The origins of medullary carcinoma and papillary carcinoma of thyroid are embryologically different. We report a case of simultaneous occurrence of medullary carcinoma and papillary carcinoma of the thyroid in the same thyroid gland. In this case, the occurrence of the two tumors may be a coincidence, does not have embryological or genetical significance.
Carcinoma, Medullary ; Carcinoma, Papillary* ; Thyroid Gland*

We report a rare case of multiple myeloma with biclonal gammopathy (IgG kappa and IgA lambda type) in a 58-year-old man with prostate cancer who presented with lower back pain. Through computed tomography (CT) imaging, an osteolytic lesion at the L3 vertebra and an enhancing lesion of the prostate gland with multiple lymphadenopathies were found. In the whole body positron emission tomography-computed tomography (PET-CT), an additional osteoblastic bone lesion was found in the left ischial bone. A prostate biopsy was performed, and adenocarcinoma was confirmed. Decompression surgery of the L3 vertebra was conducted, and the pathologic result indicated that the lesion was a plasma cell neoplasm. Immunofixation electrophoresis showed the presence of biclonal gammopathy (IgG kappa and IgA lambda). Bone marrow plasma cells (CD138 positive cells) comprised 7.2% of nucleated cells and showed kappa positivity. We started radiation therapy for the L3 vertebra lesion, with a total dose of 3,940 cGy, and androgen deprivation therapy as treatment for the prostate cancer.
Adenocarcinoma/complications/*diagnosis/radiotherapy ; Antineoplastic Agents/therapeutic use ; Bone Marrow Cells/metabolism/pathology ; Combined Modality Therapy ; Humans ; Immunoelectrophoresis ; Immunoglobulin kappa-Chains/blood ; Immunoglobulin lambda-Chains/blood ; Male ; Middle Aged ; Multiple Myeloma/complications/*diagnosis/drug therapy ; Neoplasm Staging ; Positron-Emission Tomography ; Prostatic Neoplasms/complications/*diagnosis/radiotherapy ; Spine/pathology ; Syndecan-1/metabolism ; Tomography, X-Ray Computed

PURPOSE: Cancer invasion is induced by several proteolytic enzyme systems associated with the destruction of basement membrane and extracellular matrix. Urokinase-type plasminogen activator (uPA) and plasminogen activator inhibitor-1 (PAI-1) have been reported as prognostic factors in breast cancer patients and plasminogen activation is regulated by various factor such as uPAR and growth factor. So we examined the tissue levels of urokinase-type plasminogen activator receptor (uPAR) in breast cancer patients. MATERIALS AND METHODS: Tissue uPAR levels were measured by ELISA assay in 268 breast cancer patients. RESULTS: The median and mean values of tissue uPAR level in breast cancer were 3.5 ng/mg and 4.8+-3.6 ng/mg cytosol protein, respectively. Tissue uPAR level was the highest in T1 stage, but there was no statistical significance between T stage (p >0.05). In nodal stage, there was also no difference in the value of uPAR according to progression. And the value of uPAR expression was not associated with estrogen and progesteron receptor status, number of involved node and percent of node involvement. In TNM stage, tissue uPAR levels were higher in patients with stage I-II than in patients with stage III-IV (p=0.027). In univariate analysis, nodal factor (p=0.0023) and TNM stage (p=0.0004) were significantly associated with overall survival. But, multivariate analysis showed that TNM stage was the only significant prognostic factor (p=0.0002). CONCLUSION: These results suggest that uPAR is mainly associated with initial tumor invasion and other factors might be involved in later stages of cancer progression.
Basement Membrane ; Breast Neoplasms* ; Breast* ; Cytosol ; Enzyme-Linked Immunosorbent Assay ; Estrogens ; Extracellular Matrix ; Humans ; Multivariate Analysis ; Plasminogen Activators* ; Plasminogen* ; Urokinase-Type Plasminogen Activator*

