Unexpected Radiologic Findings for a Casting Type of Radiolucent Colorectal Foreign Body Composed of Polyurethane Foam

Radiologic diagnosis of colorectal foreign bodies is usually not very difficult, because inserted materials are often clearly visible on plain abdominal radiographs. However, when they are radiolucent, a plain abdominal radiograph has been reported to be useless. As radiolucent colorectal foreign bodies appear as radiolucent artificial contours or air-trapped materials in the pelvis, almost always the diagnosis itself can be made by careful evaluation of plain abdominal radiographs. We encountered a case of casting type of radiolucent colorectal foreign body formed from polyurethane foam. It presented us with unexpected radiologic findings and led to diagnostic difficulties

Positive Therapeutic Response to Bevacizumab Plus Paclitaxel in a Patient with Advanced, Life-Threatening Breast Cancer and Carcinomatous Lymphangitis:a Subsequent Treatment Change to Hormone Therapy

We present a case of advanced, life-threatening breast cancer with carcinomatous lymphangitis treatedwith bevacizumab plus paclitaxel. A positive therapeutic response was achieved and the treatment was subsequentlychanged to hormone therapy.The patient was a 53-year-old postmenopausal woman with a non-contributory medical history. She presentedto a nearby hospital with chief complaints of continued exertional dyspnea and coughing since March2012. Physical findings included a palpable mass in the left breast, and the patient was referred and presentedto our hospital in May. Examinations at our hospital revealed left-sided breast cancer (estrogen receptorpositive, progesterone receptor positive, and no amplification of the human epidermal growth factorreceptor 2 by FISH). The patient had bone metastasis and carcinomatous lymphangitis (cT2N3cM1-stageIV). The condition was life threatening, and administration of bevacizumab plus weekly paclitaxel was initiatedwith the expectation of a high response rate. Coughing and dyspnea resolved two weeks later. CTscans were taken in August after the completion of 3 cycles and showed improvement in carcinomatouslymphangitis. No major side effects were observed due to bevacizumab plus weekly paclitaxel. When theCT scans were taken in December after the completion of 6 cycles, the primary lesion and lymph node metastaseswere reduced in size. In the lung field, there was no thickening of the interlobular septa or subpleuralinterstitium, and the findings of carcinomatous lymphangitis were improved. Thus, bevacizumab plus paclitaxelwere discontinued and the treatment was changed to oral letrozole (2.5 mg/day). The patient hasbeen followed up with no recurrence as of March 2013

A Case of Inflammatory Pseudotumor of the Breast after Augmentation Mammoplasty

Inflammatory pseudotumor is a benign reactive lesion which forms due to diverse tissue responses of inflammatory cells and mesenchymal cells. It can occur in various organs of the body but rarely in the breast. We report a case of inflammatory pseudotumor of the breast after augmentation mammoplasty. The patient was a 78-year-old woman who noticed a mass in her right breast in July 2012. She had a history of augmentation mammoplasty at age 24 years. She was referred to our hospital for thorough examination. A 3-cm immovable induration was palpated in the upper lesion of the right breast. Ultrasound examination revealed a hypoechoic mass at the same site. The mass was 2.9×1.7 cm with irregular, ill-defined borders. Mammography revealed some areas of elevated density with coarse, lucent-centered calcifications in bilateral breasts but no clear findings of malignancy. Core needle biopsy of this site revealed marked fibrous hyperplasia and proliferation of fibroblast-like spindle cells. Infiltration of neutrophils and plasma cells was observed in the stroma. There were spindle cells with no atypia and scarce mitotic figures. Thus, the patient was diagnosed with inflammatory pseudotumor. The patient received only follow-up observation without surgical resection as per the patient\u27s wishes. There has not been any change as of May 2013

Post-intervention Status in Patients With Refractory Myasthenia Gravis Treated With Eculizumab During REGAIN and Its Open-Label Extension

OBJECTIVE: To evaluate whether eculizumab helps patients with anti-acetylcholine receptor-positive (AChR+) refractory generalized myasthenia gravis (gMG) achieve the Myasthenia Gravis Foundation of America (MGFA) post-intervention status of minimal manifestations (MM), we assessed patients' status throughout REGAIN (Safety and Efficacy of Eculizumab in AChR+ Refractory Generalized Myasthenia Gravis) and its open-label extension. METHODS: Patients who completed the REGAIN randomized controlled trial and continued into the open-label extension were included in this tertiary endpoint analysis. Patients were assessed for the MGFA post-intervention status of improved, unchanged, worse, MM, and pharmacologic remission at defined time points during REGAIN and through week 130 of the open-label study. RESULTS: A total of 117 patients completed REGAIN and continued into the open-label study (eculizumab/eculizumab: 56; placebo/eculizumab: 61). At week 26 of REGAIN, more eculizumab-treated patients than placebo-treated patients achieved a status of improved (60.7% vs 41.7%) or MM (25.0% vs 13.3%; common OR: 2.3; 95% CI: 1.1-4.5). After 130 weeks of eculizumab treatment, 88.0% of patients achieved improved status and 57.3% of patients achieved MM status. The safety profile of eculizumab was consistent with its known profile and no new safety signals were detected. CONCLUSION: Eculizumab led to rapid and sustained achievement of MM in patients with AChR+ refractory gMG. These findings support the use of eculizumab in this previously difficult-to-treat patient population. CLINICALTRIALSGOV IDENTIFIER: REGAIN, NCT01997229; REGAIN open-label extension, NCT02301624. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that, after 26 weeks of eculizumab treatment, 25.0% of adults with AChR+ refractory gMG achieved MM, compared with 13.3% who received placebo

Minimal Symptom Expression' in Patients With Acetylcholine Receptor Antibody-Positive Refractory Generalized Myasthenia Gravis Treated With Eculizumab

The efficacy and tolerability of eculizumab were assessed in REGAIN, a 26-week, phase 3, randomized, double-blind, placebo-controlled study in anti-acetylcholine receptor antibody-positive (AChR+) refractory generalized myasthenia gravis (gMG), and its open-label extension