scholarly journals Solid Pseudopapillary Neoplasms Are Rare, Indolent Pancreatic Tumors in Young Women

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Amin Dalili ◽  
Mohsen Aliakbarian ◽  
Mehdi Karimi-Shahri ◽  
Alireza Samadi ◽  
Sara Raji

Introduction. Solid pseudopapillary neoplasm (SPN) is a rare and indolent pancreatic tumor with low malignant potential which frequently occurs in reproductive-age females. Complete resection is almost always the curative option. Case Presentation. We present a 20-year-old woman with acute epigastric pain and vomiting in multiple episodes. Abdominal ultrasound showed a hypoechoic lesion with the probable source in the pancreas. Following that, CT scans and Endoscopic Ultrasound (EUS) manifested a 9 × 7.5   cm -sized hypodense mass with heterogeneous well-defined margins in the pancreas suggesting the diagnosis of SPN. Whipple’s procedure was performed. Histopathological examination and immunohistochemistry confirmed SPN without evidence of malignancy. Discussion. SPN is known as a tumor with a favorable prognosis and a long survival rate after complete resection. However, some literature focused on minimally invasive surgery as an alternative surgical approach.

2021 ◽  
Author(s):  
Ze Liang ◽  
Jingzhao Han ◽  
Hongfang Tuo ◽  
Dongdong Xue ◽  
Hanxiang Yu ◽  
...  

Abstract BackgroundPrimary undifferentiated pleomorphic sarcoma (UPS) of the pancreas is an exceedingly rare malignant tumor, with only 15 cases have been reported in the medical literature. At present, clinicians have poor recognition of the tumor, the epidemiology, diagnosis and treatment of this disease have yet not been established. Case presentationIn this report, we depict the clinical and imaging characteristics of a 37-year-old man presenting with a primarily cystic UPS. The patient complained of epigastric pain and distention over 20 days. Abdominal CT and pancreatic magnetic resonance imaging revealed cystic and cystic solid masses in the pancreatic body and tail. An abdominal ultrasound echogram revealed the mass in the body of the pancreas to be cystic with separation echo inside, and the wall was thick, not smooth. Besides, a hypoechoic mass was seen in the tail area of the pancreas with an inhomogeneous echoic pattern, containing small patches of no echo zone in the central. Microscopically, spindle fibroblast-like cells are arranged in a characteristic storiform pattern with pleomorphic and multinucleated cells. Immunohistochemically, tumor cells were positive for CD68 and vimentin. Seven months postoperatively, he was diagnosed with pulmonary lymph node metastasis and died five months later. Combined with this case report, we also reviewed the literature regarding UPS of the pancreas. ConclusionsAs we know, this is the first report on ultrasonography findings of pancreatic UPS. Despite there are no distinctive manifestation of UPS, a solid cystic lesion on ultrasonography or a hypodense area in the lesion on T2-weighted imaging, should be considered for differential diagnosis with pancreatic UPS. We believe this article may add some ideas into the diagnosis and therapy of patients with this tumor.


Author(s):  
Qingyun Liu ◽  
Zhenhua Huang ◽  
Sihai Gao

Background: Synovial sarcoma is a rare soft-tissue malignant tumor most commonly occurring in the extremities and head and neck region, and rarely occurring in the pericardium. Case presentation: We report a 7-year-old boy was admitted to the hospital with recurrent fever and chest pain over the past four months. A cardiac magnetic resonance imaging (MRI) revealed a tumor beneath the heart in the pericardial, and we surgical resection it completely. The postoperative histopathological examination resulted in a diagnosis of monophasic spindle cell type synovial sarcoma. After two weeks of hospitalization, the patient was discharged. Three months after discharge, the positron emission tomography (PET/CT) scans did not show any signs of recurrence. Conclusion: Pericardial synovial sarcoma is a rare disease that is detected early, and complete resection improves patient survival. We recommend CT be performed in patients with recurrent fever and sizeable pericardial effusion to rule out possible pericardial synovial sarcoma considering the echocardiography limitations.


