Multiloculated omental cystic tumor hiding an angioleiomyoma: case report of a rare and atypical presentation and literature review.

Angioleiomyoma is a rare benign tumor arising from vascular smooth muscle and generally located in the subcutaneous tissue of the extremities. We reported a rare case of an intra-abdominal localization originating from the small omentum in which progressive growth detected on radiological follow-up indicated surgical excision. Histology documented a cavernous angioleiomuscular tumor with uncertain potential for malignancy. Although angioleiomyoma is described as a benign tumor, the uncertain behavior for malignancy of this case could have led to neoplastic degeneration. Early diagnosis followed by surgical excision of the neoplasia is crucial.

Early and late outcomes of a series of 255 patients with Crohn's disease who underwent resection: 10 years of experience at a single referral center.

Patients with Crohn's disease experience an increased risk of postoperative complications and disease recurrence. The aim of this study was to investigate the role of the risk factors in determining these outcomes and whether preoperative removal of some of these risk factors would optimize the results. We conducted a retrospective study analyzing a consecutive series of 255 patients who underwent surgical resection for Crohn's disease between 2010 and 2020. We considered short- and long-term endpoints, such as postoperative complications categorized according to the Clavien-Dindo classification and the appearance of surgical and endoscopic postoperative recurrence. Univariable and multivariable analyses showed that multiple and extensive localizations increased the incidence of postoperative complications (OR = 2.19; 95% CI 1.05-4.5; p = 0.035 and OR = 1.015; 95% CI 1.003-1.028; p = 0.017 for each cm of resected segment, respectively). Regarding theoretically modifiable factors, preoperative hypoalbuminemia (for each g/L reduction) increased the risk of complications with an OR = 1.1; 95% CI 1.02-1.12; p = 0.003. Preoperative steroid therapy exerted a similar effect, with an OR = 2.6; 95% CI 1.1-5.9; p = 0.018. Modifying these last two risk factors by improving the nutritional status or discontinuing steroid therapy significantly reduced complications.Microscopic positivity of the resection margins was a risk factor for surgical recurrence (OR = 8.7; 95% CI 1.9-40; p = 0.05). Based on the results of the present study, surgeons must examine modifiable risk factors, and careful preoperative tailored management may reduce postoperative complications and disease recurrence.

Use of electrochemotherapy in a combined surgical treatment of local recurrence of rectal cancer.

Recurrence of rectal cancer (RRC) affects up to one-third of patients. The survival is strictly dependent on the possibility of performing surgery without microscopic tumor residues (R0). Electrochemotherapy (ECT) is based on the effect that electric pulsations have on increasing the permeability of the cell membrane to certain drugs. We propose the association of ECT to the surgical excision of perineal RRC in a 72-year-old male patient. Given the proximity between the recurrence and the urethra, it was decided to use ECT in order to clean any further neoplastic residues 10 mm from the surgical resection margin. Pelvic MRI at 4 and 7 months and clinical follow-up conducted for 9 months did not document disease recurrence. ECT combined with surgery can prove to be a valid choice in selected cases and could be the best treatment the patient is willing to accept.