Undifferentiated embryonal sarcoma of liver with macroaneurysms and arteriovenous shunt

Undifferentiated embryonal sarcoma (UES) is an uncommon primary hepatic tumour of childhood. The mass usually shows paradoxical features of being cystic on CT and solid on ultrasound. These lesions are usually hypovascular. Very rarely they may present as hypervascular liver masses with macroaneurysms and arteriovenous (AV) shunt, with only less than six cases reported in literature. We report a case of an 11-year-old child who presented with progressive abdominal distention, and CT revealed a large exophytic hypervascular mass of liver with multiple macroaneurysms, pooling of contrast and a high-flow AV shunt. Histopathology, along with immunohistochemistry, revealed the mass to be UES. The child underwent neoadjuvant chemotherapy followed by successful surgery. The prognosis of this tumour depends on prompt diagnosis and early intervention. We present this case to highlight the atypical presentation of UES, which will encourage radiologists to keep this differential in relevant clinical settings.

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Erratum to: A Case of Ruptured Adult Embryonal Sarcoma of the Liver with Excellent Outcome After Neoadjuvant Chemotherapy

Journal of Gastrointestinal Cancer ◽

10.1007/s12029-016-9889-2 ◽

2016 ◽

Vol 48 (1) ◽

pp. 119-119

Author(s):

Saurabh Zanwar ◽

Mahesh Goel ◽

Shraddha Patkar ◽

Anant Ramaswamy ◽

Nitin Shetty ◽

...

Keyword(s):

Neoadjuvant Chemotherapy ◽

Excellent Outcome ◽

Embryonal Sarcoma

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Giant intracranial varices secondary to high-flow arteriovenous fistulae

Journal of Neurosurgery ◽

10.3171/jns.1987.66.2.0198 ◽

1987 ◽

Vol 66 (2) ◽

pp. 198-203 ◽

Cited By ~ 80

Author(s):

Fernando ViñUela ◽

Charles G. Drake ◽

Allan J. Fox ◽

David M. Pelz

Keyword(s):

High Flow ◽

Vein Of Galen ◽

Arteriovenous Fistulae ◽

Content Type ◽

Av Fistula ◽

Intracerebral Bleeding ◽

Endovascular Occlusion ◽

Av Shunt ◽

Fine Print

✓ An intracranial varix is rare and has been associated mostly with vein of Galen fistulae or arteriovenous (AV) malformations. The authors present eight cases of intracranial, pial or subpial AV fistulae with concomitant giant varices. Six were supratentorial and two were infratentorial. Only one case involved the vein of Galen. In six cases successful surgical and/or endovascular occlusion of the intracranial AV fistula was obtained, and one case was treated conservatively. Staging of surgery and postoperative hypotension were considered to be important in avoiding edema and hemorrhage following obliteration of a large AV shunt. One patient died from delayed postoperative intracerebral bleeding.

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Undifferentiated embryonal sarcoma masquerading as liver abscess: A case report with typical imaging features

South African Journal of Radiology ◽

10.4102/sajr.v25i1.2179 ◽

2021 ◽

Vol 25 (1) ◽

Author(s):

Ranjan K. Patel ◽

Swasti Pathak

Keyword(s):

Magnetic Resonance Imaging ◽

Computed Tomography ◽

Abdominal Pain ◽

Case Report ◽

Magnetic Resonance ◽

Liver Abscess ◽

Imaging Features ◽

Resonance Imaging ◽

Hepatic Tumour ◽

Embryonal Sarcoma

Undifferentiated embryonal sarcoma (UES) is an uncommon paediatric hepatic tumour that clinically simulates a liver abscess when present with fever. This report describes a case of UES in a 12-year-old boy, who presented with abdominal pain, swelling and fever, all simulating a liver abscess. The possibility of UES was considered at imaging, based on the solid appearance on ultrasound and cystic appearance with serpiginous peripheral vessels on computed tomography/magnetic resonance imaging. The diagnosis was confirmed at histopathology.

