Pelvic exenteration in advanced and recurrent cervical cancer

Pelvic exenteration consists in a radical surgical procedure for patients with advanced and recurrent cervical cancer and it offers the chance for cure. Surgical techniques have been developed for reducing morbidity and mortality. From July 2005 to September 2009, Pelvic Exenteration was performed for 20 patients with primary advanced cancer cervix and 10 patients with recurrent cervical carcinoma. Full data about the surgery [type of exenteration, type of feacal and urinary diversion, lymph node dissection, and operative morbidity] was recorded. No operation-related mortality, the complications rate was 23.3% and the overall mean survival was 34.7 months [95% CI=28.0-41.5]. Multiple factors were analyzed [univariate analysis] to determine their association with long-term survival. Mean survival was 37.2 months [95% CI 29.7-44.7] in the primary group and was 21.6 months [95% CI=12.8-30.4] in the recurrent group [p=0.033 by Cox regression]. An important prognostic factor was the margin status. Mean survival was 39.2 months [95% CI<=33.0-45.4] for patients with tumor-free resection margins and was 6.4 months [95% CI=3.3-9.5] for those with positive margins [p<0.001 by Cox regression]. In patients with primary advanced cervical cancer, exenteration is a valid alternative to primary chemoradiation. In patients with recurrent tumor limited to the pelvis, secondary exenteration should be offered without post operative mortality although the morbidity rate is still high. Univariate analysis showed that margin status is important prognostic factor for survival

Fetus in fetu

Fetus in fetu is a rare abnormality secondary to the abnormal embryo genesis in a diamniotic, monochorionic pregnancy. To our knowledge fetus in fetu originally described by Meckel in the late J8th century [Senyuz et al, 1992], it is a rare pathological condition fewer than 100 cases were reported in the literature [Thakral et al, 1998,, we reported a 2 months old girl suffering from abdominal mass since birth, and referred to the Cancer Institute as suspicious of Wilms tumor, conventional radiograph of the abdomen revealed a mass containing numerous calcifications, C. T scan showed a heterogeneous retroperitoneal mass with well-defined calcified structures within the mass. The decision was made for surgical exploration, [he diagnosis was made intra-operatively and the mass was successfully excised, physical examination of the mass with review of literature confirmed the diagnosis of fetus in fetu. Although it is a rare condition imaging may play an important role in our ability to correctly diagnose cases in a prospective fashion. Surgical excision is the recommended treatment