A Rare Presentation of Metachronous Multicentric Pelvic and Extracranial Chondrosarcoma: A Case Report

Conventional chondrosarcomas rarely metastasize and it is extremely unusual to see multicentric- behaviour in malignant cartilage tumour. We report a 40 year old lady with presentation of two non-contiguous metachronous foci of low to intermediate grade of chondrosarcoma over left pelvic bone and right scalp respectively in the absence of pulmonary or visceral metastasis.

Application of retroperitoneal laparoscopic partial nephrectomy in the treatment of unilateral multifocal renal tumors / 中华泌尿外科杂志

Objective To discuss the safety and efficacy of retroperitoneal laparoscopic partial nephrectomy in the treatment of unilateral multifocal renal tumors.Methods The data of 12 patients with unilateral multifocal renal tumors managed with retroperitoneal laparoscopic partial nephrectomy between 2009 and 2012 were reviewed retrospectively.The 12 patients had a mean age of 42 years (28 to 62) and body mass index of 23.5 kg/m2 (18.6 to 29.3),including 4 males and 8 females.Four cases were in the left side,7 cases were in the right side,and 1 case had bilateral renal tumors.The diameter of renal tumors ranged from 0.5 cm to 4.7 cm,and all tumors were projected on the surface of kidney.Nine cases were diagnosed as renal cell carcinoma,and 3 cases were diagnosed as angiomyolipoma before operation.All patients underwent retroperitoneal laparoscopic partial nephrectomy under general anesthesia,while 1 patient with bilateral renal tumors experienced radical nephrectomy of the contralateral renal tumor 3 months after the first operation.Results All the oprations were successful without conversion to open surgery.The mean renal artery cut off time,operative time,estimated blood loss and hospital stay were 36 min (26-60),126 min (75-184),142 ml (50-300) and 5 d (3-9),respectively.No complication occurred and 1-week postoperative serum creatinine was (78.1 ±8.1)μmol/L.Histopathological study revealed 9 cases of renal cell carcinomaand 3 cases of angiomyolipoma.During the follow-up for 33 months (13-51),1 patient with yon Hippel-Lindau syndrome was operated with ipsilateral radical nephrectomy for a local recurrence while the remains had no local recurrence or metastasis.Conclusions For localized and exogenous unilateral multifocal renal tumors,retroperitoneal laparoscopic partial nephrectomy is feasible and safe.Those who have hereditary and/or malignant renal tumors should be monitored closely.

Multiple Rectal Neuroendocrine Tumors: Report of Five Cases / 대한소화기학회지

Carcinoids are slow growing neuroendocrine tumors (NET) originating in the enterochromaffin cells of the gastrointestinal tract. In previous studies, rectal NET comprised only about 1% of all anorectal neoplasms; however, the incidence of rectal NET has shown a recent increase. Typically, rectal NET presents as a single subepithelial nodule, and multicentricity of rectal NETs is rare, with reported incidence of 2-4.5%. Due to the rarity of multiple rectal NETs, there is no consensus or guidelines for treatment of multiple rectal NETs. However, NETs of the rectum that are less than 10 mm in diameter and do not infiltrate the muscularis propria, without distant metastasis, can be removed by endoscopy, as with solitary rectal NET. We encountered five cases of multiple rectal NETs which were treated successfully by endoscopy.

Colecistite alitiásica aguda: manifestação inicial de uma doença autoimune? / Acute cholecystitis alitiasica: initial manifestation of na autoimune disease?

A Colecistite Alitiásica Aguda (CAA) é uma inflamação da vesícula biliar na ausência de colelitíase. É uma forma pouco frequente de colecistite, representando cerca de 10% de todos os casos, sendo tradicionalmente descrita em pacientes graves, submetidos a grandes procedimentos cirúrgicos, queimados, sépticos, politraumatizados ou em nutrição parenteral total por tempo prolongado. Existem relatos na literatura da sua associação também com o diabetes mellitus, insuficiência cardíaca, síndrome da imunodeficiência adquirida, dentre outras patologias. Doenças autoimunes como poliarterite nodosa e Lúpus Eritematoso Sistêmico (LES) também podem se manifestar através da CAA, causada por uma lesão isquêmica na vesícula biliar. Nosso objetivo é relatar um caso clínico de Colecistite Alitiásica Aguda numa paciente sem fator de risco que, durante a evolução, apresenta quadro de rash cutâneo facial, com Fator Antinuclear (FAN) positivo, porém sem critérios diagnósticos para LES segundo os protocolos e que, após início da corticoterapia, apresentou remissão total dos sintomas.

