scholarly journals Diffuse peritonitis caused by spontaneous perforation of pyometra: A case report and literature review

Author(s):  
Hao Xu ◽  
Yifan Zhuang ◽  
Caiming Wang ◽  
Yongjie Zhou ◽  
Haofei Chen ◽  
...  

Abstract BackgroundUterine perforation is commonly caused by iatrogenic injuries, tumours, and traumas. Uterine perforation resulting from infection is less common, and such perforation rarely causes abdominal empyema and diffuse peritonitis. Infectious complications such as shock and multiple organ dysfunction are extremely dangerous and even life threatening. Correct early diagnosis and appropriate treatment can reduce the mortality of pyometra.Case presentationA 62-year-old woman presented to our hospital with persistent abdominal pain for 5 hours. The patient had undergone hysteroscopy six months ago, and a cystic space-occupying lesion of the uterus was found one month ago. Perfect the various examinations, consider the patient as acute diffuse peritonitis Perforation of the digestive tract? Uterine cavity infection. In the emergency department, laparoscopic exploration was performed. During the operation, it was diagnosed as pyometra and perforation of the right uterine fundus. Then, combined with a gynecologist, a hysterectomy with double appendages was performed. The operation went smoothly. The patient had paralytic intestinal obstruction after the operation. After active symptomatic treatment The patient recovered well and was discharged. Postoperative pathology results were as follows: 1. Moderately differentiated squamous cell carcinoma of the cervix (non-keratinizing type); 2. Metastatic squamous cell carcinoma of the right ovary; 3. Perforation of the fundus of the uterus, pyometra, and extensive purulent inflammation of the muscle wall .ConclusionsUterine perforation is a rare cause of acute abdomen. Clinicians often don't know enough about this, and they are prone to misdiagnosis and missed diagnosis. For elderly women with abdominal pain and peritonitis, the possibility of empyema perforation should be considered during diagnosis and treatment, and the examination should be improved to avoid misdiagnosis, because correct early diagnosis and appropriate treatment can reduce the mortality of empyema.

2021 ◽  
Vol 7 ◽  
pp. 2513826X2110084
Author(s):  
Weston Thomas ◽  
Kevin Rezzadeh ◽  
Kristie Rossi ◽  
Ajul Shah

Introduction: Skin graft reconstruction is a common method of providing wound coverage. Rarely, skin grafting can be associated with the development of squamous cell carcinoma (SCC) in the graft donor site. Case Report: The patient is a 72-year old male with a 15-year history of bilateral hip wounds. He underwent a multitude of treatments previously with failed reconstructive efforts. After presenting to us, he underwent multiple debridements and eventual skin grafting. Within 4 weeks of the final skin graft, a mass developed at the skin graft donor site at the right thigh. Excisional biopsy returned a well differentiated keratinizing SCC. Discussion/Conclusion: This case demonstrates the acute presentation of SCC in a patient following a skin graft without known risk factors. The purpose of this unique case report is to highlight a very rare occurrence of SCC at a skin graft donor site.


2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Tapan Kumar Sahoo ◽  
Saroj Kumar Das ◽  
Chandraprava Mishra ◽  
Ipsita Dhal ◽  
Rohani Nayak ◽  
...  

Primary squamous cell carcinoma of the renal parenchyma is an extremely rare entity. The diagnosis of squamous cell carcinoma of the renal pelvis is usually unsuspected due to the rarity and inconclusive clinical and radiological features. Most of the patients are diagnosed at an advanced stage and are with poor outcome. Radical nephrectomy is the mainstay of the treatment. We reported a case of squamous cell carcinoma of the kidney in a 50-year-old female who presented with the right sided abdomen pain. The patient was treated with radical nephrectomy.


2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Rachel Roth ◽  
Susan Moffatt-Bruce ◽  
Marino E. Leon

Histopathologic techniques are insufficient for distinguishing primary squamous cell carcinoma (SCC) from metastatic SCC, which is clinically important. A patient with SCC of the anus was found to also have SCC of the lung, and the question of metastatic versus synchronous primary diseases was raised. Immunohistochemical and hematoxylin and eosin (H&E) staining on sections of tissue could not discriminate between the two entities. Immunostain for p16 and chromogenicin situhybridization for human papillomavirus (HPV) type 16 were positive in both tumors. Additionally, allelotyping for loss of heterozygosity displayed similar findings and confirmed the histopathological impression of anal SCC metastasis to the lung. The patient was treated with palliative chemotherapy instead of additional surgical treatment. When multiple tumors are present, determining metastatic versus synchronous primary tumors is necessary for appropriate treatment. Identification can be achieved using allelotyping for loss of heterozygosity.


