Radical surgical resection of giant Angiosarcoma of the posterior Mediastinum: A rare neoplasm with rare presentation as epigastric pain

Pancreatic endometriosis is an extremely rare condition, with only a few cases described in the literature. Definitive diagnosis is often difficult to elucidate and will almost always require biopsy or surgical resection. We present a case of a female in her early thirties with a well-known history of widespread endometriosis presenting with vague epigastric pain. CT imaging showed an 11 cm well-circumscribed simple-appearing cyst in the lessor sac. Its origin could not be determined preoperatively but it appeared to involve the parenchyma of the body of the pancreas. Due to the associated pain and indeterminate nature, subtotal surgical resection of the extrapancreatic cyst was performed with the intrapancreatic cyst being managed by a cystogastrostomy to the adjacent stomach in a planned pancreas-sparing procedure following intraoperative confirmation it was arising within the pancreas. Pathological evaluation of the resected cyst confirmed it to be an endometrial cyst. The cystogastrostomy anastomosis subsequently obstructed a few weeks postoperatively and symptoms recurred from cyst enlargement. Redo robotic resection with resection of the remnant cyst, cystogastrostomy and en bloc spleen-preserving distal pancreatectomy was performed. The patient had an uneventful recovery. She has had no recurrence of cyst or symptoms since. A procedure video is included in the report.

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Case of primary hepatic leiomyosarcoma successfully treated with laparoscopic right hepatectomy

BMJ Case Reports ◽

10.1136/bcr-2019-233567 ◽

2020 ◽

Vol 13 (2) ◽

pp. e233567 ◽

Cited By ~ 1

Author(s):

Stephanie Vella ◽

Kelvin Cortis ◽

David Pisani ◽

James Pocock ◽

Luca Aldrighetti

Keyword(s):

Physical Examination ◽

Surgical Resection ◽

Epigastric Pain ◽

Large Mass ◽

Disease Recurrence ◽

Right Hepatectomy ◽

Liver Lobe ◽

Laparoscopic Right Hepatectomy ◽

The Right

We describe the case of a 77-year-old woman, presenting with non-specific epigastric pain. Physical examination and subsequent imaging revealed the presence of a large mass in the right liver lobe. This was shown to be a leiomyosarcoma on biopsy histology. Further investigation confirmed this to be a primary hepatic leiomyosarcoma with no evidence of metastases. The patient underwent successful surgical resection. She is currently under imaging follow-up, with no evidence of disease recurrence.

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Massive hemoptysis following cannulation of right internal jugular vein for insertion of cuffed hemodialysis catheter: A rare complication of central venous catheterization

The Journal of Vascular Access ◽

10.1177/1129729820910304 ◽

2020 ◽

pp. 112972982091030

Author(s):

Hamed Ghoddusi Johari ◽

Mohammad Mehdi Lashkarizadeh ◽

Parviz Mardani ◽

Reza Shahriarirad

Keyword(s):

Internal Jugular Vein ◽

Jugular Vein ◽

Main Bronchus ◽

Rare Complication ◽

Posterior Mediastinum ◽

Chest Roentgenogram ◽

Massive Hemoptysis ◽

Rare Presentation ◽

Hemodialysis Catheter ◽

The Right

Here we report an extremely rare presentation of internal jugular vein catheterization, presenting as massive hemoptysis which was noted during right internal jugular vein cuffed hemodialysis catheter insertion of a 39-year-old man known-case of End-Stage Renal Disease. Chest roentgenogram and computerized tomography scan showed pleural effusion and misplacement of the tip of hemodialysis catheter in the posterior mediastinum causing possible damage to the right main bronchus. After chest tube insertion and removing the misplaced hemodialysis catheter, a proper cuffed catheter was inserted and the patient was discharged with an uneventful post-op course.

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Clinical Pathological Analysis of Surgically Resected Superficial Esophageal Carcinoma to Determine Criteria for Deciding on Treatment Strategy

Diagnostic and Therapeutic Endoscopy ◽

10.1155/dte.3.211 ◽

1997 ◽

Vol 3 (4) ◽

pp. 211-220 ◽

Cited By ~ 16

Author(s):

H. Makuuchi ◽

H. Shimada ◽

K. Mizutani ◽

O. Chino ◽

T. Nishi ◽

...

