We report a rare case of thyroid metastasis from early gastric cancer with lymph node metastasis in a 63-yr old woman. She was diagnosed with metastatic adenocarcinoma one and a half years after distal subtotal gastrectomy, by fine needle aspiration (FNA) using thyroid sonography. Thyroid metastasis from gastric cancer is extremely rare, and this case is particular in that it is the first report of thyroid metastasis from early gastric cancer.
*Adenocarcinoma/pathology/secondary ; Biopsy, Fine-Needle ; Fatal Outcome ; Female ; Humans ; Lymphatic Metastasis/*pathology ; Middle Aged ; Stomach Neoplasms/*pathology ; Thyroid Neoplasms/pathology/*secondary

Delayed-onset continuous bruxism due to brain stem infarction has not yet been reported. A 49-year old man presented with quadriplegia and ophthalmoplegia. Brain MRI showed acute infarction in the bilateral midbrain, right thalamus and the superior cerebellum. One month later, the patient developed bruxism which persisted during sleep. A palatal myoclonus was not observed. Follow up MRI taken 4 months later showed bilateral olivary hypertrophy. We suggest that the patient's bruxism may be related to the olivary hypertrophy. The bruxism generator may be located in the pontine-reticular-formation (PRF). Bilateral large midbrain lesions interrupting the cortical inhibition may have produced bilateral olivary hypertrophy, which could stimulate the PRF, producing continuous bruxism.
Brain ; Brain Stem Infarctions* ; Bruxism* ; Cerebellum ; Follow-Up Studies ; Humans ; Hypertrophy* ; Infarction ; Magnetic Resonance Imaging ; Mesencephalon ; Middle Aged ; Myoclonus ; Ophthalmoplegia ; Quadriplegia ; Thalamus

A 34-year-old male patient was first admitted to our Department on October 16, 1965. He complained of frontal headaches especially in the morning and ild right hemiparesis over the previous 6 months, which were progressively more severe as time went by. On examination, he was mentally clear ut slightly dysphasic: there were mild right hemisparesis and marked bilateral papilledema. Angiogram showed a left posterior frontal vascular tumor. At operation on November 3, 1965, total excision of a posterior frontal parasagittal tumor was performed. To the naked eye, this seemed to be a meningioma; the tumor was egg-sized, round but somewhat lobulated, graysish white in color, firm and fibrotic appearance, and it attached to the superior longitudinal sinus, involving without occluding it. Histologically. It was considered a meningioma of firbrolastic type, containing small amount of capillaries and some areas of collegen deposition around the fibroblasitc cell masses with foci of meningoendothelial cluster; though some doubt was expressed over its innocence. He tolerated the resection of frontal tumor well, and remained in relatively good health for 7 years, as to do his usual farmer work with minimal right hemiparesis. There were some episodes of generalized seizure during there periods. The patients was readmitted on December 25, 1972, however, because of frontal headaches and vomiting over recent 6 months and dysphasia, mental confusion developing rapidly over the previous 3 months. Urinary incontinence was also complained of. On examination he was drowsy, apathetic and mentally confused, more so than when first admitted. There was a goose-egg sized tense bulging in the left frontotemporal region, previously operated. Central-typed right facial palsy, right hypoglossal palsy and bilateral marked papilledema were noted. There were spastic hemiparesis, greater in the upper extremity, and long tract signs on the right side. Angiogram revealed a posterior frontal parasagittal vascular tumor, much as before. At operation on January 5, 1973, subtotal resection of tumor was performed, remaining the deep-seated parasagittal posterior frontal mass. The gross appearance of tumor was necrotic partially on the surfaces, potato-shaped with nodularith and pinkish white in color. On sectioning cut surface was slightly myxoid with cystic degeneration in the center. There was also patchy degeneration, showing yellow tinge in the cut surface. Microscopically, there were prominent hypercellularity with many mitoses, atypism, pleomorphism and degenerative process. Vascutar reaction with amyloid-like infiltration in perivascular area was also demonstrated as with focal pseudocartilagenous degeneration and partial hemorrhage; overall findings were highly suggestive of recurrent memingioma with malignant change (sarcomatous change) in left posterior frontal parasagittal region.
Adult ; Aphasia ; Capillaries ; Facial Paralysis ; Headache ; Hemorrhage ; Humans ; Male ; Meningioma* ; Mitosis ; Muscle Spasticity ; Papilledema ; Paralysis ; Paresis ; Seizures ; Superior Sagittal Sinus ; Tolnaftate ; Transcutaneous Electric Nerve Stimulation ; Upper Extremity ; Urinary Incontinence ; Vomiting

Trigeminal neurinoma is a rare condition arising from the gasserian or trigeminal nerve root. It comprises 0.2% of all brain tumors, and usually affects middle life, but about 10% of it appears in adolescents. Middle fossa syndrome, symptoms and signs of cerebellopontine angle tumor and mixture of these may be developed through the extension of the tumor. Symptoms and signs of cerebellar and midbrain compression may also be elicited in some stage of the tumor. Erosion of the Anteromedial portion of the petrous apex and defect of the flow of the middle fossa contribute to the diagnosis. Air studies and cerebral antiography have been used, and recently pantopaque basal cisternography has been introduced. The route of operation depends upon the main localization of the tumor, but transtemporal approach with tentorial section is widely used for dumbbell-shaped tumor. A case of cerebellopontine angle tumor which had been postoperatively proved to be a trigeminal neurinoma is reported.
Adolescent ; Brain Neoplasms ; Diagnosis ; Humans ; Iophendylate ; Mesencephalon ; Neurilemmoma* ; Neuroma, Acoustic ; Puberty* ; Trigeminal Nerve

