A case of small cell carcinoma of the uterine cervix / 대한내과학회지

Small cell carcinoma of the uterine cervix is a rare malignancy representing less than 5% of all cases of cervical carcinoma. It is clinically characterized by frequent early nodal and distant metastasis. Survival is relatively poor with hysterectomy alone. Currently, there is no consensus for the optimal management of small cell carcinoma of the uterine cervix. Most patients are treated with a multimodality approach, using chemotherapy and radiotherapy. We treated a 32-year-old woman with primary small cell carcinoma of the uterine cervix. The pelvic MR imaging showed a 3 cm mass in the uterine cervix and no evidence of other abnormalities in the adnexa. The patient treated with a radical hysterectomy alone and adjuvant therapy was not provided. Five months later, the patient had recurrent disease with multiple bone and liver metastases. We treated the patient with cisplatin and etoposide combination chemotherapy. Here we report the case of a primary small cell carcinoma of the uterine cervix with rapid progression after surgical treatment alone and review the medical literature.

A case of primary thymic MALT lymphoma / 대한내과학회지

Primary thymic MALT lymphoma is a rare thymic tumor, with only eight previous cases having been described worldwide to date. We report a case of a 60-year-old Korean woman diagnosed as primary thymic MALT lymphoma. She was found to have an anterior mediastinal tumor during a medical check-up in 2006 and was referred to our hospital for further examination and treatment. The thymus was resected through a median sternotomy and pathology revealed primary thymic MALT lymphoma. Two months later, a follow-up chest CT showed a residual mediastinal soft tissue mass and increased FDG uptake was detected on PET CT scan. The patient was irradiated with 4,140 cGy. After radiation therapy, no evidence of residual soft tissue was found in follow-up chest CT scan and the patient is alive and well 15 months after treatment. We report the details of this case of primary thymic MALT lymphoma treated with irradiation and also offer a review of the literature.

An inoperable osteosarcoma of the maxillary sinus with long-term survival after chemotherapy and radiotherapy / 대한내과학회지

Maxillary osteosarcoma is an aggressive disease with a high mortality rate. Extensive surgical resection is accepted as the standard treatment for the disease. The beneficial role of chemotherapy and radiotherapy in the treatment of the disorders is uncertain. We experienced a case of an osteosarcoma of the maxillary sinus. Paranasal sinus computed tomography showed a huge solid mass lesion at the left maxillary sinus walls. An endoscopic biopsy showed an osteoblastic type osteosarcoma. In this case, radical surgery was impossible, and the patient was treated with chemotherapy and radiotherapy. This regimen involved four cycles of chemotherapy, cisplatin, 100 mg/m2 intravenously on the first day of weeks 1, 4, 7, and 10, and doxorubicin, 25 mg/m2 per day on the first 3 days of weeks 1, 4. 7. and 10, followed by external beam radiotherapy with a total dose of 6,600 cGy. We report here a case of an inoperable osteosarcoma of the maxilla with long-term survival after chemotherapy and radiotherapy with an accompanying review of the literature.

Primary small cell carcinoma of the ovary and the long-term survival after systemic chemotherapy / 대한내과학회지

Ovarian small cell carcinoma is a rare type of ovarian carcinoma with a poor prognosis.The hypercalcemic type is a tumor of unknown histogenesis, and small cell carcinoma of the pulmonary type may be a component of a typical ovarian surface epithelial-stromal tumor. We experienced a case of primary ovarian small cell carcinoma and lung metastasis. The patient was a 65-year old woman who complained of rectal heaviness. The chest x-ray and chest CT scan revealed multiple pulmonary metastases. Abdominal MRI showed a well defined heterogenous solid mass with central necrosis arising from the right ovary and hydronephrosis of the right kidney. Biopsy of the ovarian mass showed small cell carcinoma of the pulmonary type. After 4 cycles of cisplatin (80 mg/m2, on day 1, iv), etoposide (100 mg/m2, on day 1 to 3, iv), the patient achieved a complete response. The follow up chest CT scan 5 years after treatment revealed no evidence of disease. We report here in a case of primary small cell carcinoma of the ovary with lung metastasis and we include a review of the literature.