Mama supranumeraria: resección mediante técnica abierta con dren versus sin dren / Supranumerary breast: resection by open technique with drain vs without drain

Introducción. El tejido mamario accesorio es una anomalía congénita que se presenta en el 2-6 % de la población femenina. En este tejido se pueden desarrollar las mismas patologías que en la mama normal. El manejo curativo es la resección quirúrgica. El objetivo de este estudio fue comparar los resultados de la técnica de resección vía abierta de tejido mamario accesorio con dren vs sin dren. Métodos. Se realizó un estudio observacional tipo cohorte retrospectivo, teniendo en cuenta dos grupos de pacientes con tejido mamario accesorio: a uno de ellos se les realizó resección quirúrgica mediante técnica abierta con dren y al otro grupo sin dren. Además, se incluyó un brazo prospectivo donde se evaluó la calidad de vida y la satisfacción de las pacientes con el resultado posoperatorio mediante el uso de la herramienta Breast-Q. Resultados. Se recolectó la información de 82 pacientes, la mayoría mujeres; 22 se intervinieron con técnica con dren y 60 con técnica sin dren. 13,6 % de los pacientes presentaron complicaciones tempranas, siendo la infección de sitio operatorio la más frecuente (36,4 %). En general, las complicaciones fueron más comunes en el grupo con dren (40,9 % vs 3,4 %), con una diferencia estadísticamente significativa (p=0,000). La calidad de vida fue similar en ambos grupos. Conclusiones. Los pacientes a quienes se les realizó resección de mama supernumeraria y se dejó un sistema de drenaje en el lecho de disección presentaron más complicaciones posoperatorias que las pacientes a quienes no se les dejó dren

Introduction. Accessory breast tissue is a congenital anomaly that occurs in 2-6% of the female population. It can develop the same pathologies that in the normal breast. The curative management of this pathology is surgical resection. The objective of this study was to compare the results of the accessory breast tissue open resection technique with a drain vs without a drain. Methods. An observational retrospective cohort study was conducted considering two groups of patients with accessory breast tissue: one of them underwent surgical resection using an open technique with a drain and the other group without a drain. In addition, a prospective arm where the quality of life and satisfaction of the patients with the postoperative result was evaluated by the Breast-Q tool. Results. Eighty-two patients were included, most of them women; 22 were operated with open technique with drain and 60 without drain. 13.6% of patients presented early complications, with surgical site infection being the most frequent (36.4%) and, in general, complications were more common in the group with drain (40.9% vs 3.4%) with a statistically significant difference (p=0.000). Quality of life was similar in both groups.Conclusions. Patients who undergo supernumerary breast resection and leaving drainage in the dissection bed present more postoperative complications compared to those without drain

An unusual case of respiratory epithelial cyst of orbit presenting as a lid swelling in a child

This case highlights the importance of histopathological examination in all cases of choristoma undergoing excision.

Research progress of ocular choristoma / 中国医师杂志

Ocular choristoma is composed of ectopic tissues with normal structures. The pathogenesis still remains uncertain. Histopathologically, it is a dense connective tissue mixed with epidermal appendages, smooth muscle cells, mature adipose tissue, lacrimal glands, lymph nodes, skeletal muscle fibers, cartilage and bone. Because of its low incidence, most of published literature are case reports. The clinical manifestations are non-specific and we need to distinguish it from other ocular masses. The choice of surgical resection depends on the ocular symptoms, the effect on appearance, and the need for clinical confirmation. This paper reviews the epidemiology, etiology, pathogenesis, clinical manifestations, diagnosis, differential diagnosis and treatment of ocular choristoma.

