Pancreatic pseudocyst in the left hepatic lobe: a report of two cases

The ultrasound and computed tomographic imaging features in a rare pancreatic pseudocyst of the liver are described in two patients. The pseudocysts occurred in the left lobe in both cases, one after a traumatic injury and the other after alcoholic pancreatitis. The possible topographical sequences with which pancreatic secretions entered the left hepatic lobe to form a cyst are discussed.     

Pancreatic tuberculosis. Report of two cases

We report two cases of pancreatic tuberculosis. The first patient had abdominal pain, jaundice and weight loss. Ultrasonography and CT scan suggested a pancreatic tumor. The second patient presented with abdominal pain without jaundice while CT scan showed a pancreatic mass. Diagnosis of pancreatic tuberculosis was made at laparotomy in the two cases. The two patients underwent hepatico-jejunostomy. The first one received antituberculous chemotherapy and completely recovered while the second died because of post-operative shock related to sepsis. Tuberculosis must be suspected in the presence of a pancreatic mass in endemic countries or in immunocompromised patients. Needle biopsy may in some cases lead to diagnosis and avoid laparotomy.     

Adrenocortical carcinoma: Report of two cases

Adrenocortical carcinoma (ACC) is a rare neoplasm with a slight predilection for female patients. We report two cases of ACC. The first case was of a 7-year-old girl who presented with clitoromegaly. The second case was of a 22-Year-old female who presented with a lump in the abdomen and features of Cushing's syndrome with virilization.The clinical, biochemical, histological features along with differential diagnosis are discussed. These cases are presented because of their rarity, and also to highlight the importance of differentiating ACC from an adenoma particularly in pediatric patients.     

Pancreatic metastases of renal cell carcinoma: report of two cases

Two cases of renal cell carcinoma, metastatic to the pancreas, are presented. The lesions were hypoechoic with ultrasound examination, and were mixed iso- and hypodense with computed tomography. Angiography was performed in one case, and showed a typical hypervascular pattern of the metastatic tumor.     

Anorectal verrucose squamous carcinoma: Report of two cases

Summary Two cases of anorectal verrucose squamous-cell carcinoma are presented. The clinical course and pathology of these tumors are reviewed. Surgical treatment based on the depth of histologic invasion is recommended. Read at the meeting of the American Society of Colon and Rectal Surgeons, Orlando, Florida, May 8 to 12, 1977.     

Pancreatic carcinoma: report of two cases presenting with unusual metastases.

We report two patients with adenocarcinoma of the body and tail of the pancreas who presented with features localized to the metastatic sites. A 67-year-old gentleman presented with right groin mass due to spermatic cord metastasis and later developed duodenal obstruction; the other gentleman was 69 years old and presented with change of bowel habit as a result of pelvic/pararectal metastasis.     

Pancreatic pseudocyst drainage guided by endoscopic ultrasound

Pancreatic pseudocysts can be managed conservatively in the majority of patients but some of them will require surgical, endoscopic or percutaneous drainage. Endoscopic drainage represents an efficient modality of drainage with a high resolution rate and lower morbidity and mortality than the surgical or percutaneous approach. In this article we review the endoscopic pseudocyst drainage procedure with special emphasis on technical details.     

Mixed adenoneuroendocrine carcinoma of gastrointestinal tract: Report of two cases

Mixed adenoneuroendocrine carcinoma(MANEC) is a rare tumor of the gastrointestinal tract that consists of a dual adenocarcinomatous and neuroendocrine differentiation, each component representing at least 30% of the tumor. To date, only seven cases have been reported in the cecum, and less than 40 in the stomach. Our first case was diagnosed in a 74-years-old female as a polypoid lesion of the cecum with direct invasion in the transverse colon, without lymph node metastases. The second case was diagnosed in the stomach of a 46-years-old male as a polypoid tumor of the antral region that invaded the pancreas and presented metastases in 22 regional lymph nodes. The metastatic tissue was represented by the glandular component. In both cases, the tumor consisted of a moderately-differentiated tubular adenocarcinoma(with mucinous component in Case 1) intermingled with neuroendocrine carcinoma. Ki67 index was lower than 20% in Case 1, respectively higher than 20% in Case 2. The neuroendocrine component was marked by synaptophysin and neuron specific enolase, being negative for Keratins 7/20. The neuroendocrine component represented 60% in Case 1, and 40% in Case 2, respectively. The glandular components were marked by carcinoembryonic antigen, maspin and keratin 20/7(Case 1/2). Both cases were proved to be microsatellite stable. Independently by the localization and tumor stage, MANECs appear to be highly malignant tumors, with high risk for distant metastases. The aggressiveness seems to depend on the endocrine component, independent of its proportion. The neuroendocrine component could be a dedifferentiated adenocarcinoma with a neuroendocrine phenotype.     