Uterine cervical cancer is the 5(th) most common malignancy in Korean women. With the development of new diagnostic and therapeutic modalities, earlier stage cancers are being diagnosed with longer survival rates being anticipated. Accordingly, recurrent cancers are being encountered more often in clinical practice. Most recurrent uterine cervical cancer patients, have intra-pelvic lesions and adjacent lymph node involvement, while a distant metastasis alone is extremely rare. A mediastinal recurrence of uterine cervical cancer is not common with most manifesting as small lymph node enlargements. We report a case of a 46-year-old woman with recurrent uterine cervical cancer presenting only as a huge mediastinal mass without a local recurrence.
Female ; Humans ; Lymph Nodes ; Middle Aged ; Neoplasm Metastasis ; Recurrence ; Survival Rate ; Uterine Cervical Neoplasms*

Multiple primary cancers are the occurrence of more than two cancers of different origin in an individual. Penile cancer is a rare disease, and finding it combined with other cancers is even rarer. A 64-year-old man with a painful penile mass was referred to us from a primary urological clinic. We performed a biopsy of the penile mass and the histology revealed a well-differentiated squamous cell carcinoma. Abdominal computed tomography showed a localized bladder tumor with inguinal lymphadenopathy. The patient underwent a partial penectomy, transurethral resection of the bladder tumor and inguinal lymph node dissection. The histology of the bladder tumor was high-grade papillary carcinoma, and that of the lymph node was squamous cell carcinoma. The penile and bladder tumors were in stage II (T1N1M0) and stage I (T1N0M0), respectively. We successfully treated the patient with adjuvant radiotherapy and systemic chemotherapy.
Biopsy ; Carcinoma, Papillary ; Carcinoma, Squamous Cell ; Humans ; Lymph Node Excision ; Lymph Nodes ; Lymphatic Diseases ; Male ; Middle Aged ; Penile Neoplasms ; Radiotherapy, Adjuvant ; Rare Diseases ; Urinary Bladder ; Urinary Bladder Neoplasms

PURPOSE: The purpose of this research is to elucidate the trend of incidence of childhood cancers for the recent 5 years and to use this study as a database of childhood cancers research by comparing to the existing data. METHODS: Childhood cancer patients registered in the cancer registry program of the Ministry of Health and Welfare in Korea during January 1, 1995 to December 31, 1999 were included as study samples. Our current data was obtained to be compared with the previous results 1st report during 1982~1987 and 2nd report during 1988~1992). Analysis of our study was obtained from the data of the patients of childhood cancers under 15 years old registered in the 128 hospitals, except for the patients who are registered repeatedly. RESULTS: Accumulated number of cases of the childhood cancers was 5, 433 (1.5% of the total cases of all ages). A male to female incidence ratio was 1.3 to 1. The most common malignant tumor was leukemia (33.1%). Out of 1, 800 cases of leukemia, 1, 142 cases (63.4%) were lymphoid leukemia, 468 cases (26.0%) were acute non-lymphocytic leukemia and 97 cases (5.4%) were chronic myeloid leukemia. The second most common malignancy was central nervous system tumor (16.0%), followed by lymphoma (8.0%), gonadal and germ cell tumors (7.9%), sympathetic nervous system tumor (6.7%), bone tumor (5.1%), soft tissue sarcoma (4.8%), renal tumor (4.0%), retinoblastoma (3.3%) and hepatic tumor (2.6%). The most common malignant tumor in the 0~4 year-old age was leukemia (32.6%), followed by central nervous system tumor (12.7%) and sympathetic nervous system tumor (11.5%). In the 5~9 year-old age group, the most common malignant tumor was leukemia (38.0%), as well, followed by central nervous system tumor (21.7%) and lymphoma (11.6%). In the 10~14 year-old age group, the most common cancers were leukemia (29.8%), central nervous system tumor (16.5%) and bone tumor (11.7%). CONCLUSION: We were unable to note any differences in the incidence of childhood cancers when comparing the current data and the previous ones.
Adolescent ; Central Nervous System ; Female ; Gonads ; Humans ; Incidence ; Korea* ; Leukemia ; Leukemia, Lymphoid ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Lymphoma ; Male ; Neoplasms, Germ Cell and Embryonal ; Retinoblastoma ; Sarcoma ; Sympathetic Nervous System

