scholarly journals EP.TU.693A rare case of anal melanoma: An entity to be aware of

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Ahmed Dhaif ◽  
Cameron Boyle ◽  
Katherine Lowe ◽  
Rosemary Paterson ◽  
Ashutosh Gumber
Keyword(s):  
Rare Case ◽  
Intraoperative Complications ◽  
Perforator Flap ◽  
Disease Recurrence ◽  
General Anaesthetic ◽  
Anal Margin ◽  
Superficial Spreading ◽  
Anal Melanoma ◽  
General Physical

Abstract Aims Anal melanoma is a rare but aggressive malignancy representing a small percentage anorectal cancers. We report a rare case incidentally detected during bowel screening. Methods A 74-year-old female presented for endoscopy after a positive qFIT. She was asymptomatic. During endoscopy, perianal examination revealed a jet black naevus of approximately 3x3cm from 9 to 12’O clock position, overlying the perianal body, involving anal margin to the posterior vagina. General physical, abdominal and rectal examinations were unremarkable. During colonoscopy, a benign polyp was removed from the sigmoid colon. She underwent examination of rectum and vagina under general anaesthetic, and incisional biopsies were obtained. Histopathology confirmed an invasive, superficial spreading malignant melanoma, with a Breslow thickness of 1.5mm and Clark Level IV invasion. Staging CT scans did not reveal metastasis. Following loco-regional MDT discussion, a combined colorectal and plastic surgery was offered. She underwent wide local excision from the posterior vaginal fourchette to the anal canal, bilateral perforator flap reconstruction, and defunctioning sigmoid loop colostomy. Results There were no intraoperative complications. She recovered well post-operatively. After histopathology, her tumour was staged as pT2b, N0, M0. She did not require further treatment post-operatively as per MDTdiscussion. No disease recurrence has been detected yet with 30 months follow up, and she is awaiting reversal of colostomy. Conclusions Prognosis is generally poor in anal melanoma. This case report adds to the limited literature and emphasizs that despite no consensus on management, early detection and surgical resection offers the best chance for favorable outcomes.

scholarly journals Paraganglioma Presenting as a Nasal Septal Mass: Case Report and Literature Review

2018 ◽  
Vol 2018 ◽  
pp. 1-7
Author(s):  
James H. Kim ◽  
Nathan Tu ◽  
Bozena Barbara Wrobel
Keyword(s):  
Differential Diagnosis ◽  
Nasal Septum ◽  
Tumor Recurrence ◽  
Rare Case ◽  
Nasal Congestion ◽  
Surgical Excision ◽  
Disease Recurrence ◽  
Mass Case ◽  
Sphenoid Sinuses

Objectives. To describe a rare case of a paraganglioma arising from the nasal septum and review the diagnosis and management of paragangliomas in the nasal cavity and paranasal sinuses.Methods. We present a case of a 70-year-old female presenting with persistent nasal congestion and obstruction. Nasal endoscopy revealed a posterior septal mass approaching the sphenoid sinuses and partially obstructing the nasopharynx. A biopsy of the mass was taken, and histologic analysis confirmed a diagnosis of paraganglioma.Results. The patient underwent an endoscopic resection of the tumor. There has been no evidence of disease recurrence after 3 months of follow‐up.Conclusions. Paragangliomas arising from the nasal septum are exceedingly rare, but should be considered in the differential diagnosis in patients presenting with nasal septal masses. These tumors are typically benign, although few cases of malignant sinonasal paragangliomas have been reported. Treatment requires surgical excision with close follow-up as several cases of tumor recurrence have been reported.

Ex-vivo renal surgery and auto-transplantation for benign and malignant renal pathologies: our early evolving experience of three cases

2017 ◽  
Vol 11 (1) ◽  
pp. 27-32
Author(s):  
Muhammad Z Aslam ◽  
Tim Brown ◽  
Ali A Thwaini
Keyword(s):  
Partial Nephrectomy ◽  
Ex Vivo ◽  
Intraoperative Complications ◽  
Disease Recurrence ◽  
Laparoscopic Nephrectomy ◽  
Renal Surgery ◽  
Renal Functions ◽  
Doppler Signals ◽  
The Right

