Perineal involvement by metastatic renal cell carcinoma (RCC) is very rare, and there are only few reports on its radiological findings in the literature. Here, we present a case of a 76-year old female who presented with perineal pain caused by metastatic clear cell RCC. We discuss the radiological changes of the tumor before and after targeted therapy.

Spontaneous rupture of intrahepatic cholangiocarcinoma is rare due to its abundant fibrous stroma. We report our experience in a case of spontaneous rupture of intrahepatic cholangiocarcinoma in a pregnant patient. In our case, multiple hepatic masses with intratumoral hemorrhage were noted on post-delivery computed tomography and magnetic resonance imaging and they caused hemoperitoneum. A right hemi-hepatectomy was carried out to control the bleeding and the diagnosis of intrahepatic cholangiocarcinoma with metastasis was performed.
Bile Ducts, Intrahepatic ; Cholangiocarcinoma* ; Diagnosis ; Hemoperitoneum ; Hemorrhage ; Humans ; Magnetic Resonance Imaging ; Neoplasm Metastasis ; Pregnancy ; Rupture ; Rupture, Spontaneous*

Testicular or scrotal involvement has been reported in children with Henoch-Schonlein purpura (HSP), but there are very few reports on penile involvement. We report the initial and follow-up ultrasonographic findings of scrotal and penile involvement of HSP in a 5-year-old boy. On ultrasonography, scrotal soft tissue thickening and epididymal swelling with increased vascularity were noted, and on the penis, a focal mass-like lesion appeared on the dorsal surface of the distal penis, having a hypoechoic mass-like appearance without visible vascular flow on a Doppler study. After 2 days of treatment, follow-up ultrasonography showed normal scrotum and penis with a resolved soft tissue mass-like lesion. Therefore, we think that HSP ultrasonographic findings involving the scrotum and penis might help to diagnose scrotal and penile involvement in a case of HSP and to avoid unnecessary medication and/or surgical procedures.
Child ; Child, Preschool ; Follow-Up Studies ; Humans ; Male ; Penis ; Purpura, Schoenlein-Henoch* ; Scrotum ; Ultrasonography*

OBJECTIVE: To evaluate the prevalence of known risk factors for contrast-induced nephropathy (CIN) and their association with the actual occurrence of CIN in patients undergoing intravenous contrast-enhanced computed tomography (CECT) in Korea. MATERIALS AND METHODS: Patients who underwent CECT in 2008 were identified in the electronic medical records of 16 tertiary hospitals of Korea. Data on demographics, comorbidities, prescriptions and laboratory test results of patients were collected following a standard data extraction protocol. The baseline renal function was assessed using the estimated glomerular filtration rate (eGFR). We identified the prevalence of risk factors along the eGFR strata and evaluated their influence on the incidence of CIN, defined as a 0.5 mg/dL or 25% increase in serum creatinine after CECT. RESULTS: Of 432425 CECT examinations in 272136 patients, 140838 examinations in 101487 patients met the eligibility criteria for analysis. The mean age of the participants was 57.9 +/- 15.5 years; 25.1% of the patients were older than 70 years. The prevalence of diabetes mellitus was 11.9%, of hypertension 13.7%, of gout 0.55% and of heart failure was 1.7%. Preventive measures were used in 40238 CECT examinations (28.6%). The prevalence of risk factors and use of preventive measures increased as the renal function became worse. A CIN was occurred after 3103 (2.2%) CECT examinations, revealing a significant association with decreased eGFR, diabetes mellitus, and congestive heart failure after adjustment. CONCLUSION: Risk factors for CIN are prevalent among the patients undergoing CECT. Preventive measures were seemingly underutilized and a system is needed to improve preventive care.
Adult ; Aged ; Aged, 80 and over ; Comorbidity ; Contrast Media/*adverse effects ; Female ; Glomerular Filtration Rate ; Humans ; Incidence ; Kidney Diseases/*chemically induced/epidemiology/*radiography ; Male ; Middle Aged ; Prevalence ; Republic of Korea/epidemiology ; Risk Factors ; Tomography, X-Ray Computed/*methods

Peliosis hepatis, an uncommon vascular condition, is characterized by multiple blood-filled cavities distributed throughout the liver. Computed tomography and magnetic resonance imaging findings of peliosis hepatis are nonspecific. A 40-year-old woman presented with multiple hepatic cystic masses. Two years later, the number and sizes of the masses had increased. We suspected metastatic hepatic disease and performed a liver biopsy. Histological examination revealed dilatation of hepatic sinusoids and multiple blood-filled cavities throughout the liver parenchyma. Thus, a diagnosis of peliosis hepatis was confirmed.
Biopsy ; Dilatation ; Female ; Humans ; Liver ; Magnetic Resonance Imaging ; Peliosis Hepatis

