A Case of Primary Leiomyosarcoma of the Femur / 대한내과학회지

Primary leiomyosarcoma rarely occurs in bone; when it occurs, it is more frequent in middle-aged individuals and frequently metastasizes to the lung. Here, we report a case of primary leiomyosarcoma of the femur in a 47-year-old woman who complained of pain in the left hip. The plain x-ray revealed an osteolytic lesion in the greater trochanter of the femur. The histopathological and immunohistochemical evaluation revealed a moderately differentiated leiomyosarcoma. Computed tomography of the chest and abdomen revealed no other potential primary lesions. The patient was diagnosed with primary leiomyosarcoma of the bone. Although surgical removal was recommended, the patient refused surgery. As an alternative, she was given radiotherapy and chemotherapy. No local progression or distant metastasis has been observed during the 4-year follow-up period.

A Case of Multiple Hypervascular Hyperplastic Liver Nodules in a Patient with No History of Alcohol Abuse or Chronic Liver Diseases / 대한소화기학회지

Up-to-date imaging modalities such as three-dimensional dynamic contrast-enhanced CT (3D CT) and MRI may contribute to detection of hypervascular nodules in the liver. Nevertheless, distinguishing a malignancy such as hepatocellular carcinoma from benign hypervascular hyperplastic nodules (HHN) based on the radiological findings is sometimes difficult. Multiple incidental liver masses were detected via abdominal ultrasonography (US) in a 65-year-old male patient. He had no history of alcohol intake and no remarkable past medical history or relevant family history, and his physical examination results and laboratory findings were normal. 3D CT and MRI showed numerous enhanced nodules with hypervascularity during the arterial phase. After US guided liver biopsy, the pathological diagnosis was HHN. To date, several cases of HHN have been reported in patients with chronic alcoholic liver disease or cirrhosis. Herein, we report on a case of HHN in a patient with no history of alcoholic liver disease or cirrhosis.

Small Bowel Infarction by Mesenteric Venous Thrombosis due to Methylenetetrahydrofolate Reductase Gene Mutation

Acute mesenteric venous thrombosis (MVT) is an uncommon form of intestinal ischemia with high mortality and usually occurs in the setting of preexisting comorbidities including thrombophilia and abdominal inflammatory conditions. Hyperhomocysteinemia has been known to be a risk factor for thromboembolism, often located on an unusual site. Considering that homocysteine metabolism is determined genetically to a high degree, a mutant of methylenetetrahydrofolate reductase (MTHFR) C677T causes hyperhomocysteinemia, leading to thrombophilia. Until now, there have been few reports of MVT associated with MTHFR gene mutation. We, herein, report a case of small bowel infarction associated with MVT by MTHFR gene mutation in an adult without any other risk factors of thrombophilia.