Case Report: Diagnosis and Treatment of a Giant Retroperitoneal Liposarcoma Presenting as an Irreducible Inguinal Hernia

2020 ◽  
Author(s):  
Zhiqing Yuan ◽  
Qiwei Li ◽  
Jianhua Sun ◽  
Wei Zhou ◽  
Tao Chen
Keyword(s):  
Inguinal Hernia ◽  
Tumor Resection ◽  
Radical Resection ◽  
Left Ventricular ◽  
Diagnosis And Treatment ◽  
Left Ventricular Ejection ◽  
Resected Specimen ◽  
Left Testis ◽  
Ventricular Ejection Fraction ◽  
Retroperitoneal Liposarcoma

Abstract Background: Retroperitoneal liposarcoma protrude to the inguinoscrotal area presenting as an irreducible inguinal hernia is extremely rare. For the rare cases and little experience of diagnosis and treatment of this disorder, the clinical guidelines are vacant. We report a successful example for the management of a giant retroperitoneal liposarcoma extending to the inguinoscrotal area. Case presentation: A 55-year-old male patient was admitted to our hospital in August 2018 with a large left inguinal mass without abdominal pain or digestive symptoms. Preoperative contrast-enhanced computed tomography revealed an abdominopelvic huge mass, and ultrasound guided biopsies showed liposarcoma. The patient also suffered from dilated cardiomyopathy and the left ventricular ejection fraction is only 39%. The left renal pedicle was squeezed by the mass and the left glomerular filtration rate is as low as 29.25ml/min. Intraoperatively, the mass was incarcerated in the inguinal canal and involved the left testis. We performed a radical tumor resection with two incisions, including resection of the retroperitoneal tumor, resection of the scrotal tumor and a tension-free repair of left inguinal hernia. The resected specimen for the retroperitoneal part measured 50*28*9 cm, weighed 13.5 kilograms and the scrotal part measured 16.5*7*4.5 cm, weighed 6.2 kilograms. Pathologically, the tumor was diagnosed as a well-differentiated liposarcoma, and originated from perirenal fat. The patient did not undergo adjuvant therapy post-operation and is completely clinical remission fifteen months after the operation. Conclusions: Careful distinction for inguinoscrotal mass is essential to minimize complications and improve patient prognosis. The prime principle to treat well differential retroperitoneal liposarcomas is radical resection with protection of vital organs and vessels.

scholarly journals Case Report: Malignant Pheochromocytoma Without Hypertension Accompanied by Increment of Serum VEGF Level and Catecholamine Cardiomyopathy

2021 ◽  
Vol 12 ◽  
Author(s):  
Hideaki Kaneto ◽  
Shinji Kamei ◽  
Fuminori Tatsumi ◽  
Masashi Shimoda ◽  
Tomohiko Kimura ◽  
...  
Keyword(s):  
Case Report ◽  
Adrenal Gland ◽  
Tumor Resection ◽  
Left Ventricular ◽  
Malignant Pheochromocytoma ◽  
Left Ventricular Ejection ◽  
Normal Range ◽  
Ventricular Ejection Fraction ◽  
The Right ◽  
Vegf Level

IntroductionPheochromocytoma is a catecholamine-producing tumor in the adrenal medulla and is often accompanied by hypertension, hyperglycemia, hypermetabolism, headache, and hyperhidrosis, and it is classified as benign and malignant pheochromocytoma. In addition, persistent hypertension is often observed in subjects with malignant pheochromocytoma.Case PresentationA 52-year-old Japanese male was referred and hospitalized in our institution. He had a health check every year and no abnormalities had been pointed out. In addition, he had no past history of hypertension. In endocrinology markers, noradrenaline level was as high as 7,693 pg/ml, whereas adrenaline level was within normal range. Abdominal contrast-enhanced computed tomography revealed a 50-mm hyper-vascularized tumor with calcification in the right adrenal gland and multiple hyper-vascularized tumors in the liver. In 131I MIBG scintigraphy, there was high accumulation in the right adrenal gland and multiple accumulation in the liver and bone. In echocardiography, left ventricular ejection fraction was as low as 14.3%. In coronary angiography, however, there was no significant stenosis in the coronary arteries. Based on these findings, we finally diagnosed him as malignant pheochromocytoma accompanied by multiple liver and bone metastases and catecholamine cardiomyopathy. However, blood pressure was continuously within normal range without any anti-hypertensive drugs. Right adrenal tumor resection was performed together with left hepatic lobectomy and cholecystectomy. Furthermore, serum levels of vascular endothelial growth factor (VEGF) and parathyroid (PTH)-related protein were very high before the operation but they were markedly reduced after the operation.ConclusionsThis is the first report showing the time course of serum VEGF level in a subject with malignant pheochromocytoma, clearly showing that malignant pheochromocytoma actually secreted VEGF. In addition, this case report clearly shows that we should bear in mind once again that malignant pheochromocytoma is not necessarily accompanied by hypertension.

