A Case of Extraskeletal Ewing Sarcoma Treated With Wide Local Excision With Latissimus Dorsi Flap and Systemic Therapy.

Extraskeletal Ewing sarcoma (EES) is a rare tumor of the soft tissue that looks the same as skeletal Ewing sarcoma (ES). A male in his 50s was diagnosed with extraskeletal Ewing sarcoma (EES) of the right shoulder, which had infiltrated the muscles around the shoulder joints. Although uncommon, all members of the ES family of tumors, including EES, were treated following the same general protocol for sarcoma tumors. Due to the significant tumor size in this patient and local invasion, wide local excision and a latissimus dorsi flap were required. This case highlighted the management of EES, including the surgical removal of the mass on the right shoulder, followed by chemotherapy, which led to a successful outcome.

Retroperitoneal Ancient Neurilemmoma: A Nervous Rarity.

Neurilemmomas are tumors of neural origin that comprise Schwann cell proliferation in a characteristic pattern. They are benign in nature. Ancient neurilemmomas are usually longstanding growths that exhibit degenerative features that could be mistaken for malignancy. We report a case of ancient neurilemmoma in a 70-year-old male patient in the retroperitoneal area. Retroperitoneal schwannomas are extremely uncommon along with ancient neurilemmoma features making it worth reporting.

Two-Point Fixation Technique in Retrosternal Midcolon Interposition for Corrosive Stricture of Esophagus-Our Experience With 25 Patients.

Background. In 1911, Vuillet and Kelling independently described the anatomical and surgical bases of esophageal replacement with the colon. An important complication, in particular in later follow-up, is redundancy of the interposed colon, seen more after retrosternal interposition. The best treatment is prevention by a meticulous surgical technique and measurement of the length of the colon needed to replace the esophagus. Methods. This was a retrospective study of innovative surgical technique. A total of 25 patients with corrosive stricture of the esophagus undergoing two-point fixation in retrosternal colon interposition were included in the study. Preventive Operative Technique. After straightening of conduit by pulling very delicately over both sides, first fixation point we considered cervical anastomoses and second fixation point was made in subxiphoid space, taking two seromuscular stiches from the antimesenteric border of the colon to falciform ligament situated on the right side of the conduit. Results. There were 07 male and 18 female patients with M:F was 1:2.5; mean age was 29 years (range: 23-45 years) and mean hospital stay was 14 days (range: 10-23 days). In this study, we did not encounter any subjective or objective evidence of redundancy in any patients in follow-up barium swallow after 2.5 years of follow-up. Conclusion. Our Two-point fixation technique is refinement of already performed and tried fixation techniques to prevent redundancy of the colon conduit considering kinetics, anatomical alignment, and pathology.

Side to Side Esophagogastrojejunoplasty in Post-corrosive Stricture of Distal Esophagus and Proximal Stomach.

A four years old female child presented after 2 months of ingestion of battery fluid (sulfuric acid) accidently with stricture of the distal esophagus, esophagogastric junction, and fundus as well as proximal portion of the body of the stomach. Corrosive stricture involving the distal esophagus with the proximal stomach is not a frequently encountered condition. Side to side esophagogastrojejunostomy without removal of the strictured esophagus or stomach (side to side esophagogastrojejunoplasty) can be done in such patient hence preserving the stomach which is important physiologically as a reservoir and for the secretion of gastric juices. In review of literature in search engines like MD Consult, PubMed, Cochrane Library, and Embase and standard textbooks of surgery, we could not find such procedure had been performed till date, so that it is the innovative approach with support of literature and surgical principles.