scholarly journals A Rare Case of Recurrence of Craniopharyngioma at Ectopic Site after Surgical Resection of Primary Tumor

2018 ◽  
Vol 07 (03) ◽  
pp. 265-268 ◽  
Author(s):  
Subir Dey ◽  
Akhilesh Rao ◽  
Shilpa Sinha ◽  
Sanjay Kumar ◽  
Keyword(s):  
Surgical Resection ◽  
Rare Case ◽  
Primary Lesion ◽  
Cystic Fluid ◽  
Cystic Tumors ◽  
Ectopic Recurrence ◽  
The Right ◽  
Histopathologic Confirmation

AbstractEctopic recurrence of craniopharyngiomas after surgical resection of primary lesion is extremely rare. In this article, the authors describe a case of a 12-year-old girl with ectopic recurrence of craniopharyngioma in an extra-axial location in the right frontal region, after an attempt to completely resect the lesion originally located in the sellar region. The patient was investigated radiologically, hormonally, and histopathologic confirmation was sought. During surgery, it is important to take extra care in removing the primary lesion in toto. In case of cystic tumors, it is very important to aspirate cystic fluid completely, before resecting the capsule to avoid rupture or spillage. Long-term clinical and radiologic follow-up is suggested as ectopic recurrence may occur at a very late stage.

Ectopic Recurrence of Craniopharyngioma after an Interhemispheric Transcallosal Approach: Case Report

Neurosurgery ◽  
2002 ◽  
Vol 50 (3) ◽  
pp. 639-645 ◽  
Author(s):  
Jeannette M. Liu ◽  
Ira M. Garonzik ◽  
Charles G. Eberhart ◽  
Prakash Sampath ◽  
Henry Brem
Keyword(s):  
Vasogenic Edema ◽  
Case Reports ◽  
Postoperative Radiotherapy ◽  
Transcallosal Approach ◽  
Ectopic Recurrence ◽  
Microsurgical Resection ◽  
Surgical Field ◽  
The Right

Abstract OBJECTIVE AND IMPORTANCE: Ectopic recurrence of a craniopharyngioma is a rare postoperative complication. We present a case of a craniopharyngioma that ectopically recurred along the tract of a previous surgical route. CLINICAL PRESENTATION: A 73-year-old female patient presented 8 years earlier with a suprasellar craniopharyngioma. She underwent a right frontal craniotomy, with an interhemispheric transcallosal approach, for total microsurgical resection of the tumor. No postoperative radiotherapy was administered. Four years after surgery, magnetic resonance imaging studies revealed a well-circumscribed, heterogeneously enhancing, parasagittal mass with significant vasogenic edema in the right frontal lobe. Enlargement of the lesion was noted in subsequent radiological evaluations until 8 years after surgery, when the patient experienced a significant decline in neurocognitive status and the mass was surgically resected. INTERVENTION: Gross total resection of a histologically confirmed craniopharyngioma was achieved. CONCLUSION: To our knowledge, only eight previous case reports described the ectopic recurrence of a craniopharyngioma. Transplantation of tumor cells along the tract of a previous surgical route in six cases and dissemination in cerebrospinal fluid in two cases are presumed to be the primary mechanisms by which these ectopic recurrences occurred. The results of our literature review led us to conclude that total surgical resection, combined with careful inspection and irrigation of the surgical field, is the optimal treatment for preventing ectopic recurrences. Furthermore, it is recommended that, after primary craniopharyngioma resection, patients undergo long-term clinical and radiological follow-up monitoring for the rare development of an ectopically recurring tumor.

scholarly journals A long-term survivor of clear cell sarcoma-like tumor of the gastrointestinal tract with liver metastasis: a case report

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Takuhisa Okada ◽  
Yasumitsu Hirano ◽  
Shintaro Ishikawa ◽  
Hiroka Kondo ◽  
Toshimasa Ishii ◽  
...  
Keyword(s):  
Small Intestine ◽  
Lymph Node ◽  
Gastrointestinal Tract ◽  
Liver Metastasis ◽  
Surgical Resection ◽  
Clear Cell ◽  
Clear Cell Sarcoma ◽  
Cell Sarcoma

