scholarly journals Unclear Retroperitoneal Tumors, an Interdisciplinary Challenge – A Case Report and Review of the Literature

2021 ◽  
Author(s):  
Benno Traub ◽  
Benedikt Haggemüller ◽  
Lisa Baumann ◽  
Johannes Lemke ◽  
Doris Henne-Bruns ◽  
...  
Keyword(s):  
Case Report ◽  
Clinical Symptoms ◽  
Malignant Tumors ◽  
Tumor Resection ◽  
Vena Cava ◽  
Retroperitoneal Tumors ◽  
Common Clinical Presentation ◽  
One Year ◽  
The Right ◽  
Upper Abdomen

Abstract BackgroundUnclear retroperitoneal tumors still impose major challenges for clinicians. Tumors can originate primarily from retroperitoneal tissue or secondarily invade into the retroperitoneal space. While benign lesions also occur, malignant tumors are far more common. Clinical presentation often depends on replacement or invasion of other organs and is therefore highly variable. The heterogeneous tumor composition makes a definitive preoperative diagnosis difficult. Nevertheless, surgical resection is the gold standard for treatment but often proves challenging due to frequent involvement of large retroperitoneal vessels.Case presentationWe present a case report of a 70-year old woman diagnosed with a large, unclear retroperitoneal tumor. Initial clinical symptoms were increasing dyspnea and dysphagia in our clinic. Gastroenterologic and cardiologic workup was unremarkable. Computed Tomography (CT) revealed a large retroperitoneal mass in the right upper abdomen with severe displacement of the inferior vena cava and renal veins. Without signs of irresectability, the patient was scheduled for tumor resection. The procedure was challenging due to the vessel involvement and large blood pressure alterations during tumor mobilization. The post-op pathologic workup then revealed the rare finding of a completely resected paraganglioma. The post-surgical course was uneventful. One year after diagnosis, the patient is relapse-free.CconclusionThis case impressively shows the challenges of retroperitoneal tumors and the importance of interdisciplinary work in these cases.

scholarly journals Anterior Clinoid Metastasis Removed Extradurally: First Case Report

2018 ◽  
Vol 79 (02) ◽  
pp. e55-e62 ◽  
Author(s):  
Mirza Pojskić ◽  
Blazej Zbytek ◽  
Kenan Arnautović
Keyword(s):  
Case Report ◽  
Malignant Tumors ◽  
Tumor Resection ◽  
Disease Recurrence ◽  
Double Vision ◽  
Anterior Clinoid Process ◽  
First Case ◽  
Magnetic Resonance Imaging Mri ◽  
The Right

Background We report a case of isolated metastasis on the anterior clinoid process (ACP) mimicking meningioma. Clinical Presentation A 58-year-old male presented with headaches, right-sided visual disturbances, and blurred and double vision. The cause of double vision was partial weakness of the right III nerve, resulting from compression of the nerve by “hypertrophied” tumor-involved right anterior clinoid. Medical history revealed two primary malignant tumors—male breast cancer and prostate cancer (diagnosed 6 and 18 months prior, respectively). The patient was treated with chemotherapy and showed no signs of active disease, recurrence, or metastasis. Postcontrast head magnetic resonance imaging (MRI) showed extra-axial well-bordered enhancing mass measuring 1.6 × 1.1 × 1 × 1 cm (anteroposterior, transverse, and craniocaudal dimensions) on the ACP, resembling a clinoidal meningioma. Extradural clinoidectomy with tumor resection was performed via right orbitozygomatic pretemporal skull base approach. Visual symptoms improved. Follow-up MRI showed no signs of tumor residual or recurrence. Conclusion This is the first case report of a metastasis of any kind on ACP. Metastasis should be included as a part of the differential diagnosis of lesions of the anterior clinoid. Extradural clinoidectomy is a safe and effective method in the treatment of these tumors.

scholarly journals A case report of unilateral conductive hearing loss as a consequence of malignant sinonasal melanoma: the importance of completing a full clinical history and examination

