Perforated High-Grade Mixed Neuroendocrine Nonneuroendocrine Neoplasm of Cecum: Unusual Presentation of Rare Disease

Mixed neuroendocrine nonneuroendocrine neoplasms (MiNENs) are rare neoplasms of the gastrointestinal tract, where the neuroendocrine as well as the nonneuroendocrine components each comprise at least 30% of the tumor. Of all cases of colorectal malignancies, MiNENs constitute around 3–9.6%, with only a few cases reported to be arising in the cecum. Since majority present with nonspecific clinical and radiological findings, its diagnosis preoperatively is almost impossible and these are usually diagnosed after histopathological examination of the resected specimen. Owing to the rarity of these tumors as well as lack of complete molecular characterization, optimal treatment remains unestablished. We, here, report a rare case of MiNENs of the cecum infiltrating the right psoas muscle and presenting with perforation for which right hemicolectomy and en bloc excision of the involved psoas muscle was done followed by adjuvant chemotherapy.

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P3.CR-29 En-Bloc Excision of Intrapericardial Thymoma Using Single Port Video-Assisted Thoracoscopic Surgery. A Rare Case

Journal of Thoracic Oncology ◽

10.1016/j.jtho.2018.08.2008 ◽

2018 ◽

Vol 13 (10) ◽

pp. S1039

Author(s):

H.v. Kara ◽

A. Turna ◽

I. Sarbay ◽

S. Batur

Keyword(s):

Rare Case ◽

Single Port ◽

Thoracoscopic Surgery ◽

En Bloc ◽

Video Assisted ◽

En Bloc Excision ◽

Bloc Excision ◽

Video Assisted Thoracoscopic Surgery

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Subungual exostosis of the great toe: A case report

Journal of Kathmandu Medical College ◽

10.3126/jkmc.v8i4.32391 ◽

2020 ◽

Vol 8 (4) ◽

pp. 235-238

Author(s):

Pradeep Kafle ◽

Nishchal Rijal ◽

Ashish Kumar Pandey

Keyword(s):

Histopathological Examination ◽

Nail Plate ◽

Excisional Biopsy ◽

Great Toe ◽

En Bloc ◽

Orthopaedic Literature ◽

Clinical Series ◽

Bloc Excision ◽

The Right ◽

Mature Bone

Subungual exostosis is typically a rare benign, acquired tumor of cartilaginous bone occurring on the medial surface of the distal hallux of toes or fingers. These are usually associated with secondary changes such as elevation of the nail plate, ulceration or subungual hyperkeratosis and hyperpigmentation. On histological examination, the lesion consists of mature bone at the base with proliferating fibrocartilaginous cap. A 14-year-old male presented with a solitary firm swelling gradually increasing in size for three months on the distal part of the right great toe. On physical examination, a firm, non-tender, non-mobile, whitish nodule was noted in the distal dorsomedial aspect of the right great toe distorting the adjacent nail. Radiographs demonstrated a dorsal bony outgrowth that was continuous with the distal phalanx. Excisional biopsy was done and on histopathological examination, a characteristic trabecular pattern of mature bone covered with a hyaline and fibrocartilaginous cap was seen. There was lack of true anaplasia, thereby confirming the diagnosis of subungual exostosis. There was no recurrence over six months. This topic is underrepresented in the orthopaedic literature, because many of the important clinical series have been published in journals from other branches of medicine i.e. mainly by dermatologists and pathologists. This reflects the fact that the condition is treated by many kinds of non-orthopaedic providers. We, as orthopaedic surgeons, must be careful while evaluating lesions of distal phalanges, always keeping in mind the possibility of subungual exostosis. Radiographs are helpful in diagnosis but confirmation can be done by histopathological examination. En bloc excision with minimal nail plate deformation can help prevent recurrence or deformity.

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Pedunculated Cecal Lipoma Causing Colo-Colonic Intussusception: A Rare Case Report

Case Reports in Surgery ◽

10.1155/2012/279213 ◽

2012 ◽

Vol 2012 ◽

pp. 1-3 ◽

Cited By ~ 2

Author(s):

Stefanos Atmatzidis ◽

Grigoris Chatzimavroudis ◽

Aristidis Patsas ◽

Basilis Papaziogas ◽

Spiros Kapoulas ◽

...

Keyword(s):

Case Report ◽

Preoperative Diagnosis ◽

Rare Case ◽

Histopathological Examination ◽

Exploratory Laparotomy ◽

Right Hemicolectomy ◽

Resected Specimen ◽

Ascending Colon ◽

Imaging Studies ◽

Rare Case Report

Colonic lipomas are uncommon nonepithelial neoplasms that are typically sessile, asymptomatic and incidentally found during endoscopy, surgery, or autopsy. We present a very rare case of a 34-year-old female patient with symptomatic pedunculated cecal lipoma causing intermittent colo-colonic intussusception. Despite adequate imaging studies, definite preoperative diagnosis was not established and the patient underwent exploratory laparotomy. Intraoperatively, intussusception of the cecum into the ascending colon was found and right hemicolectomy was performed. Macroscopic assessment of the resected specimen showed the presence of a giant cecal pedunculated polypoid tumor with features of lipoma, causing intussusception. Histopathological examination confirmed the diagnosis of pedunculated cecal lipoma.

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Efficacy of Paclitaxel in a Patient with Inoperable Pulmonary Vein Leiomyosarcoma

Case Reports in Oncology ◽

10.1159/000477657 ◽

2017 ◽

Vol 10 (2) ◽

pp. 564-570

Author(s):

Shinji Kounami ◽

Hiroshi Tsujimoto ◽

Takayuki Ichikawa ◽

Megumi Yoshiyama ◽

Mitsuru Yuzaki ◽

...