Abstract Background Clear cell sarcoma-like tumor of the gastrointestinal tract (CCSLTGT) is extremely rare. It is a mesenchymal neoplasm that usually forms in the small intestine of adolescents and young adults, is prone to local recurrence and metastasis, and has a high mortality rate. We report a patient with CCSLTGT with lymph node- and liver metastases, who continues to survive 6 years after initial surgical resection. Case presentation A 38-year-old woman presented with lightheadedness. Laboratory analysis revealed anemia (hemoglobin, 6.7 g/dL), and enhanced computed tomography (CT) demonstrated a mass in the small intestine, about 6 cm in diameter, with swelling of 2 regional lymph nodes. Double-balloon small intestine endoscopic examination revealed a tumor accompanied by an ulcer; the biopsy findings suggested a primary cancer of the small intestine. She was admitted, and we then performed a laparotomy for partial resection of the small intestine with lymph node dissection. Pathologic examination revealed CCSLTGT with regional lymph node metastases. About 3 years later, follow-up CT revealed a single liver metastasis. Consequently, she underwent a laparoscopic partial liver resection. Histopathologic examination confirmed that the liver metastasis was consistent with CCSLTGT. It has now been 3 years without a recurrence. Conclusion Repeated radical surgical resection with close follow-up may be the only way to achieve long-term survival in patients with CCLSTGT.

Physiological Pacing: A New Road to Future

2021 ◽  
pp. 263246362097804
Author(s):  
Vanita Arora ◽  
Pawan Suri
Keyword(s):  
Side Effects ◽  
Fibrous Tissue ◽  
Cardiac Pacing ◽  
His Bundle ◽  
Anatomy And Physiology ◽  
Long Term Follow Up ◽  
Pacing Lead ◽  
The Right

Anatomy and physiology are the basis of human body functioning and as we have progressed in management of various diseases, we have understood that physiological intervention is always better than an anatomical one. For more than 50 years, a standard approach to permanent cardiac pacing has been an anatomical placement of transvenous pacing lead at the right ventricular apex with a proven benefit of restoring the rhythm. However, the resultant ventricular dyssynchrony on the long-term follow-up in patients requiring more than 40% ventricular pacing led to untoward side effects in the form of heart failure and arrhythmias. To counter such adverse side effects, a need for physiological cardiac pacing wherein the electrical impulse be transmitted directly through the normal conduction system was sought. His bundle pacing (HBP) with an intriguing alternative of left bundle branch pacing (LBBP) is aimed at restoring such physiological activation of ventricles. HBP is safe, efficacious, and feasible; however, localization and placement of a pacing lead at the His bundle is challenging with existing transvenous systems due to its small anatomic size, surrounding fibrous tissue, long-learning curve, and the concern remains about lead dislodgement and progressive electrical block distal to the HBP lead. In this article, we aim to take the reader through the challenging journey of HBP with focus upon the hardware and technique, selective versus nonselective HBP, indications and potential disadvantages, and finally the future prospects.

Transcatheter closure of defects within the oval fossa using the Amplatzer® Septal Occluder

2002 ◽  
Vol 12 (3) ◽  
pp. 224-228 ◽  
Author(s):  
Haifa Abdul Latiff ◽  
Mazeni Alwi ◽  
Hasri Samion ◽  
Geetha Kandhavel
Keyword(s):  
Transcatheter Closure ◽  
Standard Procedure ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Term Outcome ◽  
Long Term Follow Up ◽  
One Year ◽  
The Right

