Mucinous cystic neoplasm of the liver

A 55-year-old woman was investigated for occasional epigastric pain and weight loss. T2-weighted abdominal magnetic resonance imaging and magnetic resonance cholangiography revealed a multilocular cyst with multiple septa and a solid component in the liver, measuring 6.1 x 4.8 x 6.5 cm. Given the patient’s symptoms and malignant potential, a laparoscopic segmentectomy with partial resection of segments IV B and V was performed to completely remove the cystic lesion, associated with cholecystectomy. Histopathology demonstrated a cyst lined by columnar mucinous epithelium. Therefore, the diagnosis was mucinous cystic neoplasm of the liver. This article presents a case report and literature review of this entity.A 55-year-old woman was investigated for occasional epigastric pain and weight loss. T2-weighted abdominal magnetic resonance imaging and magnetic resonance cholangiography revealed a multilocular cyst with multiple septa and a solid component in the liver, measuring 6.1 x 4.8 x 6.5 cm. Given the patient’s symptoms and malignant potential, a laparoscopic segmentectomy with partial resection of segments IV B and V was performed to completely remove the cystic lesion, associated with cholecystectomy. Histopathology demonstrated a cyst lined by columnar mucinous epithelium. Therefore, the diagnosis was mucinous cystic neoplasm of the liver. This article presents a case report and literature review of this entity

Chondrosarcoma of the Sternum Treated with En Bloc Resection: A Case Report

Introduction: Chondrosarcomas are malignant neoplasms of cartilaginous mesenchymal. The diagnosis is based on a complete radiological examination. The treatment of choice is surgical, being the only curative option due to the resistance of the lesions to chemotherapy and radiotherapy. Case presentation: 66-year-old male patient presenting chest pain, dry cough and occasional dyspnea, diagnosed with sternal chondrosarcoma and treated with en bloc resection of the tumor mass.Conclusion: A primary chondrosarcoma of the sternum was treated with resection of the anterior costal railing, pericardium, tumor mass and partial sternectomy, en bloc. Reconstruction was performed using Marlex microporous mesh

Innovative hybrid technique of bile duct exploration in the treatment of Choledocolithiasis

Common bile stone disease (CBDS) is frequent and has potentially severe complications, such as acute biliary pancreatitis and cholangitis. Unnecessary and unplanned procedures must be avoided, so before choosing the best treatment of common bile duct lithiasis it is essential to have a proper diagnose. CBDS is currently treated by therapeutic endoscopic retrograde cholangiopancreatography (ERCP) or laparoscopic bile duct exploration (LCBDE). The aim of this article is to present a innovative hybrid technique of common bile duct exploration, on account of one option in those cases where the laparoscopic approach is not resolutive, avoiding the need of conversion to open approach technique. The hybrid technique has the same benefits of open and laparoscopic techniques, but without increasing costs with material and with good resolutivity in complex cases of common bile duct stones.                                                  Keywords: Choledocholithiasis; laparoscopic common bile duct exploration; LCBDE; open common bile duct exploratio

Justapapillar Duodenal Gastrointestinal Stromal Tumor (gist) Local Resection: A Case Report

Introduction: Gastrointestinal stromal tumors (GISTs) are the most frequent non-epithelial tumors of the gastrointestinal tract (GIT). The most common location is the stomach, followed by small intestine, being very rare the cases of duodenal origin, where it can cause digestive bleeding and anemia. The surgical resection of the tumor is the gold-standard treatment and the definitive diagnosis is based on immunohistochemical analysis of the surgical specimen.Case presentation: A case of exophytic and endophytic GIST located in the second portion of the duodenum, one centimeter below the duodenal papilla, was reported in a 33-year-old female patient.Conclusion: The gold-standard treatment is surgical resection of the tumor with negative margins (R0), with no need for lymphadenectomy. Local lesion resection or duodenopancreatectomy can be performed. Duodenopancreatectomy, unlike local resection of the lesion, is associated with increased length of hospital stay and longer intraoperative time. Therefore, it should be reserved for lesions that cannot be resected locally. Fortunately, a local resection was performed, which have a more favorable prognosis

Treatment of posterior gastric wall gastrointestinal stromal tumor with gastric sleeve: A case report

Gastrointestinal stromal tumors (GISTs) are the most common non-epithelial tumors of the gastrointestinal tract1. The most usual location is the stomach, followed by the small intestine, where it may cause digestive bleeding and anemia6. Surgical resection of the tumor is the gold standard treatment, and definitive diagnosis is based on immunohistochemical analysis of the surgical specimen8. We report the case of a 53-year-old man with gastric GIST presenting with endophytic and exophytic growth, located at the posterior wall of the stomach, in the antrum-body transitional zone, treated with gastric sleeve.Keywords: Gastrointestinal stromal tumors; gastrointestinal neoplasms; gastric sleeve; diagnosis; prognosis; treatmen

