• Advances in pediatric surgery
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• v.15 no.1
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• pp.64-67
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• 2009

Splenic cystic lesion is uncommon in children, and cystic lymphangioma of the spleen has not been reported in Korean pediatric patients. Here we report a case of cystic lymphangioma arising from the spleen in a 16 year-old male. The patient presented with left flank pain for 5 days after blunt trauma to the same site. On physical examination, left abdominal tenderness and a palpable spleen were noted. Abdominal ultrasound and MRI revealed multiple septated macro-cystic mass abutting to the spleen medially, suggestive of cystic lymphangioma of the spleen. Laparotomy revealed a 20 cm sized cyst in the spleen, and 2,000mL of dark-brownish fluid was aspirated from the cyst. Splenectomy was performed. Pathological examination revealed the cystic lymphangioma. Post-operative recovery was uneventful, and the patient was discharged at 7 days after surgery.

• Parasites, Hosts and Diseases
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• v.52 no.3
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• pp.295-298
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• 2014

Primary renal echinococcosis, a rare disease involving the kidney, accounts for 2-3% of human echinococcosis. A 64-year-old female patient from Uzbekistan presented with complaints of left flank pain. A CT scan revealed a cystic mass in the upper to midpole of the left kidney. We regarded this lesion as a renal malignancy and hand-assisted laparoscopic radical nephrectomy was performed to remove the renal mass. The mass consisted of a large unilocular cyst and multiple smaller cysts without any grossly visible renal tissue. The final pathologic diagnosis was a renal hydatid cyst. For patients from endemic areas, hydatid cyst should be included in the differential diagnosis. Here, we present a case of renal hydatid cyst in a female patient who relocated from Uzbekistan to Korea.

• 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.

• Journal of Chest Surgery
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• v.34 no.7
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• pp.574-577
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• 2001

A 54-year-old homosexual man was diagnosed as human immunodeficiency virus-1-positive in 1992. He was admitted to a tertiary hospital in March, 2000 because of right flank pain, fever and intermittent cough. A chest roentgenogram showed right-sided pleural effusion, and closed thoracostomy was performed for drainage Salmonella species and Escherichia coli were isolated from the pleural fluid. In spite of 6 weeks of antibiotic treatment, fever did not subside and the general condition gradually deteriorated, and under the diagnosis of lung abscess with empyema thoracis, right pleuropneumonectomy was performed. The general condition improved postoperatively until day 10 when he showed sudden change in mental status to stuporous and developed focal seizure. Brain CT showed multiple abscesses in right frontal and left frontotemporal lobes and he expired on postoperative day 14.

• Childhood Kidney Diseases
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• v.10 no.1
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• pp.72-76
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• 2006

Perinephric abscess is an accumulation of pus in the perinephric space, the area anatomically defined between the kidney and Gerota's fascia. Gram negative organisms are the most prevalent bacterial species found in perinephric abscess. Fever, flank pain, vomiting and abdominal mass are the usual presenting complaints. But with its insidious onset, variable symptoms and rue frequency in children, perinephric abscess has been a major diagnostic problem, leading to delayed diagnosis and inappropriate treatment, which increase the rate of complication and mortality. Clinical diagnosis of perinephric abscess is difficult but must always be considered in children with a febrile septicemic illness. For appropriate treatment, early detection is very important, and either ultrasonography or computed tomography(CT) facilitates the diagnosis and establishment of treatment method. We experienced a case of left perinephric abscess treated by percutaneous drainage in a 1-year 7-month old boy. Review of literature was made briefly.

• Childhood Kidney Diseases
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• v.8 no.2
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• pp.239-243
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• 2004

Acute poststreptococcal glomerulonephritis(APSGN) is the most common form of postinfectious glomerulonephritis, and acute pyelonephritis(APN) is the most severe form of urinary tract infection in childhood. However, the concurrence of two diseases is uncommon in the literature. We describe a case of APSGN accompanied with APN in a 5-year-old female who presented with fever, left flank pain, headache and facial edema. Urinalysis showed pyuria, microscopic hematuria, and mild proteinulra. Serial urine cultures grew Escherichia coli. ${^99m}$Tc-DMSA renal scan revealed a cortical defect in the upper pole of left kidney. She had a history of preceding pharyngitis, in addition, showed high blood pressure, high anti-streptolysin 0 titer, and low serum complement levels. The patient improved completely with supportive treatment, Including antibiotic and antihypertensive therapy. These findings suggested that APSGN and APN could be manifested simultaneously or be .superimposed on each other.