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Atypical presentation of adenosquamous carcinoma: A case report

SAGE Open Medical Case Reports ◽

10.1177/2050313x18801217 ◽

2018 ◽

Vol 6 ◽

pp. 2050313X1880121

Author(s):

Annie Genois ◽

Catherine Maari ◽

Danielle Bouffard

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Clinical Presentation ◽

Adenosquamous Carcinoma ◽

Malignant Neoplasm ◽

Atypical Presentation ◽

Rare Tumour ◽

The Past ◽

Prompt Diagnosis

Cutaneous adenosquamous carcinoma is a rare malignant neoplasm that is more aggressive than conventional squamous cell carcinoma. The typical clinical presentation is an indurated papule or plaque on the head and neck of elderly patients. The authors report the case of a 52-year-old man with a right scrotal and inguinal tumour measuring 10 cm × 15 cm that had progressed over the past 2 years. The histological examination was compatible with adenosquamous carcinoma. Metastatic inguinal and pelvic lymph nodes were identified. This case demonstrates an atypical presentation of a rare tumour. Adenosquamous carcinoma is more aggressive than conventional squamous cell carcinoma, and prompt diagnosis is important.

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A Case of Ruptured Adult Embryonal Sarcoma of the Liver with Excellent Outcome After Neoadjuvant Chemotherapy

Journal of Gastrointestinal Cancer ◽

10.1007/s12029-016-9877-6 ◽

2016 ◽

Vol 48 (1) ◽

pp. 100-102 ◽

Cited By ~ 2

Author(s):

Saurabh Zanwar ◽

Mahesh Goel ◽

Shraddha Patkar ◽

Anant Ramaswamy ◽

Nitin Shetty ◽

...

Keyword(s):

Neoadjuvant Chemotherapy ◽

Excellent Outcome ◽

Embryonal Sarcoma

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Spontaneous Rupture of the Spleen Masquerading as a Pulmonary Infection

Case Reports in Surgery ◽

10.1155/2014/196525 ◽

2014 ◽

Vol 2014 ◽

pp. 1-3

Author(s):

Dimitrios Anyfantakis ◽

Miltiades Kastanakis ◽

Paraskevi Karona ◽

Giorgios Fragiadakis ◽

Ioannis Kokkinos ◽

...

Keyword(s):

Pulmonary Infection ◽

Splenic Rupture ◽

Atypical Presentation ◽

Thoracic Pain ◽

Normal Spleen ◽

Clinical Phenomenon ◽

Abdominal Examination ◽

Rupture Of The Spleen ◽

Prompt Diagnosis ◽

Main Factor

Atraumatic rupture of a normal spleen represents a rare clinical phenomenon. We report on an atypical presentation of a spontaneous splenic rupture in a 44-year-old previously healthy Greek male admitted to the emergency department due to left-sided pleuritic thoracic pain in the course of a pneumonia diagnosed 2 days before. During his stay, pain extended to the epigastric region. Abdominal examination revealed generalized tenderness. We presume that coughing secondary to respiratory infection was the main factor that precipitated splenic rupture. Despite the rarity of the condition physicians have to consider the diagnosis of spontaneous nontraumatic splenic rupture when they encounter healthy patients with nonspecific lower thoracic or abdominal pain. Prompt diagnosis is essential for a better outcome.

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A novel LC system embeds analytes in pre-formed gradients for rapid, ultra-robust proteomics

10.1101/323048 ◽

2018 ◽

Cited By ~ 2

Author(s):

Nicolai Bache ◽

Philipp E. Geyer ◽

Dorte B. Bekker-Jensen ◽

Ole Hoerning ◽

Lasse Falkenby ◽

...

Keyword(s):

Mass Spectrometry ◽

High Pressure ◽

Small Molecules ◽

High Throughput ◽

High Flow ◽

Clinical Settings ◽

High Pressure Pump ◽

High Throughput Manner ◽

New System ◽

Long Storage

ABSTRACTTo further integrate mass spectrometry (MS)-based proteomics into biomedical research and especially into clinical settings, high throughput and robustness are essential requirements. They are largely met in high-flow rate chromatographic systems for small molecules but these are not sufficiently sensitive for proteomics applications. Here we describe a new concept that delivers on these requirements while maintaining the sensitivity of current nano-flow LC systems. Low-pressure pumps elute the sample from a disposable trap column, simultaneously forming a chromatographic gradient that is stored in a long storage loop. An auxiliary gradient creates an offset, ensuring the re-focusing of the peptides before the separation on the analytical column by a single high-pressure pump. This simplified design enables robust operation over thousands of sample injections. Furthermore, the steps between injections are performed in parallel, reducing overhead time to a few minutes and allowing analysis of more than 200 samples per day. From fractionated HeLa cell lysates, deep proteomes covering more than 130,000 sequence unique peptides and close to 10,000 proteins were rapidly acquired. Using this data as a library, we demonstrate quantitation of 5200 proteins in only 21 min. Thus, the new system-termed Evosep One-analyzes samples in an extremely robust and high throughput manner, without sacrificing in depth proteomics coverage.