Objectives: We describe our experience of ex-vivo renal surgery and autotransplantation for complex renal pathologies. These cases were carried out in the urology and transplant departments between July 2015 and January 2016. Materials and methods: Case 1 was a 63-year-old man presenting with spontaneous bleed from a renal mass in a solitary functional right kidney. Case 2 was a 50-year-old man with bilateral renal tumours involving renal veins. Case 3 was a 50-year-old man with two previous failed right-sided pyeloplasties. Results: No intraoperative complications were encountered. Case 1 underwent laparoscopic nephrectomy, ex-vivo partial nephrectomy followed by autotransplantation. There was no disease recurrence after 6 months’ follow-up, with stable renal functions. Case 2 had bilateral open radical nephrectomies performed. On the right autotransplantation was performed after ex-vivo partial nephrectomy. On the left, a further procedure was abandoned after radical nephrectomy due to extensive disease involvement. Postoperatively, the patient became anuric with poor Doppler signals. Exploration suggested complete renal vein obstruction with infarction of the autotransplanted right kidney requiring nephrectomy. Disease recurrence at the native renal bed was found at 6 months’ follow-up. Case 3 had laparoscopic nephrectomy, ex-vivo pyeloplasty and autotransplantation was performed. At 12 months’ follow-up, the patient was asymptomatic with stable renal functions. Conclusions: Ex-vivo renal surgery is a viable option for complex renal conditions. However, appropriate patient selection is essential to achieve good outcomes.

scholarly journals EXTREMELY RARE CASE OF BILATERAL EXOGENIC RHINOLITHIASIS WITH 16 YEARS HISTORY

2020 ◽  
pp. 650-654
Author(s):  
U.A. KURBANOV ◽  
◽  
S.M. DZHANOBILOVA ◽  
SH.I. KHOLOV ◽  
K.M. MARDONZODA ◽  
...  
Keyword(s):  
Foreign Body ◽  
Nasal Cavity ◽  
Rare Case ◽  
Nasal Congestion ◽  
Intraoperative Complications ◽  
Previous Treatment ◽  
Acute Exacerbations ◽  
Duration Of Hospitalization ◽  
Unpleasant Smell

The article describes a rare case of bilateral rhinolithiasis. The presence of a foreign body in the nasal cavity comprised 16 years. Pathogenetic aspects of the occurrence of the rhinoliths and their chemical composition are presented. Frequent recurrent acute exacerbations of chronic rhinitis, sensations of unpleasant smell, partial loss of smell, breathing problems due to nasal congestion and durable ineffectiveness of previous treatment triggered the patient to address to the clinic. CT revealed the presence of a foreign body on both sides of the nasal cavity. The patient underwent the surgery on bilateral rhinolithiasis with the application of precision technology and optical zoom. The nidus of rhinolith became plastic bullets of a toy gun. Intraoperative complications were not observed. The duration of hospitalization was 5 days. Follow-up evaluation by CT of the nasal cavity and paranasal sinuses in the period of 4 months after surgery revealed the absence of foreign bodies and nasal symptoms. Keywords: Foreign body, bilateral rhinolithiasis, nasal cavity, CT scan.

Minimal complications observed with a modified surgical approach for treatment of canine anal sac neoplasia

2021 ◽  
Vol 260 (S1) ◽  
pp. S59-S64
Author(s):  
Carolyn L. Chen ◽  
Janis M. Lapsley ◽  
Laura E. Selmic
Keyword(s):  
Postoperative Complication ◽  
Intraoperative Complications ◽  
Systemic Disease ◽  
Disease Recurrence ◽  
Complication Rates ◽  
Short Term ◽  
Term Outcome ◽  
Local Disease ◽  
Anal Sac

Abstract OBJECTIVE To describe a modified approach to closed anal sacculectomy and report the short-term outcomes of dogs that underwent the procedure for treatment of neoplasia. ANIMALS 16 client-owned dogs. PROCEDURES Medical records of 1 referral hospital were reviewed to identify dogs that underwent modified closed anal sacculectomy for treatment of anal sac neoplasia between January 2018 and September 2020. Data collected included signalment, examination and diagnostic imaging findings, surgical details, intraoperative and postoperative complications, cytologic and histologic findings, adjuvant treatments, duration of follow-up, and short-term outcome. RESULTS 15 dogs had apocrine gland anal sac adenocarcinoma, and 1 had a collision tumor. No dogs had intraoperative complications; 1 dog had a minor postoperative complication (paraparesis) that resolved. The median duration of postoperative follow-up was 286 days (range, 67 to 777 days). One dog had confirmed local disease recurrence 290 days after surgery, and 1 had suspected local disease recurrence 203 days after surgery and was euthanized because of systemic disease progression. CONCLUSIONS AND CLINICAL RELEVANCE The modified closed anal sacculectomy was well tolerated in this sample of dogs, with minimal short-term complications. This study provided evidence to justify evaluation of the procedure in a larger number of dogs and assessment of the effects of procedural modifications on postoperative complication rates and time to local recurrence.

