Surgical management of giant recurrent retroperitoneal liposarcoma: a case report and review of the literature.

Liposarcoma is a rare, primary, malignant mesenchymal tumor. It represents ∼7% of all mesenchymal sarcomas and 1% of all cancers. Their incidence does not exceed to 2.5 cases/million inhabitants/year. This tumor is locally invasive, diagnosed at a late stage, and can reach a significant size and weight, resulting in a locally advanced tumor. Case presentation: A 59-year-old female patient consulting for a large abdominal mass. The abdominal computed tomography showed three retroperitoneal masses, and the surgical exploration revealed a huge process in the retroperitoneal cavity, which takes the left renal compartment, and the left colon. The intervention consisted of a mono-bloc excision of the mass taking the spleen, the left renal compartment, and the left colon with colonic anastomosis. The histological examination concluded the existence of a well-differentiated myxoid liposarcoma of grade I, the postoperative follow-up was simple. One year later, she underwent an excision of a recurrence of the same retroperitoneal location, but of a pleomorphic cell histological type of grade II according to the FNCLCC classification. We review the literature, the pathological, therapeutic, and prognostic aspects of this tumor. Discussion: Retroperitoneal liposarcoma is a rare tumor. Its gravity is due to an often-late diagnosis, a complete imaging workup including ultrasound, computed tomography and often MRI is necessary preoperatively to determine the relationship with the different organs. The definitive diagnosis is histological, surgery is the most effective treatment and can be extended to neighboring organs. the frequency of recurrence requires particular surveillance. Conclusions: We highlight the importance of radical surgical excision to avoid retroperitoneal liposarcoma tumor complications and to minimize the recurrence risk.

Primary signet-ring cell carcinoma of the cecum: A rare case report.

INTRODUCTION AND IMPORTANCE: Primary SRCC is a rare histological colorectal cancer subtype. It is characterized by distinct clinical presentation. CASE PRESENTATION: This case report describes a rare case of a Primary Signet-ring cell carcinoma of the cecum. A 37-year-old man came to the emergency department with bowel obstruction and altered general condition. The abdominal CT scan showed an intestinal occlusion upstream a thickening of the cecum. An exploratory laparotomy found a distention of the bowl with a suspect thickening of the cecum. The patient underwent a right ileo-colectomy and ileocolostomy. Histologic analysis of the operatory specimen confirmed the diagnosis of a primary Signet-ring cell carcinoma of the cecum. The recovery was uneventful, and the patient is in good health after six -months of follow-up. After completing the chemotherapy, the patient is scheduled for a colonoscopy and reversal of colostomy. CLINICAL DISCUSSION: Colorectal primary signet ring cell carcinoma (SRCC) is a rare entity, and it is associated with poor prognosis compared with common colorectal adenocarcinomas. characterized by distinct clinical presentation, with very poor response rates. CONCLUSION: Primary SRCC is an aggressive histological type of colon cancer and it is associated with a poor prognosis. There are no conclusive guidelines for the treatment of this type of tumor.

Littoral Cell Angioma of Spleen: A rare case report.

Introduction: Spleen's Littoral Cell Angioma is a rare benign vascular tumor. The main clinical presentation is isolated splenomegaly. Case presentation: we present the case of a 37 years old male patient who suffers from chronic pain in the left hypochondrium.The abdominal examination finds a painful splenomegaly related to a biological bicytopenia. The CT Scan shows a 32 cm splenomegaly.An exploratory laparotomy with splenectomy was performed. The histological and immunohistochemical study confirmed The final diagnosis of Littoral Cell Angioma. Clinical discussion: Isolated splenomegaly of unknown etiology is the main clinical sign. Splenectomy is required for a diagnostic purpose and substratum for histological study. Conclusion: Littoral Cell Angioma of the Spleen is a rare benign vascular tumor, however it should be highlighted by clinical and radiological features, the definitive diagnosis is made upon histological study.

Chronic lymphocytic leukemia, a rare cause of spontaneous rupture of the spleen.

INTRODUCTION: Spleen Spontaneous Rupture SRS is a rare phenomenon in which the spleen ruptures without associated trauma. This pathology is rarely caused by Chronic Lymphocytic Leukemia. PRESENTATION OF THE CASE: We present a case of a 59-year-old male patient with chronic Lymphocytic Leukemia, who was admitted with an acute abdomen whose clinical and paraclinical examinations revealed a spleen spontaneous rupture. The treatment consisted of a splenectomy. DISCUSSION: Spontaneous spleen rupture was first described by Rokitansky in 1861 and mentioned in many cases since, the common causes of non-traumatic Splenic rupture include myeloproliferative diseases, vasculitis, and infections. However, Chronic Lymphocytic Leukemia (CLL) remains an obscure cause of splenic rupture that requires unique attention. The diagnosis of splenic rupture should be considered in all patients with hematologic malignancies presenting with abrupt onset of abdominal pain, hemodynamic instability, or acute anemia. The choice between conservative treatment and splenectomy depends on different variables: the etiology of the SRS, the hemodynamic stability, the amount of packed red blood cells transfused. Thus, an interventional approach can be advocated for a spontaneous splenic rupture over nonoperative management. Splenic embolization can provide patients with the advantages of both operative splenectomy and conservative management. The mortality rate from SRS is 12.2 %. Neoplastic pathologies were most significantly associated with fatal outcomes. CONCLUSION: The high mortality rate seems to be mainly related to the delayed diagnosis and/or the severity of the underlying pathology. Given its seriousness, it requires a rapid diagnosis and adapted management.

Giant parathyroid carcinoma: Diagnostic, difficulties and therapeutic strategies: A case report.

INTRODUCTION: Parathyroid carcinoma is a very aggressive malignant tumor. It is mostly revealed by clinical primary hyperparathyroidism. CASE PRESENTATION: We report a rare case of parathyroid carcinoma in a 61-year-old-male patient who presented with a painless right-sided cervical tumefaction of hard consistency associated with cervical lymphadenopathy. Cervical ultrasonography showed a right parathyroid mass with intimate contact with the homolateral thyroid lobe. A parathyroidectomy enlarged to the adjacent thyroid parenchyma with a selective neck dissection level VI was performed. CLINICAL DISCUSSION: The clinical presentation is most often manifested with clinical features of primary hyperparathyroidism associating bone disorders. Surgery remains the treatment of choice. The benefit of adjuvant treatments is controversial and remains to be evaluated. CONCLUSION: Parathyroid carcinoma is a rare tumor. This rare entity is often presented with clinicobiological features of severe primary hyperparathyroidism.

Massive post-traumatic neglicted diaphragmatic hernia revealed by necrotizing pancreatitis, A case report according scare guidelines.

•Atypical chest presentation of acute pancreatitis consisting of a post-traumatic of less than 10 cases reported in the literature.•We describe a very exceptional complication of diaphragmatic rupture.•We propose to take into consideration diaphragmatic involvement in any patient suffering from abdominal trauma.