2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Monet E. Meter ◽  
David J. Nye ◽  
Christian R. Galvez

Introduction. It is rare for actinic or squamous cell carcinoma (SCC) in situ to metastasize. Case Presentation. A 67-year-old male had a significant medical history including severe psoriatic arthritis treated with UVB, methotrexate, and rapamycin. He had twenty-five different skin excisions of actinic keratosis four of which were invasive SCC. Our patient developed shortness of breath necessitating a visit to the emergency department. A CT scan of his chest revealed a mass in the right lower lung. A subsequent biopsy of the mass revealed well-differentiated SCC. He underwent thoracoscopic surgery with wedge resection of the lung lesion. Discussion. Actinic keratosis (AK) is considered precancerous and associated with UV exposure. It exists as a continuum of progression with low potential for malignancy. The majority of invasive SCCs are associated with malignant progression of AK, but only 5–10% of AKs will progress to malignant potential. Conclusion. In this case, a new finding of lung SCC in the setting of multiple invasive actinic cutaneous SCC associated with a history of extensive UV light exposure and immunosuppression supports a metastatic explanation for lung cancer.


1998 ◽  
Vol 44 (1) ◽  
pp. 58-60
Author(s):  
Fujio ATSUTA ◽  
Jiro KATO ◽  
Hidetaka YOKOE ◽  
Tsuneo MIYA ◽  
Hideki TANZAWA ◽  
...  

2021 ◽  
Vol 49 ◽  
Author(s):  
Yasmin Najm Bortoletto ◽  
Júlia De Assis Arantes ◽  
Alessandra Mayer Coelho ◽  
Lais Maria Gomes ◽  
Manuela Cristine Camargo Lambert ◽  
...  

Background: Equines are routinely subjected to enucleation due to palpebral tumors. Blepharoplasties in horses, especially in the lower eyelid, are rarely performed due to the difficulty of sliding once the tissue around the eyes presents low mobility. Defects involving more than 50% of the lower eyelid is considered challenging after tumor removal. Squamous cell carcinoma (SCC) is the second most reported neoplasm in horses, being very common in regions of the lower eyelid, third eyelid, sclera and or cornea. The aim of this study is to present the Destro VY skin advancement flap as a blepharoplasty technique performed after surgical excision of a SCC, with total commitment of the lower eyelid, completely covering the right eye of a mare.Case: A 8-year-oldmarePaint Horse, weighing420 kg,was referred for evaluation of tumor tissue of 6.0 x 4.0 x 2.0 cm, with nodular and ulcerated appearance, involving the right lower eyelid, in its total extension and completely covering the eye, without adhering to it. Considering the initial suspicion of SCC, the treatment strategy performed was surgical eyelid excision and maintenance of the eye, followed by blepharoplasty as an attempt to reconstruct the eyelid. Under general inhalation anesthesia, the animal was placed in left lateral recumbency, when the surgical region was prepared and local anesthetic block was performed. After antisepsis, a skin incision was made circumscribing the tumor, respecting a margin of 10 mm apart and excision of all visible tumor tissue was performed followed by intralesional ozone therapy. Blepharoplasty was performed to cover the portions of the exposed lacrimal and zygomatic bones, as well as correction of the eyelid aesthetics. For this, Destro VY skin advancement flap was performed for reconstruction of the lower eyelid. An incision of approximately 7 cm in V-shaped skin was performed, and the subcutaneous tissue under the V was dissected, maintaining a central pedicle, responsible for the vascularization of the flap, which was slid, approximately 20 mm, towards the eye. After obtaining the desired skin approximation, Y-suture was performed, covering the exposed bone and reconstructing the lower eyelid. In the postoperative period, local instillation of mitomycin eye drops and systemic meloxicam administration were instituted. The mare had her vision restored, presenting satisfactory morpho functional and aesthetic results and no tumor recurrence during 1-year of follow-up. Discussion: The repair of lower eyelid imperfections is challenging, especially when they have large defects, and there are no reports of performing the Destro VY skin advancement flap technique in horses for lower eyelid reconstruction. In this case, the importance of the blepharoplasty technique is emphasized, avoiding enucleation, preserving horse’s vision and aesthetics. In addition, aiming to avoid tumor recurrence, especially if surgical safety margins can not be achieved, other complementary treatments should be associated, including intralesional ozone therapy, mitomycin, an antineoplastic chemotherapy drug, and meloxicam, a COX-2 selective, non-steroidal anti-inflammatory drug, as performed in this study. It is concluded that the use of the Destro VY skin advancement flap technique for reconstruction of the external lamella in cases of SCC in the lower eyelid of horses is a feasible technique, which preserves the animal's vision, as well as aesthetics. The safety margin in the surgical excision of the SCC and the association of complementary therapies in the resolution of the condition are important points also to be considered.Keywords: epidermoid carcinoma, equine, ophthalmology, plastic surgery, skin tumor. Título: Exérese tumoral seguida de blefaroplastia no tratamento de carcinoma de células escamosas em pálpebra inferior de equino 


