scholarly journals Successful en bloc resection with acceptable cosmesis of a right recurrent giant scalp-orbital AVM causing severe disfigurement: a case report

2021 ◽  
Vol 24 (1) ◽  
pp. 28-33
Author(s):  
Anjan Singh Karki ◽  
Dipendra Kumar Shresha ◽  
Gopal Sedain ◽  
Sushil Krishna Shilpakar
Keyword(s):  
Rare Case ◽  
Surgical Techniques ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Imaging Findings ◽  
En Bloc ◽  
Facial Disfigurement ◽  
Visual Obstruction ◽  
Subcutaneous Layer ◽  
The Right

Scalp arteriovenous malformation (AVM) accounts for only 8.1% of all AVM cases. These lesions are made up of an abnormal fistulous tangle of tortuous dysmorphic network of vessels “vascular nidus” directly connecting between the feeding arteries and draining veins, without capillary connection, located within the incision subcutaneous layer. With time, these congenital lesions may evolve and enlarge and clinically manifest with variable features. The only effective method of preventing evolution of these malformations is to exclude the lesion completely from the circulation. Involvement of the orbit and face may cause severe facial disfigurement, proptosis, visual obstruction and even facial palsy. These lesions may be complicated by ulceration, infection and profuse bleeding. We present a rare case of 40-year-old female with a recurrent congenital scalp-orbital AVM causing proptosis, visual obstruction on the right eye with severe facial disfigurement. The lesion was successfully excised with acceptable cosmesis and removal of the visual obstruction. A brief literature review, imaging findings and the surgical techniques have been presented.

scholarly journals Mobile spine chordoma: results of 166 patients from the AOSpine Knowledge Forum Tumor database

2016 ◽  
Vol 24 (4) ◽  
pp. 644-651 ◽  
Author(s):  
Ziya L. Gokaslan ◽  
Patricia L. Zadnik ◽  
Daniel M. Sciubba ◽  
Niccole Germscheid ◽  
C. Rory Goodwin ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Survival Data ◽  
Large Scale ◽  
Surgical Techniques ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
En Bloc ◽  
Increased Risk ◽  
Significant Difference ◽  
Mobile Spine

OBJECT A chordoma is an indolent primary spinal tumor that has devastating effects on the patient's life. These lesions are chemoresistant, resistant to conventional radiotherapy, and moderately sensitive to proton therapy; however, en bloc resection remains the preferred treatment for optimizing patient outcomes. While multiple small and largely retrospective studies have investigated the outcomes following en bloc resection of chordomas in the sacrum, there have been few large-scale studies on patients with chordomas of the mobile spine. The goal of this study was to review the outcomes of surgically treated patients with mobile spine chordomas at multiple international centers with respect to local recurrence and survival. This multiinstitutional retrospective study collected data between 1988 and 2012 about prognosis-predicting factors, including various clinical characteristics and surgical techniques for mobile spine chordoma. Tumors were classified according to the Enneking principles and analyzed in 2 treatment cohorts: Enneking-appropriate (EA) and Enneking-inappropriate (EI) cohorts. Patients were categorized as EA when the final pathological assessment of the margin matched the Enneking recommendation; otherwise, they were categorized as EI. METHODS Descriptive statistics were used to summarize the data (Student t-test, chi-square, and Fisher exact tests). Recurrence and survival data were analyzed using Kaplan-Meier survival curves, log-rank tests, and multivariate Cox proportional hazard modeling. RESULTS A total of 166 patients (55 female and 111 male patients) with mobile spine chordoma were included. The median patient follow-up was 2.6 years (range 1 day to 22.5 years). Fifty-eight (41%) patients were EA and 84 (59%) patients were EI. The type of biopsy (p < 0.001), spinal location (p = 0.018), and if the patient received adjuvant therapy (p < 0.001) were significantly different between the 2 cohorts. Overall, 58 (35%) patients developed local recurrence and 57 (34%) patients died. Median survival was 7.0 years postoperative: 8.4 years postoperative for EA patients and 6.4 years postoperative for EI patients (p = 0.023). The multivariate analysis showed that the EI cohort was significantly associated with an increased risk of local recurrence in comparison with the EA cohort (HR 7.02; 95% CI 2.96–16.6; p < 0.001), although no significant difference in survival was observed. CONCLUSIONS EA resection plays a major role in decreasing the risk for local recurrence in patients with chordoma of the mobile spine.

scholarly journals A Giant retroperitoneal liposarcoma encasing entirely the right kidney: A case report and a review of nephrectomy indications

2021 ◽  
Author(s):  
Houssem Harbi ◽  
Amira Akrout ◽  
Mohamed Fourati ◽  
Amine Zouari ◽  
Nozha Toumi
Keyword(s):  
Elderly Patient ◽  
Case Report ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Resection Margins ◽  
En Bloc ◽  
Retroperitoneal Liposarcoma ◽  
R1 Resection ◽  
The Right

A 68-year-old female was operated for a giant dedifferentiated retroperitoneal liposarcoma (RLS) encasing entirely the right kidney. She had an en-bloc resection of the tumor with right nephrectomy. The en-bloc resection should avoid R1 resection margins. Renal conservation is suggested if the kidney is widely displaced and for elderly patient.