2016 ◽  
pp. 41-45
Author(s):  
V.N. Goncharenko ◽  

The aim of the study: was improvement of results of surgical treatment of patients of reproductive age eligibility with hyperplastic processes of endometrium (HPE) through the introduction of individualized treatment algorithm with the use of monopolar radio wave and hysteroscopic endometrial ablation. Materials and methods. The study included 62 women with non-atypical form of hyperplasia of the endometrium who were treated at the Center of General gynecology of the clinical hospital «Feofania», gynecological Department at the city maternity hospital № 3 of Kyiv. Depending on the age group, nature of the pathological process and method of treatment is randomized, the distribution of women according to groups: group 1 – 41 women's reproductive eligibility age netipichnaya forms of endometrial hyperplasia (PHEBA and KGEB), who were subjected to hysteroscopic monopolar endometrial ablation; group 2 – 21 female reproductive eligibility age netipichnaya forms of endometrial hyperplasia (PHEBA and KGEB), which was held radiowave ablation of the endometrium (RHAE). In the 1st group the age of patients ranged from 42 to 54 years, mean age was 49.9±4.7 years. In the 2nd group the age of patients ranged from 41 to 53 years, mean age of 51.6±4.3 years. Results. A comparative analysis of the techniques for hysteroscopic monopolar ablation and RHEE showed the fact that for RHEE used local anesthesia, while carrying out hysteroscopic monopolar ablation was necessary intravenous anesthesia. The duration of the hysteroscopic monopolar endometrial ablation was 28.6±5.5 min, RAE – according to the standard method – 44.3±0.3 min. When performing hysteroscopic monopolar endometrial ablation in 2 patients (3.7%) patients observed the signs of intravasation of fluid, increased blood pressure and tachycardia. This syndrome was successfully docked, but in the future, women have conducted a thorough examination. When you run RHAE intraoperative complications have been identified. Conclusion. 1. Women with netipichnaya forms of endometrial hyperplasia eligibility and late reproductive age who do not have reproductive plans as an alternative to hysterectomy, in the presence of contraindications or ineffectiveness of hormone treatment may be recommended or radiowave monopolar hysteroscopic ablation of the endometrium. 2. Monopolar hysteroscopic endometrial ablation is indicated for women with netipichnaya forms of endometrial hyperplasia, can be used in the presence of submucous form of uterine fibroids, postoperative scars on the uterus, but in the absence of adenomyosis II–III degree. The effectiveness of monopolar hysteroscopic endometrial ablation in women with non-atypical form of hyperplasia of the endometrium is 87.8%. 3. Women after endometrial ablation should be under observation for two years. The method of choice for dynamic monitoring of the condition of the uterus in women who underwent endometrial ablation is transvaginal ultrasound which should be performed after 1, 3, 6, 12 and 24 months of follow up. 4. In case of recurrence of hyperplastic process of the endometrium (bleeding, thickening of the M-mode echo according to the ultrasound) shows a hysteroscopy with a mandatory histopathological examination and verification of the diagnosis. Key words: endometrial hyperplasia, women eligibility age, women of reproductive age, ablation of the endometrium.


2021 ◽  
pp. 014556132110039
Author(s):  
Jelena Sotirović ◽  
Ljubomir Pavićević ◽  
Stanko Petrović ◽  
Saša Ristić ◽  
Aleksandar Perić

Differential diagnosis of globus sensation in an otherwise asymptomatic patient should include hypopharyngeal fibrovascular polyp to avoid potentially fatal complications like airway compromise following regurgitation. We present a case of a 74-year-old man with a 13-cm long hypopharyngeal fibrovascular polyp with 9 months history of globus sensation. A narrow stalk of the giant polyp allowed endoscopic removal and complete resection with the CO2 laser. Histopathological examination was conclusive for the fibrovascular polyp.


