Angiosarcoma of the breast following breast preservation therapy and local radiation therapy for breast cancer.

This is a case of angiosarcoma following breast preservation therapy and local radiation therapy over a 3-year period.

Gastric phytobezoar: treatment using meat tenderizer.

In summary bezoars are rarely symptomatic. CT scan of the abdomen is rapidly becoming the first tool of diagnosis, while endoscopy still remains the best diagnostic test. Medical treatment is usually successful, as in this case and rarely do patients require surgery.

Laparoscopic cholecystectomy: analysis of the complications at a community hospital.

With the worldwide acceptance of laparoscopic cholecystectomy (LC) as the treatment of choice for symptomatic gallbladder disease, great concern has grown over the spectrum of complications associated with this new procedure. The nature, causes, frequency, as well as ways to avoid these complications have been the subject of many articles and studies. Although it is established that the frequency of the major complications decreases with increased experience, there will still be new surgeons performing the procedure with limited experience in the early stages of their surgical practice. Therefore, continuous efforts should be exerted to bring to a minimum the number of serious morbidities, especially common bile duct injuries. Review of each institution's experience and sharing it with other medical centers may be a valuable approach to achieve this important goal. In this report, we will analyze the spectrum of complications we encountered during our experience with LC as well as some recommendations to avoid some of the serious morbidities related to this procedure.

Abdominal wall sinus tract secondary to gallstones: a complication of laparoscopic cholecystectomy.

A persistent sinus tract of the abdominal wall caused by retained fragments of gallstones following laparoscopic cholecystectomy is reported. Review of the literature and suggested technique and methods to avoid this complication are described.

Comparison of needle aspiration cytologic diagnosis with excisional biopsy tissue diagnosis of palpable tumors of the breast in a community hospital.

Fine needle aspiration cytologic examination has not extensively been used in our hospital in the work-up evaluation of solid tumors of the breast and its reliability as a basis on which to perform definitive treatment of carcinoma of the breast was in question. One hundred and five aspiration cytologic specimens were obtained from palpable solid tumors of the breast just prior to excisional biopsy. Specimens were numbered and submitted to three different staff pathologists for diagnosis in a single blind manner. Results were then compared with tissue diagnosis of the same tumors. Of 105 specimens taken at biopsy of the breast, 28 malignant lesions were diagnosed on the final tissue report. Of those, ten were diagnosed as malignant (Class V), two were highly suspicious (Class IV) and six were insufficient specimens (Class O). Of those diagnosed as class IV and V by the results of cytologic examination, all were malignant on permanent section for a specificity of 100 per cent and a sensitivity of 36 per cent. The cytologic diagnoses of Classes I, II and III did not correlate with any histologic report, benign or malignant. Malignant growths were misdiagnosed by cytologic examination in 36 per cent and missed because of inadequate specimens in 28 per cent. We believe that a Class V cytologic finding is sufficient basis on which to perform definitive treatment of carcinoma of the breast provided rigid criteria are used. There is a learning curve associated with this diagnostic modality.