Metastatic liver cancer： A rare case

Hemangiopericytoma is a rare tumor especially when it rises in the peritoneal cavity. We present a case of a 60-year-old woman with an isolated recurrent hemangiopericytoma of the liver. The patient presented with a palpable right upper quadrant abdominal mass, which occurred 7 years after undergoing resection of a malignant hemangiopericytoma arising from the greater omentum. She had not followed up 6 mo after surgery. Various imaging studies showed a single large, well-capsulated liver tumor with central necrosis, accompanied by hypervascularity typical of a vascular tumor. Preoperative laboratory HBsAg and anti-HCV workup were both negative. Under the impression of recurrent malignant hemangiopericytoma, right triseg-mentectomy was performed to completely resect the tumor. Pathological examination confirmed the diagnosis of recurrent hemangiopericytoma. Even though the incidence of the hemangiopericytoma is relatively low, malignant hemangiopericytoma has a tendency to recur frequently after a long-term disease-free interval. Also, the recurrent hemangiopericytoma is not easily detected early during follow-up until it becomes symptomatic because there are no specific tumor markers, and because of the diversity with regard to site of recurrence. The authors suggest that Positron Emission Tomogram (PET) may be a useful tool for the detection of recurrent hemangiopericytoma. We describe herein some characteristics and behaviors of malignant hemangiopericytoma, particularly after surgical resection.     

Role of pilocarpine use following laser peripheral iridotomy in eyes with refractory acute angle closure glaucoma: A case report and literature review

Rationale:Angle closure glaucoma (ACG) is one of the most emergent types of glaucoma in clinical practice. Laser peripheral iridotomy (LPI) could minimize pupillary block and prevent ACG from an acute attack. However, recurrent increase in intraocular pressure (IOP) may still occur despite successful LPI. The aim of this study is to highlight the importance of postLPI pilocarpine use and larger LPI size as well as to share some experiences of cataract surgery in patients with ACG.Patient concerns:A 63-year-old female was referred to our hospital for headache, and poor control of IOP in the right eye for 3 hours.Diagnoses:The patient was diagnosed ACG in the right eye. Recurrence of ACG in the right eye and new-onset and recurrent ACG in the left eye were noted during follow-up, despite successful LPI. The diagnosis was confirmed through slit lamp and gonioscope examination.Interventions:The LPI size was enlarged and pilocarpine use was maintained at 2% (1 drop 4 times a day) in both the eyes. Finally, cataract surgery was performed in both the eyes.Outcomes:No recurrence of ACG was noted during postLPI pilocarpine use in both the eyes. The postoperative IOP was stable for >6 months after cataract surgery without any surgical intervention or antiglaucoma medication use. No discomfort or major complication was observed.Conclusion:This report highlights the importance of postLPI pilocarpine use and larger LPI size in patients with refractory ACG.     

A case of primary intracranial hemangiopericytoma with hepatic metastases: successful treatment with radiofrequency ablation and transcatheter arterial chemoembolization

Intracranial hemangiopericytoma is an uncommon soft tissue sarcoma. We report a case of a 54-year-old Japanese female with hepatic metastasis from primary intracranial hemangiopericytoma. At age 44 years the patient underwent primary resection of the intracranial tumor, followed by no adjuvant therapy. At age 53 years she underwent resection of bone metastases in her left upper arm and tenth right rib. The following year, three hepatic tumors with high vascularity were detected by ultrasonography, computed tomography scans, and magnetic resonance imaging. An ultrasound-guided liver biopsy specimen confirmed the diagnosis of hepatic metastases from the primary intracranial hemangiopericytoma. A combination therapy of transcatheter arterial chemoembolization and radiofrequency ablation was performed against the hepatic metastasis. After 5 years, there has been no local recurrence in the liver.     

