RESUMEN
Angiosarcoma is a rare, highly malignant tumor arising from endothelial cells of small blood vessels. They usually occur in the skin, deep soft tissues, breast and liver. Pleural angiosarcomas are extremely rare and are restricted to case reports in medical literature. It is very difficult to distinguish them from malignant mesotheliomas on clinical, radiological and even histopathological features. Immunohistochemistry is valuable in making the diagnosis, showing negative reactivity for mesothelial markers and positivity for vascular markers. Prognosis is generally dismal except in occasional cases where the disease is localized and amenable for surgical resection. We report a 55-year-old man who presented to us with chest pain, cough and hemoptysis and was diagnosed to have a pleural angiosarcoma.
Asunto(s)
Hemangiosarcoma/cirugía , Neoplasias Pleurales/cirugía , Hemangiosarcoma/patología , Humanos , Masculino , Persona de Mediana Edad , Neoplasias Pleurales/patologíaAsunto(s)
Carcinoma de Células Escamosas , Vértebras Cervicales , Glosectomía/métodos , Imagenología Tridimensional/métodos , Imagen por Resonancia Magnética/métodos , Disección del Cuello/métodos , Neoplasias Faríngeas , Radioterapia/métodos , Curvaturas de la Columna Vertebral , Tomografía Computarizada por Rayos X/métodos , Neoplasias de la Lengua , Biopsia/métodos , Carcinoma de Células Escamosas/patología , Carcinoma de Células Escamosas/fisiopatología , Carcinoma de Células Escamosas/terapia , Vértebras Cervicales/diagnóstico por imagen , Vértebras Cervicales/patología , Humanos , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Neoplasias Primarias Múltiples , Planificación de Atención al Paciente , Posicionamiento del Paciente/métodos , Neoplasias Faríngeas/patología , Neoplasias Faríngeas/fisiopatología , Neoplasias Faríngeas/terapia , Seno Piriforme/diagnóstico por imagen , Seno Piriforme/patología , Índice de Severidad de la Enfermedad , Curvaturas de la Columna Vertebral/diagnóstico , Curvaturas de la Columna Vertebral/fisiopatología , Neoplasias de la Lengua/patología , Neoplasias de la Lengua/fisiopatología , Neoplasias de la Lengua/terapia , Resultado del TratamientoRESUMEN
Non-occlusive mesenteric ischemia (NOMI) is a disorder with an extremely high mortality. Salvage of affected patients requires early recognition and aggressive intervention to prevent intestinal gangrene. We present a case of NOMI developing after esophagectomy and discuss the pathophysiology diagnosis and therapy.
Asunto(s)
Esofagectomía/efectos adversos , Isquemia/etiología , Oclusión Vascular Mesentérica/etiología , Oclusión Vascular Mesentérica/patología , Complicaciones Posoperatorias/patología , Inhibidores de la Enzima Convertidora de Angiotensina/uso terapéutico , Carcinoma de Células Escamosas/cirugía , Neoplasias Esofágicas/cirugía , Resultado Fatal , Humanos , Isquemia/patología , Isquemia/fisiopatología , Masculino , Arterias Mesentéricas/patología , Arterias Mesentéricas/fisiopatología , Oclusión Vascular Mesentérica/fisiopatología , Venas Mesentéricas/patología , Venas Mesentéricas/fisiopatología , Persona de Mediana Edad , Infarto del Miocardio/complicaciones , Infarto del Miocardio/tratamiento farmacológico , Nitratos/uso terapéutico , Complicaciones Posoperatorias/fisiopatología , Vasodilatadores/uso terapéuticoRESUMEN
BACKGROUND: Axillary dissection is the gold standard for treatment of the axilla. It provides important prognostic information, accurately stages the axilla, and has the lowest recurrence rate among all modalities. In today's age of conservation surgery, the axilla is often addressed through a cosmetically acceptable small incision with limited access, thereby making clearance of the level III nodes difficult. METHODS: We describe a method of apical lymph node dissection through the interpectoral plane, which effectively clears the apex despite the constraints of limited exposure. RESULTS: This method has been used in nearly 5,000 axillary dissections performed at our institute, with excellent results. It preserves the innervation of the pectoral muscles and affords access to the interpectoral nodes. CONCLUSIONS: Our method has a short learning curve, provides good exposure of a difficult area and consistently provides a good yield of nodes.