This study reviewed the short-term outcome of transcatheter closure of the defects within the oval fossa using an Amplatzer® Septal Occluder. From January 1997 to December 2000, 210 patients with defects within the oval fossa underwent successful transcatheter closure. We reviewed a total of 190 patients with left-to-right shunts, assessing the patients for possible complications and the presence of residual shunts using transthoracic echocardiogram at 24 h, 1 month, 3 months and one year. Their median age was 10 years, with a range from 2 to 64 years, and their median weight was 23.9 kg, with a range from 8.9 to 79 kg. In 5 patients, a patent arterial duct was closed, and in 2 pulmonary balloon valvoplasty performed, at the same sitting. The median size of the Amplatzer® device used was 20 mm, with a range from 9 to 36 mm. The median times for the procedure and fluoroscopy were 95 min, with a range from 30 to 210 min, and 18.4 min, with a range from 5 to 144 min, respectively. Mean follow-up was 20.8 ± 12.4 months. Complete occlusion was obtained in 168 of 190 (88%) patients at 24 h, 128 of 133 (96.2%) at 3 months, and 103 of 104 (99%) at one year. Complications occurred in 4 (2.1%) patients. In one, the device became detached, in the second the device embolized into the right ventricular outflow tract, the lower end of the device straddled in the third, and the final patient had significant bleeding from the site of venupuncture. There were no major complications noted on follow-up. We conclude that transcatheter closure of defects within the oval fossa using the Amplatzer® Septal Occluder is safe and effective. Long-term follow-up is required, nonetheless, before it is recommended as a standard procedure.

Does thrombolysis for pulmonary embolism reduce the risk of chronic complications?

2021 ◽  
Vol 20 (1) ◽  
pp. 15-17
Author(s):  
Caroline Apsey ◽  
◽  
Muhammad Jawad ◽  
Martin Daschel ◽  
Daniel Woosey ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Pulmonary Artery ◽  
Right Ventricle ◽  
Chronic Complications ◽  
The Right

We assessed the efficacy of thrombolysis in avoiding long-term complications. Notes of patients thrombolysed for PE in the 2-year period were reviewed. The initial CTPA and echocardiogram results before thrombolysis were compared to the results of follow up imaging repeated after 6 months. Twenty-two patients were thrombolysed for PE. 14 patients had sub-massive PE and 8 patients had massive PE. The right ventricle (RV) was dilated on pre-thrombolysis echocardiogram in 16 patients. On follow up echocardiography all patients with massive PE (6 studies) had a normal RV size, with pulmonary artery pressures (PAP) of 29mmHg. Follow up echocardiography of patients with submassive PE (13 studies) showed 11 patients with a normal RV, with PAP of 28 mmHg.

Recurrence and disease-specific survival after 10-year disease-free interval in patients with primary retroperitoneal liposarcoma: Implications for long-term surveillance.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 11546-11546
Author(s):  
Mark Archer Eckardt ◽  
Danielle S. Graham ◽  
Brian E. Kadera ◽  
Kyle D. Klingbeil ◽  
Scott D. Nelson ◽  
...  
Keyword(s):  
Surgical Resection ◽  
Surgical Margin ◽  
Disease Specific Survival ◽  
Risk Of Recurrence ◽  
Retroperitoneal Liposarcoma ◽  
Initial Surgery ◽  
Surveillance Imaging ◽  
Disease Specific

