RESUMO
Tracheoesophageal fistula (TEF) and esophageal atresia (EA) are rare congenital anomalies occurring in approximately 1 in 2500 to 3500 neonates. We present a neonatal patient diagnosed with EA/TEF in conjunction with pulmonary agenesis requiring definitive repair via median sternotomy. The child was born at 33 weeks gestational age with post-delivery respiratory distress necessitating intubation. A nasogastric tube was unable to be passed. After subsequent imaging, TEF and pulmonary agenesis were diagnosed. During planned staged repair with ligation of TEF via standard right thoracotomy approach, significant ventilatory compromise was encountered. Due to concern for ventilatory compromise and anatomical variance limiting visualization, a median sternotomy approach was utilized for definitive repair. This exposure and repair were successful and may be considered for cases with complex pulmonary malformation limiting standard thoracotomy. To our knowledge, this is only the second reported case of a successful TEF/EA repair using a median sternotomy approach.
Assuntos
Atresia Esofágica , Esternotomia , Fístula Traqueoesofágica , Humanos , Fístula Traqueoesofágica/cirurgia , Esternotomia/métodos , Recém-Nascido , Atresia Esofágica/cirurgia , Masculino , FemininoRESUMO
Ovarian cysts in adolescents are typically managed conservatively given the low rate of malignancy and the cysts typically regress over time. We present a case of a 14 year-old female with large bilateral adnexal cysts causing ureteral obstruction which was successfully treated with surgical resection and ensuring maximum preservation of ovarian tissue.
Assuntos
Cistos , Cistos Ovarianos , Síndrome do Ovário Policístico , Obstrução Ureteral , Feminino , Adolescente , Humanos , Obstrução Ureteral/etiologia , Obstrução Ureteral/cirurgia , Cistos Ovarianos/complicações , Cistos Ovarianos/cirurgia , Cistos Ovarianos/patologiaRESUMO
An enteric duplication cyst (EDC) is a rare congenital anomaly. Although EDCs can occur at any point throughout the gastrointestinal tract, they are most commonly reported in the ileum and only around 5-7% are of gastroduodenal origin. We report a case of a pyloric duplication cyst in a 3 hour old male with prenatal ultrasound showing a cystic mass. The patient had an abdominal ultrasound after birth that showed a mass with probable trilaminar wall. The diagnosis of pyloric duplication cyst was made in surgery and confirmed with histopathologic examination following resection. The patient is doing well with appropriate weight gain at follow-up appointments.
Assuntos
Cistos , Anormalidades do Sistema Digestório , Recém-Nascido , Gravidez , Feminino , Masculino , Humanos , Cistos/diagnóstico por imagem , Cistos/cirurgia , Piloro/diagnóstico por imagem , Ultrassonografia , ÍleoRESUMO
Neuroendocrine tumors are defined as tumors that express neuroendocrine markers, specifically synaptophysin and/or chromogranin in at least 50% of tumor cells. To date, neuroendocrine cancers of the breast are extremely rare with reports that they account for less than 1% of all neuroendocrine tumors and less than .1% of all breast cancers. Limited literature exists to guide treatment decisions tailored to neuroendocrine tumors of the breast, despite the possibility that they may be associated with an overall worse prognosis. We present a rare case of neuroendocrine ductal carcinoma in situ (NE-DCIS) which was discovered upon workup for bloody nipple discharge. In this case, NE-DCIS was managed with the standard recommended treatment regimen for ductal carcinoma in situ.
Assuntos
Neoplasias da Mama , Carcinoma Intraductal não Infiltrante , Carcinoma Neuroendócrino , Tumores Neuroendócrinos , Humanos , Feminino , Carcinoma Intraductal não Infiltrante/cirurgia , Carcinoma Intraductal não Infiltrante/patologia , Mama/patologia , Neoplasias da Mama/cirurgia , Neoplasias da Mama/patologia , Carcinoma Neuroendócrino/cirurgia , Carcinoma Neuroendócrino/patologia , Tumores Neuroendócrinos/diagnóstico , Tumores Neuroendócrinos/cirurgiaRESUMO
Melanoma is currently the fifth most common cancer in the United States (US) and most often develop on areas that have increased sun exposure, such as the arms, legs, back or face. The incidence of primary cutaneous melanoma increases each year and curative treatment improves with earlier detection of disease. Primary cutaneous umbilical melanoma is extremely rare with as few as 46 cases reported worldwide. As a result, limited literature is available regarding the management of tumors originating in the umbilicus. By evaluating uncommon areas such as the umbilicus, earlier detection and possible intervention can be provided. We present a rare case of a 33-year-old female with a primary cutaneous melanoma of the umbilicus successfully treated with wide local excision (WLE) and sentinel lymph node biopsy (SLNB).