2020 ◽  
Vol 36 (1) ◽  
Author(s):  
Victoria Blackabey ◽  
Olivia Kenyon ◽  
Rishi Talwar
Keyword(s):  
Hearing Loss ◽  
Case Report ◽  
Clinical Symptoms ◽  
Symptomatic Relief ◽  
Clinical History ◽  
Histological Diagnosis ◽  
Unusual Presentation ◽  
Sinus Surgery ◽  
Cancer Management ◽  
The Right

Abstract Background Sinonasal melanoma is a rare head and neck tumour. It is associated with a poor prognosis, high rates of loco-regional recurrence and distant metastasis. Treatment of the disease is therefore complicated, and because of limited data regarding the cancer, management is frequently tailored to the individual patient. We describe an unusual presentation of sinonasal melanoma with relevant histology, radiology and clinical photography. Case presentation The case report describes the presentation of a 64-year-old man to the Ear, Nose and Throat department with progressive right-sided hearing loss. A thorough history highlighted other clinical symptoms including unilateral nasal obstruction and epistaxis. Clinical examination showed a right middle ear effusion with a polypoidal lesion in the right nasal cavity. Relevant imaging demonstrated a destructive process that required further assessment. An endoscopic sinus procedure was performed to obtain histological diagnosis as well as providing symptomatic relief. Histology confirmed malignant mucosal melanoma. The patient underwent maxillectomy and orbital exenteration (due to further progression of disease) at a tertiary centre with a plan for subsequent immunotherapy. This however has been delayed due to further surgery to excise a metastatic lesion to the right femur. Conclusions This case report highlights the importance of a thorough clinical history and examination. An unusual presentation of a sinonasal tumour can easily be missed leading to a significant delay in treatment. The case report also describes the use of functional endoscopic sinus surgery in order to obtain histological diagnosis and to debulk the tumour, providing symptomatic relief. The current literature regarding management will be discussed as well as current developments guiding future treatment.

Stent Graft Placement in the Top-Down Direction for Treating Traumatic Intra-Abdominal Suprahepatic Inferior Vena Cava Rupture: A Case Report

2021 ◽  
pp. 152660282110250
Author(s):  
Yun Chul Park ◽  
Hyoung Ook Kim ◽  
Nam Yeol Yim ◽  
Byung Chan Lee ◽  
Chan Park ◽  
...  
Keyword(s):  
Case Report ◽  
Inferior Vena Cava ◽  
Stent Graft ◽  
Inferior Vena ◽  
Vena Cava ◽  
Endovascular Management ◽  
Top Down ◽  
Life Threatening ◽  
The Right ◽  
Suprahepatic Inferior Vena Cava

Purpose The treatment of suprahepatic inferior vena cava (IVC) ruptures results in high mortality rates due to difficulty in performing the surgical procedure. Here, we present a case of successful endovascular management of a life-threatening suprahepatic IVC rupture with top-down placement of a stent graft. Case Report A 33-year-old woman was involved in a traffic accident and presented to our emergency department due to unstable hemodynamics after blunt abdominal wall trauma. Computed tomography (CT) revealed massive extravasation of contrast agent from the suprahepatic IVC, which suggested traumatic suprahepatic IVC rupture. To seal the IVC, to salvage major hepatic veins, and to prevent migration of the stent graft into the right side of the heart after placement, an aortic cuff with a proximal hook was introduced in a top-down direction via the right internal jugular vein. After closure of the injured IVC, the patient’s hemodynamics improved, and additional laparotomy was performed. After 3 months of trauma care, the patient recovered and was discharged. Follow-up CT after 58 months showed a patent stent graft within the IVC. Conclusion Endovascular management with top-down placement of a stent graft is a viable option for emergent damage control in patients with life-threatening hemorrhage from IVC rupture.