11546 Background: Surveillance imaging of patients with retroperitoneal liposarcoma (RP-LPS) following surgical resection is based on a projected risk of locoregional and distant recurrence. The duration of surveillance is not well defined as the long-term natural history of RP-LPS after treatment is poorly understood. We evaluate a cohort of RP-LPS patients—without evidence of disease 10 years following initial resection—to assess the long-term risk of recurrence and disease-specific survival (DSS). Methods: The prospectively maintained UCLA Sarcoma Database was used to identify RP-LPS patients who demonstrated 10-year progression-free survival (10yr-PFS) after initial diagnosis and treatment. Patients in the 10yr-PFS cohort were subsequently evaluated for recurrence and DSS. Time intervals start at date of initial surgical resection. Cox proportional hazards models were used to determine factors associated with recurrence and DSS. Results: From 1972-2010, 76 patients with RP-LPS had at least 10 years of follow-up. Of these, 37 (49%) demonstrated 10yr-PFS. Median follow-up was 15 years (range 10-35 years). Among the 10yr-PFS patients, 43% (16/37) developed a recurrence >10 years after the initial surgery, and 19% (7/37) died of disease. Neither long-term recurrence nor DSS were significantly associated with age, sex, tumor size, LPS subtype, surgical margin, or peri-operative treatment with radiation or chemotherapy (Table). Conclusions: Patients with primary RP-LPS treated with surgical resection +/- multimodality therapy have a long-term risk of recurrence and disease-specific death that is unacknowledged by current surveillance imaging guidelines. Among the patients with a 10yr-PFS, 43% developed a recurrence and 19% died of disease. These findings suggest a need for lifelong surveillance imaging in patients with RP-LPS.[Table: see text]

“Craniotomy Within Craniotomy” Technique for Safe Resection of an Intracranial Arteriovenous Malformation With Frontal Bony Erosion: 2-Dimensional Operative Video

2021 ◽  
Author(s):  
MirHojjat Khorasanizadeh ◽  
Kristine Ravina ◽  
Aristotelis Filippidis ◽  
Christopher S Ogilvy
Keyword(s):  
Surgical Resection ◽  
Endovascular Embolization ◽  
Acute Onset ◽  
Bone Flap ◽  
Intracranial Arteriovenous Malformation ◽  
Excessive Bleeding ◽  
Left Hand ◽  
The Right ◽  
Venous Varix

Abstract Surgical resection is one option in the treatment of large high-grade brain arteriovenous malformations (AVMs). Resection of AVMs with skull-eroding components can be challenging due to the risk of excessive bleeding from these components during craniotomy and bone flap removal. We present a case of a 25-yr-old woman who presented with an acute onset right-sided frontal headache. She was found to have a large, frontal Spetzler-Martin grade IV AVM with an associated dural AVM. The AVM had caused focal erosions of the right frontal bone by a venous varix traversing the region of the calvarial defect. An elective staged endovascular embolization followed by surgical resection was recommended considering the patient's young age and the large size of the AVM located in a noneloquent area. Given the high risk of intraoperative hemorrhage during the craniotomy portion of the procedure, a “craniotomy within craniotomy” approach was planned. During this approach, a small rectangle of bone, including the portion eroded by the venous varix, was left in place, while the larger bone flap surrounding it was removed for an initial approach to the AVM. The small bony piece was safely removed at later stages of resection once the arterial feeders had been reasonably obliterated. Immediate postoperative catheter angiogram demonstrated good filling of the intracranial vascular territories with no residual AVM. The patient developed mild left facial and left hand weakness postoperatively, which resolved after 2 wk of follow-up. The patient remained neurologically intact on further follow-up.

scholarly journals Juvenile Aggressive Trabecular Ossifying Fibroma of Mandible: A Rare Case Report

2016 ◽  
Vol 6 (1) ◽  
pp. 45-51
Author(s):  
Deepa Das Achath ◽  
Abhishek Sanjay Ghule ◽  
Preeti Kanchan-Talreja ◽  
Sunanda Bhatnagar
Keyword(s):  
Case Report ◽  
Rare Case ◽  
Histological Analysis ◽  
High Recurrence Rate ◽  
Ossifying Fibroma ◽  
Appropriate Treatment ◽  
Juvenile Ossifying Fibroma ◽  
Rare Case Report