scholarly journals Parathyroid Carcinoma: An Up-to-Date Retrospective Multicentric Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-5 ◽  
Author(s):  
Francesco Quaglino ◽  
Luca Manfrino ◽  
Luca Cestino ◽  
Massimo Giusti ◽  
Enrico Mazza ◽  
...  
Keyword(s):  
Serum Calcium ◽  
Parathyroid Carcinoma ◽  
Surgical Techniques ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
En Bloc ◽  
Region Data ◽  
Males And Females ◽  
Cancer Network ◽  
Multiple Symptoms

Parathyroid carcinoma (PC) is a rare disease responsible for about 1% of primary hyperparathyroidism (PHPT) cases. PC usually has an indolent course, tough to differentiate from the benign causes of PHPT, and the only certain diagnosis is histologic. The gold standard surgical treatment is the en bloc resection associated with the homolateral thyroid loboistmectomy. The aim of this study was to underline the main differences between PC and benign PHPT, along with gathering epidemiological knowledge relative to PC in our region. Data from the regional cancer network (Rete Oncologica del Piemonte e della Valle d’Aosta) since 2007 have been reported, including 21 patients from three hospitals (AO S. Croce e Carle of Cuneo, AOU Città della Salute of Turin, and ASL Città di Torino). The incidence of the disease, gender, age at time of diagnosis, presence of renal and bone symptoms, serum calcium and PTH levels, surgical technique performed, and percentage of recurrence were analysed. PC data were than compared with a series of patients affected by benign PHPT, referred to ASL Città di Torino, Maria Vittoria Hospital, from 2007 to 2019. A PC incidence of 0.05 cases per 100,000 inhabitants was found in our region. Benign forms occurred more frequently in females (p=0.0002), while PC equally occurred in males and females and affected younger patients (p=0.026). Serum calcium and PTH levels were significantly higher in PC patients; accordingly, typical PHPT symptoms were more frequently reported in PC than in benign PHPT. In the PC group, the en bloc resection shows a 13 times lower risk for relapse compared with all the other surgical techniques. PC is equally gender distributed, and the average patients’ age is in the fifth decade of life. It is usually functioning, with greater biochemical activity and multiple symptoms. A not-radical surgical resection is associated with a higher recurrence rate. A meticulous presurgical evaluation of PHPT patients showing PC’s evocative features is mandatory to obtain a complete disease extirpation.

Combined endoscopic and laparoscopic en bloc resection of the urachus and the bladder dome in a rare case of urachal carcinoma

2007 ◽  
Vol 14 (4) ◽  
pp. 362-364 ◽  
Author(s):  
Francesco Porpiglia ◽  
Cecilia M Cracco ◽  
Carlo Terrone ◽  
Marco Cossu ◽  
Julien Renard ◽  
...  
Keyword(s):  
Rare Case ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
En Bloc ◽  
Urachal Carcinoma ◽  
Bladder Dome

scholarly journals Effectiveness of S-O Clip-Assisted Colorectal Endoscopic Submucosal Dissection

2021 ◽  
Vol 11 (1) ◽  
pp. 141
Author(s):  
Haruka Fujinami ◽  
Akira Teramoto ◽  
Saeko Takahashi ◽  
Takayuki Ando ◽  
Shinya Kajiura ◽  
...  
Keyword(s):  
Endoscopic Submucosal Dissection ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Resection Rate ◽  
Right Colon ◽  
En Bloc ◽  
Submucosal Dissection ◽  
Colorectal Endoscopic Submucosal Dissection ◽  
The Right ◽  
Surgery Duration

This study aimed to assess the utility of the S-O clip during colorectal endoscopic submucosal dissection (ESD). We conducted a retrospective study on 185 patients who underwent colorectal ESD from January 2015 to January 2020. The patients were divided into two groups: before and after the introduction of the S-O clip. Forty-two patients underwent conventional ESD (CO group) and 29 patients underwent ESD using the S-O clip (SO group). We compared the surgery duration, dissection speed, en bloc resection rate, and complication rate between both groups. Compared with the CO group, the SO group had a significantly shorter surgery duration (70.7 ± 37.9 min vs. 51.2 ± 18.6 min; p = 0.017), a significantly higher dissection speed (15.1 ± 9.0 min vs. 26.3 ± 13.8 min; p < 0.001), a significantly higher en bloc resection rate (80.9% vs. 98.8%; p ≤ 0.001), and a significantly lower perforation rate (4.3% vs. 1.3%). In the right colon, the surgery duration was significantly shorter and the dissection speed was significantly higher in the SO group than in the CO group. Moreover, the rate of en bloc resection improved significantly in the right colon. S-O clip-assisted ESD reduces the procedure time and improves the treatment effects, especially in the right colon.

scholarly journals Giant cell tumor cuboid: a rare case report.

