RESUMO
One case of epithelioid hemangioendothelioma (EHE) of the liver is reported. The problems of a correct diagnosis of this unusual type of vascular tumor are discussed. A final diagnosis can be established only by histologic examination of appropriate material and may be helped by immunohistochemistry and ultrastructural examination. Tumor cells are vasoformative and synthesized Factor VIII-related antigen. The accurate diagnosis of EHE of the liver is of clinical and therapeutic relevance, for the favourable prognosis, also without therapy, nevertheless liver transplantation represents in selected cases (patients exhibiting a rapidly progressive liver failure) the only possible treatment. The case studied in our Department is very interesting, because it represents a summary of knowledge regarding this type of neoplasm in a 20-year period.
Assuntos
Hemangioendotelioma Epitelioide , Neoplasias Hepáticas , Feminino , Humanos , Pessoa de Meia-IdadeRESUMO
The authors report a rare case of iatrogenous arteriovenous fistula between left gastric artery and vein, arising after gastric resection. The observation caused a reviewing of the literature (19 cases published, of which only one between left gastric artery and vein) and some remarks about the physiopathology, pathological anatomy, clinics and treatment of such rare diseases. The authors, in their conclusions, emphasize that such arteriovenous fistulas can remain asymptomatic for a long time; they, moreover, with evident effects on the liver physiology, can progressively cause a serious state of portal hypertension, in the genesis of which the time-factor plays a primary role.
Assuntos
Fístula Arteriovenosa/etiologia , Artéria Celíaca/lesões , Gastrectomia/efeitos adversos , Doença Iatrogênica , Veias Mesentéricas/lesões , Idoso , Fístula Arteriovenosa/patologia , Feminino , Humanos , Hipertensão Portal/etiologia , Hipertensão Portal/patologia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/patologia , Prognóstico , Fatores de TempoRESUMO
The vena cava is the seat of obstructive disorders for which direct reparative surgery may sometimes become necessary. S.C.S. is mainly caused by neoplastic invasions or, in the case of the inferior vena cava, by progression of phlebothrombosis of the lower limbs. Prosthesis or autologous substitution and thrombointimectomy are specifically indicated in the two cases respectively. The two methods are described in detail and exemplified through the authors' personal cases consisting in an inferior caval thrombointimectomy and four superior caval by passes. It is concluded that surgical procedures are effective when the primitive disorder can be dominated and the thrombosis is not excessively extensive.