Coristoma pancreático dentro de un divertículo duodenal: a propósito de un caso / Pancreatic Choristoma within a duodenal diverticulum, an accidental finding: apropos of a case

Resumen El coristoma pancreático, o páncreas heterotópico, es una condición rara en gastroenterología. Esta entidad consiste en el hallazgo de tejido pancreático aberrante, en alguna zona del tracto gastrointestinal, sin continuidad vascular o anatómica con el páncreas normal, es poco reportado y presenta sintomatología variable. Presentamos el caso de un individuo de 46 años con dolor abdominal a quien se le encontró mediante exámenes invasivos un divertículo duodenal, el cual al examen histopatológico e inmunohistoquímico mostró un coristoma pancreático.

Abstract Pancreatic choristoma, also called heterotopic pancreas is a rare condition in gastroenterology. This entity consists of the presence of aberrant pancreatic tissue in some other area of the gastrointestinal tract without vascular or anatomical continuity with the normal pancreas; it has been seldomly reported and it could exhibit variable symptomathology. We herein report the case of a 46-year-old male, who presented with abdominal pain and was found, through invasive examinations to have a pancreatic choristoma within a duodenal diverticulum. The diagnosis was made using histopathology and immune-histochemistry testing.

Divertículo de Meckel: un hallazgo incidental / Meckel's diverticulum: an incidental finding

RESUMEN Fundamento: el divertículo de Meckel es una anomalía congénita con una baja incidencia y prevalencia. La mayoría de los pacientes que lo presentan son asintomáticos y son diagnosticados de forma incidental, sin embargo, alrededor del 2 % de los individuos desarrollan una complicación a lo largo de su vida, pero como estas tienden a disminuir conforme avanza la edad, es muy rara diagnosticarla en adultos. Objetivo: describir la presentación de un divertículo de Meckel en paciente adulto hallado de forma incidental durante la autopsia. Presentación del caso: paciente masculino de 66 años de edad, que al realizarle el estudio autópsico se revela la presencia de un saco diverticular a 62 cm de la válvula ileocecal, que al estudio histológico con hematoxilina y eosina permitió la observación de áreas de mucosa gástrica ectópica. Conclusiones: el divertículo de Meckel es una anomalía congénita que se localiza con frecuencia a 60 cm de la válvula ileocecal, en el borde antimesentérico; 50 % de ellos contienen tejido ectópico y su diagnóstico se realiza en la mayoría de los casos de forma incidental.

ABSTRACT Background: Meckel's diverticulum is a congenital anomaly with a low incidence and prevalence. The majority of patients who present it are asymptomatic and are diagnosed incidentally, however about 2% of individuals develop a complication throughout their lives, but as these tend to decrease as age progresses, it is very rare to diagnose it in adults. Objective: to describe the presentation of a Meckel diverticulum in an adult patient found incidentally during the autopsy. Case report: a 66-year-old male patient who, upon performing the autopsy study, revealed the presence of a diverticular sac 62 cm from the ileocecal valve, which revealed the presence of areas of ectopic gastric mucosa in the histological study with hematoxylin and eosin. Conclusions: Meckel's diverticulum is a congenital anomaly that is frequently located 60 cm from the ileocecal valve, on the anti-mesenteric edge; 50% of them contain ectopic tissue; and its diagnosis is made in most cases incidentally.

Bronchogenic cyst in an unusual location / Cisto broncogênico de localização não habitual

ABSTRACT This article reports the case of a patient with lingual bronchogenic cyst and presents a brief review of discrepancies in the nomenclature of lingual cysts. A 2-year-old male patient was admitted to the pediatric surgery outpatient clinic of a university hospital due to the presence of a 2 cm mass on the dorsal surface of the tongue. The tumor was excised and the anatomopathological report revealed a foregut cyst, bronchogenic subtype. Lingual cysts are rare, especially when compatible with bronchogenic formations. Their pathogenic process is not clear; one of the possibilities is the separation of cells from the primitive gut, before the separation between the esophagus and the trachea. The treatment usually consists of surgical excision.