Hemangiopericytoma of the lung--a rare differential diagnosis of lung tumors

The authors report of a 50 year old woman who was operated on because of a rectum carcinoma 5 years ago. At a follow-up examination a 2 x 2 x 1 cm sized tumor was found in the lower lobe of the right lung. Under the diagnosis of lung metastasis after rectum carcinoma resection, operation (wedge resection) was carried out. The histological examination revealed the rare tumor hemangiopericytoma. Based on this case, frequency of the tumor, clinical symptoms, surgical treatment, prognosis as well as recurrence rate and formation of metastases are discussed.     

Uterine hemangiopericytoma with cardiac involvement and pulmonary metastasis: A case report and literature review

Uterine hemangiopericytoma is extremely rare. This article describes a case of uterine hemangiopericytoma. The tumor involved the parauterine vein; extended into the inferior vena cava, right cardiac cavity, and pulmonary artery; and metastasized to the lungs. It was irregular in shape and exhibited the string-of-beads sign on echocardiography, and it was tightly attached to the right ventricular surface and pulmonary artery wall. The patient underwent tumor resection without adjuvant treatment. A pelvic nodule was found 3 months postoperatively and was considered a recurrent lesion.     

Primary hemangiopericytoma of the heart associated with pseudoaneurysm of the pulmonary artery--a case report

A thirty-three-year-old male with malignant hemangiopericytoma of the right ventricular outflow tract and the pulmonary artery associated with pseudoaneurysm formation at the latter is presented. Contrast computed tomography was helpful in diagnosing the pseudoaneurysm of the pulmonary artery. The positional change of the murmur, with a tumor plop caused by the pedunculated tumor of the right ventricular outflow tract, was detected.     

Primary pulmonary hemangiopericytoma in a 3-year-old child

Hemangiopericytoma is an uncommon and potentially malignant mesenchymal tumor that apparently arises from spindle-shaped pericytes. The tumor usually grows insidiously until considerable size has been reached, at which point symptoms may indicate invasion of the chest wall, mediastinum, or pleura. Because of its malignant potential, hemangiopericytoma must be distinguished from other vascular tumors. While this tumor has been reported in adolescents and adults, it has never before, to our knowledge, been reported in a small child. We present, within the context of a brief review, a case of apparently benign primary pulmonary hemangiopericytoma in a 3-year-old child. Postoperatively, our patient showed no evidence of disease at 9-month follow-up evaluation. However, long-term follow-up is needed in cases of hemangiopericytoma because recurrence over several decades has been shown.     

Magnetic resonance imaging of cardiac hemangiopericytoma

We report a patient with hemangiopericytoma, a rare soft tissue sarcoma involving the left ventricle. T1- and T2-weighted magnetic resonance imaging (MRI) revealed a high signal mass invading the left ventricular wall. A biopsied specimen obtained from the metastatic subcutaneous tumor in the right popliteal fossa showed pathologic findings consistent with hemangiopericytoma.     

Early Reconstruction Surgery Resolving Visual Occlusion and Ocular Malformation: A Case Report

Congenital ocular malformation may lead to failure of the development of ocular regions and visual function in the pediatric population. Orbital bones are established within the first 2 months of embryogenesis. Any abnormalities may lead to failure in development of the ocular region.In this case report, we present a newborn with congenital canthus malposition, a distorted tarsus, and mild enophthalmos caused by an embryogenesis fibroma, which although rare, can result in amblyopia.Surgical resection of the fibroma followed by orbital reconstruction of the canthus, correction of malposition and tarsus extension were performed. Twelve months and 5 years follow-up showed no recurrence and the visual acuity was 20/20 in the left eye and 16/20 in the right. The deformity of the left orbit was corrected without complications and was symmetrical with the right side.This is the first known case of children with embryonic fibroma. It is likely that early reconstruction surgery may avoid visual occlusion and ocular malformation.     

