Hemangioma of the liver: Report of a case surgically treated and review of the literature

A case of double hemangioma of the right lobe of the liver, treated surgically, is presented. The technics for diagnosing and resecting such vascular tumors are reviewed. The need for a wide excision and for placing all incisions in the normal adjacent liver parenchyma and the dangers of partial excision and of biopsy are re-emphasized. The value of roentgenotherapy in diffuse or inoperable hemangiomas is acknowledged.     

Primary cardiac paraganglioma. Case report and review of surgically treated cases.

A 58 year old man with an infiltrating non-resectable left atrial paraganglioma was diagnosed by sternotomy and open biopsy. The patient remains symptom free 16 months after the operation. No evidence of an increase in the size of the tumour has been detected by echocardiography. The literature regarding surgically treated patients with cardiac paragangliomas is reviewed.     

Vagal paraganglioma.

OBJECTIVES: To report the outcomes of surgical treatment of vagal paragangliomas and to define a management protocol. DESIGN: A retrospective case series. PATIENTS AND METHODS: Sixteen consecutive patients with vagal paragangliomas managed by surgical resection using a cervicoparotid approach and pericapsular dissection using microsurgical techniques between 1990 and 2003. RESULTS: All patients either had or developed a vagal palsy. Additional cranial nerve deficits were sustained in 8 patients. No patients died as a result of surgery or from their disease. CONCLUSIONS: The technique used and described in this article allowed adequate exposure of the retrostyloid parapharyngeal space for the safe removal of all vagal tumors in this series. Careful consideration must be given to the likely natural progression of these tumors before committing to surgical resection. This is particularly important in patients with multifocal disease.     

Treatment of single hepatic metastasis from surgically treated breast carcinoma. (Report of a clinical case and review of the literature)

In the natural history of the breast cancer, the liver metastatic location represents a clear element of an advanced stage of the disease, because it is often accompanied to multiple locations in the same organ and/or in different organs and tissues. The finding into two years after the primary intervention, during the ordinary follow-up, of an insulated metastasis in the 3rd hepatic segment in a patient operated for breast carcinoma, and the following surgical treatment of the metastasis, have suggested us to draft this note. The finding of a single metastasis in the liver in patients operated for breast carcinoma imposes a revaluation of the stage of sickness to highlight the contemporary presence of subsequent distance metastatic location; the negativity of the instrumental investigations performed has triggered the question about the type of therapeutic treatment to do to the patient. The range of therapeutic hypothesis spaces from the ultrasound guided mini-invasive techniques (alcoholization, infusion of LAK cells, use of radio frequencies), to the chemotherapy, so general that local one, by means of super selective catheterization of the hepatic artery, up to the, finally, minus usual (in these cases) surgical therapy. In the patient observed we have chosen the surgical treatment, consisting of a segmentary resection, we haven't any complication, neither intra- nor post-operative, and the patient was discharged in 8th day. Our choice of the surgical approach has bean consequence of an attentive evaluation so of the clinical indicators of the patient (good general conditions, bulk of the injury and surgical treatableness) that of the biological parameters of the neoplasm. The results of our experience, in line with whet indicated from the other AA., encourage the choice of the surgical treatment of the insulated hepatic metastasis from breast carcinoma, with the awareness of the concept of "adjuvant" that it necessarily engages in such circumstances, and, however, after an accurate selection of the patients.     

