EDITORIAL Current management strategy of hepatocellular carcinoma

doi:10.3748/wjg.15.321

Updates on abdominal desmoid tumors

5Desmoid tumor is a monoclonal, fibroblastic proliferation arising in musculoaponeurotic structures. This connective tissue hyperplasia infiltrates locally, recurs frequently after resection but does not metastasize. Abdominal desmoid occurs sporadically, in association with some familial syndromes and often represents a clinical dilemma for surgeons. The enigmatic biology and anatomical location of abdominal desmoids make treatment recommendations difficult. This distinct pathological entity is reviewed with a specific focus on aetiology and management.reservedmixedRAMPONE B; PEDRAZZANI C; MARRELLI D; PINTO E; ROVIELLO FRampone, Bernardino; Pedrazzani, Corrado; Marrelli, Daniele; Pinto, Enrico; Roviello, Franc

Updates on abdominal desmoid tumors

Desmoid tumor is a monoclonal, fibroblastic proliferation arising in musculoaponeurotic structures. This connective tissue hyperplasia infiltrates locally, recurs frequently after resection but does not metastasize. Abdominal desmoid occurs sporadically, in association with some familial syndromes and often represents a clinical dilemma for surgeons. The enigmatic biology and anatomical location of abdominal desmoids make treatment recommendations difficult. This distinct pathological entity is reviewed with a specific focus on aetiology and management

Current management strategy of hepatocellular carcinoma

Hepatocellular carcinoma (HCC) still remains a considerable challenge for surgeons. Surgery, including liver transplantation, is the most important therapeutic approach for patients with this disease. HCC is frequently diagnosed at advanced stages and has a poor prognosis with a high mortality rate even when surgical resection has been considered potentially curative. This brief report summarizes the current status of the management of this malignancy and includes a short description of new pharmacological approaches in HCC treatment

Diagnosi di mucocele appendicolare gigante in corso di laparotomia per addome acuto. Caso clinico e revisione della letteratura

Gli Autori descrivono un caso clinico di mucocele appendicolare gigante secondario a tumore mucinoso dell’appendice, diagnosticato in corso di laparotomia per addome acuto. Con una revisione della letteratura evidenziano la singolare presentazione della neoplasia con complicanza acuta da rottura della parete appendicolare e le conseguenti difficoltà diagnostiche e gestionali dell’approccio in emergenza

Rottura traumatica di cisti idatidea epatica

La malattia idatidea è una patologia endemica in alcuni aree del mondo. Il fegato è l’organo maggiormente colpito. Le cisti possono rompersi a causa di un trauma o spontaneamente per un incremento della pressione intracistica. La rottura della cisti idatidea richiede il trattamento chirurgico d’urgenza. Riportiamo la nostra esperienza nel trattamento della rottura traumatica di una cisti idatidea epatica

Lymph node involvement in advanced gastroesophageal junction adenocarcinoma

OBJECTIVE: The prognosis of gastroesophageal junction adenocarcinoma is unquestionably related to the extent of nodal involvement; nonetheless, few studies deal with the pattern of lymph node spread and specifically analyze the prognostic value of the site of metastasis. The present study was aimed at evaluating these key aspects in advanced gastroesophageal junction adenocarcinoma. METHODS: Of 219 patients consecutively operated on for gastroesophageal junction adenocarcinoma at the Department of General Surgery and Surgical Oncology, University of Siena, and at the Department of General Surgery, University of Verona, 143 pT2-4 tumors not submitted to prior chemoradiation were analyzed according to the Japanese Gastric Cancer Association pN staging system. RESULTS: The majority of patients were given diagnoses of nodal metastases (77.6%). The mean number (P = .076) and the percentage of patients with pN+ disease (P = .022) progressively increased from Siewert type I to type III tumors. Abdominal nodes were involved in all but 1 of the patients with pN+ disease; conversely, nodal metastases into the chest were 46.2% for type I, 29.5% for type II, and 9.3% for type III tumors. Survival analysis showed virtually no chance of recovery for patients with more than 6 metastatic nodes or lymph nodes located beyond the first tier. CONCLUSIONS: In advanced gastroesophageal junction adenocarcinoma, the high frequency of nodal metastases and the related unfavorable long-term outcome achieved by means of surgical intervention alone are indicative of the need for aggressive multimodal treatment along with surgical intervention to improve long-term results

Presacral ganglioneuroma: a case report and review of literature

8Presacral ganglioneuromas are so rare benign tumors that only 17 cases have been reported in the literature. They are abdominal masses growing slowly and differential diagnoses have to be considered. Surgical resection is important for definitive diagnosis because it represents the only therapeutic choice. Because of the benign nature of ganglioneuroma, adjuvant chemo- or radiotherapy is not indicated but regular follow-up is necessary for an early diagnosis of potential local recurrence. We report a case of a 64-year-old man with a presacral ganglioneuroma.reservedmixedCERULLO G; MARRELLI D; RAMPONE B; C. MIRACCO; CARUSO S; DI MARTINO M; MAZZEI MA; ROVIELLO FCerullo, Guido; Marrelli, Daniele; Rampone, Bernardino; Miracco, Clelia; Caruso, Stefano; DI MARTINO, Marianna; Mazzei, MARIA ANTONIETTA; Roviello, Franc