Asunto(s)
Internado y Residencia , Entrenamiento Simulado , Humanos , Microcirugia , Autonomía ProfesionalRESUMEN
BACKGROUND: Neuroendocrine tumors are a group of rare neoplasms, and the pancreatic neuroendocrine tumors (PNETs) represent only 1-2% of all pancreatic malignant tumors. The most common sites of these tumors include the gastrointestinal tract, lung, adrenal gland, and thyroid gland. Moreover, the most common sites of PNET metastases are the lymph nodes, liver, spleen, and bone. A 40-year-old woman with pT3N1 PNET underwent surgical excision of the lesion (12 cm, at the level of the pancreatic body and tail). Postsurgical treatment included chemotherapy and radiation, both of which the patient showed a good tolerance for. After a 12-month disease-free interval, however, the patient reported the development of a lesion in her left breast and a small lesion in the left posterior region of her neck. The lesions were surgically excised, and the histological findings characterized both as pancreatic neuroendocrine metastatic poorly differentiated neoplasms (G3). A re-staging CT scan showed multiple metastases in the left axillary, clavicular, and latero-cervical lymph nodes, as well as diffuse osteolytic-osteoblastic bone metastases, almost mimicking the behavior of a primitive breast tumor. CONCLUSION: This case of breast and subcutaneous metastases from PNET should prompt awareness of potential metastatic lesions in unusual locations.
Asunto(s)
Neoplasias de la Mama/secundario , Tumores Neuroendocrinos/patología , Neoplasias Pancreáticas/patología , Adulto , Neoplasias de la Mama/cirugía , Femenino , Humanos , Tumores Neuroendocrinos/cirugía , Neoplasias Pancreáticas/cirugía , PronósticoRESUMEN
INTRODUCTION: Inguinal hernia may contain vermiform appendix in very rare cases. This particular condition is known as Amyand's hernia and it has an incidence of 1%. Diagnosis is very difficult preoperatively, so it is usually an incidental finding. PRESENTATION OF CASE: We report a case of a 80 year old man with an irreducible mass in right inguinal region. During surgical procedure an Amyand's hernia was identified and we performed hernioplasty sec Trabucco and appendectomy. DISCUSSION: According to Losanoff and Basson classification, our case was type 1 and its management is very controversial. CONCLUSION: Surgical treatment depends on surgeon's experience and on clinical evaluation because there are many factors that may increase morbidity and mortality.