Late recurrent seminoma: 18 years after bilateral orchidectomy in patient with bilateral stage one testicular seminoma

Late recurrence of stage I seminoma is an uncommon event. We reported a patient with seminoma recurred 18 years after the initial bilateral orchidectomy for bilateral stage I seminoma. He was on surveillance after the initial treatment and remained disease free for 18 years. He then presented with liver mass and diagnosed as recurrent seminoma. Systemic chemotherapy and subsequent hepatectomy for residual hepatic tumour mass were performed and the disease was cleared. The incidence and management of the late recurrence of seminoma would be discussed.     

Late treatment results in patients with bilateral congenital hip dislocations

In the present work, from the position of final outcomes, have been analyzed the results of treatment of bilateral dysplastic femur dislocation with application of different methods of femur setting without correction of space position of proximal section of femur and cotyloid cavity. The best long-term results are observed with the patients, subjected to single-step closed or sparing open hip setting. Age-comparable groups of patients have similar characteristics of the final outcome structure. Open femur setting, following the pattern of arthroplasty, as traumatic intervention shouldn't be applied for bilateral hip dislocation treatment.     

Late recurrence of a seminoma

We report a case of an extragonadal mediastinal seminoma that recurred almost 19 years after successful initial remission had been achieved with actinomycin D and chlorambucil. Treatment of the recurrence consisted of excision of a single involved supraclavicular lymph node followed by combination chemotherapy with cis-platinum, vinblastine and bleomycin. The patient has remained free of residual disease for 3 years. To our knowledge this case represents the longest reported interval to recurrence for a germ cell neoplasm.     

A case of synchronous bilateral spermatocytic seminoma

Bilateral testis tumors are rare and the majority of cases are classic seminoma presenting metachronously. We present the only reported case of synchronous bilateral spermatocytic seminoma.     

A case report of bilateral spermatocytic seminoma

Spermatocytic seminoma is a rare germ cell tumor which was first described by Masson in 1946. We experienced a case of bilateral spermatocytic seminoma. A 56-year-old man presented with painless swelling of left scrotal contents. This patient was diagnosed with bilateral testicular tumor after various image examinations (ultrasonography/computerized tomography/magnetic resonance imaging) and bilateral high orchidectomy was performed. Histological diagnosis was bilateral spermatocytic seminoma, pT1. After the operation, this patient was followed closely without adjuvant therapy. There has been no sign of recurrence at five months after the operation.     

Late results of treatment of anal fistulas

OBJECTIVE: The aim of this paper was to analyse the results of treatment of anal fistulas retrospectively. METHODS: Between 1992 and 2004, 407 patients were operated on for perianal fistula. In the follow-up period, 107 patients were lost, so 300 patients were analysed in the study. The mean follow-up time was 4.2 years. Analysed parameters included: types of surgical procedures in different kinds of fistulas and postoperative complications. Various types of surgical procedures and their effectiveness were described. Late results were assessed taking into account healing time, duration of sick leave, recurrence rate and incidence of anal sphincter dysfunction. Severity of gas and stool incontinence was assessed according to the Cleveland Clinic Incontinence Score. RESULTS: In our study, subcutaneous fistula was diagnosed in 23.3%, inter-sphincteric in 18%, trans-sphincteric in 37.7%, supra-sphincteric in 16% and extra-sphincteric in 5% of patients. Single-tract fistulas were present in 88.7% and multi-tract fistulas were present in 11.3%. Overall, 242 patients had primary fistulas and 58 patients had recurrent fistulas. The most frequently performed procedures were cutting seton (139 patients) and radical fistulectomy (104 patients). Recurrent fistulas developed in 14.3%. Postoperative gas and/or stool incontinence was noticed in 10.7%. The recurrence rate was 5.4% in patients with primary fistula and in 51.7% patients presenting with a recurrent fistula. Gas and stool incontinence developed in 3.7% of patients with primary fistulas and in 39.7% of patients presenting with recurrent fistulas. Recurrence rate was 12% in the patients of single-tract fistulas and 32.4% in the patients of multi-tract fistulas. Postoperative gas and/or stool incontinence occurred in 8.3% of patients of single-tract fistulas and in 29.4% of patients of multi-tract fistulas. CONCLUSIONS: The complication rate was 10-fold higher in patients presenting with a recurrent fistula than in those with primary fistulas and threefold higher in patients with multi-tract fistulas than in those with single-tract fistulas.     

Late results of surgical treatment of bronchiectasis in children

Among the causes of early postoperative complications in children after surgery for bronchiectasia is infection of the prehilar region due to spread of the infection from the bronchial mucosa; it remains on the stump of the bronchus after application of the and instruments during operations on the lungs. Some cases with diminished efficacy of operative treatment of bronchiectasia in the late-term periods are also attributed to this cause. Treatment of the end of the stump of the resected bronchus with the beam of the "Skalpel-l" laser leads to coagulation of the mucous membrane and considerable improvement of the late-term results of operative management of bronchiectasia in patients who had no complications in the early postoperative period.     

Late results of our treatment method in calcaneus fractures

The authors treated their patients, who had fractures of the calcaneus body in association with dislocation, by means of a new method: repositioning was effected by means of a special apparatus, retention via percutaneous screw osteosynthesis. Previously, they had used a Kirschner wire drilled from the tuber calcanei. The types of fracture differ very widely; the authors subdivide them into three groups, taking into consideration the involvement of the posterior talocalcaneal joint surfaces. The patients were subsequently followed up, and the results of 182 fractures of the calcaneum were evaluated, taking numerous different aspects into consideration. The authors were thus able to establish that the results of the treatment are greatly improved by accurate repositioning followed by percutaneous screw osteosynthesis.