• Title/Summary/Keyword: Retroperitoneal Mass

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A Case of Myxoid Liposarcoma of the Cheek (협부에 발생한 점액양 지방육종의 치험례)

  • Yoo, Jun-Ho;Roh, Si-Gyun;Lee, Nae-Ho;Yang, Kyoung-Moo;Cha, Eun-Jung
    • Archives of Plastic Surgery
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    • v.38 no.4
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    • pp.505-507
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    • 2011
  • Purpose: Liposarcoma is the most common soft tissue sarcoma, and usually occurs on the thigh or in the retroperitoneal space, but rarely in the oral region. This report presents a case of liposarcoma of the cheek and includes a review of the literatures. Methods: A 21-year-old woman was admitted with a palpable mass in her cheek of about two years duration, which increased in size gradually initially, but had increased rapidly over the three months. There was no particular pain or tenderness. MRI showed a well-enhanced, well-defined mass, which suspected to be hemangioma. Results: The spherical, well-encapsulated mass was surgically excised. Biopsy results revealed myxoid liposarcoma. FDG PET-CT on the seventh postoperative day, revealed a minimal to mild FDG-uptake soft tissue lesion around the mass defect area without evidence of distant metastasis. The patient is being observed and undergoing radiation therapy. Conclusion: Liposarcoma in the head and neck region is a rare disease, and can be overlooked as a benign tumor without a pathologic diagnosis. Therefore, proper treatment and follow-up are required based on an understanding of this disease.

Interleukin-6-producing paraganglioma as a rare cause of systemic inflammatory response syndrome: a case report

  • Yin Young Lee;Seung Min Chung
    • Journal of Yeungnam Medical Science
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    • v.40 no.4
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    • pp.435-441
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    • 2023
  • Pheochromocytomas and paragangliomas (PPGLs) may secrete hormones or bioactive neuropeptides such as interleukin-6 (IL-6), which can mask the clinical manifestations of catecholamine hypersecretion. We report the case of a patient with delayed diagnosis of paraganglioma due to the development of IL-6-mediated systemic inflammatory response syndrome (SIRS). A 58-year-old woman presented with dyspnea and flank pain accompanied by SIRS and acute cardiac, kidney, and liver injuries. A left paravertebral mass was incidentally observed on abdominal computed tomography (CT). Biochemical tests revealed increased 24-hour urinary metanephrine (2.12 mg/day), plasma norepinephrine (1,588 pg/mL), plasma normetanephrine (2.27 nmol/L), and IL-6 (16.5 pg/mL) levels. 18F-fluorodeoxyglucose (FDG) positron emission tomography/CT showed increased uptake of FDG in the left paravertebral mass without metastases. The patient was finally diagnosed with functional paraganglioma crisis. The precipitating factor was unclear, but phendimetrazine tartrate, a norepinephrine-dopamine release drug that the patient regularly took, might have stimulated the paraganglioma. The patient's body temperature and blood pressure were well controlled after alpha-blocker administration, and the retroperitoneal mass was surgically resected successfully. After surgery, the patient's inflammatory, cardiac, renal, and hepatic biomarkers and catecholamine levels improved. In conclusion, our report emphasizes the importance of IL-6-producing PPGLs in the differential diagnosis of SIRS.

Malignant Retroperitoneal Paraganglioma in a Siberian Tiger (시베리아 호랑이에서 발생한 악성후복막부신경절종 증례)

  • Shin, Sang-Kyung;Park, Byung-Min;Youm, So-Young;Kim, Tae-Wang;Na, Ki-Jeong;Ahn, Byeong-Woo
    • Journal of Veterinary Clinics
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    • v.28 no.5
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    • pp.522-525
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    • 2011
  • A 14 year old female Siberian tiger presented for postmortem examination. A large mass attached to sublumbar area was found to be circumscribing aorta with metastases to mesenteric lymph nodes, uterus, kidney, adrenal gland, lung and thymus. The tumor cells were arranged in clusters or nests separated by well-developed fibrovascular stroma. The individual cells were plump and polygonal with granular eosinophilic cytoplasms and had distinct cell borders. The tumor cells were positive for synaptophysin, chromogranin A and neuron-specific enolase, and negative for cytokeratins, S100 and glial fibrillary acidic protein. The primary tumor was diagnosed as a malignant retroperitoneal paraganglioma.

What Is the Ideal Entry Point for Transforaminal Endoscopic Lumbar Discectomy?

