Metastatic Breast Tumor Arising from Synovial Sarcoma: Report of a Case

We report a case of metastatic breast tumor arising from a synovial sarcoma of the lower limb. A 27-year-old Japanese woman was diagnosed to have synovial sarcoma 14 months prior to finding a mass in her left breast. An excisional biopsy was performed and a metastatic synovial sarcoma to the breast was confirmed. Eight months after the resection of the breast lesion, the patient developed local recurrences in both her knee and breast. A tumor resection of the limb lesion and a simple mastectomy for the huge lesion, which was diagnosed to be a metastatic breast tumor without lymph node metastasis, were performed. After the operation, the patient received adjuvant systemic chemotherapy. To the best of our knowledge, this is only the second reported case of a solitary metastatic breast tumor arising from synovial sarcoma.     

Creation of a One-Way Interatrial Communication in the Treatment of Critical Pulmonary Stenosis with Intact Ventricular Septum: A Case Report

A bstract Background : In biventricular repair of pulmonary outflow tract obstruction with intact ventricular septum, the right ventricle is loaded with total pulmonary blood flow acutely as the right-to-left shunt is abolished by closure of the atrial septal defect (ASD). Methods : We designed a one-way interatrial communication by creation of an atrial septal flap to reduce the excessive volume load of the right ventricle. Results : This procedure was successfully performed in a 3-year-old girl undergoing definitive biventricular repair for critical pulmonary stenosis associated with tricuspid stenosis and a small right ventricle. Conclusions : We believe that creation of a one-way interatrial communication might be a good alternative to adjustable ASD and/or bidirectional Glenn shunt in biventricular repair of critical pulmonary stenosis or pulmonary atresia with intact ventricular septum.     

Digital Embolus Arising from a Pseudoaneurysm after Radial Artery Catheterization: a Case Report

Heterotopic ossification is defined as the formation of mature, lamellar bone within soft tissues other than the periosteum. We present a case of a 9-year-old girl with formation of heterotopic bone tissue in the elbow after surgical treatment of a fracture of the lateral humeral condyle. Eight months after the first operation the girl was re-operated to resect the heterotopic bone tissue. We believe that radical surgical excision of heterotopic bone, following physiotherapy around the elbow in children can improve the function of the extremity.     

Successful Repair of a Huge Right Coronary Artery to a Right Ventricular Fistula: Report of a Case

Congenital coronary artery fistulas account for only 0.27%–0.4% of all congenital cardiac defects. We report a case of a right coronary artery (RCA) to a right ventricular(RV) fistula found in 14-year-old girl with clinical signs of heart failure. Echocardiography and cardiac catheterization showed the fistula and a dilated RCA with a diameter of 10 mm. Operative intervention was required, so we performed intracardiac closure of the ventricular fistulous opening under cardiopulmonary bypass (CPB). The patient recovered uneventfully. This method of closure spares the involved coronary artery and is associated with a low risk of recurrence or residual fistula.     

Pulmonary Artery Intimal Sarcoma: Case Report

Abstract   A 72-year-old woman with pulmonary artery intimal sarcoma was successfully treated with surgery. With heightened clinical awareness and technological advancement, more and more cases were diagnosed definitely before operation. Computed tomography of the chest showed a mass in right ventricular extending to pulmonary trunk and the left pulmonary artery. The patient underwent complete surgical resection and repair of the pulmonary artery with no evidence of recurrence during the 12-month follow-up, suggesting that early identification and aggressive surgical intervention would improve survival. (J Card Surg 2010;25:29-31)     

Inflammatory Myofibroblastic Tumor Arising in the Pancreatic Head: a Rare Case Report

Inflammatory myofibroblastic tumor (IMT) is a rare neoplastic lesion with tendency toward local aggressive behavior and recurrence. It is primarily a visceral and soft tissue tumor; however, involvement of pancreas is extremely unusual. A localization in the pancreas needs differentiation from other tumors and chronic pancreatitis. We report a case of inflammatory myofibroblastic tumor arising in pancreatic head in a 32-year-old female who underwent Whipple’s procedure.     

Successful Treatment of Massive Bleeding into the Open Thoracotomy Space by Pulmonary Artery Occlusion: Report of a Case

A 69-year-old man underwent decortication and latissimus dorsi muscle transposition for the treatment of chronic empyema in January 2001. The empyema recurred in March 2002, and open drainage was thus started in July 2002. In February 2003, massive hemorrhaging from the thoracic cavity occurred. Tamponade and hemostasis were performed immediately, and angiography revealed bleeding from the pulmonary artery (PA). After identification of the bleeding point, surgical hemostasis was successfully achieved following PA occlusion with a Swan-Ganz thermodilution catheter.     

Metastatic Pulmonary Adenocarcinoma Deposit Arising Within a Cutaneous Basal Cell Carcinoma: A Case Report

Skin metastases are rare complications of internal malignancies, and most commonly arise from primary lung carcinoma (Brownstein and Helwig in Arch Dermatol 105:82–68, 1972). Metastatic cutaneous lesions have not previously been documented to arise within other skin tumours. We report our experience of a solitary pulmonary adenocarcinoma metastasis that arose within a pre-existing basal cell carcinoma in a patient with undiagnosed lung cancer. Immunohistochemistry was invaluable in confirming both the metastatic nature of the secondary skin lesion and its site of origin.     

