Primary retroperitoneal mucinous cystadenocarcinoma in pregnancy - case report.

INTRODUCTION: Primary retroperitoneal mucinous cystadenoma (PRMC) and its malignant variant - cystadenocarcinoma are extremely rare tumors known only from case studies and reviews. PRMC is a cystic tumor of the retroperitoneum, which remains asymptomatic for a long time and can reach significant proportions. It occurs mainly in women. CASE REPORT: We present the case of a 38-year-old healthy woman with diagnosed resistance in the right mesogastrium during a c-section. The delivery was terminated without a surgical intervention. The above mentioned resistance was examined further by ultrasound, computed tomography and magnetic resonance imaging. All imaging examinations showed a solid - cystic bilocular expansion, which looked like a mesenteric cyst in the right paracolic area. The patient was asymptomatic at all times, with only a palpable resistance of the abdominal wall. In November 2020, the patient underwent an elective surgery - extirpation of the cystic tumor and prophylactic appendectomy. The operation was performed classically, via midline laparotomy without perioperative perforation of the cystic tumor and without complications in the postoperative period. The histopathological examination showed a malignant variant of PRMC. So far, the patient remains free of any problems and is followed at the department of oncology. CONCLUSION: The goal of treatment is to achieve complete surgical removal of the tumor without its perioperative perforation. Due to the rare occurrence of the disease, there are no guidelines for the diagnosis and treatment of PRMC. Precisely because PRMC is a rare tumor, it should be part of the differential diagnosis of cystic tumors of the retroperitoneum, especially when young women are concerned.

Laparoscopic versus open liver resections for colorectal cancer liver metastases: short term results.

INTRODUCTION: Analysis and comparison of short-term results of laparoscopic liver resections (LLR) and open liver resections (OLR) for colorectal cancer liver metastases (CRCLM). METHODS: Retrospective analysis of patients operated for CRCLM in the time period from May 2007 to May 2019 (12 years) at the department of surgery, University Hospital Hradec Králové and University Hospital Královské Vinohrady. RESULTS: 206 liver resections were performed; 167 (81.1%) OLR and 39 (18.9%) LLR procedures. Conversion to open surgery was necessary in 6 cases (15.4%). LLR was associated with a longer operation time (194±107 min) vs (129±58 min) for OLR. The ICU stay, 3.5±4.3 days for OLR and 4.1±8.1 days for LLR, and the hospital stay, 11.9±8.3 days (OLR) vs 12.1±11.3 days (LLR), were comparable. Perioperative blood loss was lower in the LLR group, 189±166 ml vs 360±410 ml. Total transfusion rate was similar, 10.8% (OLR) vs 12.8% (LLR). Oncologic radicality was also comparable in both groups; negative resection margin was achieved in 78% (OLR) and 80% (LLR). Postoperative morbidity and mortality was comparable in both groups; morbidity was 33% (OLR) vs 31% (LLR), while mortality was 1.8% (OLR) vs 2.6% (LLR). CONCLUSION: LLR for CRCLM provided comparable short-term results compared to OLR in our group of patients even in the learning curve period. However, it should be noted that the study group is a highly selected group of patients.

[An uncommon case of purulent mesenteric lymphadenitis]. / Neobvyklý prípad mezenteriální abscedující lymfadenitidy.

The authors present a case of a middle-aged female with large isolated mesenteric lymphadenitis. Abdominal ultrasonography undertaken as a preventive assessment revealed a solid tumour mass in the left mesogastrium, sized 70x55x55 mm. A solid abdominal tumour such as a GIST or sarcoma was considered and the patient underwent elective laparoscopic surgery. The tumour was completely removed. Histopathological examination confirmed an unexpected result of nonspecific purulent mesenteric lymphadenitis. The authors discuss potential causes of mesenteric lymphadenitis.Key words: abdominal tumour mesenteric lymphadenopathy purulent lymphadenitis - solitary lymphadenopathy.