scholarly journals The Giant Paraganglioma of The Sigmoid Mesentery：A Case Report

2021 ◽  
Author(s):  
Xinxin Wang ◽  
Yuan Li ◽  
Xiaojun Yang
Keyword(s):  
Perioperative Period ◽  
Primary Treatment ◽  
Pathological Examination ◽  
Pelvic Cavity ◽  
Preoperative Preparation ◽  
Case Presentation ◽  
Anesthesia Monitoring ◽  
Painless Mass ◽  
Slow Growing

Abstract Background: PGL is originated from pheochromaffin cells in the adrenal paravertebral ganglion and often presented as a slow-growing, painless mass in the clinical, so many PGL are detected by imaging during physical examination. At present, surgery is still the primary treatment for radical treatment of PGL. However, If the disease and medical history cannot be asked in detail before surgery or imaging examination and related tests cannot be finished for diagnosis, the preoperative preparation will be insufficient and increasing the risk of surgery. Here, we reports the treatment of a case with undiagnosed giant sigmoid mesangial PGL before operation.Case presentation: The 56-year-old male patient was admitted to the hospital with "intermittent headache and dizziness for 3 years and aggravation for 1 week". Abdominal and pelvic CT showed that round soft tissue density shadow could be seen beside the left iliac artery in the pelvic cavity. The laparoscopic surgery was performed. The patient's blood pressure increased rapidly when the mass was removed intraoperatively, and decreased sharply when it was removed. Postoperative pathological examination showed that is a PGL.Conclusion: For patients diagnosed as space-occupying lesions accompanied by long-term persistent or intermittent hypertension, careful differentiation and diagnosis should be made in combination with the history and relevant examinations to reduce the misdiagnosis rate of the PGL. Meanwhile, the adequate preoperative preparation, intraoperative anesthesia monitoring and postoperative symptomatic supportive treatment should be done to reduce the risk of surgical treatment of this disease in the perioperative period.

scholarly journals Surgical treatment for esophageal neurofibroma: report of two cases and review of literature

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhedong Zhang ◽  
Xun Wang ◽  
Zuli Zhou ◽  
Jun Wang ◽  
Guanchao Jiang
Keyword(s):  
Thoracoscopic Surgery ◽  
Submucosal Tumor ◽  
Tumor Resection ◽  
Pathological Examination ◽  
Preoperative Imaging ◽  
Tumor Diameter ◽  
Case Presentation ◽  
Surgical Methods

Abstract Background Neurofibroma of the esophagus, originated from the nerve sheath cells and fibroblasts of the esophageal submucosal plexus or the intestinal intermuscular plexus, is a very rare mesenchymal tumor. Most of the cases are treated by surgical methods. Due to the technical complexity of video-assisted thoracoscopic surgery (VATS), there are few reports in the literature of VATS for esophageal neurofibroma in recent years. Case presentation We report on two rare cases of esophageal neurofibroma, one of which is a 52-year-old male patient diagnosed with a 4.6 × 5.7 cm upper esophageal submucosal tumor in physical examination. He was admitted to our hospital and the tumor was enucleated by VATS combined with intraoperative endoscopy. There were no complications after operation, and the patients was discharged on the 16th postoperative day. The other patient was a 76-year-old man, with the main clinical manifestation of dysphagia for over 1 year, diagnosed with an 8.0 × 6.0 × 8.0 cm giant subepithelial mass in the lower esophagus. As the intraoperative exploration revealed the tumor connected tightly with the wall of the esophagus, this patient treated by transthoracic partial esophagectomy. The patient was discharged on the 14th postoperative day, and no signs of post-operative complication during the 53-month follow-up. The diagnosis of esophageal neurofibroma was based on these patients’ postoperative pathological examination. In the latest follow-up, these two patients had no evidence of long-term postoperative complication and recurrence. Conclusion This is the first reported case of 5 cm in diameter esophageal neurofibroma treated by VATS. This technique can be a commendable treatment option for esophageal neurofibroma, and the tumor diameter is not an absolute contraindication for thoracoscopy. To reduce the unnecessary damage, surgical method for complete tumor resection needs to be determined according to preoperative imaging and intraoperative conditions, partial esophagectomy can be performed via thoracotomy or thoracoscopy for removing neurofibroma when necessary.

scholarly journals The Use of Radiation Therapy in the Management of Selected Patients with Atypical Lipomas

Sarcoma ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Josephine Kang ◽  
Maikel Botros ◽  
Saveli Goldberg ◽  
Christine Giraud ◽  
G. Petur Nielsen ◽  
...  
Keyword(s):  
Late Toxicity ◽  
Primary Treatment ◽  
Benign Tumors ◽  
Management Approach ◽  
Subtotal Resection ◽  
Primary Treatment Modality ◽  
Total Radiation Dose ◽  
Grade 3 ◽  
Slow Growing