scholarly journals Effects of oxygen ozone therapy on cardiac function in a patient with a prior myocardial infarction

Ozone Therapy ◽  
2017 ◽  
Vol 2 (1) ◽  
Author(s):  
Sergio Pandolfi ◽  
Angelo Zammitti ◽  
Marianno Franzini ◽  
Vincenzo Simonetti ◽  
William Liboni ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Disease ◽  
Inguinal Hernia ◽  
Ischemic Heart Disease ◽  
Autologous Blood ◽  
Left Ventricular ◽  
Ischemic Heart ◽  
Left Ventricular Ejection ◽  
Ozone Therapy ◽  
Ventricular Ejection Fraction

Oxygen-ozone therapy has been piloted in Italy patients with ischemic heart disease or suffering from myocardial infarction since 1991. Over time, it has been observed that ozone exerts a significant anti-inflammatory and rheological activity: ozone activates the redox system, lowers the pro-inflammatory cytokines16β, TNFα, modulates the NF-KB system, reduces platelet aggregation, and stimulates the release of growth factors. It is because of these characteristics that oxygen-ozone therapy is used in the prevention and treatment of ischemic heart disease and for post-infarction rehabilitation. The case study – a critically ill patient aged 76 with acute myocardial infarction (AMI), suffering from ischemic heart disease and heart attacks, high blood pressure, renal failure, ischemic vascular pluri-infarct CNS disease, Parkinsonism, stroke, neurological bladder disease and debilitating inguinal hernia – after a year and a half of AMI with infusions of autologous blood treated with ozone (GAE), recovered the left ventricular ejection fraction from 33 to 50% and underwent a successful inguinal hernia operation. It appears evident that oxygen ozone therapy using GAE protect the hearts of patients suffering from ischemic heart disease, and is useful during the acute phase of infarctions, as well as for rehabilitating patients who have had an AMI with stenting.

scholarly journals Improvement of neurological conditions and recovery of the left ventricular ejection fraction subsequent to oxygen-ozone therapy through auto-hemoinfusion of ozonated blood

Ozone Therapy ◽  
2016 ◽  
Vol 1 (1) ◽  
pp. 10
Author(s):  
Sergio Pandolfi ◽  
Claudio Di Giovanni ◽  
Eleonora Marinari ◽  
Marianno Franzini
Keyword(s):  
Myocardial Infarction ◽  
Inguinal Hernia ◽  
Left Ventricular Ejection Fraction ◽  
Ejection Fraction ◽  
Heart Function ◽  
Left Ventricular ◽  
Ventricular Ejection ◽  
Left Ventricular Ejection ◽  
Ozone Therapy ◽  
Ventricular Ejection Fraction

Here we present the case of a 76-year-old patient who suffered from ischemic cardiopathy and myocardial infarction in January 2014, arterial hypertension, kidney failure, Parkinsonism, vascular multinfarctual ischemic cerebropathy, cerebral ictus, neurogenic bladder, and inguinal hernia. The left ventricular ejection fraction evaluated through repeated echocardiographic examinations remained reduced to 33% from January 2014 to March 2015. The left ventricular ejection fraction, after 14 months from acute myocardial infarction and despite the coronary angioplasty and medical therapy, remained constantly reduced to 33%. On 3<sup>rd</sup> July 2015 he started the oxygen-ozone therapy with 2 autohemoinfusions of ozonated blood per week. Over the first two months of therapy we noticed a marked improvement of his heart conditions with a net reduction in asthenia and neurological status, the improvement of heart conditions was corroborated by the echocardiogram of 5<sup>th</sup> November 2015 which showed an increase in the left ventricular ejection fraction from 33% to 50%. In this case the heart function improvement of left ventricular ejection fraction was noticed only after having started the systemic oxygen-ozone therapy through large autohemoinfusion. In April 2015, before starting the oxygen-ozone therapy we assessed the patient’s inguinal hernia to be inoperable due to the lapsed heart conditions, while the subsequent reassessment in December 2015, after the patient underwent oxygen-ozone therapy for 5 months, we assessed him to be operable considering the heart function improvement.

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