A malignant peripheral nerve sheath tumor (MPNST) is an extremely rare soft tissue tumor in the general population. On the other hand, there is a higher incidence of MPNST in patients with neurofibromatosis type I (von Recklinghausen's disease). The common sites are the extremities, trunk, head and neck. However, an intraabdominal or intrathoracic manifestation is uncommon. This paper reports two patients, a 31 year-old woman with multiple neurofibromatosis presenting as an intraabdominal malignant peripheral nerve sheath tumor, and a 33 year-old woman with an intrathoracic malignant peripheral nerve sheath tumor. The patients were treated with chemotherapy followed by radiotherapy. However, one patient died as a result of disease progression 21 months after the diagnosis and the other patient is currently being treated with radiotherapy.
Abdominal Neoplasms/*diagnosis ; Adult ; Female ; Humans ; Nerve Sheath Tumors/*diagnosis ; Neurofibromatosis 1/*complications ; Thoracic Neoplasms/*diagnosis

Symptoms of a peritoneal progression from ovarian cancer are nonspecific such as abdominal pain, abdominal distention and more. Many imaging studies and serum CA-125 help diagnosis. However, it is difficult to exclude the instances of the diffuse peritoneal diseases that mimic carcinomatosis. The elevated CA-125 level usually correlates with the peritoneal carcimatosis, but it is often found in other peritoneal diseases. Therefore, the pathologic confirmation is necessary because of other mimicking diseases. In our case, CA-125 levels were elevated. Abdominal computed tomography finding was suspected a peritoneal tuberculosis but the pathologic result was the peritoneal carcimatosis, eventually.
Abdominal Pain ; Carcinoma* ; Diagnosis ; Ovarian Neoplasms ; Peritoneal Diseases ; Peritonitis, Tuberculous*

Acute appendicitis (AA) is one of the most common causes of acute abdominal pain, which can progress to perforation of the appendix and peritonitis. Recently, AA has been classified into uncomplicated (nonperforated, no phlegmon) or complicated (abscess, perforation, phlegmon) appendicitis, for an appropriate initial treatment. With respect to surgical treatment of AA, laparoscopic surgery has been widely accepted worldwide as a safe and feasible first-line treatment. Over the last decade, non-operative treatment has been proposed as an alternative to surgery in uncomplicated AA, and has also played an important role in the management of complicated AA. AA is also the most common cause for abdominal surgery during pregnancy, though an accurate diagnosis of AA during pregnancy is challenging. In this review, the topics being discussed include: 1) Non-operative management for uncomplicated AA, 2) Management for AA in pregnancy, 3) Management for complicated appendicitis (especially immediate laparoscopic surgery for appendiceal abscess), 4) Appendiceal neoplasms related to complicated AA.
Abdominal Pain ; Appendiceal Neoplasms ; Appendicitis ; Appendix ; Diagnosis ; Laparoscopy ; Peritonitis ; Pregnancy

An isolated injury of the gallbladder rarely occurs after blunt abdominal trauma and is usually associated with damage to other intra-abdominal organs, which clearly necessitating surgical intervention. Blunt abdominal trauma is often overlooked because there may be no visible signs on the abdominal wall. It is important to closely follow up patients and look for early signs of organ damage as an isolated injury of the gallbladder often follows a vague and insidious clinical course. A combination of special investigations, including a contrast enhanced computed tomographic scan, may be required to confirm the diagnosis of this relatively rare, but serious injury, and if a lesion is suspected, a laparoscopy can be successfully used to confirm the diagnosis and treat this condition without the usual requirement of open exploration. Unfortunately, in our case, a laparoscopy could not be performed due to the patient having undergone previous surgery for early gastric cancer. Herein, the case of a 56-year-old male presenting with an isolated gallbladder injury immediately after violent blunt abdominal trauma, diagnosed on the basis of a computed tomographic scan, which was treated successfully, is reported.
Abdominal Injuries ; Abdominal Wall ; Diagnosis ; Gallbladder* ; Humans ; Laparoscopy ; Male ; Middle Aged ; Stomach Neoplasms

Primary hepatic leiomyosarcoma is a very rare tumor of the liver and primary hepatic leiomyosarcoma with Behcet's disease has not been reported previously. Behcet's disease is a multisystem disorder presenting with recurrent oral and genital ulcerations as well as ocular lesions; it has rarely been reported in association with malignant disease. We report a case of primary hepatic leiomyosarcoma with intrahepatic and abdominal subcutaneous metastasis in a patient with Behcet's disease; this is the first report of these findings in Korea.
Abdominal Neoplasms/diagnosis/*secondary ; *Abdominal Wall ; Adult ; Behcet Syndrome/*complications ; Female ; Humans ; Leiomyosarcoma/*complications/diagnosis/*secondary ; Liver Neoplasms/*complications/diagnosis/*secondary ; *Subcutaneous Tissue