The Acute Cholecystitis Alitiasica (CAA) is an inflammation gallbladder in the absence of cholelithiasis. It is a Uncommonly of cholecystitis, representing about 10% of all cases, traditionally described in critically ill patients undergoing to major surgical procedures, burns, sepsis, multiple trauma or parenteral nutrition total time for prolongado. There are reports in literature also its association with diabetes mellitus, heart failure, immunodeficiency syndrome acquired, among other patologias. Diseases as autoimmune lupus erythematosus and polyarteritis nodosa (SLE) may also manifest by CAA, caused by an ischemic lesion in gall biliar. Our goal is to report a case Acute cholecystitis in a patient without Alitiásica factor risk that during evolution, presents frame facial rash with antinuclear antibodies (ANA) antibody positive, but no diagnostic criteria for SLE according to protocols and that after the start of steroid therapy, showed total remission of symptoms.

Apresentação rara de carcinoma epidermoide: relato de caso / Rare presentation of epidermoide carcinoma: case report

O diagnóstico endoscópico de carcinoma epidermoide esofágico múltiplo é incomum. Descrevemos o caso de um paciente de 49 anos com três lesões tumorais, que podem ter surgido por metástase intramural de lesão primária ou por multicentricidade. Este artigo objetiva o estudo deste caso através de dados da literatura.

The endoscopic diagnosis of the multiple oesophageal squamous cell carcinoma is uncommon. We describe a forty-nine-year old patient case with three tumor lesions that could have appeared through an intramural metastasis of primary lesion or multicentricity. This article aims the study of this case based on medical data.

A Case of Multiple Carcinoid Tumors of the Rectum / 대한소화기내시경학회지

Carcinoid tumors are rare and arise from enterochromaffin cells of the gastrointestinal tract. The rectum is the most common site for gastrointestinal carcinoids. The tumor usually present as small solitary submucosal nodules and multicentricity is rare, occurring in only a few percent of cases. The treatment for a rectal carcinoid tumor is based on the size of the lesion and depth of invasion. Although the present treatment guidelines for multiple rectal carcinoids are controversial, each small lesion of less than 1 cm without evidence of a metastasis can be adequately treated by local resection such as an endoscopic mucosal resection. We experienced a case of multiple rectal carcinoids that were completely resected after a hot biopsy and endoscopic mucosal resection.

Multicentricity of Papillary Thyroid Carcinoma in Contralateral Lobe: A comparison of preoperative ultrasonographic findings with those of postoperative histopathologic examination

PURPOSE: Total thyroidectomy can be recommended for patients with bilateral thyroid cancer. Sometimes, it is difficult to preoperatively detect multicentric foci in the contralateral lobe. The aim of this retrospective study is to determine the incidence of multicentricity in the contralateral lobe of papillary thyroid carcinoma (PTC) and to evaluate the diagnostic value of preoperative ultrasonography for multicentricity. METHODS: From January 1997 to December 2001, 93 patients with PTC underwent ultrasonography before total thyroidectomy. Ultrasonographic findings of multicentric foci in contralateral lobes were compared with histopathologic examination. RESULTS: Forty-four (47.3%) of the 93 patients were presumed bilateral PTC ultrasonographically, but 24 (25.8%) were confirmed histopathologically to have multicentricity in the contralateral lobes. Sensitivity and specificity of ultrasonography were 79.2% and 63.8%, respectively. False positive was 26.9%, consisting of 11 patients with benign diseases, 10 with normal glands, and 4 with intrathyroidal extension of PTC. False negative was 5.4%, which were all microcarcinoma with mean size of 0.3 cm. Ultrasonographic accuracy was 72.0%, but this was decreased to 35.3% in the cases of PTC combined with benign diseases. Clinical factors, except extrathyroidal invasion of PTC, were not related to multicentricity. CONCLUSION: Preoperative ultrasonography in PTC patients has a limited diagnostic value for multicentric foci within contralateral lobes, due to the technical variation of ultrasonography, combined benign diseases and diagnostic inaccuracy for micronodules.

Unilateral multicentric breast cancer:a report of 14 cases / 中国普通外科杂志

Objective To study the clinical features and treatment of unilateral multicentric breast cancer.Methods The clinical data of 14 cases of unilateral multicentric breast cancer,which were found from July,2004 to December,2007 were analyzed retrospectively.ResultsSix cases(42.9%) had infiltrating lobular carcinoma,and the other 8 cases(57.1%) were invasive ductal carcinoma.The number of cancer focus was 2 to 9,and with a diameter of 0.5-4.3 cm.The focus in 12 cases were located in upper lateral quadrant;1 case was located in the upper medial and lateral quadrant;1 case was located in the upper lateral quadrants,the junction area of upper medial and upper lateral quadrants,and between upper lateral quadrant and lower lateral quadrants.One patient was treated by breast conservation operation,with no recurrence at 3-5 years follow-up;while the other 13 cases received modified radical operation,and with no recurrence at 2-37 months of follow-up.ConclusionsUnilateral multicentric breast cancer are often distributed in the same quadrant or adjacent quadrants of breast,and the majority cases are with invasive ductal carcinoma.For treatment of these lesions were a modified radical operation combine with comprehensive treatment.