膀胱副神经节瘤1例报告并文献复习

目的提高膀胱副神经节瘤的诊疗水平。方法回顾性分析1例膀胱副神经节瘤患者的临床资料,分析总结该病的临床特征及诊疗经过。患者,男,51岁,排尿后头晕同时血压升高,血儿茶酚胺和尿香草苦杏仁酸明显升高,MRI见膀胱前壁33 mm×27 mm 肿块,膀胱镜检未发现肿瘤。术前考虑膀胱前壁副神经节瘤,完善扩容降压3周以上,行腹腔镜下膀胱部分切除术。结果手术顺利,切除范围包括瘤体及部分膀胱壁,术中生命体征平稳。术后10 d 拔除导尿管,未见排尿时血压升高及头晕。术后病理证实为膀胱副神经节瘤。术后3个月复查,血压正常,盆腔CT未见复发。结论膀胱副神经节瘤术前应做好充分准备,术中预防血压波动导致的高血压危象,腹腔镜下膀胱部分切除术治疗效果满意,术后需定期随访。     

Intrasellar paraganglioma: a case report and review of the literature

Summary Intrasellar paragangliomas are very rare lesions with only six previous cases described in the literature. We present a further case of intrasellar paraganglioma. The patient was a 52 yr-old man who developed two transient ischemic attacks. A CT scan showed an intra- and supra-sellar expanding lesion, which was regarded as a possible non-functioning pituitary macro-adenoma. Removal of the lesion was accomplished by transsphenoidal surgery. Histological examination was diagnostic of a paraganglioma. We review the literature and discuss pathological features and possible pathogenesis of sellar and parasellar paragangliomas, underlining the necessity to consider paraganglioma in the differential diagnosis of sellar lesions.     

Swyer-James-MacLeod syndrome in a surgically treated child: a case report and brief literature review

Swyer-James-Macleod syndrome (SJMS) is a rare, complex disease characterized by unilateral hyperlucent lung or lobe owing to loss of pulmonary vasculature and alveolar hyperdistention. Treatment is generally conservative, and surgical management is rare. In fact, only 4 reports on surgically treated children with SJMS are available in the literature. We describe an 8-year-old patient with a history of recurrent respiratory infections since 2 months old. The patient presented with cough and dyspnea on effort. Chest radiograph showed hyperlucency and reduction of the right lung. Computed tomography revealed reduced volume and vasculature in the right lung, whereas pulmonary scintigraphy showed that 85% of ventilation and perfusion occurred in the left lung. Pulmonary function tests showed a forced expiratory volume in 1 second of 0.85 L (56% of expected value) and a forced vital capacity of 1.20 L (70% of expected value). The child underwent right pneumonectomy because of severe compromise of pulmonary function and recurrent respiratory infections. Histologic examination revealed panacinar emphysema and chronic bronchitis/bronchiolitis. At 6-month follow-up, the child showed improved symptoms and a forced expiratory volume in 1 second of 1.15 L (77% of expected value) and a forced vital capacity of 1.4 L (83% of expected value). This report shows that although rarely indicated, surgical treatment can improve quality of life and pulmonary function in SJMS.     

Thyroid paraganglioma: report of a case and review of the literature

A case of thyroid paraganglioma is reported. Immunohistochemically the tumor showed negativity for thyroglobulin and calcitonin and positivity for chromogranin A and S-100. Protein-positive sustentacular cells were demonstrated. The authors discuss the previous literature on these tumors.     

双侧肾上腺嗜铬细胞瘤并腹膜后副神经节瘤1例报告并文献复习

目的:探讨嗜铬细胞瘤及副神经节瘤的诊断和治疗。方法:诊治1例双侧肾上腺嗜铬细胞瘤并腹膜后副神经节瘤的患者。该患者同时患有高血压、Ⅱ型糖尿病,术前血浆及尿游离儿茶酚胺水平明显高于正常,CT检查提示双侧肾上腺富血供占位病变,腹膜后占位病变。结果:术前口服酚苄明降压及充分扩容后,全麻下行开放手术切除右侧肾上腺肿瘤,3个月后腹腔镜下切除左肾上腺肿瘤及腹膜后肿瘤。病理检查诊断为双侧肾上腺嗜铬细胞瘤、腹膜后副神经节瘤。患者术后半月余血糖恢复正常,血压较术前无明显变化,随访6个月无肾上腺皮质功能减退表现,未见肿瘤复发和转移。结论:提高认识、选择适当检查是诊断嗜铬细胞瘤和副神经节瘤的关键,进行充分的术前准备后手术切除肿瘤病灶是其首选治疗方法,术后应严格随访。     

Cardiac paraganglioma (chemodectoma): a case report and review of the literature.