Relapse of small cell carcinoma of the lung with metastasis to iris]

We reported a case of small cell carcinoma of the lung with metastasis to the iris during a stage of complete remission obtained with chemotherapy and radiation therapy. The patient was a 55-year-old man hospitalized for hoarseness and abnormal chest radiographs in August 1996. Small cell carcinoma of the lung had been diagnosed, and the stage was limited disease. Treatment consisted of 3 cycles of chemotherapy with cisplatin and etoposide, together with radiation therapy. The patient achieved complete remission and was discharged. In mid-December, he visited an eye clinic with the complaints of blurred vision and congestion in the right eye. Metastatic tumor of the iris was diagnosed. At that time, neither local recurrence of the lung cancer nor metastasis to other organs were observed. The patient was treated with cisplatin and etoposide again, resulting in a reduction of the iris tumor's size. After chemotherapy, the right eye was treated with electron irradiation, and the iris tumor and other clinical signs almost entirely disappeared. The patient retained normal vision during the clinical course.     

Hyperacute iris neovascularization following cataract surgery

Rationale:We describe a case of acute neovascularization of the iris after uneventful cataract surgery.Patient concerns:A 78-year-old man visited our clinic for cataract surgery and glaucoma management.Diagnoses:The patient underwent bilateral laser iridotomy 4 years ago. On ocular examination, the best-corrected visual acuity was no light perception in the right eye and 20/100 in the left eye. We observed pseudophakic bullous keratopathy in the right eye and cataracts and hemicentral retinal vein occlusion (CRVO) in the left eye.Interventions:The patient underwent cataract surgery in the left eye without complications.Outcomes:The day after surgery we observed 360° of neovascularization in the iris and aggravated hemi-CRVO with macular edema. Therefore, we administered intravitreal bevacizumab in the left eye, after which the iris neovascularization and macular edema improved.Lessons:Cataract surgery can rapidly aggravate hemi-CRVO and cause iris neovascularization, which is responsive to bevacizumab.     

颅内血管外周细胞瘤的特点及复发的影响因素分析

目的研究颅内血管外周细胞瘤（HPC）的特点及复发的影响因素。 方法选取山东大学齐鲁医院神经外科自2008年1月至2018年10月经手术病理证实的颅内HPC患者42例,总结颅内HPC患者的临床表现、影像资料、手术处理、病理、随访等资料,并采用Kaplan-meier单因素生存分析和Cox多因素分析影响HPC患者复发的因素。 结果本组患者症状以颅内高压及视力障碍最常见。影像学上肿瘤表现为均一或混杂信号,部分呈囊实性或边界不清,脑膜尾征不明显。随访24~144个月,单因素分析结果显示,肿瘤位置、肿瘤大小、肿瘤切除程度、Ki-67指数是肿瘤复发的相关因素,而根据临床经验,静脉窦受侵袭情况对HCP复发也有影响。进一步纳入Cox多因素分析显示,肿瘤切除程度、静脉窦受侵袭情况是肿瘤复发的独立影响因素。 结论手术是治疗颅内HPC的首选措施,肿瘤切除程度、静脉窦受侵袭情况是肿瘤复发的独立影响因素。     

Primary pulmonary haemangiopericytoma: a very rare case

Hemangiopericytoma is a mesenchymal neoplasm originating from pericytes--a cell type that surround capillaries. Its primary localization in the lung is extremely rare. A 41-year-old male patient was admitted to our hospital with an abnormal opacity on his chest X-ray. A primary tumor, located in the left upper lobe, was resected, and final diagnosis was hemangiopericytoma of pulmonary origin. The patient has been well for 2 years since the operation with no sign of recurrence or metastasis. A rare case of primary pulmonary tumor has been presented, and possibilities and difficulties in diagnosis as well as therapy are discussed.     

Retroperitoneal pelvic hemangiopericytoma. Combined abdominoperineal resection.

