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Benign Lipoid Neoplasm or Malignant Liposarcoma in Disguise? Diagnostic Dilemmas Pertaining to Lipomatous Neoplasms of the Retroperitoneum 良性脂肪样肿瘤还是伪装的恶性脂肪肉瘤?腹膜后脂肪瘤性肿瘤的诊断困境
Pub Date : 2022-02-10 DOI: 10.31487/j.crss.2021.02.05
L. Xanicia, Welras Jirui
Retroperitoneal benign lipoid lesions are extremely rare, representing about 2.9% of all primary retroperitoneal tumors. Despite being of benign origin, they can have severe complications. We report a case of an elderly Chinese male presenting with urinary obstruction and lower limb deep vein thrombosis, with computer tomography findings of an extending pre-sacral retroperitoneal lesion. Histology and fluorescence in situ hybridization investigations confirmed that the lesion was of benign lipoid origin. Patient was offered surgical intervention which he declined in view of age.
腹膜后良性脂质病变极为罕见,约占所有原发性腹膜后肿瘤的2.9%。尽管它们是良性的,但它们可能有严重的并发症。我们报告一例中国老年男性,以尿路梗阻和下肢深静脉血栓形成为主要表现,计算机断层扫描显示骶前腹膜后病变。组织学和荧光原位杂交检查证实病变为良性脂质起源。病人接受手术治疗,但考虑到年龄,他拒绝了。
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引用次数: 0
Anomalous Presentation of a Renal Angiomyolipoma 肾血管平滑肌脂肪瘤的异常表现
Pub Date : 2022-02-03 DOI: 10.31487/j.crss.2021.02.06
L. Xanicia
Angiomyolipoma (AML) of the kidney is a benign hamartomatous neoplasm which is usually asymptomatic and picked up incidentally on radiological imaging. AMLs that present symptomatically are typically those of large sizes exceeding 4cm with complications of rupture and retroperitoneal bleed. The classical triad in symptomatic cases includes flank pain, flank mass and gross haematuria. In cases of severe hemorrhage, patients may even turn hypotensive. AMLs rarely present as fever or urinary tract infection. This report presents a case of a middle-aged lady who presented with fever and lower urinary tract symptoms, and urinary studies performed were suggestive of a urinary tract infection. Radiological investigations revealed a right sided renal AML. This report discusses how renal AMLs can present atypically and includes a review of literature.
肾脏血管平滑肌脂肪瘤(AML)是一种良性错构瘤,通常无症状,在放射成像中偶然发现。典型的aml是那些超过4cm的大细胞,并伴有破裂和腹膜后出血的并发症。典型的三联征症状包括腹部疼痛、腹部肿块和肉眼血尿。在严重出血的情况下,患者甚至可能出现低血压。aml很少表现为发热或尿路感染。本文报告了一位中年妇女的病例,她表现出发烧和下尿路症状,泌尿系统检查提示她患有尿路感染。放射检查显示右侧肾急性髓性白血病。本报告讨论肾脏aml如何表现为非典型,并包括文献综述。
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引用次数: 0
Radiation-Related Hypopharynx-Stenosis with Spared Larynx Treated by a Novel-Shaped Silicone Stent 新型硅胶支架治疗放射相关性下咽狭窄伴保留喉
Pub Date : 2021-10-12 DOI: 10.31487/j.crss.2021.02.04
Michael A. Herzog, A. Velten, Benjamin Velten, V. Bogdanov, D. Grafmans
Background: Radiation-related hypopharyngeal stenoses are considered as complications after larynx sparing therapy of hypopharyngeal or laryngeal tumors.Methods: The reported patient suffered from chondronecrosis of the cricoid after radiation of a larynx carcinoma and was treated by removing the necrotic cartilage. To prevent emerging stenosis of the hypopharynx, a customized hypopharyngeal stent was constructed on the basis of CT scan data. The Y-shaped stent was placed dorsal to the larynx, caudal to the arytenoid cartilages and remained in place without dislocation or irritation of the larynx for 8 weeks. During that time, the hypopharynx was stented, and the mucosa grew around the stent covering the complete circumference of the hypopharynx again. 18 weeks after removal of the stent, the hypopharynx did not reveal any re-stenosis.Conclusion: This customized hypopharyngeal stent is the first reported approach applied with spared larynx, which has been tolerated for a long period of time.
