Morphologically and immunohistochemically undifferentiated gastric neoplasia in a patient with multiple metastatic malignant melanomas: a case report

Introduction: Malignant melanoma is a neoplasia which frequently involves the gastrointestinal tract (GIT). GIT metastases are difficult to diagnose because they often recur many years after treatment of the primary cutaneous lesion and also manifest clinically at an advanced stage of the neoplasia. Furthermore, GIT metastases can appear in various morphological forms, and therefore immunohistochemistry is often useful in distinguishing between a malignant melanoma and other malignancies. Case presentation: We report the case of a 60-year-old man with a multiple metastatic melanoma who underwent an upper endoscopy to clarify the possible involvement of the gastric wall with a mass localized in the upper abdomen involving the pancreas and various lymph nodes, which was previously described with computed tomography. Clinically, the patient reported a progressive loss of appetite, nausea and vomiting. The upper endoscopy and histological examination revealed a gastric location of an undifferentiated neoplasm with an absence of immunohistochemical characteristics referable to the skin malignant melanoma that was removed previously. Conclusion: The present case report shows the difficulty in diagnosing a metastatic melanoma in the GIT and therefore, it seems worthwhile to consider metastatic malignant melanoma in the differential diagnosis of undifferentiated neoplasia. © 2008 Alghisi et al; licensee BioMed Central Ltd

Оцінка оновлення основних засобів за рахунок позикових коштів

Оновлення основних засобів є актуальною проблемою сьогодення. Для багатьох підприємств кредити банків є чи не єдиним джерелом коштів на модернізацію виробничих потужностей. В даній статті нами були розглянуті можливості і перспективи приватних фірм для використання з цією метою позикових засобів, оцінений ступінь прозорості банківських установ, річні ставки за інвестиційними кредитами та інші умови їхнього надання.Modernizing of the basic assets is a topical problem of the present. For many business firms bank loans are may be the only source of funds for renewal of production facilities. In the article we have considered the opportunities and prospects for use of borrowed funds by private firms for this purpose, rated the degree of transparency of banking institutions, the annual rates of investment credits and other conditions of their granting

Computer imaging: true or false.

Technologic advancements in the field of computer imaging are providing plastic surgeons with the ability to give patients a visual forecast of postsurgical outcome and serve as a platform for improved doctor-patient communication. This same technology allows the convenient and stable storage, cataloguing and rapid retrieval of massive numbers of photographs in minimal space. Along with these positive aspects, negative ones are becoming apparent. Poor prediction of outcomes by the physician, whether conscious or not, could result in patient dissatisfaction with what might be an optimal operative result. The hard copy evidence of the predicted outcome may then serve as evidence in our very unyielding legal system. Our inability to discern altered from unaltered photographs, negatives and slides presents our profession with ethical challenges in the presentation of data to our peers. Some partial solutions are discussed but the advent of this new technology calls us to a unique and absolute commitment to professional honesty

0209

Thoracic disc herniation has always carried with it the potential for serious adverse neurological consequences if not treated appropriately. The authors review the historical evolution of treatment for thoracic disc herniation from the early surgical series using dorsal approaches (which were known to involve a significant risk of paraplegia) to later surgical series in which lateral and then ventral approaches to the disc were increasingly emphasized, with significant improvement in patient outcome. The evolution of minimally invasive thoracoscopic techniques is discussed, together with the results of several surgical series demonstrating significant reductions in morbidity compared with more traditional methods. The technique of thoracoscopic discectomy is presented in detail. KEY WORDS • thoracic spine • herniated disc • thoracoscopic surgery • endoscopy • minimally invasive surgery Neurosurg. Focus / Volume 9 / October, 2000 1 Abbreviations used in this paper: CT = computerized tomography; LECA = lateral extracavitary approach; LPEA = lateral parascapular extrapleural approach; MR = magnetic resonance; VATS = video-assisted thoracoscopic surgery; 3D = three-dimensional