Case Report - Intraglandular lipoma of the parotid gland

A 56-year-old female patient, with a relatively rare condition, intraglandular lipoma of the parotid is reported. Lipoma of the parotid gland constitute around 3% of all parotid tumors and include tumors which are outside the parotid capsule - peri parotid, tumors surrounded all around by the parotid gland -intraglandular, lipomatous pleomorphic adenoma, lipoadenoma and nontumorous interstitial lipomatosis and liposarcoma. These are asymptomatic and occur both in the deep and the superficial lobe of the parotid. The most favored age group is from the fifth to sixth decade of life and is ten times more common in the males. Surgical excision, preserving facial nerve is the treatment of choice

Case Report - Intraglandular lipoma of the parotid gland

A 56-year-old female patient, with a relatively rare condition, intraglandular lipoma of the parotid is reported. Lipoma of the parotid gland constitute around 3% of all parotid tumors and include tumors which are outside the parotid capsule - peri parotid, tumors surrounded all around by the parotid gland -intraglandular, lipomatous pleomorphic adenoma, lipoadenoma and nontumorous interstitial lipomatosis and liposarcoma. These are asymptomatic and occur both in the deep and the superficial lobe of the parotid. The most favored age group is from the fifth to sixth decade of life and is ten times more common in the males. Surgical excision, preserving facial nerve is the treatment of choice

Surgical outcomes of gallbladder cancer: the OMEGA retrospective, multicentre, international cohort study

Background Gallbladder cancer (GBC) is rare but aggressive. The extent of surgical intervention for different GBC stages is non-uniform, ranging from cholecystectomy alone to extended resections including major hepatectomy, resection of adjacent organs and routine extrahepatic bile duct resection (EBDR). Robust evidence here is lacking, however, and survival benefit poorly defined. This study assesses factors associated with recurrence-free survival (RFS), overall survival (OS) and morbidity and mortality following GBC surgery in high income countries (HIC) and low and middle income countries (LMIC).Methods The multicentre, retrospective Operative Management of Gallbladder Cancer (OMEGA) cohort study included all patients who underwent GBC resection across 133 centres between 1st January 2010 and 31st December 2020. Regression analyses assessed factors associated with OS, RFS and morbidity.Findings On multivariable analysis of all 3676 patients, wedge resection and segment IVb/V resection failed to improve RFS (HR 1.04 [0.84-1.29], p = 0.711 and HR 1.18 [0.95-1.46], p = 0.13 respectively) or OS (HR 0.96 [0.79-1.17], p = 0.67 and HR 1.48 [1.16-1.88], p = 0.49 respectively), while major hepatectomy was associated with worse RFS (HR 1.33 [1.02-1.74], p = 0.037) and OS (HR 1.26 [1.03-1.53], p = 0.022). Furthermore, EBDR (OR 2.86 [2.3-3.52], p < 0.0010), resection of additional organs (OR 2.22 [1.62-3.02], p < 0.0010) and major hepatectomy (OR 3.81 [2.55-5.73], p < 0.0010) were all associated with increased morbidity and mortality. Compared to LMIC, patients in HIC were associated with poorer RFS (HR 1.18 [1.02-1.37], p = 0.031) but not OS (HR 1.05 [0.91-1.22], p = 0.48). Adjuvant and neoadjuvant treatments were infrequently used.Interpretation In this large, multicentre analysis of GBC surgical outcomes, liver resection was not conclusively associated with improved survival, and extended resections were associated with greater morbidity and mortality without oncological benefit. Aggressive upfront resections do not benefit higher stage GBC, and international col-laborations are needed to develop evidence-based neoadjuvant and adjuvant treatment strategies to minimise surgical morbidity and prioritise prognostic benefit.Funding Cambridge Hepatopancreatobiliary Department Research Fund.Copyright & COPY; 2023 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)