背景:放射相关的下咽狭窄被认为是下咽或喉部肿瘤保喉治疗后的并发症。方法:本病例为喉癌放射治疗后环状软骨坏死患者,采用切除坏死软骨的方法治疗。为防止下咽出现狭窄,根据CT扫描数据定制下咽支架。y形支架放置于喉背侧、杓状软骨尾侧,8周内未发生脱位或刺激喉。在此期间,下咽植入支架,粘膜在支架周围生长,再次覆盖下咽的完整周长。移除支架18周后,下咽未发现再狭窄。结论:这种定制的下咽支架是首次报道的适用于保留喉的入路,并且长期耐受。
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引用次数: 0
Treatment of Deep Vein Thrombosis Using Factor Xa Inhibitor Concurrent with Platinum Based Chemotherapy Regimen: A Case Report Xa因子抑制剂联合铂类化疗方案治疗深静脉血栓1例
Pub Date : 2021-10-01 DOI: 10.31487/j.crss.2021.02.01
G. H. Gunasekaran, W. Sabri, Mohd Ezrul Helmi Bin Jamaluddin
Deep Vein Thrombosis (DVT) is a common treatment-related complication following surgery and chemotherapy. We are reporting a case of colorectal cancer-associated thrombosis during platinum-based chemotherapy. The patient was treated with Rivaroxaban (Xarelto), a highly selective direct Factor Xa inhibitor. This case report highlights the concurrent use of novel oral anticoagulants, which does not interrupt the chemotherapy schedule among patients receiving cytotoxic agents.
深静脉血栓形成(DVT)是手术和化疗后常见的治疗相关并发症。我们报告一例结直肠癌相关血栓在铂基化疗。患者接受了利伐沙班(Xarelto)治疗,这是一种高选择性的直接Xa因子抑制剂。本病例报告强调了同时使用新型口服抗凝剂,这不会中断接受细胞毒性药物的患者的化疗计划。
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引用次数: 0
Repeated Middle Meningeal Artery Embolization for Chronic Subdural Hematoma Management: Case Report 反复脑膜中动脉栓塞治疗慢性硬膜下血肿1例
Pub Date : 2021-09-03 DOI: 10.31487/j.crss.2021.02.02
Dimitri Sigounas, Kenneth Sack, G. Thomas
Aim: Middle Meningeal Artery (MMA) embolization has emerged as a viable neuroendovascular technique for the management of chronic subdural hematoma (SDH). Comparative analysis of various endovascular techniques for embolization is lacking. Guidance on operative techniques in situations of prior embolization failure is rare. Materials and Methods: In this case report, we present a patient with a chronic subdural hematoma that failed previous coil embolization of the MMA. Digital Subtraction Angiography showed the previously placed coil and continued distal flow to the dural membranes. Results: Onyx liquid embolization was completed successfully, effectively halting both anterograde flow to the MMA and retrograde flow from external circulation collaterals. Conclusion: This case report suggests that in situations of MMA embolization failure, follow-up angiography may be completed to determine if further embolization through other procedural techniques may be possible. The angiographic images contained here highlight the advantages of liquid embolization over coil embolization of the MMA in halting SDH angiogenesis.
