ABSTRACT
Liver transplantation [LT] is the treatment of choice for localized hepatocellular carcinoma [HCC] associated with cirrhosis. Extra hepatic metastasis is the most common cause of death in these patients. There is very little evidence regarding the natural history and treatment options for patients developing HCC recurrence after LT
Surgical resection offers a unique opportunity for solitary metastasis
We report a 61 year old male with solitary right adrenal metastasis 15 months post LT which was managed with open adrenalectomy. The patient is alive and disease free 24 months after the surgery. The case, histo-pathological findings and literature review is discussed
ABSTRACT
The aim of our study was to highlight the importance of better surgical outcome if presentation is earlier. Gastric cancer is second most common malignancy of gastrointestinal tract after colorectal carcinoma. The common presentation is pain epigastrium, weight loss, vomiting and anorexia. Patients usually present in advanced disease and only palliative surgery is possible. Commonest type is adenocarcinoma. We conducted a case series of 60 patients who were treated for gastric carcinoma at Mayo Hospital, Lahore from March 2003 to March 2008. The objective of study was to assess the morbidity, mortality and outcome of surgical management. Out of 60 patients included in this study, 27 patients were male and 23 female. Commonest presentation was vomiting 69.9%. Most of the patients presented in advance disease. Operative procedures include Billroth-I and D1 resection, 20% Billroth II + L.N. dissection [16.6%], total gastrectomy along with reconstruction [6.7%]. Most of the patients [23.3%] had palliative procedure in the form of bypass or feeding jejunostomy [56.7%]. Only 30.1% presented in early stage of disease and its mortality rate was low. Postop complications recorded were diarrhea 30 patients, bilious vomiting in 24 patients, 2 patients underwent revisional surgery. Surgical outcome is directly related to stage of disease at presentation. Early presentation leads to better outcome