ABSTRACT
INTRODUCTION: Giant colonic diverticulum (GCD), a rare complication of the diverticular disease, can present with a wide range of nonspecific symptoms as abdominal pain and bowel obstruction. Its diagnosis represents a challenge that mainly depends on imaging findings. PRESENTATION OF CASE: We report the case of a 79 year-old female patient that came to our emergency department complaining of 5-day history of hypogastric pain and constipation. Physical examination reveled a 15cm hypogastric round, tender and tympanic mass. Enhanced abdominal CT scan showed a large air-filled cyst adjacent to a diverticular sigmoid colon without evidence of intra-abdominal free air or fluid. Based on the radiological features, GCD was suspected and surgical treatment performed. The mass and the sigmoid colon were resected. The postoperative course was uneventful. Histopathology confirmed the preoperative diagnosis. DISCUSSION: GCD, defined as a diverticulum larger than 4cm, represents a rare complication of the diverticular disease. Usually abdominal X-ray and computed tomography (CT) scan show a gas-filled structure, sometimes communicating with the adjacent colon. GCD resection and segmental colectomy are strongly recommended even in asymptomatic cases due to the high incidence and severity of complications. CONCLUSION: Because of its rarity and variable and non-specific clinical presentation, the diagnosis of GCD depends mainly on imaging findings. The gold standard treatment is surgical resection of the GCD and the compromised colon with primary anastomosis when possible.
ABSTRACT
Hepatocellular carcinoma is the fifth most common cancer in the world and is the third cause of cancer-related death with varying prevalence according to endemic risk factors. Despite therapeutic advances, there has not been significant improvement in the overall survival of patients who have hepatocellular cancer in the last 2 decades. Treatment selection should be based on tumor characteristics and the underlying liver disease.
Subject(s)
Carcinoma, Hepatocellular/therapy , Liver Neoplasms/therapy , Antineoplastic Agents/therapeutic use , Carcinoma, Hepatocellular/pathology , Catheter Ablation , Chemoembolization, Therapeutic , Hepatectomy , Humans , Liver Neoplasms/pathology , Liver Transplantation , Neoplasm StagingSubject(s)
Carcinoma, Hepatocellular/surgery , Hepatitis B/surgery , Liver Neoplasms/surgery , Liver Transplantation , Algorithms , Carcinoma, Hepatocellular/complications , Data Interpretation, Statistical , Hepatitis B/complications , Humans , Liver Neoplasms/complications , Patient Selection , Prognosis , Proportional Hazards Models , Tissue and Organ Procurement/statistics & numerical data , Treatment OutcomeABSTRACT
BACKGROUND: The most common type of gallbladder cancer is the adenocarcinoma. The squamous cell carcinoma represents only a 0-12% of all gallbladder tumors. METHODS: 124 cases of malignant neoplasias of the gallbladder were diagnosed during the last 33 years in the Department of Surgery of our hospital. From these cases, 5 were squamous cell carcinomas, representing 2.41% of our series. CASE REPORT: The ratio female: male was 1.5:1, and the mean age was 50.2 years. Liver involvement was observed in 4 of 5 patients at the moment of diagnosis. Four patients underwent surgery and one received palliative treatment with percutaneous bile dreinage. The mean survival was 14.5 months. CONCLUSION: The tumor extention at the time of diagnosis is generally advanced and the outcome is not promising in this kind of gallbladder cancer.
Subject(s)
Carcinoma, Squamous Cell , Gallbladder Neoplasms , Adult , Argentina , Carcinoma, Squamous Cell/diagnosis , Carcinoma, Squamous Cell/therapy , Female , Gallbladder Neoplasms/diagnosis , Gallbladder Neoplasms/therapy , Humans , Male , Middle Aged , Retrospective Studies , Sex DistributionABSTRACT
BACKGROUND: The most common type of gallbladder cancer is the adenocarcinoma. The squamous cell carcinoma represents only a 0-12
of all gallbladder tumors. METHODS: 124 cases of malignant neoplasias of the gallbladder were diagnosed during the last 33 years in the Department of Surgery of our hospital. From these cases, 5 were squamous cell carcinomas, representing 2.41
of our series. CASE REPORT: The ratio female: male was 1.5:1, and the mean age was 50.2 years. Liver involvement was observed in 4 of 5 patients at the moment of diagnosis. Four patients underwent surgery and one received palliative treatment with percutaneous bile dreinage. The mean survival was 14.5 months. CONCLUSION: The tumor extention at the time of diagnosis is generally advanced and the outcome is not promising in this kind of gallbladder cancer.
