Abdominal desmoid-type fibromatosis – a case report and an overview of treatment options

Nowa Medycyna ◽  
2018 ◽  
Vol 25 (2) ◽  
Author(s):  
Justyna Koszarska-Mirek ◽  
Jakub Orleański
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Abdominal Wall ◽  
Treatment Options ◽  
Fibrous Tissue ◽  
Distant Metastases ◽  
Desmoid Tumour ◽  
Recurrence Rates ◽  
Abdominal Organs ◽  
Appropriate Treatment

Fibromatosis (desmoid, desmoid tumour) is a tumour belonging to the group of fibrous tissue proliferative diseases. Although the tumour cannot produce distant metastases, it shows local malignancy by invading adjacent tissues, as well as high recurrence rates after local resection. The incidence of fibromatosis is 2-4 cases per 1 million inhabitants per year. Three types of fibromatosis have been distinguished: extra-abdominal, abdominal wall and intra-abdominal type. Although the most common types are sporadic, coexistence with familial adenomatous polyposis (FAP), known as the Gardner’s syndrome, is observed. Available therapeutic options include surgical treatment, watchful waiting, hormone therapy, non-steroid anti-inflammatory drugs, chemotherapy and radiation therapy. This case report aims to draw attention to the difficulties in selecting an appropriate treatment option, limited surgical treatment, the psychological aspect of the disease, as well as the need to actively search for modern diagnostic and therapeutic solutions. We present a case of a 26-year-old patient who was ultimately diagnosed with a desmoid tumour invading the abdominal wall and internal abdominal organs. The patient presented to a county hospital due to suspected gastrointestinal obstruction. It was found from medical history that the patient had palpated a tumour of the abdominal wall 9 months before admission.

scholarly journals Appendicitis in puerpeium: Case report

2011 ◽  
Vol 58 (4) ◽  
pp. 111-112 ◽  
Author(s):  
Milica Berisavac ◽  
Biljana Kastratovic-Kotlica ◽  
V. Tosic ◽  
N. Markovic ◽  
S. Ljustina ◽  
...  
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Early Detection ◽  
Acute Appendicitis ◽  
Abdominal Wall ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Laboratory Infection ◽  
Infection Parameters ◽  
Clinical Signs And Symptoms

Acute appendicitis in puerperium is often diagnosed too late, because clinical signs can be unrelaible. Abdominal wall rigidity is rarely noticed in puerpeium because of weak abdominal wall muscles, laboratory parameters are not enough relaible and atipycal appendix presentation makes difficulties in diagnosis3,4. Knowing clinical signs and symptoms of appendicitis, possible complications and their early detection, make a chance for a good surgical outcome. Measuring of axillar and rectal temperature can take confusion in, and prolong time until surgical treatment. Leucocytosis in puerperium is not valid for diagnosis. We report a case of patient in puerperium with high laboratory infection parameters. Diagnosis of appendicitis is made based on clinical signs and symptoms, that is proved intraoperatively and histologicaly. Appendectomy without perforation carries less risks for mother and fetus.

scholarly journals Scrotal Calcinosis: A Case Report and Review of Pathogenesis and Surgical Management

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Usman M. Tela ◽  
M. Bashir Ibrahim
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Rare Disease ◽  
Surgical Management ◽  
Treatment Options ◽  
Wide Excision ◽  
Scrotal Skin ◽  
Direct Closure ◽  
Benign Disorder ◽  
Skin Nodules

Idiopathic scrotal calcinosis is an uncommon benign disorder of the scrotal skin which is characterized by multiple calcified intradermal nodules. We report a 33-year old with asymptomatic multiple calcified scrotal skin nodules. He had wide excision of the lesions and direct closure of the scrotum. We review the pathogenesis and surgical treatment options for this rare disease of the scrotum.

scholarly journals Surgical treatment of hemorrhoids: a critical appraisal of the current options

2014 ◽  
Vol 27 (1) ◽  
pp. 66-70 ◽  
Author(s):  
Marlise Mello CERATO ◽  
Nilo Luiz CERATO ◽  
Patrícia PASSOS ◽  
Alberto TREIGUE ◽  
Daniel C. DAMIN
Keyword(s):  
Surgical Treatment ◽  
Postoperative Pain ◽  
Treatment Options ◽  
Surgical Techniques ◽  
Postoperative Recurrence ◽  
Long Term Results ◽  
Published Data ◽  
Complication Rates ◽  
Recurrence Rates

Introduction : Surgical treatment of hemorrhoids is still a dilemma. New techniques have been developed leading to a lower rate of postoperative pain; however, they are associated with a greater likelihood of recurrence. Aim : To review current indications as well as the results and complications of the main techniques currently used in the surgical treatment of hemorrhoidal disease. Methods : A systematic search of the published data on the options for treatment of hemorrhoids up to December 2012 was conducted using Medline/PubMed, Cochrane, and UpToDate. Results : Currently available surgical treatment options include procedure for prolapse and hemorrhoids (PPH), transanal hemorrhoidal dearterialization (THD), and conventional hemorrhoidectomy techniques. Excisional techniques showed similar results regarding pain, time to return to normal activities, and complication rates. PPH and THD were associated with less postoperative pain and lower complication rates; however, both had higher postoperative recurrence rates. Conclusion : Conventional surgical techniques yield better long-term results. Despite good results in the immediate postoperative period, PPH and THD have not shown consistent long-term favorable results.