2006 ◽  
Vol 130 (3) ◽  
pp. 393-396 ◽  
Author(s):  
Alan D. Proia ◽  
M. Angelica Selim ◽  
Jason C. Reutter ◽  
John J. Michon

Abstract A 93-year-old woman developed a mass on her right lower eyelid that was present for more than 6 months but underwent rapid expansion during several weeks prior to her ophthalmological evaluation. Examination revealed an approximately 1.8 cm in diameter, fleshy, fungating growth involving more than 60% of the right lower eyelid. Excisional biopsy disclosed a neoplasm arising from the epidermis composed of adjoining basal cell and signet-ring squamous cell carcinoma, without a transition zone. The cells comprising the basal and squamous cell carcinomas were distinct immunophenotypically, with only the basal cell carcinoma reacting with Ber-EP4 and CAM 5.2 antibodies. To our knowledge, this case represents the first example of a collision tumor composed of basal cell and signet-ring squamous cell carcinoma.


2020 ◽  
Vol 2020 (10) ◽  
Author(s):  
Obed Rockson ◽  
Christine Kora ◽  
Abdelbassir Ramdani ◽  
Badr Serji ◽  
Tijani El Harroudi

Abstract Squamous cell carcinoma (SCC) of the colon is a rare malignant tumor occurring as either a primary or secondary lesion. Few cases of metastatic or secondary colonic SCC have been published. We report an unusual case of a 59-year-old female patient who was treated by Wertheim hysterectomy and adjuvant chemoradiation for stage IIB SCC of the uterine cervix. Two years later, she developed a metastatic location in the caecum causing an acute intestinal obstruction. She underwent an emergency open right hemicolectomy with ileocolic anastomosis and resection of two nodules of the umbilicus and the right parietal peritoneum. Histopathological examination confirmed a triple metastatic location of SCC. She is disease-free 11 months after surgery. We discuss the clinicopathological features, management strategies, and the prognosis of this rare entity.


2020 ◽  
Vol 13 (11) ◽  
pp. e238731
Author(s):  
Marica Reise-Filteau ◽  
Michael Carter ◽  
Ryan DeCoste ◽  
Ali Kohansal

Metastatic spread of cutaneous squamous cell carcinoma (cSCC) to the gastrointestinal tract is a rare entity. A 63-year-old woman with a history of poorly controlled HIV and a recurrent cSCC on the right temple presented with functional decline, ascites and shortness of breath. A CT scan showed widespread metastatic malignancy involving lung, pleura, heart, stomach, liver, retroperitoneum and soft-tissue. In the case presented here, an upper endoscopy revealed a submucosal lesion in the stomach. Biopsies described the lesion as a poorly differentiated SCC. Comprehensive genomic profiling yielded striking molecular similarities between the gastric tumour and the patient’s prior cSCC. It confirmed the origin of the disease and excluded spread from an occult primary. This case adds to the limited literature on gastrointestinal metastases of cSCC and serves as a reminder that non-AIDS-defining cancers are on the rise in the HIV-population.


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