Sebaceous Carcinoma Arising from Nevus Sebaceus: A Case Report

BACKGROUND: Sebaceous carcinoma (SC) is a rare, aggressive, malignant tumor that is derived from adnexal epithelium of sebaceous glands that are distributed mostly in the skin of the head, neck, and hair-bearing regions of the body. OBJECTIVE: To discuss the clinical and histologic features and the prognosis of the extraocular SC. METHOD: We report a case of SCs of the scalp arising from a previous lesion clinically compatible with a nevus sebaceous. The lesion was surgically excised completely. RESULTS: The postoperative course was free of complications, and the patient was clinically free of disease at her recent follow-up 2 years after treatment. CONCLUSIONS: The absence of metastasis or cutaneous recurrence in our patient, notwithstanding the size of the lesion and its late removal, almost 25 years after the first signs of its growth, confirms a much improved prognostic behavior for extraocular SCs.     

Ductal Carcinoma In Situ Arising in a Benign Phyllodes Tumor: Report of a Case

Malignant epithelial change within a phyllodes tumor (PT) is a rare event. To our knowledge, only six cases of ductal carcinoma in situ arising in a PT have been reported in English. We report a case of PT with an intraductal carcinoma component, which grew rapidly to a huge size in 3 months. Histologically, the stromal element showed mild to moderate cellularity with few mitoses and mild nuclear atypia. The epithelial element consisted of irregularly dilated ducts with a phyllodes structure that had moderate to severe epithelial hyperplasia, and foci of cribriform ductal carcinoma in situ with comedo necrosis.     

Extra-Abdominal Fibromatosis (Desmoid Tumor) Arising in the Infratemporal Fossa: A Case Report

Aggressive fibromatosis (or desmoid tumor) refers to a histologically benign but locally aggressive lesion arising from musculoaponeurotic structures in various anatomic sites. Extra-abdominal desmoids represent about one third of all desmoid tumors; of these only about 11 to 15% arise in the head and neck. Desmoid tumors arising in the infratemporal fossa are exceedingly rare; to our knowledge only one such tumor has been reported in the literature. We present a desmoid tumor arising in the infratemporal fossa with intracranial extension in a twenty-seven year old male and review the literature on this rare condition.     

A Primary Peritoneal Pseudomyxoma Peritonei Arising from the Mullerian Tissue: a Case Report

A primary Pseudomyxoma Peritonei is uncommon. For a long time, ovaries, colon and appendix were proposed like a site origin of these enigmatic lesions. Recent publications show that the majority of cases are due to a rupture of appendicle adenoma.

We report a case of a pseudomyxoma peritonei arising in an elderly patient with a previous medical history of appendectomy undergone in infancy. The pseudomyxoma was misdiagnosed as an abdominal abscess related to colitis. In our opinion, metaplasia of the Müllerian system is a possible source of a primary peritoneal pseudomyxoma.     

Successful Video-Assisted Thoracic Surgery for Pulmonary Endometriosis: Report of a Case

Pulmonary endometriosis is a disease in which uterine endometrial cells with stromal components grow in the pulmonary parenchymal tissues or pleura. Surgical resection is considered an effective and radical treatment for pulmonary endometriosis to avoid the adverse effects of long-term hormone therapy in young women of childbearing years with a localized abnormal lesion. We report a case of pulmonary endometriosis with catamenial hemoptysis, an uncommon result of this disease, which was diagnosed histologically and treated successfully by video-assisted thoracic surgery.     

Hepatocellular Carcinoma Arising from Autoimmune Hepatitis: Report of a Case

We describe an operative case of a 64-year-old woman with hepatocellular carcinoma (HCC) associated with autoimmune hepatitis (AIH) during a 4.8-year follow-up. Sixty-seven cases of HCC with AIH have been previously reported as a sporadic complication of AIH. The survival rate after diagnosis with HCC showed the 5-year survival rate to be 10.4%, thus indicating the majority of patients to have either extensive HCC or severe liver dysfunction. Immunosuppressant therapy helped to postpone the hepatocarcinogenesis but it did not improve the prognosis of the patients demonstrating HCC with AIH. A univariate analysis of factors associated with prognosis disclosed that the histology of nontumorous lesion at diagnosis with HCC, tumor size, tumor number, and treatment for HCC were independent prognostic predictors. Patients with AIH were not recognized to be a high-risk group for developing HCC because HCC occasionally occurred even in patients with long-standing cirrhosis in the absence of hepatitis B virus and hepatitis C virus infection.     

Successful Arterial Reconstruction with Collateral Artery Bypass for a Femoral Artery Aneurysm: Report of a Case

The outcome of surgery for femoral artery aneurysms is dependent on the preoperative status of the runoff vessels. We report a case of a femoral artery aneurysm complicated by thromboembolic obstruction of the distal superficial femoral and profunda femoris arteries. Fortunately, the collateral arteries were viable runoff vessels for restoring adequate blood flow to the limb.