatoid combined HCC-CC in a 60-year-old woman who complained of right upper quadrant pain and presented with a 7 cm mass in the S4 region of the liver in abdominal CT. Ultrasonography-guided needle biopsy diagnosed it as HCC, and left lobectomy of the liver followed. Microscopically, the tumor consisted of two portions: HCC portion showing trabecular pattern, which had partially sarcomatous area with spindle-shaped tumor cells, and CC portion with glandular pattern. Immunohistochemically, HCC portion reacted positively with alpha-fetoprotein while CC portion demonstrated positive reactivity with carcinoembryonic antigen and mucicarmine. Sarcomatoid cells reacted positively for cytokeratin. She died of tumor recurrence and hepatic failure 12 months after the operation. Combined HCC-CC has poor prognosis, and sarcomatoid HCC has high metastatic potential and poor prognosis compared with ordinary HCC.

A Case of Gastric Adenocarcinoma Arising from Gastritis Cystica Profunda / 대한소화기내시경학회지

Gastritis cystica profunda (GCP) is a disease characterized by gastric foveolae elongation along with hyperplasia and cystic dilatation of the gastric glands extending into the tisssue beneath the submucosa. It mainly occurs on the site of gastroenterostomy, but can occasionally be found in an unoperated stomach. GCP may present as a submucosal tumor or polyp, and rarely a giant gastric mucosal fold. This lesion has traditonally been regarded as a benign lesion. However, there are many debates over its malignant potential. Further investigations on the relation between GCP and gastric carcinoma may be necessary. To our knowledge, this is the second description of adenocarcinoma arising from GCP in an unoperated stomach.

A Case of Left Atrial Myxoma Presenting with Myocardial Infarction

Coronary artery embolization is an extremely rare and potentially lethal complication of atrial myxomas. We observed of a case of left atrial myxoma associated with acute anteroseptal and inferior myocardial infarction. A transthoracic echocardiographic study revealed the presence of an echogenic, mobile mass, compatible with myxoma in the left atrium. Coronary angiography disclosed abrupt occlusions of the distal left anterior descending artery and the right coronary artery. The tumor was successfully removed surgically after medical treatment and the patient was doing well post operatively at 6-month follow-up.