16 research outputs found
Intranodal palisaded myofibroblastoma: a case report
Intranodal palisaded myofibroblastoma is a rare benign soft tissue tumor, almost always arising from inguinal lymph nodes. It usually presents as a painless, slow-growing inguinal mass. We report herein a case of an intranodal palisaded myofibroblastoma occurring in a 36-year-old man. The salient clinicopathologic features of this unusual tumor are presented and the literature is briefly reviewed
A rare coexistence of adrenal cavernous hemangioma with extramedullar hemopoietic tissue: a case report and brief review of the literature
<p>Abstract</p> <p>Background</p> <p>Cavernous hemangiomas of the adrenal gland are rare, benign, non-functioning neoplastic tumors. To our knowledge, 55 cases have been reported in the literature to date.</p> <p>Case presentation</p> <p>We report the first case of a large, non-functioning adrenal cavernous hemangioma that was incidentally found during the preoperative staging workup of a 75 year old woman with left breast adenocarcinoma. Imaging with US, CT scan and MRI showed a heterogeneous 8 cm mass with non-specific radiological features that was located on the left adrenal gland. The mass was surgically excised and pathology revealed an adrenal hemangioma with areas of extramedullar hemopoiesis.</p> <p>Conclusion</p> <p>Although adrenal hemangiomas are rare and their preoperative diagnosis is difficult, they should always be included in the differential diagnosis of adrenal neoplasms.</p
Mixed acinar-endocrine carcinoma of the pancreas: a case report and review of the literature
and review of the literatur
The presencee of chemokine receptors in normal breast tissue, in benign and malignant breast diseases
Recurrent Pulmonary Embolism Due to Giant Hepatic Hamangioma Treated With Hepatectomy Under Vascular Exclusion
Giant hepatic hemangiomas are benign tumors that measure more than 4 cm
and are usually asymptomatic. Pulmonary embolism (PE) is an extremely
rare manifestation of giant hepatic hemangiomas. We report a case of a
44-year-old woman who suffered of recurrent pulmonary emboli that, after
thorough work up, were attributed to thrombi formation inside a giant
hepatic hemangioma. A right hepatectomy under vascular exclusion was
performed and the hemangioma, measuring 17 cm, was resected. Two years
later the patient remains asymptomatic. The report highlights the value
of investigating giant liver hemangiomas in case of PE. In such cases,
the hemangioma should be resected preferably under occlusion of the
venous outflow of the liver to avoid PE intraoperatively
Special problems encountering surgical management of large retroperitoneal schwannomas
Abstract Background Retroperitoneal schwannomas are rare, usually benign tumors that originate in the neural sheath and account for only a small percentage of retroperitoneal tumors. The aim of this clinical study is to present our experience in managing retroperitoneal schwannomas with a review of the current literature and to point out the surgical technical difficulties we faced, due to the tumor's strange behavior that eroded the vertebra in two cases without causing malignant invasion. Methods We reviewed the medical files of 69 patients treated in our department for retroperitoneal tumors from January 1991 until December 2006. Five patients had retroperitoneal schwannomas according to pathology report. Results There were two male and three female patients, with a mean age of 56 years (range 44–67 years). All patients were asymptomatic and none suffered from von Recklinghausen disease. Imaging workup included ultrasonography, computed tomography and magnetic resonance imaging. One patient, after having a non-diagnostic computed tomography fine needle aspiration (CT-FNA), underwent exploratory laparotomy and incisional biopsy that established the diagnosis of schwannoma. After complete excision of the tumors, postoperative course was uneventful in all patients. Tumors' maximum diameter was 12.7 cm (range 7–20 cm). No recurrences were detected during the follow up period (6–75 months). Conclusion Preoperative establishment of diagnosis is difficult in case of retroperitoneal schwannomas, however close relationship of retroperitoneal tumors with adjacent neural structures in imaging studies should raise a suspicion. Complete surgical resection is the treatment of choice. Histology and Immunohistochemistry confirms the diagnosis.</p
Ischemic Preconditioning Confers Antiapoptotic Protection During Major Hepatectomies Performed Under Combined Inflow and Outflow Exclusion of the Liver. A Randomized Clinical Trial
Extensive experimental studies and a few clinical series have shown that
ischemic preconditioning (IPC) attenuates oxidative ischemia/reperfusion
(I/R) injuries in liver resections performed under inflow vascular
control. Selective hepatic vascular exclusion (SHVE) employed during
hepatectomies completely deprives the liver of blood flow, as it entails
simultaneous clamping of the portal triad and the main hepatic veins.