Keyword(s):

Pulmonary Vein ◽

High Dose Chemotherapy ◽

High Dose ◽

Complete Regression ◽

En Bloc ◽

Superior Pulmonary Vein ◽

Left Atrial Wall ◽

En Bloc Excision ◽

Bloc Excision ◽

The Right

Pulmonary vein leiomyosarcoma is extremely rare and has a poor prognosis. Surgical resection with a wide margin seems to offer the only chance of cure. The role of adjuvant therapy is controversial, and the exact efficacy of chemotherapy has not been observed. In this report, we present an 18-year-old male patient with pulmonary vein leiomyosarcoma in whom the use of paclitaxel (PAX) proved to be effective. Because the tumor originated from the left superior pulmonary vein and diffused into the left atrial wall and the junction of the right superior pulmonary vein and left atrium, the en bloc excision of the tumor was impossible. The first-line chemotherapy, including ifosfamide, doxorubicin, and dacarbazine, in conjugation with radiation therapy could not demonstrate any effect on the tumor size. However, the following PAX-containing regimen provided complete regression of the tumor. After PAX-based high-dose chemotherapy with autologous peripheral blood stem cell transplantation, the patient showed complete remission for 2 years. Although he suffered metastatic recurrences and died 4 years after the onset of symptoms, our patient’s clinical course clearly reveals the efficacy of PAX.

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Recurrence of a complex anterior skull base tumour managed with an uncommon surgical approach

BMJ Case Reports ◽

10.1136/bcr-2018-228622 ◽

2019 ◽

Vol 12 (3) ◽

pp. e228622

Author(s):

Muhammad Ibaad ur Rehman Alvi ◽

Omar Pathmanaban ◽

Raj Bhalla ◽

Navin Mani

Keyword(s):

Visual Fields ◽

Three Dimensional ◽

Endoscopic Biopsy ◽

Low Grade ◽

En Bloc ◽

Craniofacial Resection ◽

Primary Surgery ◽

En Bloc Excision ◽

Bloc Excision ◽

The Right

A well 74 -year-old woman presented to routine ophthalmology clinic instituted following treatment of a frontoethmoidal sarcoma initially excised in 1989 and diagnosed then as a sinus mucosal melanoma. At review in ophthalmology clinic, a reduction in right visual fields was noted. CT scan showed recurrence of a mass now involving the frontoethmoidal region, frontal sinus and abutting the cribiform plate. Endoscopic biopsy confirmed the recurrence as a low-grade biphenotypic sarcoma. This was discussed at the sarcoma multidisciplinary meeting. Using a three-dimensional printed model of the patients skull for planning, primary surgery with craniofacial resection combining intracranial and transfacial approaches with reconstruction was decided on. The implications of no treatment would be tumour involvement of the dura and brain as well as the right only-seeing eye. Craniofacial surgery would involve otolaryngolical, neurosurgical and maxillofacial multispecialty involvement and close teamwork. The goal was en bloc excision with negative surgical margins.

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Iliac wing osteochondroma in a 16-year-old boy: a case report

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20205585 ◽

2020 ◽

Vol 7 (1) ◽

pp. 171

Author(s):

Shrihari L. Kulkarni ◽

Sunil Mannual ◽

Manjunath S. Daragad ◽

Sharan H. Girirajaiah

Keyword(s):

Bone Tumour ◽

Neurovascular Compression ◽

Rare Entity ◽

En Bloc ◽

Iliac Wing ◽

Benign Bone Tumour ◽

Rare Site ◽

En Bloc Excision ◽

Bloc Excision ◽

The Right

<p class="abstract">Osteochondroma is the most common benign bone tumour. Commonly seen in the long bones of the lower extremity. Ilium is a rare site. We present a 16-year-old boy with swelling in the right groin for 8 months. After clinical and radiological evaluation, it was diagnosed as osteochondroma of right iliac wing. Patient underwent en-bloc excision of the lesion and histopathology confirmed the diagnosis. Pelvic osteochondroma is a rare entity but not unusual. Extra periosteal en-bloc excision is the management of choice in patients with cosmetic deformity, neurovascular compression and malignant transformation with very low recurrence rate.</p>

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An Unusual Case of Huge Tophaceous Pseudogout Mimicking as a Tumor-Like Lesion around the Ankle Joint: A Case Report and Literature Review

Case Reports in Orthopedics ◽

10.1155/2019/9617184 ◽

2019 ◽

Vol 2019 ◽

pp. 1-5

Author(s):

Mohammed Sadiq ◽

Mayur Nayak ◽

Ayesha Farheen ◽

Vijay Digge

Keyword(s):

Unusual Case ◽

Histopathological Examination ◽

Calcium Pyrophosphate ◽

Calcium Pyrophosphate Dihydrate ◽

Rare Form ◽

En Bloc ◽

Calcium Deposits ◽

En Bloc Excision ◽

Pyrophosphate Dihydrate ◽

Bloc Excision

Pseudogout or calcium pyrophosphate dihydrate deposition disease (CPPD) primarily affects the joints and the periarticular tissues. Tophaceous or tumoral pseudogout is a rare form of this disease which is seen around the joints of extremities. It can be misdiagnosed as a neoplastic condition because of its clinicoradiological similarities, and thus, a proper histopathological examination is indispensable. We report one such case of extra-articular deposition of the CPPD crystals in a 65-year-old man who presented with an asymptomatic swelling around the left ankle. Radiographs showed a dense homogenous calcification, and FNAC revealed dense calcium deposits with numerous rhomboid-shaped crystals. It was managed by en bloc excision, and postoperative biopsy reports confirmed the diagnosis. Possibility of pseudogout should be kept as a differential diagnosis in patients presenting with calcified soft tissue swellings and should be subjected to a detailed histopathological examination for confirmation.

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