Desmoid-type Fibromatosis of the Mesentery: A Case Report

2017 ◽  
Vol 10 (1) ◽  
pp. 58-62
Author(s):  
Tatyana M. Betova ◽  
Savelina L. Popovska ◽  
Radoslav G. Trifonov ◽  
Konstantina S. Karakadieva ◽  
Genoveva B. Valcheva ◽  
...  
Keyword(s):  
Case Report ◽  
Abdominal Wall ◽  
Multidisciplinary Approach ◽  
Abdominal Cavity ◽  
Metastatic Potential ◽  
Surgical Method ◽  
Anatomical Position ◽  
Abdominal Organs ◽  
Mesenchymal Neoplasm

SummaryDesmoid-type fibromatosis is a rare mesenchymal neoplasm with locally aggressive, infiltrating and destructive growth that is not characterized by a metastatic potential. According to their anatomical position, desmoid-type fibromatoses can be divided into three groups: extra-abdominal, intra-abdominal, and fibromatoses of the abdominal wall. Mesenteric fibromatoses account for 8% of the intra-abdominal ones. The latter are characterized by myofibroblastic proliferation and infiltration of both the pelvic and abdominal organs. We report a 26-year-old woman who complained of abdominal enlargement, feeling of heaviness, discomfort and reflux, which symptoms dated back 1-2 months prior to hospitalization. The patient underwent laparotomy due to subocclusive symptoms. Intraoperatively, a tumor sized 30 cm in diameter was found. The tumor originated from the mesentery and infiltrated in the jejunum, the entire ileum, and part of the caecum with perforation towards the abdominal cavity. The histological and immunohistochemical examinations are important for clarification of the diagnosis. The treatment requires a multidisciplinary approach, in which the surgical method has the key role.

scholarly journals Unique Application of K-Y Jelly in Cryotherapy for Giant Cell Tumors of the Distal Femur - A Case Report

2021 ◽  
pp. 1-7
Keyword(s):  
Case Report ◽  
Distal Femur ◽  
Tissue Architecture ◽  
Recurrence Rates ◽  
Giant Cell Tumors ◽  
Intralesional Curettage ◽  
Appropriate Treatment ◽  
Thermal Conducting ◽  
Aggressive Tumor ◽  
Semi Solid

GCTs are a locally aggressive tumor that can result in significant pain and dysfunction through the disruption of bony and nearby soft tissue architecture. Although generally benign, these tumors have been shown to have 1-9% chance of metastasis and a local recurrence rate of up to 65%. For these reasons, appropriate treatment is essential to remove primary lesions as well as reduce the odds of metastatic disease and lower recurrence rates. Cryosurgery is a welldescribed technique used to achieve local control of primary GCTs. Modern cryoablation utilizes a cryoprobe to freeze surrounding tissues via release of a thermal conducting gas (argonhelium). The optimal technique for eradication of GCT is a widely debated topic rooted in rates of complications and tumor recurrence. Herein, we describe a case report of a 30-year-old female with a large distal femoral GCT that underwent intralesional curettage and adjunctive cryotherapy utilizing K-Y jelly as a semi-solid medium to transmit the freeze zone more evenly within the cavity. Following cryoablation, the cavity was filled with antibiotic loaded polymethyl methacrylate cement. This technique has scarcely been described in the literature and warrants further investigation.

scholarly journals Blunt Trauma Leading to Anterior Abdominal Wall Hernia

2021 ◽  
Keyword(s):  
Abdominal Wall ◽  
Treatment Options ◽  
Abdominal Wall Hernia ◽  
Skin Penetration ◽  
Exploratory Laparotomy ◽  
Operative Management ◽  
High Energy ◽  
Free Fluid ◽  
Abdominal Organs ◽  
Hernial Repair

Traumatic abdominal wall hernia (TAWH) has a reported incidence of around 1%. It is defined as herniation of intra-abdominal organs following trauma without skin penetration. High-energy trauma is often associated with intra-abdominal injury. Treatment options vary from non-operative management to surgical repair either open or laparoscopic. We present a case of a middle-aged male who presented with a history of rickshaw roll over injury. On examination, there was tender abdominal swelling with abrasions. Computerized Tomography (CT) scan confirmed the diagnosis of TAWH and free fluid in abdomen. Emergency exploratory laparotomy was performed. Mesenteric tears were repaired and primary restoration of abdominal wall was done. The patient was discharged on a fourth post-operative day without any complications. Management of TAWH should be tailored according to individual patient presentation. Midline exploratory laparotomy with the primary hernial repair is an operative intervention of choice for those with high-energy injury as there is an increased chance of accompanying visceral trauma. Keywords: Laparotomy; Trauma; Hernia.

