Giant uterine leiomyoma.

Uterine leiomyomas represent the most common benign tumors of the female reproductive tract. Giant uterine leiomyomas are very rare neoplasms and represents a great diagnosis and therapeutic challenge. This article illustrates a case of a 45-year old woman presented to our surgery department with a 10-month history of progressive increasing abdominal size, back pain, vague abdominal pressure sensations, weight loss, constipation and urinary frequency. Physical examination, laboratory evaluation, transabdominal ultrasound and computed tomography scanning suggested a giant abdominopelvic mass. Abdominal supracervical hysterectomy with bilateral salpingo-oophorectomy was performed. Histologically, the specimen was a 18.1 Kg uterine leiomyoma measuring 33/28/22 cm. The patient's postoperative course was uneventful and she was discharged from the hospital on the sixth postoperative day.

[Giant parathyroid adenoma with hypersecretion and severe clinical course--clinical case]. / Adenom paratiroidian gigant hipersecretant cu evolutie severa--prezentare de caz.

Primary hyperparathyroidism is an uncommon disease, with late diagnosis due to insidious and various symptoms. Parathyroid adenoma is the most frequent cause of primary hyperparathyroidism. This paper presents the clinic of disease, the necessary exams to perform in order to obtain a positive diagnosis also the case of young man with long evolution period prior to diagnosis and with severe complications at bones. Surgery represents the only valid option resulting complete healing.

[Left paraduodenal hernia with particular evolution]. / Hernie paraduodenala stânga cu evolutie particulara.

Paraduodenal hernia is a rare situation, less than 400 cases being published in literature. This condition is difficult to explore, diagnose appear within an occlusive syndrome. The etiopathology involves perturbation of intestinal rotation during the intrauterine life, producing paraduodenal fossa, which generates conditions for internal hernias and occlusive situations. We present the case of a 36 years old woman with chronic epigastric pain, diagnosed as duodenal ulcer, later as acute pancreatitis and in the end as high occlusion syndrome. Open laparotomy was performed, uncovering a strangulated left paraduodenal hernia, with severe pathologic lesions of the intestinal loops. Kelotomy and pure-string suture of parietal defect was performed. Post-operative evolution has been difficult with hepatic failure with coagulopathy and diffuse intestinal hemorrhage, threatening the patient's life. Intensive care lead eventually to a favorable condition. The rarity of this disease, difficulty of diagnosis and the particular evolution were the reasons to present this rare case.