Sparganosis is a parasitic infection caused by the plerocercoid larvae of diphyllobothroid tapeworms belonging to the genus Spirometra, as first described by Manson in 1882. The infection is transmitted by ingestion of contaminated water, frogs, and snakes, and contact between a second intermediate host and an open wound or mucus membranes. Humans are accidental hosts in the life cycle, but dogs, cats, and other mammals are definitive hosts. Once a human becomes infected, the plerocercoid larvae migrate to a subcutaneous location, where they typically develop into a painful nodule. We misdiagnosed vulva sparganosis as a Bartholin's gland abscess. The patient was a green consumer, so she may have been infected by consuming health foods. Sparganosis should be considered as a cause of soft tissue masses especially among patients who have ingested health foods.
Abscess ; Animals ; Cats ; Cestoda ; Dogs ; Eating ; Food, Organic ; Humans ; Life Cycle Stages ; Mammals ; Membranes ; Mucus ; Snakes ; Sparganosis ; Sparganum ; Spirometra ; Vulva

Angular pregnancy is rare, in which the embryo in the lateral angle of uterine cavity and located medial to the utero-tubal junction. Angular pregnancy is differentiated from interstitial pregnancy. There is no report about term angular pregnancy in Republic of Korea, a few reports in other countries. Angular pregnancy has different clinical characteristics according to the trimester. We diagnosed angular pregnancy by ultrasonography and computed tomography (CT). The CT is a useful diagnostic method. We report a case of term angular pregnancy with placenta accreta and review the diagnostic process and complications.
Embryonic Structures ; Placenta ; Placenta Accreta ; Pregnancy ; Republic of Korea

An acardiac twin is one of the very rare anomalies that occurs in monochorionic twins and the incidence of this is about one out of 35,000 births. We present the serial prenatal ultrasound findings, along with the postnatal histologic correlation, of an acardiac twin that manifested as a single lower extremity.
Fetus ; Humans ; Incidence ; Lower Extremity ; Parturition ; Ultrasonography, Prenatal

PURPOSE: The aim of this study was to determine whether hyperechoic fatty tissue (HFT) at transabdominal and transvaginal ultrasonography in women with acute pelvic pain has a diagnostic role. MATERIALS AND METHODS: We studied 201 women (mean age, 32 years) with acute pelvic and lower abdominal pain; we performed ultrasonography (US) in all them. Of the 201, 94 with gynecological problems were included., They were divided into two groups: with pelvic inflammatory disease (PID; n = 45) and without PID (n = 49). We evaluated the presence and distribution of HFT and its role in differential diagnosis between PID and non-PID groups. RESULTS: We found, using US, HFT in 36/45 (80%) patients with PID by US. Of the 36, single-center HFT was observed in 12/36 (33.3%) patients and multicentric HFT was detected in 24/36 (66.7%). HFT was present adjacent to inflammatory foci, tuboovarian abscesses or inflamed salpinx in 30 women; HFT was present outside the pelvic cavity in 24. Among the latter 24, HFT was present only in the lower abdomen, and not in the pelvic cavity in 6. In the non-PID group, HFT was found in the lower abdomen and pelvic cavity in 7 women. Four of the seven were misdiagnosed with PID. One of seven women with a hemorrhagic corpus luteal cyst rupture with underlying PID and two with ectopic pregnancy with HFT were correctly diagnosed. CONCLUSION: The presence of HFT may be a reliable US finding for the diagnosis of PID. HFT distinguishes PID from other acute gynecological problems.
Abdomen ; Abscess ; Adipose Tissue ; Diagnosis, Differential ; Fallopian Tubes ; Female ; Humans ; Pelvic Inflammatory Disease ; Pelvic Pain ; Pelvis ; Pregnancy ; Pregnancy, Ectopic ; Rupture

Peritoneal calcifying fibrous tumor is a rare tumor in the peritoneal cavity. In this case, plain radiography showed multiple conglomerated calcifications and several separate calcifications scattered in the lower abdomen and pelvic cavity. CT showed several well-circumscribed masses with a group of conglomerated nodular calcifications in their centers, and these were surrounded by three bands with different attenuation. Ultrasonography showed a well-circumscribed mass with strong posterior shadowing from its anterior surface and hyperechoic calcifications in its center. The histopathological diagnosis was calcifying fibrous tumor. The mass was well circumscribed and non-encapsulated and it was mainly composed of hyalinized fibrosclerotic tissue and dystrophic calcification with no inflammatory cells. We report here on a case of peritoneal calcifying fibrous tumor, along with a review of the relevant literature.
Abdomen ; Hyalin ; Peritoneal Cavity ; Peritoneum ; Shadowing (Histology) ; Tomography, X-Ray Computed