Primary liposarcoma of esophagus： A case report

Liposarcoma is the most common soft tissue sarcoma inadult life while esophageal liposarcoma is an extremelyrare tumor.In the world literature,only 14 cases ofesophageal liposarcomas have been described.We reporta 72-year old male patient who was urgently admittedto our hospital for acute epigastric pain with a burningretrosternal sensation,persistent nausea,vomiting anddysphagia.Barium swallow,upper gastrointestinal(GI)endoscopy,esophageal manometry and CT scan,failedto accurately diagnose the lesion.After surgical resectionof an esophageal polypoid tumor,the histologicalexamination revealed a well-differentiated grade Iliposarcoma.Diagnostic and therapeutic tools were dis-cussed and the results of literature were reviewed.     

Primary liposarcoma of the omentum: A case report

Rationale:Omental liposarcoma is extremely rare, and only a few reports have been published in the literature. Due to the rarity of the disease, establishing a clear diagnosis and formulating a treatment plan may be challenging for clinicians.Patient concerns:The patient was a 51-year-old woman who presented with a protruding mass and pain in the lower abdomen.Diagnosis:Magnetic resonance imaging revealed a tumor measuring 15 cm in diameter in the pelvis. Ovarian cancer was suspected based on pre-operative imaging findings.Interventions:An exploratory laparotomy was performed. Intra-operative analysis of the frozen section suggested a benign tumor.Outcomes:Postoperative histopathological analysis confirmed the diagnosis of omental liposarcoma. The patient recovered well after surgery.Lesson:This case report helps clinical oncologists to develop a comprehensive understanding of this disease and treat it accordingly.     

A case of primary omental torsion presenting as an acute abdominal pain]

Torsion of greater omentum is a rare cause of acute abdomen. However, it should be included in the differential diagnoses in addition to acute cholecystitis, acute appendicitis, cecal diverticulitis, and other variable causes of acute abdomen. Diagnosis is usually made at laparotomy for suspected appendicitis. In some cases, computed tomography demonstrates a successful preoperative detection of omental torsion. We report a case of surgically and pathologically proven torsion with subsequent infarction of greater omentum presented as an acute abdominal pain.     

Primary gastric dedifferentiated liposarcoma resected endoscopically: A case report

BACKGROUNDLiposarcoma is one of the most common adult mesenchymal tumors but is uncommon in the gastrointestinal tract and extremely rare in the stomach. Furthermore, the histological subtypes of liposarcoma usually reported in the stomach are well-differentiated or myxoid, and few reports have been issued on small-sized gastric liposarcomas resected endoscopically and followed up. Herein, we report a case of primary gastric dedifferentiated liposarcoma (DL) that was resected endoscopically.CASE SUMMARYA 67-year-old female Korean patient was referred to our institution for further evaluation of a gastric submucosal tumor (SMT) located in the lesser curvature of the gastric body by esophagogastroduodenoscopy. Endoscopic ultrasound revealed a well-circumscribed, slightly heterogeneous, isoechoic, 17 mm × 10 mm sized mass originating from the third sonographic layer. Computed tomography showed no evidence of significant lymph node enlargement or distant metastasis. Endoscopic resection was undertaken using the snare resection technique after mucosal precutting to provide a definitive histopathologic diagnosis, which proved to be consistent with DL, based on its morphology and the immunoexpressions of MDM2 and CDK4. The patient was planned for surgery because the deep resection margin was positive for malignancy. After declining any invasive procedure or adjuvant treatment, the patient was placed under close follow-up, and at one year after endoscopic resection, remained disease free.CONCLUSIONThis is the first reported case of a small primary gastric DL resected endoscopically and followed up. This report demonstrates that when diagnosis of a SMT is uncertain, the use of invasive techniques, including endoscopic resection, should be considered.     

Intraperitoneal dedifferentiated liposarcoma： A case report

Dedifferentiated liposarcoma is a variant of liposarcoma with a more aggressive course. Mutations of the p53 gene have been found in different types of soft tissue sarcoma. It is generally accepted that p53 mutations in human malignant tumors are often related to a poor prognosis. In our case, analysis of p53 gene mutation in tumor samples was performed, p53 gene mutation was observed in dedifferentiated tumor tissue samples but not in well-differentiated tumor tissue samples. It has been reported thatp53 gene mutation occurs most commonly in the retroperitoneum and rarely in other anatomic locations. Herein we report a case of dedifferentiated liposarcoma located at intraperitoneum.     