Chronic, refractory abdominal pain without a metabolic or structural gastroenterological etiology can be challenging for diagnosis and management. Even though it is rare, it has been reported that such a recurrent abdominal pain associated with radicular pattern can be derived from structural neurologic lesion like spinal cord tumor. We experienced an unusual case of chronic recurrent abdominal pain that lasted for two years without definite neurologic deficits in a patient, who has been harboring thoracic spinal cord tumor. During an extensive gastroenterological workup for the abdominal pain, the spinal cord tumor had been found and was resected through surgery. Since then, the inexplicable pain sustained over a long period of time eventually resolved. This case highlights the importance of taking into consideration the possibility of spinal cord tumor in differential diagnosis when a patient complains of chronic and recurrent abdominal pain without other medical abnormalities.
Abdominal Pain* ; Diagnosis ; Diagnosis, Differential ; Humans ; Neurologic Manifestations ; Spinal Cord Neoplasms*

Desmoid tumor is a rare benign tumor derived from fibrous sheath or musculoaponeurotic structure. The tumor is benign histologically but considered as malignant clinically because it has high propensity on infiltrative growth with local invasion and tendency to recurrence after local excision. Especially, when this tumor happens to be in the intra-abdomen, the prognosis is worse because it can cause intestinal obstruction, ureter obstruction and, fistula formation. It also can invade major vessels in abdomen. This tumor occurs more frequently in patients with familial adenomatous polyposis (FAP), in post-partume women, and at old surgical incision site. However, in this case, the patient had neither previous surgery nor a FAP history. We report a rare case of the young male patient who presented with an acute abdomen and underwent laparotomy and was found to have an intra-abdominal desmoid tumor with abscess formation.
Abdominal Abscess/diagnosis ; Adult ; Diagnosis, Differential ; Fibromatosis, Abdominal/*diagnosis/pathology/surgery ; Humans ; Male ; Peritoneal Neoplasms/*diagnosis/pathology/surgery ; Tomography, X-Ray Computed

Malignant mesothelioma (MM) is a relatively rare carcinoma of the mesothelial cells, and it is usually located in the pleural or peritoneal cavity. Here we report on a unique case of MM that developed in the chest, abdominal and pelvic walls in a 77-year-old female patient. CT and MRI revealed mesothelioma that manifested as a giant mass in the right flank and bilateral pelvic walls. The diagnosis was confirmed by the pathology and immunohistochemistry. Though rare, accurate investigation of the radiological features of a body wall MM may help make an exact diagnosis.
Abdominal Neoplasms/diagnosis/*pathology ; Abdominal Wall ; Aged ; Female ; Humans ; Magnetic Resonance Imaging ; Mesothelioma/diagnosis/*pathology ; Muscle Neoplasms/diagnosis/pathology ; Pelvic Neoplasms/diagnosis/*pathology ; Thoracic Neoplasms/diagnosis/*pathology ; Tomography, X-Ray Computed

Abdominal Neoplasms ; diagnosis ; surgery ; Aged ; Diagnosis, Differential ; Hernia, Inguinal ; diagnosis ; Humans ; Inguinal Canal ; pathology ; Lymphangioma ; diagnosis ; surgery ; Male ; Treatment Outcome

Lymphangioleiomyomatosis (LAM) is a rare disease usually occurring in young women of child-bearing age. It is characterized by a distinctive proliferation of lymphatic smooth muscle cells, especially occurring in the pulmonary parenchyme. The majority of primary LAM occurs in the lung, but there are a few reports of extrapulmonary cases. We report a case of a 21-yr-old female who first complained of low abdominal pain and was referred from a local clinic with the impression of an ovarian cyst. Gynecologic ultrasonography revealed a large posterior pelvic mass with an irregular echogenicity measuring 9.7x4.2 cm in size. Pelviscopy showed a large, thin walled, partly cystic, pelvic mass. The mass was partly removed. Microscopically, the mass was characterized by a haphazard proliferation of smooth muscle cells arranged in fascicular, trabecular, and papillary patterns around a ramifying network of endothelium-lined spaces. The cells were plump or epithelioid with abundant eosinophilic cytoplasm and showed a positive reaction for both alpha-smooth muscle actin and HMB-45 antigen. Surgical and pathological findings were consistent with pelvic retroperitoneal LAM. Despite the numerous treatment attempts, the patient suffered from intractable chylous ascites and developed pulmonary LAM and died due to severe respiratory distress.
Abdominal Pain/diagnosis/etiology ; Adult ; Diagnosis, Differential ; Female ; Humans ; Lung Neoplasms/complications/*diagnosis ; Lymphangioleiomyomatosis/complications/*diagnosis ; Pelvic Neoplasms/complications/*diagnosis ; Rare Diseases/complications/diagnosis