2019 ◽  
Vol 26 (09) ◽  
pp. 1597-1599
Author(s):  
Mukesh Kumar ◽  
Masroor Ahmed ◽  
Muhammad Saleem ◽  
Khurram Sahar
Keyword(s):  
Giant Cell Tumor ◽  
Giant Cell ◽  
Skeletal Maturity ◽  
Osteolytic Lesion ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Cell Tumor ◽  
En Bloc ◽  
Cuboid Bone ◽  
The Right

Osteoclastoma (Giant Cell Tumor) of Cuboid bone is a rare bone tumor. GCT is primarily seen in metaphyseo-epiphyseal region of long bones after skeletal maturity. This patient is a 17 years old female, presented with painful swelling of the right foot. On conventional radiographs, there is osteolytic lesion in Cuboid bone of right foot. En bloc resection and autologous bone grafting (iliac crest) was done. Patient's pain and swelling disappeared following the procedure and there is no evidence of recurrence at 18 months follow up.

scholarly journals Sacroplasty Augmentation of Instrumented Pelvic Reconstruction After High Sacrectomy: A Technical Case Report

2021 ◽  
Author(s):  
Amanda N Sacino ◽  
Sutipat Pairojboriboon ◽  
Ian Suk ◽  
Daniel Lubelski ◽  
Robin Yang ◽  
...  
Keyword(s):  
Mechanical Stability ◽  
Pelvic Ring ◽  
Surgical Techniques ◽  
Extent Of Resection ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
En Bloc ◽  
Mobile Spine ◽  
Sacral Tumors ◽  
Fibrous Tumor

Abstract BACKGROUND AND IMPORTANCE En bloc resection of sacral tumors is the most effective treatment to help prevent recurrence. Sacrectomy, however, can be destabilizing, depending on the extent of resection. Various surgical techniques for improving stability and enabling early ambulation have been proposed. CLINICAL PRESENTATION Here, we report a case in which we use PMMA (poly[methyl methacrylate]) to augment pelvic instrumentation to improve mechanical stability after sacrectomy for en bloc resection of a solitary fibrous tumor. CONCLUSION We highlight the use of sacroplasty augmentation of pelvic ring reconstruction to provide biomechanical stability without the need for fusion of any mobile spine segments, which allowed for early patient ambulation and no appreciable loss of range of motion or mobility.

scholarly journals Rare case of retroperitoneal cystic lymphangioma in an adult

2019 ◽  
Vol 6 (6) ◽  
pp. 2213
Author(s):  
Cherring Tandup ◽  
Anish Chowdhury ◽  
Yashwant Raj Sakaray ◽  
Nasika Venkata Kanaka Naga Karthik
Keyword(s):  
Rare Case ◽  
Cystic Lesion ◽  
Benign Tumor ◽  
Lymphatic Vessels ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Cystic Lymphangioma ◽  
En Bloc ◽  
Recommended Treatment ◽  
Cystic Mesothelioma

Cystic lymphangioma is benign tumor originating from the lymphatic vessels. Most commonly occurs in childhood and in the head or neck regions, retroperitoneal localization and presentations in adulthood are rare. Making a pre-operative diagnosis is challenging, and only possible subsequent to the histological examination. En bloc resection is the recommended treatment for cystic lymphangioma, and recurrence occurs due to an incomplete excision. We here present a case of 40 year female presenting with progressive palpable lump associated with pain in right quadrant of abdomen, which on computed tomography revealed a large retroperitoneal cystic lesion probably lymphanigoma or cystic mesothelioma.

scholarly journals Histological Comparison of Testicular Needle Biopsy and En Bloc Samples in Abattoir Calves

Animals ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. 918
Author(s):  
Maike Rohländer ◽  
Henning Otzen ◽  
Kristina Rode ◽  
Klaus Jung ◽  
Marion Schmicke ◽  
...  
Keyword(s):  
Cross Sections ◽  
Needle Biopsy ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Sample Collection ◽  
En Bloc ◽  
Significance Level ◽  
Inner Diameter ◽  
The Individual ◽  
The Right

The aim of this study was to test whether a single testicular needle biopsy could provide histological results comparable to en bloc resection histology and whether one biopsy was sufficient to reflect the histology of an entire pair of testicles. Two methods of sample collection were tested on 32 bull calves aged five to eight months to compare histological parameters of needle biopsy with those of en bloc resection samples. One testicular needle biopsy of the right and three en bloc samples of both testicles were collected and compared for the number of tubular cross sections, tubules with elongated spermatids (ES), outer/inner diameter of tubules, thickness of tubular wall, and number of Sertoli cells (SC). Additionally, animal data were considered. No significant differences were found between the left and right testis or among the individual locations of en bloc samples. However, histologically significant differences (Bonferroni-adjusted significance level: p < 0.05/6 = 0.0083) were found between the needle biopsy and en bloc resection regarding the tubular cross sections per visual field (p < 0.05), the outer (p = 0.01) and inner diameter and the thickness of the tubular wall (both p < 0.01). In the SOX9 immunohistochemical staining, no significant differences (p > 0.05) could be observed for SC numbers between needle biopsy and en bloc samples. In conclusion, results of testicular needle biopsy do not have the same validity as the en bloc resection histology. Furthermore, one biopsy is insufficient to reflect the histology of the entire testicular pair.

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