Pressurized intraperitoneal aerosol chemotherapy in nonresectable carcinomatosis from colorectal cancer

Peritoneal carcinomatosis colorectal cancer unfortunately represents a frequently encountered condition during the natural history of this malignancy which has been considered for a long period of time as a terminal event. However, once new surgical and oncological therapies have been reported significant changes have been reported in the management of these cases. Therefore, cytoreductive surgery to no residual disease as a stand-alone procedure or in association with intraperitoneal hyperthermic chemotherapy has been proposed and significant benefits in terms of survival have been reported; unfortunately not all patients with peritoneal carcinomatosis are candidates for this combined approach, especially if extended, nonresectable lesions are present. In such cases pressurized intraperitoneal aerosol chemotherapy (PIPAC) has been proposed with promising results. The aim of the current paper is to review the most important studies conducted on this issue.

Postoperative bleeding in a patient with appendiceal mucinous adenocarcinoma and liver dysfunction patient: A case-report

Background: Appendiceal malignant tumors are rare in the clinic, and the incidence rate of gastrointestinal tumors is only approximately 0.5%. Our aim is to describe our experience with this rare disease and to increase knowledge on the diagnosis and treatment of appendiceal malignant tumors. Case presentation: We report the case of a 69-year-old woman who was admitted to the hospital due to dyspepsia. The patient was a carrier of hepatitis B virus, and liver dysfunction was diagnosed preoperatively. Abdominal enhanced computed tomography and colonoscopy showed that the appendix was significantly enlarged and dilated, and effusion and appendicitis were observed. Mucinous adenocarcinoma and appendiceal abscesses were not excluded because of the lack of specificity, which makes it difficult to diagnose the disease before a surgery. Laparoscopic appendectomy was performed, and a rapid frozen pathological examination showed a mucinous tumor of the appendix. Intraperitoneal hyperthermic chemotherapy with cisplatin was administered. The patient had abdominal hemorrhage on the fifth day after the surgery. After active treatment, she was discharged from the hospital 19 days after the surgery.Conclusions: The diagnosis of appendiceal malignant tumors mainly depends on preoperative imaging and microscopic results,and highly suspected patients, rapid pathological examination is needed during the operation., and so on. Notably, for elderly patients with hepatitis B infection and liver dysfunction, there is a probability of postoperative bleeding.

The Controversy of Intraperitoneal Hyperthermic Chemotherapy for Ovarian Cancer

Although the standard treatment for ovarian carcinoma with peritoneal metastases is systemic chemotherapy alone or systemic chemotherapy with debulking surgery, a new technique gains more ground: a combination of hipertermic intraperitoneal chemotherapy (HIPEC) and optimal cytoreduction surgery. The proof is mounting regar-ding the benefi ts of HIPEC for patients with metastatic ovarian carcinoma but it still lacks a standard protocol of use. It has increased costs, and incomplete data regarding its safety. Due to these reasons, it is still considered an alternative treatment. Our study aimed to evaluate the published literature regarding this technique from the point of view of safety and effi cacy when compared with the standard of care treatment.

Malignant mesothelioma of the tunica vaginalis testis: A Rare Malignant Tumor without Asbestos Exposure

: Malignant mesothelioma of the tunica vaginalis testis is an extremely rare and often a deadly tumor. Preoperative diagnosis is very difficult due to lack of specific clinical manifestations, mainly including hydrocele formation and painless inguinal mass. In this abstract we present a case of a young patient with hydrocele and dull pain of left testes, was planned for laparoscopic repair of left inguinal hernia, during which a mass attached to the scrotal cord was discovered. Dissection and release of the mass from the cord structure were done, and postoperative pathological examination revealed a malignant mesothelioma arising from the left tunica vaginalis testis. Case was then referred to oncology center where intraperitoneal hyperthermic chemotherapy with cytoreductive surgery were done.