RESUMEN Este artículo relata el caso de un paciente con quiste broncogénico lingual y presenta una breve revisión de las discrepancias de nomenclatura para quistes linguales. Paciente de sexo masculino, de 2 años de edad, acudió a cirugía pediátrica de un hospital universitario con una masa de 2 cm en la cara dorsal de la lengua. El tumor fue extirpado y el informe anatomopatológico reveló quiste de duplicación, subtipo broncogénico. Quistes linguales no son frecuentes, sobre todo cuando concomitantes con formaciones broncogénicas. Su patogénesis es incierta: una de las posibilidades es la separación de células del intestino primitivo antes de la separación entre esófago y tráquea. El tratamiento, en general, consiste en escisión quirúrgica.

RESUMO Este artigo relata o caso de um paciente com cisto broncogênico lingual e apresenta uma breve revisão das discrepâncias de nomenclatura para cistos linguais. Paciente do sexo masculino, 2 anos de idade, foi admitido no ambulatório de cirurgia pediátrica de um hospital universitário devido à presença de uma massa de 2 cm na face dorsal da língua. O tumor foi excisionado; o laudo anatomopatológico revelou foregut cyst, subtipo broncogênico. Cistos linguais são raros, especialmente quando compatíveis com formações broncogênicas. Seu processo de patogênese é incerto, e uma das possibilidades é a separação de células do intestino primitivo antes da separação entre esôfago e traqueia. O tratamento, comumente, consiste em excisão cirúrgica.

Hemorragia digestiva alta por páncreas ectópico: A propósito de un caso / Hemorragia digestiva alta por páncreas ectópico: A propósito de un caso

Introducción: El coristoma pancreático o páncreas ectópico es la presencia de tejido pancreático fuera de la localización anatómica del páncreas. Es una patología rara que puede presentarse en cualquier localización del tracto gastrointestinal, mayormente es asintomático, pero puede manifestarse como inflamación, hemorragia, obstrucción y cambios neoplásicos. Reporte de caso: Presentamos un paciente varón de 27 años, procedente de Cajamarca, con antecedente desde los 12 años de úlcera péptica, que ingresa con cuadro de hemorragia digestiva y descompensación hemodinámica, con evidencia endoscópica de tumoración duodenal y estudio histopatológico posterior de páncreas ectópico. Conclusiones: El páncreas ectópico es una entidad rara, siendo el estómago y el intestino las ubicaciones más frecuentes; su hallazgo es incidental, a menos que se complique con hemorragia gastrointestinal, inflamación o malignización. En nuestro caso la ubicación fue duodenal, con presentación hemorrágica, que requirió tratamiento endoscópico y posteriormente quirúrgico.(AU)

Introduction: The pancreatic choristoma or ectopic pancreas is the presence of pancreatic tissue outside the anatomic location of the pancreas. It is a rare pathology that can occur in any location of the gastrointestinal tract, it is mostly asymptomatic, but it can manifest as inflammation, bleeding, obstruction and neoplastic changes. Case report: Present a 27-year-old patient from Cajamarca, with a 12-year history of peptic ulcer, presenting with symptoms of gastrointestinal hemorrhage and hemodynamic decompensation, with endoscopic evidence of duodenal tumor and subsequent histopathological study of ectopic pancreas. Conclusions: The ectopic pancreas is a rare entity, being the stomach and intestine the most frequent; Its finding is incidental, unless complicated by bleeding, inflammation or malignancy. In our case, the location was duodenal, with hemorrhagic presentation, which required endoscopic and later surgical treatment. (AU)

Two cases of osseous choristoma on tongue base / 대한두경부종양학회지

Osseous choristoma is a rare, benign proliferative osseous lesion, which is defined as the growth of normal tissue in an abnormal location. The etiopathogenesis for its formation is unknown, but various hypotheses have been proposed. Treatment of choice is en-bloc resection, and no recurrence has been reported. Here, we report the two cases of osseous choristoma, presented with a mass on the base of the tongue with/without globus symptom and were treated with surgical excision.

