Intraperitoneal migration of a hookwire following wide local excision of a breast lesion presenting as a spontaneous pneumothorax

2021 ◽  
Vol 14 (8) ◽  
pp. e244086
Author(s):  
Maximilian Olavi Joret ◽  
Falah El-Haddawi
Keyword(s):  
Local Excision ◽  
Wide Local Excision ◽  
Blood Test ◽  
Breast Lesion ◽  
Foreign Bodies ◽  
Surgical Intervention ◽  
Rare Complication ◽  
Vital Signs ◽  
Iatrogenic Injuries ◽  
Breast Neoplasia

Hookwire migration is a rare complication of wide local excision surgery for breast neoplasia. We report the case of a 64-year-old woman who presented to hospital with acute on chronic left upper quadrant and left scapular pain. She had undergone a hookwire-guided wide local excision of a right breast neoplasm 5 years previously. Her vital signs, clinical examination and blood test were unremarkable. A CT scan revealed a left-sided pneumothorax and a 20 cm metallic intraperitoneal foreign body transpiercing the diaphragm. A review of the patient’s clinical record revealed that she experienced a vagal collapse during hookwire implantation. This article underlines the importance of clear communication between members of a multidisciplinary team involved in a staged surgical intervention and exemplifies that foreign bodies can migrate across large distances, sometimes against gravity, to cross multiple anatomical compartments and cause iatrogenic injuries multiple years after an index intervention

scholarly journals Does Mode of Surgical Intervention Based on Oncotype DX Score Influence Disease Recurrence in Early Breast Cancer?

2020 ◽  
Vol 06 (02) ◽  
pp. e135-e138
Author(s):  
T. M. Aherne ◽  
M. R. Boland ◽  
D. Catargiu ◽  
K. Bashar ◽  
T. P. McVeigh ◽  
...  
Keyword(s):  
Breast Cancer ◽  
High Risk ◽  
Early Breast Cancer ◽  
Local Excision ◽  
Wide Local Excision ◽  
Surgical Intervention ◽  
Disease Recurrence ◽  
Low Risk ◽  
Oncotype Dx ◽  
Significant Difference

Abstract Introduction Routine utilization of multigene assays to inform operative decision-making in early breast cancer (EBC) treatment is yet to be established. In this pilot study, we sought to establish the potential benefits of surgical intervention in EBC based on recurrence risk quantification using the Oncotype DX (ODX) assay. Materials and Methods Consecutive ODX tests performed over a 9-year period from October 2007 to May 2016 were evaluated. Oncotype scores were classified into high (≥31), medium (18–30), or low-risk (0–17) groups. The primary outcome was breast cancer recurrence. Subgroup analysis offered assessment of the recurrence effect of mode of surgical intervention for patient groups as defined by the oncotype score. Results In total 361 patients underwent ODX testing. The mean age and follow-up were 55.25 (± 10.58) years and 38.59 (± 29.1) months, respectively. The majority of patients underwent wide local excision (86.7%) with 8.9 and 4.4% patients having a mastectomy or wide local excision with completion mastectomy, respectively. Fifty-one percent of patients fell into the low risk ODX category with a further 40.2 and 8.5% deemed to be of intermediate and high risk. Five patients (1.38%) had disease recurrence. Comparative analysis of operative groups in each oncotype group revealed no difference in recurrence scores in the low- (p = 0.84) and high-risk groups (p = 0.92) with a statistically significant difference identified in the intermediate risk group (p = 0.002). Conclusion To date we have been unable to definitively identify a role for ODX in guiding surgical approach in EBC. There is, however, a need for larger studies to examine this hypothesis.

scholarly journals Wide Local Excision for Dermatofibrosarcoma Protuberans: A Single-Center Series of 90 Patients

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Byung Jun Kim ◽  
Hyeonwoo Kim ◽  
Ung Sik Jin ◽  
Kyung Won Minn ◽  
Hak Chang
Keyword(s):  
Local Recurrence ◽  
Local Excision ◽  
Wide Local Excision ◽  
Safety Margin ◽  
Dermatofibrosarcoma Protuberans ◽  
Low Grade ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Incomplete Removal ◽  
Surgical Methods

