Local recurrence and distant metastases 18 years after resection of the greater omentum hemangiopericytoma

<p>Abstract</p> <p>Background</p> <p>Hemangiopericytoma occurs with increasing frequency in 5^thdecade of life and has prediction for retroperitoneum and extremities. A case of a local recurrence and metastases of hemangiopericytoma is described.</p> <p>Case presentation</p> <p>Recurrence of hemangiopericytoma in the greater omentum and the jejunal mesentery as well as metastases in the retroperitoneal space were diagnosed in a 61-year-old patient who had a hemangiopericytoma of the greater omentum excised 18 years before.</p> <p>Conclusion</p> <p>Because of the rarity of this disease and its typical clinical course associated with late recurrence and metastases, the authors decided to present this case emphasizing the necessity of systematic oncological follow-up after the end of treatment.</p

Management of colorectal cancer presenting with synchronous liver metastases

Up to a fifth of patients with colorectal cancer (CRC) present with synchronous hepatic metastases. In patients with CRC who present without intestinal obstruction or perforation and in whom comprehensive whole-body imaging confirms the absence of extrahepatic disease, evidence indicates a state of equipoise between several different management pathways, none of which has demonstrated superiority. Neoadjuvant systemic chemotherapy is advocated by current guidelines, but must be integrated with surgical management in order to remove the primary tumour and liver metastatic burden. Surgery for CRC with synchronous liver metastases can take a number of forms: the 'classic' approach, involving initial colorectal resection, interval chemotherapy and liver resection as the final step; simultaneous removal of the liver and bowel tumours with neoadjuvant or adjuvant chemotherapy; or a 'liver-first' approach (before or after systemic chemotherapy) with removal of the colorectal tumour as the final procedure. In patients with rectal primary tumours, the liver-first approach can potentially avoid rectal surgery in patients with a complete response to chemoradiotherapy. We overview the importance of precise nomenclature, the influence of clinical presentation on treatment options, and the need for accurate, up-to-date surgical terminology, staging tests and contemporary management options in CRC and synchronous hepatic metastatic disease, with an emphasis on multidisciplinary care

Effect of processing and cooking on total and soluble oxalate content in frozen root vegetables prepared for consumption

The oxalate content of beetroot, carrot, celeriac and parsnip after freezing by traditional and modified methods (the latter resulting in a convenience food product), and after the preparation of frozen products for consumption was evaluated. The highest content of total and soluble oxalates (105 and 82 mg 100 g-1 fresh matter) was found in beetroot. The lowest proportion (55%) of soluble oxalates was noted in celeriac; this proportion was higher in the remaining vegetables, being broadly similar for each of them. Blanching brought about a significant decrease in total and soluble oxalates in fresh vegetables. Cooking resulted in a higher loss of oxalates. The level of oxalates in products prepared for consumption directly after freezing approximated that before freezing. Compared with the content before freezing, vegetables prepared for consumption by cooking after frozen storage contained less oxalates, except for total oxalates in parsnip and soluble oxalates in beetroot and celeriac. The highest ratio of oxalates to calcium was found in raw beetroot; it was two times lower in raw carrot; five times lower in raw celeriac; and eight times lower in raw parsnip. These ratios were lower after technological and culinary processing. The percentage of oxalate bound calcium depended on the species; this parameter was not significantly affected by the procedures applied. The true retention of oxalates according to Judprasong et al. (2006) was lower than retention calculated taking its content in 100 g fresh matter into account.

Strategies for Management of Synchronous Colorectal Metastases

The management of synchronous presentation of colorectal cancer and liver metastases has long been a topic of debate and discussion for surgeons due to the unique dilemma of balancing operative timing along with treatment strategy. Operative strategies for resection include staged resection with colon first approach, “reverse” staged resection with liver metastases resected first, and one-stage, or simultaneous, resection of both the primary tumor and liver metastases approach. These operative strategies can be further augmented with perioperative chemotherapy and other novel approaches that may improve resectability and patient survival. The decision on operative timing and approach, however, remains largely dependent on the surgeon’s determination of disease resectability, patient fitness, and the need for neoadjuvant chemotherapy