AVASCULAR NECROSIS OF THE TRIQUETRUM: A CASE REPORT

Hand Surgery ◽  
2005 ◽  
Vol 10 (01) ◽  
pp. 91-94 ◽  
Author(s):  
Y. C. POR ◽  
W. Y. CHEW ◽  
I. Y. Y. TSOU
Keyword(s):  
Case Report ◽  
Avascular Necrosis ◽  
Total Ischemia ◽  
One Year ◽  
The Right

A case of total ischemia of the triquetrum after a crushing injury to the right wrist by a dumbbell is reported. He was treated conservatively with splinting and analgesia. There was complete clinical and radiological recovery after a follow-up of one year.

ANOMALIES OF THE PULMONARY VEINS AND THEIR SURGICAL SIGNIFICANCE

PEDIATRICS ◽  
1952 ◽  
Vol 9 (2) ◽  
pp. 152-166
Author(s):  
HARRY G. PARSONS ◽  
ANN PURDY ◽  
BRUCE JESSUP
Keyword(s):  
Superior Vena Cava ◽  
Clinical Symptoms ◽  
Superior Vena ◽  
Pulmonary Veins ◽  
Vena Cava ◽  
Ductus Venosus ◽  
Return Flow ◽  
Right Heart ◽  
Surgical Measures ◽  
The Right

The successful operations upon abnormalities of the outflow tracts of the heart suggest that surgical measures may also be applied to the correction of abnormal inflow tracts. Technically the anastomosis of veins to the auricle has been proved feasible in the experimental animal. Therefore, it should be possible to correct abnormally placed pulmonary veins in man. A wide variety of such anomalies occur. In 55 of 136 reported cases, all the oxygenated blood from the lungs was returned to the right heart through anomalous vessels. Thirty-five per cent of these cases of complete diversion were accompanied by other major cardiac defects. It is estimated that 50% or more of the return flow from the lungs must reach the right heart to produce clinical symptoms. Two cases are presented of persistence of the left superior vena cava which transmitted all the freshly oxygenated blood to the right auricle, by way of the left innominate and the right superior vena cava. The clinical picture was that of growth retardation, minimal cyanosis, a huge hyperactive heart, a loud left mesocardial systolic murmur, pulsating shadows in both upper pulmonary fields, and nearly identical oxygen-saturation of blood obtained from the right heart and femoral artery. One case is reported in which all the oxygenated blood from the lungs is carried to the right auricle by way of the ductus venosus. Surgical correction of the abnormality of these cases by transplantation of one or more of the veins would have been possible. However, no case known to the authors has yet been successfully corrected.

Treatment of Hepatic Embryonal Undifferentiated Sarcoma With Cardiothoracic Involvement

2018 ◽  
Vol 11 (4) ◽  
pp. NP199-NP202 ◽  
Author(s):  
Carlos Domínguez-Massa ◽  
Félix Serrano-Martínez ◽  
Óscar R. Blanco-Herrera ◽  
Alberto Berbel-Bonillo ◽  
Fernando Hornero-Sos ◽  
...  
Keyword(s):  
Inferior Vena ◽  
Circulatory Arrest ◽  
Tumor Resection ◽  
Vena Cava ◽  
Hepatic Tumors ◽  
Undifferentiated Sarcoma ◽  
Right Pulmonary Artery ◽  
The Right ◽  
Disease Free

Thorough study is required to decide the appropriate management of hepatic tumors in children. We present a case report of a hepatic embryonal undifferentiated sarcoma with unfavorable prognosis in a nine-year-old girl. After undergoing a detailed cancer characteristics and extension study, a two-stage surgery approach was decided. The hepatic tumor resection was the first procedure to be performed. One week later, under cardiopulmonary bypass, deep hypothermia, and circulatory arrest, thrombectomy of the inferior vena cava and right atrium was accomplished, plus thromboendarterectomy of the right pulmonary artery. During a four-year follow-up, the patient continues to be disease-free.

