Appendiceal mucocele - Case Report and Review of the Literature.

Appendiceal mucocele (AM) was described for the first time by Rokitansky in 1842.1 Its incidence is 0.2 - 0.4% of all apendectomies performed, as it is observed predominantly in women with the ratio of 4/1 versus men and most frequently at the age of 50.2,3 We present to your attention a 64-year-old woman, who was referred to diagnostic further clarification after a preventive gynaecologic exam. Appendiceal mucocele with retrocecal location, enveloped by additional Jackson'™s membranes was determined intraoperatively. The formation has been dissected and appendectomy was performed without mucocele integrity being compromised. The permanent histological specimen revealed mucinous cystadenoma with clear resection lines, without any data on the appendiceal base being affected. The patient was discharged on the third day after surgery without any complications, and further follow-up was scheduled in 6 months.

Extraskeletal Osteosarcoma of the Omentum with Aggressive Development.

For the first time extraskeletal osteosarcomas (ESOS) were described by Wilson in 1941. They are extremely rare neoplasms, presenting 4% of all osteosarcomas and 1,2% of all soft-tissue sarcomas. About 300 cases have been reported in the literature up to date. We present a 66-year-old female patient, admitted in the clinic because of acute bleeding in retroperitoneal space. Revision of the retroperitoneal space and haemostasis were performed. The patient was re-operated because postoperative bowel obstruction. The reason for it was intestinal infiltration from large tumor of the omentum, determined histopathologically as ESOS. The case was considered as an unresectable neoplasm so a colostomy was performed. In the literature we found 3 case reports of ESOS, originated from omentum.

Recurrent perineal hernia -- case report and review of the literature.

Perineal hernia is the protrusion of intra-abdominal viscera through the pelvic floor. We present a patient with recurrent perineal hernia - 12x9 cm with a palpable soft, hardly adjustable in the pelvic tunnel formation and attenuated skin over it. The patient was operated by abdominoperineal approach. We performed two layer Titanium mesh plasty of the pelvic floor with the use of the omentum and the pelvic muscles.

Management of recurrent or metastatic retroperitoneal soft-tissue sarcomas.

UNLABELLED: Retroperitoneal soft tissue sarcomas remain a serious therapeutic problem. The aim of the study is to define the optimal treatment strategy of patients with locally recurrent or metastatic retroperitoneal soft tissue sarcomas. MATERIAL AND METHODS: A retrospective study was performed.Between 2001 and 2013, 89 patients with retroperitoneal soft tissue sarcomas were surgically treated in the University Hospital Queen Joanna ISUL and the Specialized Hospital for Active Treatment in Oncology Sofia. Clinicopathological data were investigated with SPSS 19. RESULTS: The mean time of onset of the first and second relapse of sarcomas was 23 and 13 months, respectively. Over 40% of the studied patients underwent more than one operation because of recurrence. Ability of radical extirpation of the tumour decreased with each subsequent relapse. The 5 year survival rate was 60% for patients with primary combined radical resection versus 28% for patients with partial resection. In the presence of metastatic lesions the 3 year survival rate was only 22%. CONCLUSION: Local recurrences, the presence of distant metastases and the ability of radical extirpation are the main long term prognostic factors.