ABSTRACT Fibroosseous lesions of the jaws, including juvenile ossifying fibroma (JOF), pose diagnostic and therapeutic difficulties due to their clinical, radiological, and histological variability. There are two histological varieties of it, one as psammomatoid type and second as trebacular type; here, we present a trebacular type, which is a rare variety. After the clinical examination, radiological and histological analysis, it was diagnosed as juvenile trebacular ossifying fibroma. Although JOF is an uncommon clinical entity, its aggressive local behavior and high recurrence rate means that it is important to make an early diagnosis, apply the appropriate treatment, and, especially, follow-up the patient over the long term. How to cite this article Ghule AS, Achath DD, Kanchan- Talreja P, Bhatnagar S. Juvenile Aggressive Trabecular Ossifying Fibroma of Mandible: A Rare Case Report. J Contemp Dent 2016;6(1):45-51.

scholarly journals Benign tumors of the heart: Myxoma of the right atrium - a case report

2018 ◽  
Vol 75 (5) ◽  
pp. 512-515 ◽  
Author(s):  
Sasa Hinic ◽  
Jelena Saric ◽  
Predrag Milojevic ◽  
Jelena Gavrilovic ◽  
Tijana Durmic ◽  
...  
Keyword(s):  
Case Report ◽  
Body Position ◽  
Atrial Myxoma ◽  
Right Atrial ◽  
Benign Tumors ◽  
Non Invasive ◽  
Right Atrial Myxoma ◽  
The Right

Introduction. Myxoma is the most common primary benign heart tumor. The most frequent location is the left atrium, the chamber of the heart that receives oxygen- rich blood from the lungs. Myxomas usually develop in women, typically between the ages of 40 and 60. Symptoms may occur at any time, but most often they are asymptomatic or oligosymptomatic for a long period of time. Symptoms usually go along with body position, and are related to compression of the heart cavities, embolization and the appearance of general symptoms. The diagnosis of benign tumors of the heart is based on anamnesis, clinical features and findings of the tumor masses by use of non-invasive and invasive imaging methods. Extensive surgical resection of the myxoma is curative with minimal mortality. Long term clinical and echocardiographic follow-up is mandatory. Case report. We reported a case of a 62-year-old male, presented with 15 days of intermittent shortness of breath, dizziness and feeling of heart palpitations and subsequently diagnosed with right atrial myxoma based on transthoracic echocardiography . The patient was emergently operated in our hospital. Long-term followup did not reveal recurrence. Conclusion. Our case was an atypical localisation of right atrial myxoma. Whether the intracardiac mass is benign or malignant, early surgery is obligatory in order to prevent complications.

scholarly journals Improved Biochemical Parameters in Patients Who Undergo Early Resection in Isolated Ileocaecal Crohn’s Disease

2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
Mirzafaraz Saeed ◽  
Hari Hullur ◽  
Amro Salem ◽  
Abbas Ali ◽  
Yousif Sahib ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Surgical Resection ◽  
Complete Blood Count ◽  
Long Term Results ◽  
Number Of Patients ◽  
Long Term Follow Up ◽  
One Year

Introduction. The aim of this study is to evaluate the outcome of introduction of early surgery in the course of isolated ileocecal Crohn’s disease, where there is no absolute indication of surgery. Methods. Observational study involving patients with isolated ileocecal Crohn’s disease who underwent early surgical resection (within one year of the presentation of the hospital). A complete blood count, ESR, and CRP were done and compared between the preoperative value, 1st postoperative visit (3-4 weeks), and last follow-up visit. Statistical analysis was done using Analysis of Variance (ANOVA) to compare the different figures. Results. There was a statistically significant increase in the hemoglobin levels between preoperative, postoperative, and long-term follow-up and a significant decrease in leukocyte count between the pre- and postoperative values (F=19.8, p<0.001 and F=8.9, p=0.002, resp.). Similarly, the ESR and CRP values were decreased significantly at long-term follow-up (F=8.5, p=0.019 and F=8.3, p=0.013, resp.). Conclusion. Early surgical resection in isolated ileocaecal Crohn’s disease achieved significant biochemical improvements. These successful results in this small number of patients indicate that early surgical intervention may provide better outcomes. These initial results encourage larger and comparative studies of long-term results versus long-term use of biological agents.

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