scholarly journals En bloc Pancreaticodudenectomy with Colectomy for Locally Advanced Right Sided Colon Cancer

2015 ◽  
Vol 53 (200) ◽  
pp. 301-303 ◽  
Author(s):  
Ramesh Singh Bhandari ◽  
Paleswan Joshi Lakhey ◽  
Parsu Ram Mishra
Keyword(s):  
Locally Advanced ◽  
Preoperative Assessment ◽  
Right Hemicolectomy ◽  
Hepatic Flexure ◽  
En Bloc ◽  
Curative Intent ◽  
Proliferative Growth ◽  
Well Differentiated ◽  
The Right ◽  
Enhanced Computed Tomography

A 57 year old male presented to our outpatient clinic with history of on and off melena, weight loss and decreasing appetite for 10 months duration and a noticeable mass on the right upper quadrant. Abdominal examination revealed an intra-abdominal lump in right upper quadrant which was subsequently evaluated by colonoscopy, which revealed an ulcero-proliferative growth in the hepatic flexure and the biopsy from it confirmed well-differentiated adenocarcinoma. Contrast enhanced computed tomography demonstrated hepatic flexure mass with possible invasion into adjacent duodenum without features of advanced disease. After completion of necessary preoperative assessment and investigations, patient was explored with curative intent and underwent extended right hemicolectomy with en bloc pancreaticodudenectomy. Patient was discharged on 10th postoperative day and at 14 months follows up; he was doing well without any evidence of recurrence. Keywords: colectomy; locally advanced; pancreaticoduodenectomy.

scholarly journals Undifferentiated colonic neoplasm with SMARCA4 germline gene mutation and loss of SMARCA4 protein expression: a case report and literature review

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Huanli Duan ◽  
Wei Gao ◽  
Leiming Wang ◽  
Feng Cao ◽  
Lianghong Teng
Keyword(s):  
Protein Expression ◽  
Tumor Cells ◽  
Epigastric Pain ◽  
Abdominal Distension ◽  
Colonic Neoplasm ◽  
Right Hemicolectomy ◽  
Hepatic Flexure ◽  
The Right ◽  
Multiple Liver Metastases ◽  
Enhanced Computed Tomography

Abstract Background Nonsense mutation or inactivation of SMARCA4 (BRG1) is associated with a monomorphic undifferentiated histological appearance in tumors at different sites. The association between SMARCA4 alteration and undifferentiated colonic carcinoma needs to be further elucidated. Methods A 61-year-old male patient presented to the hospital with intermittent epigastric pain in the right upper abdomen and abdominal distension. The enhanced computed tomography detected a mass in the hepatic flexure of the colon and multiple liver metastases. Results The right hemicolectomy contained a 4.5-cm undifferentiated malignancy with cells arranged in sheets, abundant necrosis, and areas showing rhabdoid morphology. The immunohistochemistry result showed that these tumor cells were focally positive for cytokeratin (CK), CK8, and CK18; however, diffusely positive for vimentin, P53, Fli-1, and SALL-4. Notably, tumor cells showed a heterogeneous loss of SMARCA4 expression pattern and intact SMARCB1 expression. Next-generation sequencing showed a germline SMARCA4 c.3277C>T(p.R1093*)mutation, somatic APC mutation, and no abnormal SMARCB1 gene. The tumor exhibited microsatellite stability, negative PD-L1 expression, and few infiltrating CD8 + T cells. The patient died a month later after surgery. Conclusions We presented a rare case of undifferentiated colonic neoplasm with loss of SMARCA4 protein expression and germline SMARCA4 mutation. Moreover, the role of SMARCA4 alterations in tumor diagnosis and treatment was also summarized.

scholarly journals Renal Angiomyolipoma Mimicking a Well-Differentiated Retroperitoneal Liposarcoma

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Honoka Fuse ◽  
Masaya Ito ◽  
Kosuke Takemura ◽  
Shuzo Ikuta ◽  
Toru Motoi ◽  
...  
Keyword(s):  
Clinical Diagnosis ◽  
Core Needle Biopsy ◽  
Needle Biopsy ◽  
Tumor Resection ◽  
Renal Angiomyolipoma ◽  
Core Needle ◽  
Well Differentiated ◽  
The Right ◽  
Enhanced Computed Tomography ◽  
Solid Lesions

