Unexpected Leiomyosarcoma 4 Years after Laparoscopic Removal of the Uterus Using Morcellation

Background. Laparoscopic hysterectomies are increasingly popular; a morcellation device is often used. Although there are some clear benefits, morcellation of tissue does have potential risks.Case Presentation. In this case report we present a 55-year-old woman with an abdominal tumour 4 years after a laparoscopic hysterectomy using a morcellation device. Postoperative histological analysis, compromised by morcellated tissue, showed benign myoma. Because of the benign tumour no follow-up was performed. The patient presented now with an abdominal tumour, and she was scheduled for surgical removal of the tumour. During abdominal surgery the tumour appeared malignant and biopsies were taken. Histological analysis showed leiomyosarcoma, and the patient was referred to a third care centre for further treatment. The patient recovered quickly after abdominal removal of the tumour; however, after 7 months the patient had complaints and a CT scan showed a large intra-abdominal tumour with possible lung metastasis. The patient received palliative chemotherapy and died after 10 months.Conclusion. This case shows that although unexpected after a hysterectomy, a leiomyosarcoma has to be considered in case of a suspect tumour in the lower abdomen.

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Benign notochordal cell tumor of the clivus with chordoma component: report of 2 cases

Journal of Neurosurgery ◽

10.3171/2019.6.jns19529 ◽

2020 ◽

Vol 133 (5) ◽

pp. 1355-1359

Author(s):

Maria Peris-Celda ◽

Laura Salgado-Lopez ◽

Carrie Y. Inwards ◽

Aditya Raghunathan ◽

Carrie M. Carr ◽

...

Keyword(s):

Histological Analysis ◽

Cell Tumor ◽

Surgical Removal ◽

Anatomical Site ◽

Adjuvant Radiation ◽

Resonance Imaging ◽

Adjuvant Radiation Therapy ◽

Notochordal Cell ◽

Transsphenoidal Resection

Benign notochordal cell tumors (BNCTs) are considered to be benign intraosseous lesions of notochord origin; however, recent spine studies have suggested the possibility that some chordomas arise from BNCTs. Here, the authors describe two cases demonstrating histological features of BNCT and concomitant chordoma involving the clivus, which, to the best of the authors’ knowledge, have not been previously documented at this anatomical site.An 18-year-old female presented with an incidentally discovered clival mass. Magnetic resonance imaging revealed a 2.8-cm nonenhancing lesion in the upper clivus that was T2 hyperintense and T1 hypointense. She underwent an uneventful endoscopic transsphenoidal resection. Histologically, the tumor demonstrated areas of classic chordoma and a distinct intraosseous BNCT component. The patient completed adjuvant radiation therapy. Follow-up showed no recurrence at 18 months.A 39-year-old male presented with an incidentally discovered 2.8-cm clival lesion. The nonenhancing mass was T2 hyperintense and T1 hypointense. Surgical removal of the lesion was performed through an endoscopic transsphenoidal approach. Histological analysis revealed areas of BNCT with typical features of chordoma. Follow-up did not demonstrate recurrence at 4 years.These cases document histologically concomitant BNCT and chordoma involving the clivus, suggesting that the BNCT component may be a precursor of chordoma.

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Intracardic migration of Kirschner wire from the right sternoclavicular joint: a case report

BMC Surgery ◽

10.1186/s12893-021-01292-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Peng Wang ◽

Cong Chen ◽

Bo Liu ◽

Xiaokang Wang ◽

Wei Jiang ◽

...

Keyword(s):

Chest Pain ◽

Emergency Service ◽

Kirschner Wire ◽

Median Sternotomy ◽

Sternoclavicular Joint ◽

Case Presentation ◽

Potential Risks ◽

And Migration ◽

The Right

Abstract Background Migration of wires and pins within the heart is an uncommon complication. Intracardic migration of Kirschner wire can cause several complications. Case presentation A 55-year-old male patient was admitted to the emergency service with dyspnea, stabbing chest pain. The patient’s medical history showed that he had undergone a fixation operation using Kirschner wire and plate for treatment of the right sternoclavicular joint dislocation about 5 months prior. Chest computerized tomography revealed a metallic foreign body locating in the pericardium between the aorta and the right ventricle. There were not any serious complications occurred before operation due to the timely detection of potential risks. Removal of the wire was performed via median sternotomy under general anesthesia without cardiopulmonary bypass. The symptoms of dyspnea and chest pain were relieved after surgery, and the patient recovered without any complications. Conclusion The Kirschner wire should be used judiciously in amphiarthrosis in orthopedic surgery for the risk of breakage and migration. The possibility of intracardiac migration of wire should be considered when chest symptoms presenting after surgery with the Kirschner wire. Migrated wires must be removed immediately to prevent serious complications. Regular follow-up and early removal of fixation wires are recommended to prevent migration of wires.