Extratemporal Refractory Epilepsy

2019 ◽  
pp. 117-125
Author(s):  
Vamsidhar Chavakula ◽  
Eun-Hyoung Park ◽  
Joseph R. Madsen
Keyword(s):  
Surgical Treatment ◽  
Refractory Epilepsy ◽  
Treatment Options ◽  
Clinical History ◽  
Postoperative Management ◽  
Metabolic Imaging ◽  
Appropriate Treatment ◽  
Functional Localization ◽  
History Of ◽  
Medically Refractory Epilepsy

Medically refractory epilepsy is defined as the persistence of seizures after appropriate treatment with 2 different medications. A thorough understanding of the clinical history and semiology of seizures is important when considering surgical treatment options, as multifocal epilepsy may not be amenable to resective surgery. Anatomic, functional, and metabolic imaging sequences may assist in identifying a seizure focus, and EEG will provide a functional localization. The surgeon must make a careful and informed decision about the maximal amount of lesion that may be resected without incurring neurologic deficits. Specific postoperative management should be dictated by the natural history of the noted pathology.

scholarly journals Left Colon Diverticulitis Presenting as Perforated Lumbar Abscess: A Case Report and Review of the Current Literature

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Daniel Paramythiotis ◽  
Konstantinia Kofina ◽  
Vassileios N. Papadopoulos ◽  
Antonios Michalopoulos
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Surgical Treatment ◽  
Abdominal Wall ◽  
Current Literature ◽  
Left Colon ◽  
Common Complication ◽  
Colon Diverticulitis ◽  
The Creation

Diverticular perforation is a common complication of diverticulitis and can lead to the creation of abscesses. The presence of such abscesses on the abdominal wall is rare and can lead to misdiagnosis. We present the case of a patient with abdominal pain and the formation of a large left lumbar abscess due to perforation of a diverticulum of the left colon and our surgical treatment of choice with favorable results.

scholarly journals Primary Subcutaneous Umbilical Endometriosis: Case Report and Review of the Literature

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Lorenzo Capasso ◽  
Valerio Sciascia ◽  
Giuseppe Loiaco ◽  
Giovanni Guida ◽  
Francesco Iarrobino ◽  
...  
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Gold Standard ◽  
Care Setting ◽  
Standard Treatment ◽  
Treatment Options ◽  
Hormonal Treatment ◽  
Review Of The Literature ◽  
Adjuvant Hormonal Treatment ◽  
Umbilical Endometriosis

We report the case of a patient diagnosed with primary umbilical endometriosis intending to discuss the diagnostic and therapeutic management of this rare disease. A 45-year-old woman suffering from a painful swelling located in the umbilical region, with intact and normal cutaneous aspect, came to our attention. Ultrasonography of the umbilical region showed a nodule with a nonhomogeneous echotexture pattern. Partial omphalectomy was performed under local anesthesia in day care setting surgery. Histology confirmed the diagnosis of umbilical endometriosis. Pre- and postoperative clinical controls showed no evidence for other endometriosis localization. No medical treatment was administered. No signs of recurrence were observed after 5 years from surgery. A review of the literature of the last 10 years was generated based on MEDLINE research, selecting some specific keywords. Several lesions can occur in the umbilical region, and endometriosis has to be ruled out even in patients without any surgery in their medical history. Surgery is the gold standard treatment for this condition: partial and radical omphalectomy are the two treatment options. We believe that given the significant psychological and aesthetical value of the umbilicus, surgical treatment has to be tailored and in case of a small endometrial umbilical nodule, partial omphalectomy (local excision of the umbilical endometrial nodule) with a 3 mm free border, even without adjuvant hormonal treatment, could ensure adequate and effective treatment.

scholarly journals Primary Epithelioid Sarcoma Manifesting as a Fungating Scalp Mass - Imaging Features and Treatment Options. A Case Report and Literature Review

2021 ◽  
Vol 15 (11) ◽  
pp. 1-9
Author(s):  
Yonghao Zhang ◽  
Tarun Mohan Mirpuri ◽  
Chi Long Ho
Keyword(s):  
Case Report ◽  
Adjuvant Radiotherapy ◽  
Multimodality Imaging ◽  
Treatment Options ◽  
Epithelioid Sarcoma ◽  
Distant Metastases ◽  
Imaging Features ◽  
Rare Malignancy ◽  
Scalp Mass

Primary epithelioid sarcoma is an extremely rare malignancy of the scalp. To date, less than a dozen such cases have been reported in the literature. The diagnosis often is a challenge to both radiologists and clinicians. This is largely attributed to the lack of literature on the imaging features of scalp epithelioid sarcoma. In this report, we highlight the role of multimodality imaging in the diagnosis of primary scalp epithelioid sarcoma and review the epidemiology, imaging, treatment options, and prognosis of these malignant scalp tumors. Displaying a multilobulated morphology, heterogeneous enhancement, and restricted diffusion on MRI, these tumors typically show central degeneration with hemorrhage, necrosis, and calcification. Wide surgical resection and adjuvant radiotherapy are the mainstays of treatment for localized scalp tumors. Nevertheless, the prognosis of patients with distant metastases at diagnosis is extremely poor compared to those with local or regional diseases.

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