We report a case of large-size pelvic hemangiopericytoma (HPC) incidentally discovered in a 32-year-old woman. Prior to surgery the patient was studied using a CT scan and magnetic resonance imaging (MRI). Because of the size and scarce extent of the tumour (it expanded downwards, into the right ischiorectal fossa) a combined abdomino-perineal approach was needed for complete resection. Seventy-two months after initial surgery the patient remains asymptomatic, with no signs of local recurrence or distant metastasis.     

颅内血管外皮细胞瘤手术辅助放疗和化疗的效果及病理学分析

目的探讨手术切除颅内血管外皮细胞瘤后辅助放疗和化疗的效果及病理学改变。方法回顾性分析首都医科大学宣武医院经病理学检查证实的17例颅内血管外皮细胞瘤患者的临床资料,分析手术切除肿瘤辅以放疗和化疗的治疗效果。其中男13例,女4例;年龄为28～54岁,平均49岁。肿瘤全切除的15例,术后实施全脑放疗,放射剂量为50～60Gy。肿瘤次全切除的2例,采用伽玛刀治疗,放射剂量为30Gy。术后放疗前、术后2周和8周,采用尼莫司汀化疗3次,150mg/次。结果颅前窝底（6例）及矢状窦前1/3处（3例）肿瘤于手术显微镜下全部予以切除,术后头痛、呕吐、视力下降、复视的症状消失。8例小脑幕肿瘤患者中,6例手术显微镜下全切除肿瘤,2例手术显微镜下次全切除肿瘤。术后头痛症状消失,3例视野缺损症状好转,5例无明显改善。所有患者术后未出现新的神经功能缺损,无死亡病例。病理学检查示：肿瘤内有丰富的血管网,状似＂鹿角＂,这些血管扩张明显,近似血窦,肿瘤细胞围绕着血管排列,有分化和未分化两种细胞。未分化肿瘤细胞内有大量的胞质,核呈圆形或卵圆形,可见核分裂。9例患者的肿瘤有囊变,未见钙化征象。免疫组化提示血管外皮细胞瘤对Vimentine及CD34染色呈阳性反应。术后对所有患者MRI随访6～40个月,未见肿瘤复发。结论颅内血管外皮细胞瘤是一种血管丰富的恶性肿瘤,手术彻底切除肿瘤及术后辅以放疗和化疗,可防治其复发和转移。     

Efficacy and safety of sodium bromfenac eye drops in the treatment of postoperative inflammation in cataract surgery: A protocol for systematic review and meta-analysis

Background:A cataract is a degenerative change in the optical quality of the lens caused by protein denaturation. Modern medicine is mainly based on surgical treatment. Cataract surgery is often accompanied by severe inflammation, and glucocorticoid therapy has many adverse reactions and side effects. The non-steroidal anti-inflammatory drug sodium bromfenac not only has good anti-inflammatory, analgesic and anti-allergic effects, but also does not produce side effects caused by hormone drugs. Clinical studies have shown that sodium bromfenac eye drops have a good curative effect in treating postoperative inflammation of cataract, with low recurrence rate and certain therapeutic advantages, but lack of evidence-based medicine evidence. The purpose of this study is to systematically evaluate the efficacy and safety of sodium bromfenac eye drops in the treatment of postoperative inflammation of cataracts.Methods:Use computer to search English and Chinese databases, such as PubMed, Embase, Web of Science, the Cochrane Library, CNKI, Wanfang, Weipu, China Biomedical Database, and Chinese Clinical Trial Registry for randomized controlled trials on the treatment of postoperative postoperative inflammation in cataract surgery with sodium bromfenac eye drops from the establishment of the database to September 2020, and data extraction and literature quality evaluation were conducted independently by two researchers, and Meta analysis was conducted on the included literature using RevMan5.3 software.Results:In this study, the efficacy and safety of sodium bromfenac eye drops in the treatment of postoperative inflammation of cataract surgery were evaluated by the effective rate, symptom score, adverse reactions, incidence, recurrence rate, etc.Conclusion:This study will provide reliable evidence-based evidence for the clinical application of bromofenac sodium eye drops in the treatment of postoperative inflammation of cataract.OSF Registration number:DOI 10.17605/OSF.IO/3KP7R     

Primary liver hemangiopericytoma associated with hypoglycemia: report of a second case.

