Hepatocellular Carcinoma with Osteoclast-Like Giant Cells: Report of the Seventh Case in the Literature

Hepatocellular carcinoma with osteoclast-like giant cells is extremely rare, and only six cases have been previously reported. Its histogenesis is at the moment controversial. The authors report a case of hepatocellular carcinoma with osteoclast-like giant cells found in a 74-year-old woman. The patient came with a dull pain in the right upper abdominal quadrants due to a liver neoplasm described at CT scan. A wedge resection of the fifth hepatic segment with appendectomy, omentectomy, and debulking of the major peritoneal implants was performed. Histologically, the diagnosis of hepatocellular carcinoma with high grade differentiation associated with giant osteoclast-like cells was done without any evidence of hepatitis or cirrhosis in the surrounding hepatic parenchyma. Immunohistochemistry was positive for CD10 and CD68 and in situ hybridization revealed the expression of receptor activator of nuclear factor-kappa B (RANK) in the giant cells and receptor activator of nuclear factor-kappa B ligand (RANKL) in the tumor cells

Endoscopic entero-enteral bypass to treat postsurgical benign complications of hepatico-jejunostomy: Update of a 7-year single-center experience

Background and study aims Since 2014, we have been using a new endoscopic approach to improve management of biliary adverse events (BAEs) after bilio-digestive anastomosis. We provide an update about our experience at 7 years. Patients and methods Patients with BAEs on hepatico-jejunostomy underwent entero-enteral endoscopic by-pass (EEEB) creation between the duodenal/gastric wall and the biliary jejunal loop. Evaluation of results during our seven-year experience was performed. Results Eighty consecutive patients (32 patients from Jan 2014 to Dec 2017 and 48 patients from Jan 2018 to Jan 2021) underwent EEEB, which was successful in all but one patient. The cumulative AEs rate was 32 %. Endoscopic retrograde cholangiography (ERC) through the EEEB successfully treated all types of BAEs in these patients. Cumulative disease recurrence was 3.8 % (three patients) and was retreated through the EEEB. Conclusions The update of our experience with EEEB confirmed that in patients with BAEs after bilio-digestive anastomosis, EEEB allows successful long-term treatment of different BAEs in a tertiary referral center with an acceptable rate of related AEs

Manuale di Chirurgia Generale

Dal continuo lavoro del corpo docenti dell’Accademia Italiana Medici Specializzandi (AIMS) nasce questa sesta edizione del Manuale di Chirurgia Generale - Sesta Edizione 2020. Si tratta di un testo specificamente pensato per la preparazione del laureato in Medicina e Chirurgia affinché possa affrontare efficacemente il nuovo Concorso delle Scuole di Specializzazione Mediche: è una risorsa schematica, sintetica e aggiornata in base alle più recenti linee guida che consente uno studio rapido della disciplina. La trattazione semplice ma, al tempo stesso, rigorosa, stimola la capacità di ragionamento clinico del giovane medico che ne affronta lo studio e rende quest’opera un strumento valido, unico nel suo genere e complementare alla preparazione del corso di preparazione AIMS. L’intera Opera è corredata da una grande varietà di immagini e schemi, pensati per facilitare la comprensione e la memorizzazione degli argomenti trattati