Mediastinal Mature Teratomas Penetrating the Chest Wall

2021 ◽  
Vol 2021 ◽  
Author(s):  
Abdelfettah Zidane ◽  
Ikram Samri ◽  
Adil Arsalane
Keyword(s):  
Chronic Inflammation ◽  
Chest Wall ◽  
Surgical Resection ◽  
Rare Case ◽  
Surgical Planning ◽  
Anterior Mediastinum ◽  
Complete Resection ◽  
En Bloc ◽  
Slow Growing

Mediastinal mature teratomas (MMT) are benign and slow-growing tumors in the anterior mediastinum, which can reach a huge size. Surgical resection is often challenging, however, with proper surgical planning, complete resection is feasible with good outcomes. we report a rare case of MMT penetrating the chest wall as a result of chronic inflammation successfully treated with en bloc surgical resection.

scholarly journals Tailgut cyst: from differential diagnosis to surgical resection—case report and literature review

2020 ◽  
Vol 2020 (7) ◽  
Author(s):  
Gustavo de Castro Gouveia ◽  
Letícia Yukari Okada ◽  
Beatriz Pires Paes ◽  
Thalita Millene Moura ◽  
Amarildo Henrique da Conceição Júnior ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Surgical Resection ◽  
Rare Case ◽  
Surgical Planning ◽  
Standard Treatment ◽  
Tailgut Cyst ◽  
Rare Tumor ◽  
Retrorectal Space ◽  
Cyst Excision ◽  
Pilonidal Cyst

Abstract Tailgut cyst is a rare tumor originating from the embryonic remnant located in the retrorectal space. The diagnosis is usually incidental duse to the absence of symptoms. When present, they are nonspecific, such as abdominal pain, dysuria and tenesmus. Imaging tests are a great help in the diagnosis and surgical planning. The standard treatment is resection, which the surgeon must perform to avoid future complications, such as malignancy. We present a case of tailgut cyst in a young patient with prior pilonidal cyst excision, subsequently submitted to surgical resection, to share our experience with a rare case, with few reports in the literature.

Successful surgical resection of a rare case of a giant sacral chordoma: a multidisciplinary feat

2020 ◽  
Vol 13 (9) ◽  
pp. e235045
Author(s):  
Safwan Omar Alomari ◽  
Shadi Bsat ◽  
Mohammad Khalife ◽  
Ghassan Skaf
Keyword(s):  
Surgical Resection ◽  
Neurological Deficit ◽  
Rare Case ◽  
Tumour Resection ◽  
Two Stage ◽  
En Bloc ◽  
Ct Guided ◽  
Second Stage ◽  
Sacral Chordoma ◽  
Ct Guided Biopsy

We, here, report the case of a 72-year-old man who presented with a giant sacral chordoma without aggressive clinical and neurological course and confirmed with a CT guided biopsy. The patient underwent multidisciplinary, two-stage successful complete en bloc sacrectomy along with total gross tumour resection, followed by lumboiliac fusion and instrumentation in the second stage without any neurological deficit nor bladder or bowel-related complications.

scholarly journals Perioperative strategy and outcome in giant retroperitoneal dedifferentiated liposarcoma—results of a retrospective cohort study

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Robert Bachmann ◽  
Franziska Eckert ◽  
Daniel Gelfert ◽  
Jens Strohäker ◽  
Christian Beltzer ◽  
...  
Keyword(s):  
Surgical Resection ◽  
Soft Tissue Sarcomas ◽  
Radical Resection ◽  
Complete Resection ◽  
Neoadjuvant Radiochemotherapy ◽  
En Bloc ◽  
Free Survival ◽  
Retroperitoneal Liposarcoma ◽  
Median Diameter