Polyp of the uterine cervix with heterologous fatty tissue

This report documents an uncommon case of choristomatous cervical polyp-containing fat tissue. The patient was a 24-year-old female who presented with irregular intermenstrual bleeding. On examination, a polypoid lesion with smooth outlines, measuring 1 cm in diameter was removed. Microscopic examination demonstrated abnormal fibrous stroma, devoid of endocervical glands, containing mature adipose tissue, and thick-walled blood vessels. The lesion was covered by a typical mature squamous cell outer lining. To the best of our knowledge, this is only the second report of an adipose tissue arising from the cervical wall. Further clinicopathologic considerations are needed to elucidate the origin of the fatty component in cervical polyps.

Choroid Osteoma in Schimmelpenning-Feuerstein-Mims Syndrome

Background: Schimmelpenning syndrome is a multisystem disorder. Casecharacteristics: A term female neonate with sebaceous nevi of the face had choroidosteoma of the right eye. Observation: At one month of age, the infant was observed tohave choroidal neovascularization that was successfully treated with laser photo-coagulation and anti-VEGF. Message: Choroid osteoma and neovascularization are rareassociations of Schimmelpenning syndrome, and should be screened for and managedearly.

A Case of Extensive Epibulbar Choristoma Associated with Microphthalmos

PURPOSE: Choristomas represent congenital overgrowth of normal tissues in an abnormal location. The simultaneous presence of epibulbar choristoma and microphthalmos has rarely been reported. The authors report a case of extensive epibulbar choristoma associated with microphthalmos. CASE SUMMARY: A 9-day-old boy with the left eyeball absent from birth was referred to our clinic. A large cornea-like structure covered by keratinized membrane was observed inside the eyelid aperture, therefore buphthalmos or corneal staphyloma with microphthalmos was presumed. At the age of 2 months, a large mass of central conjunctival sac protruded through the left eyelid aperture. Manual reduction could not return the tissue to its original site and the mass immediately protruded again. At the age of 9 months, orbital magnetic resonance imaging showed the small presumed ocular tissue behind the large mass of fat signal in the central anterior orbit, therefore, extensive epibulbar choristoma associated with microphthalmos was diagnosed. At 12 months of age, partial excision of the protruding portion of the mass was performed. Based on pathologic examination, the mass was determined to be a choristoma and cosmetically acceptable appearance with prosthesis was maintained for 10 months after the surgery. CONCLUSIONS: Because there is no vision in extensive choristoma associated with microphthalmos, the treatment goal is cosmetic improvement. Conjunctivoplasty following partial mass excision for prosthesis wearing is a good treatment option.

Invasive Micropapillary Carcinoma in Axillary Ectopic Breast and Synchronous Ductal Carcinoma In Situ in the Contralateral Breast / 한국유방암학회지

The development of ectopic breast tissue is attributable to the failure of primitive mammary tissue to regress after the development of the mammary ridge, except at pectoral breast sites, and is most often evident in the axillae. Several benign and malignant breast diseases have been reported in ectopic axillary breast tissues. The most common cancerous pathology of ectopic breast tissue is invasive ductal carcinoma. Ectopic breast cancer presenting with simultaneous primary cancer of the pectoral breast is extremely rare. Herein, we report an invasive micropapillary carcinoma of an axillary ectopic breast, combined with a synchronous ductal carcinoma in situ in the contralateral pectoral breast of a 61-year-old woman.

Complex limbal choristoma in linear nevus sebaceous syndrome managed with scleral grafting.

Linear nevus sebaceous syndrome (LNSS) is characterized by nevus sebaceous, mental retardation, seizures, and ocular abnormalities such as complex limbal choistoma. A young male with history of mass in right eye and blackish discoloration of skin over right and left side of forehead since birth presented with foreign body sensation and diminished vision in right eye. Ocular examination showed mass over epibulbar region with chorioretinal coloboma and posterior staphyloma in right eye and megalocornea in left eye. Histopathology report revealed complex limbal choristoma with compound melanocytic nevus. The case was managed by surgical excision of the limbal mass and filling the gap with scleral graft.