目的:脑膜中动脉(MMA)栓塞已成为治疗慢性硬膜下血肿(SDH)的一种可行的神经血管内技术。缺乏各种血管内栓塞技术的比较分析。在先前栓塞失败的情况下,很少有关于手术技术的指导。材料和方法:在这个病例报告中,我们提出了一个慢性硬膜下血肿患者,先前的MMA线圈栓塞失败。数字减影血管造影显示先前放置的线圈和继续远端流向硬膜。结果:成功完成了玛瑙液体栓塞,有效阻断了MMA的顺行血流和外循环侧支的逆行血流。结论:本病例报告提示,在MMA栓塞失败的情况下,可以完成随访血管造影,以确定是否可以通过其他手术技术进一步栓塞。此处的血管造影图像强调了液体栓塞比MMA线圈栓塞在阻止SDH血管生成方面的优势。
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引用次数: 0
Rare Case of Gallbladder Perforation in Pediatric Patient: A Pitfall in Generalized Peritonitis in Late Presented Typhoid Fever 罕见的小儿胆囊穿孔病例:迟发性伤寒中广泛性腹膜炎的一个隐患
Pub Date : 2021-05-24 DOI: 10.31487/J.CRSS.2021.01.03
Ageng Budiananti, Sapta Prihartono
An 11-year-old boy presented to the emergency room with generalized abdominal pain, inability to pass gas nor stool in 2 days, along with stepladder pattern fever which he had been having in the past 2 weeks before being admitted to the hospital. Abdominal surgical complications are one of most common complications (10-15% of typhoid fever patients) in pediatric typhoid fever, but gallbladder perforation is an uncommon one. Emergency surgical exploration with cholecystectomy was initiated and showed satisfying outcome [1].
一名11岁男孩在入院前2周出现全身性腹痛、不能排便、不能放屁,并伴有阶梯型发热,于2天内出现在急诊室。腹部手术并发症是小儿伤寒最常见的并发症之一(占伤寒患者的10-15%),但胆囊穿孔并不常见。急诊探查胆囊切除术开始,并取得满意的结果[1]。
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引用次数: 0
Hemostasis Surgery of Spontaneous Hemothorax Complicating Neurofibromatosis Type 1 自发性血胸合并1型神经纤维瘤病的止血手术
Pub Date : 2021-02-19 DOI: 10.31487/J.CRSS.2021.01.01
A. Mahdi, Ben Saad Soumaya, Zribi Hazem, Zairi Sarra, B. Imen, M. Adel
Vascular lesions in Von Recklinghausen’s disease also known as Neurofibromatosis type 1 (NF1), are rare but have a fatal and potentially life threatening complications such as spontaneous hemothorax. An emergent thoracotomy is indicated when there is an active bleeding associated unstable hemodynamic status. Despites surgery is laborious and unpredictable but it have a merit to stop hemorrhage. A conservative management with endovascular embolization or non-operative approach have also been reported in case of hemodynamic stability. We report two case report of spontaneous hemothorax in patient with Recklinghausen disease. A chest tube was immediately inserted for two patients. Due to continuous bleeding and hemodynamic instability (Patient 1), and the increase of pleural effusion volume (Patients 1 & 2), emergent surgery of thorax was done with favourable post-operative follow up.
Von Recklinghausen病的血管病变也被称为1型神经纤维瘤病(NF1),是罕见的,但有致命的和潜在威胁生命的并发症,如自发性血胸。当血流动力学状态不稳定并伴有活动性出血时,需要紧急开胸手术。尽管手术是费力的和不可预测的,但它有一个优点,以防止出血。在血流动力学稳定的情况下,采用血管内栓塞或非手术方法进行保守治疗也有报道。我们报告两例自发性血胸的病例报告,病人的雷克林豪森病。我们立即为两名患者插入了胸管。由于持续出血和血流动力学不稳定(患者1),以及胸腔积液量增加(患者1和2),急诊胸腔手术并进行了良好的术后随访。
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引用次数: 0
Unusual Case of Pseudomyxoma Peritonei of a Mature Teratoma in Adult Men 成年男性成熟畸胎瘤腹膜假性粘液瘤的罕见病例
Pub Date : 2020-10-05 DOI: 10.31487/J.CRSS.2020.02.04
C. Ceribelli, M. David, A. Ayav, J. Raft, A. Leroux, F. Marchal
Pseudomyxoma peritonei (PMP) is a rare disease usually originating from appendiceal neoplasm and itsincidence is 1-2 cases per million. Extra-appendicular origin is less common and is related to ovary, urachus,stomach, colon and pancreas cancer. A few cases of mature ovarian teratoma associated with PMP havebeen described. We report an extremely rare case of a man treated for a mature teratoma recurrence as aPMP. A 57-year-old man with multiple surgeries for mature teratoma excision as a newborn was addressedto our institution. At the age of 55, a surgical exploration found a low-grade PMP. The patient wasasymptomatic, and surveillance was performed. Nine months later, a sub-complete cytoreductive surgery(CRS) with Mitomycin C HIPEC (hyperthermic intraperitoneal chemotherapy) was performed. One yearlater, the residual mass volume was treated by a new CRS with Mitomycin C HIPEC. After a two-yearfollow-up patient has no recurrence. PMP extra-appendiceal origin in less than 10%. This is the first reportedcase of PMP originating as a mature teratoma recurrence in a man. A few cases describe PMP from ovarianteratoma in women. Despite PMP’s different origins, gold standard treatment still remains CRS and HIPEC.