The aim of the present study was to identify whether IPC can also
protect hepatocytes during liver resections performed under SHVE.
Patients undergoing major liver resection were randomly assigned to have
either only SHVE (control group, n = 43) or SHVE combined with IPC-10
min of ischemia followed by 15 min of reperfusion before SHVE was
applied (IPC group, n = 41).
The two groups were comparable with regard to age, liver resection
volume, blood loss and transfusions, warm ischemic time, and total
operative time. In liver remnant biopsies obtained 60 min
post-reperfusion, IPC patients had significantly fewer cells stained
positive by TUNEL compared to controls (19% +/- A 8% versus 45% +/- A
12%; p < 0.05). Also IPC patients had attenuated hepatocyte necrosis,
systemic inflammatory response, and oxidative stress as manifested by
lower postoperative peak values of aspartate transaminase,
interleukin-6, interleukin-8, and malondialdehyde compared to controls.
Morbidity was similar for the two groups, as were duration of intensive
care unit stay and extent of total hospital stay.
In major hepatectomies performed under SHVE, ischemic preconditioning
appears to attenuate apoptotic response of the liver remnant, possibly
through alteration of inflammatory and oxidative pathways
A rare coexistence of adrenal cavernous hemangioma with extramedullar hemopoietic tissue: a case report and brief review of the literature
Background: Cavernous hemangiomas of the adrenal gland are rare, benign,
non-functioning neoplastic tumors. To our knowledge, 55 cases have been
reported in the literature to date.
Case presentation: We report the first case of a large, non-functioning
adrenal cavernous hemangioma that was incidentally found during the
preoperative staging workup of a 75 year old woman with left breast
adenocarcinoma. Imaging with US, CT scan and MRI showed a heterogeneous
8 cm mass with non-specific radiological features that was located on
the left adrenal gland. The mass was surgically excised and pathology
revealed an adrenal hemangioma with areas of extramedullar hemopoiesis.
Conclusion: Although adrenal hemangiomas are rare and their preoperative
diagnosis is difficult, they should always be included in the
differential diagnosis of adrenal neoplasms
Surgical Challenges in the Treatment of Leiomyosarcoma of the Inferior Vena Cava: Analysis of Two Cases and Brief Review of the Literature
Background: Leiomyosarcoma of the inferior vena cava (IVC) is a rare
tumor of mesenchymal origin. Optimal treatment should include complete
resection of the malignant lesion with preservation of venous return. We
present our experience from two patients treated in our hospital in the
last 3 years.
Methods and Results: The first case is that of a 54-year-old woman, with
a 9 cm a primary IVC leiomyosarcoma extending from the level of the
right renal vein to the common iliac veins. The patient underwent
radical tumor resection and reconstruction of the IVC with a
polytetrafluoroethylene patch. She received adjuvant chemotherapy and is
free of recurrence almost 3 years after surgery. The second case is that
of a 56-year-old woman presenting with back pain due to an 8-cm
retroperitoneal mass in close proximity to the right renal vein. She
underwent exploratory laparotomy, where initially the effort of en bloc
resection of the mass failed. Eventually, partial resection of the IVC
was performed and the defect was primarily repaired. Pathological
examination confirmed primary leiomyosarcoma of the IVC. She received
adjuvant chemotherapy, but was referred to our hospital with local
recurrence 6 months after the operation and is suffering from
disseminated abdominal disease almost a year postsurgery.
Conclusion: Radical surgical en bloc resection is the mainstay of
treatment for IVC leiomyosarcomas. Extensive vascular reconstruction
techniques may be necessary to restore adequate venous return to the IVC
after tumor resection, and combination with adjuvant chemoradiotherapy
has been shown to prolong disease-free survival rates