A 32 year-old male was admitted to our hospital complaining of nausea, vomiting, fever and abdominal pain. Physical examination revealed lower abdominal mass associated with severe peritoneal irritation sign. The right testis was not palpated. Though the tumor might be the abdominal cryptorchid testis tumor. the other surgical abdominal conditions of non-urologic origin couldn't be rouled out. So, we performed emergent exploration. The mass had been ruptured and adhered to sigmoid colon. Histological examination revealed mixed germ cell tumor, composed of yolk sac tumor and classic seminoma. We performed systemic chemotherapy with bleomycin. etoposide and cisplatin under diagnosis of mixed germ cell tumor of stage III B-5.
Abdominal Pain ; Adult ; Bleomycin ; Cisplatin ; Colon, Sigmoid ; Diagnosis ; Drug Therapy ; Endodermal Sinus Tumor ; Etoposide ; Fever ; Humans ; Male ; Nausea ; Neoplasms, Germ Cell and Embryonal ; Physical Examination ; Rupture, Spontaneous* ; Seminoma ; Testis* ; Vomiting

No abstract available.

PURPOSE: To evalute the usefulness of contrast-enhanced fat saturation T1-weighted imaging for the evaluationof spinal lipoma, compared with clinical symptoms and surgical findings. MATERIALS AND METHODS: Ten patients withlipomyelomeningocele, confirmed by surgery, were included in this study. In all cases, conventional spin echoT1-and T2-weighted MR imaging, and contrast-enhanced fat saturation T1-weighted imaging was performed to evaluateclinical symptoms, the position of the conus medullaris, the prescence of cord tethering, and associatedanomalies, and to compare the relative usefulness of the techniques. RESULTS: All ten patients were sufferingfrom lipomyelomeningocele without filum terminale fibrolipoma or intradural lipoma. All cases were associated withcord tethering. As associated anomalies, there were seven cases of syringomyelia without hydrocephalus oranorectal anomaly. To evaluate the position of the spinal conus and the prescence of cord tethering, conventionalT1-weighted imaging was more useful than the contrast-enhanced fat saturation equivalent. CONCLUSION: In patientswith early-stage spinal lipona, MRI is useful for evaluation of the causes and position of cord tethering andassociated anomalies Our results suggest that contrast-enhanced fat saturation T1-weighted images do not provideadditional information concerning spinal lipoma, and that for the diagnosis of this condition, conventional T1 and T2-weighted images are more useful than those obtained by contrast-enhanced fat saturation T1-weighted imaging.
Cauda Equina ; Conus Snail ; Diagnosis ; Humans ; Hydrocephalus ; Lipoma* ; Magnetic Resonance Imaging ; Spinal Cord ; Syringomyelia

PURPOSE: The aim of this study was to determine a safe gastrointestinal contrast agent that could be used in various clinical situations where there is a risk of aspiration using a rabbit model. MATERIALS AND METHODS: 30 healthy white rabbits were used. The rabbits were divided into 5 groups containing six animals each, one control group (anesthesia only) and 4 groups receiving various contrast agents [Solotop (Barium sulphate suspension), Gastrografin (Sodium and meglumine amidotrizoate), and Telebrix (Meglumine ioxitalamate), Visipaque (Iodixanol)]. The contrast agents were injected selectively into a main bronchus via a catheter inserted under fluoroscopy guidance. The rabbits were sacrificed either 1 day or 7 days after injecting the contrast agents, and the tissue reaction of the bronchi and lungs were examined both macro- and microscopically. The level of alveolar septal thickening, peribronchiolar lymphocytic infiltration, pulmonary congestion and edema, inflammatory exudate in the alveoli or bronchiolar lumina, microabscess formation, necrosis, pigmentation of materials injected, and fibropurulent pleurisy were evaluated and graded according to the severity as follows: no change, mild, moderate, marked in degree. RESULTS: The common microscopic findings were alveolar septal thickening and peribronchiolar lymphocytic infiltration. Pulmonary congestion and edema, inflammatory exudate in the alveoli or bronchiolar lumina were observed in 21 out of 24 rabbits receiving the contrast agents. Pigmentation of the materials injected was observed only in the group receiving Solotop. An inflammatory exudate in the alveoli and bronchiolar/bronchial lumina, microabscess formation, and necrosis were noted in most groups, but was more frequent and severe in the group receiving Gastrografin. CONCLUSION: The histopathological reactions of the rabbit lungs after the intrabronchial application of a contrast agent showed variable degrees of inflammatory reactions. Gastrografin produced most severe and extensive reaction, Solotop and Telebrix a moderate reaction, and Visipaque a minimal reaction. Therefore, a non-ionic dimeric contrast agent such as Visipaque may be the safest contrast agent in the lung when a GI tract examination is performed in clinical situations where there is a risk of aspiration.
Animals ; Bronchi ; Catheters ; Contrast Media* ; Diatrizoate Meglumine ; Edema ; Estrogens, Conjugated (USP) ; Exudates and Transudates ; Fluoroscopy ; Gastrointestinal Tract ; Lung* ; Meglumine ; Necrosis ; Pigmentation ; Pleurisy ; Rabbits