ABSTRACT
Somatostatinoma is a rare neuroendocrine tumor which especially develops in the pancreas. There are few communicated cases about extra-pancreatic localization, having as a particularity the absence of somatostatin hypersecretion syndrome and frequent association with von Recklinghausen neurofibromatosis. We present the case of a 42-year old patient with Von Recklinghausen neurofibromatosis admitted in our clinic with a chronic upper digestive obstruction syndrome. The presence of a first jejunal loop somatostatinoma was an intraoperative surprising diagnosis that imposed jejunal resection and association of complementary specific treatment. Despite the therapeutic correct management, the status of the patient deteriorated very fast, confirming the aggressiveness of this neoplasia.
Subject(s)
Adrenal Gland Neoplasms/complications , Jejunal Neoplasms/complications , Neoplasms, Multiple Primary , Neurofibromatosis 1/complications , Pheochromocytoma/complications , Somatostatinoma/complications , Adrenal Gland Neoplasms/diagnosis , Adrenal Gland Neoplasms/therapy , Adult , Barium Sulfate , Biopsy , Contrast Media , Digestive System Surgical Procedures , Disease Progression , Endoscopy, Gastrointestinal , Fatal Outcome , Gastric Dilatation/etiology , Humans , Intestinal Obstruction/etiology , Jejunal Neoplasms/diagnosis , Jejunal Neoplasms/therapy , Neurofibromatosis 1/diagnosis , Neurofibromatosis 1/therapy , Pheochromocytoma/diagnosis , Pheochromocytoma/therapy , Predictive Value of Tests , Somatostatinoma/diagnosis , Somatostatinoma/therapy , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
Pseudo-achalasia is a rare pathologic entity that mimics idiopathic achalasia, usually secondary to malignant infiltration of the cardia. Its significance is related to the fact that it may be difficult to distinguish from primary achalasia; the outcome and therapeutic course are different. In fact, a large variety of processes may be responsible for the development of a secondary achalasia syndrome; we present a case with pseudo-achalasia due to a middle thoracic esophageal squamous cell carcinoma.
Subject(s)
Carcinoma, Squamous Cell/complications , Carcinoma, Squamous Cell/diagnosis , Cardia , Esophageal Achalasia/diagnosis , Esophageal Neoplasms/complications , Esophageal Neoplasms/diagnosis , Carcinoma, Squamous Cell/therapy , Cardia/pathology , Chemotherapy, Adjuvant , Diagnosis, Differential , Esophageal Achalasia/etiology , Esophageal Achalasia/therapy , Esophageal Neoplasms/therapy , Esophagectomy/methods , Humans , Male , Middle Aged , Radiotherapy, Adjuvant , Treatment OutcomeABSTRACT
A 56-year-old man with a large paraesophageal hiatus hernia, treated in a tforeign clinic with a Nissen fimdoplication (when a lesion of the gastric fornix during laparoscopic dissection has determined conversion to open technique) is admitted 3 weeks after surgery, being diagnosed with an esophageal leekage witch maintains a large subphrenic abscess with sepsis. The patient was cured by draining the leakage, excluding the esophagus by an "à minima" alimentary jejunostomy, under broad spectrum antibiotherapy.
