A 38-year-old woman was admitted due to an abnormal ECG and dyspnea on effort. Transoesophageal echocardiography and cardiac computed tomography (CT) showed severe aortic regurgitation (AR) due to pentacuspid aortic valve, which consisted of 4 relatively equal cusps and 1 larger cusp. Mild mitral regurgitation, atrial septal defect (ASD) and coronary-pulmonary artery fistula were complicated for her. She underwent aortic valve replacement, mitral valve annuloplasty, direct closures of ASD and coronary-pulmonary artery fistula. The pathophysiology of the resected aortic valve showed 4 equal size cusps and a large one with mild myxomatous change. Aortic valve regurgitation due to pentacuspid aortic valve is extremely rare and there was little report concerning it in the literature. We reported the surgical repair of this rare case of severe AR due to pentacusupid aortic valve.

Six patients with malignant retroperitoneal tumor extending into the inferior vena cava (VCI) were surgically treated with use of a normothermic extracorporeal circulation (ECC). Origin of malignant tumor was renal cancer in four, adrenal cancer in one and seminoma in one. Four patients excluding two of renal cancer had metastasis to the lung or bone preoperatively. One of renal cancer with lung metastasis and invasion to the colon died six months after surgery. The remaining five patients have been alive and well with follow up of 1 year to 7 years (mean 3 years 3 months). Cytological examination of an arterial filter of ECC and intra-circuit blood was made and negative in two patients. Long term results and cytology revealed a rare chance of intraoperative dissemination of malignant cells. These results suggested feasibility of surgery using normothermic ECC for the treatment of malignant retroperitoneal tumor with extension into VCI.

We present a rare case of medulloblastoma which presented with unilateral sudden sensorineural hearing loss as an initial symptom. A 19-year-old man was admitted to our hospital with a chief complaint of dizziness and facial numbness on the right side. His illness had begun two years previously with sudden hearing loss on the right side, for which he had been treated as an idiopathic sudden hearing loss. Magnetic resonance imaging demonstrated abnormal signals located mainly in the right middle cerebellar peduncle. We performed partial resection of the tumor by suboccipital craniotomy. The histopathological diagnosis was medulloblastoma. Intrinsic brain tumor is an extremely rare cause of sudden sensorineural hearing loss and is therefore easily overlooked as was in the present case. The present case highlights not only the need to evaluate patients with sudden sensorineural hearing loss by magnetic resonance imaging but also the importance of paying attention to intrinsic lesions involving the brainstem. Although this condition like the presented case might be rare, intrinsic brain tumor should be considered as a potential cause of sudden sensorineural hearing loss, as it may be easily missed leading to a delay in appropriate treatment.
Brain Neoplasms ; Brain Stem ; Craniotomy ; Dizziness ; Hearing Loss, Sensorineural ; Hearing Loss, Sudden ; Humans ; Hypesthesia ; Magnetic Resonance Imaging ; Medulloblastoma ; Young Adult