RESUMO
Lipomas of the ligamentum teres hepatis are extremely uncommon. There have been only a few cases reported in the literature, including lipomas of the falciform ligament of the liver. Here we report a case of torsion and infarction of a lipoma of the ligamentum teres hepatis in a 43-year-old female patient, who presented with acute epigastric pain, nausea and vomiting. Diagnosis was based on computed tomography and magnetic resonance imaging. Patient underwent exploratory laparoscopy followed by laparoscopic excision of the infracted lipoma. Finally, we also provide a mini-review of the literature in order to highlight that although rare, this pathology should be included in the differential diagnosis of acute abdomen.
RESUMO
BACKGROUND: Cutaneous melanoma is known for its aggressive tendency for metastasis, most commonly to lymph nodes, lung, liver, and brain. CASE REPORT: We present the case of an 80-year-old male, with a history of cutaneous melanoma, found to have biopsy-proven metastatic melanoma deposits in the sigmoid colon. This rare case was initially thought to be a walled-off perforation secondary to diverticulitis. Although, computed tomography, showed features more strongly suggestive of malignancy. We propose early consideration of bowel metastasis in patients with a history of cutaneous melanoma presenting with lower gastrointestinal symptoms. CONCLUSION: Once malignancy is included in the differential for any inflammatory type bowel lesion, arranging endoscopy and biopsy is essential to confirm the diagnosis and guide management. Multidisciplinary team discussion is recommended to determine the most appropriate treatment strategy - radical versus palliative, which must always consider the patient's performance status alongside cancer staging. HIPPOKRATIA 2017, 21(4): 194-196.