Effect of Roux-en-Y gastric bypass in the control of erosive esophagitis

Background: Gastroesophageal reflux disease (GERD) is a multifactorial disease associated with environmental and genetic factors. Obesity is among the risk factors for its development, which also correlates with an increase in severity of clinical presentation and a higher incidence of complications associated with reflux.Aims: To evaluate the impact of Roux-en-Y gastric bypass on the control of erosive esophagitis and metabolic and anthropometric parameters related to obesity.Methods: This historical cohort study included a sample of 249 patients who had undergone bariatric surgery using the Roux-en-Y gastric bypass technique at the Hospital São Vicente de Paulo, Passo Fundo, southern Brazil, from January 2014 to December 2015. Results: Of 249 patients, 77.9% (190 patients) were female and the mean age was 38 years. The occurrence of reflux esophagitis was 81.1% (196 patients) in the preoperative period and 31.3% (75 patients) in the postoperative period. With regard to bariatric treatment response to control moderate and severe esophagitis (grades B, C and D), there was a reduction in prevalence from 62 (25%) to 12 (5%) patients (p<0.05).  Conclusion: Bariatric surgery using the Roux-en-Y gastric bypass technique is effective in the control of reflux esophagitis. Regression is observed mainly in cases of moderate and severe esophagitis.Keywords: Erosive esophagitis; GERD; bariatric surgery; obesity; comorbidit

Mucinous cystic neoplasm of the liver

A 55-year-old woman was investigated for occasional epigastric pain and weight loss. T2-weighted abdominal magnetic resonance imaging and magnetic resonance cholangiography revealed a multilocular cyst with multiple septa and a solid component in the liver, measuring 6.1 x 4.8 x 6.5 cm. Given the patient’s symptoms and malignant potential, a laparoscopic segmentectomy with partial resection of segments IV B and V was performed to completely remove the cystic lesion, associated with cholecystectomy. Histopathology demonstrated a cyst lined by columnar mucinous epithelium. Therefore, the diagnosis was mucinous cystic neoplasm of the liver. This article presents a case report and literature review of this entity.A 55-year-old woman was investigated for occasional epigastric pain and weight loss. T2-weighted abdominal magnetic resonance imaging and magnetic resonance cholangiography revealed a multilocular cyst with multiple septa and a solid component in the liver, measuring 6.1 x 4.8 x 6.5 cm. Given the patient’s symptoms and malignant potential, a laparoscopic segmentectomy with partial resection of segments IV B and V was performed to completely remove the cystic lesion, associated with cholecystectomy. Histopathology demonstrated a cyst lined by columnar mucinous epithelium. Therefore, the diagnosis was mucinous cystic neoplasm of the liver. This article presents a case report and literature review of this entity

Laparospic Resection of Gastrointestinal Stromal Tumors (GIST) of Small Intestine: A case report

Although gastrointestinal stromal tumors (GISTs) are a rare type of cancer, they are the commonest mesenchymal tumors of the gastrointestinal tract (GIT). GISTs can affect any segment of the GIT, but the usual location is the stomach, followed by the small intestine. Surgical resection of the tumor is the gold standard treatment for localized GISTs, and in patients with inoperable and metastatic disease, imatinib mesylate is the standard treatment. Pathological diagnosis is based on morphology and immunohistochemical findings. We report the case of a 55-year-old man with jejunal GIST presenting with endophytic and exophytic growth, located in the proximal jejunum. He had history of melena, anemia and one episode of enterorrhagia, and was treated with surgical resection of the lesion.Keywords: Gastrointestinal stromal tumor; gastrointestinal neoplasm

Innovative hybrid technique of bile duct exploration in the treatment of Choledocolithiasis

Common bile stone disease (CBDS) is frequent and has potentially severe complications, such as acute biliary pancreatitis and cholangitis. Unnecessary and unplanned procedures must be avoided, so before choosing the best treatment of common bile duct lithiasis it is essential to have a proper diagnose. CBDS is currently treated by therapeutic endoscopic retrograde cholangiopancreatography (ERCP) or laparoscopic bile duct exploration (LCBDE). The aim of this article is to present a innovative hybrid technique of common bile duct exploration, on account of one option in those cases where the laparoscopic approach is not resolutive, avoiding the need of conversion to open approach technique. The hybrid technique has the same benefits of open and laparoscopic techniques, but without increasing costs with material and with good resolutivity in complex cases of common bile duct stones.                                                  Keywords: Choledocholithiasis; laparoscopic common bile duct exploration; LCBDE; open common bile duct exploratio

Mesenteric desmoid tumor after bariatric surgery: a case report

We report the case of a 37-year-old woman investigated for left flank pain, 1 year after bariatric surgery (Roux-en-Y gastric bypass). Abdominal computed tomography (CT) revealed a solid, heterogeneous and expansive intra-abdominal lesion, measuring 9.3x9.4x10.4cm, compressing adjacent structures with no signs of invasion. The main diagnostic hypothesis considered was desmoid tumor/Schwannoma and a ileocolectomy with partial mesenteric resection was performed. A histopathological and immunohistochemical analysis confirmed the diagnosis of mesenteric desmoid tumor