Keyword(s):

Lymph Node ◽

Lymph Node Metastasis ◽

Surgical Resection ◽

Lymph Vessel ◽

Depth Of Invasion ◽

Submucosal Cancer ◽

Node Metastasis ◽

Wide Range ◽

Esophageal Carcinomas ◽

Radical Surgical Resection

We performed a clinical pathological study of conventionally resected superficial esophageal carcinomas since this type of lesion has been increasing, in order to develop criteria of determination for therapeutic strategies. Pathological studies were performed on specimens obtained by radical surgical resection in 133 cases of superficial esophageal cancer. Evaluation was performed in terms of the gross classification of the lesion type, depth of invasion, lymph node metastasis, vascular invasion, size of the lesion, outcome, etc. In 0-I, 0-IIc+0-IIa, and 0-III type submucosal cancer lesions the rate of metastasis to lymph nodes was more than 40%, but in 0-IIa and 0-IIb mucosal cancer cases no lymph node metastasis was observed. 0-IIc type lesions showed a wide range of invasiveness, ranging from m1 to sm3. In cases with m1 or m2 invasion, no lymph node or lymph-vessel invasion was recognized, but in m3, sm1, sm2, and sm3 cases lymph node metastasis was recognized in 12.5%, 22.2%, 44.0% and 47.4%, respectively. In 47% of lesions with a greatest dimension of less than 30 mm invasion was limited to the mucosa. Seventy-two percent of m1 and m2 cases were 30 mm in size or less. Lymph node metastasis was recognized in only 16.7% of cases less than 30 mm in size, but in cases of lesions 30 mm or more the rate of lymph node metastasis was 35.8%. 0-IIb and 0-IIa type lesions are indications for endoscopic esophageal mucosal resection (EEMR), while 0-I, 0-IIc+0-IIa, and 0-III lesions should be candidates for radical surgical resection. In the 0-IIc category, lesions in which the depression is relatively flat and with a finely granular surface are indications for EEMR, but those cases in which the surface of depression shows granules of varying sizes should be treated with radical surgical resection. Cases of 0-IIa type 30 mm or larger in greatest dimension which have a gently sloping protruding margin shoulder or reddening should be treated with caution, but EEMR can be performed first and subsequent therapeutic strategy decided on, based on the pathological findings of the specimen.

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Radical surgical resection and high-dose intraoperative radiation therapy (HDR-IORT) in patients with recurrent gynecologic cancers

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/s0360-3016(01)01507-3 ◽

2001 ◽

Vol 50 (3) ◽

pp. 687-694 ◽

Cited By ~ 62

Author(s):

Mary L Gemignani ◽

Kaled M Alektiar ◽

Mario Leitao ◽

Boris Mychalczak ◽

Dennis Chi ◽

...

Keyword(s):

Radiation Therapy ◽

Surgical Resection ◽

Intraoperative Radiation Therapy ◽

High Dose ◽

Gynecologic Cancers ◽

Intraoperative Radiation ◽

Radical Surgical Resection

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Gastrointestinal stromal tumors (GISTs): Our experience in the management of 26 patients

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.19506 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 19506-19506

Author(s):

E. Maiello ◽

L. Tozzi ◽

T. P. Latiano ◽

A. De Bonis ◽

M. Bisceglia ◽

...

Keyword(s):

Overall Survival ◽

Surgical Resection ◽

Advanced Disease ◽

Epigastric Pain ◽

Standard Dose ◽

Locally Advanced ◽

Postoperative Mortality ◽

Gastrointestinal Neoplasms ◽

Primary Tumor Site ◽

Metastatic Relapse

19506 Background: GISTs represents 0.1–3% of gastrointestinal neoplasms; most cases occur in people 40 to 80 years old, and are more common in men than in women. More than half of all GISTs patients present with locally advanced, recurrent, or metastatic disease (mainly to liver or peritoneum). Methods: From January 2001 to December 2005 we observed in our Institution 26 pts with GISTs; all were CD117+.The main characteristics of these pts were as follows: median age: 61 yr; sex (F/M): 14/12; primary tumor site: stomach 13 (50 %), small intestine 7 (27 %), rectum 1 (4 %), retroperitoneum 4 (15 %), liver 1 (4 %); first symptoms: epigastric pain 10 (38 %); abdominal pain 4 (15 %); hematemesis 1 (3 %); anemia 5 (18,5 %), palpable abdominal mass 1 (3 %), defecation disorders 2 (7 %); melena 3 (11 %); rectal bleeding 1 (3 %); ascites 1 (3 %). Results: Radical surgical resection was performed in 21 patients (81 %), 2 patients received a debulking surgery, and no postoperative mortality or major complications were observed; 3 pts showed an advanced disease. Seven pts (33%) developed recurrence, local or at distance, and the median time to relapse was 7,5 months (range 2–11). One pt with advanced disease dead before any treatment and 11 pts received Imatinib (I), at the standard dose (400 mg/d), starting from the date of diagnosis of advanced disease or metastatic relapse and given until development of intolerance or progressive disease. Main toxicities of I included: neutropenia G3 (4%), skin rash (4%), periorbital oedema (4%). We achieved 3 PR (lasting 12+, 21+ and 40 mos), 6 SD and 2 PD. With a median follow-up of 30 months, all but three pts (dead for progressive diseases) are alive. The overall survival rate was 88.5 % and the median overall survival was 16 mos (range 1–49). Conclusions: Surgical resection remains the only effective treatment for GISTs. However, in pts with advanced or relapsed disease treatment with I is effective with an high disease control rate. No significant financial relationships to disclose.

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