We report a rare case of gastric adenocarcinoma with enteroblastic differentiation (GAED) that was treated with endoscopic submucosal dissection followed by additional distal gastrectomy with lymph node dissection. A 67-year-old man underwent endoscopic submucosal dissection for a gastric lesion, which was diagnosed as GAED with submucosal and lymphatic invasion. Histologically, GAED is characterized by a tubulopapillary growth pattern and clear cells that resemble those of the primitive fetal gut. Immunohistochemically, GAED variably expresses oncofetal proteins such as glypican-3, alpha-fetoprotein, and spalt-like transcription factor 4. Despite negative margins, additional gastrectomy with lymph node dissection was performed due to submucosal and lymphatic invasion. No residual tumor or metastasis was detected, and the patient remained disease-free for 2 years before dying from causes unrelated to GAED. Given its aggressive nature, frequent lymphovascular invasion, and high metastatic potential, clinicians should recognize the histopathological diagnosis of this rare tumor and its propensity for aggressiveness.

A 66-year-old postmenopausal woman received routine gynecologic check-up. Transvaginal ultrasonography and abdominal and pelvic computed tomography showed about 5-cm cystic mass in uterus with solid component and the patient had thin endometrium and the serum level of CA 125 was normal. We performed a total hysterectomy and bilateral salpingo-oophorectomy and found tumor which had brownish cystic fluid and about 2 cm sized and colored in light yellowish, polypoid protruding solid mass, located within the myometrial wall. Histopathological examination of frozen section revealed malignancy. The tumor was confined within the myometrium and its histologic type was clear cell adenocarcinoma. Finally we identified that the myometrial mass was clear cell adenocarcinoma originated from adenomyosis pathologically. The malignant transformation of adenomyosis is very rare. When we find a cystic change with solid component in adenomyosis patients, clear cell adenocarcinoma should be suspected as a differential diagnosis and magnetic resonance imaging should be considered for further evaluation.

Pericardial drainage is an important diagnostic and therapeutic option in the symptomatic patient with large amount of pericardial effusion (PE). However, when the amount of PE is relatively small, physicians are often reluctant to perform the invasive drainage of the fluid due to the increased risk of causing myocardial injury during the procedure. Even in some cases of suspected pericarditis with small amount PE, an initial empirical anti-inflammatory therapy is often recommended. A 65-year-old woman presented with mild dyspnea for two weeks. The echocardiography revealed small amount of PE. A careful fluoroscopy-guided pericardiocentesis, subsequent pericardial fluid cytology, and thorough whole body check-up demonstrated adenocarcinoma with no proven primary site. After the palliative chemotherapy, she had survived for 15 months until her death due to asphyxia. Although pericardiocentesis is considered dangerous in small amount of PE, a prompt and careful drainage may provide early detection of hidden malignancy and better survival outcome.

Surgery is the primary treatment for adenocarcinoma originating from the esophagogastric junction. However, many physicians attempt various endoscopic treatments for the cases of early adenocarcinoma and high-grade dysplasia of esophagogastric junction in order to avoid the high risk of complications associated with surgical resection. Recently, there is an increasing tendency to use endoscopic mucosal resection for the management of early esophageal cancer due to low morbidity and mortality rates. We report here on a case of early adenocarcinoma at esophagogastric junction successfully treated with endoscopic mucosal resection.

Hepatoid adenocarcinoma was described by Ishikura in 1985 for the first time. It is a very rare variant of adenocarcinoma characterized by morphological and functional features of hepatocyte differentiation. It is most commonly presented as gastric adenocarcinoma with otherwise unexplained elevation of serum alpha-fetoprotein level. Most of the patients with gastric hepatoid adenocarcinoma were diagnosed in advanced stages having vascular invasion and/or extensive metastasis in liver or lymph nodes. Accordingly, the prognosis of hepatoid adenocarcinoma is dismal. We experienced a typical case of gastric hepatoid adenocarcinoma and described the clinical features.

Nowadays increasing use of abdominal ultrasound in routine check-up may increase the detection rate asymtomatic cystic lesions of pancreas. Even through the majority of the cystic lesions of pancreas is pseudocyst, about 10-15% of those lesions are caused by pancreatic cystic tumor. In the pancreatic cystic tumor, especially, mucinous cystic tumor should be exicised due to its malignant potential, while the pancreatic pseudocyst or serous cystic tumon can be observed for a period or treated medically. Several clinical, radiological, biochemical and pathologic guidelines have been developed in order to distinguish among them. Among pancreatic cystic tumors, mucinous cystic adenocarcinoma is very rare and accounts for only 1% of all pancreatic neoplasms. Unlike extremely poor prognosis of pancreatic adenocarcinoma, mucinous cystic adenocarcinoma has an indolent course and shows a good prognosis after its curative resection. Recently we experienced a 69-year-old woman who had a mucinous cystic adenocarcinoma of the pancreas. We report this case with a review of literature.