Giant dedifferentiated liposarcoma of the gastrocolic ligament: A case report.

BACKGROUND: Dedifferentiated liposarcoma (DDLS) has a worse prognosis and occurs most commonly in the retroperitoneal region and rarely in the intraperitoneal region. Histological diagnosis was revolutionized by the combined contributions of histo-immuno-chemistry and molecular biology. Aside from surgery, there is no consensus on the optimal treatment for this chemoresistant cancer. CASE SUMMARY: A thirty-year-old black female presented with a large painful abdominal mass occupying nearly the entire abdomen and progressive weight loss was admitted for surgery. Abdominal computed tomography showed a large heterogeneous mass of the mesentery that was sized 18 cm × 16 cm in size and had heterogeneous contrast enhancement. During laparotomy, en bloc excision of the large and multilobulated gastrocolic ligament mass was performed. The initial postoperative histopathological diagnosis was undifferentiated sarcoma. Finally, the results of immunohistochemistry and molecular biology allowed us to confirm the diagnosis of DDLS. The tumour followed an aggressive evolution with diffuse metastasis, causing the death of the patient less than 5 mo after the operation. CONCLUSION: Dedifferentiated liposarcomas are rare tumours that typically originate in the retroperitoneum but may arise in unexpected locations.

A transmural migration of a gossypiboma in the right colon responsible for a mass which mimicked an abscessed colonic tumor: A case report.

INTRODUCTION: Gossypiboma or retained surgical sponge is a rare but serious complication of abdominal surgery. Clinical and radiological polymorphism of gossypiboma makes an accurate preoperative diagnosis difficult. PRESENTATION OF CASE: We report an unusual case of a transmural migration of a gossypiboma in the right colon responsible for a mass which mimicked an abscessed colonic tumor, three years after an open myomectomy. A 40-year-old woman was admitted in emergency with generalized abdominal pain associated with fever. Initially, physical examination revealed an acute localized peritonitis in lower right quadrant. A right pericolic perforated abscess was found. A right hemicolectomy was performed. Surgical specimen dissection revealed an intracolonic surgical sponge. DISCUSSION: Gossypiboma after laparotomy may present with symptoms of acute surgical or chronic abdominal pain. Radiographs are the most commonly used method to detect retained sponges. Surgery is the preferred method of treatment for gossypiboma. CONCLUSION: Episodes of atypical colonic obstruction and nonspecific abdominal pain that have occurred for several years in a patient with a history of multiple abdominal surgery should be suggestive of intra-colonic migration of a gossypiboma. The most important approach to reduce the incidence of gossibypomas is prevention.

Cholecystoparietal Fistula Revealed by an Epigastric Abscess.

Cholecystocutaneous fistula, the ultimate complication of abscessed or overlooked acute cholecystitis, is due to perforation of the gallbladder in the abdominal wall. The authors report an unusual case of cholecystoparietal fistula revealed by an epigastric abscess. Fistulography and modern imaging tools make the diagnosis easier. Surgery is the best available treatment.