2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Silvia Pavone ◽  
Roberto Rinoldo ◽  
Elisa Albini ◽  
Alessandro Fiorucci ◽  
Biagio Caponi ◽  
...  

Abstract Background Comamonas kerstersii is rarely associated with infections in humans and has never been reported in animals until now. Case presentation Herein, we describe a case of urinary tract infection caused by C. kerstersii in a young goat. A seven-month-old male goat showed lethargy, generalised weakness and anorexia and in the last hours before its death, severe depression, slight abdominal distention, ruminal stasis, and sternal recumbency. Grossly, multifocal haemorrhages in different organs and tissues, subcutaneous oedema and hydrocele, serous fluid with scattered fibrin deposition on the serosa of the abdominal organs and severe pyelonephritis with multifocal renal infarction were detected. Histopathological examination confirmed severe chronic active pyelonephritis with renal infarcts, multi-organ vasculitis and thrombosis suggestive of an infectious diseases of bacterial origin. The bacterium was identified using routine methods, matrix assisted laser desorption/ionisation time-of-flight mass spectrometry (MALDI-TOF-MS), and sequencing of the gyrB gene. Conclusions To the best of our knowledge, this is the first report of C. kerstersii infection in animals (goat). Our findings support the possibility of C. kerstersii isolation from extraintestinal sites and suggest this organism as a possible cause of urinary tract infection.


2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S77-S77
Author(s):  
N C Jadhav ◽  
D L Gang

Abstract Casestudy: Pancreatic neuroendocrine neoplasms (PanNEN) are rare accounting for 2-5% of pancreatic tumors. Although mostly sporadic, 10-20% are associated with inherited syndromes, notably MEN-1, Von Hippel- Lindau disease, neurofibromatosis type 1, and tuberous sclerosis (TS). When compared to sporadic cases, PanNEN in hereditary syndromes occur at a younger age, are often multifocal, cystic, and may show characteristic microscopic patterns. TS is an autosomal dominant multi-system disorder with mutations involving TSC1 or TSC2 genes which function as tumor suppressors by inhibiting mTORC1 kinase. PanNEN is observed in 1.5-1.8% of patients with TS and no surveillance guidelines for the assessment of pancreatic lesions are established. Compared to other syndromes, PanNEN associated with TS are solitary. To our knowledge, only two cases of multifocal PanNEN in TS patients have been reported. We present a case of a 67-year-old gentleman with a history of TS also affecting two daughters. He presented to the emergency department with severe abdominal pain. Abdominal ultrasound suggested acute appendicitis and an incidental 2.0 cm solid lesion was noted in the head of the pancreas. Follow-up MRI revealed two additional non-cystic masses in the pancreatic tail. Endoscopic ultrasound-guided biopsy of a tail lesion revealed monomorphic tumor cells with stippled chromatin without cytologic atypia. Immunohistochemical staining was positive for synaptophysin and chromogranin. Ki-67 labelling index was under 1%. Diagnosis of a well-differentiated neuroendocrine tumor (G1) was made. The patient denied symptoms of the carcinoid syndrome and no biologically active hormones were detected. Gallium PET scan revealed multiple foci of radiotracer uptake throughout the pancreas in addition to those described on MRI. Although PanNEN are rare in TS, malignant behavior has been reported. This case reinforces the importance of early detection through active surveillance, especially as surgical options may be limited in multifocal disease.


2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Hiroshi Saito ◽  
Koichiro Sawada ◽  
Jyunichi Ogawa ◽  
Masashi Hashimoto ◽  
Masahiro Oshima ◽  
...  