Background and Objectives. Atypical lipomas are uncommon, slow-growing benign tumors. While surgery has been the primary treatment modality, we have managed some patients with radiation (RT) as a component of the treatment and have reported their outcomes in this study.Methods. A retrospective review of all cases of extremity and trunk atypical lipomas in The Sarcoma Database at the study institution was conducted.Results. Thirteen patients were identified. All patients underwent surgical resection at initial presentation and received pre- or postoperative radiation for subtotal resection (n=2), local recurrence (n=8), or progressive disease (n=3). The median total radiation dose was 50 Gy. Median followup was 65.1 months. All patients treated with RT remained free of disease at the last followup. No grade 3 or higher late toxicity from radiation was observed. No cases of tumor dedifferentiation occurred.Conclusion. For recurrent or residual atypical lipomas, a combination of reexcision and RT can provide long-term local control with acceptable morbidity. For recurrent tumors, pre-op RT of 50 Gy appears to be an effective and well-tolerated management approach.

scholarly journals A case report of Talaromyces marneffei Oro-pharyngo-laryngitis: a rare manifestation of Talaromycosis

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Thanyarak Wongkamhla ◽  
Piriyaporn Chongtrakool ◽  
Anupop Jitmuang
Keyword(s):  
Pathological Examination ◽  
Fungal Culture ◽  
Unusual Manifestation ◽  
Case Presentation ◽  
Thai Woman ◽  
Amphotericin B Deoxycholate ◽  
Rare Manifestation ◽  
Oral Itraconazole ◽  
The Right

Abstract Background The incidence of Taralomyces marneffei infection in HIV-infected individuals has been decreasing, whereas its rate is rising among non-HIV immunodeficient persons, particularly patients with anti-interferon-gamma autoantibodies. T. marneffei usually causes invasive and disseminated infections, including fungemia. T. marneffei oro-pharyngo-laryngitis is an unusual manifestation of talaromycosis. Case presentation A 52-year-old Thai woman had been diagnosed anti-IFNɣ autoantibodies for 4 years. She had a sore throat, odynophagia, and hoarseness for 3 weeks. She also had febrile symptoms and lost 5 kg in weight. Physical examination revealed marked swelling and hyperemia of both sides of the tonsils, the uvula and palatal arches including a swelling of the epiglottis, and arytenoid. The right tonsillar biopsy exhibited a few intracellular oval and elongated yeast-like organisms with some central transverse septum seen, which subsequently grew a few colonies of T. marneffei on fungal cultures. The patient received amphotericin B deoxycholate 45 mg/dayfor 1 weeks, followed by oral itraconazole 400 mg/day for several months. Her symptoms completely resolved without complication. Conclusion In patients with anti-IFN-ɣ autoantibodies, T. marneffei can rarely cause a local infection involving oropharynx and larynx. Fungal culture and pathological examination are warranted for diagnosis T. marneffei oro-pharyngo-laryngitis. This condition requires a long term antifungal therapy.

scholarly journals Colitis Cystica Profunda with Gastrointestinal Stromal Tumor: A Case Report

2020 ◽  
Author(s):  
Xiaolu Ren ◽  
Bo Jiang ◽  
Yixun Zhang
Keyword(s):  
Clinical Symptoms ◽  
Medical Condition ◽  
Correct Diagnosis ◽  
Stomach Neoplasm ◽  
Pathological Examination ◽  
Colitis Cystica Profunda ◽  
Case Presentation ◽  
Exact Etiology ◽  
Relevant Family History

Abstract Backgroud: Colitis Cystica Profunda(CCP) is a rare benign medical condition and its exact etiology is still unknown. The clinical symptoms could be atypical and even asymptomatic, and also associated with several diseases. Most CCP patients may be misdiagnosed due to its complexity, and can be recognized after long-term medical treatment or surgical resection, especially in the elder or patients with relevant family history. Case presentation: In this case, a 58-year-old man presented with change in bowel habits for 3 years. Gastroscopy and colonoscopy were performed, and the lesions in stomach were resected. Colonoscopy revealed most lesions were significantly smaller after the resection of stomach neoplasm. Notably, these lesions recurred 3 years later. Conclusion: This case is an important reference for primary physician and pathologist to make correct diagnosis through initial endoscopic and pathological examination.

