ABSTRACT
Pneumatosis intestinalis, defined as gas in the bowel wall, is often first identified on abdominal radiographs or computed tomography (CT) scans. It is a radiographic finding and not a diagnosis, as the etiology varies from benign conditions to fulminant gastrointestinal disease. We report here a case of pneumatosis intestinalis associated with cetuximab therapy for squamous cell carcinoma of head and neck. The patient underwent laparotomy based on the CT scan and the result was pneumatosis intestinalis without any signs of necrotizing enterocolitis.
ABSTRACT
Since ancient times biliary surgery has been one of the major interests of doctors and other scientists around the world. From the ancient Greeks and Egyptians to the greatest scientists of modern times biliary surgery has advanced remarkably. Especially during the last century huge progress has been made in this field. Minimally invasive surgical techniques have been developed and combined with general anesthesia and antisepsis that have made biliary surgery particularly safe for every patient and have made cholecystectomy one of the most common operations in the world today.
Subject(s)
Biliary Tract Diseases/history , Biliary Tract Surgical Procedures/history , Biliary Tract/anatomy & histology , Biliary Tract Diseases/surgery , Egypt , Europe , History, 16th Century , History, 17th Century , History, 18th Century , History, 19th Century , History, 20th Century , History, Ancient , HumansABSTRACT
INTRODUCTION: Pleomorphic giant cell pancreatic cancer is a very rare and aggressive pancreatic neoplasm. A case of pleomorphic giant cell pancreatic cancer presenting as a cystic lesion and in association with a serous cystadenoma presents a unique case which has not been described before. CASE PRESENTATION: A 44-year-old alcoholic man presented with abdominal pain, vomiting, and weight loss. Initially, imaging suspected a pancreatic pseudocyst measuring 4.2 cm. Endoscopic ultrasound- (EUS-) guided fine-needle aspiration revealed a serous cystadenoma. With conservative intervention only (fluid resuscitation, analgesia, and antiemetics) the patient improved and was discharged under close observation. Follow-up scan at four months revealed minimal change. Three months later, he was admitted acutely. Repeat scans demonstrated mild cyst enlargement with new liver lesions. Laparoscopic biopsy revealed pleomorphic giant cell carcinoma with the organ of origin the pancreas. CONCLUSION: This unusual case highlights the challenges in managing pancreatic cystic lesions and emphasizes the importance of considering less common forms of pancreatic cystic masses when the findings are atypical for the presentation. Surgical excision in these cases over conservative steps may be the most appropriate management.
Subject(s)
Carcinoma, Giant Cell/diagnosis , Carcinoma, Giant Cell/secondary , Cystadenoma, Serous/diagnosis , Liver Neoplasms/diagnosis , Liver Neoplasms/secondary , Pancreatic Neoplasms/diagnosis , Adult , Diagnosis, Differential , Humans , Male , Pancreatic Neoplasms/pathologyABSTRACT
A past history of sporadic solid cancers is disclosed in 10% of gastrointestinal stromal tumor (GIST) patients. Simultaneous occurrence with other malignancies is encountered in 14 to 16%, but the synchronous occurrence of GIST and hepatocellular carcinoma (HCC) has been reported only once in the English literature. An 81-year-old male patient is presented with a preoperatively known HCC, in whom a synchronous small nodular omental GIST adjacent to the lesser curvature of the stomach was incidentally discovered. When a GIST is encountered, a thorough intraoperative investigation of the abdominal cavity currently remains the only reliable method for detection of a possible coexisting malignancy.
Subject(s)
Carcinoma, Hepatocellular/complications , Gastrointestinal Stromal Tumors/complications , Liver Neoplasms/complications , Peritoneal Neoplasms/complications , Aged, 80 and over , Carcinoma, Hepatocellular/diagnosis , Carcinoma, Hepatocellular/pathology , Carcinoma, Hepatocellular/surgery , Catheter Ablation , Diagnosis, Differential , Gastrointestinal Stromal Tumors/diagnosis , Gastrointestinal Stromal Tumors/pathology , Gastrointestinal Stromal Tumors/surgery , Humans , Liver Neoplasms/diagnosis , Liver Neoplasms/pathology , Liver Neoplasms/surgery , Male , Omentum/pathology , Peritoneal Neoplasms/diagnosis , Peritoneal Neoplasms/pathology , Peritoneal Neoplasms/surgery , Proto-Oncogene Proteins c-kit/analysisABSTRACT
BACKGROUND: Gastrointestinal stromal tumors (GIST) represent the most common mesenchymal tumors of the digestive tract. Over the last ten years the management of GISTs has dramatically altered but their coexistence with other gasrointesinal tumors of different histogenesis presents a special interest. The coexistence of GISTs with other primaries is usually discovered incidentally during GI surgery for carcinomas. CASE PRESENTATION: We present here, a case of a 66-year-old patient with intestinal GIST and a synchronous colorectal adenocarcinoma discovered incidentally during surgical treatment of the recurrent GIST. Immunohistochemical examination revealed the concurrence of histologically proved GIST (strongly positive staining for c-kit, vimentin, SMA, and focal positive in S-100, while CD-34 was negative) and Dukes Stage C, (T3, N3, M0 according the TNM staging classification of colorectal cancer). CONCLUSION: The coexistence of GIST with either synchronous or metachronous colorectal cancer represents a phenomenon with increasing number of relative reports in the literature the last 5 years. In any case of GIST the surgeon should be alert to recognize a possible coexistent tumor with different histological origin and to perform a thorough preoperative and intraoperative control. The correct diagnosis before and at the time of the surgical procedure is the cornerstone that secures the patients' best prognosis.
