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
A second primary malignancy (SPM) can occur in patients with gastrointestinal carcinoids. A patient underwent endoscopic resection of a gastric carcinoid. Repeat gastroscopy revealed recurrence of the lesion and multiple nodular gastric lesions, while an abdominal computed tomography scan revealed a small solid lesion in the left hepatic lobe. The patient underwent total gastrectomy and wedge resection of what proved to be a hepatocellular carcinoma. This case illustrates the significance of considering SPM in every patient with gastrointestinal carcinoids. SPMs are more aggressive than carcinoids, and awareness and early resection of these tumors may improve prognosis.
Subject(s)
Carcinoid Tumor/pathology , Carcinoma, Hepatocellular/pathology , Liver Neoplasms/pathology , Neoplasms, Second Primary/pathology , Stomach Neoplasms/pathology , Carcinoid Tumor/surgery , Carcinoma, Hepatocellular/surgery , Female , Gastrectomy , Humans , Liver Neoplasms/surgery , Middle Aged , Neoplasms, Second Primary/surgery , Stomach Neoplasms/surgeryABSTRACT
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.