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Re-TEVAR in treatment of stent graft-induced new entry between two non-overlapping stent-grafts: a case report

Journal of Cardiothoracic Surgery ◽

10.1186/s13019-020-01359-w ◽

2020 ◽

Vol 15 (1) ◽

Author(s):

Yiwei He ◽

Shoujun Tang ◽

Yongheng Zhang ◽

Jianping Liu ◽

Haining Zhou

Keyword(s):

Stent Graft ◽

Early Period ◽

Aortic Disease ◽

Sudden Onset ◽

Stent Grafts ◽

Short Term ◽

Case Presentation ◽

Potential Risks ◽

New Entry

Abstract Background Progress of the aortic disease after the stent graft treatment of aortic dissection implicates the potential risks of stent graft-induced new entry (SINE). Although rarely reported, it should be vigilant in patients who might incur serious complication in early period after the thoracic endovascular aortic repair (TEVAR). Thus, the development of aortic disease-specific stent grafts would assist in achieving positive patient outcomes when suffering SINE. However, it is an extremely rare for SINE between two non-overlapping stent-grafts. Case presentation We here reported a 59-year-old male patient with sudden onset of chest pain for 4 h. Multi-detector computed tomography (MDCT) revealed a huge SINE formed between two non-overlapping stent-grafts. The re-TEVAR surgery was performed and the patient experienced a good recovery. Conclusion The SINE between two non-overlapping stent-grafts treated by re-TEVAR operation was alternative and feasible. The short-term and medium-term follow-up results were satisfactory.

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Vulvodynia Treated Successfully with Breathing Biofeedback and Integrated Stress Reduction: A Case Report

Biofeedback ◽

10.5298/1081-5937-43.2.04 ◽

2015 ◽

Vol 43 (2) ◽

pp. 94-100 ◽

Cited By ~ 2

Author(s):

Erik Peper ◽

Pamela Martinez Aranda ◽

Donald Moss

Keyword(s):

Case Report ◽

Stress Reduction ◽

Surgical Removal ◽

Self Healing ◽

Lower Abdomen ◽

Diaphragmatic Breathing ◽

Treatment Interventions ◽

Pain And Suffering

Millions of women experience substantial pain and suffering from vulvodynia, which is pain around the entrance to the vagina (vulva). A common treatment is surgical removal of the tissue (vestibulectomy). This case report describes the detailed process of a holistic biofeedback-based intervention that successfully resolved the vulvodynia in a 23-year-old woman. The four-session treatment interventions included teaching diaphragmatic breathing to transform shallow thoracic breathing into slower diaphragmatic breathing. Treatment transformed her feeling of powerlessness, a belief that there was nothing she could do, into empowerment and a hope that she could reduce her symptoms and optimize her health. She also practiced self-healing imagery and learned to change her posture from collapsed to erect/empowered. Each time she felt discomfort or was fearful, her lower abdomen tended to tighten. After treatment, she used this sensation as a reminder to breathe lower and slower and sit or stand erect. After 6 weeks, she once again could initiate and enjoy intercourse and has been symptom free during the 8 month follow-up.

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Intramedullary Teratoma: Case Report and Review of the Literature

Tumori Journal ◽

10.1177/030089169608200622 ◽

1996 ◽

Vol 82 (6) ◽

pp. 616-620 ◽

Cited By ~ 18

Author(s):

Riccardo Caruso ◽

Mariano Antonelli ◽

Luigi Cervoni ◽

Maurizio Salvati

Keyword(s):

Case Report ◽

Surgical Removal ◽

International Literature ◽

Review Of The Literature ◽

Personal Case

Aims and Background Intramedullary teratoma is an extremely exceptional tumor (5 cases), although a careful review of international literature has shown it to be more frequent (32 cases) than believed. Methods The authors present a personal case with some unusual aspects. Results Our case is unusual not only because it was diagnosed by MRI (only one case has been reported in the literature) but also because surgical removal of the tumor was apparently total (only 4 other cases have been described), with a long follow-up period (4.5 years) and excellent results, in clinical and neuroradiologic terms.