scholarly journals AYURVEDIC APPROACH ON CYSTOID MACULAR OEDEMA - A CASE REPORT

2021 ◽  
Vol 9 (8) ◽  
pp. 1904-1907
Author(s):  
Sabarinath M K ◽  
Pasha S M
Keyword(s):  
Case Report ◽  
Macular Oedema ◽  
Marked Improvement ◽  
Cystoid Macular Oedema ◽  
Field Of Vision ◽  
The Subject ◽  
One Year ◽  
The Right ◽  
Photocoagulation Therapy

Cystoid Macular Oedema or CME is a painless disorder that affects the central retina or macula. It refers to the accumulation of fluid in the outer plexiform and inner nuclear layer of the retina with the formation of a fluid-filled cyst. The primary symptom of macular oedema is blurry or wavy vision near or in the centre of your field of vision. Materials and Methods: A male patient of 48 yrs. presented in Shalakya OPD of GAMC Bengaluru with symp- toms of diminished vision in his right eye for one year. The patient was diagnosed with cystoid macular oedema in the right eye for which he was given photocoagulation therapy but did not find much relief. So, he approached our OPD. After thorough examination patient was started with Ayurvedic Medicines. Result: The subject showed marked improvement both subjectively and objectively. Discussion: Oedema which is the terminus of the pathology in this condition has to be understood as Ekanga Shopha. Though Kapha is the predominant dosha involved in forming Shopha here, the lakshanas manifesting are that of Vataja Timira. So, in this case study, Kapha Vata Hara followed by Shopha Hara line of treatment is adopted. Keywords: Cystoid macular oedema, Shopha, Vataja Timira, Nasya, Punarnavadi Kashaya.

scholarly journals Angiosarcoma of the Heart: Case Report

2020 ◽  
Vol 3 (11) ◽  
pp. 01-07
Author(s):  
Marc Vanderheyden ◽  
Sofie Dhaeyer ◽  
Chirik Wah Lau ◽  
Vanessa Meert ◽  
Jan Leeman ◽  
...  
Keyword(s):  
Case Report ◽  
Malignant Tumors ◽  
Local Relapse ◽  
Review Of The Literature ◽  
Poor Survival ◽  
Right Heart ◽  
Course Of Disease ◽  
Metastatic Recurrence ◽  
Primary Angiosarcoma ◽  
The Right

Cardiac angiosarcomas are rare malignant tumors, predominantly affecting the right heart with poor survival outcomes. The current mainstay of treatment consists of surgery with or without chemotherapy, but often yields limited results with local relapse or metastatic recurrence. This case report describes 2 patients with primary angiosarcoma located in the right atrium. One patient received neo-adjuvant and adjuvant chemotherapy; both were scheduled for surgical resection. The course of disease is described followed by a comprehensive review of the literature.

scholarly journals Retroperitoneal Robot-Assisted Laparoscopic Partial Nephrectomy for Horseshoe Kidney: A Case Report

2021 ◽  
Author(s):  
Dongxu Zhang ◽  
Youyi Lu ◽  
Fengze Sun ◽  
Di Wang ◽  
Xingjun Bao ◽  
...  
Keyword(s):  
Case Report ◽  
Partial Nephrectomy ◽  
Tumor Resection ◽  
Three Dimensional ◽  
Horseshoe Kidney ◽  
Laparoscopic Partial Nephrectomy ◽  
Robot Assisted ◽  
3D Reconstructions ◽  
Case Presentations ◽  
The Right

Abstract Background: Horseshoe kidney (HSK) have always been a challenge for urologists depending on its particular anatomy. We report a case of renal tumor in a patient with HSK, who underwent tumor resection by retroperitoneal robot-assisted laparoscopic partial nephrectomy. Case Presentations: A 47-year-old man presented to our hospital with a solid renal mass. Computed tomography urography (CTU) showed a 4.3 × 4.4 cm mass in the upper pole of the right kidney. Patients received a retroperitoneal robot-assisted laparoscopic partial nephrectomy on basis of three-dimensional (3D) reconstructions.Conclusion: The present case report highlights the feasibility of robot-assisted laparoscopic partial nephrectomy for horseshoe kidney, and the advantages of preoperative 3D reconstructions.

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