Abstract Background and objectives Retroperitoneal liposarcoma (RPLS) are common soft tissue sarcomas of adulthood. The aim of this study is to show resectability of even giant liposarcomas and to identify factors associated with recurrence and survival in primary retroperitoneal liposarcomas. Methods We retrospectively reviewed the records of patients with retroperitoneal liposarcoma. Seventy-seven patients met inclusion criteria. Out of these 10 patients with primary giant, dedifferentiated retroperitoneal liposarcomas were operated with en bloc compartment resection with intention of radical resection. Treatment consisted of neoadjuvant radiochemotherapy and surgical resection or surgical resection. Results In 6 patients, neoadjuvant radiochemotherapy was performed; 3 patients were treated with surgical resection alone and 1 patient received adjuvant chemotherapy. The median diameter of tumor size was 360 mm (300 to 440 mm). Operative outcome showed complete resection in all 10 patients. Local tumor free survival was in median 19 month. Tumor recurrence was seen in 3 of 4 patients (75%) without neoadjuvant radiochemotherapy, and in 2 of 6 patients (33%) after neoadjuvant radiochemotherapy in 2 years follow-up. Conclusion Even in case of giant retroperitoneal liposarcoma, complete resection is possible and remains the principal treatment. The rate of recurrence was improved in patients with neoadjuvant radiochemotherapy.

scholarly journals Complete resection of a cavoatrial metastatic dedifferentiated liposarcoma under hypothermic circulatory arrest

2021 ◽  
Author(s):  
Ryumon Matsumoto ◽  
Koki Maekawa ◽  
Toshiki Fujiyoshi ◽  
Kentaro Kamiya ◽  
Jun Matsubayashi ◽  
...  
Keyword(s):  
Surgical Resection ◽  
Poor Prognosis ◽  
Rare Case ◽  
Circulatory Arrest ◽  
Tumor Resection ◽  
Complete Resection ◽  
Hypothermic Circulatory Arrest ◽  
Tumor Mass ◽  
The Poor

A patient had undergone surgical resection twice for primary and metastatic dedifferentiated liposarcomas. Follow-up computed tomography revealed a new tumor mass located at the cavoatrial junction. Prompt surgical resection of the tumor with thrombectomy was successfully performed using cardiopulmonary bypass with hypothermic circulatory arrest. We report a rare case of a patient surviving for 8 years after the first tumor resection despite the poor prognosis of metastatic or recurrent liposarcoma.

scholarly journals Growing Teratoma Syndrome: A Rare Case Report and Review of the Literature

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Nirmala Kampan ◽  
Trika Irianta ◽  
Arifuddin Djuana ◽  
Lim Pei Shan ◽  
Mohd Hashim Omar ◽  
...  
Keyword(s):  
Case Report ◽  
Surgical Resection ◽  
Rare Case ◽  
Complete Resection ◽  
Review Of The Literature ◽  
Growing Teratoma Syndrome ◽  
Aged Group ◽  
Rare Case Report

Growing teratoma syndrome is rare and usually it occurs in the younger aged group. The use of chemotherapy following initial surgical resection will yield the diagnosis following tumour enlargement. Complete resection is usually curative and renders better prognosis.

scholarly journals Isolated thoracic intramedullary Erdheim-Chester disease presenting with paraplegia: a case report and literature review

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Ikchan Jeon ◽  
Joon Hyuk Choi
Keyword(s):  
Surgical Resection ◽  
Fdg Pet ◽  
Rare Case ◽  
Systemic Disease ◽  
Mass Lesion ◽  
Erdheim Chester Disease ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Erdheim Chester ◽  
Chester Disease

Abstract Background Erdheim-Chester disease (ECD) is a rare, idiopathic, systemic non-Langerhans cell histiocytosis involving long bone and visceral organs. Central nervous system (CNS) involvement is uncommon and most cases develop as a part of systemic disease. We present a rare case of variant ECD as an isolated intramedullary tumor. Case presentation A 75-year-old female patient with a medical history of diabetes and hypertension presented with sudden-onset flaccid paraparesis for 1 day. Neurological examination revealed grade 2–3 weakness in both legs, decreased deep tendon reflex, loss of anal tone, and numbness below T4. Leg weakness deteriorated to G1 before surgery. Preoperative magnetic resonance imaging (MRI) and 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) showed an intramedullary mass lesion at T2-T4 with no systemic lesion, which was heterogeneous enhancement pattern with cord swelling and edema from C7 to T6. Gross total removal was achieved for the white-gray-colored and soft-natured intramedullary mass lesion with an ill-defined boundary. Histological finding revealed benign histiocytic proliferation with foamy histiocytes and uniform nuclei. We concluded it as an isolated intramedullary ECD. The patient showed self-standing and walkable at 18-month with no evidence of recurrence and new lesion on spine MRI and whole-body FDG-PET/CT until sudden occurrence of unknown originated thoracic cord infarction. Conclusions We experienced an extremely rare case of isolated intramedullary ECD, which was controlled by surgical resection with no adjuvant therapy. Histological examination is the most important for final diagnosis, and careful serial follow-up after surgical resection is required to identify the recurrence and progression to systemic disease.