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Workplace Exposures

Clinics in Colon and Rectal Surgery ◽

10.1055/s-0039-1693010 ◽

2019 ◽

Vol 32 (06) ◽

pp. 435-441

Author(s):

Janet T. Lee ◽

Wolfgang B. Gaertner

Keyword(s):

Early Intervention ◽

Colorectal Surgery ◽

Clinical Settings ◽

Infectious Agents ◽

Workplace Exposure ◽

Colorectal Surgeons ◽

Common Device

AbstractWorkplace exposure in colorectal surgery is unique compared with other surgical specialties and generally underreported. Although the most common device-associated exposure in surgery is suture needle injury, colorectal surgeons are increasingly exposed to gastrointestinal-related infectious agents, radiation, and other hazards in multiple different clinical settings. Highlighting the unique workplace exposures in colorectal surgery may help increase awareness, improve education, and identify possible targets for early intervention in order to minimize these risks.

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Report of a feasibility study of a Mindfulness group for clients, carers and staff of an early intervention in psychosis service

The Cognitive Behaviour Therapist ◽

10.1017/s1754470x13000019 ◽

2012 ◽

Vol 5 (4) ◽

pp. 93-101 ◽

Cited By ~ 7

Author(s):

S. Moorhead

Keyword(s):

Mental Health ◽

Early Intervention ◽

Mindfulness Meditation ◽

Clinical Settings ◽

Clinical Team ◽

Mixed Group ◽

Team Members ◽

Before And After ◽

Health Promoting ◽

Early Intervention In Psychosis

AbstractMindfulness meditation is developing momentum as a mental health promoting activity in clinical and non-clinical settings. Our Early Intervention in Psychosis (EIP) service wished to determine its acceptability and utility among a mixed group of participants. All clinical team members, their patients and their carers were offered an 8-week Mindfulness group. Participants rated acceptability before and after. They prospectively identified, then monitored, distress associated with areas of their lives they hoped might improve. Nineteen participants provided a mean attendance of 11.25 per group. The group was overwhelmingly positively perceived and distress associated with participants’ items significantly improved. Findings support further implementation. The goal of inclusion was achieved with some reservation about staff preparation.

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Long-term treatment outcome of venous-predominant arteriovenous malformation

Journal of Neurosurgery ◽

10.3171/2015.4.jns142475 ◽

2016 ◽

Vol 124 (4) ◽

pp. 1100-1106 ◽

Cited By ~ 4

Author(s):

Jin Pyeong Jeon ◽

Jeong Eun Kim ◽

Jun Hyong Ahn ◽

Won-Sang Cho ◽

Young Dae Cho ◽

...

Keyword(s):

Conservative Treatment ◽

Arteriovenous Malformation ◽

Treatment Strategies ◽

High Flow ◽

Low Flow ◽

Asymptomatic Patients ◽

Long Term Treatment ◽

Av Shunt

OBJECT Treatment strategies for venous-predominant arteriovenous malformation (vp-AVM) remain unclear due to the limited number of cases and a lack of long-term outcomes. The purpose of this study was to report the authors’ experience with treatment outcomes with a review of the pertinent literature in patients with vp-AVM. METHODS Medical and radiological data from 1998 to 2011 were retrospectively evaluated. The degree of the arteriovenous (AV) shunt was categorized into 2 groups, a high- and low-flow AV shunt based on the angiographic findings. RESULTS Sixteen patients with a mean age of 45.3 years (range 16–78 years) and a mean follow-up of 79.9 months (range 25–264 months) were examined. Symptomatic lesions were noted in 13 patients: intracranial hemorrhage (ICH) in 9, seizure in 1, and headache in 3. A high-flow shunt was observed on angiography in 13 patients. Among these 13 patients, 12 patients were symptomatic. Nine patients presenting with ICH underwent hematoma removal with additional Gamma Knife surgery (GKS; n = 4), GKS only (n = 2), or conservative treatment (n = 3). The 3 asymptomatic patients received conservative treatment, and 1 rebleeding episode was observed. Seven of 8 patients who underwent GKS as an initial or secondary treatment modality experienced a marked reduction in the AV shunt on follow-up angiography, but complete obliteration was not observed. CONCLUSIONS Poor lesion localization makes a vp-AVM challenging to treat. Symptomatic patients with a high-flow shunt are supposedly best treated with GKS, despite the fact that only 87.5% of the vp-AVMs treated this way showed a reduction in the malformation volume, and none were cured.

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