Relapsed plasmacytoma in central nervous system after complete remission of extramedullary plasmacytoma / 영남의대학술지

Extramedullary plasmacytoma (EMP) is a rare disease that occurs in 3% to 5% of patients with plasma cell disorder. It occurs most commonly in the upper respiratory tract and the oral cavity. Very few EMP cases have been reported in the central nervous system (CNS). We report herein an unusual case of EMP in the nasal cavity that recurred in the CNS without systemic involvement. A 67-year-old man visited our hospital due to a month-long bout with exophthalmos. He was diagnosed with EMP in the nasal cavity, paranasal sinus, and orbital cavity. He received radiotherapy to which he had complete responses. After 2 years, he visited our hospital because of a month-long headache. He was diagnosed with EMP recurrence in the CNS via brain magnetic resonance imaging and cerebrospinal fluid analysis. He was treated with whole brain radiotherapy and intrathecal chemotherapy with methotrexate, but he expired due to pneumonia.

A Case of Acute Colonic Pseudo-Obstruction Combined with Rhabdomyolysis induced by Severe Hypokalemia / 대한내과학회지

Acute colonic pseudo-obstruction (ACPO) or Ogilvie's syndrome is a rare disorder of intestinal motility characterized by massive colonic dilatation without mechanical obstruction. We report a case of ACPO combined with rhabdomyolysis induced by severe hypokalemia. A 78-year-old male with a 10-year history of hypertension presented with abdominal pain and distension for 2 days. The laboratory findings showed hypokalemia with markedly elevated serum creatine phosphokinase and myoglobin levels. A plain abdominal x-ray revealed a markedly distended ascending and transverse colon with a cut-off sign at the descending colon. Mechanical obstruction of the intestine was excluded by computed tomography and colonoscopy. He was initially treated with supportive therapy, including insertion of a rectal tube and intravenous fluids with potassium replacement. However, the ACPO persisted, and neostigmine was administered in two separate 2.0-mg intravenous injections, 24 hours apart. Subsequently, the abdominal pain and colonic distension were relieved.