Glomus Tumor: “A-Not-So-Rare” Cause of Chronic Shoulder Pain—A Case Report and Literature Review

Case. A 61-year-old male presented with chronic shoulder pain resistant to conservative treatment. Imaging identified a nodular lesion in the deltoid muscle, which histology after resection identified as a glomus tumor. After surgery, the patient became asymptomatic and at 4-year follow-up has not shown signs of recurrence. Conclusion. Glomus tumors around the shoulder should be considered when investigating chronic shoulder pain, as they are more common than thought. Despite being elusive, when diagnosed, excellent outcomes may be expected, with surgery resection being curative.

Cardiac paraganglioma: stent in right coronary artery prior to surgery resection

Cardiac paragangliomas are extremely rare. Sometimes surgical resection is a challenge owing to the proximity of vital structures and coronary arteries involvement. We report a case of a 34-year-old man with cardiac paragangliomas located between right atrium and right ventricle with a feeding blood supply from collaterals of the right coronary artery. In this case, we implanted a covered single stent (PK Papyrus®) in the right coronary artery with the objective of embolizing collateral branches and to reinforce the coronary artery wall. Although tumour mass was not reduced, vascularization was minimized, and this hybrid strategy made the surgery easier and safer.

Teratoma in Children: Three cases experience in Sanglah Hospital, Bali, Indonesia

Teratomas are the most common germ cell tumor, and further classified into mature or immature. Immature teratoma comprise less than one percent of all teratomas and with the peak incidence at birth until four years. They were diagnosed by history taking, physical examination, laboratory, imaging, and pathological anatomy as a gold standard. This report presents our experience of diagnosed, giving treatment with or without surgery and chemotherapy in three patients with teratoma. We report three cases of teratoma, at age six months, eight months and four years old with site of cases are retroperitoneal immature teratoma, cervical teratoma and ovarian immature teratoma. History taking of these patients, they have same symptom such as enlargement of the mass. Two cases were noticed after birth and progressively getting bigger until six and eight months old. One case was noticed when the patient had abdominal pain and was suspected with appendicitis at first. The computed tomography (CT) scan of these cases showed a mass as a part of teratoma and confirmed with pathological anatomy. Two cases were immature, and one case was mature teratoma. Two patients undergone surgery resection and continue with chemotherapy (cisplatin, etoposide, and bleomycin) for 10-14 weeks showed a good result until now and showed no residual mass anymore form CT scan, but one patient did not undergo surgery and chemotherapy yet. Early diagnosis of teratomas is leading us to a definitive therapy and showed a good result.

Focal, Extranodal Primary Polymorph Hemangioendothelioma Treated With Endovascular Embolization Plus Open Surgery Resection: Rare Case Report and Review

Background: We report the rare case of an adult with a primary extranodal polymorphous hemangioendothelioma at dorsum, treated with endovascular coiling followed by open surgery resection. Clinical history, findings of spinal arteriography, histopathological findings and combined surgical procedure are reported.Case report: A 22-year-old male patient complained of a dorsal mass that has been increasing in size, painful, soft, no mobile and without neurological symptoms. A vascular tumor was suspected and an endovascular followed by an open surgical approach was performed. Histopathological diagnosis of an extranodal polymorph hemangioendothelioma was documented and a total resection was confirmed by free-tumor resection margin. The postoperative course was uneventful. Conclusion: Polymorph hemangioendothelioma is a rare vascular tumor. given the high vascular features of the lesion and, therefore, the high rate of bleeding during surgery.

Features of the diagnostics and treatment of a rare source of small bowel bleeding — venous malformations of the small bowel with Blue rubber bleb nevus syndrome (Bean’s syndrome)

The aim of the study is to demonstrate the possibilities of enteroscopy in diagnostics of rare source of small bowel bleeding in patient with blue rubber blue nevus syndrome.A 31-years old patient with severe anemia from the early age applied to our Hospital to diagnose the source of gastrointestinal bleeding. Previously performed EGD and colonoscopy didn’t reveal any sources of bleeding. Scintigraphy detected the signs of ongoing intestinal bleeding. Endoscopic methods (videocapsule and balloon-assisted enteroscopy) revealed multiple venous malformations of small bowel, as the source of gastrointestinal bleeding of «unknown source». The patient was performed surgery — resection of segments of small bowel with malformations. The diagnosis was verified morphologically. Postoperative period was without complications. For the first time in several years the patient had a fully restored level of hemoglobin.

Surgical Management of Disseminated Pulmonary Mucormycosis in the Immunocompromised

Background: Pulmonary mucormycosis is a rare and aggressive fungal infection that is known to predominantly affect immunocompromised hosts. Early surgical resection with prolonged antimycotic therapy is an established therapy for localized disease; however, the role of surgery in multifocal pulmonary disease is less clear. Case: We report successful treatment of medically refractory disseminated pulmonary mucormycosis with a salvage lobectomy and intrapleural antibiosis in a 58-year-old immunocompromised female. Conclusion: Surgery resection of necrotic foci in disseminated pulmonary mucormycosis is a viable surgical treatment option even if extensive resection is required. This treatment option should be considered early, given the high incidence of medically refractory disease.

The characteristic of tumor immune microenvironment in pulmonary carcinosarcoma

Pulmonary carcinosarcoma (PCS) is a rare but aggressive neoplasm, due to late diagnosis and early metastasis. Surgery combined with radiotherapy is a standard treatment. However, PCS features an easy relapse after surgery resection and resistance to chemotherapy and radiotherapy. Tumor immune microenvironment reflects tumor immunophenotyping and affects immunotherapy efficiency. This review summarized current studies on the characteristic of tumor immune microenvironment in PCS and discussed the potential of immunotherapy combined with other regimes strategy as a candidate for treatments in PCS.