Cutaneous Metastasis at a Surgical Drain Site after Gastric Cancer Resection

Cutaneous metastasis from intra-abdominal malignant solid tumours such as gastric adenocarcinoma is very rare. Here, we report the case of a 76-year-old male patient with a T4N2M0, poorly differentiated, signet-ring cell gastric carcinoma, who underwent potentially curative resection of the tumour and developed cutaneous metastasis at the site of the surgical drain 4 months after the operation while he was on chemotherapy. The lesion involved the skin and the subcutaneous fat only. A CT scan revealed local recurrence at the resection bed but no distant metastases. The patient died 1 month later. It is concluded that the development of cutaneous metastasis after gastric carcinoma resection indicates tumour recurrence or disseminated disease and is associated with poor prognosis

Laparoscopic resection of a pancreatic serous cystadenoma preserving the integrity of main pancreatic duct: a case report

Pancreatic serous cystadenomas are rare benign cystic neoplasms. Extended operations are unnecessary for serous cystadenomas and minimally invasive surgery should be performed. Laparoscopic pancreatic procedures are under evaluation. We present a case of a 79-year-old Greek woman with symptomatic cholelithiasis and a serous pancreatic cystadenoma located at the neck of the pancreas. In the occasion of a standard laparoscopic cholecystectomy the pancreatic mass was resected with a novel minimally invasive laparoscopic method preserving the integrity of the main pancreatic duct and the whole pancreas. Laparoscopic resection is a feasible, safe and effective treatment of benign pancreatic tumors, in experienced hands under proper indications

Synchronous Breast and Rectal Cancers in a Man

Breast cancer in men is relatively rare and its coexistence with other primary non-breast cancers exceptional. Here, we report the case of a 50-year-old man who presented with symptoms of rectal adenocarcinoma and in whom a synchronous, asymptomatic cancer of the left breast was found incidentally at physical examination

Synchronous Carcinoma of the Ampulla of Vater and Colon Cancer

Carcinoma of the papilla of Vater is a relatively rare tumor and its coexistence with other primary sporadic cancers is very exceptional. Here we report the case of a 76-year-old man who presented with painless obstructive jaundice, pathologically elevated liver function tests and increased serum levels of carbohydrate antigen 19-9 and carcinoembryonic antigen. Endoscopic retrograde cholangiography revealed a large polypoid mass in the ampulla of Vater. A large tumor in the ascending colon was also incidentally detected by abdominal computed tomography. Endoscopic biopsies from both lesions showed adenocarcinomas. Metastases to the liver and to the hepatoduodenal ligament and hepatic artery lymph nodes were found during surgery. Right colectomy and a biliary bypass were performed. Histological analysis showed an ampullary adenocarcinoma with metastases to regional lymph nodes and the liver and a colonic adenocarcinoma with local invasion into the pericolic fat. Treatment with gemcitabine plus cisplatin was suggested postoperatively. The association of sporadic ampullary and colonic adenocarcinomas and the mutually increased risk of developing either a synchronous or a metachronous tumor following each other should be considered in patients with primary ampullary or colorectal cancer during the preoperative evaluation and postoperative follow-up of these patients

Antiphospholipid Syndrome and Pregnancy-Diagnosis, Complications and Management: An Overview

Antiphospholipid syndrome which is also known as APS is an autoimmune disease which represents an acquired form of thrombophilia. The etiology of APS remains unknown. This disorder occurs when the immune system mistakenly attacks some of the normal human proteins and manifests itself as recurrent arterial or venous thrombosis and it could emerge after abortions or in recurrent pregnancy loss. In APS, the body produces the wrong antibodies against phospholipid-binding proteins, that is present in the blood and plays an important role in coagulation. Antibodies are specific proteins that usually target and neutralize the body’s invaders, such as viruses and bacteria. When antibodies attack phospholipid-binding proteins, blood clots abnormally. Specifically, it could cause blood clots in veins or arteries leading to stroke and various pregnancy complications such as: endometrial death, miscarriage, preeclampsia, intrauterine growth restriction and prematurity. APS is divided into primary and secondary, which is associated with autoimmune diseases and more often with systemic lupus erythematosus (SLE), while antibodies against cardiolipin are detected in many other conditions (infections, malignancies, drugs, etc.). The symptoms of APS, in addition to arterial and/or venous thrombosis and pregnancy complications, are multisystemic and the differential diagnosis of the primary APS from the secondary, in the context of SLE, is of particular clinical interest and is subject of this literature review