scholarly journals Crossed complete fused left to right renal ectopia with solitary left ureter: A rare ‘Case Report’

2020 ◽  
Vol 26 (1) ◽  
Author(s):  
Ghanshyam Kumawat ◽  
Mohit Singla ◽  
Nishkarsh Mehta ◽  
Prashant Gupta ◽  
SS Yadav
Keyword(s):  
Urinary Bladder ◽  
Rare Case ◽  
Adolescent Male ◽  
Ct Urography ◽  
Renal Ectopia ◽  
Rare Case Report ◽  
Crossed Fused Renal Ectopia ◽  
General Physical ◽  
First Time

Abstract Background Crossed fused renal ectopia is a rare congenital anomaly where both the kidneys are fused and situated on one side and drain bilaterally into the urinary bladder. Rarely crossed fused ectopia can present with a single ureter draining ipsilaterally into the bladder, but here we are presenting for the first time a rare case of right crossed fused ectopia, where a solitary ureter crosses midline and drains contralaterally into the bladder. Case presentation A 19-year-old adolescent male patient presented with intermittent chronic right flank pain for 3 months. General physical and per abdominal examinations were normal. Computerized tomography (CT) urography showed right side crossed fused ectopic kidneys with a solitary ureter draining both the kidneys and opening into the left side of the urinary bladder. The patient was managed conservatively and is on regular follow-up. Conclusion Crossed complete renal fused ectopia with solitary contralateral ureteral is a rare case. Individualized case-based management is needed depending upon the symptoms, associated anomalies, and pathology. Reporting of all rare congenital cases will help in the future understanding and management of these conditions.

scholarly journals A life-threatening spontaneous ascending aortic rupture due to a small penetrating aortic ulcer

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110377
Author(s):  
Yasuhito Nakamura ◽  
Kiyoshi Doi ◽  
Syojiro Yamaguchi ◽  
Etsuji Umeda ◽  
Osamu Sakai ◽  
...  
Keyword(s):  
Rare Case ◽  
Aortic Wall ◽  
Aortic Rupture ◽  
Ascending Aorta ◽  
Bleeding Site ◽  
Penetrating Aortic Ulcer ◽  
Postoperative Course ◽  
Life Threatening ◽  
Aortic Dissections

We reported a rare case of spontaneous frank rupture of a small (4 mm) penetrating aortic ulcer in the ascending aorta resulted in catastrophic bleeding. The ulcer only created a pinhole wound in the adventitia without saccular aneurysms, intramural hematomas, or aortic dissections. Notably, the wound could be directly closed because the aortic wall was intact only 5 mm away from the bleeding site. The postoperative course was uneventful, and the patient was discharged on the 11th postoperative day. After 8 months, follow-up computed tomography showed no abnormality of the aortic wall at the repair site.

A rare case of hypokalaemia and hypophosphataemia secondary to geophagia

2021 ◽  
Vol 14 (5) ◽  
pp. e239322
Author(s):  
Charmaine Schmidt ◽  
Jonathan Oxley Oxland ◽  
Robert Freercks
Keyword(s):  
Creatine Kinase ◽  
Iron Deficiency ◽  
Phosphate Binder ◽  
Rare Case ◽  
Potassium Level ◽  
Serum Potassium Level ◽  
Electrolyte Abnormality ◽  
Distal Muscle

We report a case of severe hypokalaemia and moderate hypophosphataemia from clay ingestion. A 60-year-old woman presented with flaccid paralysis. Investigations revealed a serum potassium level of 1.8 mmol/L, phosphate level of 0.56 mmol/L and creatine kinase level of 30 747 IU/L. She had marked proximal and distal muscle weakness due to severe hypokalaemia and concurrent hypophosphataemia, which likely contributed to the onset of rhabdomyolysis. The patient subsequently admitted to significant pica, most likely secondary to an associated iron deficiency. We conclude that the ingested clay acted as a potassium and phosphate binder. Although we did not investigate the content of the clay in this case, it has been reported that clay can bind potassium in vitro and is rich in minerals such as aluminium that could play a role in the binding of phosphate, although the exact mechanism remains unclear. The patient recovered fully and outpatient follow-up at 6 months and again at 40 months confirmed no electrolyte abnormality, myopathy nor any further geophagia.

