RESUMO
Evisceration and necrosis of the greater omentum at the site of a prolapsed colostomy is a rare situation. Considered an early stoma complication, it often occurs during the first month after surgery. We report the observation and our attitude to such a situation in a 56-year-old patient who underwent initial surgery for a locally advanced rectal adenocarcinoma after receiving neoadjuvant radio-chemotherapy. A loop colostomy for decompression was performed due to large bowel obstruction. On the 10th day after surgery, he was readmitted for an oedematous prolapsed colostomy and a necrotic end of the greater omentum, which eviscerated through the colostomic hole, secondary to severe ascites. Emergency re-intervention involving resection of the prolapsed stoma with the necrotic segment of the omentum was performed. The three factors associated with the development of this rare peri-colostomy complication were: emergency surgery, locally advanced rectal tumor, and increased intra-abdominal pressure.
RESUMO
Ganglioneuroma is a nerve tumor arising from the sympathetic neural crest. It is a rare benign tumor. Retroperitoneum is its second location after the posterior mediastinum. Usually asymptomatic, it is discovered incidentally on imaging. Surgical resection is the sole treatment. The prognosis is good if the diagnosis is made early with quality R0 surgical excision. We report a case in a 14-year-old female admitted to the emergency department for obstructive pyelonephritis. Imaging features found a retroperitoneal mass with characteristics suggestive of a retroperitoneal ganglioneuroma, which was confirmed by histological study. Ganglioneuroma should be a part of differential diagnoses for any retroperitoneal mass in children and young adults.
RESUMO
Struma ovarii is an extremely rare type of ovarian teratoma distinguished by the unusual presence of thyroid tissue. It is usually a benign condition; however, malignant transformation is sometimes detected. The diagnosis relies on histopathological examination and is infrequently made on routine investigations. We report two cases of struma ovarii: one benign and the other malignant. The first case involved a 27-year-old woman who underwent a right ovarian cystectomy for an incidental ultrasonographic finding of a solid right adnexal mass. The diagnosis of a benign struma was made after histopathological study. The second case involved a 68-year-old woman who underwent a right salpingo-oophorectomy for a right ovarian bulky mass and the histopathological diagnosis was consistent with that of a malignant struma. We examine the challenges involved in the diagnosis and management of this rare entity.
RESUMO
Squamous cell carcinoma (SCC) of the colon is a rare malignant tumor occurring as either a primary or secondary lesion. Few cases of metastatic or secondary colonic SCC have been published. We report an unusual case of a 59-year-old female patient who was treated by Wertheim hysterectomy and adjuvant chemoradiation for stage IIB SCC of the uterine cervix. Two years later, she developed a metastatic location in the caecum causing an acute intestinal obstruction. She underwent an emergency open right hemicolectomy with ileocolic anastomosis and resection of two nodules of the umbilicus and the right parietal peritoneum. Histopathological examination confirmed a triple metastatic location of SCC. She is disease-free 11 months after surgery. We discuss the clinicopathological features, management strategies, and the prognosis of this rare entity.
RESUMO
Endometrial adenocarcinomas arising in a complete septate uterus with cervical and vaginal duplication are rare. Here, we report a case of stage III endometrioid endometrial adenocarcinoma arising in a complete septate uterus with a double cervix and vagina coupled with a left serous ovarian cystadenoma in a 35-year-old-female patient. The patient underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy and was addressed to the oncologist for adjuvant radio-chemotherapy. We highlight the symptoms, diagnosis, and therapeutic management, and compare them to the recent literature.
RESUMO
Gallbladder tuberculosis (GT) is an extremely rare disease entity, even in our country Morocco known for being an endemic area. The lack of pathognomonic clinical presentation and radiological features of GT makes preoperative diagnosis unlikely and poses a diagnostic dilemma regarding gallbladder carcinoma (GC). The diagnosis is usually made by histological examination after cholecystectomy, highlighting the importance of sending every gallbladder specimen to pathology. We report an exceedingly rare case of GT mimicking GC and refer to a recent review of the literature to discuss the clinical and radiological features of GT.
RESUMO
Scar endometriosis is an uncommon type of extra-pelvic endometriosis. However, it should be suspected in any woman of childbearing age complaining of a cyclic, painful nodule in a scar from a previous obstetric or gynecologic procedure, after excluding other differential diagnoses. The treatment of choice is surgical resection. We report two cases of scar endometriosis that appeared in two young ladies after cesarean sections, discovered by a parietal mass near the cesarean scars.