RESUMO
A case of surgically staged G1, FIGO 1 endometrial cancer patient with isolated, pelvic nodal metastasis after radical hysterectomy with bilateral salpingo-oophorectomy and selective lymph node dissection. No adjuvant radiotherapy passed. Pre surgery diagnosis was made by Doppler Ultrasound, Angiography, MRI, and PET-CT. A high risk surgery was performed with pelvic lymphonodectomy and resection of big pelvic blood vessels. Aggressive intraoperative infusion therapy was leaded for patient restitution. This particular case raised again the questions about routine systematic pelvic lymphonodectomy and postoperative radiotherapy for first stage (G1, G2) endometrial cancer patients.
Assuntos
Neoplasias do Endométrio/patologia , Endométrio/patologia , Excisão de Linfonodo , Linfonodos/cirurgia , Pelve/cirurgia , Idoso , Neoplasias do Endométrio/cirurgia , Endométrio/cirurgia , Feminino , Humanos , Excisão de Linfonodo/métodos , Linfonodos/patologia , Gradação de Tumores , Metástase Neoplásica/patologia , Pelve/irrigação sanguínea , Pelve/patologiaRESUMO
Acute mesenteric ischemia secondary to arterial occlusion is a highly lethal condition, mandating early diagnosis and prompt therapy, to prevent, or at least to minimize, bowel infarction. Progress in understanding the pathophysiology of mesenteric ischaemia has led to novel methods of treatment, so that in some circumstances therapy may be purely medical. More often surgery is demanded and is frequently life saving. Percutaneous transcatheter procedures are increasingly employed in both diagnosis and treatment. Close collaboration between surgeons, radiologists, physicians and anesthesiologists is therefore necessary if clinical outcome is to be improved. This conclusion is drawn by the presented case report.
Assuntos
Artéria Mesentérica Superior/cirurgia , Oclusão Vascular Mesentérica/cirurgia , Idoso de 80 Anos ou mais , Feminino , Humanos , Isquemia/patologia , Isquemia/cirurgia , Artéria Mesentérica Superior/patologia , Oclusão Vascular Mesentérica/patologia , StentsRESUMO
Acute mesenteric ischemia secondary to arterial occlusion is a highly lethal condition, mandating early diagnosis and prompt therapy, to prevent, or at least to minimize, bowel infarction. Progress in understanding the pathophysiology of mesenteric ischaemia has led to novel methods of treatment, so that in some circumstances therapy may be purely medical. More often surgery is demanded and is frequently life saving. Percutaneous transcatheter procedures are increasingly employed in both diagnosis and treatment. Close collaboration between surgeons, radiologists, physicians and anesthesiologists is therefore necessary if clinical outcome is to be improved. This conclusion is drawn by the presented case report.