Trigeminal neurinoma is a rare condition arising from the gasserian or trigeminal nerve root. It comprises 0.2% of all brain tumors, and usually affects middle life, but about 10% of it appears in adolescents. Middle fossa syndrome, symptoms and signs of cerebellopontine angle tumor and mixture of these may be developed through the extension of the tumor. Symptoms and signs of cerebellar and midbrain compression may also be elicited in some stage of the tumor. Erosion of the Anteromedial portion of the petrous apex and defect of the flow of the middle fossa contribute to the diagnosis. Air studies and cerebral antiography have been used, and recently pantopaque basal cisternography has been introduced. The route of operation depends upon the main localization of the tumor, but transtemporal approach with tentorial section is widely used for dumbbell-shaped tumor. A case of cerebellopontine angle tumor which had been postoperatively proved to be a trigeminal neurinoma is reported.
Adolescent ; Brain Neoplasms ; Diagnosis ; Humans ; Iophendylate ; Mesencephalon ; Neurilemmoma* ; Neuroma, Acoustic ; Puberty* ; Trigeminal Nerve

Dystrophic calcifications themselves in the breast are classified as typically benign according to the Breast Imaging Reporting and Data System. However, we experienced a patient with invasive ductal carcinoma surrounding large dystrophic calcifications that could be regarded as long-standing benign conditions such as fat necrosis or hematoma. A 61-year-old woman presented with two large dystrophic calcifications within an irregular mass in the right upper outer breast on mammography. Ultrasonography revealed an irregular mass with dense calcifications showing strong posterior acoustic shadowing. On contrast enhanced magnetic resonance imaging, an irregular mass showed a persistent enhancement pattern and high signal intensity on a diffusion weighted image with non-enhancing areas corresponding to the calcifications. No abnormal uptake was observed on Tc-99m methylene diphosphonate bone scan. Invasive ductal carcinoma was observed on ultrasonography-guided core needle biopsy. In this case, we conclude that typical dystrophic calcifications within a breast mass cannot guarantee a benign diagnosis if the imaging characteristics of the mass are suspicious.
Acoustics ; Biopsy, Large-Core Needle ; Breast* ; Carcinoma, Ductal ; Diagnosis ; Diffusion ; Fat Necrosis ; Female ; Hematoma ; Humans ; Information Systems ; Magnetic Resonance Imaging ; Mammography ; Middle Aged ; Shadowing (Histology) ; Technetium Tc 99m Medronate ; Ultrasonography

BACKGROUND AND OBJECTIVES: Sudden deafness in the elderly is rare and its prognosis is poorer than in adults. The unaffected ear also may have hearing impairment of variable severity and physiological hearing threshold shift termed presbycusis in the elderly. The old person often had various systemic complications including diabetes and hypertension. This study was designed to evaluate clinical manifestations and prognosis of sudden deafness in the elderly and to compare with sudden deafness in adults and children. SUBJECTS AND METHOD: We reviewed the medical and audiological records of 96 patients (102 ears) who are more than 60 years of age, and admitted to the Department of Otolaryngology, Pusan National University Hospital from January 1990 to December 2001. RESULTS: The total recovery rate of sudden deafness was lower in the elderly than in adults and children. Hearing recovery was significantly poorer in the patients with diabetes and hypertension. Hearing recovery was significantly poor in the patients with profound degree of hearing loss. The patients who had been treated within 7 days after onset of hearing loss showed better recovery rate than those treated 7 days later. CONCLUSION: We consider the effect of treatment of sudden deafness in the elderly to be best judged in various degrees of hearing impairment in the unaffected ear. The poor prognosis observed in patients with the concurrent disease is likely to have been brought about by preexisting microvascular diseases of the hearing organ, which is highly affected by aging. Good hearing recovery in the elderly is considered to be associated with time of initial treatment and expected in patients without concurrent diseases.
Adult ; Aged* ; Aging ; Busan ; Child ; Ear ; Hearing ; Hearing Loss ; Hearing Loss, Sudden* ; Humans ; Hypertension ; Otolaryngology ; Presbycusis ; Prognosis

OBJECTIVE: To evaluate the early clinical experience associated with radiofrequency (RF) ablation in patients with renal cell carcinoma (RCC). MATERIALS AND METHODS: The RF ablation treatment was performed on 17 tumors from 16 patients (mean age, 60.5 years; range, 43-73 years) with RCC. The treatment indications were localized, solid renal mass, comorbidities, high operation risk, and refusal to perform surgery. All tumors were treated by a percutaneous CT (n = 10), followed by an US-guided (n = 2), laparoscopy-assisted US (n = 2), and an open (n = 2) RF ablation. Furthermore, patients underwent a follow-up CT at one day, one week, one month, three and six months, and then every six months from the onset of treatment. We evaluated the technical success, technical effectiveness, ablation zone, benign periablation enhancement, irregular peripheral enhancement, and complications. RESULTS: All 17 exophytic tumors (mean size, 2.2 cm; range, 1.1-5.0 cm) were completely ablated. Technical success and effectiveness was achieved in all cases and the mean follow-up period was 23.8 months (range, 17-33 months). A local recurrence was not detected in any of the cases; however, five patients developed complications as a result of treatment, including hematuria (n = 2), mild thermal injury of the psoas muscle (n = 1), mild hydronephrosis (n = 1), and fistula formation (n = 1). CONCLUSION: The RF ablation is an alternative treatment for exophytic RCCs and represents a promising treatment for some patients with small RCCs.
Adult ; Aged ; Carcinoma, Renal Cell/radiography/*surgery ; *Catheter Ablation/adverse effects ; Female ; Humans ; Kidney Neoplasms/radiography/*surgery ; Male ; Middle Aged ; Tomography, X-Ray Computed