A 37-year-old Burmese woman presented with an incidentally found retroperitoneal fat-containing tumor. The tumor was 9 cm in the longest diameter, surrounding the right kidney, and composed of homogenous adipose tissue with thickened septum-like structures and spotty nonadipose structures, which were enhanced on contrast-enhanced computed tomography and magnetic resonance imaging. The tumor did not show either a beak sign or synchronous angiomyolipoma-like lesion in the kidneys. The tumor had irregular septa, thin blood vessels, and spotty small soft-tissue nodules. The tumor did not contain any heterogeneously enhanced solid lesions suspicious for dedifferentiated liposarcomas. Based on these imaging findings, a clinical diagnosis of a well-differentiated liposarcoma was made. Under the consensus of a multidisciplinary cancer board, she was recommended to undergo core-needle biopsy to confirm the clinical diagnosis. However, she declined to undergo biopsy for financial reasons. She underwent kidney-sparing retroperitoneal tumor resection. Histopathologically, the tumor was an angiomyolipoma with positive immunostaining for HMB45 and Melan A. The present case suggests the importance of core-needle biopsy prior to surgical intervention for retroperitoneal fat-containing tumors.

scholarly journals Wide Excision of a Retroperitoneal Liposarcoma with En Bloc Ureterectomy and Renal Salvage by Autotransplantation

2019 ◽  
Vol 2019 ◽  
pp. 1-3
Author(s):  
Siegfredo R. Paloyo ◽  
Arjel D. Ramirez ◽  
Ferri P. David-Paloyo ◽  
Rodney B. Dofitas
Keyword(s):  
The Philippines ◽  
Wide Excision ◽  
Low Grade ◽  
En Bloc ◽  
Excellent Outcome ◽  
Mesenchymal Neoplasm ◽  
Renal Autotransplantation ◽  
Characteristic Features ◽  
Well Differentiated ◽  
The Right

Liposarcoma is a malignant mesenchymal neoplasm composed of adipose tissue with varying degrees of atypia. These tumors grow slowly and may reach an enormous size particularly if located in the retroperitoneum. We report a 40-year-old male with a 6-month history of gradual abdominal enlargement. Computed tomography (CT) of the abdomen showed a huge retroperitoneal mass with characteristic features consistent with liposarcoma. On laparotomy, the mass was noted to be encasing the right ureter for which a wide excision with en bloc ureterectomy and subsequent renal autotransplantation for organ preservation was done. Post-operative course was uneventful with excellent outcome after 6 months of follow-up. Final histopathologic diagnosis was low-grade, well differentiated liposarcoma, which has favorable prognosis following radical surgery. This was the first report of such a case in the Philippines.

Multimodal management of locally advanced rhabdoid tumour of the kidney in an adult

2021 ◽  
Vol 14 (4) ◽  
pp. e236830
Author(s):  
Ritesh Goel ◽  
Sridhar Panaiyadiyan ◽  
Brusabhanu Nayak ◽  
Prabhjot Singh
Keyword(s):  
Radical Nephrectomy ◽  
Renal Mass ◽  
Kinase Inhibitor ◽  
Locally Advanced ◽  
Early Recurrence ◽  
En Bloc ◽  
Curative Intent ◽  
Rhabdoid Tumour ◽  
Paediatric Tumours ◽  
Multimodal Management

Malignant rhabdoid tumours of the kidney (MRTK) are rare paediatric tumours known for their aggressive nature and early metastasis. However, MRTK in adults are even more rare with only a few cases reported in the literature. Herein, we report a case of 65-year-old woman with rapidly progressive left renal mass requiring en-bloc radical nephrectomy, splenectomy and distal pancreatectomy. Histopathology revealed a malignant rhabdoid tumour with characteristic histological and immunohistochemical findings with negative margins. To the best of our knowledge, this is the first reported case of aggressive surgical management of locally advanced MRTK. Despite surgery with curative intent, the patient developed early recurrence and started on tyrosine kinase inhibitor. Unfortunately, the patient expired after 8 months of surgery due to disease progression.