Hemangiopericytoma is an uncommon vascular tumor which usually develops in soft tissues. It has been exceptionally described in the liver and only one case associated with hypoglycemia has been reported in this organ. A giant hemangiopericytoma which was revealed by life-threatening hypoglycemia is described. Imaging and pathological features are presented. The patient, a 73 year-old woman, was treated by hepatectomy. She is perfectly well after a 3-year follow-up, without any evidence of recurrence.     

Corneal perforation in ocular cicatricial pemphigoid: A CARE-compliant case report

Rationale:Ocular cicatricial pemphigoid (OCP) is a potentially blinding, rare systemic autoimmune disease. The definite etiology of OCP remains under debate, early diagnosis is important to prevent rapid deterioration. The majority of the discussion has been focused on its medical therapeutic strategy, while little effort has been made to study the role of amniotic membrane transplantation (AMT). We describe the first case of OCP with minimal immunosuppressant and initial ocular surface reconstruction procedure using double layer AMT.Patient concerns:A 66-year-old female patient presented to our outpatient department with right eye pain for several days.Diagnosis:Slit lamp examination revealed the right eye cornea perforation with iris incarceration and total collapse of anterior chamber. Symblepharon formation and severe fornix shortening was also noted. While bulbi phthisis with ankyloblepharon and ocular surface keratinization was observed in the left eye. The final diagnosis was right eye stage III ocular cicatricial pemphigoid complicated with corneal perforation and iris prolapsed.Interventions:The patient underwent ocular surface reconstruction with the aid of amniotic membrane. The first layer of the amniotic membrane was attached with tissue adhesive and fibrin glue while the second layer amniotic membrane came with a conformer ring which supported the fornix space that was recreated. Postoperative care included topical medications for inflammation alleviation. Systemic immunosuppressive agents were not administered except for oral prednisolone.Outcomes:No recurrence of symblepharon was noted during the one year follow-up.Lessons:We aim at highlighting the possible important role of AMT in advance OCP. Further investigation is still needed for providing evidence to incorporate the procedure into treatment protocol.     

Intracavitary metastatic hepatocellular carcinoma of the right ventricle

We report a rare case of direct intracavitary metastasis of a hepatocellular carcinoma (HCC) to the right ventricle (RV) without intravascular involvement. A 65-year-old female, with a history of HCC and partial right hepatectomy, developed symptoms of congestive heart failure. Echocardiography revealed a large tumor in the RV with extension to the outflow tract. Palliative excision of the cardiac tumor under cardiopulmonary bypass and cardioplegic arrest was performed due to severe hemodynamic compromise. The final pathology report disclosed metastatic HCC. Tumor recurrence in the RV was noted 2 months later and the patient succumbed to the disease.     

Ptosis as an initial manifestation of orbital lymphoma: a case report

Ptosis on its own is an infrequent initial manifestation of orbital lymphoma. Orbital lymphoma usually presents as a palpable mass with proptosis, diplopia, and conjunctival ("salmon-pink") swelling. We report here a 62-year-old female patient who presented with right eye ptosis. The initial imaging study showed an indistinct enlargement of the superior rectus-levator muscle complex. After 3-4 months, ptosis and upward gazing movement were further restricted. The imaging study revealed a definite soft-tissue mass in the superior orbit surrounding the superior rectus-levator muscle complex. A tumor biopsy through anterior orbitotomy revealed a large diffuse B-cell lymphoma. With the experience of this case, we suggest that orbital lymphoma should be included in the differential diagnosis of ptosis accompanied by impairment of levator muscle function.