Studying on 35 patients were preoperative diagnosed as pancreatic adenocarcinoma received operations in ViÖt §øc hospital during 2000-2001 showed that: 29 patients with pancreatic adenocarcinoma and 6 patients without the disease. The two dimensional ultrasound found 18 cases (62%) with specificity (50%) and correct (60%), value of positive predict (85.7%). The rate of precise diagnosis of two dimensional ultrasound, CT scanner, and endoscopic ultrasound were 60%, 72.7%, and 83.3%, respectively.
Adenocarcinoma ; Pancreas ; Endosonography ; Ultrasonography

Tailgut cyst is a rare congenital anomaly arising in the retrorectal space. Malignancy arising from the tailgut cyst is very rare. We experienced a case of adenocarcinoma arising from the tailgut cyst. The findings of this rare tumor are bony destruction of the sacrum on plain radiograph, a cystic mass on ultrasound, a low attenuation mass with calcification and enhancement on CT, and a multiseptated cystic mass containing solid component on MRI.
Adenocarcinoma* ; Magnetic Resonance Imaging ; Sacrum ; Ultrasonography

We encountered a patient with a breast mass which had metastasized from gastric carcinoma representing as aninflammatory carcinoma on ultrasonography. We described the radiologic and clinical features, and review theliterature. The patient had advanced gastric carcinoma and breast ultrasonography demonstrated the presence ofvery ill-defined, infiltrating, and mixed echoic lesions indistinguishable from findings of primary inflammatorybreast carcinoma. Metastatic gastric adenocarcinoma was confirmed pathologically.
Adenocarcinoma ; Breast Neoplasms* ; Breast* ; Humans ; Stomach Neoplasms* ; Ultrasonography ; Ultrasonography, Mammary

A 70-year-old man was admitted to our institution due to aggravation of blood-sugar level control and because an abdominal CT showed dilatation of the main pancreatic duct. Upper gastrointestinal endoscopy revealed a flat elevated tumor with central ulceration in the second portion of the duodenum. Subsequent duodenoscopy for a more detailed examination showed that the tumor had originated in the minor duodenal papilla. A biopsy specimen showed moderately differentiated adenocarcinoma. Endoscopic retrograde pancreatography via the major duodenal papilla revealed a slightly dilated main pancreatic duct and obstruction of the accessory pancreatic duct. Endoscopic ultrasonography showed a hypoechoic mass in the minor duodenal papilla with retention of the muscularis propria of the duodenum. These findings suggest that the tumor existed only to a limited extent in the minor duodenal papilla, and that the tumor did not infiltrate into the pancreas. For treatment, pylorus-preserving pancreatoduodenectomy was performed, and histological findings revealed a well-differentiated adenocarcinoma that originated in the minor duodenal papilla. Primary adenocarcinoma of the minor duodenal papilla is extremely rare. Our case is the first report of primary adenocarcinoma of the minor duodenal papilla at an early stage with no infiltration into muscularis propria of the duodenum and pancreas.
Adenocarcinoma/*pathology/ultrasonography ; Aged ; Endosonography ; Humans ; Male ; Pancreatic Ducts/*pathology/ultrasonography ; Pancreatic Neoplasms/*pathology/ultrastructure

OBJECTIVE: We wanted to evaluate the mammographic and sonographic differential features between pure (PT) and mixed tubular carcinoma (MT) of the breast. MATERIALS AND METHODS: Between January 1998 and May 2004, 17 PTs and 14 MTs were pathologically confirmed at our institution. The preoperative mammography (n = 26) and sonography (n = 28) were analyzed by three radiologists according to BI-RADS. RESULTS: On mammography, a mass was not detected in eight patients with PT and in one patient with MT (57% vs. 8%, respectively, p = 0.021), which was statistically different. The other findings on mammography and sonography showed no statistical differences between the PT and MT, although the numerical values were different. When the lesions were detected mammographically, an irregularly shaped mass with a spiculated margin was more frequently found in the MT than in the PT (100% vs. 83%, respectively, p = 0.353). On sonography, all 28 patients presented with a mass and most lesions showed as not being circumscribed, hypoechoic masses with an echogenic halo. Surrounding tissue changes and posterior shadowing were more frequently found in the MT than in the PT (75% vs. 50%, respectively, p = 0.253, 58% vs. 19%, respectively, p = 1.000). An oval shaped mass was more frequently found in the PT than in the MT (44% vs. 25%, respectively; p = 0.434). CONCLUSION: PT and MT cannot be precisely differentiated on mammography and sonography. However, the absence of a mass on mammography or the presence of an oval shaped mass would favor the diagnosis of PT. An irregularly shaped mass with surrounding tissue change and posterior shadowing on sonography would favor the diagnosis of MT and also a less favorable prognosis.
Adenocarcinoma/pathology/*radiography/*ultrasonography ; Adult ; Aged ; Breast Neoplasms/pathology/*radiography/*ultrasonography ; Diagnosis, Differential ; Female ; Humans ; Mammography ; Middle Aged ; Ultrasonography, Mammary