Electrocardiogram Recognition and Ablation of Atrial Tachycardia

2011 ◽  
Vol 3 (1) ◽  
pp. 80
Author(s):  
Alexander Feldman ◽  
Jonathan M Kalman ◽  
◽  
Keyword(s):  
Catheter Ablation ◽  
Atrial Tachycardia ◽  
Primary Treatment ◽  
P Wave ◽  
Wave Morphology ◽  
Focal Atrial Tachycardia ◽  
Mapping Techniques ◽  
Electrocardiogram Ecg ◽  
Surface Electrocardiogram

Focal atrial tachycardia (AT) is a relatively uncommon cause of supraventricular tachycardia, but when present is frequently difficult to treat medically. Atrial tachycardias tend to originate from anatomically determined atrial sites. The P-wave morphology on surface electrocardiogram (ECG) together with more sophisticated contemporary mapping techniques facilitates precise localisation and ablation of these ectopic foci. Catheter ablation of focal AT is associated with high long-term success and may be viewed as a primary treatment strategy in symptomatic patients.

Preoperative preparation of alcohol and psychoactive substances-addicted patients

2011 ◽  
Vol 58 (2) ◽  
pp. 151-155
Author(s):  
Ivan Dimitrijevic ◽  
Zoran Zoricic ◽  
Miodrag Milenovic ◽  
Ivan Palibrk ◽  
Draga Dimitrijevic ◽  
...  
Keyword(s):  
Substance Abuse ◽  
Postoperative Care ◽  
Surgical Intervention ◽  
Elective Surgery ◽  
Perioperative Period ◽  
Psychoactive Substance ◽  
Preoperative Preparation ◽  
Psychoactive Substances ◽  
Key Issues ◽  
Proper Diagnosis

Proper diagnosis of psychoactive substance abuse and addiction, as well as acute intoxication, withdrawal syndrome and overdosing are of great importance in patients who are preparing for surgical intervention. There are some specific details in their preoperative preparation whether they underwent emergency or elective surgery. Good knowledge of the characteristics of psychoactive substance abuse and addiction, interaction of psychoactive substances and anesthetics and any other drugs that could be used in the perioperative period is important especially for anastesiologist. In this work we present key issues for recognizing theese patients as well as some guidelines for adequate preoperative preparation and postoperative care.

scholarly journals Refractory pharyngeal ulceration due to cytomegalovirus in a patient with HIV infection: a case report and literature review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Morichika Osa ◽  
Akihiro Sato ◽  
Maki Sakagami ◽  
Masaki Machida ◽  
Takao Sato ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Pathological Examination ◽  
Cmv Infection ◽  
Case Presentation ◽  
Immunodeficiency Virus ◽  
Before And After ◽  
Infected Cells ◽  
Immunocompromised Hosts ◽  
Inflammatory Syndrome ◽  
Nonspecific Inflammation

Abstract Background Cytomegalovirus (CMV) is an important pathogen among immunocompromised hosts. Typically, CMV in human immunodeficiency virus (HIV) infection causes diseases of the retina, digestive tract, lungs and liver, but there are few cases of CMV infection of the pharynx and larynx. Case presentation A 57-year-old man with HIV infection was admitted because of pharyngeal pain. Before and after admission, pharyngeal biopsies guided by laryngeal endoscopy were performed four times, but pathological examination showed nonspecific inflammation, and the cause of pharyngeal ulceration was unclear. Additionally, the ulceration deteriorated after initiation of retroviral therapy. Laryngomicrosurgery was conducted under general anesthesia to remove tissue, and pathological diagnosis confirmed CMV infection. Pathological features included enlargement of the cytoplasm and nucleus in infected cells, and intranuclear bodies called owl’s eye inclusions. Ganciclovir dramatically improved the symptoms and laryngoscopic findings. Conclusions This case was diagnosed as pharyngitis and pharyngeal ulceration caused by CMV infection, related to immune reconstitution inflammatory syndrome. In previous reports of CMV-induced pharyngeal or laryngeal ulceration in HIV infection, we found six cases similar to our present case. All cases were diagnosed by biopsy. The present case indicates the importance of biopsy for definitive diagnosis. CMV infection should be considered as a differential diagnosis of pharyngeal ulceration in patients with HIV infection.

scholarly journals COVID-19 related mortality in post-operative cardiac surgical patients

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Azhar Hussain ◽  
Amina Khalil ◽  
Priyanka Kolvekar ◽  
Prity Gupta ◽  
Shyamsunder Kolvekar
Keyword(s):  
Cardiac Surgery ◽  
Long Term Outcomes ◽  
Case Presentation ◽  
Elective Cardiac Surgery ◽  
The United Kingdom ◽  
Global Pandemic ◽  
Cardiac Operations ◽  
Related Mortality

Abstract Background COVID-19 has caused a global pandemic of unprecedented proportions. Elective cardiac surgery has been universally postponed with only urgent and emergency cardiac operations being performed. The National Health Service in the United Kingdom introduced national measures to conserve intensive care beds and significantly limit elective activity shortly after lockdown. Case presentation We report two cases of early post-operative mortality secondary to COVID-19 infection immediately prior to the implementation of these widespread measures. Conclusion The role of cardiac surgery in the presence of COVID-19 is still very unpredictable and further studies on both short term and long term outcomes are warranted.

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