scholarly journals Is the Rationale of Anatomical Liver Resection for Hepatocellular Carcinoma Universally Adoptable? A Hypothesis-Driven Review

Medicina ◽  
2021 ◽  
Vol 57 (2) ◽  
pp. 131
Author(s):  
Young-Jen Lin ◽  
Cheng-Maw Ho
Keyword(s):  
Hepatocellular Carcinoma ◽  
Tumor Microenvironment ◽  
Surgical Resection ◽  
Tumor Recurrence ◽  
Hepatic Metastases ◽  
Vascular Supply ◽  
Tumor Ablation ◽  
Supporting Evidence ◽  
En Bloc ◽  
Margin Width

Surgical resection is the first-line curative treatment modality for resectable hepatocellular carcinoma (HCC). Anatomical resection (AR), described as systematic removal of a liver segment confined by tumor-bearing portal tributaries, may improve survival by reducing the risk of tumor recurrence compared with non-AR. In this article, we propose the rationale for AR and its universal adoption by providing supporting evidence from the advanced understanding of a tumor microenvironment and accumulating clinical experiences of locoregional tumor ablation therapeutics. AR may be advantageous because it completely removes the en-bloc by interrupting tumor vascular supply and thus extirpates the spreading of tumor microthrombi, if they ever exist, within the supplying portal vein. However, HCC is a hypervascular tumor that can promote neoangiogenesis in the local tumor microenvironment, which in itself can break through the anatomical boundary within the liver and even retrieve nourishment from extrahepatic vessels, such as inferior phrenic or omental arteries. Additionally, increasing clinical evidence for locoregional tumor ablation therapies, such as radiofrequency ablation, predominantly performed as a non-anatomical approach, suggests comparable outcomes for surgical resection, particularly in small HCC and colorectal, hepatic metastases. Moreover, liver transplantation for HCC, which can be considered as AR of the whole liver followed by implantation of a new graft, is not universally free from post-transplant tumor recurrence. Overall, AR should not be considered the gold standard among all surgical resection methods. Surgical resection is fundamentally reliant on choosing the optimal margin width to achieve en-bloc tumor niche removal while balancing between oncological radicality and the preservation of postoperative liver function. The importance of this is to liberate surgical resilience in hepatocellular carcinoma. The overall success of HCC treatment is determined by the clearance of the theoretical niche. Developing biomolecular-guided navigation device/technologies may provide surgical guidance toward the total removal of microscopic tumor niche to achieve superior oncological outcomes.

scholarly journals A121 UNDERWATER EMR FOR NON-LIFTING SESSILE COLORECTAL LESIONS

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 102-103
Author(s):  
C Galts ◽  
R Barclay ◽  
D Percy
Keyword(s):  
Surgical Resection ◽  
De Novo ◽  
Lesion Size ◽  
Colorectal Polyps ◽  
Invasive Cancer ◽  
Previous Attempt ◽  
Tubular Adenoma ◽  
En Bloc ◽  
Clinical Role ◽  
Submucosal Injection

