ABSTRACT
An extra-adrenal paraganglioma is a rare tumor derived from the chromaffin cells of sympathetic ganglia. This report documents a rare case of nonfunctional extra-adrenal paraganglioma in a 20-year-old woman with persistent flank pain. Ultrasonography and computed tomography revealed a solid mass with calcification in center, measuring 7 x 6 x 6 cm, and localized in the left upper para-aortal retroperitoneal region. Absence of typical clinical symptoms made a correct preoperative diagnosis unlikely. Tumor was successfully removed through a midline laparotomy incision, and pathological analysis of the surgical specimen revealed a paraganglioma. After 12 months, the patient is still in a good health, asymptomatic, and without evidence of tumor recurrence. This case emphasizes the necessity to include extra-adrenal paraganglioma in the differential diagnosis and management of retroperitoneal tumors, despite its rarity.
Subject(s)
Paraganglioma, Extra-Adrenal/diagnosis , Retroperitoneal Neoplasms/diagnosis , Adult , Female , Humans , Paraganglioma, Extra-Adrenal/surgery , Retroperitoneal Neoplasms/surgery , Tomography, X-Ray ComputedABSTRACT
Lipoma of the colon is a relatively rare benign tumor. A case with intermittent subacute colon obstruction due to a giant lipoma of the cecum is reported. A 51-year-old woman presented with intermittent, abdominal crampy pain in the right upper and lower quadrants, accompanied by alternative episodes of diarrhea and constipation. She had had similar symptoms over the last three months. A double-contrast barium enema showed a large (approx. 7 cm in diameter) polypoid mass occluding the lumen of the cecum and the ascending colon. Colonoscopy revealed a submucosal mass suspected of benign tumor but too large for endoscopic resection. Surgery revealed a hard elongated mass in the right colon, which telescoped into the transverse colon and caused colo-colonic intussusception. Right hemicolectomy was performed and pathology documented a mature, submucosal lipoma of the cecum. Six years after the surgery, the patient has not showed any of the previous symptoms. Along with a review of the literature, the incidence, diagnosis complications and treatment of colonic lipomas are discussed.
Subject(s)
Cecal Neoplasms/diagnosis , Lipoma/diagnosis , Barium Sulfate/administration & dosage , Cecal Neoplasms/surgery , Colectomy , Colonoscopy , Contrast Media/administration & dosage , Diagnosis, Differential , Enema , Female , Humans , Lipoma/surgery , Middle AgedABSTRACT
Dieulafoy's lesion is a rare arterial malformation, which may produce massive gastrointestinal hemorrhage. Most commonly, the lesion occurs in the proximal part of the stomach. We present the case report of a 59-year-old man who was admitted to our emergency unit with massive hematemesis. Urgent endoscopic examination revealed a Dieulafoy's lesion with spurting bleeding, which was located in the proximal part of the stomach. Bleeding was successfully stopped by endoscopic hemoclipping without any further recurrence. Follow-up endoscopy performed 3 days later showed that the hemoclips became detached, and the protruding artery disappeared. The patient was discharged 4 days after primary endoscopic procedure without any complications. There was no recurrence of the bleeding during the 12 months of observation. Thus, we found that hemoclipping represents an alternative method of achieving endoscopic hemostasis in Dieulafoy's lesions
