Iatrogenic seeding of tumor cells in thigh soft tissue upon surgical removal of intracranial meningioma

Introduction: Meningioma is a benign and slowly-growing tumor that is responsible for 20% of brain neoplasms. It can be accompanied by some genetic disorders such as neurofibromatosis type 2 and is more common among women. As a space occupying lesion, it produces a wide range of signs and symptoms by compressing the adjacent and underlying tissues in the brain. Trauma and viruses are possible etiologies for meningioma. The ideal treatment of benign meningioma is surgical resection

Case Presentation: In this case report, we present a middle-aged man with a seeding metastasis of the cranial meningioma [after its removal] in the left thigh. During the removal operation, fascia lata had been used to repair the dura mater and the skin defect was repaired primarily

Conclusion: We believe that the occurrence of meningioma at the site of incision in the thigh is related to using the same surgical instruments for the removal of the brain tumor

Temporary abdominal closure in the critically ill patients with an open abdomen

The emergent abdominal surgeries from either of traumatic or non traumatic causes can result in situations in which the abdominal wall cannot initially be closed. Many techniques have been reported for temporary coverage of the exposed viscera, but the result of various techniques remains unclear. During 94 months, 19 critically ill patients whit an open abdomen underwent surgery using plastic bags [Bogot? bag]. The study population comprised of 11 [57.9%] male and 8 [42.1%] female with an average age of 32.26+14.8 years. The main indications for temporary abdominal coverage were as follows: planned reoperation in 11 [57.9%] patients, subjective judgment that the fascia closure is too tight in 6 [31.6%] patient's damage control surgery in one patient [5.3%] and development of abdominal compartment surgery in one patient [5.3%]. Surgical conditions requiring temporary abdominal closure was severe post operative peritonitis in 9 [47.4%] patients, post operative intestinal fistula in 4 [21.1%] patients, post traumatic intra abdominal bleeding in 3 [15.8%] patients and intestinal obstructions in 3 [15.8%] patients. Length of hospitalization was 45+23.25 days and the mean total number of laparotomies was 6.2+3.75 times per patient. Three bowel fistulas occurred due to a missed injury at the time of initial operation that was discovered during changing the plastic sheet. They were unrelated to coverage technique. All of them were treated by repair of the defect and serosal patch by adjacent bowel loop. Only one [10.0%] patient underwent definitive closure within 6 months of initial operation. The remaining survivor has declined to have hernia repaired. There were 4 [%21.1] early postoperative deaths that were not related to the abdominal coverage technique. Also, there were 5 [26.3%] late deaths that were due to dissemination of malignancy with a mean survival time of 20.8+13 [range 2-54] months. Currently 10 patients [52.6%] are alive at a follow up of 45 [range 1-94] months. Only one [10.0%] patient underwent definitive closure within 6 months of initial operation. The remaining survivor has declined to have hernia repaired. Bogot? bag technique is a rapid, simple and inexpensive technique for temporary abdominal coverage