Young-Woo Kang

Intussuscepted sigmoid colonic lipoma mimicking carcinoma.

Colonic lipomas are the most common nonepithelial tumor, and they are the third most common tumor, after hyperplastic and adenomatous polyps (1). The majority of colonic lipomas are small and asymptomatic (2). Large lesions may be significant because of their related symptoms, and especially, intussuscepted colonic lipomas are often confused with malignant tumors, so that most of them are diagnosed after intervention (3). We present a case of an intussuscepted lipoma mimicking a malignant tumor in a 62-year-old man. Intussuscepted colonic lipoma is uncommon, and a right-side intussuscepted colonic lipoma is especially rare. The malignant transformation of lipoma is extremely rare, and recurrent lipoma has never been reported. Nonetheless, operative or endoscopic intervention may be required to differentiate this lesion from a malignant or premalignant lesion. This case is very unique in the aspects of the lipoma’s shape and size and the location in which it was found.

Cryptococcal meningitis in a patient with chronic hepatitis C treated with pegylated-interferon and ribavirin.

Various adverse events have been reported during combination therapy with pegylated (PEG)-interferon-α and ribavirin, although opportunistic infections, especially cryptococcal meningitis, are very rare. A 61-year-old woman complained of headaches and a fever during treatment of a chronic hepatitis C virus (HCV) infection. She had been treated for 7 months. Her headaches were refractory to analgesics, and she developed subtle nuchal rigidity. The cerebral spinal fluid (CSF) revealed a white blood cell count of 205/mm3, 51 mg/dL protein, 35 mg/dL glucose, and negative Cryptococcus antigen. The CSF culture resulted in no growth. Five days later, the CSF was positive for Cryptococcus antigen. We administered amphotericin B and flucytosine, followed by fluconazole. Approximately 2 months later, she was discharged. For the first time, we report a case of cryptococcal meningitis during the treatment of chronic HCV with PEG-interferon-α and ribavirin.