scholarly journals En bloc pancreaticoduodenectomy and right hemicolectomy to treat locally advanced right colon cancer: report of three cases

2010 ◽  
Vol 8 (1) ◽  
pp. 97-101 ◽  
Author(s):  
Sergio Renato Pais Costa ◽  
Sergio Henrique Couto Horta ◽  
Alexandre Cruz Henriques ◽  
Jaques Waisberg ◽  
Manlio Basílio Speranzini
Keyword(s):  
Colon Cancer ◽  
Locally Advanced ◽  
Pancreatic Head ◽  
Multivisceral Resection ◽  
Right Hemicolectomy ◽  
Right Colon ◽  
En Bloc ◽  
Term Survival ◽  
Proximal Duodenum ◽  
Right Colon Cancer

ABSTRACT Although colorectal tumors are fairly common surgical conditions, 5 to 12% of these tumors are locally advanced (T4 tumors) upon diagnosis. In this particular situation, the efficacy of en bloc multivisceral resection has been proven. When right-colon cancer invades the proximal duodenum or even the pancreatic head, a challenging dilemma arises due to complexity of the curative surgical procedure. Therefore, en bloc pancreaticoduodenectomy with right hemicolectomy should be performed to obtain free margins. The present study reports three cases of locally advanced right-colon cancer invading the proximal duodenum. All of these cases underwent successful en bloc pancreaticoduodenectomy plus right hemicolectomy, with no death occurrence. Long-term survival was observed in two cases (30 and 50 months). In the third case, the patient did not present any recurrence twelve months after surgical treatment. Multivisceral resection with en bloc pancreaticoduodenectomy should be considered for patients who present acceptable risk for major surgery and no distant dissemination. This approach seems justified since the length of postoperative survival is longer in radically ressected groups (R0) than in palliativelly resected groups (R1-2).

Appendiceal Mucocele of Mucinous Cystadenocarcinoma with a Cutaneous Fistula

2002 ◽  
Vol 30 (4) ◽  
pp. 452-456 ◽  
Author(s):  
A Nakao ◽  
S Sato ◽  
A Nakashima ◽  
A Nabeyama ◽  
N Tanaka
Keyword(s):  
Iliac Fossa ◽  
Right Hemicolectomy ◽  
Cystic Mass ◽  
Japanese Woman ◽  
Mucinous Cystadenocarcinoma ◽  
Appendiceal Mucocele ◽  
Old Japanese ◽  
Well Differentiated ◽  
The Right ◽  
Skin Fistula

We report a novel case of cystadenocarcinoma forming an appendiceal mucocele with development of a skin fistula. The patient was a 75-year-old Japanese woman who originally presented with a skin ulcer on the right flank (inferior to the ribs and superior to the iliac bone) with mucus discharge. The serum concentration of carcinoembryonal antigen was elevated (57.4 ng/ml). Ultrasonography and computed tomography demonstrated a cystic mass with septations in the right iliac fossa. Fistulography from the skin ulceration showed a communication via the fistula to the caecum. A right hemicolectomy and enbloc resection of the skin fistula was performed. The histological findings revealed a well-differentiated mucinous cystadenocarcinoma of the appendix. The patient has been alive for 7 years following surgery without any sign of recurrence. This report is of interest as it demonstrates that tumour rupture to the extraperitoneal space could result in a good outcome by preventing the development of pseudomyxoma peritonei.

scholarly journals En bloc right hemicolectomy with pancreatoduodenectomy for right-sided colon cancer invading duodenum

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiao-Luan Yan ◽  
Kun Wang ◽  
Quan Bao ◽  
Hong-Wei Wang ◽  
Ke-min Jin ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Lymph Node ◽  
Mutational Analysis ◽  
Regional Lymph Node ◽  
Univariate Analysis ◽  
Locally Advanced ◽  
Disease Free Survival ◽  
Right Hemicolectomy ◽  
En Bloc ◽  
Right Colon Cancer

