A disseminated variant of pancreatic serous cystadenoma causing obstructive jaundice, a very rare entity: a case report and review of the literature

BACKGROUND: Microcystic adenoma or serous cystadenoma (SCA) is an uncommon tumor type, accounting for only 1–2% of pancreatic exocrine neoplasms. Usually unifocal, SCAs present as single, large, well-demarcated, multiloculated, cystic tumors, 1–25 cm in size. CASE PRESENTATION: A 73-year-old man initially presented with epigastric abdominal pain and was diagnosed with SCA involving the whole pancreas. Eleven months later, he presented with obstructive jaundice, and total pancreatectomy was performed. The removed tissue allowed histological verification of pancreatic SCA. Histopathological examination showed both microcysts and macrocysts, lined by cuboidal epithelium, with optically clear cytoplasm and the absence of detectable mitosis or necrosis. CONCLUSIONS: Thus, although relatively rare, pancreatic SCA is one of the differential diagnoses of epigastric abdominal pain; we recommend early surgical intervention for symptomatic pancreatic SCA

Single-port video-assisted thoracoscopic surgery for the diagnosis of intrathoracic lesions

Background and Aim of Study: Diagnostic and therapeutic uniportal video-assisted thoracic surgery (VATS) is now considered a feasible and safe procedure with good results. In this retrospective chart review study, I will present our experience in diagnostic VATS at King Abdul Aziz Specialist Hospital, Taif, Saudi Arabia. Materials and Methods: The data of 108 patients undergoing uniportal diagnostic VATS in King Abdul Aziz Specialist Hospital, Taif, Saudi Arabia, from January 2013 to June 2015, were collected through a review of their hospital records. Results: The study included 108 patients (75 males and 33 females) with a mean age of 36.4 ± 8.1 years. The mean operative time was 28.5 ± 6.7 min. The most common morbidity was intraoperative bleeding that occurred in 15 cases (13.9%) and was easily controlled. Failure of VATS occurred in three cases (2.8%) due to massive adhesions, necessitating minithoracotomy. Reinsertion of the intercostal tube was required in 12 cases (11.1%). The mean duration to removal of the intercostal tube was 4.4 ± 0.9 days. The mean hospital stay was 6.4 ± 1.4 days. No operative or early postoperative mortality was recorded. Conclusion: Uniportal VATS is a safe and effective method for the diagnosis of intrathoracic lesions allowing resection of small localized lesions. It has a limited operative time that is improving with progress in the learning curve