ABSTRACT
Undifferentiated(embryonal) sarcoma of the liver developing predominantly in the late childhood is extremely rare in malignant hepatic tumors. It has been described by a variety of terms such as malignant mesenchymoma, embryonal sarcoma, fibromyxosarcoma, embryonal rhabdomyosarcoma or primary sarcoma of the liver. The tumor usually presents a huge mass containing solid and sometimes cystic components, and is cmposed of large stellate and spindle cells in an abundant myxoid matrix. The treatment of choice is surgical resection with or without adjuvant chemotherapy and/or radiotherapy, but the prognosis of this disease has been reported extremly poor. We experienced a case of undifferentiated(embryonal) sarcoma of the liver recently which was confirmed by pathological examinations in a 18-year-old boy. He visited our hospital for examination of the progressive growing RUQ abdominal mass detected incidentally. On physical examination, a firm, non-tender, hard, fixed, huge, abdominal mass was palpated in the right upper quadrant of abdomen. Abdominal ultrasonography, computerized tomography and magnetic resonance imaging showed a 10x15cm sized mass confined to the left lobe of the liver, and it was hypovascular mass on angiography. We performed left lobectomy including the tumor and it was confirmed as undifferentiated (embryonal) sarcoma of the liver by pathologic examination. We herein report this case including histologic, electronmicroscopic and flow cytometric results with the review of literatures.
Subject(s)
Adolescent , Humans , Male , Abdomen , Angiography , Chemotherapy, Adjuvant , Liver , Magnetic Resonance Imaging , Mesenchymoma , Physical Examination , Prognosis , Radiotherapy , Rhabdomyosarcoma, Embryonal , Sarcoma , UltrasonographyABSTRACT
Elevation of aspartate aminotransferase (AST), alanine aminotransferase(ALT),and bilirubin levels was noted incidentally in patients who received laparoscopic cholecystectomy(LC). This study was attempted to investigate the elevation of liver enzymes and bilirubin levels after LC and its clinical significance. Twenty patients who showed normal levels of preoperative liver function test were entered into this study, and blood was collected at 24hours, 72hours and 7days after operation for measurement of AST, ALT, alkaline phosphatase(ALP), and bilirubin levels. In AST, a mean 2.76-fold postoperative increase was observed in 18 patients(90%) and 12 patients(60%) showed an elevation rise above normal limits. In ALT, a mean 2.14-fold postoperative increase was observed in 16 patients(80%) and 10 patients(50%) showed an elevation rise above normal limits. A mean 1.42-fold and a mean 2.12-fold increase were observed in total and direct bilirubin level respectively and elevation above normal limits occured in 7 patients(35%) and 4 patients (20%) respectively. The patients with an elevation of AST, ALT and bilirubin levels did not show any related clinical problem, and the elevations were transitory and returned to normal value within several days without any specific treatment.. Although the exact causes of these elevations need further investigation, theys appear to have no obvious clinical significance.
Subject(s)
Humans , Alanine , Aspartate Aminotransferases , Bilirubin , Cholecystectomy, Laparoscopic , Liver Function Tests , Liver , Reference ValuesABSTRACT
Primary lymphoma of the spleen is a relatively rare disease entity and is usually defined, although it is still controversial and hard to define, as the lymphoma which involved primarily the spleen and splenic hilar lymph nodes without involvement in any other site, particularly in the liver and in the mesenteric or para-aortic lymph nodes. In laparotomy of patients with non-Hodgkin's lymphoma, splenic involvements are found in 30 to 50% of patients as part of a diffuse pattern of the disease, but primary lymphoma of the spleen accounts for less than 1 % of all lymphoma cases. And it is often difficult to determine during laparotomy whether splenic involvement with lymphoma is primary or the result of a spread from another site. We herein report on a case of primary lymphoma of the spleen which was detected incidentally during evaluation of the cause of right upper quadrant abdominal pain. During the operation, a splenic tumor was found without the evidence of involvement in other sites, and it was confirmed pathologically to be a non-Hodgkin's lymphoma of the spleen. She lives well now without evidence of recurrence 14 months after the operation.
Subject(s)
Humans , Abdominal Pain , Laparotomy , Liver , Lymph Nodes , Lymphoma , Lymphoma, Non-Hodgkin , Rare Diseases , Recurrence , SpleenABSTRACT
Liposarcoma is one of the most common soft tissue sarcomas in adults and its incidence rate is above 10% of all soft tissue sarcoma. The two common sites of liposarcoma are the extremities, particularly the thigh, and the retroperitoneum, but it developes rarely in spermatic cord, testis, chest wall and breast, mediastinum, omentum and mesentery. Primary solid tumors of omentum are exceedingly rare. Most of them are of mesenchymal origin and about one-half of them are malignant. Primary liposarcoma occurring in the omentum has been reported rarely, and especially round cell type liposarcoma, one of the histologic subtype of liposarcoma, has been known to be extremely rare. Recently, we experienced a patient with round cell liposarcoma arising primarily in the omentum. Herein, we report the clinical case with a consideration of the cytopathologic and ultrastructural features and a review of the literature.