A case of cutaneous acrometastasis in the right 5th finger tip by metastatic breast cancer / 대한내과학회지

Acral metastasis to the finger is a very rare phenomenon. We report herein a case of cutaneous acrometastasis to the right 5th finger tip in a 36-year-old woman with metastatic breast cancer. The patient underwent a right modified radical mastectomy for T3N3 invasive ductal carcinoma and received adjuvant chemotherapy and radiotherapy. After 2 years, she developed metastasis to the brain, bones, and lungs. She was found to have a growing tender mass on the tip of right 5th finger. A well-demarcated, soft tissue mass was identified on sonography. Under the clinical impression of a possible benign process, the nodule was surgically removed. The pathologic finding was consistent with metastatic breast cancer. Immunohistochemical staining for estrogen receptor, progesterone receptor, and HER2 were all negative, as in the primary tumor. Radiation was given to the finger tip and systemic chemotherapy with capecitabine was tried for systemic metastatic disease.

Successful Pacemaker Revision Through Sustained Right Superior Vena Cava in a Patient With Situs Inversus Totalis

In patients with situs inversus totalis, the superior vena cava is normally positioned on the left side and drains into a left-sided right atrium (RA). If right-side superior vena cava (RSVC) is also present, it should be thought of as a combined congenital anomaly. Here, we report a case of successful pacemaker lead insertion through the RSVC in a patient with situs inversus totalis. The left-side superior vena cava (LSVC) had been already used as a route for the first pacemaker lead insertion 15 years earlier. During the pacemaker lead revision, we found that the LSVC was obliterated, and used the RSVC as a route for a new pacemaker lead insertion.

Interstitial Nephritis and IgA Nephropathy in a Patient with Acute Hepatitis A / 대한신장학회지

Hepatitis A is one of the most common infectious diseases. It is a self-limiting disease affecting the liver. Although extrahepatic manifestations are not common, a few cases associated with renal diseases have been reported. In those cases, patients presented with acute tubular necrosis, acute interstitial nephritis, IgA nephropathy, mesangioproliferative glomerulonephritis, etc. We here report a case of interstitial nephritis and IgA nephropathy associated with acute hepatitis A. A previously healthy 31-year old woman was admitted with an acute hepatitis A, which was confirmed by IgM anti-hepatitis A antibody. Acute renal failure was developed and hemodialysis was urgently required. The patient had acute interstitial nephritis and IgA nephropathy diagnosed by kidney biopsy. Liver and kidney functions gradually recovered their normal conditions.

A Case of Ankylosing Spondylitis Accompanying Sarcoidosis / 대한류마티스학회지

Sacroiliitis is a rare manifestation in patients with sarcoidosis and there have been several case reports of ankylosing spondylitis (AS) accompanying sarcoidosis. Recently, the development of sarcoidosis has been reported in AS patients treated with tumor necrosis factor blocker. We described a 27-year-old male patient with AS and histologically proven sarcoidosis who was treated with etanercept without aggravation of sarcoidosis.

A Case of Systemic Lupus Erythematosus with Degos' Disease / 대한류마티스학회지

Degos' disease, malignant atrophic papulosis, is a rare disease characterized by a pathognomonic appearance of porcelain-white, atrophic papules with peripheral erythema and multiple occlusive thrombotic vascular pathology. It sometimes involves internal viscera such as the gastrointestinal tract, the central nervous system and kidney which may bring to death. Although several reports showed the associations between Degos' disease and antiphospholipid antibody or systemic lupus erythematosus, its pathogenetic significance remains elusive. The previous 4 Korean cases of Degos's disease involved only skin and/or the gastrointestinal tract. We report a case of systemic lupus erythematosus with Degos' disease involving skin, kidney and small intestine.