A Novel Surgical Technique for Large Frontoencephalocele Management: The Mercy Ships Approach

FACE ◽  
2021 ◽  
pp. 273250162097932
Author(s):  
Naikhoba C. O. Munabi ◽  
Eric S. Nagengast ◽  
Gary Parker ◽  
Shaillendra A. Magdum ◽  
Mirjam Hamer ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Intraoperative Complications ◽  
Complication Rates ◽  
The Novel ◽  
Middle Income ◽  
Middle Income Countries ◽  
Lumbar Drain ◽  
Cerebral Herniation ◽  
Long Nose

Background: Large frontoencephaloceles, more common in low and middle-income countries, require complex reconstruction of cerebral herniation, elongated nose, telecanthus, and cephalic frontal bone rotation. Previously described techniques involve multiple osteotomies, often fail to address cephalad brow rotation, and have high complication rates including up to 35% mortality. This study presents a novel, modified, single-staged technique for frontoencephalocele reconstruction performed by Mercy Ships. This technique, which addresses functional and aesthetic concerns with minimal osteotomies, may help improve outcomes in low resources settings. Methods: Retrospective review was performed of patients who underwent frontoencephalocele reconstruction through Mercy Ships using the technique described. Patient data including country, age, gender, associated diagnoses, and prior interventions were reviewed. Intraoperative and post-operative complications were recorded. Results: Eight patients with frontoencephalocele (ages 4-14 years) underwent surgery with the novel technique in 4 countries. Average surgical time was 6.0 ± 0.9 hours. No intraoperative complications occurred. Post-operatively 1 patient experienced lumbar drain dislodgement requiring replacement and a second had early post-operative fall requiring reoperation for hardware replacement. In person follow-up to 2.4 months showed no additional complications. Follow-up via phone at 1 to 2 years post-op revealed all patients who be satisfied with surgical outcomes. Conclusions: Reconstruction of large frontoencephaloceles can be challenging due to the need for functional closure of the defect and craniofacial reconstruction to correct medial hypertelorism, long nose deformity, and cephalad forehead rotation. The novel surgical technique presented in this paper allows for reliable reconstruction of functional and aesthetic needs with simplified incision design, osteotomies, and bandeau manipulation.

Penile Lymphoepithelioma-Like Carcinoma: A Rare Case With PD-L1 Expression

2021 ◽  
pp. 106689692098834
Author(s):  
Raquel Machado-Neves ◽  
Bernardo Teixeira ◽  
Elsa Fonseca ◽  
Pedro Valente ◽  
Joaquim Lindoro ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Tumor Cells ◽  
Rare Case ◽  
Malignant Tumors ◽  
Squamous Cell Carcinomas ◽  
The Third ◽  
The Past ◽  
First Case ◽  
Lymphoplasmacytic Infiltrate

Most malignant tumors of the penis are squamous cell carcinomas (SCC), being divided in 2 groups, one human papillomavirus (HPV)-related and another non-HPV-related, with lymphoepithelioma-like carcinoma (LELC) being one of the rarest HPV-related SCC. In this article, we report a case of a 50-year-old man who presented testicular swelling and pain for the past 3 months. A penile mass was identified, and the patient was submitted to a total penectomy. The penectomy specimen showed an ulcerated lesion at the glans reaching the cavernous bodies. Microscopic examination showed undifferentiated epithelial cells with syncytial growth pattern mix with a dense lymphoplasmacytic infiltrate, consistent with LELC. The tumor cells expressed p16 and all 3 different clones of PDL1 (22C3, SP263, and SP142). The patient is alive and well with a follow-up of 3 months. To our knowledge, this is the third LELC of the penis reported in literature and the first case reported with PDL1 expression.

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