－S 168 －
― F-91 ―
Metastatic osteosarcoma presenting as a colon polyp
Department of Medicine, Samsung Medical center, Sungkyunkwan University school of Medicine, Seoul, Korea
*A-Reum Han, Young HO Kim
골육종은 골에 발생하는 원발성 악성 종양으로 종양 세포에 의해 미성숙 골조직이나 유골 조직이 형성되는 것이 특징이다. 골에 발생하는 육종 중 가장 흔하며, 원발성 골종양 중에는 다발성 골수종 다음으로 흔한 것으로 알려져 있다. 진단 당시 10%에서 20%의 골육종 환자에서 원격성 전이가 발견된다. 비록 최근 연구에서 수술과 함께 보조 항암 치료를 받은 환자들이 늘어남에 따라 폐외 전이의 빈도가 높아지고 있으나, 아직까지 원격성 전이의 대부분은 폐에서 발생된다. 그 외 골, 흉막, 심장이나 간 등에서 원격성 전이가 드물게 발견된다. 그러나, 골육종의 위장관 전이는 굉장히 드물며, 특히 대장으로의 전이는 국내 보고된 바가 없다. 이에 저자들은 골육종 환자에서 대장 용종으로 발현된 대장 전이를 경험하였기에 문헌고찰과 함께 보고하는 바이다.
― F-92 ―
A case of Degos' disease(Malignant atrophic papulosis, MAP) presenting with abdominal angina and widespread skin lesions
Departments of Internal Medicine and Pathology2, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
*Hyo Kyung Choi, M.D., Dong Kyung Chang, M.D., Yeun Jung Lim, M.D., Kee-Taek Jang, M.D.2, Jae J. Kim, M.D., Hee Jung Son, M.D., Young-Ho Kim, M.D., Poong-Lyul Rhee, M.D., Jun Haeng Lee, M.D., Jin Yong Kim, M.D. and Jong Chul Rhee, M.D.
Malignant atrophic papulosis (MAP; also known as Degos' disease) is a rare thrombo-occlusive disease of uncertain etiology, with fewer than 7 cases reported so far in korea. It is characterized by atrophic papular skin lesions and variable association of systemic involvement, especially the gastrointestinal tract and nervous system. MAP has a purely cutaneous variant and a systemic variant with cutaneous manifestations. The former is a benign condition what can be life-long. The latter which comprised the majority of cases, is usually fatal within 2-3 years from the onset of systemic involvement. No treatment has been shown to be effective in the treatment of MAP. We describe a 52-year old man presented with a 5-month history of abdominal angina and 2-year history of multiple skin lesions on the trunk and extremities. The skin lesion was papule of 4-6mm in diameter with porcelain-white center and a slightly raised erythematous telangiectatic rim. The biopsy of skin lesion showed wedge shaped degeneration of collagen in dermis and atrophic epidermis. The finding of explorative laparotomy was that multiple yellow-whitish plaques scattered throughout the small bowel. The biopsy of small bowel showed submucosal hyalinized nodule. He has been commenced on aspirin 100mg daily and alive for 13months since the onset of gastrointestinal symptom.
