A Case of Huge Hepatic Recurrence of Low Risk Gastrointestinal Stromal Tumor / 대한내과학회지

Gastrointestinal stromal tumors (GISTs) are rare mesenchymal tumors that express c-kit. The majority of GISTs are located in the stomach and small intestine. The tumors are classified into very-low-risk, low-risk, intermediate-risk, and high-risk categories based on size and mitosis activity. The recurrence of low-risk GIST is extremely rare. We report a hepatic recurrence of a low-risk gastric GIST that had been removed completely 8 years earlier, and presented as a huge hepatic mass. Since recurrent GIST has a poor prognosis, regular long-term follow-up must be considered, although the primary GIST was low risk.

A Case of Spontaneous Hemorrhagic Cholecystitis without Gallstone / 대한소화기학회지

Hemorrhagic acalculous cholecystitis is an extremely rare but potentially fatal disease if detection is delayed. Its risk factors include critical illness, diabetes, malignant disease, uremia, and bleeding diathesis. This is the first case report in which hemorrhagic acalculous cholecystitis not accompanied by any risk factor. We herein present a case of hemorrhagic acalculous cholecystitis in a previously healthy patient who suffered from acute abdomen.

A Case of Strongyloides Stercoralis Concurrently Invading the Stomach and Colon / 대한소화기내시경학회지

Strongyloides stercoralis is a nematode that may involve any segment of the Gl tract or virtually every human organ because of its autoinfection cycle and hyperinfection. It may occur in either immunocompetent or immunocompromised individuals. A 72-year-old woman who had no notable medical history presented with chronic diarrhea and generalized edema and she revealed protein losing eneteropathy. She was diagnosed with Strongyloidiasis infection through EGD and a colonoscopic biopsy specimen at a time when there were rhabditiform larvae present. The patient was treated with albendazole 400 mg/day for three days. At the follow-up three months later, the endoscopic biopsy specimens revealed no evidence of Strongyloidiasis infection and her clinical symptoms had progressively improved. The present case represents a rare report of Strongyloidiasis in a immunocompetent patient diagnosed through EGD and the colonoscopic biopsy specimen concurrently. So, we report on this case along with a review of the relevant literature.

A case of lemierre syndrome poorly responsive to medical treatment / 대한내과학회지

Lemierre syndrome is a rare clinical condition that is characterized by anaerobic oropharyngeal infections leading to septic thrombophlebitis of the internal jugular vein and frequent secondary metastatic infections. The accurate diagnosis and treatment, for early stage disease, is important because it may be associated with a high mortality rate if untreated. We present the case of a 34-year-old man who presented with a history of typical for the diagnosis of Lemierre syndrome. Supportive care with antibiotics did not improve the clinical condition. The clinical course improved after treatment with IV anticoagulant and surgical thrombectomy. In addition, he had the antiphospholipid syndrome, which is known to be a common cause of acquired arterial or venous thrombosis. Therefore, in this patient the associated antiphospholipid syndrome might precipitate an internal jugular venous thrombophlebitis after an oropharyngeal infection or might account for the poor response to medical treatment.