Nephrogenic diabetes insipidus (DI) secondary to chronic urinary tract obstruction is a rare disease. The exact cause is unknown but it is likely that increased collecting duct pressures cause damage to the tubular epithelium, resulting in insensitivity to the action of arginine-vasopressin (AVP). A 77-year-old man complaining of polyuria and polydipsia was treated with alpha glucosidase inhibitor under the impression of polyuria due to diabetes mellitus. But his symptoms did not improve. Water deprivation and AVP administration study revealed that the patient had nephrogenic DI. Urinary tract obstruction due to an enlarged prostate was suggested as a principal cause of nephrogenic DI. The patient underwent transurethral resection of the prostate and bilateral subcapsular orchiectomy. After surgery, the urine osmolarity was normalized and the patient became symptom-free. We report a case of nephrogenic DI due to obstructive uropathy which was cured by surgery eliminating obstruction.
Adenocarcinoma/ultrasonography ; Adenocarcinoma/radionuclide imaging ; Adenocarcinoma/pathology ; Adenocarcinoma/complications* ; Aged ; Case Report ; Constriction, Pathologic/etiology ; Diabetes Insipidus, Nephrogenic/etiology* ; Human ; Male ; Prostatic Neoplasms/ultrasonography ; Prostatic Neoplasms/radionuclide imaging ; Prostatic Neoplasms/pathology ; Prostatic Neoplasms/complications* ; Urologic Diseases/etiology*

We report a case in which mucinous adenocarcinoma arose in a duplication cyst at the distal ileum with in-traperitoneal seeding. A thirty-three-year-old male patient presented with abdominal distension. Ultrasonography, CT and MR imaging revealed a dumbbell-shaped cystic mass adherent to the small intestine. The wall of the mass was thickened in two areas and contained inhomogeneous materials. A large amount of ascites with irregular masses along the greater omentum were seen present. Surgery revealed a duplication cyst adherent to the ileum. Pathologic examination proved that the thickened portions of the wall of the mass were mucinous adenocarcinoma, and that the nodules on the greater omentum were metastatic adenocarcinoma.
Adenocarcinoma* ; Adenocarcinoma, Mucinous ; Ascites ; Humans ; Ileum ; Intestinal Neoplasms ; Intestine, Small ; Intestines ; Magnetic Resonance Imaging ; Male ; Omentum ; Ultrasonography

