Management of Intramural Esophageal Dissection with Gastric Feeding Tube in an Alcoholic-hepatitis Patient / 대한소화기학회지

Intramural esophageal dissection is a rare but clinically important condition in the field of gastroenterology. Classically, intramural esophageal dissection rarely occurs in patients who are anticoagulated or have poor medical condition, and its clinical presentation may include chest pain, dysphagia and hematemesis. Herein, we present a case of intramural esophageal dissection in an alcoholic hepatitis patient that was diagnosed by endoscopy and successfully treated with conservative management.

Predictive Factors of Malignant Potential in Gallbladder Polyps / 대한췌담도학회지

BACKGROUND/AIMS: Although the incidence of GB polyps is increasing with improved surveillance, the study of predictive factors of malignant potential has not been sufficient. The aim of this retrospective study is to investigate the predictive factors of malignant potential in GB polyps. METHODS: Among 3,159 patients with laparoscopic cholecystectomy in Chonbuk National University hospital January 2009 to December 2013, 437 patients confirmed GB polyps pathologically were enrolled. The patients were divided into two groups; one with benign GB polyp and another with GB adenoma and incidental GB cancer. RESULTS: Group I with benign GB polyp was seen in 359 patients. On the other hand, 53 patients with GB adenoma and 25 patients with GB cancer in gourp II were identified. The patients in group II had shown a significantly higher incidence of age older than 50 years (53/78, 67.9% vs. 163/359, 45.4%, p=0.001), size larger than 10mm (40/78, 51.3% vs. 37/359, 10.3%, p<0.001), and GB wall thickening (36/78, 46.2% vs. 77/359, 21.5%, p<0.001). The presence of GB stone had not shown significant differences between two groups (26/78, 33.3% vs. 96/359, 26.7%, p=0.378). CONCLUSIONS: Cholecystectomy should be considered for the patients with GB polyp with these predictive factors.

Solitary Pituitary Metastasis of Advanced Breast Cancer Treated with Anti-Human Epidermal Growth Factor Receptor 2 Drug

Metastasis to the pituitary gland from systemic cancer is a rare condition. The breast and lung are the most common sites of primary tumor metastasis. Most often, they occur in the setting of widespread metastatic disease, which most frequently occurs in elderly patients. However, an increase in the incidence of solitary pituitary metastasis of breast cancer as the first recurrence has been reported. Diabetes insipidus is the most frequent symptom at presentation, and visual field defects or cranial nerve deficits are common symptoms of pituitary metastasis. Unlikely these symptoms, deficiencies of anterior pituitary hormones may only become evident in critical situation because symptoms are of an insidious onset and sometimes nonspecific. We report here on a rare case of solitary pituitary metastasis from breast cancer presenting as hyponatremia without other symptoms.

Late Recurrence of Ovarian Cancer Mimicking a Primary Lung Malignancy after Curative Resection

The majority of patients with an advanced-stage ovarian cancer relapse within approximately 18 months after completion of the first-line therapy. Recurrent ovarian cancer commonly presents as peritoneal seeding, while other distant sites are anywhere including the pleura, liver, lung, central nervous system, spleen, skin, bone, and breast. As pulmonary metastases usually occur through hematogenous or lymphangitic routes, the pattern of the metastases of ovarian cancer is multiple and scattered diffusely. The solitary pulmonary metastasis of ovarian cancer is an extremely rare condition, thus it can be misdiagnosed as a primary lung cancer, unless physician has a clinical suspicion. Herein, we introduce a case of solitary pulmonary metastasis of ovarian cancer which occurred 9 years after the curative surgery and chemotherapy.