Uterine Embolization as a New Treatment Option in Adenomyosis Uteri

Adenomyosis is characterized by the development of endometrial ectopic glands and tissue in the myometrium layer in depth greater than 2.5 mm from the endometrial surface of the separative area by -myomas well as by hypertrophy and hyperplasia of the smooth muscles of the myometrium. This is filtration, not mere displacement, of the myometrium, from the endometrium. Clinical symptoms include dysmenorrhea and menorrhagia. It is diffuse (adenomyosis) or focal (adenomyoma), asymmetrically affects the uterine wall of premenopausal women (usually the posterior) and often coexists with myomas. The pathogenesis of adenomyosis remains unknown. The treatment options are: drug therapy, invasive treatment of fibroids: myomectomy (open—intra-abdominal, laparoscopic, hysteroscopic), hysterectomy, myolysis—cryocatalysis, microwave or radiofrequency thermal catalysis (RF-ablation), ultrasound focus catalysis (FUS), laser photocatalysis and percutaneous selective uterine artery embolization (UAE). Embolization remains an alternative and not a substitute of hysterectomy. The medical indication is made on a case-by-case basis, depending on age, desire for pregnancy and the clinical symptoms of adenomyosis

The clinical significance of serum soluble e-cadherin in patients with adenocarcinoma of the gastrointestinal tract

Modifications in E-cadherin expression are associated with dedifferentiation, progression, metastasis and poor prognosis in many types of tumors. The aim of the present study was to identify a potential association of the pre- and post-operative serum E-cadherin levels with the clinicopathological parameters of patients with gastric and colon cancer. Serum E-Cad levels were determined in 99 gastric cancer patients, 113 colon cancer patients and 78 healthy volunteers by ELISA. High sE-Cad levels were present in both groups of patients, while associations to clinicopathological parameters differentiated among gastric and colon cancer. Soluble E-Cad proved as a significant independent diagnostic and pre-therapeutic factor in gastric cancer, while demonstrating an ability to identify liver metastasis and choice of treatment in colon cancer patients. The possibility of utilizing circulating E-cadherin, as a prognostic marker for distant and liver metastasis in gastric and colon cancer patients is of great clinical significance and should be further studied.Τα μόρια προσκόλλησης διαδραματίζουν σημαντικό ρόλο στη διαφοροποίηση, διήθηση, μετάσταση και γενικά την πορεία της και την κακή πρόγνωση της νόσου. Ο σκοπός της παρούσης μελέτης ήταν η εκτίμηση των επιπέδων της διαλυτής μορφής της Ε-καντερίνης (sE-Cad) σε ασθενείς με γαστρικό καρκίνο και καρκίνο του παχέος εντέρου προεγχειρητικά, αλλά και 30 ημέρες μετά την επέμβαση. Η sE-Cad εκτιμήθηκε στον ορό μέσω της ανοσοενζυμικής μεθόδου ELISA σε 99 ασθενείς με γαστρικό, σε 113 ασθενείς με ορθοκολικό καρκίνο, καθώς και 78 υγιείς εθελοντές. Υψηλά επίπεδα sE-Cad ανιχνεύθηκαν και στις δύο μορφές καρκίνου, σε σύγκριση με την ομάδα ελέγχου, αλλά παρατηρήθηκαν διαφοροποιήσεις όσων αφορά τη δράση και τη σημαντικότητά της μεταξύ των ομάδων των ασθενών. Σύμφωνα με τα αποτελέσματά μας, η sE-Cad αποδείχθηκε ένας καλός ανεξάρτητος διαγνωστικός και προ-θεραπευτικός παράγοντας για τον καρκίνο του στομάχου και ένας καλός προθεραπευτικός και προγνωστικός δείκτης ύπαρξης ηπατικών μεταστάσεων, στον καρκίνο του παχέος εντέρου. Η πιθανή χρήση του μορίου ως προγνωστικό δείκτη της ύπαρξης απομακρυσμένων και ηπατικών μεταστάσεων (τόσο προεγχειρητικά όσο και μετεγχειρητικά) στις δύο αυτές μορφές καρκίνου, είναι ένα πολύ ενδιαφέρον εύρημα που αξίζει να μελετηθεί περισσότερο

Artificial Intelligence in Colorectal Cancer Screening, Diagnosis and Treatment. A New Era

The development of artificial intelligence (AI) algorithms has permeated the medical field with great success. The widespread use of AI technology in diagnosing and treating several types of cancer, especially colorectal cancer (CRC), is now attracting substantial attention. CRC, which represents the third most commonly diagnosed malignancy in both men and women, is considered a leading cause of cancer-related deaths globally. Our review herein aims to provide in-depth knowledge and analysis of the AI applications in CRC screening, diagnosis, and treatment based on current literature. We also explore the role of recent advances in AI systems regarding medical diagnosis and therapy, with several promising results. CRC is a highly preventable disease, and AI-assisted techniques in routine screening represent a pivotal step in declining incidence rates of this malignancy. So far, computer-aided detection and characterization systems have been developed to increase the detection rate of adenomas. Furthermore, CRC treatment enters a new era with robotic surgery and novel computer-assisted drug delivery techniques. At the same time, healthcare is rapidly moving toward precision or personalized medicine. Machine learning models have the potential to contribute to individual-based cancer care and transform the future of medicine