Isolated Splenic Metastasis from Colorectal Cancer: Report of a Case

The authors report a case of a patient with splenic metastasis with previous history of colorectal cancer. A 69-year-old woman underwent a left hemicolectomy for sigmoid colon cancer. The tumor was staged T3N0M0. Two years after the operation, there was an elevation of CEA and computed tomography (CT) scan revealed a mass in the spleen, considered as an isolated metastasis. The patient underwent splenectomy. Histological diagnosis confirmed a metastatic adenocarcinoma from colorectal carcinoma. Patient was alive without neoplasic recurrence 5 years after splenectomy. Generally, splenic metastasis is uncommon. However, with the case of colorectal cancers, metastasis to the spleen is particularly rare. As with splenic metastasis of all primary tumors, the literature recommends that the treatment, where possible, is surgical

Effect of preoperative endoscopic biliary drainage on infectious morbidity after pancreatoduodenectomy: a case-control study

BackgroundThe utility of preoperative endoscopic biliary drainage (PEBD) in jaundiced patients before pancreatoduodenectomy (PD) is still debated. This is in part due to the heterogeneity of the studied population, including different tumor location, drainage techniques, and surgical procedures. The aim of the current study was to report the influence of PEBD on postoperative infectious morbidity of PD. Materials and Methods Between January 1996 and December 2004, 124 patients underwent a PD and 28. Twenty-eight (22.6%) of these patients underwent a PEBD. This group of patients was matched to 28 control patients who underwent PD without PEBD during the same period. The 2 groups were matched for age, sex, indication of surgery, and serum bilirubin levels. Results The specific morbidity of PEBD before surgery was 10.7% (n = 3). The postoperative overall morbidity, medical morbidity, and surgical morbidity rates were not different between the 2 groups. At the time of surgery, 89.3% (n = 25) of the patients in the PEBD group had positive bile culture in comparison to 19.4% (n = 4) in the control group (P < .001). The number of patients with 1 or more infectious complications was higher in the PEBD group (50%; n = 14) than in the control group (21.4%; n = 6) (P = .05). Conclusions Before PD, PEBD should be routinely avoided whenever possible in patients with potentially resectable pancreatic and peripancreatic lesions. In patients with cholangitis, requiring extensive preoperative assessment (such as liver biopsy) or neoadjuvant treatment, PEBD might still be indicated

Surgery using plasma energy for deep endometriosis: A quality of life assessment

OBJECTIVE: The principal objective of our study was to assess women\u27s quality of life (QoL) after surgery for Deep Endometriosis (DE), according to the surgical technique used. MATERIAL AND METHODS: Qualitative single-center survey in the department of obstetrics and gynecology, Angers University Hospital Center, France. All women who underwent surgery for DE from January 2011 to December 2015 were contacted by phone. The Endometriosis Health Profile-5 score was used to assess QoL before and after the surgery. Fifty-two women (response rate=86%) were included and classified into 3 groups according to the surgical technique used: simple shaving, shaving exclusively or in part by plasma vaporization (plasma), and resection. RESULTS: The 3 groups were comparable for surgical history, preoperative QoL score, and characteristics of endometriotic lesions (size and site). All DE symptoms and QoL scores improved significantly after the surgery, all techniques combined (P<0.01). QoL scores for women who had plasma shaving or complete resection were significantly higher than those for women with simple shaving (respectively, 375 [225-800] and 450 [-50 to 725] vs 275 [-100 to 600]; P=0.04). Self-image significantly improved only in the plasma group (P=0.03). The complete resection group had longer hospitals stays than the other groups (P=0.001), as well as a higher surgical revision rate (23% vs 0%; P=0.02). CONCLUSION: Plasma and complete resection improved QoL similarly for women with DE, both more than shaving alone. The advantage of plasma vaporization lies in the lesser morbidity and better self-image, both better than in women with resection

Malignant rhabdoid tumors of the liver: an exceptional tumor in adults - a case report and literature review

Malignant rhabdoid tumor (MRT) is a very rare liver tumor, with only a few cases reported in the literature. MRT generally occurs in pediatric patients and prognosis is usually very poor. Here we report a very rare case of MRT occurring in a young adult who is still alive with no sign of recurrence at 41 months of follow-up. MRI and computed tomography scans revealed a voluminous heterogeneous mass in the left liver with no specific pattern. The mass included necrotic and fibrous components. Histology showed fusiform, loosely cohesive cells with abundant eosinophilic cytoplasm resulting in eccentric nuclei, thus creating the characteristic rhabdoid appearance. Immunohistochemical studies revealed a lack of nuclear INI1 protein expression. The patient\u27s treatment included a major left liver resection associated with chemotherapy. A thorough search of the literature revealed one case of MRT in a young adult who died at 48 months of follow-up. A less malignant nature of the tumor in young adults may be suspected, but a longer disease-free survival may also be the fruit of aggressive surgical and oncological treatment

Rupture of Hepatocellular Carcinoma into the Biliary System with Resulting Bile Duct Thrombi: Report of Two Cases

We report two cases of hepatocellular carcinoma revealed by jaundice and the presence of free-floating tumoural fragments within the biliary system. Two men (one of 64 and one of 73) presented with isolated jaundice. The results from ultrasound, CT and MRI were suggestive of a cholangiocarcinoma. Surgical intervention demonstrated bile duct thrombi from the primary tumour causing obstructive jaundice