Abstract Background Sessile colorectal lesions which do not elevate with submucosal injection — “non-lifting” lesions — are considered poor candidates for EMR due to concerns of possible invasive cancer and increased procedural risk. However, a non-lifting sign is an unreliable predictor of malignancy, relegating many benign lesions to surgical resection. Underwater EMR (UEMR), which obviates submucosal injection, is effective for sessile colorectal polyps but has not been evaluated specifically for non-lifting lesions. Aims The aim of this study was to assess the efficacy of UEMR for “non-lifting” large sessile colorectal lesions with the hypothesis that UEMR may have a clinical role in managing complex lesions. Methods We reviewed our database from 2016 to 2019 for patients referred for large (≥ 20 mm) non-lifting colorectal lesions without overt signs of invasive cancer, who subsequently underwent UEMR. Results Thirty-two cases were successfully treated with single session UEMR. 18 (56%) were de novo lesions whereas the remainder had undergone previous attempt(s) at conventional EMR. The mean lesion size was 37 ± 17 mm. 4 cases (13%) were resected en bloc; the remainder piecemeal. Final pathology was T1 adenocarcinoma, N=3 (9%); tubulovillous adenoma, N=15 (47%); tubular adenoma, N=8 (25%); sessile serrated, N=6 (19%); high-grade dysplasia, N=2 (6%). One patient with cancer underwent surgical resection (T1N0); the remainder had endoscopic follow-up over 8 ± 3 months with benign recurrent/residual lesions in 8%, all amenable to UEMR. There were no procedural complications. Conclusions In this series of large sessile non-lifting colorectal lesions, UEMR was effective for both de novo and previously treated lesions, obviating surgery in the majority of cases. Funding Agencies None

scholarly journals Gastric Schwannoma: A Rare but Important Differential Diagnosis of a Gastric Submucosal Mass

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
William Yoon ◽  
Kari Paulson ◽  
Paul Mazzara ◽  
Sweety Nagori ◽  
Mohammed Barawi ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Surgical Resection ◽  
Treatment Options ◽  
Partial Gastrectomy ◽  
Preoperative Imaging ◽  
Mesenchymal Tumors ◽  
Gastric Schwannoma ◽  
Gastric Mass ◽  
Submucosal Mass ◽  
Slow Growing

Schwannomas are generally slow growing asymptomatic neoplasms that rarely occur in the GI tract. However, if found, the most common site is the stomach. Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract, and 60–70% of them occur in the stomach. Owing to their typical presentation as submucosal neoplasms, gastric schwannomas and GISTs appear grossly similar. Accordingly, the differential diagnosis for a gastric submucosal mass should include gastric schwannomas. Furthermore, GI schwannomas are benign neoplasms with excellent prognosis after surgical resection, whereas 10–30% of GISTs have malignant behavior. Hence, it is important to distinguish gastric schwannomas from GISTs to make an accurate diagnosis to optimally guide treatment options. Nevertheless, owing to the paucity of gastric schwannomas, the index of suspicion for this diagnosis is low. We report a rare case of gastric schwannoma in 53-year-old woman who underwent laparoscopic partial gastrectomy under the suspicion of a GIST preoperatively but confirmed to have a gastric schwannoma postoperatively. This case underscores the importance of including gastric schwannomas in the differential diagnosis when preoperative imaging studies reveal a submucosal, exophytic gastric mass. For a gastric schwannoma, complete margin negative surgical resection is the curative treatment of choice.

scholarly journals A Rare Case of Primary Anterior Mediastinal Yolk Sac Tumor in an Elderly Adult Male

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Sammy G. Nakhla ◽  
Srinath Sundararajan
Keyword(s):  
Germ Cell ◽  
Rare Case ◽  
Germ Cell Tumors ◽  
Anterior Mediastinum ◽  
Yolk Sac ◽  
Yolk Sac Tumor ◽  
Elderly Adult ◽  
Children And Young Adults ◽  
Extragonadal Germ Cell Tumors ◽  
Mediastinal Germ Cell Tumors

Mediastinal germ cell tumors are extragonadal germ cell tumors (EGGCTs) commonly seen in children and young adults. They are more common in men. Clinically they are classified as teratomas, seminomas, and nonseminomatous germ cell tumors. Primary mediastinal yolk sac neoplasm is an extremely rare tumor. We present here a very rare case of primary yolk sac tumor of the anterior mediastinum in a 73-year-old male. Mediastinal germ cell tumors have a worse prognosis than gonadal germ cell tumors. Chemotherapy followed by adjuvant surgery improves overall response in EGGCTs. However, comorbidities can render treatment with chemotherapy and surgery challenging in elderly patients.

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