Abstract Background En bloc right hemicolectomy with pancreatoduodenectomy (RHCPD) is the optimum treatment to achieve the adequate margin of resection (R0) for locally advanced right-sided colon cancer with duodenal invasion. Information regarding the indications and outcomes of this procedure is limited. Method In this retrospective study, 2269 patients with right colon cancer underwent radical right colectomy between October 2010 and May 2019, in which 19 patients underwent RHCPD for LARCC were identified. The overall survival (OS), disease-free survival (DFS), operative mortality, postsurgical complications, gene mutational analysis, and prognostic factors were evaluated. Survival was estimated using Kaplan–Meir method. Results Of these 19 patients who underwent LARCC, the OS was 88%, 66%, and 58% at 1, 3, and 5 years. The DFS was 72%, 56%, and 56% at 1, 3, and 5 years. The median operative time was 320 min (range: 222–410 min), and the median operative blood loss was 268 mL (range: 100–600 mL). The OS was significantly better among patients with well-differentiated tumor, N0 stage, and high microsatellite instability (MSI) and in patients who received adjuvant chemotherapy. The major postoperative complications occurred in 8 patients (42%), with pancreatic fistula (PF) being the most common. On the basis of the univariate analysis, poorly differentiated tumor, regional lymph node dissemination, MSI status, and no perioperative chemotherapy were the significant predictors of poor survival (P < 0.05). Conclusions This study suggests that RHCPD is feasible and can achieve complete tumor clearance with favorable outcome, particularly in patients with lymph node-negative status.

scholarly journals Perforated High-Grade Mixed Neuroendocrine Nonneuroendocrine Neoplasm of Cecum: Unusual Presentation of Rare Disease

2021 ◽  
pp. 1-6
Author(s):  
Gunasekaran Gopalakrishnan ◽  
Bheemanathi Hanuman Srinivas ◽  
Biju Pottakkat ◽  
Senthil Gnanasekaran ◽  
Raja Kalayarasan
Keyword(s):  
Rare Case ◽  
Histopathological Examination ◽  
Psoas Muscle ◽  
Right Hemicolectomy ◽  
Resected Specimen ◽  
Radiological Findings ◽  
En Bloc ◽  
En Bloc Excision ◽  
Bloc Excision ◽  
The Right

Mixed neuroendocrine nonneuroendocrine neoplasms (MiNENs) are rare neoplasms of the gastrointestinal tract, where the neuroendocrine as well as the nonneuroendocrine components each comprise at least 30% of the tumor. Of all cases of colorectal malignancies, MiNENs constitute around 3–9.6%, with only a few cases reported to be arising in the cecum. Since majority present with nonspecific clinical and radiological findings, its diagnosis preoperatively is almost impossible and these are usually diagnosed after histopathological examination of the resected specimen. Owing to the rarity of these tumors as well as lack of complete molecular characterization, optimal treatment remains unestablished. We, here, report a rare case of MiNENs of the cecum infiltrating the right psoas muscle and presenting with perforation for which right hemicolectomy and en bloc excision of the involved psoas muscle was done followed by adjuvant chemotherapy.

scholarly journals Outstanding issues of surgical treatment of locally advanced forms of malignant tumors

2020 ◽  
Vol 21 (4) ◽  
pp. 269-274
Author(s):  
V.V. Egorenkov ◽  
K.A. Andreychuk ◽  
M.S. Molchanov ◽  
E.V. Kuleshova
Keyword(s):  
Surgical Treatment ◽  
Malignant Tumors ◽  
Locally Advanced ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
En Bloc ◽  
Considerable Uncertainty ◽  
Histological Factors ◽  
The Right ◽  
Complete Tumor

Nowadays surgery is still the mainstay of solid tumors treatment. En Bloc resection is surgical treatment in amount of complete tumor removal. There remains considerable uncertainty about many aspects of resection boundaries, including definition and influence of anatomical and histological factors. One of the biggest challenges for the surgeon is choosing the right surgery for the «right» patient, taking into account the type of tumor and its biology.

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