Background. Dermatofibrosarcoma protuberans (DFSP), a rare low-grade sarcoma of fibroblast origin, tends to extend in a finger-like fashion beyond macroscopic tumor margins. Therefore, incomplete removal and subsequent recurrence are common. This study aimed to determine the efficacy of wide local excision (WLE) for controlling local recurrence of DFSP.Methods. The medical records of 90 DFSP patients who received WLE at our hospital between June 1992 and January 2015 were retrospectively reviewed. WLE was conducted including a 3 cm (range, 1 to 5 cm) safety margin according to tumor size, location, and recurrence status. Clinical and tumor characteristics and surgical methods were evaluated for risk factor analysis and local recurrence-free survival.Results. DFSP occurred most often in patients in their 30s (30%) and on the trunk (51.1%). Five patients (5.5%) experienced local recurrence during the 43.4-month follow-up period. Recurrence was found at a mean of 10.8 months after WLE. Although no factors were significantly associated with recurrence, recurrences were more frequent in head and neck. Recurrence-free survival was 87% in 6 years and 77% in 7 years.Conclusions. WLE with adequate lateral and deep margins can effectively control local recurrence rate and is a simple and effective method to treat DFSP.

A Comparison Between Oncoplastic Breast Conserving Surgery andStandard Wide Local Excision: A UK Experience

2016 ◽  
Vol 01 (01) ◽  
Author(s):  
Saira Khawaja ◽  
Abrar Saiyed ◽  
Darmiga Thayabaran ◽  
Sujatha Udayasankar ◽  
Joel Dias ◽  
...  
Keyword(s):  
Local Excision ◽  
Wide Local Excision ◽  
Breast Conserving Surgery

Impact of Positive Biopsy Margins and Residual Disease in Wide Local Excision (WLE) on Melanoma Survival: Implications for Management

2020 ◽  
Vol 231 (4) ◽  
pp. e208
Author(s):  
Alex H. Lee ◽  
Elysia Grose ◽  
Heidi Li ◽  
Olivier Brandts-Longtin ◽  
Hao Wang ◽  
...  
Keyword(s):  
Local Excision ◽  
Wide Local Excision ◽  
Residual Disease ◽  
Positive Biopsy

scholarly journals RECURRENT MALIGNANT APOCRINE SWEAT GLAND CARCINOMA - A CASE REPORT

2021 ◽  
pp. 1-2
Author(s):  
AKHILA JANGA ◽  
MOHAMMED ZIAUDDIN ◽  
RAVI CHANDER PATLOLLA
Keyword(s):  
Local Excision ◽  
Wide Local Excision ◽  
Sweat Gland ◽  
Early Stage ◽  
Case Reports ◽  
Case Series ◽  
Biological Behavior ◽  
Sweat Glands ◽  
Second Phase ◽  
Apocrine Carcinoma

Apocrine carcinomas arise from normal or modified sweat glands. The slow-growing nature and rarity of sweat gland carcinomas complicate their diagnosis at the early stage. The incidence of PASGC is quite low at 0.0049–0.0173 cases/100,000 persons/year. A 21-year-old male patient was presented in February 2016 with small solitary mass in the right axilla with mild tenderness and pain. Underwent wide local excision and axillary dissection at our institution followed by adjuvant radio and chemotherapy. Later on, after 18 months developed local recurrence and was planned for re-surgery and a second phase of palliative radiotherapy. After a year, presented to the hospital with pin sized irregular swelling in the axilla. Sweat gland carcinomas which are rarely diagnosed create a pathological dilemma due to their unpredicted biological behavior. However, wide local excision with or without nodal dissection is the primary treatment till date. In this particular case even though patient had underwent axillary node dissection, patient had recurrence twice with no distant metastasis which is a key point to be noted. Thorough study of the available apocrine carcinoma case reports or case series, the better knowledge regarding the apocrine carcinoma can be obtained.

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