Vitamin B12 deficiency anemia is a disorder caused by impaired DNA synthesis. Vitamin B12 binds to the intrinsic factor produced by the parietal cells and is absorbed in the distal ileum. After total gastrectomy, megaloblastic anemia is developed due to the absence or deficiency of the intrinsic factor. Concomitant iron deficiency states such as various malabsorption syndromes and alcoholism induce that the bone marrow erythroid megaloblastosis and peripheral blood macroovalocytosis are masked because of countervailing the tendency of iron deficiency to produce microblasts and hypochromic microcytic erythrocytes. We experienced a case of Vitamin B12 deficiency anemia with low RBC mean corpuscular volume (MCV) due to combined with iron deficiency anemia in 42 year-old female patient and report the case with literature review.
Adult ; Alcoholism ; Anemia ; Anemia, Iron-Deficiency* ; Anemia, Megaloblastic ; Bone Marrow ; DNA ; Erythrocyte Indices ; Erythrocytes ; Female ; Gastrectomy ; Humans ; Ileum ; Intrinsic Factor ; Iron* ; Malabsorption Syndromes ; Masks ; Rabeprazole ; Vitamin B 12 Deficiency* ; Vitamin B 12* ; Vitamins*

A 55-year-old male with hemophilia A came to the outpatient clinic with chest pain for several days after overdose injection of coagulation factor. He was a heavy smoker and a chronic alcoholic. An electrocardiogram (ECG) showed no specific change. A coronary computed tomography showed moderate stenosis with soft plaque at the distal segment of right coronary artery. His pain was improved with antianginal and reflux medications. Twenty days later, he ran to the emergency room complaining of squeezing chest pain. ECG showed mild ST segment elevation in inferior territories. Invasive coronary angiography via right radial artery revealed severe thrombotic occlusion at the same lesion. A bare metal stent was deployed and dual antiplatelet therapy including aspirin and clopidogrel had been maintained for 6 months under the conventional hemophilia management. The patient did not develop any coronary events just with single clopidogrel therapy for 5 years until he passed away from pancreatic cancer. Our case implicates that the invasive coronary intervention and post-procedural management could be safely performed with conventional standards of care while maintaining the usual dose of coagulation factors in a hemophilia patient with acute coronary syndrome.

A 55-year-old male with hemophilia A came to the outpatient clinic with chest pain for several days after overdose injection of coagulation factor. He was a heavy smoker and a chronic alcoholic. An electrocardiogram (ECG) showed no specific change. A coronary computed tomography showed moderate stenosis with soft plaque at the distal segment of right coronary artery. His pain was improved with antianginal and reflux medications. Twenty days later, he ran to the emergency room complaining of squeezing chest pain. ECG showed mild ST segment elevation in inferior territories. Invasive coronary angiography via right radial artery revealed severe thrombotic occlusion at the same lesion. A bare metal stent was deployed and dual antiplatelet therapy including aspirin and clopidogrel had been maintained for 6 months under the conventional hemophilia management. The patient did not develop any coronary events just with single clopidogrel therapy for 5 years until he passed away from pancreatic cancer. Our case implicates that the invasive coronary intervention and post-procedural management could be safely performed with conventional standards of care while maintaining the usual dose of coagulation factors in a hemophilia patient with acute coronary syndrome.

A 55-year-old male with hemophilia A came to the outpatient clinic with chest pain for several days after overdose injection of coagulation factor. He was a heavy smoker and a chronic alcoholic. An electrocardiogram (ECG) showed no specific change. A coronary computed tomography showed moderate stenosis with soft plaque at the distal segment of right coronary artery. His pain was improved with antianginal and reflux medications. Twenty days later, he ran to the emergency room complaining of squeezing chest pain. ECG showed mild ST segment elevation in inferior territories. Invasive coronary angiography via right radial artery revealed severe thrombotic occlusion at the same lesion. A bare metal stent was deployed and dual antiplatelet therapy including aspirin and clopidogrel had been maintained for 6 months under the conventional hemophilia management. The patient did not develop any coronary events just with single clopidogrel therapy for 5 years until he passed away from pancreatic cancer. Our case implicates that the invasive coronary intervention and post-procedural management could be safely performed with conventional standards of care while maintaining the usual dose of coagulation factors in a hemophilia patient with acute coronary syndrome.