1.True Posterior Communicating Artery Aneurysms with High Risk of Rupture despite Very Small Diameter
Dong Gyu SHIN ; Jaechan PARK ; Myungsoo KIM ; Byoung-Joon KIM ; Im Hee SHIN
Journal of Korean Neurosurgical Society 2022;65(2):215-223
Objective:
: This retrospective study investigated the clinical and angiographic characteristics of ruptured true posterior communicating artery (PCoA) aneurysms in comparison with junctional PCoA aneurysms presenting with a subarachnoid hemorrhage.
Methods:
: The medical records and radiological data of 93 consecutive patients who underwent three-dimensional rotational angiography and surgical or endovascular treatment for a ruptured junctional or true PCoA aneurysm over an 8-year period were examined.
Results:
: The maximum diameter of the ruptured true PCoA aneurysm (n=13, 14.0%) was significantly smaller than that of the ruptured junctional PCoA aneurysms (n=80, 4.45±1.44 vs. 7.68±3.36 mm, p=0.001). In particular, the incidence of very small aneurysms <4 mm was 46.2% (six of 13 patients) in the ruptured true PCoA aneurysm group, yet only 2.5% (two of 80 patients) in the ruptured junctional PCoA aneurysm group. Meanwhile, the diameter of the PCoA was significantly larger in the true PCoA aneurysm group than that in the junctional PCoA aneurysm group (1.90±0.57 vs. 1.15±0.49 mm, p<0.001). In addition, the ipsilateral PCoA/P1 ratio was significantly larger in the true PCoA aneurysm group than that in the group of a junctional PCoA aneurysm (mean PCoA/P1 ratio±standard deviation, 2.67±1.22 vs. 1.14±0.88; p<0.001). No between-group difference was identified for the modified Fisher grade, clinical grade at admission, and 3-month modified Rankin Scale score.
Conclusion
: A true PCoA aneurysm was found to be associated with a larger PCoA and ruptured at a smaller diameter than a junctional PCoA aneurysm. In particular, the incidence of a ruptured aneurysm with a very small diameter <4 mm was significantly higher among the patients with a true PCoA aneurysm.
2.Coexistence of Papillary Thyroid Carcinoma and Strumal Carcinoid Arising from Struma Ovarii in Pregnant Women: a Case Report and Review
Myungsoo IM ; Doohwa KIM ; Soree RYANG ; Bo Hyun KIM
International Journal of Thyroidology 2023;16(1):134-138
Mature cystic teratomas (MCTs) of the ovary can occur at any age; however, the most common period is childbearing age, accounting for 10-20% of ovarian tumors and 85-97% of germ cell tumors. Differentiated thyroid cancers from MCTs in pregnant women are rare. A 32-year-old pregnant women presented with left ovarian mass revealed following a transabdominal ultrasonography performed to confirm pregnancy. After delivery, left ovarian cystectomy was performed and mass was examined by pathologists. The result of pathological examination was a combined papillary thyroid carcinoma (PTC) and stromal carcinoid from a mature teratoma.Thyroid ultrasonography was performed to check for accompanying thyroid cancer. Two nodules with no suspected malignancy were observed in both lobes and no other adjuvant therapy was administered. We would like to report this extremely rare case along with a literature review.