Young Ok Hong

Complicated benign cystic mesothelioma of mesoappendix misdiagnosed as an appendiceal abscess in a postpartum period woman

Benign cystic mesothelioma is an uncommon tumor arising from the peritoneal mesothelium. It is characterized by multilocular grapelike, thin-, and translucent-walled cysts, or a unilocular cyst lined by benign mesothelial cells. It occurs predominantly in women of reproductive age, and shows a predilection for the surface of the pelvic peritoneum or visceral peritoneum. Patients usually present abdominal pain and palpable mass, but many cases have been found incidentally during laparotomy. Definite preoperative diagnosis is known to be difficult. Benign cystic mesothelioma has a tendency towards local recurrence, although the gross microscopic features are benign. Moreover, there is controversy over whether this disease is neoplastic or reactive. Initial complete surgical resection and cytoreductive surgery for recurred cases are standard treatments. In the following report, we describe a case of complicated benign cystic mesothelioma in a postpartum woman, involving the pelvic peritoneum and mesoappendix, which was initially misdiagnosed as a periappendiceal abscess.

Diaphragm disease compared with cryptogenic multifocal ulcerous stenosing enteritis.

As the use of drugs such as nonsteroidal anti-inflammatory drugs (NSAIDs) increases, so too do gastrointestinal ulcers, bleeding, perforation and obstruction. Diaphragm disease of the small intestine is formed by submucosal fibrosis and destruction of lamina muscularis due to chronic ulceration, which corresponds to the most severe stage of NSAID enteropathy. It may lead to stricture of the small intestine. If such ulcerations and strictures in the small intestine are multiple, differential diagnosis is between diaphragm disease and cryptogenic multifocal ulcerous stenosing enteritis (CMUSE), because the gross findings of diaphragm disease are similar to those of CMUSE. We report a rare case of diaphragm disease caused by NSAID. It has been finally confirmed by capsule endoscopy and the origin of chronic obscure gastrointestinal bleeding was found to be multiple ulcers and strictures in the small intestine. After operation, we diagnosed the patient with diaphragm disease rather than CMUSE.

Spindle Cell Rhabdomyosacoma of Uterus: A Case Study

Uterine rhabdomyosarcoma (RMS) typically presents as a mixed epithelial and mesenchymal tumors. Pure RMSs of the female genital tract are uncommon. Spindle cell variant of RMS is a rare morphologic subtype of embryonal RMS and mostly occurs in the paratesticular region of children. Here, we present a case of uterine spindle cell RMS in a 76-year-old woman. The tumor, 20×15×7 cm in size, was highly necrotic and adherent to the colon and rectum. Tumor cells were mostly spindle-shaped, and isolated rhabdomyoblasts were scattered. Immunohistochemical stains for myoglobin and myo-D1 showed diffuse positivity for tumor cells. The patient died only of disease three months after diagnosis.

Hybrid Natural Orifice Transluminal Endoscopic Surgery with Sentinel Lymph Node Navigation for Deep Early Gastric Cancer in the Fundic Region.

For patients refusing surgical treatment for deep early gastric cancer, hybrid natural orifice transluminal endoscopic surgery with sentinel lymph node navigation is a potential treatment option, particularly when the anatomic location of the cancer has low probability of lymph node metastasis. We report a case of deep early gastric cancer of the fundus beyond the endoscopic submucosal dissection indication that was treated by hybrid natural orifice transluminal endoscopic surgery with sentinel lymph node navigation. In a conventional approach, a total gastrectomy would have been needed; however, the patient refused surgical intervention. In this case, since the patient showed no positivity of the sentinel lymph node on intraoperative navigation, laparoscopic basin lymph node dissection was not performed. Hybrid natural orifice transluminal endoscopic surgery might be considered for specific regions such as the safety zone where lymph node metastases are less likely to occur.

A Case of Schwannoma Arising from the Sphenoid Sinus

Schwannomas are neurogenic tumors that arise from the Schwann cells of the nerve sheath. Although up to 45% of all schwannomas occur in the head and neck region, only 4% involve the nasal cavity and paranasal sinuses. A 56-year-old female presented with an incidentally discovered lesion in the left posterior ethmoid and sphenoid sinuses on the brain magnetic resonance imaging. Magnetic resonance imaging showed a well demarcated mass without bony destruction with isointensity in T1 and hyperintensity in T2 weighted scans. Eighteen months later, repeated computed tomography showed an enlargement of the mass with the erosion of the adjacent sinus wall and left vidian canal. She underwent an endoscopic mass removal, which revealed a pale yellowish, firm mass in the left posterior ethmoid and sphe noid sinuses. Final histopathology confirmed the diagnosis of a schwannoma. There has been no evidence of recurrence during the two-year follow-up. � Korean J Otorhinolaryngol-Head Neck Surg 2011;54:89-92 Key WordsZZSphenoid sinus ㆍSchwannoma.

Ureteral Marginal Zone Lymphoma of Mucosa-Associated Lymphoid Tissue, Chronic Inflammation, and Renal Artery Atherosclerosis

Malignant lymphoma of the upper urinary tract including the renal pelvis and ureter is extremely rare. Less than ten cases have been reported in the literature, of which extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) is the most frequent histologic type [1]. MALT lymphoma arising in the stomach, skin, thyroid, and salivary gland is associated with chronic inflammation caused by pathogenic microorganisms or autoimmune disorder [2]; however, the pathogenesis of MALT lymphoma in the upper urinary tract is unknown. Herein, we report a case of upper ureteral MALT lymphoma with extensive peri-ureteropelvic inflammation and atherosclerosis of the renal artery, and discuss the possible correlation between these lesions.