内镜治疗胰腺假性囊肿并文献复习

胰腺假性囊肿是胰腺最常见的囊性肿物 ,约占胰腺囊性肿物的 75 % [1] ,因其可并发感染、出血及破裂 ,所以才有临床意义。自 192 1年Ｊｅｄｌｉｃａ行手术引流以来 ,手术治疗一直是主要的治疗方法。近来更低创的治疗方法 ,如超声或ＣＴ介导经皮假性囊肿穿刺引流及腹腔镜下引流已较为普及。随着内镜技术和方法的发展 ,在某些大的医疗中心 ,内镜下假性囊肿的内引流术已成为部分经筛选患者的首选治疗方法 ,但国内尚未见报道。我院收治 1例 ,结合文献报告如下。1　病历摘要女患 ,39岁。因慢性结石性胆囊炎急性发作 ,伴急性出血性胰腺炎 ,于 2 0 0…     

Three cases of malignant lymphoma accompanied by renal cell carcinoma

Three cases of malignant lymphoma (ML) accompanied by renal cell carcinoma (RCC) are reported. From September 1997 through August 2000, we treated 85 patients with ML. Among these patients, three had accompanying RCC (clear cell type): case 1, a 57-yr-old man with gamma/delta-T cell lymphoma; case 2, a 25-yr-old man with Grade 3 follicular lymphoma; case 3, a 64-yr-old man with MALToma of the right orbit. Renal cell carcinoma is a relatively rare disease, but several reports have indicated that, for some reason, the incidence of concurrent RCC and ML is higher than expected. It is possible that the two malignancies share some common background factors, such as genetic mutation, immunological abnormality, or an immunomodulatory effect of the first tumor. The patient in case 2 was thought to have an abnormal immunological background from his medical history, which included bronchial asthma, idiopathic thrombocytopenic purpura, and mesangial proliferative glomerulonephritis (non-IgA type). Therefore the combination of ML and RCC in this patient may have been due to immunological impairment.     

Anorectal neuroendocrine carcinoma and small cell carcinoma. Report of two cases

INTRODUCTION: Anorectal neuroendocrine small cell carcinomas are rare and frequently difficult to treat. EXEGESIS: Two women presented with a fungating tumor located on the upper part of the anal canal. Histology displayed neuron-specific enolase and chromogranin A immunoreactive small cell tumors. A plasmatic neuron-specific enolase secretion was noticed in one case. Tumors were poorly reactive to chemotherapy and irradiation, less than in usual epidermoid anal canal cancer. Evolution was quickly leading to hepatic and pulmonary metastases in both cases. CONCLUSION: Anorectal neuroendocrine small cell carcinomas are rare but need to be individualized from epidermoid anal canal tumors owing to their poor prognosis with a frequent occurrence of hepatic and pulmonary metastasis.     

Klinefelter综合征伴糖尿病二例报道

例1,男性,18岁,因糖尿病8年合并高血压入院,其外公有高血压和糖尿病史,父母已排除糖尿病或糖调节受损,其母怀孕时28岁。查体:身高174 cm、指间距168 cm、体重65 kg、血压160/95 mm Hg(1 mm Hg=0.133 kPa),性情女性化倾向,学习成绩较差,无胡须和腋毛、阴毛稀少,双侧乳房发育明显     

Pancreatic head carcinoma:clinical analysis of 189 cases

BACKGROUND:Pancreatic cancer is a lethal disease with an increasing incidence.We retrospectively reviewed the clinical data on diagnosis and treatment of pancreatic head carcinoma,and analyzed the factors affecting prognosis of the disease. METHODS:The data of 189 patients with pancreatic head carcinoma treated from September 1,1995 to August 31,2005 were reviewed retrospectively.Ninety-four patients treated from September 1,2000 to August 31,2005 were followed up in April 2008.The median survival time(MST)...     

A case of mediastinal pancreatic pseudocyst accompanied by pancreatic pleural effusion

A 62-year-old man was admitted with dyspnea. Computed tomography (CT) revealed left massive pleural effusion and a cystic lesion in the posterior mediastinal compartment extending to the pancreatic head via the esophageal hiatus. The pleural effusion had a high amylase content. Based on these findings, we diagnosed mediastinal pancreatic pseudocyst accompanied by pancreatic pleural effusion. We treated him with CT-guided puncture and endoscopic pancreatic drainage. Endoscopic pancreatic treatment is possible for pancreatic pseudocysts.     

Mevalonic aciduria: Report of two cases

Summary Mevalonic aciduria is a rare disease that is a consequence of a deficiency of mevalonate kinase, an inborn error in the biosynthesis of cholesterol. Approximately 30 cases have been reported. We present our data on two siblings with mevalonic aciduria as a contribution to the recognition of this subject. Both were born after uneventful pregnancies. Their parents were healthy and not consanguineous. They had normal somatic and psychomotor development until they were around 2 years old. After the second year of life they developed mental retardation, ataxia and hypotonia. MRI showed cerebellar atrophy of both hemispheres and vermis. One sibling , from the age of 10 years onwards, suffered from complex partial seizures that were controlled with levetiracetam and lamotrigine. At 11 and 12 years of age, respectively, they were able to walk without help, but their gait was broad and ataxic. Their speech was dysarthric, fine motor skills were impaired as result of cerebellar ataxia, and they had moderate mental retardation. Diagnosis of mevalonic aciduria was made at this age through urinary organic acid analysis by gas chromatography–mass spectroscopy, which revealed high urinary excretion of mevalonic acid. They are currently 18 and 17 years old, respectively, show mental retardation and are able to walk but with difficulty. In our patients, ataxia due to cerebellar atrophy and mental retardation have been the predominant clinical manifestations. In mildly affected patients who survive infancy, these seem to be the predominant findings. Electronic Supplementary Material The online version of this article (doi:) contains supplementary material, which is available to authorized users. Online citation: JIMD Short Report #068 (2007) Online