Melanocytic nevus is the benign proliferation of melanocytes. The most common location of melanocytic nevus is the skin of the extremities; however, there are few case reports of melanocytic nevus at the rectal mucosa. No prior case of malignant melanoma from melanocytic nevus at the rectal mucosa has been reported; therefore, it is unclear whether resection should be performed or close observation is sufficient. However, the potential malignant transformation of melanocytic nevus should be considered, including melanocytic nevus on the rectum. Melanocytic nevus of the skin can be removed by surgical excision; however, due to rare incidence on the mucosa of the gastrointestinal tract, the optimal treatment for rectal melanocytic nevus remains controversial. Here, we report the first case of melanocytic nevus on the rectal mucosa that was removed by endoscopic submucosal dissection. This case report provides useful information about the optimal management of rectal melanocytic nevus.
Extremities ; Gastrointestinal Tract ; Incidence ; Melanocytes ; Melanoma ; Mucous Membrane* ; Nevus, Pigmented* ; Rectum ; Skin

Leptomeningeal metastasis(LM) usually occurs in patients with previous cancer. But rarely it can be the first manifestation of cancer. We analyzed primary tumors and early clinical findings in 12 patients in whom LM was the presenting sign of cancer. Primary tumors were lung cancer in 5 cases, stomach cancer 1, lymphoma 1 and unknown 5. Most patients, previously healthy, developed progressive headache which was followed by symptoms and signs involving multiple neuraxis. Major symptoms on admission were headache, nausea, vomitting, visual dimmness, diplopia, hearing disturbance and the major neurologic deficits were papilledema, ocular motor palsy, decreased DTR and neck stiffness. From these clinical findings and CSF test, initially LM was suspected in only 6 patients. In the remaining 6 patients, initial diagnosis were tuberculosis meningitis(3), benigh intracranial hypertension(2) and adjustment disorder(1). In addition to cytology, which was positive in 9 cases, CSF carcinoembryonic antigen(CEA) and neuroimaging played an important role in the early diagnosis of LM. Despite whole brain radiation therapy, all patients worsened and expired 2 weeks-10weeks(median survival, 3 weeks) after the diagnosis.
Brain ; Diagnosis ; Diplopia ; Early Diagnosis ; Headache ; Hearing ; Humans ; Lung Neoplasms ; Lymphoma ; Nausea ; Neck ; Neoplasm Metastasis* ; Neuroimaging ; Neurologic Manifestations ; Papilledema ; Paralysis ; Stomach Neoplasms ; Tuberculosis

We experienced a patient of subcondylar fracture who had a squared contour of the lower face with prominent angle of the mandible and masseter hypertrophy. Our patient was increasingly seeking esthetic improvement of the lower third of the face. But she did not want multi-stage operations. Thus, we decided and performed a one-stage mandibular angle ostectomy with fracture management. We have a stable and esthetic result simultaneously despite fractures of the fixation plates during follow-up period, so report a case.
Botulinum Toxins ; Follow-Up Studies ; Humans ; Hypertrophy ; Mandible* ; Mandibular Condyle ; Mandibular Osteotomy

Central venous catheterization is used to provide a large amount of fluid, total parenteral nutrition and to administer antitumor agents with few complications reported. We report an uncommon case of pleural effusion that occurred after central venous catheterization. In many cases, the mechanism for the pleural effusion after central venous catheterization occurs through an injury to the superior vena cava by the continuous mechanical force of the catheter tip, the flow of large amount of fluid and an osmotic injury to the wall of the vein. This case is somewhat different in that the central catheter was placed in an aberrant vessel resulting in the pleural effusion. A post-placement chest roentgenogram and the correct approach of catheterization are important for preventing this complication.
Antineoplastic Agents ; Catheterization ; Catheterization, Central Venous ; Catheters ; Central Venous Catheters* ; Parenteral Nutrition, Total ; Pleural Effusion* ; Thorax ; Veins ; Vena Cava, Superior