摘要腹膜假性黏液瘤(PMP)是一种罕见的疾病,通常起源于阑尾肿瘤,发病率为百万分之1-2例。阑尾外起源较少见,与卵巢癌、输卵管癌、胃癌、结肠癌和胰腺癌有关。已经报道了一些与PMP相关的成熟卵巢畸胎瘤病例。我们报告一个极其罕见的情况下,一个男人治疗成熟畸胎瘤复发为aPMP。一位57岁的男性在新生儿时期接受了多次成熟畸胎瘤切除手术。55岁时,手术探查发现低度PMP。患者无症状,并进行了监测。9个月后,进行了亚完全细胞减少手术(CRS)和丝裂霉素C HIPEC(高温腹腔化疗)。一年后,用新的CRS与丝裂霉素C HIPEC处理残余体积。经过两年的随访,患者无复发。PMP起源于阑尾外的不到10%。这是首次报道的男性成熟畸胎瘤复发引起PMP的病例。少数病例描述女性卵巢畸胎瘤引起的PMP。尽管PMP的起源不同,但金标准治疗仍然是CRS和HIPEC。
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引用次数: 0
Robotically Assisted Laterally Extended Endopelvic Resection (LEER) of an Isolated Ovarian Cancer Recurrence 机器人辅助侧扩展盆腔内切除术(LEER)孤立性卵巢癌复发
Pub Date : 2020-06-19 DOI: 10.31487/j.crss.2020.02.02
A. Buras, A. Chudzinski, A. Dinallo, Danielle Craigg, J. Wallen, M. Hoffman, T. Lippert
A 64-year-old woman with recurrent ovarian cancer isolated to the left pelvic sidewall underwent roboticresection of a tumor adherent to the external iliac vein and encasing the ureter and internal iliac vessels. Anarrated video-clip of the case is included.
一例64岁女性复发性卵巢癌孤立于左侧盆腔侧壁,采用机器人切除附着于髂外静脉并包裹输尿管和髂内血管的肿瘤。包括该案件的视频片段。
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引用次数: 0
Gastro-Splenic Fistula from Diffuse Large B-Cell Lymphoma: Case Report 弥漫性大b细胞淋巴瘤所致胃脾瘘1例
Pub Date : 2020-05-19 DOI: 10.31487/j.crss.2020.01.10
B. Smith, Ellyn Smith, Lauren Smith
A gastro-splenic fistula is a rare complication of lymphoma, the etiology of which is poorly understood dueto the narrow spectrum of cases. Additional case reports of this complication allow for increasedunderstanding to facilitate treatment planning. This case report provides our detailed patient scenario andsurgical approach to a gastro-splenic fistula in the setting of large B-cell lymphoma and compares thisapproach to similar cases provided in the literature review
胃脾瘘是一种罕见的淋巴瘤并发症,由于病例范围狭窄,其病因尚不清楚。有关该并发症的其他病例报告有助于增进对治疗计划的了解。本病例报告提供了详细的患者情况和大b细胞淋巴瘤胃脾瘘的手术入路,并将该入路与文献综述中提供的类似病例进行了比较
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引用次数: 0
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Case Reports and Series in Surgery
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