Endometrial stromal sarcoma (ESS) is a rare malignancy. Development of extrauterine ESS form endometriosis is particularly rare. The majority of extrauterine ESS occurs in areas with preexisting endometriosis. The most common site is the ovary. We experienced a case of ESS of the ovary that arose from endometriosis with multiple disseminated lesions. This disease was managed by total abdominal hysterectomy, bilateral salpingo-oophorectomy, both pelvic lymph nodes dissection, omentectomy, and appendectomy followed by postoperative high-dose progesterone therapy. Here, we report this case with literature review.
Appendectomy ; Endometriosis* ; Female ; Hysterectomy ; Lymph Nodes ; Ovary* ; Progesterone ; Sarcoma, Endometrial Stromal*

BACKGROUND AND OBJECTIVES: Squamous cell carcinoma of thyroid is uncommon and accounts for less than 1% of all primary thyroid malignancies. Clinical features mimic the natural course of anaplastic carcinoma. This study reviewed the clinical course of six cases of primary squamous cell carcinoma of thyroid. SUBJECTS AND METHOD: We diagnosed six cases of primary squamous cell carcinoma of thyroid diagnosed from 1999 to 2006 at the College of Medicine Department of Pathology. Clinical data, treatment modality, and pathologic test results from medical records were retrospectively analyzed. RESULTS: We found five women and one man (with the mean age of 52.1 years) with squamous cell carcinoma of thyroid. The main presenting features were abruptly enlarging neck swelling and obstructive symptom. Pre-operative needle aspiration biopsy revealed papillary carcinoma in five cases. Only one patient was diagnosed as squamous cell carcinoma through pre-operative needle aspiration biopsy. Three patients had massive adjacent organ invasion, and four patients had lymph node metastasis according to the pathology review. There were no cases of distant metastasis at the time of treatment. All patients received surgery and adjuvant therapy (radiation therapy, chemotherapy, radioiodine therapy). Three patients are still alive with a mean follow up period of 47.3 months (range, 44-49 months). The other three patients died within one year post-operatively. CONCLUSION: Primary squamous cell carcinoma of thyroid should be considered in patients diagnosed with papillary carcinoma and who exhibit aggressive clinical behavior. Complete tumor resection and radiotherapy should be performed if thyroid squamous cell carcinoma is confirmed.
Biopsy, Needle ; Carcinoma ; Carcinoma, Papillary ; Carcinoma, Squamous Cell ; Female ; Follow-Up Studies ; Humans ; Hydrazines ; Lymph Nodes ; Medical Records ; Neck ; Needles ; Neoplasm Metastasis ; Retrospective Studies ; Thyroid Gland

Febrile neutropenia (FN) is the major toxicity of rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) regimen in the treatment of diffuse large B-cell lymphoma (DLBCL). The prediction of neutropenia and FN is mandatory to continue the planned R-CHOP therapy resulting in successful anti-cancer treatment. The clinical features and patterns of neutropenia and FN from 181 DLBCL patients treated with R-CHOP were analyzed retrospectively. Sixty percent (60.2%) of patients experienced at least one episode of grade 4 neutropenia. Among them, 42.2% of episodes progressed to FN. Forty-eight percent (48.8%) of patients with FN was experienced their first FN during the first cycle of R-CHOP. All those patients never experienced FN again during the rest cycles of R-CHOP. Female, higher stage, international prognostic index (IPI), age > or =65 yr, comorbidities, bone marrow involvement, and baseline serum albumin < or =3.5 mg/dL were significant risk factors for FN by univariate analysis. Among these variables, comorbidities (P=0.009), bone marrow involvement (P=0.006), and female gender (P=0.024) were independent risk factors for FN based on multivariate analysis. On observing the patterns of neutropenia and FN, primary prophylaxis of granulocyte colony-stimulating factor (G-CSF) and antibiotics should be considered particularly in female patients, patients with comorbidities, or when there is bone marrow involvement of disease.
Adolescent ; Adult ; Age Factors ; Aged ; Antibodies, Monoclonal, Murine-Derived/adverse effects/*therapeutic use ; Antineoplastic Combined Chemotherapy Protocols/adverse effects/*therapeutic use ; Chemotherapy-Induced Febrile Neutropenia/*etiology ; Cyclophosphamide/administration & dosage/adverse effects/therapeutic use ; Demography ; Doxorubicin/administration & dosage/adverse effects/therapeutic use ; Female ; Humans ; Lymphoma, Large B-Cell, Diffuse/*drug therapy ; Male ; Middle Aged ; Neoplasm Staging ; Neutropenia/etiology/pathology ; Prednisone/administration & dosage/adverse effects/therapeutic use ; Retrospective Studies ; Risk Factors ; Sex Factors ; Vincristine/administration & dosage/adverse effects/therapeutic use ; Young Adult