Abstract Background Median arcuate ligament syndrome (MALS), which results from compression of the median arcuate ligament (MAL), is a rare cause of abdominal pain and weight loss. Treatment is dissection of the MAL; however, the laparoscopic procedure is not yet established and it involves the risk of major vascular injury, especially in cases with an anomaly. Case presentation A 47-year-old man was evaluated at the hospital for epigastric pain. Contrast computed tomography scan revealed stenosis of the celiac artery origin due to the MAL. An Adachi V type vascular anomaly was also observed. Laparoscopic treatment was performed to release pressure on the celiac artery. Laparoscopic ultrasonography was used to less invasively confirm the release of the MAL. Despite a concomitant Adachi V type vascular anomaly, surgery was safely performed using the laparoscopic magnification view and intraoperative ultrasonography. Follow-up ultrasonography confirmed the celiac artery stenosis has not recurred. Conclusions A rare case of MALS with an Adachi V type vascular anomaly is presented and the laparoscopic treatment is detailed.


Author(s):  
Kotaro Matsumoto ◽  
Kentaro Kikuchi ◽  
Ayako Hara ◽  
Hiromichi Tsunashima ◽  
Koichi Tsuneyama ◽  
...  

AbstractA 25-year-old woman with fever and epigastric pain was referred to our hospital. Blood examination showed significant liver dysfunction, markedly high C-reactive protein (CRP 19.1 mg/dL) and procalcitonin (48.3 ng/mL) levels. Dynamic computed tomography showed a tumor approximately 120 mm in size in the right lobe of the liver, but with no abscess formation. The patient was hospitalized and started on antibiotics; her CRP level improved, but the procalcitonin level did not decrease. Histopathological examination of the liver tumor biopsy revealed fibrolamellar hepatocellular carcinoma (FLC). Positive staining of the FLC with an anti-procalcitonin antibody suggested the production of procalcitonin.


2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Nor Fadhlina Zakaria ◽  
Nurul Izah Ahmad ◽  
Elmina Mokhtar ◽  
Wan Zul Haikal Hafiz Wan Zukiman ◽  
Anim Md Shah

Abstract Background Patients who undergo peritoneal dialysis (PD) are at risk of gut bacteria translocation leading to peritonitis when there is chronic diarrhea. Chronic diarrhea is defined as any course of diarrhea that lasts at least 4 weeks, which can be continuous or intermittent. Chronic diarrhea of any duration may cause dehydration, electrolyte imbalance, and life-threatening hypovolemic shock. In PD patients, excessive ultrafiltration from the exchanges, combined with severe gastrointestinal loss, may cause hypovolemic shock, electrolyte imbalance, and metabolic acidosis. There are multiple causes of chronic diarrhea in PD patients including infective causes, mitotic lesions, and rarely the regular and excessive use of laxatives, which is a diagnosis of exclusion. Case presentation We report a case of Melanau lady with chronic diarrhea secondary to laxative usage in a patient being treated with automated peritoneal dialysis (APD). The patient went into hypovolemic shock, but luckily did not contract peritonitis. A colonoscopy revealed brown to black discoloration of the colon, a feature suggestive of melanosis coli. A biopsy of the intestine further confirmed the diagnosis by histopathological examination. Withdrawal of laxatives and the introduction of probiotics improved the symptoms tremendously. Conclusions The chronic use of laxatives in PD patients can potentially lead to a devastating problem; thus, the management team must monitor treatment commencement appropriately.


2011 ◽  
Vol 24 (1) ◽  
pp. 54-56
Author(s):  
KZ Shah ◽  
N Begum ◽  
MMR Khan ◽  
P Ahmed ◽  
SK Vadro

Appendiceal mucocele (AM) is a rare entity that can present in a variety of clinical syndrome. The prevalence is 0.2- 0.4 % among appendicectomies.1 A 48 Years old male patient came to our Centre for Nuclear Medicine and Ultrasound (CNMU), Rajshahi for abdominal ultrasound examination. He had pain with vomiting and feeling of lumpiness in right side of lower abdomen. Ultrasonography (US) showed an elongated regular outlined semi-cystic lesion in right iliac fossa. Laparotomy done, per-operative finding reveled AM. Post-operatively histopathological examination report revealed AM. TAJ 2011; 24(1): 54-56


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