External angular dermoid cyst: An unusual case report with surgical intervention and clinico-pathological analysis / Cisto dermóide angular externo: um relato de caso incomum com intervenção cirúrgica e análise clinico-patológica

Cistos dermóides e epidermóide, que pertencem a coristomas, geralmente se manifestam clinicamente como formações císticas móveis superficiais e profundas, mais frequentemente com um crescimento lento e intermitente. No presente artigo relatamos um caso de um cisto dermóide angular externo em um menino de 13 anos, o crescimento que estava regular na progressão. A excisão cirúrgica do cisto foi feita por aproximar-se através de uma incisão externa sub testa. Cistos dermóides são neoplasias incomuns que muitas vezes são vistas em crianças, com a mais comumente área afetada sendo a órbita na região da cabeça e pescoço. Tais cistos podem causar compressão para o lobo dos olhos e o nervo óptico. Portanto, podem se sugerir procedimentos operacionais no caso de tais cistos que tem uma progressão constante

Dermoid and epidermoid cysts which belong to choristomas, usually manifest clinically as superficial and deep cystic movable formations, most often with a slow and intermittent growth. In the present article we report a case of an external angular dermoid cyst in a 13-year-old boy, the growth of which was steady on progression. Surgical excision of the cyst was done by approaching through an external sub-brow incision. Dermoid cysts are unusual neoplasms that often seen in children with the most commonly affected site being the orbit in the head and neck region. Such cysts may cause compression to the eye lobe and the optic nerve. Hence, operative procedures may be suggested in the case of such cysts which have a constant progression

Neuroglial Choristoma of the Middle Ear with Massive Tympanosclerosis: A Case Report and Literature Review

Neuroglialchoristoma is a rare cerebral heterotopia typically involving extracranial midline structures of the head and neck, including the nose, nasopharynx and oral cavity. It rarely involves non-midline structures, such as the middle ear, mastoid and orbit. We report the case of a 63-year-old woman with right-sided hearing loss and aural fullness who was diagnosed with neuroglialchoristoma of the middle ear and mastoid. To our knowledge, this is the first report on neuroglialchoristomawith massive tympanosclerosis. The presence of combination supported the inhalation theory of neuroglialchoristoma, given that tympanosclerosis is typically caused by Eustachian tube dysfunction.

Choristomas: An Incidental Ectopic Liver: Case Report and Review of Literature.

Ectopic liver is a rare entity identified most commonly during abdominal exploration for other indications. Liver ectopia is less common than accessory liver and can be associated with multiple other congenital anomalies. We present a case of a fourty-nine year old female, who presented for elective laparoscopic cholecystectomy for symptomatic cholelethiases. Abdominal exploration showed an ectopic liver segment attached to gall bladder and draining through it with no other connections to the liver.

Quiste dermoide corneal bilateral / Bilateral corneal dermoid cyst

El dermoide es un tipo de coristoma (tejido embrionario normal en una localización anormal) que afecta con frecuencia la córnea. Aparece como una masa sólida, blanca, redonda y elevada. Suele localizarse en el limbo inferotemporal, aunque puede hacerlo en cualquier lugar del globo ocular o de la órbita. Se presenta un paciente masculino, de 8 años de edad, quien desde su nacimiento muestra una mancha blanca en ambos ojos, agudeza visual sin corrección de movimiento de mano a 33 centímetros en el ojo derecho y percepción luminosa en el ojo izquierdo. En la exploración oftalmológica de ambos ojos se apreciaron lesiones blanquecinas sobre la córnea. Se le realizó exéresis del quiste y queratoplastia lamelar de ambos ojos, con resultados visuales satisfactorios. Se concluye que el caso presenta un quiste dermoide corneal bilateral(AU)

