Intraarterial embolization for a congenital vascular malformation can provide transient symtomatic relief but recurrence of the lesion occurs in most cases. The authors present a 29-year-old female patient with extensive pelvic vascular malformation who was underwent preoperative embolzation twice and a final operative intervention.
Adult ; Female ; Humans ; Recurrence ; Vascular Malformations

Multiple myeloma is usually restricted to bone marrow, but extramedullary involvement can occur in the form of plasmacytomas. Several cases of multiple myeloma which developed into mutiple extramedullary involvements have been reported. We report a case of extramedullary plasmacytomas of posterior mediastinum, and gingiva, which developed in the course of mutiple myeloma in a 57-year-old man. The patient progressed to fulminant hepatic failure resulting in rapid fatal outcome.
Bone Marrow ; Fatal Outcome ; Gingiva* ; Humans ; Liver Failure ; Liver Failure, Acute* ; Mediastinum* ; Middle Aged ; Multiple Myeloma* ; Plasmacytoma*

BACKGROUND: The use of furosemide is well recognized as a predisposing factor to nephrocalcinosis (NC) in infants. Although furosemide is widely used for various clinical settings in adults, the association of furosemide use and nephrocalcinosis in adults is not well established. METHODS: We studied 18 consecutive adult patients(male : female=1 : 17, age range 21-59 years) who took furosemide habitually to control their weights or edema for a long-term period(range 3-25 years). NC was evaluated using renal ultrasonography(US), computed tomography(CT) and/or kidney biopsies. Patients were categorized into NC(+) and NC(-) groups while the difference in clinical features were investigated. RESULTS: Renal US and CT revealed nephrocalcinosis in the bilateral medullary pyramids in 15(83.3 %) out of 18 patients. The duration of furosemide abuse was not different between NC(+) and NC(-) groups(10.1+/-1.7 years vs. 15.3+/-0.9, p>0.05). The daily dose of furosemide was higher in NC(+) group than the NC(-) group(538+/-174 vs. 67+/-13 mg/day, p<0.01), however. All patients showed a variable degree of renal insufficiency and there was no difference in creatinine clearance between two groups(p>0.05). The kidney biopsies performed in three patients showed focal tubulointerstitial fibrosis and atrophy and calcifications were observed at outer medullary tubulointerstitium. CONCLUSION: Long-term furosemide abuse could cause medullary nephrocalcinosis in adults and the risk of developing of nephrocalcinosis is correlated with the daily dose of furosemide. We suggest that long-term furosemide abuse should be suspected in adult patients when medullary nephrocalcinosis is incidentally detected by US and/or CT.
Adult* ; Atrophy ; Biopsy ; Causality ; Creatinine ; Edema ; Fibrosis ; Furosemide* ; Humans ; Infant ; Kidney ; Nephrocalcinosis* ; Renal Insufficiency ; Ultrasonography ; Weights and Measures