Retroperitoneal liposarcoma presenting with bilateral leg lymphedema--case report

The case of a 54-year-old man with a large right retroperitoneal liposarcoma presenting with bilateral leg lymphedema, is reported. Total excision of the tumor resulted in marked reduction of the edema in both legs persisting for four years. Follow-up lymphographies demonstrated lymphatic drainage dysfunction on both sides; nevertheless, the edema did not recur. Based on these findings, a non-compressive hypothesis concerning the evolution of lymphedema in this case is postulated.     

Primary pericardial mesothelioma presenting as constrictive pericarditis: a case report

Primary malignant pericardial mesothelioma is a rare tumor and the case reported here presented as constrictive pericarditis. The patient's symptoms progressed day by day despite treatment with digitalis, diuretics and catecholamines. Although a computed tomographic scan of the chest, echocardiography and pericardiocentesis were performed, a preoperative definitive diagnosis could not be obtained. Emergency pericardiectomy and partial resection of the tumor were carried out with the aid of a percutaneous cardiopulmonary supporting system, but the patient died of cardiac failure on postoperative day 3. The tumor appeared to be the biphasic type of diffuse malignant mesothelioma. The prognosis for pericardial mesothelioma is extremely poor due to its late presentation and difficulty in completely removing it surgically and, unfortunately, there still is not a radical therapy for this tumor.     

Primary pericardial mesothelioma presenting as pericardial constriction: a case report

A 19 year old man presented with a six month history of chest pain, dyspnoea, and lethargy and was found on an echocardiogram to have a dilated left ventricle with a small pericardial effusion. Ramipril and a course of steroids were tried but serial echocardiograms showed a persistently thickened pericardium and slowly developing features of constriction. On computed tomography, a large mediastinal mass encasing the heart, along with para-aortic and paratracheal lymphadenopathy, was found. Right heart catheter studies showed equal pressures in all four chambers. His deteriorating clinical condition led to a pericardiectomy. Histology confirmed primary pericardial mesothelioma. The patient died soon after surgery.     

Giant retroperitoneal liposarcoma. One case report

INTRODUCTION: Retroperitoneal Liposarcoma is a rare and primary malignancy developed from mesenchymal tissue. It's generally unique and shows an only one histologic component. We report a case of multicentric and synchronous liposarcoma (intraperitoneal and retroperitoneal) and with different histologic types. EXEGESES: A 53-year old man presented with abdominal pain, increased abdominal girth and weight loss. Physical examination revealed two abdominal masses. Computed tomography scan showed a very large retroperitoneal mass displacing the left kidney, digestive loops and vessels. The patient underwent surgery. One enormous mass of the left renal lodge measuring 50 cm, a retroduodenal mass measuring 15 cm and a nodule of the coecum were removed. Histological examination of the mass of the left renal lodge revealed mixed type liposarcoma (dedifferentiated and myxoid). Histological examination of the retroduodenal mass and of the nodule of the coecum revealed well-differentiated liposarcoma. CONCLUSION: Pathological, therapeutic and prognostic aspects of abdominal liposarcoma will be reviewed in this article.     

Primary localized tracheobronchial amyloidosis presenting with massive hemoptysis: a case report and literature review

Primary localized tracheobronchial amyloidosis (TBA) is a rare respiratory tract dysfunction, which is a heterogeneous group of diseases involving abnormal extracellular deposition of amyloid and autologous fibrillar protein material in β‐pleated sheets. A 64‐year‐old man was referred to our hospital because of hemoptysis. Physical examination showed decreased breath sounds in the right lung on auscultation. Chest computed tomography scan displayed multiple nodules with varied size in main bronchia around bilateral hilus of the lung. After admission, bronchoscopy was performed for this patient, and roughness of mucosa in trachea and multiple nodules in respiratory tract were observed. Through further tissue biopsy, the diagnosis of primary TBA was confirmed.     