Signet ring cell carcinoma is a subtype of adenocarcinoma that is characterized by abundant intracellular mucin accumulation. Diffuse large B-cell lymphoma is the most common histological subtyple of gastrointestinal lymphoma. The gastrointestinal tract is the most frequently involved extranodal site in non-Hodgkin's lymphoma. However, little is known about the coexistence of advanced gastric cancer and gastric diffuse large B cell lymphoma. We report a case of synchronous advanced gastric adenocarcinoma and gastric diffuse large B cell lymphoma in a 62-year-old woman.
Adenocarcinoma ; Carcinoma, Signet Ring Cell ; Female ; Gastrointestinal Tract ; Humans ; Lymphoma ; Lymphoma, B-Cell ; Lymphoma, Non-Hodgkin ; Middle Aged ; Mucins ; Stomach Neoplasms

Thirty -nine non -metric cranial traits of the Korean skulls were investigated and compared with those of eighteen human populations. The Korean have the highest incidence of the accessory infraorbital foramen (18%) of all populations compared. The sutural infraorbital foramen, posterior ethmoidal foramen absent, ear exotosis, temporal ossicle and bregmatic bone were not observed in the Korean samples. The distance analyses (MMD; mean value of divergence) revealed that the Korean are more closely related to the population in Kazach and Mongol than to the population in China and Japan.
China ; Ear ; Humans ; Incidence ; Japan ; Skull*

Paraneoplastic limbic encephalitis is a rare disorder that is characterized by personality changes, irritability, depression, seizures, memory loss and dementia, and is commonly associated with small cell lung cancer. The cause is unknown but it is believed to be an autoimmune disorder that develops secondary to a carcinomatous process. We report a patient with the clinical feature consistent with limbic encephalitis. A 64-year-old women developed disorientation, memory loss and general weakness. She was diagnosed with NSCLC (adenocarcinoma) with a brain metastasis 1 year earlier and was treated with radiation and chemotherapy. Although the lung mass and brain metastatic lesions had improved, the brain T2-weighted MRI showed high signal intensity in the right temporal region. This lesion consisted of with limbic encephalitis and was negative to the other viral and immune markers. The patient's symptoms did not improve after steroid treatment. Our case demonstrated that a NSCLC (adenocarcinoma) also can be associated with paraneoplastic limbic encephalitis.
Adenocarcinoma* ; Biomarkers ; Brain ; Carcinoma, Non-Small-Cell Lung ; Dementia ; Depression ; Drug Therapy ; Female ; Humans ; Limbic Encephalitis* ; Lung* ; Magnetic Resonance Imaging ; Memory Disorders ; Middle Aged ; Neoplasm Metastasis ; Seizures ; Small Cell Lung Carcinoma

Eosinophilic gastroenteritis is a rare gastrointestinal disorder that can present with a variety of symptoms such as abdominal pain, vomiting, diarrhea and ascites. It is characterized by eosinophilic infiltration of the gastrointestinal wall. Its incidence has increased recently. However, the etiology and pathogenesis of this disease are not well understood. The relationship between hypopituitarism and eosinophilic gastroenteritis is unclear. A corticotropin deficiency and eosinophilia are observed in approximately 90% of traumatic hypopituitarism. We encountered a case of eosinophilic gastroenteritis with eosinophilic ascites in a patient with traumatic hypopituitarism including central diabetes incipidus. Abdominal computed tomography showed diffuse wall thickening of the esophagus, stomach and small bowel with a large amount of ascites. Cytologic examination of ascites showed heavy dense infiltration of eosinophils. The patient was treated with corticosteroid and responded rapidly. Two months later, she was admitted again with a relapse of symptoms. We report this case with a brief review of the relevant literature.
Abdominal Pain ; Adrenocorticotropic Hormone ; Ascites ; Diarrhea ; Eosinophilia ; Eosinophils* ; Esophagus ; Gastroenteritis* ; Humans ; Hypopituitarism* ; Incidence ; Recurrence ; Stomach ; Vomiting