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Spontaneous haemorrhage of an adrenal angiomyolipoma: case report

African Journal of Urology ◽

10.1186/s12301-019-0006-1 ◽

2019 ◽

Vol 25 (1) ◽

Author(s):

Danielle Whiting ◽

Ian Rudd ◽

Amit Goel ◽

Seshadri Sriprasad ◽

Sanjeev Madaan

Keyword(s):

Case Reports ◽

Case Presentation ◽

Open Adrenalectomy ◽

Large Size ◽

History Of ◽

Loin Pain ◽

Benign Tumours ◽

Spontaneous Haemorrhage ◽

Mesenchymal Tumours

Abstract Background Angiomyolipomas are rare mesenchymal tumours arising from the perivascular epithelioid cells consisting of variable amounts of adipose, thick-walled blood vessels and smooth muscle cells. These benign tumours commonly occur in the kidney with only a few case reports of adrenal angiomyolipomas which have the potential to reach a large size and haemorrhage. Case presentation A 45-year-old lady presented with a 3-week history of right loin pain, nausea and vomiting. A CT scan revealed a right adrenal angiomyolipoma measuring 6.3 × 6.8 cm with associated haemorrhage. The lesion was successfully treated with right open adrenalectomy, and histology confirmed the diagnosis of adrenal angiomyolipoma. The patient remained well with no evidence of recurrence at the 36-month follow-up. Conclusion Adrenal angiomyolipomas are rare benign tumours that have the ability to reach a large size and potential to bleed. Here, we report the second case of spontaneous haemorrhage in an adrenal angiomyolipoma, which was successfully treated with open adrenalectomy.

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Fourth Ventricle Outlet Obstruction and Diverticular Enlargement of Luschka Foramina in a Child with Down Syndrome

Pediatric Neurosurgery ◽

10.1159/000511088 ◽

2020 ◽

pp. 1-4

Author(s):

Valentina Orlando ◽

Pietro Spennato ◽

Maria De Liso ◽

Vincenzo Trischitta ◽

Alessia Imperato ◽

...

Keyword(s):

Down Syndrome ◽

Fourth Ventricle ◽

Endoscopic Third Ventriculostomy ◽

Obstructive Hydrocephalus ◽

Radiological Finding ◽

Outlet Obstruction ◽

Third Ventriculostomy ◽

Viable Option ◽

Case Presentation

Introduction: Hydrocephalus is not usually part of Down syndrome (DS). Fourth ventricle outlet obstruction is a rare cause of obstructive hydrocephalus, difficult to diagnose, because tetraventricular dilatation may suggest a communicant/nonobstructive hydrocephalus. Case Presentation: We describe the case of a 6-year-old boy with obstructive tetraventricular hydrocephalus, caused by Luschka and Magendie foramina obstruction and diverticular enlargement of Luschka foramina (the so-called fourth ventricle outlet obstruction) associated with DS. He was treated with endoscopic third ventriculostomy (ETV) without complications, and a follow-up MRI revealed reduction of the ventricles, disappearance of the diverticula, and patency of the ventriculostomy. Conclusion: Diverticular enlargement of Luschka foramina is an important radiological finding for obstructive tetraventricular hydrocephalus. ETV is a viable option in tetraventricular obstructive hydrocephalus in DS.

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Laparoscopic Resection of Renal Capsular Endometriosis in a Woman with Menstrual-Related Flank Pain: Case Report

African Journal of Urology ◽

10.1186/s12301-021-00186-2 ◽

2021 ◽

Vol 27 (1) ◽

Author(s):

Abbas Basiri ◽

Iman Ghanaat ◽

Hamidreza Akbari Gilani

Keyword(s):

