ABSTRACT
BACKGROUND: Large vessel sarcomas are rare tumours. Leiomyosarcoma of the inferior vena cava is the most common. About 300 cases have been reported in the literature. They tend to be large, and not develop metastasis. The prognosis of these tumours is poor. CLINICAL CASE: An 81 year-old woman who complained of pain in the right flank, with no other symptoms. Abdominal computed tomography showed a large retroperitoneal mass, which affected the inferior vena cava, with signs of thrombosis inside. It also encompassed the right renal vein and the right kidney. Excision of the tumour was performed in block, performing an autologous saphenous vein bypass between left the renal vein and proximal segment of inferior vena cava. DISCUSSION: Leiomyosarcomas of the inferior vena cava are classified according to their relationship with adjacent structures. The clinical signs and symptoms are generally non-specific. Diagnosis is made using computed tomography or magnetic resonance imaging, and biopsy of the retroperitoneal mass. Surgery is the only treatment capable of providing prolonged survival. The surgical management is determined by: the level of involvement, the extension, and the presence or absence of collateral veins. The role of adjuvant therapy is controversial. CONCLUSIONS: Inferior vena cava leiomyosarcomas remain a challenge for surgeons. At present, radical resection with negative margins, offers the highest survival rate. The best results are obtained with a multidisciplinary approach by experienced teams in the management of these tumours.
Subject(s)
Leiomyosarcoma , Vascular Neoplasms , Vena Cava, Inferior , Aged, 80 and over , Fatal Outcome , Female , Humans , Leiomyosarcoma/diagnostic imaging , Leiomyosarcoma/surgery , Vascular Neoplasms/diagnostic imaging , Vascular Neoplasms/surgeryABSTRACT
BACKGROUND: A gallstone colonic ileus is a very rare condition. CLINICAL CASE: The case is reported of an 87 year-old patient who came to the Emergency Department due to an intestinal obstruction of several days onset, which was caused by a gallstone affected sigmoid colon. CONCLUSION: Colonic gallstone ileus is a rare disease that usually occurs in older patients due to the passage of large gallstone directly from the gallbladder to colon, through a cholecystocolonic fistula. It has a high morbidity and mortality.
Subject(s)
Cholelithiasis/complications , Ileus/etiology , Sigmoid Diseases/etiology , Aged, 80 and over , Biliary Fistula/complications , Cholelithiasis/diagnostic imaging , Cholelithiasis/surgery , Emergencies , Female , Humans , Ileus/diagnostic imaging , Ileus/surgery , Intestinal Fistula/complications , Sigmoid Diseases/diagnostic imaging , Sigmoid Diseases/surgery , Tomography, X-Ray ComputedABSTRACT
No disponible