Endoscopic retrograde cholangiopancreatography (ERCP) is a useful tool for the diagnosis and management of diseases of the pancreas and biliary tract. However, ERCP has a high risk of procedure-related complications compared with other endoscopic procedures performed in the upper gastrointestinal tract. The most common complications are pancreatitis, cholangitis, hemorrhage, and perforation. Extraluminal hemorrhagic complications after ERCP are relatively rare but potentially life threatening and should be identified and treated immediately. We report a case of subcapsular hepatic hematoma after guidewire injury during ERCP in a 64-year-old woman with choledocholithiasis who had undergone ERCP with guidewire-assisted papillotomy for stone extraction. Although subcapsular hepatic hematoma is a very rare complication after ERCP, it should be considered in the differential diagnosis of patients complaining of abdominal pain after ERCP.
Abdominal Pain ; Biliary Tract ; Cholangiopancreatography, Endoscopic Retrograde* ; Cholangitis ; Choledocholithiasis ; Diagnosis ; Diagnosis, Differential ; Female ; Hematoma* ; Hemorrhage ; Humans ; Middle Aged ; Pancreas ; Pancreatitis ; Upper Gastrointestinal Tract

Recent studies indicate that there is an increased risk of amebic liver abscess among those infected with HIV, which is associated with cell-mediated immunosuppression. Although Entamoeba histolytica infection is common among HIV infected patients, only a few cases of amebic liver abscess with bilateral pleural effusion have been reported. We present a case of a 44-year-old man who presented with fever and right lower quadrant abdominal pain. Amebic liver abscess with bilateral pleural effusion was confirmed by serologic test, clinical symptoms, and radiological findings. HIV infection was incidentally diagnosed during treatment. The possibility of the presence of amebic liver abscess should be considered in HIV infected patients with space-occupying lesions in the liver, and HIV screening should strongly be recommended in patients with amebic liver abscess.
Abdominal Pain ; Adult ; Entamoeba histolytica ; Fever ; HIV ; HIV Infections ; Humans ; Immunosuppression ; Liver ; Liver Abscess, Amebic ; Mass Screening ; Pleural Effusion ; Serologic Tests

PURPOSE: To evaluate the oncologic outcomes and postoperative complications of high-intensity focused ultrasound (HIFU) as a salvage therapy after external-beam radiotherapy (EBRT) failure in patients with prostate cancer. MATERIALS AND METHODS: Between February 2002 and August 2010, we retrospectively reviewed the medical records of all patients who underwent salvage HIFU for transrectal ultrasound-guided, biopsy-proven locally recurred prostate cancer after EBRT failure (by ASTRO definition: prostate-specific antigen [PSA] failure after three consecutive PSA increases after a nadir, with the date of failure as the point halfway between the nadir date and the first increase or any increase great enough to provoke initiation of therapy). All patients underwent prostate magnetic resonance imaging and bone scintigraphy and had no evidence of distant metastasis. Biochemical recurrence (BCR) was defined according to the Stuttgart definition (PSA nadir plus 1.2 ng/mL). RESULTS: A total of 13 patients with a median age of 68 years (range, 60-76 years) were included. The median pre-EBRT PSA was 21.12 ng/mL, the pre-HIFU PSA was 4.63 ng/mL, and the period of salvage HIFU after EBRT was 32.7 months. The median follow-up after salvage HIFU was 44.5 months. The overall BCR-free rate was 53.8%. In the univariate analysis, predictive factors for BCR after salvage HIFU were higher pre-EBRT PSA (p=0.037), pre-HIFU PSA (p=0.015), and short time to nadir (p=0.036). In the multivariate analysis, there were no significant predictive factors for BCR. The complication rate requiring intervention was 38.5%. CONCLUSIONS: Salvage HIFU for prostate cancer provides effective oncologic outcomes for local recurrence after EBRT failure. However, salvage HIFU had a relatively high rate of complications.
Follow-Up Studies ; High-Intensity Focused Ultrasound Ablation ; Humans ; Magnetic Resonance Imaging ; Medical Records ; Multivariate Analysis ; Neoplasm Metastasis ; Postoperative Complications ; Prostate* ; Prostate-Specific Antigen ; Prostatic Neoplasms* ; Radionuclide Imaging ; Radiotherapy* ; Recurrence ; Retrospective Studies ; Salvage Therapy* ; Ultrasonography*