Primary liposarcoma of the ascending colon: a rare case of mixed type presenting as hemoperitoneum combined with other type of retroperitoneal liposarcoma

<p>Abstract</p> <p>Background</p> <p>Liposarcoma occurs most commonly in the extremities and retroperitoneum, however, it has been rarely observed in the colon.</p> <p>Case Presentation</p> <p>A case is reported a 41-year-old man with liposarcoma of ascending colon which was presented as hemoperitoneum and combined with a different histological type of retroperitoneal liposarcoma. He visited hospital with right lower abdominal pain and palpable mass. Laboratory data including tumor markers were within normal limits, and computed tomography revealed a 15 × 10 cm sized enhancing soft mass. Right hemicolectomy was performed, and after that, a further large retroperitoneal mass was revealed and this was also radically excised. Mixed-type colon liposarcoma and well differentiated type of retroperitoneal liposarcoma were diagnosed in pathologic report. The patient has remained free of disease for 24 months.</p> <p>Conclusions</p> <p>No standardized guidelines have been established for its treatment because too small a number of cases have been reported, but surgical resection was considered the treatment of choice.</p

Portal-Endocrine and Gastric-Exocrine Drainage Technique in Pancreatic Transplantation

Background: Pancreas transplant (PTx) is an established treatment for patients with diabetes mellitus. Diagnosisof rejection has continued to be problematic. In 2007, a new technique of PTx with portal-endocrineand gastric exocrine (P-G) drainage was first performed at our institution. This technique facilitates accessto pancreas allograft.Objective: To report our experience with the first 30 patients who underwent PTx using P-G technique.Methods: The first 30 patients who underwent PTx between 2007 and 2009 were studied. In these patients,arterial and venous anastomosis was similar to standard portal-enteric (P-E) technique, thoughcontrary to other techniques of enteric drainage, the end of allograft jejunum was anastomosed to theanterior aspect of the stomach.Results: Donor and recipient demographic data, number of antigen matches and immunosuppressant werecollected. All patients achieved euglycemia. 3 patients underwent pancreatectomy: 2 due to vessel thrombosisand 1 due to chronic rejection. 3 patients died—2 with functioning pancreatic and renal allografts.7 patients with CMV and 4 patients with rejection were diagnosed with endoscopy of allograft duodenumand treated. 1-year patient and graft survival was 94% and 85%, respectively.Conclusion: This novel technique of PTx has proven to be safe with good patient and allograft survival. Accessto donor duodenum and pancreas allograft via endoscopy is unique to this technique and providesthe added advantage of life-long easy access to allograft

Are autoimmune diseases or glomerulonephritis affecting the development of panel-reactive antibodies in candidates for renal transplantation?

Panel-reactive antibodies (PRA) are a major obstacle to kidney transplantation (KTx). It is not completely clear why only some patients develop PRA, whereas others do not. We hypothesized that other factors, such as autoimmune diseases involving the kidney, might be a trigger for PRA development. We reviewed the original diseases that led to renal failure and their possible role in PRA development. Charts of 270 patients on the active waiting list for KTx were reviewed for complete demographics, presence of PRA, peak PRA level, first KTx or retransplantation, original disease, blood transfusions, pregnancy and rejection. Patients were divided into group 1 (PRA >10%) and group 2 (PRA <10%). There was a significantly higher proportion of patients in group 1 with autoimmune diseases than in group 2. The same proportion was found significant for all of the patients as well as for the patients listed for the first KTx (new patients). Previous KTx has significant impact on both class I and II peak PRA levels when compared with new patients who are already sensitized. A subanalysis of retransplantation showed patients with autoimmune disease (54%) have more graft loss due to rejection compared with nonautoimmune disease (43%). There is an association between high PRA level and autoimmune diseases causing renal failure regardless of the previous KTx status. Besides the risk of recurrence, autoimmune disease seems to affect the risk of graft loss due to rejection