OBJECTIVE: To compare sonography and mammography in terms of their diagnostic value in breast cancer cases which initially presented as an axillary mass without a palpable mass or other clinical symptoms. MATERIALS AND METHODS: Seven patients with enlarged axillary lymph nodes who first presented with no evidence of palpable breast lesions and who underwent both mammography and sonography were enrolled in this study. In six of the seven, the presence of metastatic adenocarcinoma was confirmed preoperatively by axillary needle aspiration biopsy; in four, subsequent sonographicallyguided breast core biopsy performed after careful examination of the primary site indicated that primary breast cancer was present. In each case, the radiologic findings were evaluated by both breast sonography and mammography. RESULTS: Breast lesions were detected mammographically in four of seven cases (57%); in three of the four, the lesion presented as a mass, and in one as microcalcification. In three of these four detected cases, fatty or scattered fibroglandular breast parenchyma was present; in one, the parenchyma was dense. In the three cases in which lesions were not detected, mammography revealed the presence of heterogeneously dense parenchyma. Breast sonography showed that lesions were present in six of seven cases (86%); in the remaining patient, malignant microcalcification was detected at mammography. Final pathologic examination indicated that all breast lesions except one, which was a ductal carcinoma in situ, with microinvasion, were infiltrating ductal carcinomas whose size ranged from microscopic to greater than 3 cm. At the time of this study, all seven patients were alive and well, having been disease free for up to 61 months after surgery. CONCLUSION: In women with a palpable axillary mass confirmed as metastatic adenocarcinoma, breast sonography may be a valuable adjunct to mammography.
Adenocarcinoma/radiography/secondary/*ultrasonography ; Adult ; Axilla/*pathology ; Biopsy, Needle ; Breast/*pathology ; Breast Neoplasms/pathology/radiography/*ultrasonography ; Carcinoma, Infiltrating Duct/pathology/radiography/*ultrasonography ; Carcinoma, Intraductal, Noninfiltrating/pathology/radiography/*ultrasonography ; Female ; Human ; Lymph Nodes/radiography/*ultrasonography ; Mammography ; Middle Age ; Ultrasonography, Mammary

Accurate diagnosis of pancreatic solid lesions is often difficult using conventional imaging modalities. With the recent introduction of contrast-enhanced harmonic endoscopic ultrasound (CEH-EUS), it is now possible to evaluate the microvascular environment and dynamic enhancement of a variety of pancreatic lesions. With CEH-EUS, three patterns of pancreatic lesion enhancement compared with the normal pancreatic tissue (fast, simultaneous, or slow), two washout patterns (fast or slow) and two distribution patterns (homogeneous, inhomogeneous) can be described. By evaluating the microvasculature, enhancement speed, and washout pattern, CEH-EUS may help to differentiate pancreatic adenocarcinoma from other masses and differentiate between pancreatic neuroendocrine tumor (pNET) and inflammatory masses. The finding of a hyperenhancing lesion on CEH–EUS, both with homogeneous and inhomogeneous patterns, was a strong predictor of histology different from adenocarcinoma (94% positive predictive value). pNET was the most common hyperenhancing lesions overall. Although CEH-EUS is useful for ruling out pancreatic ductal adenocarcinoma, making the differential diagnosis between pNETs and pseudotumoral pancreatic masses is difficult because both may share an isovascular or hypervascular appearance. Currently the interpretation of CEH-EUS findings is examiner-dependent. In the future, digital image analysis by image-processing techniques should allow more objective interpretation.
Adenocarcinoma ; Diagnosis ; Diagnosis, Differential ; Microvessels ; Neuroectodermal Tumors, Primitive ; Neuroendocrine Tumors ; Pancreatic Ducts ; Ultrasonography*

PURPOSE: We would like to know whether the serum PSA could be used as a biochemical marker in the diagnosis and follow-up of patients with acute prostatitis. MATERIALS AND METHODS: The records of 23 patients with acute prostatitis whose serum PSA levels were checked, from February 1995 to February 2001, were reviewed retrospectively. Mean patient age was 54.2 years (range 27-80). We followed serum PSA of the patients regularly with 1-2 weeks interval for one month and after then with 2-4 weeks interval. RESULTS: The elevation of serum PSA level above 4ng/ml was found in 22/23 (95.6%) patients with acute prostatitis. Mean initial PSA level was 26.6ng/ml (range 1.5-100). Out of the 15 patients whose serum PSA levels were followed after treatment, 10 (66.7%) patients showed normalization of PSA level within 6 weeks. In 3 of 15 (20%) patients, PSA level was normalized after 6 weeks. Two patients whose PSA levels were elevated after resolution of prostatitis underwent transrectal ultrasonography of the prostate with biopsies. None was found to have adenocarcinoma of prostate. CONCLUSIONS: In the majority of patients with acute prostatitis, serum PSA levels were elevated initially and declined after appropriate treatments. Therefore, serum PSA level could be used as a biochemical marker in the diagnosis and follow-up of patients with acute prostatitis as an adjunct to the clinical findings.
Adenocarcinoma ; Biomarkers ; Biopsy ; Diagnosis* ; Follow-Up Studies* ; Humans ; Prostate ; Prostate-Specific Antigen* ; Prostatitis* ; Retrospective Studies ; Ultrasonography