  • Lee, Jong Un;Park, Ki Jeoung;Kim, Ki Hong;Choi, Man Kyu;Lee, Young Hwan;Kim, Dae-Hyun
    • Journal of Korean Neurosurgical Society
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    • v.63 no.5
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    • pp.614-622
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    • 2020
  • Objective : The method of approach during transforaminal endoscopic lumbar discectomy (TELD) has been the subject of repeated study. However, the ideal entry point during TELD has not been studied in detail. Therefore, this study investigated the ideal entry point for avoiding complications using computed tomography (CT) scans obtained from patients in the prone position. Methods : Using CT scans obtained from patients in the prone position, we checked for retroperitoneal or visceral violations and measured the angles of approach with five conventional approach lines drawn on axial CT scans at each disc space level (L2-3, L3-4, and L4-5). We also determined the ideal entry point distance and approach angles for avoiding retroperitoneal or visceral violations. Correlation analysis was performed to identify the patient characteristics related to the ideal entry point properties. Results : We found that the far lateral approach at the L2-3 level resulted in high rates of visceral violation. However, rates of visceral violation at the L3-4 and L4-5 levels were remarkably low or absent. The ideal angles of approach decreased moving caudally along the spine, and the ideal entry point distances increased moving caudally along the spine. Weight, body mass index (BMI), and the depth of the posterior vertebral line from the skin were positively associated with the distance of the ideal entry point from the midline. Conclusion : We reviewed the risk of the extreme lateral approach by analyzing rates of retroperitoneal and visceral violations during well-known methods of approach. We suggested an ideal entry point at each level of the lumbar spine and found a positive correlation between the distance of the entry point to the midline and patient characteristics such as BMI, weight, and the depth of the posterior vertebral line from the skin.

Intestinal duplication revealed by posterior reversible encephalopathy syndrome

  • Kerkeni, Yosra;Louati, Hela;Hamzaoui, Mourad
    • Clinical and Experimental Pediatrics
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    • v.61 no.4
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    • pp.132-134
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    • 2018
  • We report a unique case of intestinal duplication detected on posterior reversible encephalopathy syndrome (PRES) in a 13-year-old girl. She was admitted to the pediatric Emergency Department because of generalized seizures. Radiological assessment revealed a large, well-defined, thick-walled cystic lesion in the mid abdomen, suggestive of duplication cyst associated to a PRES. Exploration confirmed the diagnosis of ileal duplication cyst, and the mass was resected. The postoperative course was uneventful. Both hypertension and neurological dysfunction resolved after the mass resection. A follow-up brain magnetic resonance imaging was performed 9 months later and showed complete resolution of the cerebellar changes. Although extrinsic compression of the retroperitoneal structures has not been reported in the literature as a complication of duplication cyst, we strongly believe that this is the most logical and plausible hypothesis that would explain the pathogenesis of PRES in our patient.

Incidentally found unicentric plasma cell variant Castleman's disease in mesentery: focus on ultrasonography and CT findings (우연히 발견된 장간막의 단중심성 형질세포형 Castleman병 1예: 초음파와 CT 소견 중심으로)

  • Kim, Hyun Min;Kim, Bong Soo;Jung, In Ho;Hyun, Chang Lim;Jung, Seung Wook;Jo, Jae Min
    • Journal of Medicine and Life Science
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    • v.15 no.1
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    • pp.19-22
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    • 2018
  • Castleman's disease is a benign lympho-proliferative disorder that commonly occurs in mediastinum. It is known that the disease rarely occurs in mesentery. Most localized abdominal Castleman's diseases are histologically hyaline vascular type. The contrast-enhanced CT in patient with hyaline vascular type Castleman's disease shows a well-defined mass with homogenously intense enhancement. On the other hand, the patient with plasma cell variant has systemic symptoms, but not specific imaging features. We report a unicentric plasma cell variant Castleman's disease in mesentery nearby superior mesenteric artery as presenting a single mass, not accompanied by systemic symptoms with similar characteristics to hyaline vascular type.

Management of Meralgia Paresthetica by Lateral Femoral Cutaneous Nerve Block -Case reports- (대퇴신경지각이상증의 치료를 위한 외측대퇴피신경차단 -증례보고-)

  • Lee, Hyo-Keun;Chung, So-Young;Lee, Seong-Yeon;Suh, Young-Sun;Kim, Chan
    • The Korean Journal of Pain
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    • v.8 no.1
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    • pp.152-155
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    • 1995
  • Meralgia paresthetica is a disorder characterized by a pain or dysaesthesia, or both, in the anterolateral aspect of the thigh caused by entrapment or neurinoma formation of the lateral femoral cutaneous nerve. Currently available modes of therapy include conservative treatment, lateral femoral cutaneous nerve block with steroids and local anesthetics, and surgery. At our neuro-pain clinic, w recently encountered three cases of meralgia paresthetica, all of which were treated by lateral femoral cutaneous nerve block. In which of them, two cases were successfully treated but one case was associate with pain relapse due to entrapment of lateral femoral cutaneous nerve by a retroperitoneal mass, schwannoma. In this paper we report our experience along with a review of the current literatures.

