Publications by authors named "Samrerng Ratanarapee"

6 Publications

  • Page 1 of 1

A Case Report of Ruptured Malignant Neuroendocrine Tumor of Kidney, an Extraordinary Presentation.

J Med Assoc Thai 2016 Sep;99(9):1057-60

We report the case of a 51-year-old Thai female presented with right abdominal mass with pain and anemia. The radiographic findings showed ruptured renal mass. She underwent radical nephrectomy and the pathological report was malignant neuroendocrine tumor. Palliative chemotherapy was administered. The patient passed away three months after the operation. Renal neuroendocrine tumors are rare. Moreover, ruptured renal tumors are very rare. They are usually considered to be angiomyolipoma or renal cell carcinoma. Poor differentiation and rupture at presentation are aggressive features of tumors. To the best of our knowledge, this is the first case report of ruptured renal malignant neuroendocrine tumor.
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September 2016

Fibrosis, Connexin-43, and Conduction Abnormalities in the Brugada Syndrome.

J Am Coll Cardiol 2015 Nov;66(18):1976-1986

Cardiovascular Sciences, St. George's, University of London, London, United Kingdom. Electronic address:

Background: The right ventricular outflow tract (RVOT) is acknowledged to be responsible for arrhythmogenesis in Brugada syndrome (BrS), but the pathophysiology remains controversial.

Objectives: This study assessed the substrate underlying BrS at post-mortem and in vivo, and the role for open thoracotomy ablation.

Methods: Six whole hearts from male post-mortem cases of unexplained sudden death (mean age 23.2 years) with negative specialist cardiac autopsy and familial BrS were used and matched to 6 homograft control hearts by sex and age (within 3 years) by random risk set sampling. Cardiac autopsy sections from cases and control hearts were stained with picrosirius red for collagen. The RVOT was evaluated in detail, including immunofluorescent stain for connexin-43 (Cx43). Collagen and Cx43 were quantified digitally and compared. An in vivo study was undertaken on 6 consecutive BrS patients (mean age 39.8 years, all men) during epicardial RVOT ablation for arrhythmia via thoracotomy. Abnormal late and fractionated potentials indicative of slowed conduction were identified, and biopsies were taken before ablation.

Results: Collagen was increased in BrS autopsy cases compared with control hearts (odds ratio [OR]: 1.42; p = 0.026). Fibrosis was greatest in the RVOT (OR: 1.98; p = 0.003) and the epicardium (OR: 2.00; p = 0.001). The Cx43 signal was reduced in BrS RVOT (OR: 0.59; p = 0.001). Autopsy and in vivo RVOT samples identified epicardial and interstitial fibrosis. This was collocated with abnormal potentials in vivo that, when ablated, abolished the type 1 Brugada electrocardiogram without ventricular arrhythmia over 24.6 ± 9.7 months.

Conclusions: BrS is associated with epicardial surface and interstitial fibrosis and reduced gap junction expression in the RVOT. This collocates to abnormal potentials, and their ablation abolishes the BrS phenotype and life-threatening arrhythmias. BrS is also associated with increased collagen throughout the heart. Abnormal myocardial structure and conduction are therefore responsible for BrS.
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http://dx.doi.org/10.1016/j.jacc.2015.08.862DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4631798PMC
November 2015

Villous adenoma of the urinary bladder: a case report.

J Med Assoc Thai 2010 Nov;93(11):1336-9

Department of Pathology, Faculty of Madicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Villous adenomas of the urinary tract are rare, in contrast to urothelial neoplasms. Most reports were scattered individual cases. Only two case series of this entity have been published. The histopathology is identical to that of the much more common villous adenoma of the gastrointestinal tract. The authors reported a case of urinary bladder villous adenoma in a 41-year-old Thai patient who complained of hematuria for one day without any other symptom. Cystoscopic examination revealed a papillary growth at the bladder neck associated with marked degree of bullous edema and bilateral mild hydroureters. The clinical diagnosis was urothelial carcinoma. Transurethral resection was performed Histologic examination revealed typical features of villous adenoma. The tumor showed identical immunohistochemical profile to colonic villous adenoma. The patient has been well for more than a year after tumor removal.
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November 2010

Acute appendicitis as primary symptom of prostatic adenocarcinoma: report of a case.

J Med Assoc Thai 2010 Nov;93(11):1327-31

Department of Pathology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

The most common disease ofappendix is acute appendicitis. There have been at least 20 case reports of metastasis-induced appendicitis in English literature. The authors reported a 62-year-old Thai man who underwent appendectomy due to classical symptoms and signs of acute appendicitis and was subsequently referred to Siriraj Hospital for proper management after a pathological report of metastatic adenocarcinoma to the appendix. By morphology, the primary site was thought to be the prostate gland. Confirmation was done based on serum PSA study, transrectal ultrasound-guided core needle biopsy, and review of the material from Hua Hin Hospital. Orchidectomy was performed with satisfactory outcome. The patient was doing well for two years before upper gastrointestinal hemorrhage and obstructive jaundice caused by another aggressive tumor developed. He died of the second tumor associated with subsequent renal failure in spite of good response to orchidectomy.
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November 2010

Scrotal pain as the first manifestation of scrotal leiomyoma: a case report.

J Med Assoc Thai 2010 May;93(5):633-6

Departmant of Family Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

Primary scrotal leiomyoma is derived from smooth muscle cells of tunica dartos. A 37-year-old Thai man, barber by profession, presented with left scrotal pain and subsequently, a solid mass is reported. As a relatively rare neoplasm, the initial diagnosis and differential diagnosis are intricate. The management was surgical excision. The well circumscribed 1 cm mass appeared as homogeneous, whorled-like, with interlacing fascicles of spindled muscle cells, and a strong positive desmin immunoreactivity. Upon follow-up, pain had disappeared one year after surgery. Reassurance and careful re-examination to reduce anxiety was also needed.
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May 2010