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We describe a case of malignant endocrine tumor of the pancreas associated with von Recklinghausen's disease. A 66-year-old woman with familial von Recklinghausen's disease was admitted to our hospital with weight loss and lower abdominal pain. Endoscopy revealed a submucosal tumor in the second part of the duodenum. Contrast-enhanced computed tomography showed a heterogeneous low-density tumor, measuring 20 x 15 mm, in the head of the pancreas, and metastatic lymphadenopathy. Angiography showed faint tumor staining without encasement or apparent increase in vascularity. Pancreatoduodenectomy was performed. Macroscopically, there was a solid tumor, measuring 20 x 18 mm, in the head of the pancreas. Histologically, a malignant endocrine tumor was shown, with direct invasion to the duodenum, and lymph node metastases. This is the thirteenth case of pancreatic malignant tumor and the fourth case of pancreatic endocrine tumor associated with von Recklinghausen's disease reported in the world literature. [ABSTRACT FROM AUTHOR]

A case of adenoma of the ampulla of Vater is presented in a 48-year-old man who was admitted with epigastric pain. Gastroendoscopy revealed a sessile tumor about 3 cm in diameter at the ampulla of Vater, and the pathological diagnosis of a biopsy specimen was adenoma with moderate atypia. Because of the possibility of a malignant component, pylorus-preserving pancreatoduodenectomy was performed to avoid local recurrence. The final pathological diagnosis was adenoma with severe atypia.

We report a rare case of corrected transposition of great arteries and mitral atresia associated with double aoric arch. The patient showed polypnea and cyanosis soon after birth. She underwent balloon atrioseptostomy at the age of 18 days and pulmonary artery banding (PAB) at 24 days. But she showed severe persistent stridor after PAB. Esophagography and left counter-current aortography revealed double aortic arch. At the age of 49 days, division of the left lesser arch and ligation of patent ductus arteriosus were performed through left lateral thoracotomy. Stridor disappeared completely following operation. She underwent total cavopulmonary connection using a 18 mm Gore-Tex graft as intraatrial conduit concomitant with pacemaker implantation at the age of 8 years. Postoperative course was uneventful. To our knowledge, this is the first successful case report of surgical correction of corrected transposition of great arteries and mitral atresia associated with double aoric arch.

A 73-year-old man suffering from exertional dyspnea was admitted to our hospital. Transthoracic echocardiography revealed pericardial effusion. This case was diagnosed as idiopathic pericarditis from laboratory data and pathological findings of the pericardial biopsy. A right atrial mass was detected by computed tomography, transesophageal echocardiography and MRI during conservative treatment. Because of the risk of pulmonary embolism due to the presence of the right atrial mass, removal of the mass was performed. The atrial mass was diagnosed as organized thrombus by pathological examination. It was suggested that the cause of right atrial thrombus was congestion and damage of the right atrial endocardium due to idiopathic pericarditis and atrial fibrillation. This case of a right atrial thrombus associated with idiopathic pericarditis is very rare, and MRI was proven to be very useful in the differentiation of a thrombus from cardiac tumor.