Flank Pain ◽

Pathological Examination ◽

Histologic Evaluation ◽

Normal Renal Parenchyma ◽

Perinephric Space ◽

Superior Portion ◽

The Right ◽

First Time ◽

Laparoscopic Removal

Abstract Background Although involvement of the urinary system is not uncommon, endometriosis in the kidneys is rare. To date, laparoscopic partial nephrectomy has been the preferred approach for managing renal endometriosis. Here, we report for the first time the results of laparoscopic removal of a renal capsular endometriosis in a malrotated kidney in an attempt to save the whole kidney parenchyma, in terms of feasibility and safety. Case presentation A 37-year-old female presented with periodic right flank pain associated with her menstrual cycle. On imaging, a malrotated right kidney and a hypodense irregular-shaped lesion measuring 30 * 20 * 15 mm were seen in the superior portion of the right perinephric space. Histologic evaluation of the ultrasound-guided biopsy was consistent with renal capsular endometriosis. The patient underwent laparoscopic surgery to remove the capsular mass while preserving the normal renal parenchyma. Pathological examination of the biopsy obtained during surgery was in favor of renal endometriosis. At 6-month follow-up, the patient’s pain had completely disappeared and no complications had occurred. In addition, imaging did not show any remarkable recurrence. Conclusion Renal endometriosis should be strongly considered as a differential diagnosis in female patients with a renal capsular mass and exacerbation of flank pain during menstruation. Based on our experience, with preoperative needle biopsy and clearing the pathology, laparoscopic removal of the mass in spite of renal anatomic abnormality is feasible and safe and thus could be considered as a possible treatment option.

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Bladder hamartoma in Peutz-Jeghers syndrome: a rare case report

African Journal of Urology ◽

10.1186/s12301-021-00172-8 ◽

2021 ◽

Vol 27 (1) ◽

Author(s):

Jai Kumar ◽

Mohammad Irfaan Albeerdy ◽

Nadeem Ahmed Shaikh ◽

Abdul Hafeez Qureshi

Keyword(s):

Urinary Bladder ◽

Filling Defect ◽

Hamartomatous Polyps ◽

Case Presentation ◽

Rare Case Report ◽

Mucocutaneous Pigmentation ◽

Dominant Disease ◽

Peutz Jeghers Syndrome ◽

Comprehensive Compilation

Abstract Background Peutz-Jeghers syndrome is an autosomal dominant disease characterized by mucocutaneous pigmentation and hamartomatous polyps in the gastrointestinal tract (GIT). There have also been cases of extra GIT polyps such as the renal pelvis, urinary bladder, lungs and nares. Bladder hamartoma is an extremely rare finding, with only 12 cases described in the literature up to now. The rarity of the condition necessitates a comprehensive compilation of managements up to now so as to provide a better tool for the treatment of such conditions in the future. Case presentation A twenty-year-old male, known to have Peutz-Jeghers syndrome, presented to us complaining of obstructive urinary symptoms. A urethrogram done showed a filling defect at the base of the urinary bladder. The mass was resected transurethrally, and histopathology revealed a hamartoma of the bladder. The patient has since remained tumor-free on follow-up. Conclusions Transurethral resection of the bladder mass proved to be an effective therapy in this patient with no recurrence on the patient’s follow-up till now. There is still, however, a dearth of knowledge regarding the management of bladder hamartomas owing to the extreme rarity of the case.

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Duodenal adenocarcinoma with skin metastasis as initial manifestation: A case report

Open Life Sciences ◽

10.1515/biol-2021-0029 ◽

2021 ◽

Vol 16 (1) ◽

pp. 395-398

Author(s):

Yixiao Fu ◽

Cuiping Zheng ◽

Jian Huang ◽

Shenghao Wu ◽

Yanyan Dai

Keyword(s):

Oral Treatment ◽

Duodenal Biopsy ◽

Skin Metastasis ◽

Metastatic Adenocarcinoma ◽

Duodenal Adenocarcinoma ◽

Initial Manifestation ◽

Case Presentation ◽

Replacement Treatment ◽

Lost To Follow Up

Abstract Background Duodenal adenocarcinoma (DA) with skin metastasis as initial manifestation is clinically rare. In this study, we report a rare case of skin metastasis of DA. Case presentation An 84-year-old male patient developed multiple ecchymoses on the trunk and lower extremities. Physical examination showed that the ecchymosis was dark red and had a hard texture, but showed no bulging, rupture, or tenderness. The skin biopsy implied skin metastatic adenocarcinoma. After an endoscopic duodenal biopsy, the patient was finally diagnosed with DA with skin metastasis. The patient received two courses of oral treatment of Tegafur (40 mg, bid d1–d14). However, the patient stopped taking Tegafur because of its poor effect and received Chinese medicine as a replacement treatment. Unfortunately, he was lost to follow-up. Conclusions Early diagnosis of DA metastasis is of significant importance as prognosis of these patients is poor.

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