ABSTRACT
Recently, bisphosphonate and denosumab have been widely used for the treatment of bone metastasis of breast cancer. However, medication-related osteonecrosis of the jaw(MRONJ)has often been reported as a side effect of these drugs. We experienced a rare case of intracranial epidural abscess secondary to MRONJ. The patient died of the condition, although chemotherapy was effective. The mechanism of and therapy for MRONJ have not been clarified; therefore, its prevention should be emphasized.
Subject(s)
Bisphosphonate-Associated Osteonecrosis of the Jaw , Bone Density Conservation Agents , Epidural Abscess , Bisphosphonate-Associated Osteonecrosis of the Jaw/complications , Denosumab , Diphosphonates , Epidural Abscess/etiology , HumansABSTRACT
An epithelial cyst in an intrapancreatic accessory spleen (ECIAS) is rare. We herein report a case of a patient with ECIAS who underwent laparoscopic surgery. A 57-year-old woman was referred to our hospital because of a pancreatic tail tumor. She was asymptomatic, and a physical examination revealed no remarkable abnormalities. The levels of the tumor marker carbohydrate antigen 19-9 (CA19-9) and s-pancreas-1 antigen (SPan-1) were elevated. Ultrasonography showed a well-defined homogeneous cystic tumor. Computed tomography showed a well-demarcated cystic tumor in the pancreatic tail. Magnetic resonance imaging showed that the cystic tumor exhibited low intensity on T1-weighted images and high intensity on T2-weighted images. The cystic tumor was diagnosed as mucinous cystic neoplasm preoperatively. The patient underwent laparoscopic spleen-preserving distal pancreatectomy. A histopathological examination revealed the cyst wall to be lined by stratified squamous epithelium within splenic parenchyma, and the ultimate diagnosis was ECIAS. The postoperative course was uneventful, and the patient was discharged on postoperative day 12. ECIAS is very difficult to diagnose preoperatively. Laparoscopic surgery is a safe and minimally invasive procedure for patients with difficult-to-diagnose pancreatic tail tumor suspected of having low-grade malignancy.
