RESUMO
Granulomatous mastitis is a rare benign inflammatory disease of the breast with multiple etiologies such as tuberculosis, sarcoidosis, foreign body reaction, and mycotic and parasitic infections. In contrast, idiopathic granulomatous mastitis (IGM) is characterized by the presence of chronic granulomatous lobulitis in the absence of an obvious etiology. Clinically and radiologically it may mimic breast carcinoma and so awareness of surgeons, pathologists, and radiologists is essential to avoid unnecessary mastectomies. Cases of IGM are reported during antidepressant therapy in patients also showing high levels of prolactinemia. In these cases, we believe that surgical excision must be avoided being replaced with a conservative management of the pathological condition based on a corticosteroid treatment.
RESUMO
BACKGROUND: Anatomic unexpected variations in biliary tree may be discovered during laparoscopic cholecystectomy. CASE REPORT: A 57-year-old man was admitted for abdominal pain, vomiting and mild jaundice. Abdominal ultrasonography revealed a gallbladder containing multiple stones and biliary sludge. All pre-operative investigations showed no anatomical variations in extrahepatic biliary tree. During surgical intervention an accessory extrahepatic duct, connecting the IV segment of the liver to the fundus of gallbladder, was discovered. CONCLUSIONS: Pre-operative routine investigations for gall stones diseases may not reveal anatomic variations of biliary tree.
Assuntos
Colecistectomia , Humanos , Masculino , Pessoa de Meia-IdadeAssuntos
Laparoscopia/métodos , Linfoma não Hodgkin/cirurgia , Pancreatectomia/métodos , Cisto Pancreático/diagnóstico , Neoplasias Pancreáticas/cirurgia , Idoso de 80 Anos ou mais , Diagnóstico Diferencial , Feminino , Finlândia/epidemiologia , Seguimentos , Humanos , Linfoma não Hodgkin/diagnóstico , Linfoma não Hodgkin/mortalidade , Masculino , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/mortalidade , Estudos Retrospectivos , Taxa de Sobrevida , Vísceras/cirurgiaRESUMO
We report what to the best of our knowledge is the first case of primary angiosarcoma of the adrenal gland. A 49-year-old woman, with blunt abdominal trauma, was admitted to our department. Computed tomography revealed a suspected rupture of a liver neoplasm and surgical treatment was performed. At laparotomy there was no evidence of liver tumour but a large mass was found in the right adrenal gland. The mass was removed along with the entire periadrenal fat tissue and locoregional lymph nodes. Microscopically, we found diffuse neoangiogenesis with large, hyperchromatic cells. This cellular proliferation, together with the widespread necrosis, distorted the normal appearance of the adrenal gland. No adjuvant therapy was administered. Six months and 1 year later thoracic- abdominal computed tomography and positron emission tomography were performed, and no signs of local recurrence or metastases were observed.
Assuntos
Neoplasias das Glândulas Suprarrenais , Hemangiossarcoma , Neoplasias das Glândulas Suprarrenais/diagnóstico , Neoplasias das Glândulas Suprarrenais/cirurgia , Feminino , Hemangiossarcoma/diagnóstico , Hemangiossarcoma/cirurgia , Humanos , Achados Incidentais , Pessoa de Meia-IdadeRESUMO
Polyarteritis nodosa is a form of vasculitis that affects several organs. Gastrointestinal involvement is frequent, but cases in which the gastrointestinal tract is the only site of disease are rare. In this paper we report a case of a 70-year-old patient with polyarteritis nodosa restricted to the large intestine, who underwent a total colectomy. The patient had no other signs of chronic vasculitis and for this reason surgical treatment resolved the clinical symptoms.