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Extraordinary Response of Metastatic Pancreatic Cancer to Chemotherapy (항암 치료에 좋은 반응을 보였던 전이성 췌장암 증례)

  • Shin, Dong Woo;Kim, Jinkook;Lee, Jong-chan;Kim, Jaihwan;Hwang, Jin-Hyeok
    • Journal of Digestive Cancer Reports
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    • v.7 no.1
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    • pp.22-25
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    • 2019
  • A 58-year-old woman presented with right flank and back pain for one month. After undergoing an abdominal computed tomography (CT), she was referred to our hospital. The abdominal CT showed a hypodense pancreatic tail mass with multiple retroperitoneal lymph node metastases. Positron emission tomography-computed tomography (PET-CT) scan showed high 18F-FDG uptake in pancreatic tumor and enlarged lymph nodes. Endoscopic ultrasound fine needle aspiration (EUS-FNA) revealed adenocarcinoma, which stained strongly in hENT1 (human equilibrative nucleoside transporter 1) on immunohistochemistry. She received gemcitabine 1,000 mg/m2 + nanoparticle albumin-bound paclitaxel 125 mg/m2 as a palliative chemotherapy. Follow-up abdominal CT and PET-CT after 4 cycles of chemotherapy showed that both pancreatic mass and the metastatic retroperitoneal lymph nodes were nearly disappeared. We report a case of 58-year-old female with metastatic pancreatic cancer who had a dramatic response to palliative chemotherapy (gemcitabine plus nanoparticle albumin-bound paclitaxel).

A Case of Infantile Nephrotic Syndrome associated with Neuroblastoma

  • Kim, Soo Hyun;Park, Hyun-Min;Lee, Joo Hoon;Kim, Hyery;Go, Heounjeong;Kim, Dae Yeon;Park, Young Seo
    • Childhood Kidney Diseases
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    • v.22 no.2
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    • pp.91-96
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    • 2018
  • Nephrotic syndrome in the first year of life, characterized by renal dysfunction and proteinuria, is associated with a heterogeneous group of disorders. These disorders are often related to genetic mutations, but the syndrome can also be caused by a variety of other diseases. We report an infant with nephrotic syndrome associated with a neuroblastoma. A 6-month-old girl was admitted with a 10% weight loss over 10 days and nephrotic-range proteinuria. She was ill-looking, and her blood pressure was higher than normal for her age. Her cystatin-C glomerular filtration rate was decreased, and levels of plasma renin, aldosterone, and catecholamines were elevated. Renal ultrasonography and abdominal computed tomography showed a retroperitoneal prevertebral mass encasing both renal arteries and the left renal vein. The mass was partially resected laparoscopically, and the pathologic diagnosis was neuroblastoma. Findings on a simultaneous renal biopsy were unremarkable. The patient was treated with chemotherapy and several anti-hypertensive drugs, including an alpha blocker. Two months later, the mass had decreased in size and the proteinuria and hypertension were gradually improving. In an infant with abnormal renin-angiotensin system activation, severe hypertension, and nephrotic-range proteinuria, neuroblastoma can be considered in the differential diagnosis.

Renal Cell Carcinoma in a Pekingese Dog (페키니즈견에서 신장세포암종)

  • Lee Ki-chang;Jung Joo-hyun;Byeon Ye-eun;Oh Sun-kyung;Seo Eun-jung;Song Kyung-jin;Kweon Oh-kyeong;Yoon Jung-hee;Choi Min-cheol
    • Journal of Veterinary Clinics
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    • v.22 no.2
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    • pp.148-152
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    • 2005
  • An intact female, 5-year-old, Pekingese, weighing 3.5kg with a history of a palpated abdominal mass was referred to Veterinary Medical Teaching Hospital, Seoul National University. In laboratory examination, there were no remarkable abnormalities. Radiographic findings included a left mid-abdominal mass with ill-defined margin, serosal detail loss of peritoneal space, non-uniform opacity of retroperitoneal space, and a radiopaque cystic calculus. On abdominal ultrasonography, a heterogeneous parenchymal mass with irregular contour in the left renal region was found. Computed tomographic findings showed a tumor embolus within the caudal vena cava and an invasion into mesentery, small bowel loops, spleen and pancreas around the large left renal mass. Unilateral nephroureterectomy was performed. Histopathologic examination of the resected mass confirmed the diagnosis of renal cell carcinoma. The dog died one day after surgery. Although ultrasonography could give diagnostic information about mass characteristics, computed tomography (CT) can provide key imaging features of mass characteristics.