Adrenal metastasis as first presentation of hepatocellular carcinoma

BACKGROUND: Metastases from hepatocellular carcinoma (HCC) can be found in the lung and adrenal gland. We report case of a patient who presented with adrenal metastasis as the first clinical manifestation of HCC. CASE PRESENTATION: A patient was referred for surgical treatment for a tumor in retro-peritoneal space. The computerized tomography (CT) scan revealed a mass originating from the left adrenal gland. The patient underwent left adrenalectomy and the exploration of abdominal cavity did not reveal any other palpable lesions. Histologically, the resected lesion was a poorly differentiated metastatic tumor from HCC. Seven months later patient was readmitted complaining of cachexia, icterus, and significant weight loss. CT scan revealed hyperdense lesions of the liver CONCLUSION: HCC may have atypical presentations like in present case. Fine needle aspiration/tru-cut(® )biopsy might be useful in the investigation of an accidentally discovered adrenal mass regardless of the size and can lead to the detection of a primary tumor

Local excision as a treatment for tumors of ampulla of Vater

BACKGROUND: Although local excision (ampullectomy) was first described by Halsted in 1899, its adequacy as an alternative surgical treatment for the ampullary tumors is still a matter of debate. The aim of this study was to evaluate the results of ampullectomy as a curative treatment for benign and malignant tumors arising from the ampulla, in a 14-year single-institution experience. METHODS: From 1990 to 2004, a total of 20 patients of adenocarcinoma (12) or adenoma (8) of the ampulla of Vater underwent local excision. Clinical data were collected and morbidity, mortality, as well as long-term survival were evaluated. The usefulness of several pre or intraoperative diagnostic methods was also recorded. Median follow-up was 85 (range 6–180) months. RESULTS: The combination of endoscopic preoperative biopsies and intraoperative frozen section examination adequately diagnosed ampullary tumors in all cases. The postoperative morbidity and mortality were 0%, whereas the 3 and 5-year survival rates for the patients with adenocarcinoma was 75 % and 33.3 % respectively. All the patients with adenoma are still alive without any sign of recurrence. CONCLUSION: In our series, local excision was a safe option, associated with satisfactory long-term survival rates in patients with benign lesions and in those with small(<2 cm), pT1, well differentiated ampullary tumours without nodal involvement

Accurate correction of surface noises of polygonal meshes

In this paper we propose a new algorithm for accurate correction of surface noises of polygonal meshes. It consists of three basic components: (a) feature-preserving pre-smoothing; (b) partitioning of feature and non-feature regions; (c) second-order predictor for non-feature regions and median filter for feature regions. The unique contributions of our approach include (a) an idea of partitioning an input surface into feature and non-feature regions so that different smoothing algorithms, which are best suited for either feature or non-feature regions can be, respectively, applied; (b) a second-order predictor that provides higher smoothing accuracy and better convergence on smoothly curved surfaces. In comparison with several existing algorithms, our algorithm is evaluated quantitatively in terms of surface normal and vertex distance error metrics. Numerical experiments indicate the effectiveness of our approach in the aspects of convergence and accuracy. Copyright © 2005 John Wiley & Sons, Ltd.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/48758/1/1441_ftp.pd