A rare case of paraganglioma (chemodectoma) of the heart is reported. This is the fifth case reported in the world literature and only the second case discovered in a living person. A review of the historical background, embryology, anatomy, and pathology of the paraganglia is provided. The previously reported four cases are also discussed.     

Pancreatic pseudocyst treated by laparoscopic Roux-en-Y cystojejunostomy. Report of a case and review of the literature

Advances in laparoscopic surgical technique and instrumentation have furthered our ability to perform more complex laparoscopic procedures. We report the case of a 45-year-old man in whom a giant pancreatic pseudocyst developed after biliary pancreatitis. He underwent laparoscopic internal drainage by a Roux-en-Y cyst-jejunal anastomosis after unsuccessful percutaneous drainage. The surgical technique and a review of the current literature is presented. We conclude that although laparoscopic internal drainage technically is feasible in selected cases, additional data are required to define the role of this surgical approach in the treatment of pancreatic pseudocysts.     

Tumoural form of cerebellar schistosomiasis mansoni. Report of a surgically treated case

Summary A case of the tumoural form of cerebellar Schistosomiasis mansoni is described. The patient was a 35-year-old female, healthy until one year ago, when she started to show cerebellar and vestibular symptoms. Computerized tomography was performed and showed an expanding lesion in the cerebellar vermis and roof of the fourth ventricle, which was surgically removed. On histopathological examination numerous S. mansoni ova involved in chronic granulomatous inflammation were found. Innumerable granulomas in the productive and healing phases of fibrosis as well as rare ones in the necrotic-exudative phase were observed. This case is compared with another three previously reported in the literature. The clinical picture, diagnostic methods, the relation to the other forms of visceral involvement in Schistosomiasis mansoni and how the parasite reaches the brain are commented upon.     

Endobronchial leiomyoma: Report of a case treated by bronchoplasty and a review of the literature

Endobronchial leiomyoma is exteemely rare. Most endobronchial leiomyomas reported in the literature have been resected by either lobectomy or pneumonectomy. We herein report a case treated by sleeve bronchoplasty without pulmonary resection. A 42-year-old woman was admitted to our hospital complaining of hemoptysis. Bronchoscopy revealed a lobulated tumor arising from the medial wall of the right main stem bronchus. A sleeve resection of the right main bronchus including the tumor and end-to-end anastomosis was performed. The histological diagnosis of the resected specimen was leiomyoma with no evidence of malignancy. The importance of early diagnosis and appropriate surgical treatment to preserve pulmonary function are emphasized. Similar cases of an endobronchial type of pulmonary leiomyoma reported in the literature are also reviewed.     

膀胱非功能性副节瘤一例报告并文献复习

目的提高对膀胱副神经节瘤的临床病理特征、诊断及治疗的认识。方法回顾性分析我科收治的1例膀胱非功能性副节瘤患者的临床资料,结合文献复习并讨论膀胱副节瘤的诊断和治疗特点。结果膀胱副神经节瘤好发于年轻女性,常表现为血尿,免疫组化示CgA、NSE和S-100蛋白阳性,CK阴性。CT及MRI在鉴别诊断上意义不大。经尿道肿瘤切除及膀胱部分切除术治愈该患者,术后密切随访3月无复发。结论膀胱副神经节瘤目前治疗上以膀胱部分切除为主。诊断需结合临床表现、病理及免疫组化结果。因其为潜在恶性肿瘤,术后应长期随访。     

Nutcracker syndrome. Report of a case and review of the literature

Nutcracker syndrome is caused by compression of left renal vein between the aorta and the superior mesenteric artery. This phenomenon results in left renal venous hypertension, left gonadal vein varices and unilateral hematuria. We report a typical case of nutcracker syndrome and we review the literature in an effort to explain this pathology.