Primary liposarcoma of gallbladder diagnosed by preoperative imagings： A case report and review of literature

A 49-year-old Japanese woman was referred to our department because of high fever and a huge abdominal mass. Computed tomography (CT) and magnetic resonance (MR) imagings revealed a tumor, about 30 cm in diameter, occupied the right hepatic lobe and the peritoneal cavity. Abdominal angiography showed that the tumor was fed mainly by the cystic artery. We pre-operatively diagnosed angiosarcoma of the gallbladder and performed tumor resection with cholecystectomy because the tumor was almost casplated, however the posterior wall of the gallbladder attached to the tumor firmly. Histologically, the tumor was composed of spindle cells including lipoblasts with cellular pleomorphism, which were also detected in the muscular layer of the gallbladder. We finally diagnosed pleomorphic liposarco-ma of the gallbladder. At 10 mo and 29 mo after the first operation, she underwent two more operations because of recurrence. Now she has a good quality of life 3 years and 6 mo after the first operation.     

Left-sided omental torsion with inguinal hernia

We report a case of surgically proved left-sided torsionof the greater omentum that caused secondary byuntreated inguinal hernia.Case A 36-year-old manpresented to our hospital with abdominal pain.Hehad been diagnosed with a left inguinal hernia,but hehad not received any treatments.Contrast-enhancedcomputed tomography(CT)of the abdomen showeda large fat density mass below the Sigmoid colon andleft inguinal hernia with incarcerated fat.Exploratorylaparotomy revealed torsion of the greater omentumwith small bloody ascites.The greater omentum wastwisted into one and a half circles and entered into a leftinguinal hernia.An omentectomy with a repair of leftinguinal hernia was performed.A resected omentum wassubmitted for pathological examination,which showedhemorrhagic infarction.Omental torsion is a rare causeof acute abdominal pain but should be included in thedifferential diagnoses of acute abdomen,especially inpatients with untreated inguinal hernia.     

Pseudohypoparathyroidism presenting with ventricular arrhythmia: a case report

Pseudohypoparathyroidism (PHP) is a rare disorder characterized by varying degrees of unresponsiveness to parathyroid hormone. Patients usually present with hypocalcemia-induced seizures or tetany, whereas no case of hypocalcemia-induced cardiac arrhythmia in PHP has been described to date. In this paper, we report the case of a male adolescent with PHP type 1a who presented with hypocalcemia-induced ventricular extrasystoles (bigeminy, trigeminy) and mild corrected QT interval prolongation. The patient had brachydactyly and his second fingers and toes were longer than the others, a finding consistent with PHP. Laboratory tests detected hypomagnesemia, as well as elevated levels of creatine kinase and lactate dehydrogenase. Ventricular arrhythmia and abnormal laboratory tests improved with calcium supplementation and vitamin D treatment. The findings in this patient suggest that hypomagnesemia may make patients with PHP more susceptible to hypocalcemia and may thus prompt a state of hypocalcemia-induced arrhythmia or other cardiac complications.     

Sarcoidosis presenting with Raynaud's syndrome: a case report

We report a case of association between sarcoidosis and Raynaud's syndrome. A 39 year old female presented fatigue, Raynaud's syndrome, IgG and erithrosedimentation rate (ESR) increase, polyarthralgy in which disseminated micronodular infiltration in the chest X-ray and histological demonstration of non-caseating epitheloid microgranulomas led to a diagnosis of concomitant sarcoidosis. Clues to the diagnosis of sarcoidosis coexisting with autoimmune disease are discussed.     

Giant primary liposarcoma of the stomach: a case report

Liposarcoma is the most common soft tissue sarcoma and accounts for 15%–20% of all mesenchymal malignancies. The tumor occurs most frequently in the limbs, retroperitoneum and rarely has a visceral location. We report a case of a gastric liposarcoma in a male patient who was admitted to hospital for abdominal discomfort and feeling fullness lasting for a month. The CT examination revealed a giant epigastric mass (36 cm × 34 cm) involving the wall of the stomach. A subtotal gastrectomy together was performed. The histopathological diagnosis was a myxoïd liposarcoma. The patient did not undergo any adjuvant treatment. He was under close follow up and nine months after surgery he represented with tumor recurrence. We report this case due to the rarity of this tumor in the stomach (fifteen cases reported in the literature).     

Multiple myeloma presenting with musculoskeletal manifestations: a case report

Multiple myeloma (MM) is a malignant plasma cell disorder. Musculoskeletal and skin manifestations of this disorder are rare. Here we report a case of a young male patient presenting with polyarthritis and skin rash resembling vasculitis. Detailed investigations revealed that he was suffering from multiple myeloma in which arthritis was a musculoskeletal complication of the disease.