Aggressive Recurrent Urachal Adenocarcinoma : A Case Report And Review Of The Literature

Recurrent urachal adenocarcinomas are rare. It is commonly associated with poor prognosis. A 51-year-old woman underwent a partial cystectomy for urachal cancer in 2014. She was well throughout follow-up with annual cystoscopies. She presented with a 1-month history of rapidly progressive suprapubic mass and hematuria. A contrasted computed tomography scan of the thorax, abdomen and pelvis showed a large mixed solid cystic tumour at the right lumbar region, suprapubic area and also at the pouch of Douglas. She refused surgical extirpation and now on chemotherapy. Urachal adenocarcinoma is rare, and resection is commonly advocated; usually, no standard adjuvant therapy is advocated. Recurrent cancers represent a management dilemma, and no standard follow-up protocols exist. Bangladesh Journal of Medical Science Vol.20(4) 2021 p.911-913

Complete resection of a massive mesenteric lymphangioma in an adult

Mesenteric lymphangioma is a benign cystic tumour of the lymphatic vessels that occurs rarely in adults. Due to the infrequency of cases and the insidious presentation, these tumours can be diagnosed late and become massive. Resection of mesenteric lymphangioma in its entirety is the recommended management in order to prevent recurrence. This case report describes the finding of a massive mesenteric lymphangioma (dimensions 420×470×100 mm) in a young man, the investigations leading to diagnosis, and the subsequent surgical management. The substantial size of this tumour produced considerable challenges for the surgical team, including involvement of adjacent small bowel and mesenteric vasculature. Preoperative diagnosis and assessment of the anatomy was pivotal in achieving a complete resection and a good patient outcome.

Lymphangioma of the Small Intestine Case Report and Review of the Literature

Lymphangioma usually occurs in children and usually involves the skin. Mesenteric lymphangiomas are extremely rare in adults (1,2,3). Lymphangioma of the small-bowel mesentery is rare, representing less than 1% of all lymphangiomas (4). We report a case of a 62-year-old female who presented with abdominal pain, discomfort, nausea and vomiting. Pre-operative tests including abdominal ultrasonography and magnetic resonance imaging were performed, but they could not accurately determine the nature of the tumour. Laparotomy was performed; the tumour was excised completely, and a large cystic tumour of the small bowel mesentery was found. Histopathological examination diagnosed the tumour as a cystic lymphangioma. Lymphangiomas are extremely rare, especially in the abdomen of adults, and are asymptomatic for the most part; they often present as acute abdominal conditions, causing life-threatening complications such as secondary infection, rupture with haemorrhage, and volvulus or intestinal obstruction when the tumour increases in size, requiring emergent surgery. Lymphangioma is often difficult to diagnose, and surgical resection is selected in many cases for both diagnosis and treatment.

Central pancreatectomy for the treatment of mucinous cystic tumour by hybrid technique (laparoscopy/laparotomy).

Resumen La pancreatectomía central es una técnica preservadora de parénquima indicada para el tratamiento de lesiones benignas o de baja malignidad localizadas en cuello-cuerpo del páncreas. Presentamos el caso de una paciente de 55 años de edad con cuadros de pancreatitis aguda recidivante en relación con la existencia de una lesión quística de 8 mm de diámetro (quiste mucinoso no neoplásico) a nivel de cuello del páncreas. Como innovación técnica realizamos la intervención mediante abordaje híbrido, laparoscópico (para disección) y laparotómico (para anastomosis), que nos permitió un adecuado tratamiento de la lesión pancreática con una reducción del trauma quirúrgico. En el postoperatorio la paciente presentó una pancreatitis aguda abscesificada a nivel del remanente pancreático, próximo a la anastomosis pancreatogástrica, lo que motivó un cuadro hemorrágico con deterioro hemodinámico que precisó de reintervención urgente, realizándose una pancreatectomía córporocaudal totalizadora con esplenectomía. Tal como indica la literatura, las técnicas de cirugía pancreática preservadoras de parénquima permiten un mejor mantenimiento de las funciones endocrina y exocrina del páncreas, pero con el riesgo de una mayor morbilidad.

Benign cardiac tumours

Benign primary cardiac tumours are categorized, depending on their cellular differentiation. Benign tumours of myocyte differentiation are rhabdomyomas; those of pluripotent mesenchymal differentiation include myxomas, fibroelastomas, and haemangiomas, and those of myofibroblastic differentiation include fibromas. Lipomas and cystic tumour of the atrioventricular node form an additional group of miscellaneous masses. For each of these tumours, histopathology and CMR findings are presented.