Dermoid is a type of choristoma (normal embryonic tissue placed in an abnormal location) that frequently affects the cornea. It appears as a raised white round solid mass that may be located in the inferotemporal limbus and also in any other part of the eyeball or the orbit. This is 8 years-old boy who shows a white spot in both eyes since his birth, uncorrected visual acuity at hand movement of 33 cm in his right eye and light perception in his left eye. The ophthalmological examination of both eyes revealed whitish lesions on the cornea. The cyst was removed and lamellar keratoplasty was performed in both eyes, with satisfactory results. It was concluded that this patient has a bilateral corneal dermoid cyst(AU)

Mullerian choristoma in a case of spinal dysraphism.

It is extremely rare to fi nd mullerian choristomas in association with spinal dysraphism, with <10 cases published in English literature. We report a case of heterotopic uterus and fallopian tube-like tissue within a lumbar subcutaneous lipoma associated with spina bifi da and tethered cord. A 21-year-old lady presented with lumbar swelling since birth and dull pain in the lower back. Magnetic resonance imaging showed spina bifi da at level L3 and L4, tethering of the cord and a subcutaneous lipomatous swelling. Biopsy revealed lobules of fi broadipose tissue embedded in which were seen organoid cystic structures containing prominent smooth muscle coats in their wall. These cystic structures were lined by the endometrium and showed fallopian tube-like papillary infoldings. Immunohistochemistry showed estrogen receptor positivity in the epithelium, stroma, and smooth muscles. The epithelial cells were also positive for cancer antigen 125 and cytokeratin 7 while the stromal cells showed CD10 positivity, supporting mullerian derivation. The pathogenesis and differential diagnosis of such lesions is discussed.

A Case of Salivary Gland Choristoma Mimicking Glomus Tympanicum / 대한이비인후과학회지

Salivary gland choristoma is defined as the architecturally normal salivary gland tissues found in abnormal locations. Middle ear salivary gland choristoma usually presents with conductive hearing loss. We present a case of middle ear mass with conductive hearing loss in a 6-year-old boy. A reddish mass was incidentally found behind the normal tympanic membrane. Magnetic resonance image showed the markedly enhancing lesion which was in accordance with glomus tympanicum. Preoperative angiography was performed, but supplying artery and mass was not identified. Surgical exploration was made and the mass was dissected easily without profuse bleeding. Final diagnosis was salivary gland choristoma by histopathology. We discuss the clinical features and management of middle ear salivary choristoma with the review of literature.

Tumor dermoide córneoconjuntival. Presentación de caso / Conjunctival Dermoid Tumor. A Case Report

Los coristomas conjuntivales son lesiones benignas muy raras, pero a pesar de esto, constituyen las lesiones tumorales más frecuentes de la conjuntiva en los niños. Se presenta el caso de un paciente chino, masculino, de 16 años de edad, atendido en el Centro Oftalmológico Amistad Cuba China en la ciudad de Xining, por médico cubano. El motivo de consulta fue la sensación de molestia ocular y el enrojecimiento. Al examen físico se encontró una masa vascularizada de color amarillento, de aproximadamente 5 mm, de localización limbo inferotemporal en ojo derecho. Se diagnosticó un tumor dermoide córneoconjuntival y se decidió realizar tratamiento quirúrgico. Se presenta el caso debido a lo poco común de la entidad en nuestro ámbito.

Conjunctival choristomas are rare benign lesions; however, they are the most common conjunctival tumors in children. The case of a 16-year-old Chinese male patient, treated at the Cuba-China Friendship Eye Center in the city of Xining, by a Cuban doctor is presented. The reason for attendance was eye discomfort and redness. A yellowish vascularized mass, about 5 mm, located in the inferotemporal limbus of the right eye was found on physical examination. A córneoconjuntival dermoid tumor was diagnosed and it was decided to perform surgery. The case is presented given the rarity of this entity in our field.