• The Korean Journal of Cytopathology
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• v.5 no.1
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• pp.74-78
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• 1994

A case of retroperitoneal paraganglioma is presented with fine needle aspiration cytologic features. A 57-year-old woman complained of abdominal discomfort and left flank pain for 2 years. The abdominal CT scan revealed an ovoid mass left to the abdominal aorta. Percutaneous fine needle aspiration was performed from the mass. The smear revealed cellular sheets or groups on hemorrhagic background. The tumor cells were ovoid, round to spindle shaped with mild to moderate cellular pleomorphism. The nuclei were round to ovoid and had evenly dispersed chromatin and small nucleoli. The cytoplasm was amphophilic, finely granular and poorly defined. Cells having large or spindle nuclei were quite frequently observed, however, mitosis was not present The cytologic findings suggested paraganglioma, but the frequent spindle cell pattern and the pleomorphism made it difficult to exclude other endocrine tumors and sarcomas. The clinical, histological and ultrastructural findings as well as cytologic findings contributed to confirmatory diagnosis.

• Journal of the Korean Society of Radiology
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• v.82 no.6
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• pp.1594-1599
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• 2021

A 64-year-old male visited our emergency department due to severe right flank pain after falling from a 2-meter height. Contrast-enhanced CT revealed a right hemothorax with multiple fractures in the right ribs and iliac bone. A small hematoma in the right perihepatic space was noted, but there was no hepatic laceration on CT. Initial surgical management led to continuous uncontrolled bleeding around the porta hepatis, and subsequent arterial angiography could not demonstrate a bleeding focus. However, immediate follow-up CT showed contrast extravasation on the left side of abdomen, and a percutaneous transhepatic portal venogram revealed active bleeding from the left portal vein. Although the wound was embolized with a glue, the patient suffered from a cardiac arrest and finally expired. In conclusion, during evaluation of abdominal trauma patients, portal vein bleeding and contrecoup injuries should be considered when hepatic arteriography findings are unremarkable.

• Journal of Chest Surgery
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• v.43 no.1
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• pp.100-103
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• 2010

We report her on a rare case of a renal stent that migrated into the right ventricle in a patient with nutcracker syndrome. A 29-year-old woman was admitted to the hospital and she was suffering from flank pain. The computed tomography of the abdomen demonstrated that the left renal vein was compressed between the abdominal aorta and the superior mesenteric artery (nutcracker syndrome). A self expandable stent was placed across the left renal vein for treating her nutcracker syndrome. The next day after the procedure, the follow up chest radiograph showed that the displaced stent had migrated into the right ventricle. After percutanous endovascular stent removal had failed, the stent was ultimately removed by performing cardiac surgery. At the $6^{th}$ postoperative month, there have been no abdominal or cardiac symptoms.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.34 no.1
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• pp.71-75
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• 2012

Renal cell carcinoma (RCC) is the most frequent urological malignant tumor in adults and it occurs mostly between the fifth and the sixth decades of life. The male-female ratio is 3:1 and it is more common in smokers. It accounts for approximately 3% of adult malignancies; 90~95% of neoplasms of the kidney. The classic triad of presenting symptoms of RCC is hematuria, back pain and a mass in the flank. More than 50% of RCCs show metastasis to breast, lung and regional lymph nodes, and 15% present in the orofacialmaxillary region. This case is about a 66 year-old man who was treated for painless swelling in the left masseteric area. The mass was surgically excised and sent for biopsy. It was diagnosed as RCC and two weeks later nephronectomy of the left kidney was performed. Metastasis to other organs was detected and the patient received radiation therapy. In this case we were able to find the primary lesion by the metastatic lesion.